Evaluación de la calidad de la colonoscopia de cribado en el programa de cribado de cáncer colorectal en la CAPV.

148 p.El cáncer colorrectal (CCR) es un problema importante de salud pública debido a su incidencia y mortalidad. En el País Vasco en 2009 se implantó el Programa de Cribado de Cáncer Colorrectal, dirigido a hombres y mujeres de entre 50 y 69 años de edad, mediante un test de sangre oculta en heces y una colonoscopia de confirmación en caso de test positivo. Objetivo: Evaluar la calidad de la colonoscopia del programa de cribado poblacional del País Vasco en el periodo 2009-2018. Resultados: La proporción de exploraciones con preparación buena-excelente no obtuvo el nivel aceptable. Se realizaron 39.254 colonoscopias bajo sedación a través del programa en las que se identificaron 393 complicaciones graves. La satisfacción de las personas a las que se les realizó la colonoscopia se asoció a haber tenido una experiencia positiva en relación a la preparación colónica, no referir dolor o molestias, valorar la espera hasta la cita como corta, tener más de 55 años y hacerse la colonoscopia en un hospital comarcal. La calidad de la preparación de la colonoscopia mostró diferencia significativa entre los dos años comparados, siendo mejor tras la intervención de enfermería (141 (88,7%) vs. 132 (97,8%), p=0,003). Conclusión: Si bien los indicadores de calidad registrados se sitúan actualmente en los estándares de las Guías de Práctica Clínica, la identificación de estos factores relacionados con la experiencia del paciente permitirá mejorar los parámetros de la calidad de la colonoscopia. La realización de la consulta de enfermería de preparación colónica siguiendo el check list implantado además de la llamada telefónica 24 horas antes de la colonoscopia resultó efectiva en la mejora de la calidad de la limpieza colónica

Purification of surface-modified arc-discharge single-walled carbon nanotubes by centrifugation processes

Talk delivered at GDR-I GNT2013 conference, held at Guidel-Plages (France), from 8th-12th April 2013.Arc-discharge single-walled carbon nanotubes (SWCNTs) demonstrate well-defined spectroscopic responses and a high structural quality. In addition, the arc-discharge technique allows the synthesis of relatively large amounts of material, and the product is available at moderate prices. However, pristine arc-discharge SWCNTs contain large amounts of impurities, including catalyst metals, graphitic particles, and amorphous carbon. Well-purified commercial samples are expensive since current purification processes are time consuming and have low yields. Liquid media, which are necessary for the purification, change the physical aggregation of the SWCNTs or modify its chemical reactivity. Therefore, chemical studies on high-purity arc-discharge SWCNTs are limited. In this communication, we present our results on SWCNT purification by centrifugation or ultracentrifugation in aqueous media. More specifically, we study the influence of surface chemistry on the separation of arc-discharge SWCNTs from their impurities during the centrifugation. The results of processing chemically modified materials are analyzed in terms of graphitic and amorphous carbon impurities, residual metal content, and SWCNT spectral characteristics.Peer reviewe

Analysis of Post-Colonoscopy Colorectal Cancer and Its Subtypes in a Screening Programme

Using the algorithm of the World Endoscopy Organisation (WEO), we have studied retrospectively all colorectal cancers, both detected and non-detected by the Basque Country screening programme from 2009 to 2017. In the screening programme 61,335 colonoscopies were performed following a positive Faecal Immunochemical test (FIT) (≥20 µg Hb/g faeces) and the 128 cases of post-colonoscopy colorectal cancer (PCCRC) detected were analysed. Among them, 50 interval type PCCRCs were diagnosed (before the recommended surveillance), 0.8 cases per 1000 colonoscopies performed, and 78 non-interval type PCCRCs (in the surveillance carried out at the recommended time or delayed), 1.3 per 1000 colonoscopies. Among the non-interval type PCCRCs, 61 cases were detected in the surveillance carried out at the recommended time (type A) and 17 when the surveillance was delayed (type B), 1 case per 1000 colonoscopies performed and 0.28 cases per 1000 colonoscopies performed, respectively. Interval type PCCRC is less frequent than non-interval type PCCRC. In interval type PCCRCs, CRCs detected in advanced stages (stages III–IV) were significantly more frequent than those detected in early stages, compared to those of non-interval type PCCRCs (OR = 3.057; 95% CI, 1.410–6.625; p < 0.005). Non-interval type B PCCRCs are less frequent than non-interval type A PCCRCs, but the frequency of advanced stages is higher in interval type B PCCRCs.S.U.-A. have received funding from the Department of Education of the Basque Government through the Consolidated Research Group MATHMODE (IT1294-19)

