Effects of acute and chronic methylphenidate on prepulse inhibition: A sex difference study in Wistar rats.

BACKGROUND: The utilization of methylphenidate (MPH) is experiencing a notable surge within the adult population. This growth can be attributed to two key factors: its recreational and cognitive enhancement purposes, as well as the rising prevalence of ADHD diagnoses within this population. This study examined acute and chronic oral MPH effects on attention in male and female Wistar rats. To this end, we used a prepulse inhibition (PPI) task, which is widely used to assess psychoactive drug effects in both humans and rodents. This task allowed us to evaluate changes in attention by analyzing sensorimotor gating associated with stimulus selection process. METHODS: Animals were administered a clinically relevant dose of MPH (5 mg/kg) daily for seven days. The estrous cycle phases of the female rats were measured during behavioral sessions. The PPI task was conducted 20 min after drug administration on day 1 (acute), day 7 (chronic), and 48 h post-treatment. RESULTS: Results indicated that both acute and chronic MPH treatment impaired PPI expression in male rats, but not in female rats, regardless of their estrous cycle phase. Furthermore, a differential effect of chronic MPH treatment on the PPI task was found in male rats. Specifically, on the seventh treatment day, the PPI effect was observed when animals undertook the PPI task for the first time but was impaired in those animals in which the initial PPI session occurred under the acute influence of the drug (day 1). CONCLUSIONS: These findings suggest that the impact of MPH on sensorimotor gating responses may vary based on sex and task experience, possibly leading to state-dependent effects in healthy individuals.

Manejo del «dolor de piedra» entre los siglos xviii y xix: breve historia de una receta médica del Virreinato en la Nueva Granada / Management of “stone pain” between the 18th and 19th centuries: A brief history of a medical prescription in the Viceroyalty of New Granada

Introducción: La presencia de cálculos en el tracto urinario es una afección que acompaña al ser humano desde la antigüedad. En la época colonial, esta se denominaba «dolor de piedra» y su manejo no quirúrgico se basaba en el uso de medicinas de origen vegetal, animal o mineral.ObjetivoContextualizar una receta médica que data del siglo xviii en el Nuevo Reino de Granada, utilizada para modular el dolor de piedra. Adicionalmente, analizar sus componentes para evaluar el fundamento de sus posibles efectos fitoterapéuticos sobre la enfermedad y el dolor.Material y métodoBúsqueda documental en el Archivo Histórico Cipriano Rodríguez Santamaría de la Biblioteca Octavio Arizmendi Posada de la Universidad de La Sabana. Se analizó el documento denominado «Receta para el dolor de piedra de la vejiga o riñones». Posteriormente, se realizó una revisión de la literatura científica actual y textos originales, sin límite de tiempo.ResultadosLa transcripción del documento fuente reveló diversos agentes fitoterapéuticos como la Manzanilla (Matricaria recutita), la azucena (Lilium lancifolium), el trébol (Trifolium pratense) y raíces de malva (Malva sylvestris), acompañados para su consumo de gran cantidad de agua. (AU)

Introduction: The presence of stones in the urinary tract is a condition that has accompanied humans since ancient times. In colonial times, this condition was known as “stone pain” and its non-surgical management was based on the use of medicines derived from plants, animals and minerals.ObjectiveTo contextualize a medical prescription used to modulate stone pain in the 18th century in the New Kingdom of Granada. Additionally, to analyze its components and evaluate the basis of its possible phytotherapeutic effects on the disease and pain.Material and methodDocument search in the Cipriano Rodríguez Santamaría Historical Archive of the Octavio Arizmendi Posada Library at Universidad de La Sabana. The document entitled “Prescription for bladder or kidney stone pain” was analyzed, and a complementary review of current scientific literature and original texts was performed with no time limits, in order to compare this prescription to related findings in the history of medicine.ResultsThe transcription of the source document revealed several phytotherapeutic agents such as chamomile (Matricaria recutita), lilies (Lilium lancifolium), clover (Trifolium pratense), and mallow roots (Malva sylvestris), accompanied by a large amounts of water.ConclusionsThere is scientific evidence that could explain the anti-inflammatory and antioxidant effects of all plant-derived medicines used in this prescription. Abundant water intake to increase urine volume was an essential part of treatment. However, the lack of more precise data related to the prescription and the evolution of the patients makes it difficult to analyze its therapeutic efficacy. (AU)

