Kudo's pit pattern classification for in vivo optical diagnosis and discrimination of advanced colorectal polyps.

OBJECTIVE: Colonoscopy is currently the basic diagnostic tool for the large intestine. The size of lesions assessed during the investigation is one criterion for assessing the risk of polyps transforming into colorectal cancer. The techno-logical development of endoscopes and the possibility of direct assessment of lesion's surface during the endoscopic examination and to use appropriate treatment. The aim of this study is to analyze the consistency between the histopathological assessment of high-risk lesions in colonoscopy and the determination according to Kudo's pit pattern classification. PATIENTS AND METHODS: The analysis included the results of colonoscopies performed over a 2-year period, in which polyps were diagnosed endoscopically and either polypectomies were performed, or sections were taken from these polyps and a pit pattern analysis was done according to Kudo's classification. RESULTS: A total of 1038 patients (age, 67.2 ± 12.7 years) were enrolled in the study. Of the 1981 samples taken in total, polyps larger than 1 cm were found in 96 cases, laterally spreading tumors (LSTs) were found in 48 cases, and macroscopic infiltration or tumors were found in 110 cases. The results of the histopathological examination were obtained in 248 cases. A value of 4 or higher in the Kudo classification turned out to be the best parameter to differentiate malignant lesions from benign ones for lesions larger than 1 cm and laterally spreading tumors, with a sensitivity of 91.2% and a specificity of 70.4%. CONCLUSIONS: The assessment of polyps according to Kudo's classification is a useful tool for assessing the malignancy of lesions as part of a routine colonoscopy.

Review: Quality of animal-source foods.

This article critically reviews the current state of knowledge on the quality of animal-source foods according to animal production and food processing conditions, including consumer expectations-behaviours and the effects of consumption of animal-source foods on human health. Quality has been defined through seven core attributes: safety, commercial, sensory, nutritional, technological, convenience, and image. Image covers ethical, cultural and environmental dimensions associated with the origin of the food and the way it is produced and processed. This framework enabled to highlight the priorities given to the different quality attributes. It also helped to identify potential antagonisms and synergies among quality attributes, between production and processing stages, and among stakeholders. Primacy is essentially given to commercial quality attributes, especially for standard commodity animal-source foods. This primacy has strongly influenced genetic selection and farming practices in all livestock commodity chains and enabled substantial quantitative gains, although at the expense of other quality traits. Focal issues are the destructuration of chicken muscle that compromises sensory, nutritional and image quality attributes, and the fate of males in the egg and dairy sectors, which have heavily specialised their animals. Quality can be gained but can also be lost throughout the farm-to-fork continuum. Our review highlights critical factors and periods throughout animal production and food processing routes, such as on-farm practices, notably animal feeding, preslaughter and slaughter phases, food processing techniques, and food formulation. It also reveals on-farm and processing factors that create antagonisms among quality attributes, such as the castration of male pigs, the substitution of marine-source feed by plant-based feed in fish, and the use of sodium nitrite in meat processing. These antagonisms require scientific data to identify trade-offs among quality attributes and/or solutions to help overcome these tensions. However, there are also food products that value synergies between quality attributes and between production and processing phases, particularly Geographical Indications, such as for cheese and dry-cured ham. Human epidemiological studies have found associations between consumption of animal-source foods and increased or decreased risk for chronic non-communicable diseases. These associations have informed public health recommendations. However, they have not yet considered animal production and food processing conditions. A concerted and collaborative effort is needed from scientists working in animal science, food process engineering, consumer science, human nutrition and epidemiology in order to address this research gap. Avenues for research and main options for policy action are discussed.