Simple Signs Research Articles

Dacian Graffiti from Covasna – Cetatea Zânelor

Six graffiti from the time of the Dacian Kingdom were discovered at Covasna – Cetatea Zânelor (Fairies Fortress). Four vessels with graffiti can be associated with a building having the roof supported by three rows of wooden pillars. Two signs were made before firing and other four after burning, on good quality vessels, preserved in a fragmentary condition. The main issue is whether these graffiti are simple scratches or graphic signs.

LANGUAGE VARIATIONS IN DEPOK: A STUDY OF LINGUISTIC LANDSCAPE AND DIALECTOLOGY

Written languages are present in various media in public landscapes, such as notice boards, banners, or bumper stickers. Studying these simple signs is the starting point in observing how a language variety exists and interacts with other languages. It is interesting to study how the instances of written texts found in public landscapes can be an indicator of what language variety is actually used by the inhabitants of Depok. Based on its history and its geography, a hypothesis states that many speakers of Betawi language and Sundanese reside in Depok. The study is aimed at demonstrating the written language varieties found in Depok public landscapes based on written evidence which are compared with language varieties based on the regional variation (dialectology). This qualitative study used the sociogeolinguistic approach combining sociolinguistics, linguistic landscape, and dialectology (geolinguistics). The results show there are two language use distributions in Depok, the Sundanese and the Betawi language. From the landscapes, Betawi language is used in billboards, restaurant signboards, and local government banners. The study is useful for the local government in their efforts to confirm the identity of Depok people.

Hand posture as localizing sign in adult focal epileptic seizures.

The aim of this study was to identify specific ictal hand postures (HPs) as localizing signs of the epileptogenic zone (EZ) in patients with frontal or temporal lobe epilepsy. In this study, we retrospectively analyzed ictal semiology of 489 temporal lobe or frontal lobe seizures recorded over a 6-year period at the Seizure Disorder Center at University of California, Los Angeles in the USA (45 patients) or at the C. Munari Epilepsy Surgery Center at Niguarda Hospital in Milan, Italy (34 patients). Our criterion for EZ localization was at least 2 years of seizure freedom after surgery. We analyzed presence and latency of ictal HP. We then examined whether specific initial HPs are predictive for EZ localization. We found that ictal HPs were present in 72.5% of patients with frontal and 54.5% of patients with temporal lobe seizures. We divided HPs into 6 classes depending on the reciprocal position of the fingers ("fist," "cup," "politician's fist," "pincer," "extended hand," "pointing"). We found a striking correlation between EZ localization and ictal HP. In particular, fist and pointing HPs are strongly predictive of frontal lobe EZ; cup, politician's fist, and pincer are strongly predictive of temporal lobe EZ. Our study offers simple ictal signs that appear to clarify differential diagnosis of temporal versus frontal lobe EZ localization. These results are meant to be used as a novel complementary tool during presurgical evaluation for epilepsy. At the same time, they give us important insight into the neurophysiology of hand movements. ANN NEUROL 2019;86:793-800.

Evaluation of knowledge and perception regarding pneumonia among the mothers of under-ten children in Tangail, Bangladesh

<p class="abstract"><strong>Background:</strong> Childhood pneumonia is a serious infection and the single largest infectious cause of death in children. The study aims to evaluate knowledge and perception among mothers on pneumonia diseases among the children.</p><p class="abstract"><strong>Methods:</strong> A hospital based study was conducted to describe socio-demographic factors of mothers, their knowledge and perception of pneumonia disease. Study was conducted at Sheikh Hasina Medical College Hospital in Tangail from June to July 2018 by interviewing 215 mothers of children under-ten years attending a pediatric clinic by using structured questionnaire. </p><p class="abstract"><strong>Results:</strong> The parents were predominantly primary school graduates (70.7%). The majority of the father worked as daily laborer (61.9%) with about 5-10K BDT of family income per month. Around 88.4% of the mothers had fair knowledge about pneumonia. For children treatment, 90.2% parents consulted with qualified doctor, about 10% utilized self-medication. About 44.7% children were suffered from fever during pneumonia, about 42.8% was experienced shortness of breath, and about 28.4% experienced of wheezing. About 90.2% parents believed that the indoor temperature, humidity and air movement has effect on pneumonia. About 92.6% cares of reducing indoor smoke and dust, about 40.5% families have a smoker. The lack of knowledge among mothers about simple signs and symptoms of pneumonia and also about its causes and factors related with it has become important findings of this study.</p><p class="abstract"><strong>Conclusions:</strong> Community based public health education and training for health providers at all levels have to be provided about correct and applicable prevention and assessments of pneumonia.</p>

