Evaluation and management of chronic anorectal and pelvic pain syndromes: Italian Society of Colorectal Surgery (SICCR) position statement.

Chronic pelvic pain is a hidden issue which needs to involve many different usually uncoordinated specialists. For this reason there is a risk that treatments, in the absence of well-defined pathways, common goals, and terminology, may be poorly effective. The aim of the present paper is to summarize the evidence on anorectal pelvic pain, offering useful evidence-based practice parameters for colorectal surgeons' daily activity. Analysis of chronic anorectal and pelvic pain syndromes, the diagnostic and clinical optimal needs for evaluation, and the innumerable low evidence treatments and therapeutic options currently available suggests that a multimodal individualized management of pain may be the most promising approach. The limited availability of dedicated centers still negatively affects the applicability of these principles.

Emerging trends in European food, diets and food industry.

Understanding how an adequate food security may be determined, how nutritional intakes evolve over time and are influenced by global dynamics are few of the questions scholars are trying to answer. In addition, a great interest is devoted to the changes in consumers' preferences and expectations as well as to the analysis of food innovations and their impact on the global market. We review the recent and emerging trends in food supply chains of selected sectors (fruits and vegetables, meat, and seafood), and deepen on emerging trends in the food industry. By presenting the evidence provided by the literature and emphasizing the unresolved research questions, we offer a critical view of future directions that should be followed by research agenda.

Successful breastfeeding: a global intervention for a physiological process.

In our perinatal unit we applied the ten steps of WHO/UNICEF for Baby Friendly Hospital Initiative and evaluated the percentage of exclusive (EBF) or complementary breastfeeding (CBF), and of formula fed (FF) healthy full-term infants (HFI) at hospital discharge (HD). HFI performing EBF at HD were 85.3%, a quite high value. At the age of 3 mths EBF percentage ranged between 59-62.4%, and at 6 mths it decreased to 51.7-37.7%. Customer satisfaction questionnaire at HD ranked "good" to "very good" in 92.8%. Causes of breastfeeding reduction with time and comparison with previous and actual situation in Italy and civilized countries are discussed.

[Trends of colorectal cancer incidence, mortality and survival in the Umbria, region of Italy. 1978-82 and 1994-99]. / Incidenza, mortalità e sopravvivenza del cancro del colon-retto in Umbria: 1978-82 e 1994-99.

The aim of the study is to show the colorectal cancer trend in Umbria, a central Italian region, from 1978 to 1999. Data concerning regional incidence, mortality and survival derived from an ad hoc survey carried out in Umbria in the period 1978-1982 and from Umbria Population-based Registry (RTUP) for the years 1994-1999. The incidence of colorectal cancer increases in both sexes, expecially for the age class > 75 years. Mortality rises slightly, without no difference between sexes. Survival of patients with colorectal cancer has improved in the two sexes from 45 to 74 years-age, while the lower survival has registered for age between 75 and 84 years. We concluded that the situation in Umbria is quiet good, but it is affected by aging of Umbrian population. Delaying in diagnosis or inefficacy in therapy can explain shorter survival in older patients.

Image restoration using the Q-Ising spin glass.

We investigate static and dynamic properties of gray-scale image restoration by making use of the Q-Ising spin glass model, whose ladder symmetry allows us to take in account the distance between two spins. We thus give an explicit expression of the Hamming distance between the original and restored images as a function of the hyperparameters in the mean field limit. Finally, numerical simulations for real-world pictures are carried out to prove the efficiency of our model.

Image restoration using the chiral Potts spin glass.

We report on the image reconstruction (IR) problem by making use of the random chiral q-state Potts model, whose Hamiltonian possesses the same gauge invariance as the usual Ising spin glass model. We show that the pixel representation by means of the Potts variables is suitable for the gray-scale level image which cannot be represented by the Ising model. We find that the IR quality is highly improved by the presence of a glassy term, besides the usual ferromagnetic term under random external fields, as very recently pointed out by Nishimori and Wong. We give the exact solution of the infinite range model with q=3, the three-gray-scale-level case. In order to check our analytical result and the efficiency of our model, two-dimensional Monte Carlo simulations have been carried out on real-world pictures with three and eight gray-scale levels.

Prognostic significance of lymph node reactivity in the control of pathologic negative node squamous cell carcinomas of the oral cavity.

BACKGROUND: Identification of high-risk patients and defining prognostic factors may be useful in the treatment of head and neck cancer. The role of the lymph node reactivity is still obscure. The value of the node reactivity pattern as a predictor of tumor control in oral cavity cancer was analyzed. METHODS: Retrospective analysis of patients with oral cavity squamous cell carcinoma (OCSCC), submitted to tumor resection and neck dissection, with pathologic negative lymph nodes (pN0). Dominant node reactivity pattern was defined as lymphocytic predominance (LP), germinal centers (GC), normal (NL), sinus hystiocytosis (SH), and lymphocytic depletion (LD). Clinical and pathological characteristics of patients free of disease (DF) were compared with those of patients with control failure (CF), which included local, regional, and distant recurrences. RESULTS: Of the 26 patients with pN0 OCSCC, prevalence of SH was found in 10 cases, GC in 13, and LD, NL and PL in 1 case each. Comparing CF and DF groups, there was no significant statistical difference regarding: age, gender, performance status index, weight loss, smoking and drinking habits, complementary treatment, average follow-up, tumor grade or thickness, margins, or tumor inflammatory and desmoplastic reaction. Although there was a higher proportion of perineural invasion and larger tumors in the CF group, the difference was not statistically significant either. Germinal centers or LP were noted in only 27% of the CF group and in 73% of the DF group. Collectively, NL, SH, or LD patterns were observed in 73% of CF. This incidence was statistically different from 27% of the DF group (P <0.05). CONCLUSIONS: Lymph node reactivity pattern seems to be a prognostic index in pN0 OCSCC patients. Prospective analysis is advised to confirm these results. Prophylactic neck dissection as a staging procedure could select high-risk patients even when no metastasis is found.

[Brain metastases from papillary thyroid carcinoma: a case report and review of the literature]. / Metástase cerebral de carcinoma papilífero de tireóide como apresentação inicial da doença: relato de caso e revisão da literatura.

Papillary carcinoma, the commonest thyroid malignancy, has a good prognosis and low incidence of distant metastases. Brain metastasis is extremely rare with a frequency of about 1% in reported series. In this paper we present the clinical details of one case of histologically proven brain metastasis from papillary thyroid cancer, first presented with neurological symptoms, initially treated with excisional biopsy and radiotherapy in other hospital, without clinical response. The patient was then referred to our service, where he underwent a total thyroidectomy and modified radical neck dissection, with the aim of posterior radioactive iodine treatment for the brain lesion. Unfortunately, he died of neurological complications, two months after the neck treatment. Also presented is a review of the literature of this unusual clinical presentation.