Plastic debris in lakes and reservoirs.

Plastic debris is thought to be widespread in freshwater ecosystems globally1. However, a lack of comprehensive and comparable data makes rigorous assessment of its distribution challenging2,3. Here we present a standardized cross-national survey that assesses the abundance and type of plastic debris (>250 µm) in freshwater ecosystems. We sample surface waters of 38 lakes and reservoirs, distributed across gradients of geographical position and limnological attributes, with the aim to identify factors associated with an increased observation of plastics. We find plastic debris in all studied lakes and reservoirs, suggesting that these ecosystems play a key role in the plastic-pollution cycle. Our results indicate that two types of lakes are particularly vulnerable to plastic contamination: lakes and reservoirs in densely populated and urbanized areas and large lakes and reservoirs with elevated deposition areas, long water-retention times and high levels of anthropogenic influence. Plastic concentrations vary widely among lakes; in the most polluted, concentrations reach or even exceed those reported in the subtropical oceanic gyres, marine areas collecting large amounts of debris4. Our findings highlight the importance of including lakes and reservoirs when addressing plastic pollution, in the context of pollution management and for the continued provision of lake ecosystem services.

Competition among physical, chemical, and hybrid gelation mechanisms in biopolymers.

Depending on how they form their linkages, biopolymer gelatin gels are commonly classified as physical, chemical, or hybrid; in gelatin hybrid gels, the physical and chemical crosslinking mechanisms occur simultaneously. The viscoelastic behavior of gels following different gelation processes was determined around the gel point. Their gel fractal dimensions were obtained using the BST-scaling model from large amplitude oscillatory shear results. The fractal dimension of hybrid gels is between 1.46 and 1.60, depending on the dominant crosslinking process. The main features of the Lissajous-Bowditch curves were determined for maturated gels that follow different gelation processes, and it is possible to observe the dominant gelation mechanism. The gelation kinetics process is followed by measuring the mean squared displacement (MSD) of microspheres embedded in gelatin solutions using diffusion wave spectroscopy, which in turn allows evaluating G'(ω) and G''(ω), the persistence length, and the mesh size as a function of time throughout the gelation process. The MSD, as a function of elapsed time from the start of the gelation process, follows a behavior that depends on the gelation processes. As time elapses after gelation starts, the persistence length of the unstructured, non-bonded flexible polymer sections decreases due to the formation of bonds. In the hybrid case, it is not a mixture of both processes; they are not independent when occurring simultaneously. The time evolution of the gel network's mesh size roughly follows an exponential decay.

Impact of a 6-12-h delay between ileocolic intussusception diagnostic US and fluoroscopic reduction on patients' outcomes.

BACKGROUND: Image-guided reduction of intussusception is considered a radiologic urgency requiring 24-h radiologist and technologist availability. OBJECTIVE: To assess whether a delay of 6-12 h between US diagnosis and fluoroscopic reduction of ileocolic intussusception affects the success frequency of fluoroscopic reduction. MATERIALS AND METHODS: Retrospective review of 0-5-year-olds undergoing fluoroscopic reduction for ileocolic intussusception from 2013 to 2023. Exclusions were small bowel intussusception, self-reduced intussusception, first fluoroscopic reduction attempt>12 h after US, prior bowel surgery, inpatient status, and patient transferred for recurrent intussusception. Data collected included demographics, symptoms, air/contrast enema selection, radiation dose, reduction failure, 48-h recurrence, surgery, length of stay, and complications. Comparisons between<6-h and 6-12-h delays after ultrasound diagnosis were made using chi-square, Fisher's exact test, and Mann-Whitney U tests (P< 0.05 considered significant). RESULTS: Of 438 included patients, 387 (88.4%) were reduced in <6 h (median age 1.4 years) and 51 (11.7%) were reduced between 6 and 12 h (median age 2.05 years), with median reduction times of 1:42 and 7:07 h, respectively. There were no significant differences between the groups for reduction success (<6 h 87.3% vs. 6-12 h 94.1%; P-value = 0.16), need for surgery (<6 h 11.1% vs. 6-12 h 3.9%; P-value=0.112), recurrence of intussusception within 48 h after reduction (<6 h 9.3% vs. 6-12 h 15.7%; P-value=0.154), or length of hospitalization (<6 h 21:07 h vs. 6-12 h 20:03 h; P-value=0.662). CONCLUSION: A delay of 6-12 h between diagnosis and fluoroscopic reduction of ileocolic intussusception is not associated with reduced fluoroscopic reduction success, need for surgical intervention after attempted reduction, recurrence of intussusception following successful reduction, or hospitalization duration after reduction.

