The cancer risk of patients with inflammatory bowel diseases (IBD) has not been well documented in southern Europe. This study aimed to evaluate the overall pattern of cancer risk among patients with ...IBD in Friuli Venezia Giulia, northeastern Italy. A population-based cohort study was performed through a record linkage between local healthcare databases and the cancer registry (1995-2013). We identified 3664 IBD patients aged 18-84 years, including 2358 with ulcerative colitis (UC) and 1306 with Crohn's disease (CD). Sex- and age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were used to compare the cancer incidence of IBD patients with the general population. The cumulative cancer risk among IBD patients reached about 10% after 10 years of follow-up. A total of 246 cancers occurred among UC patients (SIR = 1.05, 95% CI: 0.92-1.19), and 141 among CD patients (SIR = 1.20, 95% CI: 1.01-1.41). As compared with the general population, no increased risk of colorectal cancers was observed for either UC or CD patients, whereas the risk of anal cancer was significantly elevated among UC patients (SIR = 6.03, 95% CI: 1.24-17.60). Increased risks were seen for specific extra-intestinal cancers, including corpus uteri (SIR = 2.67, 95% CI: 1.07-5.50) and kidney (SIR = 2.06, 95% CI: 1.03-3.69) among UC patients; thyroid (SIR = 5.58, 95% CI: 2.41-11.00) and skin non-melanoma (SIR = 1.86, 95% CI: 1.32-2.55) among CD patients. This population-based study showed that both UC and CD patients had a colorectal cancer risk similar to that of the general population. However, they were at a higher risk of developing certain extra-intestinal cancer types. Although detection biases cannot be excluded, the study findings pointed to a role of long-standing exposures to immunosuppressive therapies, underlying disease status, as well as the interactions with lifestyle factors. Our findings lent additional support to the need for monitoring the cancer burden in this at-risk population.
Purpose
To determine whether magnetic resonance enterography (MRE) performed without intravenous contrast injection is diagnostically noninferior to conventional contrast‐enhanced MRE (CE‐MRE) in ...patients with Crohn's disease (CD).
Materials and Methods
This was an Institutional Review Board (IRB)‐approved retrospective study. Ninety‐six patients (52 male and 44 female; 47.18 years ± 13.6) with a diagnosis of CD underwent MRE at 1.5T including T2‐weighted single‐shot turbo‐spin‐echo, T2‐weighted spectral fat presaturation with inversion recovery (SPAIR), T1‐weighted balanced fast‐field‐echo MR sequences, and CE‐MRE consisting in T1‐weighted breath‐hold THRIVE 3D MRI sequences after administration of gadobenate dimeglumine (0.2 mL/kg of body weight). Unenhanced MRE, CE‐MRE, and unenhanced MRE plus CE‐MRE were reviewed in separate sessions with blinding by two readers in consensus, and subsequently by two other readers independently considering a subgroup of 20 patients. Crohn's Disease Endoscopic Index of Severity (CDEIS) and/or histologic analysis of the surgical specimen were considered as reference standards for the assessment of inflammatory activity.
Results
Patients revealed prevalently active (n = 55 patients) or quiescent CD (n = 41 patients). The agreement between unenhanced MRE vs. CE‐MRE in interpreting active bowel inflammation was 96% (123/128 bowel segments; one‐sided 95% confidence interval CI, >94.4%). Unenhanced MRE vs. CE‐MRE vs. unenhanced MRE plus CE‐MRE revealed a diagnostic accuracy of 93% 90/96 vs. 92% 88/96 vs. 97% 93/96 (P > 0.05) in the diagnosis of active CD. Interreader agreement was very good for all variables (κ value = 0.8–0.9) except for the measurement of the length of disease (κ value = 0.45).
Conclusion
Unenhanced MRE was noninferior to CE‐MRE in diagnosing active inflammation in patients with CD. J. MAGN. RESON. IMAGING 2016;43:688–697.
Single-board computers (SBCs) and microcontroller boards (MCBs) are extensively used nowadays as prototyping platforms to accomplish innovative tasks. Very recently, implementations of these devices ...for diagnostics applications are rapidly gaining ground for research and educational purposes. Among the available solutions, Raspberry Pi represents one of the most used SBCs. In the present work, two setups based on Raspberry Pi and its CMOS-based camera (a 3D-printed device and an adaptation of a commercial product named We-Lab) were investigated as diagnostic instruments. Different camera elaboration processes were investigated, showing how direct access to the 10-bit raw data acquired from the sensor before downstream imaging processes could be beneficial for photometric applications. The developed solution was successfully applied to the evaluation of the oxidative stress using two commercial kits (d-ROM Fast; PAT). We suggest the analysis of raw data applied to SBC and MCB platforms in order to improve results.