Una mirada histórica a la menstruación a través de una receta médica del siglo xix en el Nuevo Reino de Granada / A historical look at menstruation through a 19th century medical prescription in the New Kingdom of Granada

La menstruación ha tenido diferentes significados en diversas culturas a lo largo de la historia. Desde Regnier de Graaf en el siglo xvii hasta la fecha, pasando por la médica norteamericana Mary Putnam Jacobi a finales del sigloxix, un buen número de pioneros científicos estudiaron el sistema reproductor femenino con el fin de entender la fisiología del ciclo menstrual. En el Nuevo Reino de Granada, durante los siglos xviii yxix, se desarrolló por parte de médicos y boticarios una receta médica a base de agentes herbarios y de origen animal con el fin de regular el ciclo menstrual, disminuyendo de esta forma síntomas asociados a esta condición para evitar el estigma sociocultural que esta condición implicaba para la mujer en aquel entonces. Esta receta se encuentra en la actualidad consignada en el archivo histórico Cipriano Rodríguez Santamaría en la biblioteca Octavio Arizmendi Posada de la Universidad de La Sabana en Chía, Colombia. La redacción y autoría de esta receta no es del todo clara, y su uso se basa eventualmente en la experiencia y observación de quienes en esa época la utilizaron, sin bases científicas para respaldar su eventual efecto modulador y terapéutico.(AU)

Menstruation has had different meanings in various cultures throughout history. From Regnier de Graaf in the 17th century to the American physician Mary Putnam Jacobi in the late 19th century, a number of pioneering scientists have studied the female reproductive system in order to understand the physiology of the menstrual cycle. In the New Kingdom of Granada, during the eighteenth and nineteenth centuries, doctors and apothecaries developed a medical prescription based on herbal and animal products in order to regulate the menstrual cycle. In this way the symptoms associated with this condition were reduced in order to avoid the socio-cultural stigma that it implied for women at that time. This prescription is currently stored in the Cipriano Rodríguez Santamaría Historical Archives at the Octavio Arizmendi Posada Library at La Sabana University in Colombia, South America. The writing and authorship of this prescription is not entirely clear, and its use is based on the experience and observation of those who used it at that time, with no scientific basis to support its eventual modulating and therapeutic effect.(AU)

Management of "stone pain" between the 18th and 19th centuries: A brief history of a medical prescription in the Viceroyalty of New Granada.

INTRODUCTION: The presence of stones in the urinary tract is a condition that has accompanied humans since ancient times. In colonial times, this condition was known as "stone pain" and its non-surgical management was based on the use of medicines derived from plants, animals and minerals. OBJECTIVE: To contextualize a medical prescription used to modulate stone pain in the 18th century in the New Kingdom of Granada. Additionally, to analyze its components and evaluate the basis of its possible phytotherapeutic effects on the disease and pain. MATERIAL AND METHOD: Document search in the Cipriano Rodríguez Santamaría Historical Archive of the Octavio Arizmendi Posada Library at Universidad de La Sabana. The document entitled "Prescription for bladder or kidney stone pain" was analyzed, and a complementary review of current scientific literature and original texts was performed with no time limits, in order to compare this prescription to related findings in the history of medicine. RESULTS: The transcription of the source document revealed several phytotherapeutic agents such as chamomile (Matricaria recutita), lilies (Lilium lancifolium), clover (Trifolium pratense), and mallow roots (Malva sylvestris), accompanied by a large amounts of water. CONCLUSIONS: There is scientific evidence that could explain the anti-inflammatory and antioxidant effects of all plant-derived medicines used in this prescription. Abundant water intake to increase urine volume was an essential part of treatment. However, the lack of more precise data related to the prescription and the evolution of the patients makes it difficult to analyze its therapeutic efficacy.

