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Introduction: since Lauren classified gastric cancer into intestinal-type adenocarcinoma and diffuse gastric carcinoma back in 1965, countless categorizations have been published that attempt to elucidate the clinicopathological and prognostic differences between histological subtypes., Objective: a retrospective study was performed of gastric cancer cases managed in a third-level site over ten years in order to compare subtypes between the most widely used classifications (Lauren and World Health Organization [WHO])., Methods: a comparative study of the most relevant clinicopathological characteristics and a multivariate survival analysis were performed., Results: significant differences exist between histological subtypes in terms of age, gender, location, extension, stage and treatment received. A univariate overall survival analysis revealed better survival rates for intestinal-type adenocarcinoma as compared to diffuse carcinoma (hazard ratio [HR]: 1.405 [1.024-1.927]) according to the Lauren's classification. Furthermore, there was a better prognosis of mucinous carcinoma (HR: 0.378 [0.164-0.868]), though failing to prove a poorer prognosis of poorly cohesive (HR: 1.242 [0.878-1.757]) and signet cell (HR: 1.354 [0.792-2.314]) carcinomas, according to the WHO classification. In the multivariate overall survival analysis, the following poor prognosis factors were identified: male gender, local infiltration (T), nodal invasion (N) and received adjuvant therapy., Conclusion: although the various histological subtypes show significant clinicopathological differences, further studies are needed to compare them and clarify the prognostic relevance of each one.

Background: The number of multiple pregnancies has been significantly increased in the last decades due to assisted reproduction techniques development. Compared to singleton, twins and multiple pregnancies are associated to more complications and risks for both mother and children. The objective of this study was to examine the proportion of patients preferring a multiple birth over a singleton after an IVF/ICSI attempt, their reasons and the influence of socio-demographic and clinical parameters on their preference., Methods: A prospective study was conducted in two different Spanish centers in 2014; a public university hospital and a private clinic, with different populations and embryo transfer policies. In order to evaluate patients and partners attitudes towards twins and singletons, an anonymous 10-question survey was conducted and 399 were invited to participate., Results: 58.2% of participants preferred having twins to having one child at a time and 4.8% preferred triplets. Primary reasons for preferring twins were "avoiding a new IVF/ICSI attempt" (61.6%), "I like the idea of having twins" (27.3%), "avoiding the waiting list" (5.8%), and "in my opinion with the latest technology, the rate and severity of complications in multiple pregnancies are low" (5.2%). The multivariate analysis showed that the only significant parameter related to a preference for multiplets was the transfer of women's own fresh embryos (OR=3.31)., Conclusion: Twin pregnancy risks are not perceived as important by the majority of IVF/ICSI couples, and many of them specifically prefer twins. In our opinion, much more information is needed highlighting the multiple pregnancy risks and that information should come from medical sources besides general media., Competing Interests: Conflict of Interest Authors declare no conflict of interest.

Aim: To assess proportions, related conditions and survival of interval cancer (IC)., Methods: The programme has a linkage with different clinical databases and cancer registers to allow suitable evaluation. This evaluation involves the detection of ICs after a negative faecal inmunochemical test (FIT), interval cancer FIT (IC-FIT) prior to a subsequent invitation, and the detection of ICs after a positive FIT and confirmatory diagnosis without colorectal cancer (CRC) detected and before the following recommended colonoscopy, IC-colonoscopy. We conducted a retrospective observational study analyzing from January 2009 to December 2015 1193602 invited people onto the Programme (participation rate of 68.6%)., Results: Two thousand five hundred and eighteen cancers were diagnosed through the programme, 18 cases of IC-colonoscopy were found before the recommended follow-up (43542 colonoscopies performed) and 186 IC-FIT were identified before the following invitation of the 769200 negative FITs. There was no statistically significant relation between the predictor variables of ICs with sex, age and deprivation index, but there was relation between location and stage. Additionally, it was observed that there was less risk when the location was distal rather than proximal (OR = 0.28, 95%CI: 0.20-0.40, P < 0.0001), with no statistical significance when the location was in the rectum as opposed to proximal. When comparing the screen-detected cancers (SCs) with ICs, significant differences in survival were found ( P < 0.001); being the 5-years survival for SCs 91.6% and IC-FIT 77.8%., Conclusion: These findings in a Population Based CRC Screening Programme indicate the need of population-based studies that continue analyzing related factors to improve their detection and reducing harm., Competing Interests: Conflict-of-interest statement: No conflicts of interest.

Background & Aims: Malnutrition is very common in patients when admitted to the hospital. The aim of the present study was: a) to determine the prevalence of malnutrition at admission in a tertiary care hospital and identify risk factors for malnutrition, and b) to test the sensitivity and specificity of different screening tests for malnutrition compared to subjective global assessment (SGA)., Methods: We conducted a prospective study at 24h of admission in order to assess malnutrition in 537 adult subjects (56.4% males, mean age of 61.3±17.7 years) using 4 different screening tools: mininutritional assessment short form (MNA-SF), nutritional risk screening 2002 (NRS2002), malnutrition universal screening tool (MUST), and SGA. Anthropometrics and co-morbidities were registered., Results: The overall rate of undernutrition was 47.3%. Specific rates were 54.2% in patients > 65y vs. 40.7% < 65y (p = 0.002) and 63.4% in medical vs. 34.0% surgical department (p < 0.001). Identified risk factors of malnutrition at admission were: the presence of heart disease (OR 1.74 CI 95% 1.16-2.60 p = 0.007) for MNASF (AUC 0.62); liver disease (OR 4.45 CI 95% 1.9410.22 p < 0.001), > 65y (OR 2.10 CI 95% 1.19-3.93 p = 0.011), medicine department (OR 3.58 CI 95% 1.93-6.62 p < 0.001) for SGA (AUC 0.96); lung disease (OR 3.34 CI 95% 1.45-7.73 p = 0.005), medicine department (OR 2.55 CI 95%1.09-5.98 p = 0.032) for NRS 2002 (AUC 0.97). Recent unintentional weight loss was a common factor., Conclusions: Undernourishment at hospital admission is frequent. Comorbidities may contribute to the presence of undernutrition at admission. Nonetheless, SGA, NRS2002, MNA-SF or MUST can be used in our setting., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)