Risultati per: Le sigarette light sono più pericolose di quelle normali

Background
It remains unclear if the increased colorectal neoplasia detection rate in inflammatory bowel disease (IBD) by high-definition (HD) dye-based chromoendoscopy compared with HD white-light endoscopy is due to enhanced contrast or increased inspection times. Longer withdrawal times may yield similar neoplasia detection rates as found by HD chromoendoscopy.

Objective
To compare colorectal neoplasia detection rates for HD white-light endoscopy with segmental re-inspection and HD chromoendoscopy, using single-pass HD white-light endoscopy as an additional control group.

Design
In a multicentre, randomised controlled trial, IBD patients aged ≥18 years without active disease and scheduled for endoscopic surveillance were included. Patients were 2:2:1 randomised to HD white-light endoscopy with segmental re-inspection of each colonic segment (double pass), HD chromoendoscopy or single-pass HD white-light endoscopy. The primary outcome was colorectal neoplasia detection rate. Assuming equal colorectal neoplasia rates (non-inferiority margin of 10%) between segmental re-inspection and chromoendoscopy and superiority of segmental re-inspection vs single-pass HD white-light endoscopy, a sample size of 566 patients was required.

Results
In total, 563 patients were analysed per-protocol. Colorectal neoplasia detection rates were 10.3% (n=24/234) for HD white-light endoscopy with segmental re-inspection and 13.1% (n=28/214) for HD chromoendoscopy. This confirmed non-inferiority to HD chromoendoscopy (–2.8%, lower limit 95% CI –7.8, p

Introduction
The aim of this study was to investigate serum Neurofilament Light polypeptide (NfL) as a biomarker for diabetic polyneuropathy (DPN) in adolescents with type 1 diabetes (T1D). Secondarily, to investigate vitamin B12 (B12) deficiency as a cause for DPN in adolescents with T1D.

Research design and methods
Cross-sectional study. Sixty Danish adolescents with T1D (age 15–18 years, diabetes duration >5 years) and 23 age-matched control subjects were included. Based on nerve conduction studies (NCS), intraepidermal nerve fibre density (IENFD) and neurological examination, patients were divided into three groups: (1) T1D without DPN, (2) T1D with subclinical DPN and (3) T1D with confirmed DPN. Blood levels of NfL, B12, B12-binding protein holotranscobalamin (HoloTC) and methylmalonic acid (MMA) were determined.

Results
Twenty-four of the adolescents were without DPN, twenty-one had subclinical DPN and eight had confirmed DPN. NCS was not conducted in three participants and four patients did not have blood samples taken. There were no significant differences in NfL levels or any of the B12 parameters between any of the groups.

Conclusions
NfL used in a cross-sectional manner was not found useful to distinguish between the adolescents with DPN and those without. Vitamin B12 deficiency did not contribute to neuropathy in Danish adolescents with T1D.

In Reply We read with interest the letter by Hirakawa. The author raised a concern about the methodology of our recently published meta-analysis assessing the effects of bright light therapy (BLT) for nonseasonal depression disorders. Hirakawa did not understand why a randomized clinical trial (RCT) conducted by Hirakawa et al in 2023 was not included in our systematic search. We thank the editorial board of JAMA Psychiatry for the opportunity to respond to the letter by Hirakawa.

To the Editor I read with interest the systematic review and meta-analysis in JAMA Psychiatry by Menegaz de Almeida et al, which reveals that bright light therapy (BLT) was an effective adjunctive treatment for nonseasonal depressive disorders. For this systematic review, trials were systematically searched from inception to March 25, 2024, and finally, 11 studies were included in this meta-analysis. I do not understand why the study by Hirakawa et al was not included. The study, published in December 2023, was a 4-week randomized clinical trial conducted on patients with mood disorders (including depression and bipolar disorder). Patients were randomly assigned to either a bright light exposure group (BL group; 10 000 lux) or a dim light exposure group (DL group; 50 lux). Although the primary outcome of our study was to investigate the effects of light therapy on the hippocampal dentate gyrus, we also assessed the change in clinical symptoms, evaluated using the 17-Item Hamilton Rating Scale for Depression (HAM-D) and Beck Depression Inventory (BDI) as a secondary outcome. The final sample in Hirakawa et al included 24 patients with mood disorders (BL group, n = 12; DL group, n = 12). In the BL group, the mean HAM-D score decreased from 9.1 to 4.9, and the mean BDI score decreased from 18.6 to 7.6 after 4 weeks of BLT. In the DL group, the mean HAM-D score decreased from 9.8 to 7.6, and the mean BDI score decreased from 20.9 to 14.3 after 4 weeks of BLT. Additionally, I can provide the response rate and remission rate for each group on reasonable request from the author.

Gastroenterologists are required to interpret visual data during endoscopy and make clinical decisions based on this data in real time. Room lighting is a key factor that affects this complex task. Hoff et al demonstrated that room light conditions affect the adenoma detection rate in screening colonoscopies.1 However, lighting remains a relatively unexplored feature of gastrointestinal (GI) endoscopy.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Volume 178, Issue 2, Page JC21, February 2025.