Investigación médico-antropológica documental: prescripciones enfocadas al manejo del dolor / Medical-anthropological research: prescriptions focused on pain management

Introducción: Las recetas médicas o prescripciones históricas en el territorio de la Nueva Granada (hoy Colombia) revelan la evolución del manejo de la enfermedad en función de los efectos benéficos de administrar algún tipo de agente medicinal de origen vegetal, animal o mineral. Objetivo: Describir el tratamiento del reumatismo en los siglos XVIII y XIX, con base en dos recetas médicas de la época con base en la fundamentación contemporánea de su interacción fisiológica. Materiales y métodos: Búsqueda documental en el archivo Histórico de la Biblioteca Octavio Arizmendi Posada de la Universidad de La Sabana, donde se encontraron las recetas tituladas "Reumatismo" y "Rehumas". Resultados: Se describen cuatro clases de tratamientos para las enfermedades reumáticas utilizados en los siglos XVIII y XIX y orientados principalmente a la disminución del dolor. Este artículo presenta las bases fisiológicas de estos tratamientos, y cómo pudieron o no haber tenido algún efecto calmante al examinar su fisiología. Conclusiones: Estos medicamentos coloniales neogranadinos no ameritan su uso en el contexto actual de la medicina, pero pudieron representar una ayuda terapéutica en su momento.

Introduction: the medical prescriptions or historical prescriptions in the territory of New Granada (present-day Colombia) reveal the evolution of disease management given the beneficial effects of administering some type of medicinal agent of plant, animal or mineral origin. Objective: To describe the treatment of rheumatism in the 18th and 19th centuries based on two medical prescriptions of the time based on the contemporary rationale of their physiological interactions. Materials and methods: Documentary search in the Historical Archive of the Octavio Arizmendi Posada Library at Universidad de La Sabana in Colombia, where the prescriptions entitled "Reumatismo" and "Rehuma" were found. Results: Four classes of treatments for rheumatic diseases used in the 18th and 19th centuries and mainly oriented to pain reduction are described. This article presents the physiological basis of these treatments, and how they may or may not have had some calming effect when examining their physiology. Conclusions: These Neogranadian colonial drugs do not deserve their use in the current context of medicine, but they may have represented a therapeutic aid at the time.

SciPy 1.0: fundamental algorithms for scientific computing in Python.

SciPy is an open-source scientific computing library for the Python programming language. Since its initial release in 2001, SciPy has become a de facto standard for leveraging scientific algorithms in Python, with over 600 unique code contributors, thousands of dependent packages, over 100,000 dependent repositories and millions of downloads per year. In this work, we provide an overview of the capabilities and development practices of SciPy 1.0 and highlight some recent technical developments.

Author Correction: SciPy 1.0: fundamental algorithms for scientific computing in Python.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Prevalencia de infecciones osteoarticulares por enterobacterias productoras de ß-lactamasas de espectro extendido / Prevalence of osteoarticular infections by Enterobacteria producing extended-spectrum ß-lactamases