A young man with a previous history of episodes of mild solid food dysphagia was admitted with a total dysphagia. The esophagogastroduodenoscopy （EGDS） showed an extensive disruption of mucosal layer ...with a cul-desac in the lower part of the esophagus. Soon after the procedure, the patient suffered from an acute chest pain and subsequent CT scan demonstrated an intramural circumferential dissection of thoracic esophagus, and a mediastinal emphysema. An emergency right thoracotomy was performed, followed by a total esophagectomy with esophagogastroplasty and jejunostomy. The histopathology confirmed that mucosal and submucosal layers were circumferentially detached from muscular wall and showed an eosinophilic infiltration of the whole organ with necrosis and erosions of mucosal, submucosal and muscular layers. The diagnosis was esophageal perforation in eosinophilic esophagitis.
Objectives: The introduction of diode lasers in dentistry had several advantages, principally consisting on the reduced size, reduced cost and possibility to beam delivering by optical fibbers. Up ...today only the wavelengths around 810 and 980 nm were the most utilized in oral surgery but recently more different lasers had been proposed.The aim of this study was to compare the efficacy of four diode laser wavelengths (810, 980, 1470 and 1950 nm) for the ablation of soft tissues. Material and Methods: Specimens were surgically collected from the dorsal surface of four bovine tongues and irradiated by four different diode wavelengths. Thermal increase was measured by two thermocouples, the first at a depth of 0.5 mm, and the second at a depth of 2 mm. Initial and final surface temperatures were recorded by IR thermometer. Epithelial changes, connective tissue modifications, presence of vascular modification and incision morphology were histologically evaluated by two blind pathologists. Results:The time necessary to perform the excision varied between 271 seconds (808 nm, 2W) and 112 seconds (1950 nm, 4W). Temperature increase superficial level varied from 16.3° (980 nm, 4W) and 9.2° (1950 nm, 2 W). The most significant deep temperature increase was recorded by 980 nm, 4 W (17.3°) and the lowest by 1950 nm, 2 W (9.7°). The width of epithelial tissue injuries varied between 74 μm from 1950 nm diode laser at 2 W to 540 μm for 1470 nm diode laser at 4 W. Conclusions: The quality of incision was better and the width of overall tissue injuries was minor in the specimens obtained with higher wavelength (1950 nm) at lower power (2W).
To define the best independent predictors for active inflammation in patients with Crohn disease (CD) examined by contrast-enhanced magnetic resonance (MR) enterography.
Ninety-one patients (47 men ...and 44 women; aged 39.58 ± 17.1 years) with a diagnosis of CD; CD activity index (CDAI) ≥ 150 (n = 19 patients) or <150 (n = 72) underwent MR enterography including T2-weighted half-Fourier acquisition single-shot turbo spin-echo, T2-weighted spectral fat presaturation with inversion recovery, T1-weighted balanced steady-state free precession, and T1-weighted breath-hold resolution isotropic high volume three-dimensional MR imaging sequences before and after administration of gadobenate dimeglumine during arterial (30 seconds), portal venous (70 seconds), and delayed phase (3 and 5 minutes from contrast injection). Two readers analyzed the MR images in consensus. Reference standard was the Crohn's Disease Endoscopic Index of Severity (CDEIS) with deep mucosal biopsy or the histologic analysis of the surgical specimen in those patients (n = 30) who underwent elective small-bowel resection. Univariate and multivariate logistic regression analyses were performed to assess CDAI, biochemical markers (C-reactive protein and fecal calprotectin levels) and MR imaging findings as potential predictors of inflammatory CD activity.
Patients revealed prevalently active (n = 47 patients) or quiescent CD with mural fibrosis (n = 44 patients). The bowel wall T2 hyperintensity (odds ratio OR, 9.20; 95% confidence interval CI, 2.71-31.19) and total length of disease (OR, 1.29; 95% CI, 1.11-1.49) were found as the best independent predictors of active CD. CDAI, C-reactive protein, and fecal calprotectin were not found independent predictors of active CD.
The bowel wall T2 hyperintensity and the length of the involved bowel tract were predictors of active inflammation in patients with CD examined by contrast-enhanced MR enterography.
AIM： To determine the overall prevalence of H pylori and CagA positive H pylori infection and the prevalence of other bacterial and viral causes of chronic infection in patients with coronary heart ...disease （CHD）, and the potential role of anti-heat-shock protein 60 （Hsp60） antibody response to these proteins in increasing the risk of CHD development.
