Avoidant/restrictive food intake disorder symptoms are not as frequent as other eating disorder symptoms when ulcerative colitis is in remission

BACKGROUND AND AIM

Recent studies have shown that up to 53% of patients with inflammatory bowel disease (IBD) screen positive for avoidant/restrictive food intake disorder (ARFID). There is however concern that ARFID screening rates are over-inflated in patients with active disease. We aimed to evaluate the frequency and characteristics of ARFID symptoms using the Nine Item ARFID Screen (NIAS), and to use another eating disorder measure, the Eating Disorder Examination-Questionnaire 8 (EDE-Q8), to rule-out/characterize other eating disorder cognitive and behavioral symptoms.

METHODS

Participants included adults with UC who are enrolled in an in an ongoing cohort study with quiescent UC (SCCAI ≤2 or fecal calprotectin <150 µg/g with corticosteroid-free clinical remission for ≥ 3 months) at baseline. We used self-reported data on demographics, gastrointestinal medications, medical comorbidities, NIAS scores, and other eating disorder symptom scores (8-item Eating Disorder Examination-Questionnaire; EDE-Q-8).

RESULTS

We included 101 participants who completed the NIAS at their baseline cohort assessment (age 49.9±16.5 years; 55% female). Eleven participants (11%) screened positively for ARFID on at least one NIAS subscale (n=8 male). Up to thirty participants (30%) screened positive for other eating disorder symptoms (EDE-Q-8 Global ≥2.3). Overall score distributions on the EDE-Q-8 showed that participants scored highest on the Weight Concern and Shape Concern subscales.

CONCLUSIONS

Among adults with UC in remission, we found a low rate of ARFID symptoms by the NIAS but a high rate of positive screens for other eating disorder symptoms.

Species composition of mosquito breeding in bamboo stumps in Sikkim, India

BACKGROUND & OBJECTIVES

Sikkim is a part of Eastern Himalayan biodiversity hotspot of India rich in bamboo flora harbouring over 30 different bamboo species. The present study was aimed to investigate the larval mosquito diversity in the bamboo stumps of Gangtok, Sikkim. Besides, efforts were also made to evaluate the propensity of particular species of mosquito towards specific bamboo species (if any).

METHODS

A total of 75 bamboo stumps of four genera were surveyed and screened at five different sampling sites of Gangtok from July to October 2017. Mosquito species similarity between the five sampling sites and the four varieties of bamboo species was calculated using the Bray-Curtis similarity index.

RESULTS

A total of 216 larvae were collected from 25 different bamboo stumps studied. The species identified were Aedes albopictus, Ae. atlanticus, Ae. aegypti, Orthopodomyia signifera, Oclerotatus japonicus, Oc. taeniorhynchus, Armigeres subalbatus, and Toxorhynchites splendens. The Oc. japonicus (34.5%) was found to be the most abundant species having distribution in Phyllostachys assamica, Dendrocalamus hamiltonii and Bambusa nutans. On the other hand, genus Armigeres subalbatus and Tx. splendens were found to breed only in the stumps of P. assamica. Based on Bray-Curtis similarity index highest species similarity was recorded between D. hamiltonii and P. assamica bamboo species.

INTERPRETATION & CONCLUSION

The study may help to understand the bioecology of the mosquito larvae which may help to devise suitable mosquito control programmes. Future studies including the survey of large number of bamboo stumps both in urban and rural areas of Sikkim may provide better insight into the mosquito diversity in the bamboo stumps of Sikkim.

[Comparison of analog and digital fluoroscopy devices regarding patient radiation exposure in enteroclysis]

PURPOSE

With the development and refinement of digital imaging, conventional fluoroscopic units are increasingly being replaced by state-of-the-art digital units for the practice of gastrointestinal imaging. The purpose of this study was to compare digital and conventional methods of gastrointestinal imaging by enteroclysis based on radiation exposure to the patient and fluoroscopy time.

MATERIALS AND METHODS

The medical records of 241 patients who underwent enteroclysis by the conventional technique in 1990 and 309 patients who underwent enteroclysis by digital technique between 2000 and 2004 were reviewed. The radiation exposure of the patient and the fluoroscopy time were evaluated.

RESULTS

The mean radiation exposure was significantly lower (p < or = 0.05) for patients examined by the digital technique (4945.07 cGy x cm (2)) than for patients examined by the conventional technique (7513.6 cGy x cm (2)). The fluoroscopy time was significantly lower with the conventional technique (mean fluoroscopy time 9 min 43 sec) than with the digital technique (17 min 10 sec).