Epoxy composites with covalently anchored amino-functionalized SWNTs: Towards the tailoring of physical properties through targeted functionalization

First published on the web August 24th, 2011Functionalization of single-walled carbon nanotubes (SWNTs) with covalently grafted amine moieties provides reactive fillers with potential for covalent anchoring to an epoxy matrix. Manufacturing and characterization of a high performance epoxy system reinforced with as-grown and aminated SWNTs are presented through four different approaches. Epoxy composite materials incorporating SWNTs aminated through sidewall addition reactions present enhanced mechanical, thermal and electrical properties, beyond the effect of unfunctionalized SWNTs. The functionalization pathways studied here lead to a composite with specific improvements in some of the physical properties of the epoxy matrix, which enables the tailored design of the composite's properties through functionalization. The amination via diazonium reaction with 4-aminobenzylamine is especially effective in enhancing the tensile and impact properties of the epoxy composites (44% improvement in impact strength at 0.1 wt% loading) and leads to the highest increase in elastic modulus reported so far for the integration of aminated nanotubes into epoxy resin. Composites incorporating aminated SWNTs throughout the 1,3-dipolar cycloaddition reaction stand out for their thermo-oxidative stability and thermomechanical properties. The incorporation of as-produced arc-discharge SWNTs into the TGAP/DDS epoxy matrix leads to composite materials with the highest electrical conductivity among all the studied samples. This journal is © The Royal Society of Chemistry.The present work was carried out with financial support from the NRC-CSIC collaboration project and fellowships from MICINN Spanish Ministry (FPU grant) and CAI-DGA and Europa XXI programmes. J.M.G.D. would like to thank Dr Benoit Simard and Dr Yadienka Martinez of SIMS-NRC for their close collaboration. Special thanks go to Prof. Maurizio Prato for kindly allowing a short research stay in his group, and his entire team. Epoxy reagents were received as a gift from Huntsman, which is gratefully acknowledged.Peer Reviewe

In-vitro toxicity of carbon nanotube/polylysine colloids to colon cancer cells

Single-walled carbon nanotubes (SWCNTs) are thoroughly purified and dispersed in an aqueous solution of high molecular weight poly-L-lysine (pLlys). Human intestinal epithelial Caco-2/TC7 cells are incubated with the SWCNT dispersions in pLlys, and their effects on cell viability are studied by image flow cytometry. No significant changes are observed in the cell culture wells up to pLlys concentrations of 10 g mL-1. However, high mortality is detected at pLlys concentrations of 100 g mL-1. The presence of oxygen-free SWCNTs does not modify the effects of pLlys on cell cultures at any of the tested concentrations (£ 1 g mL-1). In addition, SWCNTs having an 8 wt.% of surface oxygen are tested with identical results. Thus, purified SWCNTs, even bearing oxygen functional groups, act as inert particles in the cell culture medium. This result supports the applicability of SWCNTs as carriers in pharmacological formulations against digestive tract diseases.This work was funded by the Spanish Ministry MINECO and the European Regional Development Fund under the projects PRI-PIBAR-2011-1 and ENE2013-48816-C5-5-R, and the Government of Aragon and the European Social Fund (DGA-ESF-T66 Grupo Consolidado and DGA-ESF-B61 Grupo Consolidado).Peer reviewe

Epoxy composites with covalently anchored amino-functionalized SWNTs: Towards the tailoring of physical properties through targeted functionalization

