Co-immobilization of biomolecules on ultrathin reactive chemical vapor deposition coatings using multiple click chemistry strategies.

Immobilization of biomolecules, such as proteins or sugars, is a key issue in biotechnology because it enables the understanding of cellular behavior in more biological relevant environment. Here, poly(4-ethynyl-p-xylylene-co-p-xylylene) coatings have been fabricated by chemical vapor deposition (CVD) polymerization in order to bind bioactive molecules onto the surface of the material. The control of the thickness of the CVD films has been achieved by tuning the amount of precursor used for deposition. Copper-catalyzed Huisgen cycloaddition has then been performed via microcontact printing to immobilize various biomolecules on the reactive coatings. The selectivity of this click chemistry reaction has been confirmed by spatially controlled conjugation of fluorescent sugar recognizing molecules (lectins) as well as cell adhesion onto the peptide pattern. In addition, a microstructured coating that may undergo multiple click chemistry reactions has been developed by two sequential CVD steps. Poly(4-ethynyl-p-xylylene-co-p-xylylene) and poly(4-formyl-p-xylylene-co-p-xylylene) have been patterned via vapor-assisted micropatterning in replica structures (VAMPIR). A combination of Huisgen cycloaddition and carbonyl-hydrazide coupling was used to spatially direct the immobilization of sugars on a patterned substrate. This work opens new perspectives in tailoring microstructured, multireactive interfaces that can be decorated via bio-orthogonal chemistry for use as mimicking the biological environment of cells.

[Results of a study on populational colorectal cancer screening]. / Resultados de un estudio de cribado poblacional de neoplasia colorrectal.

INTRODUCTION: As colorectal cancer (CRC) screening based on occult blood detection has been shown to be effective in reducing mortality due to this disease, it is now important to decide on the best methods to obtain the maximum numbers of participants. The aim of the study was to analyse the results from a pilot CRC screening programme in a general population sample in Barcelona. A follow-up of false positive cases was made after five years. PATIENTS AND METHOD: A cross section of the population aged 50-74 years in one primary health care centre was studied. The screening test consisted of an immunological method for the detection of faecal occult blood which was sent to the homes of the target population. RESULTS: Participation was 46.6%, 11.7% of the tests were positive, and 79.3% agreed to have a colonoscopy. Eight adenocarcinomas and 32 patients with adenomas >0.4 cm were diagnosed. CONCLUSIONS: The results obtained on the initial participation and the follow-up at five years suggest the viability of a CCR screening programme in our country.

Resultados de un estudio de cribado poblacional de neoplasia colorrectal / Results of a study on populational colorectal cancer screening

Introducción: el cribado poblacional de cáncer colorrectal (CCR) basado en la detección de sangre oculta en heces se ha demostrado efectivo en disminuir la mortalidad por esta enfermedad, si bien es importante encontrar los métodos adecuados para obtener una participación suficiente. El objetivo del estudio fue analizar los resultados clínicos de un programa piloto de cribado de CCR y las causas de rechazo. También se realizó el seguimiento de los casos falsos positivos a los 5 años. Pacientes y método: se diseñó un estudio de corte transversal en una población diana de 2.105 personas de 50 a 74 años atendidas en un centro de asistencia primaria. La prueba de cribado fue un método inmunológico, que se remitió al domicilio de la población diana. Resultados: la participación fue del 46,6%, el porcentaje de positividad de la prueba fue del 11,7% y la aceptación de la colonoscopia fue del 79,3%. Se diagnosticó en total a 32 pacientes con adenomas >0,4cm y a 8 con CCR. Conclusiones: los resultados obtenidos en nuestro estudio, tanto en participación como el seguimiento a los 5 años, permiten creer en la factibilidad de un programa de cribado poblacional de la neoplasia colorrectal en nuestro país (AU)

