Large serrated polyps indicate a greater risk of advanced metachronous colorectal neoplasia than high-grade adenomas.

Background and study aims The risk of developing total metachronous advanced neoplasia (TMAN) in patients with index serrated lesions (SL) or adenoma with high-grade dysplasia (HGD) is unknown. We evaluated this risk in patients with either HGD, SL < 10 mm or SL ≥ 10 mm at index colonoscopy, who underwent surveillance colonoscopies. Patients and methods This retrospective cohort study evaluated all consecutive patients (n = 2477) diagnosed between 2010 and 2019 with colorectal HGD, SLs < 10 mm or SLs ≥ 10 mm. We excluded patients aged < 45 or > 75 years or those who had inflammatory bowel disease, hereditary colorectal cancer (CRC) syndromes, previous or synchronous CRC, or no follow-up colonoscopy. Descriptive variables were compared using analysis of variance or Pearson chi-squared tests. Multivariate Cox regressions were used to compare the risk of TMAN between the HGD, SL < 10 mm and SL ≥ 10 mm groups. Results Overall, 585 patients (mean age 63 years; 55% male; mean follow-up 3.67 years) were included (226 with SLs < 10 mm, 204 with SLs ≥ 10 mm, 155 with HGD). Compared with SLs < 10 mm, patients with HGD did not have a significantly different rate of TMAN (HR=0.75 [0.39-1.44]) and patients with SLs ≥ 10 mm had a higher rate of TMAN (HR=2.08 [1.38-3.15]). Compared with HGD, patients with SLs ≥ 10 mm had a higher rate of TMAN (HR=1.87 [1.04-3.36]). Conclusions The risk for TMAN was higher for patients with SLs ≥ 10 mm than with HGD or SLs < 10 mm. This risk should be considered when planning surveillance intervals for patients diagnosed with large SLs.

Socioeconomic status and sleep disturbances among pediatric population: a continental systematic review of empirical research.

To this day, no consensus has been established on the definition and the conceptualization of the socioeconomic status (SES), since all the available studies on the relation between SES and health did not use the same conceptual framework and operationalization to assess SES. While literature reported that SES markers (such as income, social support networks, education, employment or occupation) influence the health of populations by shaping living conditions; empirical research does not tell us which SES markers affect more strongly the sleep components of the individuals, as well as which sleep disorders (SD) are affected and how. Even though several original studies have tried to assess how changes in socioeconomic status of parents may affect the psychosocial environment and mental health of an individual directly or through his community, no systematic reviews on the influence of SES on children's sleep are available. This systematic review make an update on the different measures of SES and sleep disturbances used for pediatric population across the different regions of the world. Recommendations for a future standardization of SES measures is proposed, for a better understanding of its influence on sleep disturbances.