The British Society of Gastroenterology (BSG) and the Association of Coloproctology for Great Britain and Ireland (ACPGBI) commissioned this update of the 2002 guidance. The aim, as before, is to ...provide guidance on the appropriateness, method and frequency of screening for people at moderate and high risk from colorectal cancer. This guidance provides some new recommendations for those with inflammatory bowel disease and for those at moderate risk resulting from a family history of colorectal cancer. In other areas guidance is relatively unchanged, but the recent literature was reviewed and is included where appropriate.
Calciphylaxis: Risk Factors, Diagnosis, and Treatment Nigwekar, Sagar U., MD, MMSc; Kroshinsky, Daniela, MD, MPH; Nazarian, Rosalynn M., MD ...
American journal of kidney diseases,
07/2015, Volume:
66, Issue:
1
Journal Article
Peer reviewed
Open access
Calciphylaxis is a rare but devastating condition that has continued to challenge the medical community since its early descriptions in the scientific literature many decades ago. It is predominantly ...seen in patients with chronic kidney failure treated with dialysis (uremic calciphylaxis) but is also described in patients with earlier stages of chronic kidney disease and with normal kidney function. In this review, we discuss the available medical literature regarding risk factors, diagnosis, and treatment of both uremic and nonuremic calciphylaxis. High-quality evidence for the evaluation and management of calciphylaxis is lacking at this time due to its rare incidence and poorly understood pathogenesis and the relative paucity of collaborative research efforts. We hereby provide a summary of recommendations developed by a multidisciplinary team for patients with calciphylaxis.
Understanding the longevity of Mars’s dynamo is key to interpreting the planet’s atmospheric loss history and the properties of its deep interior. Satellite data showing magnetic lows above many ...large impact basins formed 4.1-3.7 billion years ago (Ga) have been interpreted as evidence that Mars’s dynamo terminated before 4.1 Ga—at least 0.4 Gy before intense late Noachian/early Hesperian hydrological activity. However, evidence for a longer-lived, reversing dynamo from young volcanics and the Martian meteorite ALH 84001 supports an alternative interpretation of Mars’s apparently demagnetized basins. To understand how a reversing dynamo would affect basin fields, here we model the cooling and magnetization of 200-2200 km diameter impact basins under a range of Earth-like reversal frequencies. We find that magnetic reversals efficiently reduce field strengths above large basins. In particular, if the magnetic properties of the Martian mantle are similar to most Martian meteorites and late remagnetization of the near surface is widespread, >90% of large ( > 800 km diameter) basins would appear demagnetized at spacecraft altitudes. This ultimately implies that Mars’s apparently demagnetized basins do not require an early dynamo cessation. A long-lived and reversing dynamo, unlike alternative scenarios, satisfies all available constraints on Mars’s magnetic history.Weak magnetic fields above Mars’s large impact basins are often interpreted as a signature of the dynamo’s early cessation. Here, the authors demonstrate that these weakly magnetic basins may instead have formed in a long-lived but reversing dynamo.
Meta-analyses of bipolar disorder (BD) genome-wide association studies (GWAS) have identified several genome-wide significant signals in European-ancestry samples, but so far account for little of ...the inherited risk. We performed a meta-analysis of ∼750,000 high-quality genetic markers on a combined sample of ∼14,000 subjects of European and Asian-ancestry (phase I). The most significant findings were further tested in an extended sample of ∼17,700 cases and controls (phase II). The results suggest novel association findings near the genes TRANK1 (LBA1), LMAN2L and PTGFR. In phase I, the most significant single nucleotide polymorphism (SNP), rs9834970 near TRANK1, was significant at the P=2.4 × 10(-11) level, with no heterogeneity. Supportive evidence for prior association findings near ANK3 and a locus on chromosome 3p21.1 was also observed. The phase II results were similar, although the heterogeneity test became significant for several SNPs. On the basis of these results and other established risk loci, we used the method developed by Park et al. to estimate the number, and the effect size distribution, of BD risk loci that could still be found by GWAS methods. We estimate that >63,000 case-control samples would be needed to identify the ∼105 BD risk loci discoverable by GWAS, and that these will together explain <6% of the inherited risk. These results support previous GWAS findings and identify three new candidate genes for BD. Further studies are needed to replicate these findings and may potentially lead to identification of functional variants. Sample size will remain a limiting factor in the discovery of common alleles associated with BD.
Background
Anastomotic leak (AL) represents a dreaded complication following colorectal surgery, with a prevalence of 1–19 per cent. There remains a lack of consensus regarding factors that may ...predispose to AL and the relative risks associated with them. The objective was to perform a systematic review of the literature, focusing on the role of preoperative, intraoperative and postoperative factors in the development of colorectal ALs.
Methods
A systematic review was performed to identify adjustable and non‐adjustable preoperative, intraoperative and postoperative factors in the pathogenesis of AL. Additionally, a severity grading system was proposed to guide treatment.