Resumen: Introducción: Las infecciones por enterobacterias productoras de β-lactamasas de espectro extendido (BLEEs) ocasionan una gran carga a los sistemas de salud. Poco se conoce de las infecciones osteoarticulares, por lo que este trabajo estudió la prevalencia de estas infecciones en un hospital de tercer nivel. Material y métodos: Estudio de prevalencia en pacientes de un servicio de traumatología durante 2016, con criterios de infección proporcionados por el CDC de Atlanta, Georgia. Se utilizó el sistema VITEK® 2 AST-N272 (bioMérieux) para la identificación bacteriana a nivel de especie y para las pruebas de susceptibilidad antimicrobiana. Resultados: Se reportaron 7.85% (n = 86) con infecciones osteoarticulares; 22.09% (n = 19) fueron por enterobacterias BLEEs. Con un promedio de 77.1 días de hospitalización (DE 37.7) (46-200 días); el aislamiento del microorganismo se produjo 15 días posteriores al ingreso; 16 (84.2%) pacientes presentaron osteomielitis, tres (15.8%) tuvieron infección protésica de rodilla o cadera. El promedio de días de tratamiento fue de 60 días (21-129 días); 18 pacientes (94.7%) fueron dados de alta con resolución de su cuadro infeccioso; un paciente falleció con infección sobreagregada por neumonía debida a K. pneumoniae resistente a carbapenémicos. Discusión: La prevalencia de infecciones osteoarticulares por enterobacterias BLEEs no se pudo calcular con precisión, pero consideramos que se encuentra dentro de lo esperado, las medidas de control de infecciones requieren tener estándares más elevados y falta desarrollar programas de uso racional de antimicrobianos para controlar la aparición de estas patologías.

Abstract: Introduction: Infections of enterobacteria producing extended-spectrum ß-lactamases place a heavy burden on health systems. Little is known in osteoarticular infections, so this work studied the prevalence of these infections in a third-level hospital. Material and methods: Prevalence study in patients of a Traumatology Service during 2016, with infection criteria provided by the CDC in Atlanta, Georgia. The VITEK® 2 AST-N272 (bioMérieux) system was used for bacterial identification at the species level and for antimicrobial susceptibility tests. Results: 7.85% (n = 86) were reported with osteoarticular infections; 22.09% (n = 19) were by enterobacteria BLEEs. An average of 77.1 days of hospitalization (SD 37.7) (46-200 days); isolation of the microorganism occurred 15 days after entry. Sixteen (84.2%) patients had osteomyelitis, three (15.8%) had a prosthetic knee or hip infection. The average number of treatment days was 60 days (21-129 days). Eighteen patients (94.7%) were discharged with resolution of their infectious picture; one patient died with infection over aggregated pneumonia due to carbapenem-resistant K. pneumoniae. Discussion: The prevalence of osteoarticular infections by enterobacteria BLEEs could not be accurately calculated, but we consider it to be within what is expected, infection control measures require higher standards and there is a lack of development programs to use antimicrobials rationally to control the emergence of these pathologies.

[Prevalence of osteoarticular infections by Enterobacteria producing extended-spectrum -lactamases]. / Prevalencia de infecciones osteoarticulares por enterobacterias productoras de -lactamasas de espectro extendido.

INTRODUCTION: Infections of enterobacteria producing extended-spectrum -lactamases place a heavy burden on health systems. Little is known in osteoarticular infections, so this work studied the prevalence of these infections in a third-level hospital. MATERIAL AND METHODS: Prevalence study in patients of a Traumatology Service during 2016, with infection criteria provided by the CDC in Atlanta, Georgia. The VITEK® 2 AST-N272 (bioMérieux) system was used for bacterial identification at the species level and for antimicrobial susceptibility tests. RESULTS: 7.85% (n = 86) were reported with osteoarticular infections; 22.09% (n = 19) were by enterobacteria BLEEs. An average of 77.1 days of hospitalization (SD 37.7) (46-200 days); isolation of the microorganism occurred 15 days after entry. Sixteen (84.2%) patients had osteomyelitis, three (15.8%) had a prosthetic knee or hip infection. The average number of treatment days was 60 days (21-129 days). Eighteen patients (94.7%) were discharged with resolution of their infectious picture; one patient died with infection over aggregated pneumonia due to carbapenem-resistant K. pneumoniae. DISCUSSION: The prevalence of osteoarticular infections by enterobacteria BLEEs could not be accurately calculated, but we consider it to be within what is expected, infection control measures require higher standards and there is a lack of development programs to use antimicrobials rationally to control the emergence of these pathologies.