Hepatopathy secondary to infiltration by malignant melanoma: diagnostic value of liver biopsy.

We present the case of a 61-year-old male with no relevant history of interest who was admitted to hospital due to constitutional syndrome and discomfort in the right hypochondrium. On admission, abdominal ultrasound was performed with findings of chronic liver disease and innumerable well-defined hypoechogenic lesions of small size. Although the study was extended with other imaging tests, they did not provide more information than what was available at the time. Subsequently, an ultrasound-guided liver biopsy was performed with pathological anatomy compatible with infiltration by malignant melanoma. Subsequently, a search for the primary origin of the melanoma was performed and it was found in the right thigh. Hepatic involvement by melanoma is infrequent and both the symptoms and the findings in the complementary tests are non-specific, characteristics that make diagnosis difficult. Therefore, in these cases liver biopsy plays a fundamental role in the diagnosis.

Analysis of Socio-demographic, Economic and Individual Reasons for COVID-19 Vaccination Hesitancy in Ecuador: A Nationwide Longitudinal Study.

The current outbreak of SARS-Cov-2, a virus responsible for COVID-19, has infected millions and caused a soaring death toll worldwide. Vaccination represents a powerful tool in our fight against the transmission of SARS-CoV-2. Ecuador is one of the Latin American countries most impacted by COVID-19. Despite free COVID-19 vaccines, Ecuadorians still hesitate to get vaccinated. A multivariate binary logistic regression was used to analyze data from the Ecuadorian National Institute of Statistics and Censuses. This study investigated socio-demographics, economic, and individual reasons associated with a person having "no intention" to receive COVID-19 vaccine across the study period of October 2021 to March 2022. The survey revealed an increase of unvaccinated people having no intention of COVID-19 vaccination from 57.4% (October-December 2021) to 72.9% (January-March 2022). COVID-19 vaccine hesitancy was dependent on factors like sex, age and ethnicity. Socio-economic characteristics and education level were not found to be statistically significant in lack of vaccine intention, but most vaccination hesitancy was due to distrust in the COVID-19 vaccine. People who believed that the vaccine could be unsafe because of possible side effects represented half of the surveyed participants, a proportion that barely diminished during the progress of the vaccination campaign across October-December 2021 (57.04%) and January-March 2022 (49.59%) periods. People who did not believe that the vaccine was effective enough increased from 11.47 to 18.46%. Misbeliefs about effectiveness and safety of vaccines should be considered in the implementation of public health initiatives of communication, education and intervention to improve vaccination campaigns.

Diffusion tensor imaging of the physis: the ABC's.

The physis, or growth plate, is the primary structure responsible for longitudinal growth of the long bones. Diffusion tensor imaging (DTI) is a technique that depicts the anisotropic motion of water molecules, or diffusion. When diffusion is limited by cellular membranes, information on tissue microstructure can be acquired. Tractography, the visual display of the direction and magnitude of water diffusion, provides qualitative visualization of complex cellular architecture as well as quantitative diffusion metrics that appear to indirectly reflect physeal activity. In the growing bones, DTI depicts the columns of cartilage and new bone in the physeal-metaphyseal complex. In this "How I do It", we will highlight the value of DTI as a clinical tool by presenting DTI tractography of the physeal-metaphyseal complex of children and adolescents during normal growth, illustrating variation in qualitative and quantitative tractography metrics with age and skeletal location. In addition, we will present tractography from patients with physeal dysfunction caused by growth hormone deficiency and physeal injury due to trauma, chemotherapy, and radiation therapy. Furthermore, we will delineate our process, or "DTI pipeline," from image acquisition to data interpretation.

