Relationship between time from symptom''s onset to diagnosis and prognosis in patients with symptomatic colorectal cancer

BACKGROUND: Controversy exists regarding the relationship of the outcome of patients with colorectal cancer (CRC) with the time from symptom onset to diagnosis. The aim of this study is to investigate this association, with the assumption that this relationship was nonlinear and with adjustment for multiple confounders, such as tumor grade, symptoms, or admission to an emergency department. METHODS: This multicenter study with prospective follow-up was performed in five regions of Spain from 2010 to 2012. Symptomatic cases of incident CRC from a previous study were examined. At the time of diagnosis, each patient was interviewed, and the associated hospital and clinical records were reviewed. During follow-up, the clinical records were reviewed again to assess survival. Cox survival analysis with a restricted cubic spline was used to model overall and CRC-specific survival, with adjustment for variables related to the patient, health service, and tumor. RESULTS: A total of 795 patients had symptomatic CRC and 769 of them had complete data on diagnostic delay and survival. Univariate analysis indicated a lower HR for death in patients who had diagnostic intervals less than 4.2 months. However, after adjustment for variables related to the patient, tumor, and utilized health service, there was no relationship of the diagnostic delay with survival of patients with colon and rectal cancer, colon cancer alone, or rectal cancer alone. Cubic spline analysis indicated an inverse association of the diagnostic delay with 5-year survival. However, this association was not statistically significant. CONCLUSIONS: Our results indicated that the duration of diagnostic delay had no significant effect on the outcome of patients with CRC. We suggest that the most important determinant of the duration of diagnostic delay is the biological profile of the tumor. However, it remains the responsibility of community health centers and authorities to minimize diagnostic delays in patients with CRC and to implement initiatives that improve early diagnosis and provide better outcomes. © 2022. The Author(s)

Casimir energy in spherical cavities

We calculate the Casimir energy at spherical cavities within a host made up of an arbitrary material described by a possibly dispersive and lossy dielectric response. To that end, we add to the coherent optical response a contribution that takes account of the incoherent radiation emitted by the host in order to guarantee the detailed balance required to keep the system at thermodynamic equilibrium in the presence of dissipation. The resulting boundary conditions allow a conventional quantum mechanical treatment of the radiation within the cavity from which we obtain the contribution of the cavity walls to the density of states, and from it, the thermodynamic properties of the system. The contribution of the cavity to the energy diverges as it incorporates the interaction energy between neighbor atoms in a continuum description. The change in the energy of an atom situated at the center of the cavity due to its interaction with the fluctuating cavity field is however finite. We evaluate the latter for a simple case.Comment: 9 pages, 4 figures, Proceedings of QFEXT07. To be published in J. Phys.

El álbum poético en portugués y en español: sinergia estética entre palabras e ilustraciones

Este estudo procurou problematizar a relação textual que se observa entre a palavra e a imagem em um tipo de texto especialmente concebido para crianças: o álbum poético. Para tal, utilizamos alguns exemplos textuais significativos desse subgênero literário/editorial ainda em emergência tanto em Portugal quanto na Espanha, e propusemos uma definição e uma caracterização baseadas no comentário de sequências poéticas nas quais a ilustração sustenta o conteúdo verbal. Efetivamente, centrando a atenção no álbum poético de potencial recepção infanto-juvenil, sugere-se uma análise de diversos títulos de autoria portuguesa e espanhola, assente em uma leitura dialógica do texto verbal e do visual. A sinergia que se concretiza entre as duas componentes enunciadas alicerça essa nova construção estética que tem, na verdade e na sua essência, a poesia como matriz e, em larga medida, é devedora dos efeitos expressivos da metáfora.This study aimed to discuss the relation between words and images in a type of text especially directed to children: the picture-poetry book. From significant examples of this literary subgenre still emerging in both Portugal and Spain, we propose a definition and characterization based on the review of poetic sequences in which illustrations support the verbal content. By focusing on picture-poetry books potentially aimed for adolescents and children, we present an analysis of several titles by Portuguese and Spanish authors, based on the dialogic reading between verbal and visual texts. The synergy found between these two components creates de foundantions of a new aesthetic construction which, in truth and in essence, has poetry as its matrix and owes its expressive effects to metaphors.Este estudio ha tenido como objetivo discutir la relación textual que existe entre la palabra y la imagen en un tipo texto especialmente creado para niños: el álbum poético. Para ello, utilizamos algunos ejemplos textuales significativos de un subgénero literario en emergencia tanto en Portugal cuanto en España, y hemos propuesto una definición de este subgénero y su caracterización a partir del comentario de secuencias poéticas en las cuales la imagen sustenta el contenido verbal. De hecho, centrando la atención en el álbum poético de potencial recepción infantil y juvenil, proponemos un análisis de diversos títulos de autoría portuguesa y española basado en la lectura dialógica entre el texto verbal y el texto ilustrativo. La sinergia que se establece entre estos dos componentes enunciados facilita una nueva construcción estética que da pie, en su esencia, a un tipo de poesía que, en gran medida, es deudora de los efectos expresivos de la metáfora.CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT), Portugal. Fundos Nacionais através da FCT (Fundação para a Ciência e a Tecnologia) e cofinanciado pelo Fundo Europeu de Desenvolvimento Regional (FEDER) através do COMPETE 2020 – Programa Operacional Competitividade e Internacionalização (POCI) no âmbito do CIEC (Centro de Investigação em Estudos da Criança, da Universidade do Minho) com a referência POCI-01-0145-FEDER-007562info:eu-repo/semantics/publishedVersio