Predicting Cardiac Arrest and Respiratory Failure Using Feasible Artificial Intelligence with Simple Trajectories of Patient Data

We introduce a Feasible Artificial Intelligence with Simple Trajectories for Predicting Adverse Catastrophic Events (FAST-PACE) solution for preparing immediate intervention in emergency situations. FAST-PACE utilizes a concise set of collected features to construct an artificial intelligence model that predicts the onset of cardiac arrest or acute respiratory failure from 1 h to 6 h prior to its occurrence. Data from the trajectory of 29,181 patients in intensive care units of two hospitals includes periodic vital signs, a history of treatment, current health status, and recent surgery. It excludes the results of laboratory data to construct a feasible application in wards, out-hospital emergency care, emergency transport, or other clinical situations where instant medical decisions are required with restricted patient data. These results are superior to previous warning scores including the Modified Early Warning Score (MEWS) and the National Early Warning Score (NEWS). The primary outcome was the feasibility of an artificial intelligence (AI) model predicting adverse events 1 h to 6 h prior to occurrence without lab data; the area under the receiver operating characteristic curve of this model was 0.886 for cardiac arrest and 0.869 for respiratory failure 6 h before occurrence. The secondary outcome was the superior prediction performance to MEWS (net reclassification improvement of 0.507 for predicting cardiac arrest and 0.341 for predicting respiratory failure) and NEWS (net reclassification improvement of 0.412 for predicting cardiac arrest and 0.215 for predicting respiratory failure) 6 h before occurrence. This study suggests that AI consisting of simple vital signs and a brief interview could predict a cardiac arrest or acute respiratory failure 6 h earlier.

Signizing: The root of the functions of the intentional sign

Abstract Studies on the functions of the sign to date have been inadequate in that they leave unanswered a basic question of semiotics: What are the functions of a simple sign that consists essentially in the relation between two relata? The answer to this question is to be found in the phenomenon called “signize.” For intentional signs at least, all the mental entities can be signized, but only certain kinds of them have a strong signizing value. When these mental entities are signized, they tend to be signized into certain kinds of images. The advantages of these images over those mental entities give rise to certain benefits that, in turn, result in the basic functions of simple intentional signs. These basic functions are the starting point of a systematic study of the hierarchy of functions of intentional sign.

