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PurposeThe purpose of the study was to evaluate the efficacy of preoperative intravenous (IV) ferric carboxymaltose (FCM) administration vs. no-IV iron in colon cancer (CC) anemic patients undergoing elective surgery with curative intention.MethodsThis was a multicenter, observational study including two cohorts of consecutive CC anemic patients: the no-IV iron treatment group was obtained retrospectively while FCM-treated patients were recorded prospectively.ResultsA total of 266 patients were included: 111 received FCM (median dose 1000 mg) and 155 were no-IV iron subjects. Both groups were similar in terms of demographic characteristics, tumor location, surgical approach, and intra-operative bleeding severity. The FCM group showed a significant lower need for red blood cell (RBC) transfusion during the study (9.9 vs. 38.7 %; OR: 5.9, p < 0.001). In spite of lower hemoglobin levels at baseline diagnosis and lower transfusion rates in the FCM group, the proportion of responders was significantly higher with respect to the no-IV group both at hospital admission (48.1 vs. 20.0 %, p < 0.0001) and at 30 days post-surgery (80.0 vs. 48.9 %, p < 0.0001). The percentage of patients with normalized hemoglobin levels was also higher in the FCM group (40.0 vs. 26.7 % at 30 days, p < 0.05). A lower number of reinterventions and post-surgery complications were seen in the FCM group (20.7 vs. 26.5 %; p = 0.311). The FCM group presented a significant shorter hospital stay (8.4 ± 6.8 vs. 10.9 ± 12.4 days to discharge; p < 0.001).ConclusionsPreoperative ferric carboxymaltose treatment in patients with CC and iron deficiency anemia significantly reduced RBC transfusion requirements and hospital length of stay, reaching higher response rates and percentages of normalized hemoglobin levels both at hospital admission and 30 days post-surgery.

The peer group of an image pixel is a pixel similarity-based concept which has been successfully used to devise image denoising methods. However, since it is difficult to define the pixel similarity in a crisp way, we propose to represent this similarity in fuzzy terms. In this paper, we introduce the fuzzy peer group concept, which extends the peer group concept in the fuzzy setting. A fuzzy peer group will be defined as a fuzzy set that takes a peer group as support set and where the membership degree of each peer group member will be given by its fuzzy similarity with respect to the pixel under processing. The fuzzy peer group of each image pixel will be determined by means of a novel fuzzy logic-based procedure. We use the fuzzy peer group concept to design a two-step color image filter cascading a fuzzy rule-based switching impulse noise filter by a fuzzy average filtering over the fuzzy peer group. Both steps use the same fuzzy peer group, which leads to computational savings. The proposed filter is able to efficiently suppress both Gaussian noise and impulse noise, as well as mixed Gaussian-impulse noise. Experimental results are provided to show that the proposed filter achieves a promising performance.

Peptic ulcer disease is still highly associated with H. pylori infection in southern Europe, and only 1.6% of all duodenal ulcers and 4.1% of all gastric ulcers were not associated with either H. pylori infection or NSAID use.

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