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This abstract was presented as the Nutrition in the Treatment, Management and Prevention of Disease Theme Highlight. Chronic constipation is a prevalent gastrointestinal condition affecting approximately 10% of the global population(1) and is associated with substantial healthcare costs and quality of life impairments in the UK(2). While the aetiology of chronic constipation is not fully understood, lower dietary fibre intake is associated with greater risk of constipation(3) and consumption of fruits, vegetables, and wholegrains is recommended within clinical guidelines. Although not diagnostic for constipation, low stool weight is a common feature and is associated with greater risk of colorectal cancer(4); yet few studies have ever measured stool weight in constipation. This study investigated associations between frequency of plant food intake and stool weight in people with constipation. Baseline data from a dietary intervention trial were analysed, which included participants meeting Rome IV criteria for constipation. Self-reported data on habitual consumption of nine plant food categories were collected using a validated tool. Participants performed 7-day total stool collection, which was weighed on the same weighing scales at the research centre. Associations between intake frequency for each plant food category and daily stool weight (total stool weight divided by 7 days) were analysed using independent-samples t-tests (SPSS, version 28, p<0.05 considered significant). Ninety-nine people with Rome IV constipation (89% female; mean [ ± SD] age 32.4 [ ± 12.4] y; BMI 23.0 [ ± 3.2] kg/m2) provided 7-day total stool collections. Mean (± SD) stool weight was 72.5 ± 47.2 g/day (minimum 2.1 g/day; maximum 280.6 g/day). Stool weight was significantly higher among those consuming fruit once or more per day (86.2 ± 48.2 g/day), compared with those consuming fruit less than once per day (62.4 ± 44.1 g/day; p = 0.012). Stool weight was also higher among those consuming vegetables once or more per day (98.6 ± 59.1 g/day) compared with those eating vegetables less than once per day (62.2 ± 37.2 g/day; p<0.001). Differences for green salad (79.6 ± 52.1 g/day; 63.3 ± 38.5 g/day; p = 0.088) and high-fibre breads (84.1 ± 46.6 g/day; 65.1 ± 46.6 g/day; p = 0.05) were borderline significant, when comparing those consuming these more than once per week, compared with once or less per week (respectively). No significant differences were found for frequency of consuming fruit juices, potatoes, vegetable soups/stews, high-fibre cereals, or beans and lentils. This is the most comprehensive analysis to date of measured stool weight in constipation, and its association with plant food intake. Despite presence of constipation, participants with higher intakes of fruit and vegetables had a greater daily stool weight; an important feature associated with lower colorectal cancer risk(4). However, intakes were not sufficient to manage their constipation symptoms. Intervention studies investigating potential benefits from increasing fruit and vegetable intakes in people with constipation are required and are currently underway. [ABSTRACT FROM AUTHOR]

Adenoid cystic carcinoma (ACC) of the breast is a low-grade malignancy "triple negative" breast tumor. ACC of the breast can present a great variety of morphological features having a prognostic impact. Recently, cases of ACC having solid-basaloid features (SBACC) have been described. In the present study, 6 cases of SBACC have been reported. All the cases affected female patients aged 47 to 69 years (mean = 54 years). Two patients had metastases to the axillary lymph nodes, and 2 patients experienced local recurrences. No deaths due to the tumor were observed. A review of the literature on breast SBACC showed that local recurrences and lymph node metastases are more frequent than in the ACC conventional type; nevertheless, no deaths due to the tumor are registered at the moment. On the contrary, cases of ACC with features of malignant transformation are on record. Therefore, a new grading system on breast ACC is proposed., (© The Author(s) 2015.)

Exercise is considered a fundamental tool for the management of ankylosing spondylitis (AS), in combination with pharmacological therapy that with the advent of biological therapy has improved dramatically the control of signs and symptoms of this challenging disease. Current evidence shows that a specific exercise protocol has not been validated yet. The purpose of this review is to update the most recent evidence (July 2010-November 2013) about physiotherapy in AS, analyzing the possible role and synergistic interactions between exercise and biological drugs. From 117 studies initially considered, only 15 were included in the review. The results support a multimodal approach, including educational sessions, conducted in a group setting, supervised by a physiotherapist and followed by a maintaining home-based regimen. Spa exercise and McKenzie, Heckscher, and Pilates methods seem promising in AS rehabilitation, but their effectiveness should be further investigated in future randomized controlled trials (RCTs). When performed in accordance with the American College of Sports Medicine guidelines, cardiovascular training has been proven safe and effective and should be included in AS rehabilitation protocols. Exercise training plays an important role in the biological era, being now applicable to stabilized patients, leading ultimately to a better management of AS by physiatrists and rheumatologists throughout the world. On the basis of the current evidence, further research should aim to determine which exercise protocols should be recommended.

