Effectiveness of surgery in liver metastasis from colorectal cancer: experience and results of a continuous improvement process.

PURPOSE: The aim of this study was to estimate the effectiveness of surgery in liver metastasis from colorectal cancer. METHODS: We conducted a prospective and observational study of patients with colorectal liver metastasis operated on at the San Cecilio University Hospital of Granada from March 2003 until June 2013. The primary variables of the result were survival and morbidity before 30 days of the post-operative period. We also measured preoperative and surgical variables. RESULTS: A total of 147 patients with liver metastasis of colorectal origin underwent surgical removal during the period of study, 38 of whom had repeat surgery. 34 had a second resection, 3 had a third one and one only patient had a fourth one, for a total of 185 registered operations. The global 5-year survival rate was 38 and 17 % after 10 years. There were 115 patients who had neither radiofrequency nor exploratory laparotomy, 38 % of them survived over 60 months. The average disease-free time was 23.6 months ± 47.3, with significant differences observed between types of procedures. Patients that were operated on just once (n = 25) had a five-year actuarial survival rate of 35 %, a morbidity rate of 24 % and a mortality rate of 0.6 % (1 patient only). The average hospital stay was 13.8 days and the disease-free time was 15.8 months. CONCLUSION: The results obtained in our surgical unit in terms of morbidity, mortality and five-year actuarial survival rates are comparable to those of other units at large institutions, which are currently considered the standards of quality.

[Prevalence of nutritional overweight and obesity and hypertension as well as their relationship with anthropometric indicators in a population of students in Granada and its provinces]. / Prevalencia de sobrepeso y obesidad nutricional e hipertensión arterial y su relación con indicadores antropométricos en una población de escolares de Granada y su provincia.

INTRODUCTION: Several authors have found correlations between anthropometric parameters and blood pressure levels in overweight and obese subjects. This paper is an update on the potential of these parameters as a tool for predicting cardiovascular risk. AIMS: to estimate the prevalence of overweight and obesity. Second verify the existence of a significant correlation between the main anthropometric indicators and the blood pressure levels. SAMPLE: The population consisted of 977 children and adolescents between 9 and 17 years of age belonging to 13 schools in the province of Granada and city. METHODOLOGY: anthropometric evaluation in which they were assessed six skinfolds, waist circumference, hip and determination of blood pressure in three consecutive occasions. The anthropometric assessment phase began in March 2008 lasted until April 2009. RESULTS: We found that the prevalence of overweight in girls varied between 18.3% and 32.2%. For its part, the prevalence among boys was between 10.9% and 26.1%. Regarding the prevalence of obesity, the girls had similar rates between 4.5% and 15.1%. Among boys the prevalence of obesity was similar, and found rates between 4.7% and 12.6%. Of all the parameters measured, body mass index and waist circumference were the anthropometric indicators that showed a better correlation to blood pressure. CONCLUSIONS: BMI and WC are useful anthropometric indicators to predict cardiovascular risk in non adults.

[Obesity in a school children population from Granada: assessment of the efficacy of an educational intervention]. / Obesidad de una población de escolares de Granada: evaluación de la eficacia de una intervención educativa.

OBJECTIVES: The objective of this research was to study the prevalence of obesity and excess weight in a population of school children and adolescents, and to verify the effectiveness of an educational intervention, as reflected in the variation of their body mass index values. MATERIALS: The population sample was composed of 977 school children and adolescents from 9 to 17 years of age, belonging to 13 public elementary schools and high schools in the city and province of Granada (Spain). METHODOLOGY: This longitudinal cohort study was analytical, muticentric, and observational. It was carried out in three phases. The first phase involved the evaluation of the nutritional state of the sample population by means of anthropometric measurements (weight, height, body mass index, six skin folds and four body perimeters) as well as arterial blood pressure. The second phase entailed an educational intervention focusing on good nutritional habits and physical exercise. The third and final phase evaluated the effectiveness of the intervention. RESULTS: A higher obesity prevalence (15.1%) was found in school girls between 12 and 13. In the case of boys, obesity prevalence was lower up to age 13 though afterwards, it progressively increased (12.6%). The educational intervention produced an important reduction in body mass index values in both sexes though this reduction was more significant in young females. CONCLUSIONS: There is a currently an alarming increase in obesity and overweight prevalence among the population evaluated in this study. The significant reduction in body mass index values resulting from this research confirmed the effectiveness of the educational intervention to reduce excess weight.

[Breast feeding: an effective method to prevent breast cancer]. / Lactancia materna: un método eficaz en la prevención del cáncer de mama.

INTRODUCTION: Breast cancer is the most common gynecological tumor in young women in Western countries. Its profound implications for health and an increasingly early age of diagnosis have been carefully analyzed its causes and possible preventive measures, making their study in a primary goal of epidemiological research. SAMPLE AND METHODS: We reviewed medical records pertaining to 504 female patients aged 19 to 91 years. All of them were diagnosed and treated for breast cancer between 2003-2008 at the Hospital Universitario "San Cecilio" of Granada (Spain). RESULTS: We found a significant correlation (p = 0.001) between the age of cancer diagnosis, length of breastfeeding, and the existence of personal and family history for cancer. By contrast, there were no statistically significant differences test (t-test) between the average age of diagnosis of cancer and having had offspring or not (t = 0.559, p = 0.576). CONCLUSIONS: Breastfeeding for periods of longer than six months, not only provides children with many health benefits, but may also protect the mother from serious diseases, such as breast cancer.

The antisense sequence of the HIV-1 TAR stem-loop structure covalently linked to the hairpin ribozyme enhances its catalytic activity against two artificial substrates.

This work is an in vitro study of the efficiency of catalytic antisense RNAs whose catalytic domain is the wild-type sequence of the hairpin ribozyme, derived from the minus strand of the tobacco ringspot virus satellite RNA. The sequence in the target RNA recognized by the antisense molecule was the stem-loop structure of the human immunodeficiency virus-1 (HIV-1) TAR region. This region was able to form a complex with its antisense RNA with a binding rate of 2 x 10(4) M(-1)s(-1). Any deletion of the antisense RNA comprising nucleotides of the stem-loop resulted in a decrease in binding rate. Sequences 3' of the stem in the sense RNA also contributed to binding. This stem-loop TAR-antisense segment, covalently linked to a hairpin ribozyme, enhanced its catalytic activity. The highest cleavage rate was obtained when the stem-loop structure was present in both ribozyme and substrate RNAs and they were complementary. Similarly, an extension at the 5'-end of the hairpin ribozyme increased the cleavage rate when its complementary sequence was present in the substrate. Inclusion of the stem-loop at the 3'-end and the extension at the 5'-end of the hairpin ribozyme abolished the positive effect of both antisense units independently. These results may help in the design of hairpin ribozymes for gene silencing.