[Colorectal carcinoma - How can we improve prevention?] / Kolonkarzinom.

Colorectal carcinoma - How can we improve prevention? Abstract. Colorectal cancer (CRC) is the second leading cause of cancer-related death in Europe. Comprehensive screening is useful and cost-effective. However, participation in screening programs in Switzerland is low and falls below 20 %. Immunological stool tests (FIT tests) can - when carried out every two years - detect tumours and advanced adenomas, and thus reduce mortality. These tests have replaced older guaiac faecal tests (e. g. Hämoccult®). The detection and removal of small colon polyps is still only possible through colonoscopy, which is applied for diagnostic and therapeutic purposes and continues to be the gold standard for CRC screening. The decisive factors for screening are risk-adapted prevention with stratification of patients according to risk groups and the general optimization of risk factors. Educating the patient about the advantages and disadvantages of the various screening procedures and making a shared decision are necessary prerequisites for greater participation in screening programs.

Understanding the Lifetime of Battery Cells Based on Solid-State Li6PS5Cl Electrolyte Paired with Lithium Metal Electrode.

All-solid-state batteries with solid electrolytes having ionic conductivities in the range of those of liquid electrolytes have gained much interest as safety is still a major issue for applications. Meanwhile, lithium metal seems to be the anode material of choice to face the demand for higher capacities. Still, the main challenges that come with the use of a lithium metal anode, i.e., formation and growth of lithium dendrites, are still not understood very well. This work focuses on the reasons of the lifetime behavior of lithium symmetric cells with the solid electrolyte Li6PS5Cl and lithium electrode. In particular, the voltage increases during the application of a constant current density are investigated. The interface between the lithium metal electrode and the solid electrolyte is analyzed by X-ray photoelectron spectroscopy, and the resistance changes of each electrode during stripping and plating are investigated by impedance spectroscopy on a three-electrode cell. A main factor for the lifetime influenced by lithium dendrite formation and growth is the buildup of a lithium vacancy gradient, leading to voids which decrease the interface area and therefore increase the local current density. Additionally, those lithium vacancies in lithium metal represent a limitation for conductivity rather than migration in solid electrolyte. Further experiments indicate that the seedlike plating behavior of lithium also plays a key role in increased local current density and therefore decreased lifetime. Plating of only a small amount of lithium leads to small areas of well-connected interfaces, resulting in high local current density. A medium amount of plated lithium leads to larger areas of interface between lithium and electrolyte, balancing the current density distribution. In contrast, a high amount of repeatedly deposited lithium leads to lithium seed plating on top of already plated lithium. Those seed spots grown on top represent a better interface connection, which again leads to higher local current densities at those spots and therefore results in shorter lifetimes due to short circuits caused by lithium dendrites.

Cross-Contamination with Gluten by Using Kitchen Utensils: Fact or Fiction?

A risk of cross-contamination exists when preparing a gluten-free (GF) meal in kitchen facilities that usually handle gluten-containing (GC) foods. Cross-contamination with gluten may occur during the preparation or cooking process; however, published data are lacking on gluten cross-contamination from kitchenware. This study was conducted to determine whether cross-contamination occurs through shared domestic kitchenware and, if so, which cleaning method is most reliable for avoiding this cross-contamination. Kitchenware (wooden spoon, colander, ladle, and knife) previously used to cook and/or prepare GC foods was used for the preparation of GF foods (bread and pasta). The gluten concentration of the GF foods was then determined using an established enzyme-linked immunosorbent assay. A PCR assay was also used to detect the presence of wheat ω-gliadin DNA in the food samples. Three cleaning methods were assessed to determine the concentrations of gluten and wheat DNA in GF foods cooked with utensils cleaned directly after the preparation of GC foods. Contrary to our expectations, gluten was not detected in relevant and quantifiable amounts in our samples (<20 mg/kg). The cleaning method used did not influence gluten concentrations: all samples contained <10 mg/kg. Based on PCR analyses, the only sample with lower cycle threshold ( CT) values (i.e., higher concentration of wheat DNA) was from the contaminated ladle used to serve GF pasta. This outcome led to the hypothesis that shared ladles pose a higher risk for contamination of GF foods than do shared wooden spoons, colanders, or knives. Cross-contamination with gluten in a kitchen environment may occur, but kitchen utensils used for preparing GC pasta and for cutting GC bread should not pose a relevant problem to patients with celiac disease, at least in a domestic environment.

