Evaluation of thermal water in patients with functional dyspepsia and irritable bowel syndrome accompanying constipation

AIM： To evaluate the efficacy of water supplementation treatment in patients with functional dyspepsia or irritable bowe syndrome （IBS） accompanying predominant constipation. METHODS： A total of 3872 patients with functional dyspepsia and 3609 patients with irritable bowel syndrome were enrolled in the study by 18 Italina thermal centres. Patients underwent a first cycle of thermal therapy for 21 d. A year later patients were re-evaluated at the same centre and received another cycle of thermal therapy. A questionnare to collect personal data on social and occupational status, family and pathological case history, life style, clinical records, utilisation of welfare and health structure and devices was administered to each patient at basal time and one year after each thermal treatment. Sixty patients with functional dyspepsia and 20 with IBS and 80 healthy controls received an evaluation of gastric output and oro-cecal transit time by breath test analysis. Breath test was performed at basal time and after water supplementaton therapies. Gastrointestinal symptoms were evaluated at the same time points. Breath samples were analyzed with a mass spectometer and a gascromatograph. Results were expressed as T1/2 and T-lag for octanoic add breath test and as oro-cecal transit time for lactulose breath test. RESULTS： A significant reduction of prevalence of symptoms was observed at the end of the first and second cycles of thermal therapy in dyspeptic and IBS patients, The analysis of variance showed a real and persistant improvement of symptoms in all patients. After water supplementation for 3 wk a reduction of gastric output was observed in 49 （87.5%） of 56 dyspepUc patients. Both T1/2 and T-lag were significantly reduced after the therapy compared to basal values [91 ± 12 （T1/2） and 53± 11 （T-lag）, Tables 1 and 2] with results of octanoic acid breath test similar to healthy subjects. After water supplementation for 3 wk oro-cecal transit time was shorter than that at the beginning of the study. CONCLUSION： Mineral water supplementation treatment for functional dyspepsia or conspipation accompanying IBS can improve gastric add output and intestinal transit time.

3omorbidity and survival of patients selected for radica prostatectomy at an age of 75 years or older

Radical prostatectomy in elderly patients is controversial. To identify very old candidates for radical prostatectomy with the highest probability of long-term survival, we studied 47 consecutive men who underwent radical prostatectomy between 1992 and 2005 at an age of 75 years or older. A heuristic approach was used to search for subgroups with particularly high long-term survival. Several two-sided comorbidity measures and combinations of these measures were investigated to find classifications best identifying healthy, long-living elderly candidates for radical prostatectomy. Four of the 25 two-sided comorbidity classifications or combinations reached the significance level with hazard ratios between 4.00 and 4.80. After 10 years, patients identified as healthy patients according to these comorbidity measurements had exhibited relative survival rates between 129% and 137% and overall survival rates between 86% and 95%, whereas those with comorbidities had exhibited relative survival rates of only 66%-84% and overall survival rates of 44%-58%. In conclusion, classifying comorbidity may identify a meaningful proportion of men selected for radical prostatectomy at an age of 75 years or older with an excellent long-term survival probability superseding that of the general population.

Distribution of 26 Metals in the Waters of the Aquatic Ecosystems of the Cotonou Channel and Lake Nokoué, Benin