Functionalization of single-walled carbon nanotubes (SWNTs) with covalently grafted amine moieties provides reactive fillers with potential for covalent anchoring to an epoxy matrix. Manufacturing and characterization of a high performance epoxy system reinforced with as-grown and aminated SWNTs are presented through four different approaches. Epoxy composite materials incorporating SWNTs aminated through sidewall addition reactions present enhanced mechanical, thermal and electrical properties, beyond the effect of unfunctionalized SWNTs. The functionalization pathways studied here lead to a composite with specific improvements in some of the physical properties of the epoxy matrix, which enables the tailored design of the composite's properties through functionalization. The amination via diazonium reaction with 4-aminobenzylamine is especially effective in enhancing the tensile and impact properties of the epoxy composites (44% improvement in impact strength at 0.1 wt% loading) and leads to the highest increase in elastic modulus reported so far for the integration of aminated nanotubes into epoxy resin. Composites incorporating aminated SWNTs throughout the 1,3-dipolar cycloaddition reaction stand out for their thermo-oxidative stability and thermomechanical properties. The incorporation of as-produced arc-discharge SWNTs into the TGAP/DDS epoxy matrix leads to composite materials with the highest electrical conductivity among all the studied samples. This journal is © The Royal Society of Chemistry.The present work was carried out with financial support from the NRC-CSIC collaboration project and fellowships from MICINN Spanish Ministry (FPU grant) and CAI-DGA and Europa XXI programmes. J.M.G.D. would like to thank Dr Benoit Simard and Dr Yadienka Martinez of SIMS-NRC for their close collaboration. Special thanks go to Prof. Maurizio Prato for kindly allowing a short research stay in his group, and his entire team. Epoxy reagents were received as a gift from Huntsman, which is gratefully acknowledged.Peer Reviewe

Population-based colorectal cancer screening programmes using a faecal immunochemical test:Should faecal haemoglobin cut-offs differ by age and sex?

Abstract Background The Basque Colorectal Cancer Screening Programme has both high participation rate and high compliance rate of colonoscopy after a positive faecal occult blood test (FIT). Although, colorectal cancer (CRC) screening with biannual (FIT) has shown to reduce CRC mortality, the ultimate effectiveness of the screening programmes depends on the accuracy of FIT and post-FIT colonoscopy, and thus, harms related to false results might not be underestimated. Current CRC screening programmes use a single faecal haemoglobin concentration (f-Hb) cut-off for colonoscopy referral for both sexes and all ages. We aimed to determine optimum f-Hb cut-offs by sex and age without compromising neoplasia detection and interval cancer proportion. Methods Prospective cohort study using a single-sample faecal immunochemical test (FIT) on 444,582 invited average-risk subjects aged 50–69 years. A result was considered positive at ≥20 μg Hb/g faeces. Outcome measures were analysed by sex and age for a wide range of f-Hb cut-offs. Results We analysed 17,387 positive participants in the programme who underwent colonoscopy. Participation rate was 66.5%. Men had a positivity rate for f-Hb of 8.3% and women 4.8% (p < 0.0001). The detection rate for advanced neoplasia (cancer plus advanced adenoma) was 44.0‰ for men and 15.9‰ for women (p < 0.0001). The number of colonoscopies required decreased in both sexes and all age groups through increasing the f-Hb cut-off. However, the loss in CRC detection increased by up to 28.1% in men and 22.9% in women. CRC missed were generally at early stages (Stage I-II: from 70.2% in men to 66.3% in women). Conclusions This study provides detailed outcomes in men and women of different ages at a range of f-Hb cut-offs. We found differences in positivity rates, neoplasia detection rate, number needed to screen, and interval cancers in men and women and in younger and older groups. However, there are factors other than sex and age to consider when consideration is given to setting the f-Hb cut-off

Sensitivity of single wall carbon nanotubes to oxidative processing: structural modification, intercalation and functionalisation

The effect of oxidation on modification of single wall carbon nanotubes (SWCNTs) through successive purification steps has been studied. The efficient elimination of metal impurities has been followed by induced coupled plasma spectroscopy. Upon acid treatment, Raman spectroscopy clearly proofed that HNO3 molecules were intercalated into the bundles of SWCNTs. At the same time, SWCNTs also have suffered a high degree of degradation and defects were introduced. The subsequent thermal processes led to the removal of further defect carbon materials and to the almost complete de-intercalation of the HNO3 molecules. Changes in the structure of the SWCNT bundles have been observed by transmission electron microscopy. While bundles tend to separate upon acid treatment, after the complete purification process, the remaining SWCNTs tend to form thick bundles again. The existence of functional groups in the raw single wall carbon nanotubes material and their modification and almost complete removal after the final annealing step has been studied by Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy and temperature programmed desorption. Nitrogen adsorption isotherms analysed according to Brunauer–Emmet–Teller showed important changes in the pore volume and surface area through the purification steps.This work was supported by the European Commission under the Research Training Network contract NANOCOMP (HPRN-CT-2000-00037).Peer reviewe

(Bio)analytical platforms based on the use of functionalized carbon nanotubes

Trabajo presentado al Eurosensors, celebrado en Freiburg (Alemania) del 6 al 9 de septiembre de 2015.Peer reviewe