METHODS： Eighty patients with CHD and 160 controls were employed. We also compared the levels of antiheat-shock protein 60 （Hsp60） antibodies in the two groups. The Hpylori infection and the CagA status were determined serologically, using commercially available enzyme-linked immunosorbent assays （ELISA）, and a Western blotting method developed in our laboratory. Systemic antibodies to Hsp60 were determined by a sandwich ELISA, using a polyclonal antibody to Hsp60 to sensitise polystyrene plates and a commercially available human Hsp60 as an antigen.
RESULTS： The overall prevalence of H pylori infection was 78.7% （n = 63） in patients and 76.2% （n = 122） in controls （P = 0.07）. Patients infected by CagApositive （CagA^＋） Hpylori strains were 71.4% （n = 45） vs 52.4% of infected controls （P = 0.030, OR = 2.27）. Systemic levels of IgG to Hsp60 were increased in H pylorinegative patients compared with uninfected controls （P 〈 0,001） and CagA-positive infected patients compared with CagA-positive infected controls （P = 0.007）.
CONCLUSION： CagA positive H pylori infection may concur to the development of CHD; high levels of antiHsp60 antibodies may constitute a marker and/or a concomitant pathogenic factor of the disease.
Purpose To assess whether contrast material-enhanced ultrasonography (US) can be used to differentiate responders from nonresponders among patients with clinically active Crohn disease after 6 weeks ...of pharmacologic treatment. Materials and Methods This prospective study was approved by our ethics committee, and written informed consent was obtained from all patients. Fifty consecutive patients (26 men and 24 women; mean age, 34.76 years ± 9) with a proved diagnosis of active Crohn disease who were scheduled to begin therapy with biologics (infliximab or adalimumab) were included, with enrollment from June 1, 2013, to June 1, 2015. In each patient, the terminal ileal loop was imaged with contrast-enhanced US before the beginning and at the end of week 6 of pharmacologic treatment. Time-intensity curves obtained in responders (those with a decrease in the Crohn disease endoscopic index of severity score of 25-44 before treatment to 10-15 after treatment, an inflammatory score <7, and/or a decrease ≥70 in the Crohn disease activity index score compared with baseline) and nonresponders were compared with Mann-Whitney test. Results Responders (n = 31) and nonresponders (n = 19) differed (P < .05) in the percent change of peak enhancement (-40.78 ± 62.85 vs 53.21 ± 72.5; P = .0001), wash-in (-34.8 ± 67.72 vs 89.44 ± 145.32; P = .001) and washout (-5.64 ± 130.71 vs 166.83 ± 204.44; P = .002) rate, wash-in perfusion index (-42.29 ± 59.21 vs 50.96 ± 71.13; P = .001), area under the time-intensity curve (AUC; -46.17 ± 48.42 vs 41.78 ± 87.64; P = .001), AUC during wash-in (-43.93 ± 54.29 vs 39.79 ± 70.85; P = .001), and AUC during washout (-49.36 ± 47.42 vs 42.65 ± 97.09; P = .001). Responders and nonresponders did not differ in the percent change of rise time (5.09 ± 49.13 vs 6.24 ± 48.06; P = .93) and time to peak enhancement (8.82 ± 54.5 vs 10.21 ± 43.25; P = .3). Conclusion Analysis of time-intensity curves obtained after injection of microbubble contrast material 6 weeks after beginning pharmacologic treatment can be used to differentiate responders from nonresponders among patients with clinically active Crohn disease.
RSNA, 2016.
•A Raspberry Pi and a CMOS camera were successfully employed for analytical purposes.•Conventional DPPH assay can be carried out with consumer electronics.•Results were comparable with data obtained ...using a research-grade spectrophotometer.•Open-source software libraries and consumer electronics are effetcive tools for chemistry research and education.
Microcontrollers and single-board computers are widespread tools for innovative educational labs, for prototyping and for accomplish everyday tasks by expert users. Moreover, these modules are opening new exciting possibilities in the area of biological and chemical assays. In this study a Raspberry Pi computer assembled with 3D printed parts and inexpensive opto-electronic components were employed to analyse the antioxidant capacity of several bottled tea performing diphenylpicryl-hydrazyl (DPPH) tests. A dedicated python software allowed the execution of the analysis controlling the device through a small LCD touch screen or remotely through secure connections with other devices. The Raspberry Pi-based measurements were compared with a research-grade spectrophotometer showing excellent correlation (R2 = 0.9996) and no significant differences (p < 0.05) in the range of measured values. We strongly believe that this approach could support diagnostics progress in resource-poor countries and open new opportunities in research and education.
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