Metallic elements have various origins: natural and anthropogenic sources as geochemical, marine and atmospheric sources resulting from the fallout of pollutants emitted or dust raised and which are transported by water and air currents. Thus marine, brackish and fresh continental waters may have high metal concentrations. In addition, some essential metals can become toxic above certain concentration values in aquatic environments. The aquatic ecosystems of Cotonou channel and lake Nokoué receive the pollutants charges from the town cities of Cotonou, Abomey-Calavi and town hall of So Ava. The aim of this study is to analyze waters from Eighteen (18) stations identified in the two ecosystems (nine by ecosystem). The concentrations of magnesium (Mg), calcium (Ca), vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), selenium (Se), cadmium (Cd), beryllium (Be), aluminum (Al), strontium (Sr), molybdenum (Mo), silver (Ag), tin (Sn), barium (Ba), platinum (Pt), mercury (Hg), thallium (Tl), lead (Pb), thorium (Th) and uranium (U) were measured after acid digestion of the water samples using the inductively coupled plasma source mass spectrometer (ICP-MS). The results of the analyses indicate an unequal distribution of metals in the different ecosystems. However, atypical concentrations were observed at some stations of the lake and the channel. Magnesium, calcium and manganese have very high values in Lake Nokoué respectively at Ganvié market station GAN_M (2990 ± 105 mg/L), Ganvié center, station GAN_C (4991 ± 177 mg/L) and Lake middle station MLak4 (10662 ± 17.03 μg/L). On the other hand, iron, aluminum and strontium have very high concentrations in the Cotonou Channel respectively at Agbato station AGB (5236 ± 103 and 8289 ± 519 μg/L) and at the estuary station EST (6118 ± 68 μg/L). The concentrations were compared to wells and cborehole waters in sixth neighborhood of Cotonou. We have used statistical analyzers such as MANOVA which have made it possible to classify the waters and metals in the ecosystems studied compared to groundwater and Well water waters. We use hierarchical clustering on principal components to identify similarities between stations based on metal concentration with R software packages “FactoMineR” and “factoextra”. In general, we can conclude that most of the metals have an anthropogenic source except strontium and major elements (Ca and Mg) which could respectively provide from marine waters and geochemical sources.

Modeling the Distribution of Marketable Timber Products of Private Teak(Tectona grandis L.f.)Plantations

Management of marketable products of private plantations will not be sustainable without class girth being identifiable readily. Modeling marketable products is a key to obtain good fitness between observed and theoretical girth distribution. We determine the best parameter recovery method with the Weibull function for two sylvicultural regimes (coppice and high forest). Data on stand variables were collected from 1101 sample plots. The three Weibull function parameters were estimated with three parameters recovery methods: the maximum likelihood method, the method of moments and the method of percentiles. Stepwise regression and the simultaneously re-estimated parameter using the Seemingly Unrelated Regression Estimation were applied to model each parameter. The results indicated that the three methods successfully predicted girth size distributions within the sample stands. The method of moments was the best one with lowest values of Reynolds error index and Kolmogorov-Smirnov statistic however the sylvicultural regimes. The Weibull parameter distribution model developed for each of the two sylvicultural regimes was quite reliable.

Long-term follow-up after complete ablation of Barrett's esophagus with argon plasma coagulation

AIM: To report the long-term outcome of patients after complete ablation of non-neoplastic Barrett's esophagus (BE) with respect to BE relapse and development of intraepithelial neoplasia or esophageal adenocarcinoma. METHODS: In 70 patients with historically proven non neoplastic BE, complete BE ablation was achieved by argon plasma coagulation (APC) and high-dose proton pump inhibitor therapy (120 mg omeprazole daily). Sixty-six patients (94.4%) underwent further surveillance endoscopy. At each surveillance endoscopy four-quadrant biopsies were taken from the neo-squamous epithelium at 2 cm intervals depending on the pre-treatment length of BE mucosa beginning at the neo-Z-line, and from any endoscopically suspicious lesion. RESULTS: The median follow-up of 66 patients was 51 mo (range 9-85 mo) giving a total of 280.5 patient years. A mean of 6 biopsies were taken during surveillance endoscopies. In 13 patients (19.7%) tongues or islands suspicious for BE were found during endoscopy. In 8 of these patients (12.1%) non-neoplastic BE relapse was confirmed histologically giving a histological relapse rate of 3% per year. In none of the patients, intraepithelial neoplasia nor an esophageal adenocarcinoma was detected. Logistic regression analysis identified endoscopic detection of islands or tongues as the only positive predictor of BE relapse (P= 0.0004). CONCLUSION: The long-term relapse rate of non neoplastic BE following complete ablation with high-power APC is low (3% per year).