INTRODUCCIÓN: Las infecciones por enterobacterias productoras de -lactamasas de espectro extendido (BLEEs) ocasionan una gran carga a los sistemas de salud. Poco se conoce de las infecciones osteoarticulares, por lo que este trabajo estudió la prevalencia de estas infecciones en un hospital de tercer nivel. MATERIAL Y MÉTODOS: Estudio de prevalencia en pacientes de un servicio de traumatología durante 2016, con criterios de infección proporcionados por el CDC de Atlanta, Georgia. Se utilizó el sistema VITEK® 2 AST-N272 (bioMérieux) para la identificación bacteriana a nivel de especie y para las pruebas de susceptibilidad antimicrobiana. RESULTADOS: Se reportaron 7.85% (n = 86) con infecciones osteoarticulares; 22.09% (n = 19) fueron por enterobacterias BLEEs. Con un promedio de 77.1 días de hospitalización (DE 37.7) (46-200 días); el aislamiento del microorganismo se produjo 15 días posteriores al ingreso; 16 (84.2%) pacientes presentaron osteomielitis, tres (15.8%) tuvieron infección protésica de rodilla o cadera. El promedio de días de tratamiento fue de 60 días (21-129 días); 18 pacientes (94.7%) fueron dados de alta con resolución de su cuadro infeccioso; un paciente falleció con infección sobreagregada por neumonía debida a K. pneumoniae resistente a carbapenémicos. DISCUSIÓN: La prevalencia de infecciones osteoarticulares por enterobacterias BLEEs no se pudo calcular con precisión, pero consideramos que se encuentra dentro de lo esperado, las medidas de control de infecciones requieren tener estándares más elevados y falta desarrollar programas de uso racional de antimicrobianos para controlar la aparición de estas patologías.

An instrument to measure mechanical up-conversion phenomena in metals in the elastic regime.

Crystalline materials, such as metals, are known to exhibit deviation from a simple linear relation between strain and stress when the latter exceeds the yield stress. In addition, it has been shown that metals respond to varying external stress in a discontinuous way in this regime, exhibiting discrete releases of energy. This crackling noise has been extensively studied both experimentally and theoretically when the metals are operating in the plastic regime. In our study, we focus on the behavior of metals in the elastic regime, where the stresses are well below the yield stress. We describe an instrument that aims to characterize non-linear mechanical noise in metals when stressed in the elastic regime. In macroscopic systems, this phenomenon is expected to manifest as a non-stationary noise modulated by external disturbances applied to the material, a form of mechanical up-conversion of noise. The main motivation for this work is for the case of maraging steel components (cantilevers and wires) in the suspension systems of terrestrial gravitational wave detectors. Such instruments are planned to reach very ambitious displacement sensitivities, and therefore mechanical noise in the cantilevers could prove to be a limiting factor for the detectors' final sensitivities, mainly due to non-linear up-conversion of low frequency residual seismic motion to the frequencies of interest for the gravitational wave observations. We describe here the experimental setup, with a target sensitivity of 10(-15) m/Hz in the frequency range of 10-1000 Hz, a simple phenomenological model of the non-linear mechanical noise, and the analysis method that is inspired by this model.

Systematic review with meta-analysis: the incidence of advanced neoplasia after polypectomy in patients with and without low-risk adenomas.

BACKGROUND: Patients with one to two tubular adenomas <1 cm in size without high-grade dysplasia (low-risk group) are considered at low risk for colorectal cancer. However, it is uncertain whether they have the same risk of subsequent advanced neoplasia as those with no neoplasia at baseline colonoscopy. AIM: To compare incidence of metachronous advanced neoplasia between patients in the low-risk adenoma group and those without neoplasia at index colonoscopy. METHODS: Relevant publications were identified by MEDLINE/EMBASE and other databases for the period 1992-2013. Studies comparing the incidence of post-polypectomy advanced neoplasia (adenomas ≥10 mm/high-grade dysplasia/villous or cancer) between the low-risk group and patients without colorectal neoplasia at the first colonoscopy were included. Detection rates for advanced neoplasia at endoscopic surveillance were extracted. Study quality was ascertained according to Newcastle-Ottawa Scale. Forest plot was produced based on random-effect models. Inter-study heterogeneity was assessed using the I(2) statistic. RESULTS: Seven studies provided data on 11 387 patients. Mean surveillance periods ranged between 2 and 5 years. Altogether, 267 patients with post-polypectomy advanced neoplasia were detected in the two groups. The incidence of advanced neoplasia was 1.6% (119/7308) in those without neoplasia and 3.6% (148/4079) in those with low-risk adenoma, respectively, corresponding to a relative risk of 1.8 (95% CI: 1.3-2.6). Inter-study heterogeneity was only moderate (I(2) : 37%). No publication bias was present. CONCLUSIONS: Patients with low-risk adenomas at baseline had a higher risk of metachronous advanced neoplasia than the group with no adenomas at baseline, though the absolute risk was low in both groups.