TYPES OF THE SIGHNS AND METHODS OF THEIR DIAGNOSTIC ANALYSIS IN THE LINGUISTIC RESEARCH OF ORAL SPEECH

The article examines a set of issues related to the features of the classification of signs of oral speech for various diagnostic and evaluation criteria: – by their stability / instability; – by their origin (congenital / acquired); – by their nature (dynamic / static); – according to the form of implementation (materially expressed / hidden); – according to their functional purpose (monofunctional / multifunctional); – by their composition (simple / complex / complex /; – by their classification significance (general / private); – by frequency of implementation in speech, etc. All listed classification groups of signs are described both in the content plan and in the functional one, that is, the features of their identification, evaluation of the factors under the influence of which they formed and the evaluation of their diagnostic and identification significance are analyzed. Such an approach to their study is due to the fact that the possibility of correlating a trait with a particular area of ​​scientific knowledge is not always obvious and unambiguous. Different properties of the human person can be realized in his speech in the form of one and the same sign. For example, a more closed version of the pronunciation of sound [a] can manifest itself as an individual feature of the articulation of a particular person, as a sign of speech in a non-native language or a dialect feature (a common sign that is studied in the framework of sociolinguistics, psycholinguistics and linguistics), as a sign of imitation which is studied in the framework of psycholinguistics, sociolinguistics, linguistics), as an accidental (unstable) feature, the manifestation of which is due to the physical state of the speaker, nicative situation (eating, jogging in the process of speaking), etc. Therefore, understanding the nature of the origin and realization of a particular sign in speech is a fundamental condition for its correct classification, on the basis of which an objective assessment of its diagnostic and identification significance is subsequently achieved in the complex of signs of a particular person’s speech and, consequently, of his forming expert conclusions. The article also outlines the principles for the classification of signs according to their composition by dividing them into three groups: simple signs, complex and complex. Particular attention is paid to complex features (for example, signs of cross-language interference), which consist of simple signs and are established after analyzing the signs of the components. As a result, complex signs are often not fully investigated, which can lead to the bias of the expert’s conclusions. Key words: linguistic study of oral speech, diagnostic analysis, idiolect, classification, sign, evaluation of the significance of the sign, complex of signs, persistent sign, intensity of manifestation of signs, interlingual interference, level of linguistic research.

Risk Factors of Mortality in Acute Lower Respiratory Tract Infections in Children (1 Month to 5 Years)

Introduction: ARI has been estimated to be the single largest cause of death in young children. This study will be used to evaluate factors that may predict mortality due to ALRTI in children, thus helping to identify those at risk, so that timely therapeutic measures may be instituted. Material and Methods: A prospective case control study on 200 children with acute lower respiratory tract infections in the age group of 1 month to 5 years of age, conducted during the period august 2010 to October 2011 at Ekta institute of child health, Raipur, C.G. Detailed history, clinical examination, radiological and biochemical tests were done. Case fatality rate was calculated using formula- Total number of deaths due to a particular disease / Total number of cases due to the same disease × 100 Chi square test was applied and p value calculated. Results: Cases were those who died during study & controls were those who were discharged.There were 182 controls and 18 cases, the risk factors which were evaluated are 1-2 months age, male child, class V socioeconomic status, grade IV malnutrition, very severe pneumonia, afebrile, hyponatremic and hypoxemic patients. Conclusion: In children with an acute lower respiratory tract infection, simple physical signs that require minimal expertise to recognise can be used to determine oxygen therapy and to aid in screening for referral. The association between hypoxemia and death highlights the need for early recognition of the condition and the potential benefit of treatment.

Assessment of the utility of Yale observation scale as a predictor of bacteremia in children aged 3 months to 36 months

Background: The Yale observation scale (YOS) is an illness severity helps to diagnose bacteremia based on simple noninvasive clinical signs and symptoms. The aim of the present study was to assess the utility of YOS as a predictor of bacterial infection in febrile children aged 3 to 36 months.Methods: This prospective observational study was conducted on 200 children aged 3 to 36 months presenting with fever, at the Institute of Child Health and Hospital for Children during the period from April 2016 to September 2016. Rectal temperature was taken for all children. Clinical examination was done as required based on the YOS and scores were given accordingly at the time of initial presentation of the child before invasive investigations. All the observation was assessed statistically and receiver operating characteristics (ROC) curve was performed to analyze the sensitivity of the YOS.Results: Highly significant correlation (p=0.0001) was found to exist between the age of the child, duration of the fever, higher body temperature >104, WBC count, ANC and improved condition of patient with higher YOS. ROC curves showed that the sensitivity and specificity of YOS at the best cut off value of 14.5 was found to be 97% and 79.6% respectively.Conclusions: YOS is very good tool for predicting bacteremia in young febrile children based on simple non-invasive clinical signs and symptoms. The findings ruled out by YOS aids in the immediate and early management of bacterial infections before the arrival of the results of the biochemical diagnostic tests.