Introduction: As colorectal cancer (CRC) screening based on occult blood detection has been shown to be effective in reducing mortality due to this disease, it is now important to decide on the best methods to obtain the maximum numbers of participants. The aim of the study was to analyse the results from a pilot CRC screening programme in a general population sample in Barcelona. A follow-up of false positive cases was made after five years. Patients and method: A cross section of the population aged 50–74 years in one primary health care centre was studied. The screening test consisted of an immunological method for the detection of faecal occult blood which was sent to the homes of the target population. Results: Participation was 46.6%, 11.7% of the tests were positive, and 79.3% agreed to have a colonoscopy. Eight adenocarcinomas and 32 patients with adenomas >0.4cm were diagnosed. Conclusions: The results obtained on the initial participation and the follow-up at five years suggest the viability of a CCR screening programme in our country (AU)

[Patient satisfaction in gastrointestinal endoscopy: results of a multicenter study]. / Satisfacción del paciente con la endoscopia digestiva: resultados de un estudio multicéntrico.

BACKGROUND AND AIM: The aim of this study was to determine the main quality problems perceived by patients in gastrointestinal endoscopy through a satisfaction survey. PATIENTS AND METHODS: A total of 321 patients from five gastrointestinal endoscopy units were included. Telephone interviews using a previously validated questionnaire on several aspects related to the procedure were carried out. Pareto analyses were performed to pinpoint the most common aspects among the vital few causes at each medical center. Based on the questionnaire, the satisfaction indicators were calculated for each center: the overall satisfaction score (the sum of the responses to the eight questions) and the rate of perceived problems (number of questions with a negative response divided by the number of questions asked). RESULTS: The most frequent aspects among the vital few were waiting time for an appointment and discomfort during the examination, since both factors were included in the vital few in four of the five medical centers. Significant differences were found among centers in the overall satisfaction score (questionnaire score) (p < 0.001) and for the rate of perceived problems (p < 0.001). CONCLUSION: According to the patients, the most problematic aspects were waiting time until the day of the appointment and discomfort during the examination. Perceived quality differed among the participating centers.

Variation among endoscopy units in the achievement of the standards of colonoscopic performance indicators.

BACKGROUND/AIMS: To assess the achievement of quality standards of colonoscopy at six endoscopy units. METHODOLOGY: Three indicators were used to assess the quality of 1056 colonoscopies performed at six hospitals: cecal intubation; adequate colon cleansing; and removal and recovery of all detected polyps. Analyses were performed on the total number of colonoscopies and on colonoscopies in which polyps were actually detected. The accomplishment of each indicator and a global compound index of all three indicators, named the Problem Rate, were analyzed. Results from each endoscopy unit were compared to previously established standards. RESULTS: Adequate colon cleansing was the most frequent problem for quality in all centers; adequate colon preparation was 67% (range 50 to 84%). The cecum was reached in 84% of all colonoscopies (range 76 to 90%). 75% of all patients (range 28. 79%) had all polyps excised and recovered. All centers had rates below standard for one or several indicators (p<0.01, all cases). Two of the participant hospitals had an overall problem rate above the estimated standard (p<0.01). CONCLUSIONS: There is a significant variation in the achievement of quality standards of colonoscopy between endoscopy units. Colon cleansing is the most frequent quality problem for colonoscopy.

Satisfacción del paciente con la endoscopia digestiva: resultados de un estudio multicéntrico / Patient satisfaction in gastrointestinal endoscopy: results of a multicenter study

