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The impact of stressful events is especially important during early life, because certain cortical regions, especially the prefrontal cortex (PFC), are still developing. Consequently, aversive experiences that occur during the peripubertal period can cause long-term alterations in neural connectivity, physiology and related behaviors. Although sex influences the stress response and women are more likely to develop stress-related psychiatric disorders, knowledge about the effects of stress on females is still limited. In order to analyze the long-term effects of peripubertal stress (PPS) on the excitatory and inhibitory circuitry of the adult PFC, and whether these effects are sex-dependent, we applied an unpredictable chronic PPS protocol based on psychogenic stressors. Using two strains of transgenic mice with specific fluorescent cell reporters, we studied male and diestrus females to know how PPS affects the structure and connectivity of parvalbumin expressing (PV+) interneurons and pyramidal neurons. We also studied the expression of molecules related to excitatory and inhibitory neurotransmission, as well as alterations in the expression of plasticity-related molecules. The structure of pyramidal neurons was differentially affected by PPS in male and female mice: while the former had a decreased dendritic spine density, the latter displayed an increase in this parameter. PPS affected the density of puncta expressing excitatory and inhibitory synaptic markers exclusively in the female mPFC. Similarly, only in female mice we observed an increased complexity of the dendritic tree of PV+ neurons. Regarding the perisomatic innervation on pyramidal and PV+neurons by basket cells, we found a significant increase in the density of puncta in stressed animals, with interesting differences between the sexes and the type of basket cell analyzed. Finally, the PPS protocol also altered the total number of somata expressing the polysialylated form of the neural cell adhesion molecule (PSA-NCAM) when we analyzed both sexes together. These results highlight the strong programming effects of aversive experiences during early life for the establishment of cortical circuitry and the special impact of these stressful events on females.

BackgroundMany older patients don't receive appropriate oncological treatment. Our aim was to analyse whether there are age differences in the use of adjuvant chemotherapy and preoperative radiotherapy in patients with colorectal cancer.MethodsA prospective cohort study was conducted in 22 hospitals including 1157 patients with stage III colon or stage II/III rectal cancer who underwent surgery. Primary outcomes were the use of adjuvant chemotherapy for stage III colon cancer and preoperative radiotherapy for stage II/III rectal cancer. Generalised estimating equations were used to adjust for education, living arrangements, area deprivation, comorbidity and clinical tumour characteristics.ResultsIn colon cancer 92% of patients aged under 65years, 77% of those aged 65 to 80years and 27% of those aged over 80years received adjuvant chemotherapy (chi(2)(trends)

Purpose To identify and validate risk factors that contribute to prolonged length of hospital stay (LOS) in patients undergoing resection for colorectal cancer. Methods This prospective cohort study included 1955 patients admitted to 22 hospitals for primary resection of colorectal cancer. Multivariate analyses were used to identify and validate risk factors, randomizing patients into a derivation and a validation cohort. Multiple correspondence and cluster analysis were performed to identify clinical subtypes based on LOS. Results The strongest independent predictors of prolonged LOS were postoperative reintervention, surgical site infection, open surgery, and distant metastasis. The multiple correspondence and cluster analysis provided three groups of patients in relation to prolonged LOS: patients with the longest LOS included the highest percentage of patients with open surgery, distant metastasis, deep surgical site infections, emergency admissions, additional diagnostic factors, and highly contaminated surgical sites. Patients with prolonged LOS (> 14 days) were more likely to develop adverse outcomes within 30 days after discharge. Conclusions Patients undergoing resection of colorectal cancer cluster into different groups based on LOS of the index admission. Those with prolonged LOS were more likely to develop adverse outcomes within 30 days after discharge. Some of the strongest independent predictors of prolonged LOS, such as surgical infections or open surgery, could be modified to reduce LOS and, in turn, other adverse outcomes.

