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This article discusses the outcomes of patients undergoing Endoscopic Submucosal Dissection (ESD) at a high-level center in the Tenerife south healthcare area since 2016. The study aimed to evaluate the safety and effectiveness of the ESD technique and compare outcomes over two time periods. A total of 126 procedures were included, with the majority of lesions found in the ascending colon and rectum. The study found that ESD offers significant benefits compared to conventional surgery, but there are challenges such as the risk of perforation and bleeding. The findings suggest a trend toward overtreatment, but further studies are needed to confirm these observations. [Extracted from the article]

This article, published in the journal Endoscopy, presents a case series on patients with ischemic colitis (IC), a common colonic vascular disorder. The study aims to describe the demographics, clinical features, histologic samples results, days of admission, and surveillance after discharge in patients with endoscopic diagnosis of IC. The study found that the average age at diagnosis was 69.5 years old, with a higher prevalence in females. The most frequent cardiovascular risk factors were hypertension, dyslipidemia, and diabetes. Most patients presented with bleeding, abdominal pain, and/or diarrhea upon arrival at the hospital. The study also found that the mortality rate was lower than in other series, and the clinical management did not differ when biopsies were taken or not. The authors suggest that endoscopic diagnosis may be sufficient for the management of patients with ischemic colitis. [Extracted from the article]

This article, published in the journal Endoscopy, presents a case study of a 78-year-old male patient from Portugal who experienced obscure gastrointestinal bleeding. The patient had a history of laparoscopic sigmoidectomy for colorectal neoplasm, as well as other medical conditions. After a complete endoscopic study in 2018, erosions in the distal jejunum and proximal ileum were identified as the cause of the bleeding. In 2023, the patient had another episode of bleeding, and a capsule endoscopy suggested a neoplastic origin. Surgical resection was performed, and the histological study confirmed a diagnosis of well-differentiated neuroendocrine tumor with infiltration of mesenteric fat. [Extracted from the article]

The strongest known genetic association in rheumatoid arthritis (RA) is with HLA–DRB1 alleles that share a similar amino acid sequence, termed the shared epitope (SE). Although many studies have examined the association of the SE with disease severity, the results have been inconsistent, which may reflect the relatively small sample sizes or ethnic differences. The aim of this study was to assess the association of HLA–DRB1 SE alleles and genotype with the development of bony erosions in RA by meta-analysis. We identified English-language articles published between January 1, 1987 and June 1, 1999 through Medline, EMBase, and manual searches of 6 relevant journals. Included were studies in which molecular typing of HLA–DRB1 alleles was performed and in which the presence or absence of bony erosions was reported. Data were extracted from the studies, and erosions were coded as present or absent. Authors were contacted for missing information and data on individual patients. A total of 29 studies and 3,240 patients were available for analysis. The summary odds ratios (ORs), when all patients were evaluated as a single group, demonstrated a significant association of the presence of the SE (2 or 1 versus 0 SE alleles) with erosions (OR 2.0; 95% confidence interval [95% CI] 1.8–2.2), although significant heterogeneity was present (P = 0.002). Subgroup analyses demonstrated the important influence of ethnic background. For example, no association of the SE with erosions was demonstrated in Greeks (OR 0.8 [95% CI 0.2–1.5]). In contrast, there was a striking dose-dependent relationship in southern European Caucasians and Asians, with ORs as high as 6.2 and 5.4, respectively, in patients with 2 SE alleles. Although our ability to assess the relationship between SE genotype and erosions was limited, particular importance of the DRB1*0401 SE allele was suggested in an analysis restricted to northern European Caucasians. The SE is associated with the development of erosive disease in many ethnic groups; however, striking exceptions exist. These variations may be due to allele differences between populations, such as the frequency of DRB1*0401 among different ethnic groups. Further study to better understand the genetic and environmental differences between these populations may provide insight into mechanisms that influence the clinical expression of RA. [ABSTRACT FROM AUTHOR]