FUNDAMENTO Y OBJETIVO: El objetivo de nuestro trabajo fuedeterminar los principales problemas de calidad desde elpunto de vista del paciente en la endoscopia digestiva medianteun cuestionario de satisfacción.PACIENTES Y MÉTODOS: Cinco unidades de endoscopia digestivaincluyeron a un total de 321 pacientes. Se realizó unaencuesta telefónica sobre diversos aspectos relacionados conla prueba utilizando un cuestionario previamente validado.Se realizó un análisis de Pareto para cada centro para averiguarcuáles eran los aspectos más representados entre lospoco vitales. A partir del cuestionario se calcularon dos indicadoresde satisfacción para cada centro: la puntuación globalde satisfacción (suma de los valores de las respuestas alas 8 cuestiones) y la tasa de problemas percibidos (númerode preguntas con respuesta negativa dividido por el númerode preguntas realizadas).RESULTADOS: Los aspectos más representados en los poco vitalesfueron el tiempo de espera para la cita y las molestiasdurante la exploración, pues ambos aparecían en los pocovitales de 4 de los 5 centros. Había diferencias significativasentre los centros para la puntuación global de satisfacción(puntuación del cuestionario) (p < 0,001) y para la tasa deproblemas percibidos (p < 0,001).CONCLUSIÓN: Los aspectos más problemáticos desde el puntode vista de los pacientes son el tiempo de espera hasta el díade la cita y las molestias durante la exploración. Hay diferenciasen la calidad percibida entre los centros participantes

BACKGROUND AND AIM: The aim of this study was to determinethe main quality problems perceived by patients in gastrointestinalendoscopy through a satisfaction survey.PATIENTS AND METHODS: A total of 321 patients from fivegastrointestinal endoscopy units were included. Telephoneinterviews using a previously validated questionnaire on severalaspects related to the procedure were carried out. Paretoanalyses were performed to pinpoint the most commonaspects among the vital few causes at each medical center.Based on the questionnaire, the satisfaction indicators werecalculated for each center: the overall satisfaction score (thesum of the responses to the eight questions) and the rate ofperceived problems (number of questions with a negativeresponse divided by the number of questions asked).RESULTS: The most frequent aspects among the vital fewwere waiting time for an appointment and discomfort duringthe examination, since both factors were included in thevital few in four of the five medical centers. Significant differenceswere found among centers in the overall satisfactionscore (questionnaire score) (p < 0.001) and for the rate ofperceived problems (p < 0.001).CONCLUSION: According to the patients, the most problematicaspects were waiting time until the day of the appointmentand discomfort during the examination. Perceivedquality differed among the participating centers

Long-lasting effect of a single botulinum toxin injection in the treatment of oropharyngeal dysphagia secondary to upper esophageal sphincter dysfunction: a pilot study.

OBJECTIVE: To evaluate the efficacy of botulinum toxin (BTX-A) injection in the cricopharyngeus muscle in patients with neurological dysphagia caused by alteration in the upper esophageal sphincter (UES) opening and with preserved pharyngeal contraction. MATERIAL AND METHODS: A prospective pilot study was undertaken in 10 patients (7 brain lesions and 3 cervical spinal cord injuries), with a minimum time-lapse of 6 months from neurological lesion to BTX-A injection. Dysfunction of the UES opening and the presence of pharyngeal contraction were diagnosed by videofluoroscopy (VDF) and esophageal manometry (EM). The BTX-A (100 U) injection was guided by endoscopy. Clinical, VDF, and EM follow-ups were carried out at 3 weeks, 3 and 6 months, and at 1 year post-injection. RESULTS: Prior to treatment, 6 patients were fed by nasogastric tube. VDF showed impairment of the UES opening, residue in pyriform sinuses, and aspiration in all cases. During follow-up, there was a decrease in the number of patients that had aspiration: 3 patients at one year. During swallowing, EM showed a mean UES relaxation of 90% (range: 74.5-100%), residual pressure 3.2 mmHg (range: 0-13 mmHg) and pharyngeal amplitude 52 mmHg (range: 25-80 mmHg). At follow-up, a significant improvement in UES relaxation (98% (89-100%)) and pharyngeal contraction (97 mmHg (35-165 mmHg)) was observed. At 3 months, 6 patients were eating exclusively by mouth. CONCLUSIONS: One single injection of BTX-A in the UES has long-lasting effectiveness in patients with neurological dysphagia caused by alteration in the UES opening and with pharyngeal contraction. Nevertheless, a randomized control trial should be done to confirm these results and rule out the effect of potential spontaneous improvement of neurological injury.