Effect of oral anticoagulants on the outcome of faecal immunochemical test.

BACKGROUND: We aimed to evaluate whether oral anticoagulants (OACs) alter faecal immunochemical test (FIT) performance in average-risk colorectal cancer (CRC) screening. METHODS: Individuals aged 50-69 years were invited to receive one FIT sample (cutoff 75 ng ml(-1)) between November 2008 and June 2011. RESULTS: Faecal immunochemical test was positive in 9.3% (21 out of 224) of users of OAC and 6.2% (365 out of 5821) of non-users (P-trend=0.07). The positive predictive value (PPV) for advanced neoplasia (AN) in non-users was 50.4% vs 47.6% in users (odds ratio, 0.70; 95% CI, 0.3-1.8; P=0.5). The PPV for AN in OAC more antiplatelets (aspirin or clopidogrel) was 75% (odds ratio, 2; 95% CI, 0.4-10.8; P=0.4). CONCLUSIONS: Oral anticoagulant did not significantly modify the PPV for AN in this population-based colorectal screening program. The detection rate of advanced adenoma was higher in the combination OAC more antiplatelets.

Terapia de la risa en un grupo de mujeres adultas / Laughter therapy in a group of elderly women

Objetivo: explorar los beneficios de la terapia de la risa en un grupo de mujeres adultas pertenecientes a un centro gerontológico del Municipio de Envigado (Colombia). Metodología: estudio con enfoque cualitativo mediante entrevista semiestructurada a 10 adultas entre 59 y 97 años de edad, antes y después de la aplicación de 5 sesiones, una semanal, de terapia de la risa por parte del grupo Mediclaun ôpayasos hospitalariosõ. Resultados: muchos de los cambios percibidos en las adultas coinciden con la literatura en lo que respecta a una actitud más positiva, incremento de la confianza en el otro y la aceptación; expresan el pasado con menos dolor y un mayor agrado frente al acompañamiento familiar. Conclusiones: La terapia de la risa permite al adulto mayor encontrar fortalezas que puedan ayudarle a mejorar su presente, a su vez, lograr cambios en el individuo que se le revierten positivamente y a su relación con el entorno...

Objective: to explore the benefits of laughter therapy in a group of elderly women belonging to a gerontology center (Envigado, Colombia). Methodology: a qualitative study using a semi-structured interview with 10 adult women aged 59 to 97. The participants were interviewed before and after applying 5 weekly sessions of laughter therapy. Said therapy was administered by the Mediclaun "hospital clowns" group. Results: many of the changes observed in adult women are consistent with the results described in the literature in relation to a more positive attitude, increased confidence in people and acceptance; the participants expressed the past with less pain and had a greater liking towards family support. Conclusions: laughter therapy allows seniors to find the strength to improve their present situation, thus causing positive changes in their own self and in their relationship with their surroundings...

Different effects of unexpected changes in environmental conditions on prepulse inhibition in rats and humans.