Significance of ipsilateral breast tumor recurrence after breast conserving treatment: role of surgical removal

Objective： To analyze the pattern over time （dynamics） of further recurrence and death after ipsilateral breast tumor recurrence （IBTR） in breast cancer patients undergoing breast conserving treatment （BCT）. Methods： A total of 338 evaluable patients experiencing IBTR were extracted from a database of 3,293 patients undergoing BCT. The hazard rates for recurrence and mortality throughout 10 years of follow-up after IBTR were assessed and were compared to the analogous estimates associated to the primary treatment. Results： In a time frame with the time origin at the surgical treatment for IBTR, the hazard rate for further recurrence displays a bimodal pattern （peaks at the second and at the sixth year）. Patients receiving mastectomy for IBTR reveal recurrence and mortality dynamics similar to that of node positive （N＋） patients receiving mastectomy as primary surgery, apart from the first two-three years, when IBTR patients do worse. If the patients with time to IBTR longer than 2.5 years are considered, differences disappear. Conclusions： The recurrence and mortality dynamics following IBTR surgical removal is similar to the corresponding dynamics following primary tumor removal. In particular, patients with time to IBTR in excess of 2.5 years behave like N＋ patients following primary tumor removal. Findings may be suitably explained by assuming that the surgical manoeuvre required by IBTR treatment is able to activate a sudden growing phase for tumor foci most of which, as suggested by the systemic model of breast cancer, would have reached the clinical level according to their own dynamics.

Assessing spatial genetic structure from molecular marker data via principal component analyses: A case study in a <i>Prosopis</i>sp. forest

Advances in genotyping technology, such as molecular markers, have noticeably improved our capacity to characterize genomes at multiple loci. Concomitantly, the methodological framework to analyze genetic data has expanded, and keeping abreast with the latest statistical developments to analyze molecular marker data in the context of spatial genetics has become a difficult task. Most methods in spatial statistics are devoted to univariate data whereas the nature of molecular marker data is highly dimensional. Multivariate methods are aimed at finding proximities between entities characterized by multiple variables by summarizing information in few synthetic variables. In particular, Principal Component analysis (PCA) has been used to study genetic structure of geo-referenced allele frequency profiles, incorporating spatial information with a posteriori analysis. Conversely, the recently developed spatially restricted PCA (sPCA) explicitly includes spatial data in the optimization criterion. In this work, we compared the results of the application of PCA and sPCA in the study of the spatial genetic structure at fine scale of a Prosopis flexuosa and P. chilensis hybrid swarm. Data consisted in the genetic characterization of 87 trees sampled in Córdoba, Argentina and genotyped at six microsatellites, which yielded 72 alleles. As expected, principal components explained more variance than sPCA components, but were less spatially autocorrelated. The maps obtained by the interpolation of sPC1 values allowed a better visualization of a patchy spatial pattern of genetic variability than the PC1 synthetic map. We also proposed a PC-sPC scatter plot of allele loadings to better understand the allele contributions to spatial genetic variability.

Optimization of a novel three dimensional risk calculation model for software-based aneuploidy screening in early pregnancy