Improving the patient experience during musculoskeletal interventional procedures.

In the patient-centered practice of musculoskeletal interventional radiology, pre-procedure, intra-procedure, and post-procedure factors impact the patient's overall experience. Opportunities to improve the patient experience begin before the patient procedure starts, with smooth scheduling of the appointment, a positive office environment, and appropriate communication by the musculoskeletal interventional radiology staff before the procedure, including clear expectations regarding wait times. The initial conversation between the radiologist and the patient, including the informed consent process, is a crucial opportunity for creating rapport with the patient and generating trust in the radiologist. Being able to interpret a patient's verbal and non-verbal cues during this conversation can reduce anxiety and enhance relaxation. During the procedure, there are interventions which can decrease anxiety and reduce the perception of pain by the patient. These include psychological interventions such as self-induced hypnosis, communication-based interventions such as empathic communication to mold a patient's interpretation of anxiety and painful stimuli, and the use of ancillary tools such as music or video stimulation. Finally, clear post-procedure expectations regarding post-procedure pain and its management and assurances of access to the musculoskeletal interventional radiology team can facilitate an uncomplicated post-procedure recovery.

Analysis of the reduction processes at the bottom of Lake Meirama: a singular case of lake formation.

The formation of natural lakes is a process that takes place over thousands of years, although the volumetric formation depends on hydrological and climatological phenomena, reaching a stationary hydraulic regime, the evolution of hydrochemistry is more complex and obeys not only phenomena of stoichiometry and chemical kinetics but also diffusion processes. Depending on the depth of the lakes, the anoxization process originating from the bottom is the first phase of the lake's methanogenesis. For this, the course of many thousands of years is necessary, so the studies carried out in the lakes are limited to the current knowledge of the state in which they are, without being able to have real information in this process of methanogenesis. There are no data available on the generation process of a natural lake in its primary stages. In this case, taking advantage of the rehabilitation of the old open-pit mining of Meirama (Northwest Spain), consisting of the controlled flooding of the hole by groundwater, by stopping the perimeter pumping, and the derivation of the nearby streams, whose contribution was the majority with respect to the subterranean contribution, there has been the opportunity to physically and chemically monitor the complete filling of the said hole. The present study focuses on the analysis of the evolution of the different processes initiated in the methanogenesis of the lake bottom identified in the well-known Redox ladder: obtaining oxygen from the reduction of nitrogenous compounds and metallic oxides, from the reduction of the sulfate and the generation of methane from carbon compounds, the latter phase without reaching. Although the methanization process is very slow, it has had the opportunity to know the formation of a lake at its origin, from the hydrochemical point of view. It has been possible to verify that the methanization processes at the bottom, given the anoxia conditions, are in a very primitive phase with the reduction of nitrate and nitrite to ammonium and beginning a reduction of metal oxides and sulfate.

Outcomes of neonates born to women with Covid-19.

Not available.

Pediatric chronic post-surgical pain prevalence, pain scores, and quality-of-life: results of an exploratory patient survey at a single-center tertiary care children's hospital.