The reduction of the startle response to an auditory stimulus caused by the presentation of another stimulus of lower intensity closely preceding it, a phenomenon known as prepulse inhibition (PPI), can be modulated by changes in dopaminergic activity. Schmajuk, Larrauri, De la Casa, and Levin (2009) demonstrated that this dopaminergic modulation of PPI in rats can be influenced by manipulating the experimental context, specifically by introducing changes in the ambient lighting condition that include novel elements. In this paper we analyze the effects of introducing changes in context illumination on PPI in male rats (Experiment 1) and humans (Experiment 2). The results with rats showed a reduction of PPI when the illumination condition switched from dark to light, but not from light to dark. In the experiment with human participants the reduction of PPI occurred for both changes in illumination conditions. The animal experiment results are interpreted in terms of competing exploratory behavior that appear when the context is illuminated after the dark-light transition; while in the case of human participants a perceptual and/or attentional mechanism after both illumination transitions is proposed, which may result in a reduced processing of the prepulse and subsequent lower PPI.

Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.

PillCam colon capsule endoscopy (CCE) is an innovative noninvasive, and painless ingestible capsule technique that allows exploration of the colon without the need for sedation and gas insufflation. Although it is already available in European and other countries, the clinical indications for CCE as well as the reporting and work-up of detected findings have not yet been standardized. The aim of this evidence-based and consensus-based guideline, commissioned by the European Society of Gastrointestinal Endoscopy (ESGE) is to furnish healthcare providers with a comprehensive framework for potential implementation of this technique in a clinical setting.

Clinical validation of the European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE) II criteria in an open-access unit: a prospective study.

BACKGROUND AND STUDY AIMS: The European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE I) criteria were recently updated (EPAGE II), but no prospective studies have used these criteria in clinical practice. The aim of the current study was to validate the EPAGE II criteria in an open-access endoscopy unit. PATIENTS AND METHODS: A prospective observational study was conducted in an open-access endoscopy unit at a tertiary care referral center. Consecutive outpatients (n = 1004; mean age 58.9 ±â€†13.1 years; 45 % men) were referred for diagnostic colonoscopy between September 2009 and February 2010. The appropriateness of colonoscopy was assessed based on EPAGE II criteria, and the relationship between appropriateness and both referral doctor and detection of significant lesions was examined. The effectiveness of EPAGE II criteria in assessing appropriateness was measured by means of sensitivity, specificity, and positive and negative predictive values for detecting significant lesions. RESULTS: Colonoscopic cecal intubation was achieved in 956 patients (95.2 %). Most referral doctors were gastroenterologists (58.0 %) and the most common indication was colorectal cancer (CRC) screening (35.2 %). EPAGE II criteria were applicable in 968 patients (96.4 %); of these patients, the indication was appropriate in 778 (80.4 %), inappropriate in 102 (10.5 %), and uncertain in 88 (9.1 %). Patients with appropriate or uncertain indications based on EPAGE II criteria had more relevant endoscopic findings than those with inappropriate indications (38.8 % vs. 24.5 %; OR 1.95, 95 %CI 1.22 - 3.13; P < 0.005). Sensitivity and negative predictive value of EPAGE II criteria for detecting significant lesions were 93.1 % (95 %CI 90 % - 96 %) and 75.5 % (95 %CI 67 % - 84 %), respectively, whereas for advanced neoplastic lesions these values were 98.0 % (95 %CI 95 % - 100 %) and 98.0 % (95 % CI 95 % - 100 %), respectively. Adherence to EPAGE II recommendations was an independent predictor of finding a significant lesion (OR 1.93, 95 %CI 1.20 - 3.11; P = 0.007). CONCLUSIONS: EPAGE II is a simple, valid score for detecting inappropriate colonoscopies in clinical practice.

Public awareness of colorectal cancer and screening in a Spanish population.