In a meta-analysis, bright light therapy was superior to placebo when added to antidepressant medication.

Stroke, Volume 56, Issue Suppl_1, Page AWP355-AWP355, February 1, 2025. Introduction:Variations in light exposure are associated with changes in inflammation. The risk of thrombotic events such as ischemic stroke have been found to oscillate with the day-light cycle.Aim:To investigate the impact of altering the light spectrum on ischemic stroke brain injury.Methods:Mice were exposed to ambient (mice-white, 300lux), red light (mice-red, 617nm) or blue light (mice-blue, 442 nm) with 12:12 hour light:dark cycle for 72 hours. After 72 hours of light exposure, male and female mice were subjected to transient middle cerebral artery occlusion. Stroke outcomes were assessed at 24 hours.Results:Exposure to long wavelength red light resulted in a significant reduction in infarct volume following stroke (mice-red 38.8±17.6 mm3 vs. mice-white 73.3±15.0 mm3; p

Stroke, Volume 56, Issue Suppl_1, Page ADP37-ADP37, February 1, 2025. Object:The introduction of antiplatelet agents is essential in stent-assisted coil embolization (SACE) for the treatment of intracranial aneurysms, and preoperative drug efficacy assessment is important in reducing the risk of ischemic complications. Light Transmission Aggregometry (LTA) is used in our institution to assess drug efficacy, and we analyzed the association between patient background factors, including preoperative LTA values, and perioperative complications in patients who underwent SACE in a retrospective analysis.Methods:Patients who underwent SACE for unruptured cerebral aneurysms from 1 March 2017 to 30 June 2024 were included. Two antiplatelet drugs (aspirin 100 mg and clopidogrel 75 mg /or prasugrel 3.75 mg) were administered 7 days prior to the procedure, and LTA measurements were performed on the day of surgery. The association of each patient’s background factors with ischemic complications during the hospitalization period (≥1 mRS drop) and DWI and SWI positivity rates on the day after surgery was analyzed. To investigate whether LTA value affect DWI positive rate, propensity score-matched analysis was employed to control for age, sex, alcohol consumption, smoking, family history, medical history, aneurysm shape, multiple aneurysms, symptomatic aneurysms, maximum diameter, neck diameter, aneurysm site, left or right, first treatment or not, stent type, number of stents, clopidogrel or prasugrel.Results:During the observation period, 1021 unruptured cerebral aneurysms received endovascular treatment, of which 548 (453 Neuroform Atlas, 17 Enterprise, 78 LVIS) underwent coil embolization with stenting. The mean LTA value on the day of surgery was 44.2 (20-74). Symptomatic ischemic complications were present in two patients (0.4%), but no associated factors were found. Propensity score matching was successful for pairs of 184 aneurysms in the DWI negative group and 184 aneurysms in the DWI positive group. LTA value was still significantly higher in DWI positive group than in DWI negative group (46.96 vs 42.14, p

Stroke, Ahead of Print. After 30 years of disappointment, 2 randomized controlled trials investigating the effect of neurosurgical treatment on functional outcome in patients with intracerebral hemorrhage were published in 2024. The ENRICH trial (Early Minimally Invasive Removal of Intracerebral Hemorrhage) studied the efficacy of early minimally invasive hematoma removal in patients with lobar or anterior basal ganglia intracerebral hemorrhage, whereas the SWITCH trial investigated the effect of decompressive craniectomy without hematoma removal in severe deep intracerebral hemorrhage. In this critique article, we will discuss the main findings of these trials, their implications and future perspectives.

This systematic review and meta-analysis investigates the effectiveness of bright light therapy as an adjunctive treatment for nonseasonal depressive disorders.

Historically, women have been underrepresented in surgical and procedural disciplines,1 including gastroenterology (GI). Over the past 6 decades, the number of women in these disciplines has increased, with women GI fellows accounting for 40.5% of the positions in 2023.2,3 Among GI subspecialties, inflammatory bowel disease (IBD) was selected by 26.5% of all woman GI physicians, compared with 18.9% of all men GI physicians, according to a 2021 study.4 This finding revealed the growing interest in IBD of young woman gastroenterologists; 33.5% of all IBD-GI fellowship positions were filled by women.

Historically, women have been underrepresented in surgical and procedural disciplines,1 including gastroenterology (GI). Over the past 6 decades, the number of women in these disciplines has increased, with women GI fellows accounting for 40.5% of the positions in 2023.2,3 Among GI subspecialties, inflammatory bowel disease (IBD) was selected by 26.5% of all woman GI physicians, compared with 18.9% of all men GI physicians, according to a 2021 study.4 This finding revealed the growing interest in IBD of young woman gastroenterologists; 33.5% of all IBD-GI fellowship positions were filled by women.

Bright light therapy is often used to treat seasonal depressive disorder, but the results of a recent trial in JAMA Psychiatry suggest that its benefits may not extend to treatment of depressive disorders in hospitalized adolescents.

More than 1 million people in the US and more than 40 million people worldwide are bilaterally blind (ie, visual acuity