Incidence Trends and Main Features of Gastro-Intestinal Stromal Tumours in a Mediterranean Region: A Population-Based Study.

Gastro-Intestinal Stromal Tumours (GISTs) are a kind of neoplasm whose diagnosis in common clinical practice just started in the current century, implying difficulties for proper registration. Staff from the Cancer Registry of Murcia, in southeastern Spain, were commissioned by the EU Joint Action on Rare Cancers into a pilot study addressing GIST registration that also yielded a population-based depiction of GISTs in the region, including survival figures. We examined reports from 2001 to 2015 from hospitals as well as cases already present in the registry. The variables collected were sex, date of diagnosis, age, vital status, primary location, presence of metastases, and risk level according to Joensuu's Classification. In total, 171 cases were found, 54.4% occurred in males, and the mean age value was 65.0 years. The most affected organ was the stomach, with 52.6% of cases. Risk level was determined as "High" for 45.0%, with an increment of lower levels in recent years. Incidence for the year 2015 doubled that of 2001. Overall, the 5-year net survival estimation was 77.0%. The rising incidence magnitude is consistent with trends in other European countries. Survival evolution lacked statistical significance. A more interventional approach in clinical management could explain the increase in the proportion of "Low Risk GISTs" and the first occurrence of "Very Low Risk" in recent years.

Optical Analysis of Blast Furnace Gas Combustion in a Laboratory Premixed Burner.

The use of blast furnace gas (BFG) as a fuel provides an alternative for waste stream valorization in the steel industry, enhancing the sustainability and decarbonization of its processes. Nevertheless, the implementation of this solution on an industrial scale requires a continuous control of the combustion due to the low calorific value of BFG. This work analyzes the combustion behavior and monitoring of BFG/CH4 blends in a laboratory premixed fuel burner. We evaluate several stable combustion conditions by burning different BFG/CH4 mixtures at a constant power rate over a wide range of air/fuel equivalence ratios. In addition, relevant image features and chemiluminescence emission spectra have been extracted from flames, using advanced optical devices. BFG combustion causes an increase in CO2 and CO emissions, since those fuels are the main fuel components of the mixture. On the other hand, NO x emissions decreased because of the low temperature of combustion of the BFG and its mixtures. Chemiluminescence shows that, in the case of CH4 combustion, peaks associated with hydrocarbons are present, while during the substitution of CH4 by BFG those peaks are attenuated. Image flame features extracted from both ultraviolet and visible bandwidths show a correlation with the fuel blend and air/fuel equivalence ratio. In the end, methodologies developed in this work have been proven to be valuable alternatives with a high potential for the monitoring and control of BFG cofiring for the steel industry.

Overall and stage-specific survival of patients with screen-detected colorectal cancer in European countries: A population-based study in 9 countries.

Background: An increasing proportion of colorectal cancers (CRCs) are detected through screening due to the availability of organised population-based programmes. We aimed to analyse survival probabilities of patients with screen-detected CRC in European countries. Methods: Data from CRC patients were obtained from 16 population-based cancer registries in nine European countries. We included patients with cancer diagnosed from the year organised CRC screening programmes were introduced until the most recent year with available data at the time of analysis, whose ages at diagnosis fell into the age groups targeted by screening. Patients were followed up with regards to vital status until 2016-2020 across the various countries. Overall and CRC-specific survival were analysed by mode of detection and stage at diagnosis for all countries combined and for each country separately using the Kaplan-Meier method. Findings: We included data from 228 134 patients, of whom 134 597 (aged 60-69 years at diagnosis targeted by screening in all countries) were considered in analyses for all countries combined. 22·3% (38 080/134 597) of patients had cancer detected through screening. Most screen-detected cancers were found at stages I-II (65·6% [12 772/19 469 included in stage-specific analyses]), while the majority of non-screen-detected cancers were found at stages III-IV (56·4% [31 882/56 543 included in stage-specific analyses]). Five-year overall and CRC-specific survival rates for patients with screen-detected cancer were 83·4% (95% CI 82·9-83·9) and 89·2% (88·8-89·7), respectively; for patients with non-screen-detected cancer, they were much lower (57·5% [57·2-57·8] and 65·7% [65·4-66·1], respectively). The favourable survival of patients with screen-detected cancer was also seen within each stage - five-year overall survival rates for patients with screen-detected stage I, II, III, and IV cancers were 92.4% (95% CI 91·6-93·1), 87·9% (86·6-89·1), 80·7% (79·3-82·0), and 32·3 (29·4-35·2), respectively. These patterns were also consistently seen for each individual country. Interpretation: Patients with cancer diagnosed at screening have a very favourable prognosis. In the rare case of detection of advanced stage cancer, survival probabilities are still much higher than those commonly reported for all patients regardless of mode of detection. Although these results cannot be taken to quantify screening effects, they provide useful and encouraging information for patients with screen-detected CRC and their physicians. Funding: This study was supported in part by grants from the German Federal Ministry of Education and Research and the German Cancer Aid.