In vitro Induction of Entamoeba histolytica Cyst-like Structures from Trophozoites

Inhibition of encystment can be conceived as a potentially useful mechanism to block the transmission of Entamoeba histolytica under natural conditions. Unfortunately, amoeba encystment has not been achieved in vitro and drugs inhibiting the formation of cysts are not available. Luminal conditions inducing encystment in vivo are also unknown, but cellular stress such as exposure to reactive oxygen species from immune cells or intestinal microbiota could be involved. A role for certain divalent cations as cofactors of enzymes involved in excystment has also been described. In this study, we show that trophozoite cultures, treated with hydrogen peroxide in the presence of trace amounts of several cations, transform into small-sized spherical and refringent structures that exhibit resistance to different detergents. Ultrastructural analysis under scanning and transmission electron microscopy revealed multinucleated structures (some with four nuclei) with smooth, thick membranes and multiple vacuoles. Staining with calcofluor white, as well as an ELISA binding assay using wheat germ agglutinin, demonstrated the presence of polymers of N-acetylglucosamine (chitin), which is the primary component of the natural cyst walls. Over-expression of glucosamine 6-phosphate isomerase, likely to be the rate-limiting enzyme in the chitin synthesis pathway, was also confirmed by RT-PCR. These results suggest that E. histolytica trophozoites activated encystment pathways when exposed to our treatment

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Examining the immune signatures of SARS-CoV-2 infection in pregnancy and the impact on neurodevelopment: Protocol of the SIGNATURE longitudinal study

The COVID-19 pandemic represents a valuable opportunity to carry out cohort studies that allow us to advance our knowledge on pathophysiological mechanisms of neuropsychiatric diseases. One of these opportunities is the study of the relationships between inflammation, brain development and an increased risk of suffering neuropsychiatric disorders. Based on the hypothesis that neuroinflammation during early stages of life is associated with neurodevelopmental disorders and confers a greater risk of developing neuropsychiatric disorders, we propose a cohort study of SARS-CoV-2-infected pregnant women and their newborns. The main objective of SIGNATURE project is to explore how the presence of prenatal SARS-CoV-2 infection and other non-infectious stressors generates an abnormal inflammatory activity in the newborn. The cohort of women during the COVID-19 pandemic will be psychological and biological monitored during their pregnancy, delivery, childbirth and postpartum. The biological information of the umbilical cord (foetus blood) and peripheral blood from the mother will be obtained after childbirth. These samples and the clinical characterisation of the cohort of mothers and newborns, are tremendously valuable at this time. This is a protocol report and no analyses have been conducted yet, being currently at, our study is in the recruitment process step. At the time of this publication, we have identified 1,060 SARS-CoV-2 infected mothers and all have already given birth. From the total of identified mothers, we have recruited 537 SARS-COV-2 infected women and all of them have completed the mental health assessment during pregnancy. We have collected biological samples from 119 mothers and babies. Additionally, we have recruited 390 non-infected pregnant women.This work has received support from the Fundación Alicia Koplowitz to realize the epigenetic wide association study and to the clinical assessment to the children. This work has also received public support from the Consejería de Salud y Familias para la financiación de la investigación, desarrollo e innovación (i + d + i) biomédica y en ciencias de la salud en Andalucía (CSyF 2021 - FEDER). Grant Grant number PECOVID- 0195-2020. Convocatoria financiada con Fondo Europeo de Desarrollo Regional (FEDER) al 80% dentro del Programa Operativo de Andalucía FEDER 2014-2020. Andalucía se mueve con Europa. NG-T received payment under Rio Hortega contract CM20-00015 with the Carlos III Health Institute.Peer reviewe