Colorectal cancer screening program implementation: biennial adherence and participation patterns.

INTRODUCTION AND AIM: Adherence to colorectal cancer (CRC) screening is essential for the effectiveness of screening programs. Even though organized screening programs can improve the quality of the process and adherence, there are still challenges to overcome. The aim of the present study, in which we implemented a biennial organized screening program for CRC, was to describe adherence and participation patterns. MATERIALS AND METHODS: A longitudinal, descriptive study was conducted, in which a team of trained patient navigators carried out interventions, with reminders via cellphone communication, to follow a cohort of 301 subjects eligible for CRC screening, utilizing a fecal immunochemical test (FIT). All the follow-up subjects received a FIT kit. RESULTS: A total of 747 cellphone calls were made and divided into three interventions. From the initial cohort, 126 subjects completed their biennial screening process through the FIT, indicating a consistent adherence rate of 41.8% to our program. The participation patterns were: 126 consistent participants (41.8%), 160 inconsistent participants (53.2%), and 15 participants that were never contacted (5%). CONCLUSIONS: In conclusion, our study underlines the importance of organized screening programs in the early detection of CRC. The implementation of follow-up interventions, through reminders and the training of patient navigators, can improve adherence, but there is a need for examining new strategies, to overcome barriers to communication via cellphone.

The ASIP gene in the llama (Lama glama): Alternative transcripts, expression and relation with color phenotypes.

The Agouti gene (ASIP) is one of the most important genes for coat color determination in mammals. It has a complex structure with several promoters and alternative non-coding first exons that are transcribed into mRNAs with different 5'UTR. These mRNA isoforms regulate the temporal and spatial expression of the gene, producing diverse pigmentation patterns. Here, we studied ASIP transcriptional variants and their expression in the skin of llamas with different coat color phenotypes. We also described the ASIP locus, including promoter usage and the splicing events that originate each transcript variant. Using 5'RACE-PCR we isolated seven ASIP transcripts with alternative 5'UTR, where exons 1A, 1A', 1C, 1D, and a novel non-coding exon 1A" were identified. Additionally, new alternative spliced forms were found. The diversity of ASIP 5'UTRs is originated by a complex pattern of alternative promoter usage, multiple transcription start sites and splicing events that include exon skipping and alternative 3' splicing site selection. We found that ASIP was highly expressed in llamas with white and brown phenotypes while black animals presented very low expression. The main responsible for this difference was a fusion transcript between ASIP and NCOA6 genes, which was present in the skin of white and brown llamas but not in the black ones. The rest of ASIP transcripts presented very low expression in the skin, indicating that the main regulation point for ASIP gene expression is at the transcriptional level. Nevertheless, the characteristics of the 5'UTRs sequences suggest that alternative transcripts could be regulated differently at the protein synthesis level.

[Laparoscopic Nissen fundoplication: results and prognostic factors]. / Fundoplicatura de Nissen laparoscópica: resultados y factores pronósticos.

INTRODUCTION: Laparoscopic Nissen fundoplication is the technique of choice in the surgical treatment of gastroesophageal reflux disease. AIMS: To review the cases of laparoscopic Nissen fundoplication carried out at our hospital and to analyze the prognostic factors that influenced surgical outcome. MATERIAL AND METHODS: A total of 226 patients that underwent laparoscopic Nissen fundoplication within the time frame of 1996 to 2010 were retrospectively reviewed. Surgical results and prognostic factors were evaluated in 182 patients that had a follow-up longer than one year. RESULTS: The Nissen-Rossetti technique was carried out in 219 patients, without short gastric vessel division, and the "floppy"-Nissen technique was performed on seven patients. Intraoperative complication rate was 3.1%, conversion rate was 6.6%, and postoperative complication rate was 4%. Mortality was 0. After surgery, 19% of patients presented with dysphagia that was persistent in only 3.5%. Of the 182 patients with a follow-up longer than one year, 166 (91.2%) were satisfied with the surgical results. In the univariate analysis, esophagitis (OR=0.59) was a protective factor, while a DeMeester score >50 (OR=1.97) and medical treatment resistance (OR=1.75) were risk factors. In the multivariate analysis a DeMeester score >50 (OR=4.24) was the only independent prognostic factor associated with poor outcome. CONCLUSIONS: Our results with laparoscopic Nissen fundoplication are comparable to those found in the medical literature, with a high degree of patient satisfaction. Esophagitis is associated with good outcome, while massive reflux and medical treatment resistance are negative prognostic factors.

Glial cell line-derived neurotrophic factor gene therapy ameliorates chronic hyperprolactinemia in senile rats.

Progressive dysfunction of hypothalamic tuberoinfundibular dopaminergic (TIDA) neurons during normal aging is associated in the female rat with chronic hyperprolactinemia. We assessed the effectiveness of glial cell line-derived neurotrophic factor (GDNF) gene therapy to restore TIDA neuron function in senile female rats and reverse their chronic hyperprolactinemia. Young (2.5 months) and senile (29 months) rats received a bilateral intrahypothalamic injection (10(10) pfu) of either an adenoviral vector expressing the gene for beta-galactosidase; (Y-betagal and S-betagal, respectively) or a vector expressing rat GDNF (Y-GDNF and S-GDNF, respectively). Transgenic GDNF levels in supernatants of GDNF adenovector-transduced N2a neuronal cell cultures were 25+/-4 ng/ml, as determined by bioassay. In the rats, serum prolactin (PRL) was measured at regular intervals. On day 17 animals were sacrificed and neuronal nuclear antigen (NeuN) and tyrosine hydroxylase (TH) immunoreactive cells counted in the arcuate-periventricular hypothalamic region. The S-GDNF but not the S-betagal rats, showed a significant reduction in body weight. The chronic hyperprolactinemia of the senile females was significantly ameliorated in the S-GDNF rats (P<0.05) but not in the S-betagal rats. Neither age nor GDNF induced significant changes in the number of NeuN and TH neurons. We conclude that transgenic GDNF ameliorates chronic hyperprolactinemia in aging female rats, probably by restoring TIDA neuron function.

[Application of an alternative method to counting in Neubauer chamber to determine Trichomonas vaginalis concentrations]. / Aplicación de un método alternativo al conteo en cámara de Neubauer para determinar la concentración de Trichomonas vaginalis.

It was demonstrated that there is a relation of cell concentration with the parasite reading in an ELISA reader. It was determined that absorbance showed significant values in wavelengths of visible range and the possible minimum wavelength (450 nm)was chosen to guarantee the maximum sensitivity. Likewise, it was confirmed that absorbance significantly increased (p < 0.001) after the plate was filled up, it stabilized in the 40m-2h time interval when applying 100, 150, 200 or 300 ml per well of the various cell concentrations, it was proved that the optimum volume was 150 ml, a r2 = 0,9986 was reached, and the coefficient of correction(p < 0,001) and the gradient(p < 0,001)were highly significant. In the 5 x 10(4) to 1.5 x 10(7) cell/mL interval, there was an average variation coefficient of 1.75% (0.25-3.17%). Under these conditions, the quantification limit was 5,14 x 10(4) cell/mL. Finally, it was shown that the correlation of counting in Neubauer chamber and optical density was significant.