Proportion and stage distribution of screen-detected and non-screen-detected colorectal cancer in nine European countries: an international, population-based study.

BACKGROUND: The effects of recently implemented colorectal cancer screening programmes in Europe on colorectal cancer mortality will take several years to be fully known. We aimed to analyse the characteristics and parameters of screening programmes, proportions of colorectal cancers detected through screening, and stage distribution in screen-detected and non-screen-detected colorectal cancers to provide a timely assessment of the potential effects of screening programmes in several European countries. METHODS: We conducted this population-based study in nine European countries for which data on mode of detection were available (Belgium, Denmark, England, France, Italy, Ireland, the Netherlands, Slovenia, and Spain). Data from 16 population-based cancer registries were included. Patients were included if they were diagnosed with colorectal cancer from the year that organised colorectal cancer screening programmes were implemented in each country until the latest year with available data at the time of analysis, and if their age at diagnosis fell within the age groups targeted by the programmes. Data collected included sex, age at diagnosis, date of diagnosis, topography, morphology, clinical and pathological TNM information based on the edition in place at time of diagnosis, and mode of detection (ie, screen detected or non-screen detected). If stage information was not available, patients were not included in stage-specific analyses. The primary outcome was proportion and stage distribution of screen-detected versus non-screen detected colorectal cancers. FINDINGS: 228 667 colorectal cancer cases were included in the analyses. Proportions of screen-detected cancers varied widely across countries and regions. The highest proportions (40-60%) were found in Slovenia and the Basque Country in Spain, where FIT-based programmes were fully rolled out, and participation rates were higher than 50%. A similar proportion of screen-detected cancers was also found for the Netherlands in 2015, where participation was over 70%, even though the programme had not yet been fully rolled out to all age groups. In most other countries and regions, proportions of screen-detected cancers were below 30%. Compared with non-screen-detected cancers, screen-detected cancers were much more often found in the distal colon (range 34·5-51·1% screen detected vs 26·4-35·7% non-screen detected) and less often in the proximal colon (19·5-29·9% screen detected vs 24·9-32·8% non-screen detected) p≤0·02 for each country, more often at stage I (35·7-52·7% screen detected vs 13·2-24·9% non-screen detected), and less often at stage IV (5·8-12·5% screen detected vs 22·5-31·9% non-screen detected) p<0·0001 for each country. INTERPRETATION: The proportion of colorectal cancer cases detected by screening varied widely between countries. However, in all countries, screen-detected cancers had a more favourable stage distribution than cancers detected otherwise. There is still much need and scope for improving early detection of cancer across all segments of the colorectum, and particularly in the proximal colon and rectum. FUNDING: Deutsche Krebshilfe.

Estudio comparativo del lavado de manos convencional versus uso de solución hidroalcohólica durante la realización del intercambio peritoneal / No disponible

No disponible

Assessment of groundwater vulnerability to nitrates from agricultural sources using a GIS-compatible logic multicriteria model.

In the present study an overlay method to assess groundwater vulnerability is proposed. This new method based on multicriteria decision analysis (MCDA) was developed and validated using an appropriate case study in Aragon area (NE Spain). The Vulnerability Index to Nitrates from Agricultural Sources (VINAS) incorporates a novel Logic Scoring of Preferences (LSP) approach, and it has been developed using public geographic information from the European Union. VINAS-LSP identifies areas with five categories of vulnerability, taking into account the hydrogeological and environmental characteristics of the territory as a whole. The resulting LSP map is a regional screening tool that can provide guidance on the potential risk of nitrate pollution, as well as highlight areas where specific research and farming planning policies are required.

Efectividad clínica en el cuidado del orificio de salida del catéter peritoneal / Clinical effectiveness in peritoneal catheter exit orifice care

