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The infrequent occurrence of right colon diverticulitis in the developed West has led to a controversy in the management of this disease. In Singapore, we continued to avoid colectomy whenever possible because this disease is usually nonprogressive. We reviewed 68 patients treated by conservative surgery to evaluate the effectiveness of this treatment policy. Almost 70 percent of our patients were below 40 years of age, and the clinical presentation was indistinguishable from acute appendicitis. Diverticulectomy was done only for inflamed and perforated diverticula (25 cases), while the nonperforated diverticulum was left alone (40 cases). The inflammation invariably responded to antibiotic therapy. Only three patients had colonic resection since a malignant neoplasm could not be excluded. There were no adverse sequelae over a mean follow-up period of three and one-half years, except for one patient who had recurrent attacks of right colon diverticulitis necessitating colectomy. With this policy of management we encountered no mortality, and morbidity was acceptable.

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Objective: To evaluate resection and re-resection practice in the South West region of England in patients with newly diagnosed T1 bladder cancer. Patients and methods: All patients diagnosed with T1 disease between 2005 and 2008 were identified. Patients with incomplete primary resections were excluded. Results: Of 344 patients identified, the primary resection specimen did not contain deep muscle in 110 (32%). In total, 76 patients (22%) underwent a planned re-resection within 8 weeks of their primary resection. In 225 patients, a routine check cystoscopy was performed at an interval of 3 months or greater. The remainder had no further cystoscopy. Residual disease was present in 38 (50%) patients undergoing early re-resection and 89 (40%) patients in the routine check cystoscopy group. Upstaging of tumours from T1 to T2 was demonstrated in 7% and 5% of patients within these respective groups. Grade of operating surgeon was not a predictor of adequacy of resection or tumour persistence/recurrence.

Background: Microbleeds (MBs) are common in AD and may be associated with amyloid angiopathy or cardiovascular risk factors. We aimed to investigate the prevalence of microbleeds in subjects selected for a prodromal AD trial. Additionally, baseline MBs were investigated in relation to clinical characteristics, cardiovascular risk factors and medial temporal lobe atrophy (MTA). Methods: We selected subjects from the Lipididiet (LDD) study. The LDD Study is a 24-month, double-blind, parallel-group RCT investigating the effects of Souvenaid in 300 elderly at high risk of developing AD. Inclusion criteria were a diagnosis of amnestic MCI with evidence for underlying AD pathology based on either abnormal beta amyloid or tau in cerebrospinal fluid (CSF), MTA on Magnetic Resonance Imaging (MRI) Subjects had to be 55 to 85 years with a Mini Mental State Examination (MMSE) score of 24. For this analysis we selected subjects from 3 participating centers including 86 subjects. As clinical measures we used the MMSE, the Clinical Dementia Rating (CDR) scale, the CERAD 10-word recall task, verbal fluency, and the Concept Switching Test (CST). Vascular risk factors investigated were blood pressure (BP) and Body Mass Index (BMI). MRI scans were performed on a 1.5 or 3.0 Tesla scanner. MBs were counted visually on SWI-sequences and dichotomised as present or absent. We also rated MTA.We analyzed data using multivariate logistic regression adjusted for age, education and gender. Results: Subjects were on average 71.5 years (SD 6.4) old and 39 (45.3%) of them were women. At baseline 18 subjects (20.9%) had one or more MB (median 3, range 1-30). The prevalence of MBs increased with age (15.1% in subjects < 75 years, 30.3% in subjects 75 years).Baseline MMSE (25.3 vs 26.8), CERAD word learning and recall and verbal fluency, were lower in subjects with MBs. Subjects with MBs had more severe MTA. BMI and BP were not associated with MBs. Conclusions: MBs are commonly present in subjects with prodromal AD. Subjects with MBs may represent a specific phenotype characterised by more severe cognitive impairment and MTA. The lack of association with cardiovascular risk factors suggests that these are not a major cause of the MBs in this population.