Background & Aims: Adenoma detection rate (ADR) is an important quality assurance measure for colonoscopy. Some studies suggest that narrow band imaging (NBI) may be more effective at detection of adenomas than white-light endoscopy (WLE) when bowel preparation is optimal. We conducted a meta-analysis of data from individual patients in randomized controlled trials that compared the efficacy of NBI to WLE in detection of adenomas. Methods: We searched MEDLINE, EMBASE, and Cochrane library databases, through April 2017, for randomized controlled trials that assessed detection of colon polyps by highdefinition WLE vs NBI and from which data on individual patients was available. The primary outcome measure was ADR adjusted for bowel preparation quality. Multilevel regression models were used with patients nested within trials, and trial included as a random effect. Results: We collected data from 11 trials, comprising 4491 patients and 6636 polyps detected. Adenomas were detected in 952/2251 (42.3%) participants examined by WLE vs 1011/2239 (45.2%) participants examined by NBI (unadjusted odds ratio [OR] for detection of adenoma by WLE vs

BackgroundA colonoscopy may frequently miss polyps and cancers. A number of techniques have emerged to improve visualization and to reduce the rate of adenoma miss.MethodsWe conducted a randomized controlled trial (RCT) in two clinics of the Gastrointestinal Department of the Sanitas University Foundation in Bogota, Colombia. Eligible adult patients presenting for screening or diagnostic elective colonoscopy were randomlsy allocated to undergo conventional colonoscopy or narrow-band imaging (NBI) during instrument withdrawal by three experienced endoscopists. For the systematic review, studies were identified from the Cochrane Library, PUBMED and LILACS and assessed using the Cochrane risk of bias tool.ResultsWe enrolled a total of 482 patients (62.5% female), with a mean age of 58.33 years (SD 12.91); 241 into the intervention (NBI) colonoscopy and 241 into the conventional colonoscopy group. Most patients presented for diagnostic colonoscopy (75.3%). The overall rate of polyp detection was significantly higher in the conventional group compared to the NBI group (RR 0.75, 95%CI 0.60 to 0.96). However, no significant differences were found in the mean number of polyps (MD -0.1; 95%CI -0.25 to 0.05), and the mean number of adenomas (MD 0.04 95%CI -0.09 to 0.17). Meta-analysis of studies (regardless of indication) did not find any significant differences in the mean number of polyps (5 RCT, 2479 participants; WMD -0.07 95% CI -0.21 to 0.07; I2 68%), the mean number of adenomas (8 RCT, 3517 participants; WMD -0.08 95% CI -0.17; 0.01 to I2 62%) and the rate of patients with at least one adenoma (8 RCT, 3512 participants, RR 0.96 95% CI 0.88 to 1,04;I2 0%).ConclusionNBI does not improve detection of colorectal polyps when compared to conventional colonoscopy (Australian New Zealand Clinical Trials Registry ACTRN12610000456055).

The current evidence suggests that antifungal agents should be used early in patients suffering from NEC. However, this hypothesis must be evaluated in multi-centric, randomised controlled trials.

Traditional and mainstream legal frameworks conceive law primarily as a purely rational practice, free from affect or intuition. However, substantial evidence indicates that human decision-making depends upon diverse biases. We explored the manifestation of these biases through comparisons among 45 criminal judges, 60 criminal attorneys, and 64 controls. We examined whether these groups’ decision-making patterns were influenced by (a) the information on the transgressor’s mental state, (b) the use of gruesome language in harm descriptions, and (c) ongoing physiological states. Judges and attorneys were similar to controls in that they overestimated the damage caused by intentional harm relative to accidental harm. However, judges and attorneys were less biased towards punishments and harm severity ratings to accidental harms. Similarly, they were less influenced in their decisions by either language manipulations or physiological arousal. Our findings suggest that specific expertise developed in legal settings can attenuate some pervasive biases in moral decision processes.

La infección esofágica por virus del herpes es una entidad rara que se ha reportado con mayor frecuencia en pacientes inmunocomprometidos. Esta infección afecta principalmente a pacientes con virus de la inmuno- deficiencia humana (VIH) y a pacientes que reciben terapia inmunosupresora o quimioterapia. La severidad de los síntomas está relacionada con el grado de afectación esofágica, siendo la odinofagia la presentación clínica más frecuente. Por otro lado, el hallazgo endoscópico más común es la presencia de úlceras múltiples bien circunscritas que se presentan típicamente en el tercio distal del esófago. El tratamiento estándar des- crito es el aciclovir oral por 1 a 2 semanas.