Spasticity is a characteristic and early component of the lesions of the pyramidal tract of demyelinising diseases such as multiple sclerosis, and is included in the chief neurological scales to evaluate this disease. We report the case of a woman with a clawed toes deformity caused by spasticity of the extensor digitorum (longus and brevis) muscles.

The evaluation of progressive morphological changes, with 93 morphometric parameters in tissue lesions representative of ductal breast cancer progression, has been performed in order to define in great detail the profile of chromatin texture (nuclear signature) changes. A gradual, distinctive increase in nuclear signature alterations from hyperplasia to infiltrating carcinoma has been found. The nuclear signatures' analysis of microinfiltrating foci in comedo DCIS showed sharp differences compared with those of comedo DCIS they derived from: these foci consist of cells with smaller and also more homogeneous nuclei. Opposite to the prominent heterogeneity of those of comedo DCIS: they appear to express a reduced clonality in the new, more progressed, cell population. Digital analysis of chromatin patterns seems to be useful, beyond mere extraction of individual features of value, in getting objective data for individual grading and prognosis of breast cancer.

Aims: The objective of this study is to derive highly specific nuclear signatures (NS's) for the characterization of nuclei of ductal breast epithelium in proliferative lesions and in situ cancers in order to evaluate if nuclear structural changes are able to describe the main events of ductal cancer progression and if the method can be used for objective grading., Methods: A total of 82 different features descriptive of the nuclear chromatin patterns were computed in nuclei from normal glandular breast tissue, florid hyperplasia, and ductal carcinoma in situ (DCIS) and of DCIS with microinfiltration. The feature values were arranged to form a profile or signature. Measures of difference to a standard profile derived from normal glandular breast tissue were defined. One may then compute a standardized distance measure for a nucleus from "normal". Lesions can be characterized in the same manner, on the basis of the mean profile for all of their nuclei, and on the basis of the distribution of distances of their constituent nuclei from normal., Results: The selected histopathologic patterns on which the diagnostic categories for DCIS are based were found to have corresponding distinctive patterns in the chromatin of the lesion's nuclei. A monotonic trend of ductal neoplastic progression was found. In addition, lesions histologically assessed as belonging to the same diagnostic category were found to offer substantially different distribution patterns., Conclusions: The full utilization of nuclear texture features allows the derivation of highly specific signatures for nuclei so that a reproducible grading can be performed for prognostic purposes.

Study Design: Using magnetic resonance imaging, this study analyzed the anatomic characteristics of the iliolumbar ligament insertion on humans., Objectives: To resolve certain anatomic questions about the manner of insertion of the iliolumbar ligament., Summary of Background Data: The data of the postmortem studies of the iliolumbar ligament are controversial because of the number, complexity, and variability of the structures present in the lumbosacral region., Methods: Twenty-eight iliolumbar ligaments of 14 adult volunteers were analyzed with magnetic resonance imaging. The images were acquired along the transversal planes (from inferior to superior) and coronal planes (from the ventral to the dorsal) of the lumbosacral region., Results: The anterior band of the iliolumbar ligament (broad and flat) originates from the anterior-inferior-lateral part of the L5 transverse process and expands as a wide fan before inserting on the anterior part of the iliac tuberosity below the posterior band. The posterior band of the iliolumbar ligament originates from the apex of the L5 transverse process and is thinner than the anterior with a round section, and it inserts on the iliac crest (from the anterior margin to the apex)., Conclusions: The minor width of the area of insertion on the iliac crest of the posterior band (and therefore its lower resistance with the mechanical overloads) could explain the frequency of the painful syndromes related, by some authors, to an enthesopathy of this ligament.