HCV-related advanced fibrosis/cirrhosis: randomized controlled trial of pegylated interferon alpha-2a and ribavirin.

In patients with hepatitis C virus (HCV)-related advanced fibrosis/cirrhosis, 30% of sustained HCV clearance has been reported with pegylated interferon alpha-2a (PEG-IFN) alone, but the efficacy and tolerability of the PEG-IFN/ribavirin (RBV) combination remain poorly defined. A total of 124 treatment-naïve patients with biopsy proved HCV-related advanced fibrosis/cirrhosis (Ishak score F4-F6, Child-Pugh score < or =7) were randomized to 48 weeks of PEG-IFN (180 microg sc weekly) and standard dose of RBV (1000/1200 mg po daily, STD) or PEG-IFN (180 microg sc weekly) and low-dose of RBV (600/800 mg po daily, LOW). Sustained virologic response (SVR) rates with PEG-IFN/STD RBV (52%) were higher--albeit not significantly--than that with PEG-IFN/LOW RBV (38%, P = 0.153). In multivariate analysis, genotype 2/3 and a baseline platelet count > or =150 x 10(9)/L were independently associated with SVR. The likelihood of SVR was < 7% if viraemia had not declined by > or =2 log or to undetectable levels after 12 weeks. Nine adverse events in the STD RBV and 15 in the LOW RBV group were classified as severe (including two deaths); dose reductions for intolerance were required in 78% and 57% (P = 0.013), and treatment was terminated early in 23% and 27% of patients (P = n.s.). The benefit/risk ratio of treating compensated HCV-cirrhotics with STD PEG-IFN/RBV is favourable.

Lymph node enlargement during combination therapy for chronic hepatitis C with pegylated interferon alpha and ribavirin: harmless reaction or harmful disease?

BACKGROUND: Perihepatic lymph node enlargement (LNE) is often present in patients with chronic hepatitis C (CHC) and correlates with the degree of inflammation, as well as the stage of fibrosis of the liver. LNE at sites distant from the liver hilum, however, is not a common feature of chronic hepatitis but may occur during antiviral therapy as we report here. OBJECTIVES: The aim of this study was to examine the frequency and aetiology of LNE at sites distant from the liver hilum in patients with chronic hepatitis C during combination therapy with pegylated interferon alpha and ribavirin. METHODS: The charts of all patients undergoing therapy with PEG and RIBA for CHC at our institution from January 2002 to April 2003 were reviewed for those who developed de novo LNE at sites distant from the liver hilum. RESULTS: In total, 8/217 patients (3.7%) or 5/125 patients treated within clinical trials (4.0%) were recorded to have developed de novo LNE during antiviral therapy. CONCLUSION: LNE at various sites distant from the liver hilum was observed in up to 4% of our patients during treatment of CHC with PEG and RIBA. While being reactive in nature and resolving upon cessation of therapy in the majority of patients de novo LNE may be due to serious disease and warrants further investigations.

Effect of gallbladder mucin on the crystallization of cholesterol in bile.

OBJECTIVES: Mucin is supposed to accelerate the crystallization of cholesterol in model bile while studies in native human gallbladder bile revealed conflicting results. METHODS: Therefore, we determined the relation of mucin concentration and cholesterol crystal observation time in gallbladder bile of 73 patients with cholesterol and mixed and 21 patients with pigment stones. In addition, bile samples of 20 patients with cholesterol gallstones were supplemented with either 0 (control) or 0.5-4.0 mg/ml purified bovine mucin or human mucin isolated from gallbladder bile, to study the effect of variable mucin concentrations on the crystallization of cholesterol. RESULTS: Rapid nucleating biles ( 4 days, n = 35) cholesterol crystal observation times (P < 0.05), but no correlation between mucin concentration and cholesterol crystal observation time was observed. Supplementation experiments with bovine purified mucin (up to 4.0 mg/ml) showed no significant effect on the total amount of newly formed cholesterol crystals within 21 days. However, higher amounts of newly formed cholesterol crystals were seen in bile samples supplemented with human mucin in comparison to negative controls. CONCLUSIONS: Our results demonstrate a dose-dependent effect of human but not of bovine gallbladder mucin on the formation of cholesterol monohydrate crystals in gallbladder bile of patients with cholesterol stones. Therefore, studies of cholesterol crystallization in model bile systems may be valuable but should always be confirmed in native gallbladder bile as the more physiological effector system.