The Astronomical Orientation of Ancient Greek Temples

Despite its appearing to be a simple question to answer, there has been no consensus as to whether or not the alignments of ancient Greek temples reflect astronomical intentions. Here I present the results of a survey of archaic and classical Greek temples in Sicily and compare them with temples in Greece. Using a binomial test I show strong evidence that there is a preference for solar orientations. I then speculate that differences in alignment patterns between Sicily and Greece reflect differing pressures in the expression of ethnic identity

Test-based exclusion diets in gastro-esophageal reflux disease patients: a randomized controlled pilot trial.

AIM: To investigate the clinical response of gastro-esophageal reflux disease (GERD) symptoms to exclusion diets based on food intolerance tests. METHODS: A double blind, randomized, controlled pilot trial was performed in 38 GERD patients partially or completely non-responders to proton pump inhibitors (PPI) treatment. Fasting blood samples from each patients were obtained; leukocytotoxic test was performed by incubating the blood with a panel of 60 food items to be tested. The reaction of leukocytes (rounding, vacuolization, lack of movement, flattening, fragmentation or disintegration of cell wall) was then evaluated by optical microscopy and rated as follows: level 0 = negative, level 1 = slightly positive, level 2 = moderately positive, and level 3 = highly positive. A “true” diet excluding food items inducing moderate-severe reactions, and a “control” diet including them was developed for each patient. Then, twenty patients received the “true” diet and 18 the “control” diet; after one month (T1) symptoms severity was scored by the GERD impact scale (GIS). Hence, patients in the “control” group were switched to the “true” diet, and symptom severity was re-assessed after three months (T2). RESULTS: At baseline (T0) the mean GIS global score was 6.68 (range: 5-12) with no difference between “true” and control group (6.6 ± 1.19 vs 6.7 ± 1.7). All patients reacted moderately/severely to at least 1 food (range: 5-19), with a significantly greater number of food substances inducing reaction in controls compared with the “true” diet group (11.6 vs 7.0, P < 0.001). Food items more frequently involved were milk, lettuce, brewer’s yeast, pork, coffee, rice, sole asparagus, and tuna, followed by eggs, tomato, grain, shrimps, and chemical yeast. At T1 both groups displayed a reduction of GIS score (“true” group 3.3 ± 1.7, -50%, P = 0.001; control group 4.9 ± 2.8, -26.9%, P = 0.02), although the GIS score was significantly lower in “true” vs “control” group (P = 0.04). At T2, after the diet switch, the “control” group showed a further reduction in GIS score (2.7 ± 1.9, -44.9%, P = 0.01), while the “true” group did not (2.6 ± 1.8, -21.3%, P = 0.19), so that the GIS scores didn’t differ between the two groups. CONCLUSION: Our results suggest that food intolerance may play a role in GERD symptoms development, and leucocytotoxic test-based exclusion diets may be a possible therapeutic approach when PPI are not effective or indicated

Biochemical Assessment and Clinical Evaluation of a Non-Ionic Adsorbent Resin in Patients with Intractable Jaundice

We investigated in vitro and in vivo the ability of a non-ionic adsorbing resin (styrenedivinylbenzene copolymer) to remove bilirubin and bile acids from human plasma. In preliminary experiments, human plasma from healthy donors, enriched in conjugated bile acids and bilirubin, and pooled plasma from jaundiced patients were recirculated through the resin column. The removal of bilirubin and bile acids was evaluated at two different flow rates (200 ml/min and 40 ml/min), and compared to an activated charcoal column. Four patients with severe jaundice were subsequently treated by 4-hour plasmaperfusion through the resin. The in vitro studies showed that after 1 hour the removal of bile acids was almost complete and bilirubin level decreased significantly, reaching a plateau after 4 hours. In the in vivo study, all treatments were well tolerated. After plasmaperfusion, serum bile acid levels decreased by 64.9–94.6% and total bilirubin by 35.3–57.7%. No clinical or biochemical side effects were observed. Our data suggest that plasmaperfusion through this resin is safe and efficient for removal of bilirubin and bile acids in jaundiced patients. Thus, it may serve as a method of artificial liver support in the treatment of cholestatic syndromes.</jats:p

Upper gastrointestinal endoscopy: are preparatory interventions or conscious sedation effective? A randomized trial.