This article discusses experimental data on the flexural and compressive strength of Portland cement mortars containing additions or cement replacements consisting in petroleum or coal tar, by-products of the oil and coal industries. The materials studied were two coal (BACA and BACB) and two petroleum (BPP and BPT) tars. The results show that it is feasible to use such materials as a partial replacement for cement in mortar manufacture. This should lead to the design of a new sustainable product that will contribute to lowering the environmental impact of construction materials while at the same time opening up an avenue for the re-use of this type of industrial by-products., En este artículo se presentan datos experimentales de resistencia a flexión y a compresión de morteros de cemento Portland con adición y sustitución de breas de petróleo y de alquitrán de carbón, que son subproductos de la industria del carbón o del petróleo. Los materiales estudiados son breas de alquitrán de carbón A (BACA) y B (BACB), y dos breas de petróleo (BPP) y (BPT). Los datos demuestran la viabilidad del uso de estas breas en la fabricación de morteros con menores contenidos de cemento, permitiendo diseñar un nuevo material sostenible con el medio ambiente y que contribuya a reducir el impacto ambiental de los materiales de construcción, hecho que permite abrir una nueva vía de valorización de estos subproductos.

Advances in the care of patients with metastatic colorectal cancer arise from well-designed clinical trials. In the present document we address specific challenges in the design of clinical trials for metastatic colorectal cancer regarding staging and standard of care according to prognosis, as well as some relevant methodological issues.

10.1371/journal.pone.0031280 De novo lipogenesis is involved in fatty acid biosynthesis and could be involved in the regulation of the triglyceride storage capacity of adipose tissue. However, the association between lipogenic and lipolytic genes and the evolution of morbidly obese subjects after bariatric surgery remains unknown. In this prospective study we analyze the association between the improvement in the morbidly obese patients as a result of bariatric surgery and the basal expression of lipogenic and lipolytic genes.

10.1371/journal.pone.0033264 Zinc-α2 glycoprotein (ZAG) stimulates lipid loss by adipocytes and may be involved in the regulation of adipose tissue metabolism. However, to date no studies have been made in the most extreme of obesity. The aims of this study are to analyze ZAG expression levels in adipose tissue from morbidly obese patients, and their relationship with lipogenic and lipolytic genes and with insulin resistance (IR).

Durante la última década, se ha producido un rápido desarrollo en la nefroscopia y la ureterorrenoscopia flexible, litotricia láser y diferentes instrumentos para manejar las litiasis. Realizaremos una revisión del empleo del láser en distintas situaciones. Se deben hacer esfuerzos para minimizar el daño renal y el láser juega un papel importante en el tratamiento de pacientes con urolitiasis y riñones en herradura, insuficiencia renal crónica, pacientes neurológicos. During the last decade there has been a rapid development in flexible nephroscopy, flexible ureterorenoscopy, laser lithotripsy and instruments for stone manipulation. We are going to review the use of Laser in the management of lithiasis in different situations. Efforts should be made to minimize renal injury and lasers play a significant role in patients with urolithiasis and horseshoe kidneys, chronic renal failure, neurological patients.