Publicity Tile Panels in Portugal: a Singularity within Identity

In mid-19th century when tiles turn to the outside of the buildings, covering façades, a singularity in tile production came to light: their use as advertising or publicity support. From the third quarter of the 19th century on, very simple signs made of tiles start to inform about products, shops, workshops or services. Since then, until mid-20th century, this sort of production never stopped, being able to update itself to new artistic styles following graphic arts and publicity concepts evolution. Work of unknown artists as well as of consecrated painters and designers, it evolved from the simple lettering to the most exuberant colourful figurative representations.
 Despite its decline from mid-20th century, this sort of panels never completely disappeared and continued to be produced until nowadays. The present article aims to analyse the publicity panels, a singular tile production scattered all over the country, relating them to the Portuguese artistic identity.

Doppler ultrasonography devices, including elastography, allow for accurate diagnosis of severe liver fibrosis

ObjectivesAdvanced chronic liver disease is frequent yet largely underdiagnosed. Doppler-US is a common examination and we recently identified three simple Doppler-US signs associated with severe liver fibrosis. Recent Doppler-US devices include elastography modules, allowing for liver stiffness measurement (LSM). Our aim was to assess whether the use of elastography following positive simple Doppler-US signs improves the detection of severe liver fibrosis in a single Doppler-US examination. Methods514 patients with chronic liver disease who consecutively underwent percutaneous liver biopsy were included in the study. All patients had a Doppler-US examination and LSM with Virtual Touch Quantification (VTQ) on the same day as a liver biopsy. A subset of 326 patients also had LSM with 2D shear wave elastography (SSI). Severe fibrosis was defined as Metavir F ≥ 3 on liver biopsy. ResultsMultivariate analysis confirmed our three simple Doppler-US signs (liver surface irregularity, splenomegaly ≥110 mm, and demodulation of hepatic veins) as independently associated with severe fibrosis. The presence of at least one of these three signs showed 85.6% sensitivity and 36.1% specificity for the diagnosis of severe liver fibrosis. Using VTQ (≥1.59 m/s) where there was a positive Doppler-US sign increased the specificity to 80.8%, at the cost of a decrease in sensitivity (73.7%). Similar results were obtained with SSI (≥9.5 kPa), with 73.3% specificity and 81.5% sensitivity. ConclusionElastography improves the accuracy of Doppler-US in the detection of severe fibrosis. This two-step procedure will help radiologists to accurately identify patients who need to be referred to specialist hepatologists during routine Doppler-US examinations.

Clinical profile and radiological evaluation of severe pneumonia in children, age 2 months up to 5 years: a descriptive cross-sectional study

Acute respiratory illness, primarily pneumonia, is the main cause of mortality in children under five years in most developing countries - result in 1.9 million deaths each year. To reduce mortality from these diseases, WHO introduced case management guidelines based on simple clinical signs for diagnosing pneumonia followed by empirical treatment with antibiotics. For management purposes, pneumonia is subclassified according to its severity by using general danger sign, chest indrawing or fast breathing. But these factors are influenced by malaria, meningitis, hyperactive airway disorder, bronchiolitis and fever. So clinical profile and their chest radiographs were analyzed in children aged 2-59 months who presented to a health facility with severe pneumonia using WHO guidelines. The purpose was to observe the clinical profile, evaluate radiological features of severe pneumonia and also to correlate the efficacy of clinical criteria with that of radiological findings. The study was conducted under the department of Pediatrics, Mymensingh Medical College Hospital and the samples were collected from the Inpatient department of Pediatrics in this hospital. It was a cross sectional observational study. 100 consecutive samples were collected from mothers with their children aged 2-59 months who met the inclusion criteria. Out of 100 children 56 were male and 44 were female children and male female ratio was 1.3:1. Majority (66%) of the children were partially immunized, 37% children were fully immunized and only 7% children were unimmunized as per EPI schedule. 42% of the children were malnourished and 13% were severely malnourished. Regarding clinical presentation all the patients presented with fever with cough (100%), 88% with difficult breathing, 11% had wheeze and 25% presented with general danger signs. Among the physical signs' temperature raised in 92%, Chest indrawing in 88%, flaring of alaenasi 78%, central cyanosis in 15%, pallor in 28%, stridor in 3%, bulged fontanel in 2% cases and BCG scar present in 65% of the cases. Clinical diagnosis of the studied cases revealed bronchiolitis in 31%, lobar pneumonia in 23%, bronchopneumonia in 27%, asthma in 12% and pulmonary tuberculosis in 7% cases. Routine examination of blood revealed 70% children were mild to moderately pale, 63% leukocytosis, 52% neutrophilic leukocytosis, 15% lymphocytic leukocytosis, ESR was raised in 52% of cases. Chest X-ray showed normal skiagram in 36%, consolidation in 23%, bronchopneumonia in 16%, nonspecific infection in 17% and hilar lymphadenopathy in 7% cases. 12% patients responded with ampicillin alone, 30% required gentamicin in addition, 39% required cloxacillin in addition to ampicillin and gentamicin, only ceftriaxone in 12% and 7% cases required anti tubercular treatment. Steroid used in 30% cases and bronchodilator in 42% cases. Immediate hospital outcome of these patients showed 78% cases improved, 12% patients left hospital against medical advice and 8% patients died in the hospital.
 CBMJ 2018 July: Vol. 07 No. 02 P: 24-33