AIM: The fears and concerns are associated with gastroscopy (EGD) decrease patient compliance. Conscious sedation (CS) and non-pharmacological interventions have been proposed to reduce anxiety and allow better execution of EGD. The aim of this study was to assess whether CS, supplementary information with a videotape, or presence of a relative during the examination could improve the tolerance to EGD. METHODS: Two hundred and twenty-six outpatients (pts), scheduled for a first-time non-emergency EGD were randomly assigned to 4 groups: Co-group (62 pts): throat anaesthesia only; Mi-group (52 pts): CS with i.v. midazolam; Re-group (58 pts): presence of a relative throughout the procedure; Vi-group (54 pts): additional information with a videotape. Anxiety was measured using the "Spielberger State and Trait Anxiety Scales". The patients assessed the overall discomfort during the procedure on an 100-mm visual analogue scale, and their tolerance to EGD answering a questionnaire. The endoscopist evaluated the technical difficulty of the examination and the tolerance of the patients on an 100-mm visual analogue scale and answering a questionnaire. RESULTS: Pre-endoscopy anxiety levels were higher in the Mi-group than in the other groups (P<0.001). On the basis of the patients' evaluation, EGD was well tolerated by 80.7% of patients in Mi-group, 43.5% in Co-group, 58.6% in Re-group, and 50% in Vi-group (P<0.01). The discomfort caused by EGD, evaluated by either the endoscopist or the patients, was lower in Mi-group than in the other groups. The discomfort was correlated with "age" (P<0.001) and "groups of patients" (P<0.05) in the patients' evaluation, and with "gender" (females tolerated better than males, P<0.001) and "groups of patients" (P<0.05) in the endoscopist's evaluation. CONCLUSION: Conscious sedation can improve the tolerance to EGD. Male gender and young age are predictive factors of bad tolerance to the procedure

Cost-effectiveness of colonoscopy colorectal cancer (CRC) screening in asymptomatic increased risk subjects

Screening programs represent the best tool to prevent CRC. Colonoscopy (C) is an effective CRC screening test, allowing entire colon examination, and adenomas removal, but a Cscreening program is difficult and expensive to perform in the general population. Since recent data have shown that first degree relatives of CRC patients are at increased risk for adenoma, we designed a screening program focused on this population. On October 1999 we starded a campaign stressing the usefulness of C in first degree relatives of CRC patients (meetings with GPs and surgeons, public conferences, a dedicated web site, printed booklets, newspaper articles, local radio/-rv program). Moreover, all patients undergoing surgery for CRC were asked to inform their first degree relatives about the program. All subjects aged between 45-75 yr with at least one first-degree relative with CRC were invited to a preliminary interview, in order to collect personal and family data and to suggest C as screening option. When C was refused, barium enema or faecal occult blood test were suggested. From January 2000 to October 2001, 359 subjects were interviewed (174 ma/es and 185 females, mean age 56.7): 279 had one parent, 77 one brother and 3 one son affected by CRC. 5 subjects refused to participate in the study, 22 refused C (13 chose barium enema, and 9 faecal occult blood test: all these subjects had negative findings). 332 agreed to C (92.5%): 276 C have been already performed (56 are scheduled). Polyps were found in 86 subjects (31.1%): 25 hyperplastic polyps and 61 adenomas (22.1% of C performed). Among adenomas, 43 (70.5%) were tubular, 12 (19.7%) tubulovillous, and 6 (9.8%) villous with severe dysplasia. Moreover, one carcinoma (Dukes A) was found. Multiple adenomas were found in 27 (44.2%), and in 24 (39.3%) the diameter was >1 cm. No complications related to C or polypectomy were observed. Total direct cost for C-based screening was $77,400. Costs were largely due to C (64$125, total C cost $41,430 (including histology). Indirect costs, particularly volunteer service needful for the campaign, were not included. Conclusions: - Compliance is fundamental for screening programs effectiveness: a 92.5% compliance was reached -Our results confirm a high prevalence of adenomas and early colon cancer in first degree relatives of CRC patients -Our preliminary data of cost analysis suggest the effectiveness of C in increased risk patients. A C-based screening in selected high risk populations is probably cost-effectiv