The paper describes the effect of carbon fibre on alkaliactivated slag mortar (AAS) mechanical strength, volume stability and reinforcing steel corrosion, compared to its effect on the same properties in Portland cement (PC) properties. Mechanical strength and volume stability tests were performed as set out in the respective Spanish UNE standards. The corrosion rate of steel embedded in the specimens studied was determined from polarization resistance analysis. One of the findings of the study performed was that carbon fibre failed to improve AAS or CP mortar strength. As far as volume stability is concerned, the inclusion of carbon fibres in AAS with a liquid/solid ratio of 0.5 reduced drying shrinkage by about 50%. The effect of carbon fibre on PC mortars differed from its effect on AAS mortars. Studies showed that in the presence of carbonation, steel corrosion reached higher levels in carbon-fibre reinforced AAS mortars; the inclusion of 1% carbon fibre improved corrosion resistance perceptibly in these same mortars, however, when exposed to chloride attack., Se ha estudiado el efecto de la incorporación de fibras de carbón en el comportamiento mecánico, estabilidad de volumen y nivel de corrosión de la armadura en morteros de escorias activadas alcalinamente (AAS). Se evalúa la influencia de las fibras de carbón en el comportamiento de morteros alcalinos en comparación con el efecto que producen en morteros de Portland (CP). Los ensayos mecánicos y de estabilidad de volumen se han realizado según lo establecido en la norma UNE que los regula. Se ha utilizado la técnica de la Resistencia a la Polarización para determinar la velocidad de corrosión del acero embebido en las muestras estudiadas. Como consecuencia del estudio realizado, se ha podido concluir que la adición de fibras de carbón a morteros de AAS y CP no mejora las características resistentes de los mismos. En relación con la estabilidad de volumen, la incorporación de fibras de carbón a los morteros de AAS, preparados con una relación líquido/sólido de 0,5, reduce alrededor del 50% su retracción al secado. En los morteros de CP, la influencia de las fibras de carbón difiere de la observada para los morteros de AAS. Los estudios de corrosión han demostrado que en condiciones de carbonatación, los morteros de AAS con fibras de carbón incrementan el nivel de corrosión del acero embebido en los mismos; mientras que mejora sensiblemente el comportamiento de los morteros AAS con un 1% de fibra de carbón frente a la corrosión ante el ataque por cloruros.

Primary signet-ring cell adenocarcinoma of the urinary bladder is a rare tumor. We report in this study the case of a 53 year old man consulting for gross hematuria. Computed tomography imaging demonstrated right hydronephrosis and an invasive bladder tumor. The bladder biopsy showed a signet-ring cell carcinoma; the exploration of the gastrointestinal tract did nor reveal any other tumor localization. A total cystoprostatectomy was performed followed by adjuvant chemotherapy with cisplatin and gemcitabine. The aim of this study is to determine the anatomoclinical, therapeutic and evolutionary characteristics of this rare tumor. El adenocarcinoma de células en anillo de sello primario de vejiga es un tumor raro. Describimos un caso de un varón de 53 años que consultó por hematuria macroscópica. La imagen de la tomografía axial computerizada mostró un hidronefrosis derecha y un tumor invasivo de la vejiga urinaria. La biopsia mostró un carcinoma de células en anillo de sello. No se detectó localización primaria digestiva en la exploración del tracto grastrointestinal. El paciente se trató con cistoprostatectomía total y quimioterapia adyuvante con cisplatino y gemcitabina. El objetivo de este caso es presentar las características anatomoclínicas, tratamiento y evolución de este infrecuente tumor.

Objective: To assess the impact of HIV/AIDS on the incidence of tuberculosis (TB) and to analyse the determinants of TB presenting as the first indicative disease of AIDS. Design: Analysis of TB and AIDS surveillance data. Setting: Catalonia, north-east Spain. Patients: Two separate sources were used: (i) TB cases reported to the Catalan TB registry diagnosed between January 1982 and December 1993; (ii) AIDS cases reported to the AIDS Catalan registry diagnosed between January 1982 and December 1994. Main outcome measures: Expected and observed TB cases, and number and characteristics of AIDS cases presenting with TB. Results: From 1987 to 1993 the annual TB crude incidence rate increased by 50% to a rate of 49.7 per 100 000, with at least 60% of the increase directly due to AIDS. During that period specific rates among children aged 0-4 years remained high at around 40 per 100 000. A total of 7010 AIDS cases were diagnosed between 1988 and 1994, ot whom 24.3% had TB. Multivariate analysis from those AIDS cases showed that besides male sex, young age, and urban residence, the strongest predictors of TB among AIDS cases were history of imprisonment (odds ratio, 2.16, P < 0.001) and intravenous drug use [odds ratio, 1.65; P < 0.001). Conclusions: The high rates of TB among children and young adults suggest that TB transmission has increased during this period, especially among people at high risk of AIDS. The determinants of individual risk of TB among AIDS patients act together, especially in prisons. The HIV/TB coepidemic is an emerging threat potentially for all and requires expanding targeted measures to prevent and control both diseases in our setting.