Diagnostic reasoning in internal medicine: a practical reappraisal.

The practice of clinical medicine needs to be a very flexible discipline which can adapt promptly to continuously changing surrounding events. Despite the huge advances and progress made in recent decades, clinical reasoning to achieve an accurate diagnosis still seems to be the most appropriate and distinctive feature of clinical medicine. This is particularly evident in internal medicine where diagnostic boundaries are often blurred.

Small bowel adenocarcinoma copy number profiles are more closely related to colorectal than to gastric cancers.

Background: Small bowel adenocarcinoma (SBA) is a rare cancer and consequently, the options for clinical trials are limited. As they are treated according to either a colorectal or a gastric cancer regimen and the molecular biology of a tumor is a pivotal determinant for therapy response, chromosomal copy number aberrations were compared with the colorectal and gastric adenocarcinomas.

Materials And Methods: A total of 85 microsatellite stable (MSS) adenocarcinomas from the stomach, colorectum and small bowel were selected from existing array comparative genomic hybridization (aCGH) datasets.

Evidence of high sugar intake, and low fibre and mineral intake, in the gluten-free diet.

Background: The only therapy for coeliac disease (CD) is a long-term gluten-free diet (GFD). Little is known about the detailed composition of such a diet.

Aim: To clarify the nutritional composition of a GFD and to compare it with a non-GFD diet in representative non-CD populations.