Existe una gran variedad de procedimientos y métodos, seguidos por los profesionales para realizar las curas y el cuidado del orificio de salida del catéter peritoneal. Averiguamos que todos ellos eran fundamentados y con resultados efectivos. Pero, nos preguntamos, ¿Cuál de entre ellos sería el más adecuado utilizar en nuestra unidad? Optamos por utilizar las recomendaciones de la literatura científica, incluyendo variables como las necesidades específicas de cada paciente, según las condiciones medioambientales de nuestra comunidad y las estaciones del año. El objetivo principal de nuestro estudio fue evaluar la validez y efectividad del protocolo que establecimos para nuestros pacientes. Realizamos un estudio epidemiológico descriptivo y longitudinal de 2 años y 8 meses de duración. Calculamos la tasa de incidencia de infecciones del orificio de salida del catéter y de peritonitis por paciente y para cada uno de los años de estudio (2008-2009- 2010). Evaluamos los resultados comparándolos con los índices de normalidad marcados por la Sociedad Española de Nefrología, en el año 2007. Desglosamos el total de infecciones según estaciones y calculamos el porcentaje. Diferenciamos entre las infecciones provocadas por bacterias gram+ y aquellas producidas por bacterias gram-. Los resultados obtenidos revelaron que nuestro protocolo es válido y adecuado para nuestros pacientes, obteniendo una tasa de incidencia global de peritonitis de 0.72 por cada 24 paciente-mes y una tasa de infección del orificio de salida de 0.61 paciente-año, ambas por debajo del estándar establecido por la Sociedad Española de Nefrología (2007). Se demostró una mayor incidencia de infecciones en el periodo estival, concretamente el 46%. La clorhexidina al 1% abarca la cobertura de las bacterias gram+, bacterias gram-, esporas, virus y hongos pero se comprueba su mayor efectividad con los microorganismos gram+ (AU)

There is a great variety of procedures and methods followed by the professionals who provide peritoneal catheter exit orifice care. We found that all of them had a sound basis and showed effective results. However, we asked ourselves which of them would be the most suitable to use in our unit. We opted to use the recommendations of scientific literature, including variables such as the specific needs of each patient, according to the environmental conditions of our community and the seasons of the year. The main objective of our study was to assess the validity and effectiveness of the protocol we had established for our patients. We carried out a descriptive and longitudinal epidemiological study lasting 2 years and 8 months. We calculated the incidence rate of catheter exit orifice infections and peritonitis per patient and for each of the years of the study (2008-2009-2010). We assessed the result by comparing them with the normality indices set by the Spanish Nephrology Association, in 2007. We broke down the total of infections according to seasons and calculated the percentage. We differentiated between infections caused by gram + and gram - bacteria. The results obtained showed that our protocol is valid and suitable for our patients, obtaining an overall peritonitis incidence rate of 0.72 for every 24 patient-months and an exit orifice infection rate of 0.61 patient-years, both of which are lower than the standard established by the Spanish Nephrology Association (2007). A higher incidence of infections was found in the summer period, specifically 46%. 1% chlorhexidine covers gram+ bacteria, grambacteria, spores, viruses and fungi but was found to be most effective with gram+ microorganisms (AU)

Incidencia de estreñimiento en una unidad de hemodiálisis / Incidence of constipation in a haemodialysis unit

Los pacientes en programa de hemodiálisis pueden padecer con frecuencia problemas y enfermedades intestinales por lo que hemos decidido abordar un problema tan importante como el estreñimiento. Estos pacientes tienen numerosos factores de riesgo para padecer esta enfermedad, como son restricciones en la ingesta de frutas, verduras, líquidos y otros alimentos, además de tomar medicación astringente por lo que hemos querido conocer cómo influyen estos factores y cuál era el porcentaje de estos pacientes que lo presentan. Para ello hemos realizado una encuesta dividida en dos partes; la primera recogía datos personales y de tratamiento farmacológico; y la segunda está compuesta por 14 preguntas referentes a los factores de riesgo. Fueron encuestados 40 pacientes de diversas edades y nacionalidades. Los resultados más destacables de la investigación fueron que solo un 23% de la muestra encuestada padecía estreñimiento subjetivo en la actualidad, frente a un 13%de estreñimiento objetivo, siendo la mayoría de pacientes hombres. Es necesario continuar investigando sobre este tema para que en el futuro pudiera intervenirse sobre estos pacientes para así mejorar su calidad de vida (AU)

Patients on haemodialysis programmes can often sufferfrom intestinal problems and illnesses, so we have decidedto deal with an important problem, which is that of constipation. These patients have numerous risk factors for suffering from this illness, such as restrictions on the consumption of fruit, vegetables and other food stuffs, and the fact that they take astringent medication, so we wished to know what influence these factors have and the percentage of patients who present the problem. We therefore performed a survey divided into two parts: the first collected personal detail and information on pharmacological treatment; and the second is compose of 14 questions relative to the risk factors. Forty patients were interviewed of different ages and nationalities. The most outstanding results of the research were that only 23% of the surveyed sample currently suffered from subjective constipation, as opposed to 13% objective constipation, and that the majority were men. More research is needed on this subject, so that these patients may receive intervention in the future to improve their quality of life (AU)