PURPOSE: Twenty percent of children may develop chronic post-surgical pain (CPSP), but studies investigating pediatric CPSP are limited in scope. In an exploratory patient survey, we sought to assess CPSP prevalence among children of all ages, across a wide range of surgeries, and over an extended period of time after surgery. METHODS: We conducted a survey study, including patients < 19 years of age at the time of their surgery at a single-center, quaternary care academic pediatric hospital. Pediatric patients who underwent surgery from May 2014 to August 2019 were included. Via electronic survey, patients/caregivers were asked whether the child had any pain related to their last surgery at the pediatric hospital. Patients/caregivers who answered yes were asked 11 additional questions about the child's pain and pain-related quality of life. The primary outcome was CPSP prevalence; secondary outcomes were pain scores, quality-of-life scores, and the associations of CPSP with time since surgery, preoperative pain, and patient age. RESULTS: The response rate of completed surveys was 4.0%. 30% of respondents reported CPSP; the median pain score was 4.0 on an 11 point scale (0 to 10). Responses to quality of life questions indicated CPSP negatively impacted many children's lives. Preoperative pain was associated with an odds ratio for CPSP of 1.09 [95% confidence interval (CI): 0.58, 2.04], each year after surgery with an odds ratio of 0.94 (95% CI 0.80, 1.10), and each year of age at surgery with an odds ratio of 1.07 (95% CI 1.02, 1.12). CONCLUSION: While limited by a low response rate, results from this exploratory survey suggest that CPSP is a considerable problem for children who undergo surgery across many specialties, with marked effects on patient well-being even years after surgery.

Molecular fragmentation as a way to reveal early electron dynamics induced by attosecond pulses.

We present a theoretical study of the electron and nuclear dynamics that would arise in an attosecond two-color XUV-pump/XUV-probe experiment in glycine. In this scheme, the broadband pump pulse suddenly ionizes the molecule and creates an electronic wave packet that subsequently evolves under the influence of the nuclear motion until it is finally probed by the second XUV pulse. To describe the different steps of such an experiment, we have combined a multi-reference static-exchange scattering method with a trajectory surface hopping approach. We show that by changing the central frequency of the pump pulse, i.e., by engineering the initial electronic wave packet with the pump pulse, one can drive the cation dynamics into a specific fragmentation pathway. Reminiscence of this early electron dynamics can be observed in specific fragmentation channels (not all of them) as a function of the pump-probe delay and in time-resolved photoelectron spectra at specific photoelectron energies. The optimum conditions to visualize the initial electronic coherence in photoelectron and photo-ion spectra depend very much on the characteristics of the pump pulse as well as on the electronic structure of the molecule under study.

The catalytic effects of a thiazolium salt in the oxa-Diels-Alder reaction between benzaldehyde and Danishefsky's diene: a molecular electron density theory study.

The oxa-Diels-Alder (ODA) reaction of benzaldehyde with Danishefsky's diene in the presence of a [thiazolium][Cl] salt, as a model of an ionic liquid, has been studied within Molecular Electron Density Theory (MEDT) at the M06-2X/6-311G(d,p) computational level. The formation of two hydrogen bonds (HBs) between the thiazolium cation and the carbonyl oxygen of benzaldehyde modifies neither the electrophilic character of benzaldehyde nor its electronic structure substantially but accelerates the reaction considerably. This ODA reaction presents an activation energy of 4.5 kcal mol-1; the formation of the only observed dihydropyranone is strongly exothermic by -28.8 kcal mol-1. The presence of the [thiazolium][Cl] salt decreases the Gibbs free energy of activation of the ODA reaction between benzaldehyde and Danishefsky's diene by 5.9 kcal mol-1. This ODA reaction presents total para regioselectivity and high endo stereoselectivity. This ODA reaction takes place through a highly asynchronous polar transition state structure (TS) associated with a non-concerted two-stage one-step mechanism. ELF analysis of para/endo TSs associated with the ODA reactions in the absence and presence of the [thiazolium][Cl] salt shows that the formation of the HBs at the TSs does not modify their electronic structure substantially. This MEDT study makes it possible to conclude that the acceleration found in the ODA reaction of benzaldehyde with Danishefsky's diene in ILs is a consequence of an increase of the global electron density transfer at TS3-pn, resulting from HB formation, and the greater strength of the HBs at the polar TS3-pn compared to that at the benzaldehyde : [thiazolium][Cl] complex, and that the strength in the HB formed is more relevant that than an increase of the electrophilic character of the interaction between reagent.

New benzimidazolequinones as trypanosomicidal agents.

