Impact of a colorectal cancer screening program implantation on delays and prognosis of non-screening detected colorectal cancer.

BACKGROUND: The implementation of a colorectal cancer (CRC) screening programme may increase the awareness of Primary Care Physicians, reduce the diagnostic delay in CRC detected outside the scope of the screening programme and thus improve prognosis. AIM: To determine the effect of implementation of a CRC screening programme on diagnostic delays and prognosis of CRC detected outside the scope of a screening programme. METHODS: We performed a retrospective intervention study with a pre-post design. We identified 322 patients with incident and confirmed CRC in the pre-implantation cohort (June 2014 - May 2015) and 285 in the post-implantation cohort (June 2017 - May 2018) in the Cancer Registry detected outside the scope of a CRC screening programme. In each patient we calculated the different healthcare diagnostics delays: global, primary and secondary healthcare, referral and colonoscopy-related delays. In addition, we collected the initial healthcare that evaluated the patient, the home location (urban/rural), and the CRC stage at diagnosis. We determined the two-year survival and we performed a multivariate proportional hazard regression analysis to determine the variables associated with survival. RESULTS: We did not detect any differences in the patient or CRC baseline-related variables. A total of 20.1% of patients was detected with metastatic disease. There was a significant increase in direct referral to colonoscopy from primary healthcare (25.5%, 35.8%; P = 0.04) in the post-implantation cohort. Diagnostic delay was reduced by 24 d (106.64 ± 148.84 days, 82.84 ± 109.31 d; P = 0.02) due to the reduction in secondary healthcare delay (46.01 ± 111.65 d; 29.20 ± 60.83 d; P = 0.02). However, we did not find any differences in CRC stage at diagnosis or in two-year survival (70.3%; P = 0.9). Variables independently associated with two-year risk of death were age (Hazard Ratio-HR: 1.06, 95%CI: 1.04-1.07), CRC stage (II HR: 2.17, 95%CI: 1.07-4.40; III HR: 3.07, 95%CI: 1.56-6.08; IV HR: 19.22, 95%CI: 9.86-37.44; unknown HR: 9.24, 95%CI: 4.27-19.99), initial healthcare consultation (secondary HR: 2.93, 95%CI: 1.01-8.55; emergency department HR: 2.06, 95%CI: 0.67-6.34), hospitalization during the diagnostic process (HR: 1.67, 95%CI: 1.17-2.38) and urban residence (HR: 1.44, 95%CI: 1.06-1.98). CONCLUSION: Although implementation of a CRC screening programme can reduce diagnostic delays for CRC detected in symptomatic patients, this has no effect on CRC stage or survival.

Influence of Milling Time on the Homogeneity and Magnetism of a Fe70Zr30 Partially Amorphous Alloy: Distribution of Curie Temperatures.

In this work, the mechanically alloyed Fe70Zr30 (at. %) composition has been used to study the influence of milling time on its homogeneity and magnetic properties. The microstructure and Fe environment results show the formation of an almost fully amorphous alloy after 50 h of milling in a mixture of pure 70 at. % Fe and 30 at. % Zr. The soft magnetic behavior of the samples enhances with the increase of the milling time, which is ascribed to the averaging out of the magnetocrystalline anisotropy as the crystal size decreases and the amorphous fraction increases. The formation of a non-perfectly homogenous system leads to a certain compositional heterogeneity, motivating the existence of a distribution of Curie temperatures. The parameters of the distribution (the average Curie temperature, T C ¯ , and the broadening of the distribution, ∆ T C ) have been obtained using a recently reported procedure, based on the analysis of the approach towards the saturation curves and the magnetocaloric effect. The decrease of ∆ T C and the increase of T C ¯ with the milling time are in agreement with the microstructural results. As the remaining α-Fe phase decreases, the amorphous matrix is enriched in Fe atoms, enhancing its magnetic response.

A quantitative criterion for determining the order of magnetic phase transitions using the magnetocaloric effect.

The ideal magnetocaloric material would lay at the borderline of a first-order and a second-order phase transition. Hence, it is crucial to unambiguously determine the order of phase transitions for both applied magnetocaloric research as well as the characterization of other phase change materials. Although Ehrenfest provided a conceptually simple definition of the order of a phase transition, the known techniques for its determination based on magnetic measurements either provide erroneous results for specific cases or require extensive data analysis that depends on subjective appreciations of qualitative features of the data. Here we report a quantitative fingerprint of first-order thermomagnetic phase transitions: the exponent n from field dependence of magnetic entropy change presents a maximum of n > 2 only for first-order thermomagnetic phase transitions. This model-independent parameter allows evaluating the order of phase transition without any subjective interpretations, as we show for different types of materials and for the Bean-Rodbell model.

Inhibition of early endosome fusion by Rab5-binding defective Ras interference 1 mutants.

Rin1 has been shown to play an important role in endocytosis. In this study we demonstrated that depletion of Rin1 from the cytosol blocked the fusion reaction. More importantly, endosome fusion was rescued by the addition of Rin1 proteins depending on the presence of Rab5, and its effector EEA1. Furthermore, we found that Syntaxin 13, but not Syntaxin 7, was required by Rin1 to support endosome fusion. We also identified six mutations on the Vps9 domain of Rin1 that failed to rescue the fusion reaction. Two of them, Rin1: D537A and Rin1: Y561F mutants showed dramatic inhibitory effect on the fusion reaction, which correlate with their inability to properly activate Rab5 or to bind endosomal membranes. Taken together, our results suggest that specific residues on the Vsp9 domain of Rin1 are required for its interaction with Rab5, binding to the endosomal membranes and subsequent regulation of the fusion reaction.

Angiomiolipoma renal masivo como causa de sangrado retroperitoneal espontáneo / Massive renal angiomyolipoma as a cause of spontaneous retroperitoneal bleeding

Introducción: El angiomiolipoma (AML) es un tumor renal benigno, compuesto por una cantidad variable de tejido adiposo, músculo liso y vasos sanguíneos; que habitualmente crece dentro del espacio perinéfrico y suele complicarse con hemorragia intratumoral y menos frecuentemente perinéfrica y retroperitoneal, la cual se encuentra condicionada por el tamaño de la lesión. Objetivos: Evaluar dentro de las diferentes causas de sangrado retroperitoneal espontáneo al AML masivo, en confrontación con otras causas. Material y Métodos: Se estudiaron 3 pacientes con AML masivo previamente desconocidos y sangrado retroperitoneal. Dos de ellos fueron estudiados con resonancia magnética, en secuencias de T1 SE, T2 TSE con supresión grasa, T1 TSE con supresión grasa sin y con gadolinio. Uno fue estudiado con tomografía computada (TC) pre y post administración de contraste EV. Resultados: De los 3 pacientes estudiados, todos presentaron masas renales cuyos tamaños variaron entre 10 y 26 cm. De diámetro mayor, las cuales presentaron sangrado intratumoral y retroperitoneal de jerarquía. Conclusión: El AML masivo como causante de hemorragia retroperitoneal espontánea es por lo tanto una patología a tener en cuenta.