Neurological Prognostications for the Therapeutic Hypothermia among Comatose Survivors of Cardiac Arrest.

Background:Currently, there are limited data of prognostic clues for neurological recovery in comatose survivors undergoing therapeutic hypothermia (TH). We aimed to evaluate clinical signs and findings that could predict neurological outcomes, and determine the optimal time for the prognostication.Materials and Methods:We retrospectively reviewed database of postarrest survivors treated with TH in our hospital from 2006 to 2014. Cerebral performance category (CPC), neurological signs and findings in electroencephalography (EEG) and brain computed tomography (CT) were evaluated. In addition, the optimal time to evaluate neurological status was analyzed.Results:TH was performed in 51 postarrest patients. Approximately 53% of TH patients survived at discharge and 33% of the hospital survivors had favorable outcome (CPC1-2). The prognostic clues for unfavorable outcome (CPC3-5) at discharge were lack of pupillary light response (PLR) and/or gag reflex after rewarming, and the absence of at least one of the brainstem reflexes, no eye-opening, or abnormal motor response on the 7th day. Myoclonus and seizure could not be used to indicate poor prognosis. In addition, prognostic values of EEG and CT findings were inconclusive.Conclusions:Our study showed the simple neurological signs helped predict short-term neurological prognosis. The most reliable sign determining unfavorable outcome was the lack of PLR. The optimal time to assess prognosis was either at 48–72 h or 7 days after return of spontaneous circulation.

Developing a new intelligent system for the diagnosis of tuberculous pleural effusion

Background and Objective: In countries with high prevalence of tuberculosis (TB), clinicians often diagnose tuberculous pleural effusion (TPE) by using diagnostic tests, which have not only poor sensitivity, but poor availability as well. The aim of our study is to develop a new artificial intelligence based diagnostic model that is accurate, fast, non-invasive and cost effective to diagnose TPE. It is expected that a tool derived based on the model be installed on simple computer devices (such as smart phones and tablets) and be used by clinicians widely.Methods: For this study, data of 140 patients whose clinical signs, routine blood test results, blood biochemistry markers, pleural fluid cell type and count, and pleural fluid biochemical tests’ results were prospectively collected into a database. An Artificial intelligence based diagnostic model, which employs moth flame optimization based support vector machine with feature selection (FS-MFO-SVM), is constructed to predict the diagnosis of TPE.Results: The optimal model results in an average of 95% accuracy (ACC), 0.9564 the area under the receiver operating characteristic curve (AUC), 93.35% sensitivity, and 97.57% specificity for FS-MFO-SVM.Conclusions: The proposed artificial intelligence based diagnostic model is found to be highly reliable for diagnosing TPE based on simple clinical signs, blood samples and pleural effusion samples. Therefore, the proposed model can be widely used in clinical practice and further evaluated for use as a substitute of invasive pleural biopsies.