Results
Of 1707 papers screened, 451 fulfilled the criteria for inclusion in the review. Significant preoperative risk factors were: male sex, American Society of Anesthesiologists fitness grade above II, renal disease, co‐morbidity and history of radiotherapy. Tumour‐related factors were: distal site, size larger than 3 cm, advanced stage, emergency surgery and metastatic disease. Adjustable risk factors were: smoking, obesity, poor nutrition, alcohol excess, immunosuppressants and bevacizumab. Intraoperative risk factors were: blood loss/transfusion and duration of surgery more than 4 h. Stomas lessen the consequences but not the prevalence of AL. In the postoperative period, CT is the most commonly used imaging tool, with or without rectal contrast, and a C‐reactive protein level exceeding 150 mg/l on day 3–5 is the most sensitive biochemical marker. A five‐level classification system for AL severity and appropriate management is presented.
Conclusion
Specific risk factors and their potential correction or indications for stoma were identified. An AL severity score is proposed to aid clinical decision‐making.
Factors affecting anastomotic leak incidence
We perform a spectroscopic analysis of 492 450 galaxy spectra from the first two years of observations of the Sloan Digital Sky Survey (SDSS) III/Baryonic Oscillation Spectroscopic Survey (BOSS) ...collaboration. This data set has been released in the ninth SDSS data release, the first public data release of BOSS spectra. We show that the typical signal-to-noise ratio of BOSS spectra, despite being low, is sufficient to measure stellar velocity dispersion and emission line fluxes for individual objects. We show that the typical velocity dispersion of a BOSS galaxy is ∼240 km s−1. The typical error in the velocity dispersion measurement is 14 per cent, and 93 per cent of BOSS galaxies have velocity dispersions with an accuracy of better than 30 per cent. The distribution in velocity dispersion is redshift independent between redshifts 0.15 and 0.7, which reflects the survey design targeting massive galaxies with an approximately uniform mass distribution in this redshift interval. We show that emission lines can be measured on BOSS spectra. However, the majority of BOSS galaxies lack detectable emission lines, as is to be expected because of the target selection design towards massive galaxies. We analyse the emission line properties and present diagnostic diagrams using the emission lines O ii, Hβ, O iii, Hα and N ii (detected in about 4 per cent of the galaxies) to separate star-forming objects and active galactic nuclei (AGN). We show that the emission line properties are strongly redshift dependent and that there is a clear correlation between observed frame colours and emission line properties. Within in the low-z sample (LOWZ) around 0.15 < z < 0.3, half of the emission line galaxies have low-ionization nuclear emission-line region (LINER)-like emission line ratios, followed by Seyfert-AGN-dominated spectra, and only a small fraction of a few per cent are purely star-forming galaxies. AGN and LINER-like objects, instead, are less prevalent in the high-z sample (CMASS) around 0.4 < z < 0.7, where more than half of the emission line objects are star forming. This is a pure selection effect caused by the non-detection of weak Hβ emission lines in the BOSS spectra. Finally, we show that star-forming, AGN and emission line free galaxies are well separated in the g − r versus r − i target selection diagram.
We construct asymptotically safe extensions of the standard model by adding gauged vectorlike fermions. Using large number-of-flavor techniques we argue that all gauge couplings, including the ...hypercharge and, under certain conditions, the Higgs coupling, can achieve an interacting ultraviolet fixed point.
Abstract Objective Aspirin is associated with a reduced risk of developing colorectal cancer. This study examined whether patients with colorectal cancer prescribed aspirin had improved survival. ...Design An observational population cohort study was undertaken using data linkage of cancer registry, dispensed prescriptions and death certificate records in Tayside, Scotland. All community prescribed aspirin pre- and post-diagnosis was extracted and periods of aspirin use post-diagnosis for each individual were analysed using Cox proportional hazard models. Main outcome measures were all-cause and colorectal mortality from death certificates. Results Two thousand nine hundred ninety patients were identified with colorectal cancer between 1st January 1997 and 30th December 2006 and followed up until 28th February 2010. Median age at diagnosis was 73 (interquartile range IQR 65–80) with 52% male. One thousand nine hundred ninety-eight (67%) deaths were recorded with 1021 (34%) attributed to colorectal cancer. One thousand three hundred forty (45%) patients used aspirin at some stage of the study period. Aspirin use post-diagnosis was associated with lower risk of all cause mortality (hazard ratio HR = 0.67, 95% confidence interval CI = 0.57–0.79, p < 0.001) and colorectal cancer specific mortality after allowing for age, Dukes’ stage, gender, socio-economic status and aspirin use pre-diagnosis. Increasing age and stage at diagnosis were associated with increased risk, with more affluent patients at reduced risk. Conclusions Our study suggests that aspirin use post-diagnosis of colorectal cancer may reduce both all cause and colorectal cancer specific mortality. However further work is required to ensure this is a causal relationship and to identify whether it is best used in specific groups of patients.
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