Herein, the design and synthesis of new 2-phenyl(pyridinyl)benzimidazolequinones and their 5-phenoxy derivatives as potential anti-Trypanosoma cruzi agents are described. The compounds were evaluated in vitro against the epimastigotes and trypomastigote forms of Trypanosoma cruzi. The replacing of a benzene moiety in the naphthoquinone system by an imidazole enhanced the trypanosomicidal activity against Trypanosoma cruzi. Three of the tested compounds (11a-c) showed potent trypanosomicidal activity and compound 11a, with IC50 of 0.65 µM on the trypomastigote form of T. cruzi, proved to be 15 times more active than nifurtimox. Additionally, molecular docking studies indicate that the quinone derivatives 11a-c could have a multitarget profile interacting preferentially with trypanothione reductase and Old Yellow Enzyme.

Pediatric magnetic resonance imaging training versus job-readiness: using education research tools to re-align.

BACKGROUND: Fellows begin MRI training with variable experience and expertise. To better serve patients, pediatric radiology fellows should gain competence in MRI that enables seamless transition to independent practice. OBJECTIVE: We implemented a needs assessment survey and conducted a focus group discussion to identify knowledge gaps and inform creation of a curriculum for pediatric body MRI. MATERIALS AND METHODS: We electronically distributed a comprehensive anonymous needs assessment survey in October 2016 to current fellows and recent (<5 years) graduates from Accreditation Council for Graduate Medical Education (ACGME)-accredited pediatric radiology fellowships, with follow-up in January 2017. We conducted a focus group discussion among current fellows at our institution in October 2017 to inform a better understanding of the results. RESULTS: Eighty-one pediatric radiologists (8 fellows/73 attendings) completed the survey (24%); 5 current fellows participated in the focus group. The technical issues most commonly identified with limited or no instruction during training included setting up an MR service, accessory equipment (coil) selection and MRI field inhomogeneity correction. Areas needing increased attention and inclusion within the curriculum included coil choice/patient positioning (n=42, 52%), contrast agents (n=40, 49%), field strength (n=33, 41%) and strategies for motion correction (n=33, 41%). Most fellows were uncomfortable with setting up an MR service (n=57, 70%), correcting field inhomogeneity (n=56, 69%) and improving image quality (n=50, 62%). The focus group showed consensus that there was insufficient MR training in residency to prepare them for fellowship. The group also preferred shorter lectures and streaming via video education/tutorials. CONCLUSION: While traditional instruction emphasizes image interpretation, trainees in pediatric radiology need a curriculum that also emphasizes technical and non-interpretive aspects of MRI.

Whole-body magnetic resonance imaging in the evaluation of children with fever without a focus.

BACKGROUND: Fever without a focus is defined as a temperature of 38° C or higher as the single presenting symptom. After extensive investigation, a large percentage (12-67%) of cases remain undiagnosed. OBJECTIVE: To assess the diagnostic value of whole-body magnetic resonance imaging (WB-MRI) in children with fever without a focus. MATERIALS AND METHODS: A retrospective study was performed to identify children who underwent WB-MRI for fever without a focus. Ninety-two children, 50 boys, with a mean age of 6.1 years were included. A multidisciplinary team of physicians completed in consensus a medical record review that included: 1) immune status, 2) underlying chronic conditions, 3) hospitalization status at onset of fever, and 4) results of tissue, body fluid cultures and biopsies. Original MRI reports were evaluated. WB-MRI studies were categorized into helpful WB-MRI and not helpful WB-MRI. RESULTS: A final diagnosis for the cause of the fever was available for 68/92 cases (73.9%), which were determined to be infectious in 33/68 (48.5%), oncological in 3/68 (4.4%), rheumatological etiologies in 23/68 (33.8%) and miscellaneous in 9/68 (13.2%) cases. WB-MRI was found to be helpful in 62/92 cases (67.4%) and not helpful in 30/92 cases (32.6%). WB-MRI was 10.2 times less likely to be helpful in immunosuppressed children and almost 5.7 times less likely to be helpful in cases of prolonged fever (>3 weeks) at the time of MRI (P≤0.01). CONCLUSION: WB-MRI provides helpful information in approximately 2/3 of children with fever without a focus. In most cases, it was helpful to exclude the need of further investigation.