Elevators in buildings serve a very important function and are among the critical components of an essential facility. They have several mechanical and electrical components that are known to be susceptible to damage during earthquake occurrences. The counterweights, being the heaviest, are among their most vulnerable components. The ASME code has made several provisions to improve the performance of the counterweights in seismic events. To evaluate their performance under code-mandated provisions, it is necessary that a comprehensive and realistic analytical model is used. This paper uses a detailed model of a counterweight of a traction elevator to study its in-plane and out-of-plane dynamic behavior. The model incorporates the multiple support inputs and flexibilities of the counterweight guidance system along with their non-linearities caused by the clearance limitations. The study examines the effect of changing clearances, variability of input motions, and the use of tie brackets on the system response, and evaluates the impact of some of the code provisions on the dynamic behavior of the system. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Introduction: Risperidone long-acting injection and Paliperidone Palmitate one month are value in the treatment of Schizophrenia. Objectives: The assess the long term efficacy of Risperidone vs Paliperidone to preveting relapse. Risperidone long-acting injection and Paliperidone Palmitate are a valuable strategy for the treatment of the schizophrenia. More studies are necessary to assess the efectiveness to preventing relapse. Methods: 30 patients with diagnosis of schizophrenia was treated with Risperidone and 30 patients with diagnosis of schizophrenia with Palmitate of paliperidone. We Follow 30 months PANSS, PSMQ are performed at the begin and de end of study, We defined Relapse: Rehospitalization or 25% base lane PANSS. Results: The 56,6%patients with Risperidone long-acting injection no relapse and 83,3% with Paliperidone Palmitate. The 63,3 % patients with Risperidone long-acting injection are satisfied or very satisfied while 86,6% oatients with Paliperidone Palmitate are satisfied or very satisfied. Also his famly member. The improved of de CGI scale global patients with Risperidone long-acting injection was 2,8 points, and patients with Paliperidone Palmitate was 3,9. Conclusions: We observed higher percentage of relapse free in patients treated with Paliperidone Palmitate than treated with Risperidone long-acting injection. Patients treated with Paliperidone Palmitate apperars to have greter acceptance and in her family than patients treated with Risperidone long-acting injection. [ABSTRACT FROM AUTHOR]

Introduction: The negative symtoms and metabolic syndrom are a very frecuent phemomena with hard treatment. Objectives: Find the differences in the improving of negative symtoms and the metabolic rates in patients with change of neuroleptic (oral to paliperidone palmitate injection). Methods: Observational longitudinal study during 18 months. We incluided all the patients with the diagnosis of schizophrenia, in which we done a change from oral neurolepic to Palmitate of Paliperidone and age of 18 years o more. We used SANSS and CGI-Scale for negative symtoms and metabolic rates (weight, IMC, Glucose, Colestherol, TG and prolactin) and abdominal perimeter. Results: 40 patients was incluided. 60% are male. Average age 42.48 years. 22% has metabolic disease, 32% with axis IV disease and 28% with toxic sustances Average dosis of palmate of paliperidone 105 mg/28 days. The reason of change to injection was: No response 38% to oral neuroleptic treatment and side effects 28%. Rest patients wish. Metabolic rates improved: Less in weight, IMC, Glucose, Colestherol, TG and prolactin and abdominal perimeter. The SANSS scale improved, All of them were statadistical significative (p<0,05) and CGI scale results improved. Conclusions: The change from oral neuroleptic to palmitate of paliperidone improved metabolic rates and abdominal perimeter. Also improved SANSS and CGI Scale. The palmitate of paliperidone is useful in schizophrenic patients and with less incidence of metabolic side efects and improved of negative symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Perampanel is an antiepileptic also effective on the structure of sleep. We describe the first study that evaluates perampanel in patients with chronic insomnia. Objectives: Insomnia is one of the most frequent reasons for consultation in the Sleep Units. Methods: Observational retrospective case-control study of 33 patients with chronic insomnia. All patients attended from November 2017 to November 2018. All patients with more than 4 previous treatments tested, during more than 4 years. 6 months of following. Results: 33 patients with chronic insomnia, 20 women (60%). Average age 53.48 years, average time of evolution: 11.25 years. At least 4 treatments previously tested in all patients. Main etiology: depression 13 cases (40%). After the combination of perampanel 2-4 mg (100%) with antidepressants (17 cases, 51.5%) or anxiolytics (12 cases, 36.36%) along 3 months: the ISI scale improves by 6 points on average (+/- 2.1 standard deviation DE, p <0.02), and Pittsburgh scales improves in 4 points (+/- 1.7 SD, p<0.04). In controls, the improvement of the ISI scale was 2.2 poins (+/-0.8 SD, p <0.06), on the Pittsburgh scale was 1.6 points (+/- 0.5 SD, p <0.01). The main adverse effect was irritability in 3 patients. The treatment was abandoned by 4 patients (12.12%), 2 due to lack of efficacy (6%). Conclusions: The combination of perampanel with an antidepressant, or an anxiolytic, significantly improves the quality of sleep measured by ISI and Pittsburgh scales in patients with chronic insomnia. A clinical trial compared with placebo would be necessary to corroborate these results. [ABSTRACT FROM AUTHOR]