Simple diagnostic signs in those with cognitive impairment-anything to improve detection of cognitive disorders.

With now over 50 million people worldwide with dementia (Prince et al., 2013), there are almost certainly well over 100 million people with cognitive concerns and many of these will attend their health professional keen to know what is going on. We need those without intensive training in this field to be more confident and correct in their diagnosis when such a concerned person turns up. Many simple diagnostic tests have been proposed and some assessed - these include the walk and talk (divided attention) test (those who stop when asked a question while walking may be cognitively impaired) (Lamoth et al., 2011), the clock drawing test (Brodaty and Moore, 1997), the "handbag" sign (those clutching their personal possessions are more likely to be cognitively impaired) and the "hippopotamus sign" (calling the rhinoceros, in those tests that include this, a hippopotamus). Simple screening tests have been extensively validated and are important to the clinician in formulating a diagnosis (Lorentz et al., 2002). The "head-turning" and the "attended with/alone" signs are frequently observed, and many clinicians assessing such individuals would be well aware of them and probably even unknowingly factor them into their diagnosis. In this issue, Pinar Soysal and colleagues (Soysal et al., 2017) have evaluated these signs and, in those older people attending with cognitive concerns, found they had quite good diagnostic value. They were not very specific but showed good sensitivity and negative predictive value. Indeed, at the recent Alzheimer's Association International Conference in London there were several posters evaluating "soft but simple" signs although not all performed as expected - one group found gait actually sped up in those with cognitive impairment that were asked a question.

Geological content on maps and in accompanying texts developed until the end of the 18th century

Abstract For many centuries on general geographical maps and early maritime maps geological information was rarely included. The map of the Wadi Hammamat valley, the Borgia world map, the Catalan world map and Carta de nauigar per le Isole nouamente... portolan chart were indicated as examples. Places where minerals occurred were presented mainly using textual descriptions. Among Renaissance maps and later maps published before the second half of the 18th century, the map of the Kingdom of Bavaria by Philipp Apian and the map of the Duchy of Świdnica in Silesia by Johann Wieland and Matthaus Schubart were discussed as examples. Distribution of raw materials and places of their extraction were shown using simple geometric signs with graphic characteristics for a given period. Mineralogical maps published in the second half of the 18th century were described based on the example of maps by Jean-Étienne Guettard and Johann Jirasek. Their content was compared with the texts accompanying them, developed under patronage of the contemporary scientific institutions and relevant methods of geological information presentation were described. From the late Renaissance symbols signifying extraction sites of raw materials had simplified and rather random shapes which indicates ‘unhurried’ development of cartographic methods on geological maps.

Infected nonunion of tibia.

Infected nonunions of tibia pose many challenges to the treating surgeon and the patient. Challenges include recalcitrant infection, complex deformities, sclerotic bone ends, large bone gaps, shortening, and joint stiffness. They are easy to diagnose and difficult to treat. The ASAMI classification helps decide treatment. The nonunion severity score proposed by Calori measures many parameters to give a prognosis. The infection severity score uses simple clinical signs to grade severity of infection. This determines number of surgeries and allows choice of hardware, either external or internal for definitive treatment. Co-morbid factors such as smoking, diabetes, nonsteroidal anti-inflammatory drug use, and hypovitaminosis D influence the choice and duration of treatment. Thorough debridement is the mainstay of treatment. Removal of all necrotic bone and soft tissue is needed. Care is exercised in shaping bone ends. Internal fixation can help achieve union if infection was mild. Severe infections need external fixation use in a second stage. Compression at nonunion site achieves union. It can be combined with a corticotomy lengthening at a distant site for equalization. Soft tissue deficit has to be covered by flaps, either local or microvascular. Bone gaps are best filled with the reliable technique of bone transport. Regenerate bone may be formed proximally, distally, or at both sites. Acute compression can fill bone gaps and may need a fibular resection. Gradual reduction of bone gap happens with bone transport, without need for fibulectomy. When bone ends dock, union may be achieved by vertical or horizontal compression. Biological stimulus from iliac crest bone grafts, bone marrow aspirate injections, and platelet concentrates hasten union. Bone graft substitutes add volume to graft and help fill defects. Addition of rh-BMP-7 may help in healing albeit at a much higher cost. Regeneration may need stimulation and augmentation. Induced membrane technique is an alternative to bone transport to fill gaps. It needs large amounts of bone graft from iliac crest or femoral canal. This is an expensive method physiologically and economically. Infection can resorb the graft and cause failure of treatment. It can be done in select cases after thorough eradication of infection. Patience and perseverance are needed for successful resolution of infection and achieving union.