Development of Computational Approaches with a Fragment-Based Drug Design Strategy: In Silico Hsp90 Inhibitors Discovery.

A semi-exhaustive approach and a heuristic search algorithm use a fragment-based drug design (FBDD) strategy for designing new inhibitors in an in silico process. A deconstruction reconstruction process uses a set of known Hsp90 ligands for generating new ones. The deconstruction process consists of cutting off a known ligand in fragments. The reconstruction process consists of coupling fragments to develop a new set of ligands. For evaluating the approaches, we compare the binding energy of the new ligands with the known ligands.

Chemical speciation of selected toxic metals and multivariate statistical techniques used to assess water quality of tropical Mexican Lake Chapala.

Mexican Lake Chapala is used as water supply for human consumption. Consequently, water quality of this lake is of paramount importance for the lake's wellbeing. The contribution presented in this paper investigates monitoring and assessment of lake water quality using water quality index (WQI), metal chemical speciation, and multivariate statistical techniques. Descriptive statistics shows total metal concentrations undetected conferring the lake a healthy status. Dissolved Cd and Pb exceed criterion continuous concentration limit, whereas Zn is below this limit indicating that water quality is satisfactory for aquatic life. However, WQI indicates poor water quality attributed to failure of conductivity, total solids, nitrogen, and phosphates, due to industrial and agro-industrial effluents. Metal speciations indicate that the presence of low concentrations of dissolved metals reflect interactions with gills of fish through metal-biotic ligand complexes affecting water quality. Positive correlations are obtained between conductivity and nitrates, indicating that agricultural activities and fertilizer runoffs increase the conductivity and that the environmental state of lake is being altered by human activities. Factors F1 (31%), F2 (19%), and F3 (11%) represent 61% of variability; F1 and F2 corroborate the pressure exerted by pollutants related with fertilizers and agrochemicals; F3 contains Zn and Pb with positive loads attributed to influx of tourist visitors. Sites S4, S5, S6, and S9 are identified as the most environmentally affected by COD, Alk*, pH, Cl-, nitrites, phosphates, and TS. Multivariate techniques permit to conclude that environmental stress of Lake Chapala is caused by variables pertaining to agrochemical, fertilizers and municipal wastes.

Imaging Biomarkers of the Physis: Cartilage Volume on MRI vs. Tract Volume and Length on Diffusion Tensor Imaging.

BACKGROUND: Current methods to predict height and growth failure are imprecise. MRI measures of physeal cartilage are promising biomarkers for growth. PURPOSE: In the physis, to assess how 3D MRI volume measurements, and diffusion tensor imaging (DTI) measurements (tract volume and length) correlate with growth parameters and detect differences in growth. We compared patients exposed to cis-retinoic acid, which causes physeal damage and growth failure, with normal subjects. STUDY TYPE: Case-control. POPULATION: Twenty pediatric neuroblastoma survivors treated with cis-retinoic acid and 20 age- and sex-matched controls. FIELD STRENGTH/SEQUENCE: 3T; DTI and 3D double-echo steady-state (DESS) sequences. ASSESSMENT: On distal femoral MR studies, physeal 3D volume and DTI tract measurements were calculated and compared to height. STATISTICAL TESTS: We used partial Spearman correlation, analysis of covariance, logistic regression, Wald test, and the intraclass correlation coefficient (ICC). RESULTS: The height percentile correlated most strongly with DTI tract volumes (r = 0.74), followed by mean tract length (r = 0.53) and 3D volume (r = 0.40) (all P < 0.02). Only tract volumes and lengths correlated with annualized growth velocity. Relative to controls, patients showed smaller tract volumes (8.00 cc vs. 13.71 cc, P < 0.01), shorter tract lengths (5.92 mm vs 6.99 mm, P = 0.03), and smaller ratios of 3D cartilage volume to tract length; but no difference (4.51 cc vs 4.85 cc) in 3D MRI volumes. The 10 patients with the lowest height percentiles had smaller tract volumes (5.07 cc vs. 10.93 cc, P < 0.01), but not significantly different 3D MRI volumes. Tract volume is associated with abnormal growth, with an accuracy of 75%. DATA CONCLUSION: DTI tract volume of the physis/metaphysis predicts abnormal growth better than physeal cartilage volumetric measurement and correlates best with height percentile and growth velocity. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2 J. Magn. Reson. Imaging 2020;52:544-551.

