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Junk Pancreas: An Underappreciated Junction from the Metabolism Report and also Pancreatic Adenocarcinoma.
INTRODUCTION Constipation is a very common functional gastrointestinal disorder in the general population and can be primary or secondary. OBJECTIVE to estimate the anticholinergic burden of prescribed drugs in a population diagnosed with constipation in Colombia. METHODS This was a cross-sectional study that used a population database of 6,5 million people to identify the prescription of cholinergic antagonists and drugs for the management of constipation in outpatient services. The anticholinergic burden was evaluated using the Anticholinergic Drug Scale. Potentially inappropriate prescriptions that increased the risk of constipation were identified. RESULTS A total of 3887 patients with constipation were identified; the identified patients had a mean age of 54.4 ± 21.9 years, and 69.4% were women. Eighty percent received at least one laxative, and the most prescribed laxative was bisacodyl (50.5%). Forty-one percent (n=1586) of all patients received drugs with cholinergic antagonist activity, in particular codeine (6.5%) and valproic acid (6.5%). Being over 30 years of age (OR1.79; 95%CI1.24-2.57), being treated in the cities of Manizales (OR2.20; 95%CI1.50-3.21) or Pereira (OR1.49, 95%CI1.07-2.09) and having hypothyroidism as a comorbidity (OR1.37; 95%CI1.08-1.73) were associated with a greater probability of receiving medications with an anticholinergic burden of 3 or more points. CONCLUSIONS The majority of patients with constipation were women and were using laxatives to manage the constipation. A large proportion of patients were prescribed at least one cholinergic antagonist drug, with an increased probability of use after 30 years of age. © 2020 S. Karger AG, Basel.Accelerated MRI involves undersampling k-space, creating unwanted artifacts when reconstructing the data. While the strategy of incoherent k-space acquisition is proven for techniques such as compressed sensing, it may not be optimal for all techniques. This study compares the use of coherent low-resolution (coherent-LR) and incoherent undersampling phase-encoding for real-time 3D CNN image reconstruction. Data were acquired with our 3T Philips Achieva system. A retrospective analysis was performed on six non-small cell lung cancer patients who received dynamic acquisitions consisting of 650 free breathing images using a bSSFP sequence. We retrospectively undersampled the data by 5x and 10x acceleration using the two phase-encoding schemes. A quantitative analysis was conducted evaluating the tumor segmentations from the CNN reconstructed data using the Dice coefficient (DC) and centroid displacement. The reconstruction noise was evaluated using the structural similarity index (SSIM). Furthermore, we qualitaton was reduced. The reconstruction speed achieved for our current implementation was 54 ms, providing an acceptable frame rate for real-time on-the-fly MR imaging. © 2020 Institute of Physics and Engineering in Medicine.Prompt gamma (PG) imaging is investigated for spot-by-spot in-vivo range verification for proton therapy. Previous studies pointed out that the accuracy of PG is affected by the statistics of the beams and the conformity between PG and dose distribution (PG-dose correlation). Recently an approach to re-optimize treatment plans (TPs) by boosting selected pencil beams with good PG-dose correlation above the statistics limit was proposed. However, only PG-dose correlation on the planning computed tomography (CT) was considered regardless that the robustness of the PG-dose correlation is not guaranteed in the future. In this work, this approach is further explored in the case of interfractional anatomical changes. A Matlab-based Monte Carlo (MC) treatment planning system CERR is used. Geant4 is used to simulate the dose delivery and PG generation for all pencil beams in the patient anatomy using multiple CT images for representative patient cases. First, a MC TP is created using CERR. Thereby the PG emission and dose distribution for each spot is obtained. Second, PG-dose correlation is quantified using the originally proposed approach as well as a new indicator, which accounts for the sensitivity of individual spots to heterogeneities in the 3D dose distribution. This is accomplished by using a 2D distal surface (dose surcace) derived from the 3D dose distribution for each spot. A few pencil beams are selected, based on their PG-dose correlation and dose surface, and then boosted in the new re-optimized TP. All TPs are then re-calculated with MC on the CT scans of the corresponding patient at three different time points. The result shows that all TPs are comparable in terms of dose and dose averaged LET distributions. The spots recommended maintain good PG-dose correlation on the future CTs, thus ensuring reliable range verification. Comparison to another proposed spots aggregation approach is discussed. Creative Commons Attribution license.OBJECTIVE Evaluate electrochemical properties, biological response, and surface characterization of a conductive hydrogel (CH) coating following chronic in vivo stimulation. APPROACH Coated CH or uncoated smooth platinum (Pt) electrode arrays were implanted into the cochlea of rats and stimulated over a 5 week period with more than 57 million biphasic current pulses. Electrochemical impedance spectroscopy (EIS), charge storage capacity (CSC), charge injection limit (CIL), and voltage transient (VT) impedance were measured on the bench before and after stimulation, and in vivo during the stimulation program. Electrically-evoked auditory brainstem responses were recorded to monitor neural function. Following explant, the cochleae were examined histologically and electrodes were examined using scanning electron microscopy. MAIN RESULTS CH coated electrodes demonstrated a bench-top electrochemical advantage over Pt electrodes before and after the electrical stimulation program. Fluoxetine In vivo, CH coated electrodes also had a significant advantage over Pt electrodes throughout the stimulation program, exhibiting higher CSC (p = 0.002), larger CIL (p = 0.002), and lower VT impedance (p less then 0.001). The CH cohort exhibited a greater tissue response (p = 0.003) with small deposits of particulate material within the tissue capsule. There was no loss in auditory neuron density or change in neural response thresholds in any cochleae. SEM examination of the electrode surface revealed that most CH electrodes exhibited some coating loss; however, there was no evidence of corrosion in the underlying Pt. SIGNIFICANCE CH coated electrodes demonstrated significant electrochemical advantages on the bench-top and in vivo and maintained neural function despite an increased tissue response and coating loss. While further research is required to understand the cause of the coating loss, CH electrodes provide promise for use in neural prostheses. © 2020 IOP Publishing Ltd.
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