A Poster of Disparity: A Visual Colorectal Cancer Screening Awareness Campaign Did Not Increase Screening Colonoscopy in African Americans

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States. African Americans have an increased incidence and mortality from CRC compared to other ethnicities. Despite this, African Americans continue to have lower screening rates than Caucasians. Special efforts are needed to increase CRC screening participation among African Americans. This study evaluated the effect of a simple, picture-predominant campaign promoting awareness of CRC and screening. Methods: A visual CRC awareness campaign was conducted at an urban academic medical center. Posters promoting CRC screening, comprised mainly of pictures and few words, were placed at the registration desks and waiting and examination rooms in the internal medicine department and gastroenterology division for one month. Using electronic health records, we performed a retrospective review of colonoscopies performed in the month of and one month after the campaign and in the same two months of the prior year. Patient demographics and procedure indication were obtained. Statistical analysis was conducted using Fisher's Exact Test with significance set at p< 0.05. Results: Our CRC awareness campaign of simple placards and signs increased the overall number of screening colonoscopies, but the increase among African Americans was not as significant as others. African American patients may have been less receptive to the campaign, or more reluctant to undergo the procedure or were unable to arrange a colonoscopy immediately following the campaign and within our study period. Additional efforts are needed in order to identify effective patient education techniques to increase screening rates in all patients and especially in African-Americans. Conclusion: Our CRC awareness campaign of simple placards and signs increased the overall number of screening colonoscopies, but the increase among African Americans was meager. African American patients may have been less receptive to the campaign or more reluctant to undergo the procedure. Alternatively, they may have been less able or motivated to arrange a colonoscopy immediately following the campaign and within our study period. African Americans are at increased risk for CRC morbidity and mortality and have a low rate of screening compared to Caucasians. Additional efforts are needed in order to identify effective patient education techniques to increase screening rates in this population.

Functional movement disorders.

The review highlights the most relevant recent developments in the field of functional movement disorders (FMD). The emphasis on making a 'positive' diagnosis has driven a renewed interest in assessing the value of simple clinical signs. Furthermore, an effort has been made to develop and test objective diagnostic tools. The association of FMD with several comorbidities is being acknowledged. Pathophysiological understanding has grown with the identification of new neurobiological abnormalities, including a decreased interoceptive sensitivity. Finally - and most importantly - the recognition of the potential benefits of specialized physiotherapy is changing FMD management. The field of FMD is moving forward on a number of fronts, including diagnosis, pathophysiology, and treatment. A major priority for future research is providing robust evidence regarding treatment.

Le syndrome de l’intestin irritable : nouvelles pistes physiopathologiques et conséquences pratiques

In 2015, besides the fact that it still fills the gastroenterologists’ offices and impairs patient's quality of life, the irritable bowel syndrome has considerably evolved on several points. The pathophysiology is now organized around a consensual hypothesis called the “brain-gut axis”, which gather all the influences of peripheral factors as gut microbiota or local serotonin secretion, on the central pain perception, contributing to visceral hypersensitivity and transit modifications. About the diagnosis, the key message is “avoid over-prescription” of additional tests, and reminds that a positive clinical diagnosis based on Rome III criteria is possible after the elimination of simple clinical warning signs. Finally, the food component, a neglected and historical claim of patients, finally finds a strong scientific rational, with a diet low in fermentable sugar and polyols, that gives positive and reproducible results.