Introduction: A novel three dimensional approach for aneuploidy screening in the first trimester of pregnancy was developed in which risk assessment derives directly from comparing the plotted data of nuchal translucency, pregnancy associated plasma protein A (PAPP-A), and free β-human chorionic gonadotropin (fβ-hCG) of an examined fetus with similar coordinates of fetuses with already known health status. Under this approach, it is possible to utilize either a ‘box’ or a ‘sphere’ model. In either case, optimal volume sizes and the benefits of adopting a ‘minimum number of required fetuses’ (MNR) have not yet been investigated;and for the box model, two modifications, called ‘empty box results positive’ (EB+) and ‘simulation’ (SIM), provide additional options. It was the aim of this study to analyze which of the two models and their variants provides the best test performance. Methods: The study cohort was divided into a reference collective (n = 10,954) and a test collective (n = 4239). The test collective was examined repeatedly, with another model and modification used on each occasion. Test performances were compared by the area under curve (AUC) of receiver operating characteristics (ROC) curves. Results: The sphere model was inferior to the box model when optimal volumes were used with the latter and combined with the modifications EB+ and Sim. EB+ increased the number of assessable fetuses while Sim improved the test performance. MNR improved neither the box nor the sphere model. Conclusion: A new, optimized model in line with the obtained results should be developed and tested in further studies.

Level of education and mortality after radical prostatectomy

Estimating the risk of competing mortality is of importance in men with early prostate cancer to choose the most appropriate way of management and to avoid over- or under-treatment. In this study, we investigated the impact of the level of education in this context. The study sample consisted of 2630 patients with complete data on level of education （college, university degree, master craftsmen, comparable profession, or others）, histopathological tumor stage （organ confined or extracapsular）, lymph node status （negative or positive）, and prostatectomy specimen Gleason score （〈7, 7, or 8-10） who underwent radical prostatectomy between 1992 and 2007. Overall, prostate cancer-specific, competing, and second cancer-related mortalities were study endpoints. Cox proportional hazard models for competing risks were used to study combined effects of the variables on these endpoints. A higher level of education was independently associated with decreased overall mortality after radical prostatectomy （hazard ratio [HR]： 0.75, 95% confidence interval [95% CI]： 0.62-0.91, P = 0.0037）. The mortality difference was attributable to decreased second cancer mortality （HR： 0.59, 95% Ch 0.40-0.85, P = 0.0052） and noncancer mortality （HR： 0.73, 95% Ch 0.55-0.98, P = 0.0345） but not to differences in prostate cancer-specific mortality （HR： 1.16, 95% Ch 0.79-1.69, P = 0.4536 in the full model）. In conclusion, the level of education might serve as an independent prognostic parameter supplementary to age, comorbidity, and smoking status to estimate the risk of competing mortality and to choose optimal treatment for men with early prostate cancer who are candidates for radical prostatectomy.

Prevalence of obesity in Italian adolescents:does the use of different growth charts make the difference?

Background Since populations are becoming increasingly multi-ethnic,the use of local or international charts is a matter of debate.This study aimed to evaluate how the choice of cut-off thresholds affected prevalence of underweight(UW),overweight(OW),obesity(OB)in 120011-12-year Italian adolescents,and how their somatic growth depended on parental origin.Methods The height,weight and body mass index were expressed as standard deviation score(SDS)using Italian(ISPED-2006)and UK(UK-1990)charts.The classification of UW/OW/OB was computed with the IOTF international cut-offs,and thresholds were identified as centiles corresponding to BMI values of 18.5/25.0/30.0 kg/m^(2)at 18-year in ISPED-2006 or UK-1990 references.Results About 30%participants had non-Italian parents,above all from North-Africa and Romania.Referring to the UK-1990 charts,all groups showed negative mean SDS for height,and positive SDS for weight and BMI.Referring to the ISPED-2006 charts,all mean SDS were negative.Percentage of UW individuals was higher in accordance with ISPED-2006 than with UK-1990 charts,whereas percentages of OW/OB were higher with UK-1990 than ISPED-2006 charts.The results obtained using IOFT cut-offs were similar to UK-1990 cut-offs.These results were due to the different shape of age-dependent cut-off centiles.Independently by the parental origin,the percentages of adolescents classified as OW/OB were closer to the expected values using the ISPED-2006 then the UK-1990 cut-offs.The results suggested the use of the Italian references for adolescents with immigrant parents.Conclusion The use of local charts seems more appropriate at least in Italian adolescents in the age range studied.