Diagnostic performance and role of the contrast enema for low intestinal obstruction in neonates.

PURPOSE: We aim to evaluate the diagnostic performance and relationship between clinical characteristics, imaging findings, and final diagnosis for the neonatal contrast enema (CE). METHODS: Retrospective 10-year review of all neonatal CEs including imaging findings, clinical information, indication, and final diagnosis from discharge summaries, surgical reports, and pathology (reference standard). Two blinded pediatric radiologists reinterpreted 366 CEs for obstruction, microcolon, rectosigmoid index (RSI), serrations, meconium, ileal cut-off, transition zone, diagnosis, and level of confidence. CE diagnostic performance was calculated versus reference standard. RESULTS: Diagnoses included Hirschsprung disease (HD) (15.8%), small left colon syndrome (14.8%), small intestinal atresia/colonic atresia (SIA/CA) (12.6%), meconium ileus (MI) (4.4%), and normal (48.9%). CE had a moderate specificity (87.7%) and low sensitivity (65.5%) for HD; abnormal RSI and serrations showed high specificities (90.3%, 97.4%) but low sensitivities (46.6%, 17.2%). CE showed high specificity (97.4%) and low sensitivity (56.3%) for MI blinded to cystic fibrosis status. Microcolon was specific (96.6%) but not sensitive (68.8%) for MI. CE showed highest PPV (73.1%) (specificity 95.6%, sensitivity 82.6%) for SIA/CA. Microcolon with an abrupt cut-off was specific (99.1%) but not sensitive (41.3%) for atresias. CONCLUSION: Neonatal CE demonstrates high specificities and low to moderate sensitivities across all diagnoses, with lowest performance in HD. CLINICAL TRIAL REGISTRATION: None.

Epidemiology of Acute Pancreatitis in Southern Israel: A Retrospective Study.

BACKGROUND: There is a lack of information regarding acute pancreatitis in Israel. However, the most prevalent worldwide etiologic causes of acute pancreatitis are biliary stones and alcohol abuse. OBJECTIVES: To delineate the prevalence, main causes, rate of recurrence, mortality, and complications of acute pancreatitis in southern Israel. METHODS: In this retrospective study medical files of all hospitalized patients diagnosed with acute pancreatitis during a 13-year period were reviewed. RESULTS: The study comprised 602 patients with acute pancreatitis (120/100,000 patients or 1.2/1000 admissions). The main causes were: biliary stones (41.5%), alcohol (8.8%), and drugs (8.3%). Disothiazide was the most common drug associated with acute pancreatitis followed by sitagliptin, angiotensin converting enzyme (ACE) inhibitors, and simvastatin. Undetermined etiology made up 33.6% of the cases. Recurrence rate was 33.8% (alcohol 3.7%, hypertriglyceridemia 1.8%). This finding had no implications on mortality rate, which was stable at 4.3%. Bilateral pleural effusion, advanced computed tomography severity index (CTSI) grading, older age, and being single were found to be poor prognostic predictive factors. CONCLUSIONS: Biliary pancreatitis is the main cause of acute pancreatitis in southern Israel, similar to the rest of the world, and constitutes a much more common etiology than alcohol. Furthermore, drug-induced pancreatitis is a common etiology, with disothiazide being the most common drug associated with pancreatitis followed by ACE-Inhibitors, sitagliptin, and simvastatin. Recurrence of pancreatitis is common in this geographic area, and older age, advanced CTSI grading, bilateral pleural effusion, and being single are all poor prognostic predictive factors.