CONCLUSION

We conclude that radiation exposure does not correlate directly with fluoroscopy time. Technical refinements of the digital technique such as Last Image Hold frames, which allow images to be stored with no increase in radiation dose and help to reduce digital fluorography exposures and pulsed fluoroscopy, result in significant dose reduction.

Automated Detection of Lung Nodules in Multidetector CT: Influence of Different Reconstruction Protocols on Performance of a Software Prototype

PURPOSE

To evaluate the accuracy of software for computer-aided detection (CAD) of lung nodules using different reconstruction slice thickness protocols in multidetector CT.

MATERIALS AND METHODS

Raw image data sets for 15 patients who had undergone 16-row multidetector CT (MDCT) for known pulmonary nodules were reconstructed at a reconstruction thickness of 5.0, 2.0 and 1.0 mm with a reconstruction increment of 1.5, 1.0 and 0.5 mm, respectively. The "Nodule Enhanced Viewing" (NEV) tool of LungCare for computer-aided detection of lung nodules was applied to the reconstructed images. The reconstructed images were also blinded and then evaluated by 2 radiologists (A and B). Data from the evaluating radiologists and CAD was then compared to an independent reference standard established using the consensus of 2 independent experienced chest radiologists. The eligible nodules were grouped according to their size (diameter > 10, 5 - 10, < 5 mm) for assessment. Statistical analysis was performed using the receiver operating characteristic (ROC) curve analysis, t-test and two-rater Cohen's Kappa co-efficient.

RESULTS

A total of 103 nodules were included in the reference standard by the consensus panel. The performance of CAD was marginally lower than that of readers at a 5.0-mm reconstruction thickness (AUC = 0.522, 0.517 and 0.497 for A, B and CAD, respectively). In the case of 2.0-mm reconstruction slices, the performance of CAD was better than that of the readers (AUC = 0.524, 0.524 and 0.614 for A, B and CAD, respectively). CAD was found to be significantly superior to radiologists in the case of 1.0-mm reconstruction slices (AUC = 0.537, 0.531 and 0.675 for A, B and CAD, respectively). The sensitivity at a reconstruction thickness of 1.0 mm was determined to be 66.99 %, 68.93 % and 80.58 % for A, B and CAD, respectively. The time required for detection was shortest for CAD at reconstruction slices of 1.0 mm (mean t = 4 min). The performance of radiologists was greatly enhanced when using CAD: sensitivity 91.26 % and 94.17 % for CAD+A and CAD+B, respectively (AUC = 0.889 and 0.917). CAD was most advantageous in the detection of nodules < 10 mm.

CONCLUSION

At a 1.0-mm reconstruction thickness, CAD's ability to detect nodules < 10 mm is superior to that of radiologists and its relatively short evaluation time makes it a viable second reader.

A scale to assess activities of daily living in persons affected by leprosy

The aim of this study was to develop a scale for identifying disability among people in the rural areas of developing countries. The studies were carried out in the Green Pastures Hospital and the leprosy field programme of the Western Region of Nepal. With the help of staff experienced in working with people with disability, a 68-question questionnaire was made, based on the International Classification of Impairments, Activities and Participation (ICIDH-2). A survey was carried out of 269 people affected by leprosy who had impairments, as well as a sample of those who were unimpaired. The survey results were used to develop the questionnaire into a scale, using standard scale development methods. This included checking of criterion validity, discrimination and reliability and stability using weighted kappa statistics. Of the 68 questions, 38 were included in the second draft of the instrument. Eight questions were added to identify difficulty in relationships, about the use of aids and about occupation and employment. The sum score of the scale against the expert score gave a Spearman correlation coefficient of 0.72. Intra- and inter-interviewer reliability coefficients were 0.77 (95% CI 0.73-0.81) and 0.61 (95% CI 0.56-0.67), respectively. The stability test gave an overall kappa of 0.76 (95% CI 0.70-0.82). Four questions with particularly poor results were omitted from the final draft of the instrument. An interview-based instrument was developed for identifying limitations in activities of daily living (disability) in people living in a rural setting in a developing country--the Green Pastures Activity Scale (GPAS). The scale performed well during validity and reliability testing. It consists of 34 activity questions, five relationship questions, and three questions on the use of aids, occupation and employment.