OBJECTIVES: To investigate screening intentions and previous uptake of colorectal cancer (CRC) screening tests in a general population in Spain; and to determine knowledge about CRC, risk perceptions, major barriers to screening and perceived benefits of screening. STUDY DESIGN: Cross-sectional study. METHODS: Six hundred consecutive Spanish individuals over 50 years of age completed a questionnaire to determine their screening intentions, previous CRC diagnostic procedures, and knowledge about screening procedures, risk factors for CRC, 5-year prognosis, warning signs and symptoms, incidence, age-related risk and perceived barriers to screening. RESULTS: Although 78.8% of subjects reported that they were willing to participate in CRC screening, only 12% had ever undergone a screening test, and none with screening intention. Awareness of a breast cancer screening test [odds ratio (OR) 1.67, 95% confidence interval (CI) 1.04-2.70; P = 0.035], visiting a general practitioner in the preceding year (OR 3.08, 95% CI 1.86-5.08; P < 0.0001), awareness of risk factors (OR 2.32, 95% CI 1.49-3.61; P < 0.001), awareness of CRC signs or symptoms (OR 1.65, 95% CI 1.03-2.64; P = 0.04) and belief in the efficacy of CRC screening (OR 8.85, 95% CI 1.53-51.3; P = 0.01) were independent predictors for intention to participate in CRC screening. The most common reasons given for refusing screening were 'CRC tests might be dangerous' (28.2%), 'CRC tests might be painful' (17.9%) and 'feeling healthy' (16.2%). CONCLUSION: Although reported willingness to undergo CRC screening was high, CRC knowledge and actual uptake of CRC screening were low. An educational intervention to reduce barriers and increase awareness could improve uptake of CRC screening.

The changing face of hospitalisation due to gastrointestinal bleeding and perforation.

BACKGROUND: Temporal changes in the incidence of cause-specific gastrointestinal (GI) complications may be one of the factors underlying changing medical practice patterns. AIM: To report temporal changes in the incidence of five major causes of specific gastrointestinal (GI) complication events. METHODOLOGY: Population-based study of patients hospitalised due to GI bleeding and perforation from 1996 to 2005 in Spain. We report crude rates, and estimate regression coefficients of temporal trends, severity and recorded drug use for five frequent GI events. GI hospitalisation charts were validated by independent review of large random samples. RESULTS: The incidence per 100 000 person-years of hospitalisations due to upper GI ulcer bleeding and perforation decreased over time [from 54.6 and 3.9 in 1996 (R² = 0.944) to 25.8 and 2.9 in 2005 (R² = 0.410) respectively]. On the contrary, the incidence per 100 000 person-years of colonic diverticular and angiodysplasia bleeding increased over time [3.3 and 0.9 in 1996 (R² = 0.443) and 8.0 and 2.6 in 2005 (R² = 0.715) respectively]. A small increasing trend was observed for the incidence per 100 000 person-years of intestinal perforations (from 1.5 to 2.3 events). Based on data extracted from the validation process, recent recorded drug intake showed an increased frequency of anticoagulants with colonic diverticular and angiodysplasia bleeding, whereas NSAID and low-dose aspirin use were more prevalent in peptic ulcer bleeding and colonic diverticular bleeding respectively. CONCLUSIONS: From 1996 to 2005, hospitalisations due to peptic ulcer bleeding and perforation have decreased significantly, whereas the number of cases of colonic diverticular and angiodysplasia bleeding have increased.

Effects of context novelty vs. familiarity on latent inhibition with a conditioned taste aversion procedure.

The latent inhibition phenomenon is observed when a conditioned stimulus is preexposed without any consequence before conditioning. The result of this manipulation is a reduction in conditioned response intensity to such a stimulus. In this study, we analyse the role of context novelty/familiarity on LI modulation by changing the context using a three-stage conditioned taste aversion procedure. Experiment 1 revealed that, similar to other learning procedures, a context change between preexposure and conditioning/testing (but not between preexposure/conditioning and testing) resulted in LI attenuation when the experimental contexts were novel. Experiment 2, using animals' home cages as one of the contexts, revealed a different pattern of results, with an unexpected increase in LI magnitude when the context change was introduced between conditioning and test stages. The Schmajuk et al. (1996) computational model explains these results in terms of the increased novelty of the conditioned stimulus during preexposure, conditioning, and testing.