Background/Aims: Colonoscopy is the gold standard diagnostic method for colorectal neoplasia, allowing detection and resection of adenomatous polyps; however, significant proportions of adenomas are missed. Computer-aided detection (CADe) systems in endoscopy are currently available to help identify lesions. Diminutive (≤5 mm) and nonpedunculated polyps are most commonly missed. This meta-analysis aimed to assess whether CADe systems can improve the real-time detection of these commonly missed lesions. Methods: A comprehensive literature search was performed. Randomized controlled trials evaluating CADe systems categorized by morphology and lesion size were included. The mean number of polyps and adenomas per patient was derived. Independent proportions and their differences were calculated using DerSimonian and Laird random-effects modeling. Results: Seven studies, including 2,595 CADe-assisted colonoscopies and 2,622 conventional colonoscopies, were analyzed. CADe-assisted colonoscopy demonstrated an 80% increase in the mean number of diminutive adenomas detected per patient compared with conventional colonoscopy (0.31 vs. 0.17; effect size, 0.13; 95% confidence interval [CI], 0.09–0.18); it also demonstrated a 91.7% increase in the mean number of nonpedunculated adenomas detected per patient (0.32 vs. 0.19; effect size, 0.05; 95% CI, 0.02–0.07). Conclusions CADe-assisted endoscopy significantly improved the detection of most commonly missed adenomas. Although this method is a potentially exciting technology, limitations still apply to current data, prompting the need for further real-time studies.

The present study deals with the co-ordination of cytokine(IL-4 and IFN-γ) expression and kinetics of peste des petits ruminants(PPR) virus antigen and antibody in PPRV infected and vaccinated goats.The infected animals exhibited mixed cytokine(both TH1 and TH2) responses in the initial phase of the disease.The infected and dead goats had increased IFN-γ response before their death; while IL-4 remained at the base level.The cytokine expression in recovered animals was almost similar to that of vaccinated ones,where a unique biphasic response of IL-4 expression was observed with an up-regulation of IFN-γ on 7th days post vaccination(dpv).Analysis of PPR virus antigen and antibody kinetics in different components of blood from infected and vaccinated animals revealed that the PPR virus antigen load was highest in plasma followed by serum and blood of the infected animals,whereas vaccinated animals showed only marginal positivity on 9th dpv.The antibody titer was high in serum followed by plasma and blood in both vaccinated and infected animals.Therefore,it is inferred that the presence of antigen and antibody were significant with the expression of cytokine,and that a decreased response of IL-4 was noticed during intermediate phase of the disease i.e.,7 to 12th days post infection(dpi).This indicates the ability to mount a functional TH2 response after 14th dpi could be a critical determinant in deciding the survival of the PPR infected animal.

BACKGROUND: This study was undertaken to identify the prevalence of pulmonary embolism (PE) in the emergency department (ED) of an urban teaching hospital and also to test a Bayesian model in estimating the number of CT pulmonary angiography (CTA) expected to be performed in an emergency department. METHODS: The data for this study was obtained through a retrospective review of electronic medical records for all ED patients suspected of PE who underwent chest CTA or ventilation perfusion scanning (V/Q) between 2009 and 2010. The data is presented as means and standard deviation for continuous variables and percentages with 95％ confidence intervals (95％CI) for proportions. The prevalence of PE was used as pre-test probability in the Bayesian model. Post-test probability was obtained using a Fagan nomogram and likelihood ratios for CTA. RESULTS: A total of 778 patients (560 females) with mean age of 50 years (range 18–98 years) were enrolled (98.3％ underwent chest CTA and 1.7％ underwent V/Q scan). A total of 69 patients had PE, rendering an overall prevalence of 8.9％ (95％CI, 7.1％ to 11.1％) for PE. We calculated that 132 CTA's per year could be avoided in our institution, without compromising safe exclusions of PE (keeping post-test probability of PE below 2％). CONCLUSIONS: Despite differences in our patient populations and /or study designs, the prevalence of PE in our institution is about average compared to other institutions. Our proposed model for calculating redundant chest CTA is simple and can be used by institutions to identify overuse of CTA.