Inverse LGAD (iLGAD) Periphery Optimization for Surface Damage Irradiation.

Pixelated LGADs have been established as the baseline technology for timing detectors for the High Granularity Timing Detector (HGTD) and the Endcap Timing Layer (ETL) of the ATLAS and CMS experiments, respectively. The drawback of segmenting an LGAD is the non-gain area present between pixels and the consequent reduction in the fill factor. To overcome this issue, the inverse LGAD (iLGAD) technology has been proposed by IMB-CNM to enhance the fill factor and provide excellent tracking capabilities. In this work, we explore the use of iLGAD sensors for surface damage irradiation by developing a new generation of iLGADs, the periphery of which is optimized to improve the performance of irradiated sensors. The fabricated iLGAD sensors exhibit good electrical performances before and after X-ray irradiation.

Study of Ionization Charge Density-Induced Gain Suppression in LGADs.

Gain suppression induced by excess carriers in Low Gain Avalanche Detectors (LGADs) has been investigated using 3 MeV protons in a nuclear microprobe. In order to modify the ionization density inside the detector, Ion Beam Induced Current (IBIC) measurements were performed at different proton beam incidence angles between 0° and 85°. The experimental results have been analyzed as a function of the ionization density projected on the multiplication layer, finding that the increase of ionization density leads to greater gain suppression. For bias voltages close to the gain onset value, this decrease in gain results into a significant distortion of the transient current waveforms measured by the Time-Resolved IBIC (TRIBIC) technique due to a deficit in the secondary holes component. For angles of incidence such that the Bragg peak falls within the sensitive volume of the detector, the formation of microplasmas modifies the behavior of the gain curves, producing an abrupt decrease in gain as the angle increases.

Embolización prostática como tratamiento para pacientes con hiperplasia benigna de próstata portadores de sonda vesical permanente no tributarios a cirugía desobstructiva / Prostatic artery embolization treatment for patients with benign prostatic hyperplasia who are permanent urinary catheter users ineligible for de-obstructive surgery

Introducción: La hiperplasia benigna de próstata se considera la causa más común de los síntomas del tracto urinario inferior. El sondaje vesical es el tratamiento urgente en pacientes con retención urinaria y la cirugía el de aquellos refractarios al tratamiento médico. Existe un grupo de personas con comorbilidades importantes no tributarias a cirugía. La embolización arterial prostática (EAP) podría presentarse como una alternativa segura y eficaz para conseguir el vaciamiento vesical y la micción espontánea, evitando así el sondaje vesical permanente en pacientes con comorbilidades importantes que contraindiquen la cirugía. En este estudio retrospectivo, evaluamos la eficacia de la EAP en pacientes portadores de sonda vesical permanente no tributarios de tratamiento quirúrgico.Material y métodosEstudio retrospectivo de 26 pacientes portadores de sonda vesical permanente a los que se les realizó una embolización prostática. Se revisaron los datos demográficos y clínicos (edad, uso de anticoagulación, volumen prostático, tiempo de ingreso, embolización unilateral o bilateral), la evaluación del índice de comorbilidad de Charlson y la clasificación de Clavien-Dindo para las complicaciones del procedimiento. Se analizó el éxito de la retirada de la sonda vesical permanente al mes del procedimiento.ResultadosUn total de 26 pacientes fueron incluidos en la revisión. La mediana de edad fue de 85 años, con un volumen prostático mediano de 90mL. El 88,5% de los sujetos puntuó más de 7 en la escala de comorbilidad de Charlson. Un único paciente presentó una complicación Clavien-Dindo III. De los 26 sujetos, 17 (65,4%) tuvieron una micción espontánea y un residuo posmiccional inferior a 100mL al mes del procedimiento. En total, se logró retirar la sonda vesical en 19 de los 26 sujetos (73,1%). (AU)

Introduction: Benign prostatic hyperplasia is considered the most frequent cause of lower urinary tract symptoms. Urinary catheterization is the emergency treatment for patients with urinary retention and surgery is indicated in patients refractory to medical treatment. There is a group of people with important comorbidities that make them ineligible for surgery. Prostatic arterial embolization (PAE) could be presented as a safe and effective alternative to achieve bladder emptying and spontaneous urination, thus avoiding permanent urinary catheterization in patients with significant comorbidities that represent a contraindication for surgery. In this retrospective study, we evaluated the efficacy of PAE in patients with permanent urinary catheterization who are ineligible for surgical treatment.Material and methodsRetrospective study of 26 patients with permanent urinary catheter who underwent prostatic embolization. Demographic and clinical data (age, use of anticoagulation, prostate volume, length of hospital stay, unilateral or bilateral embolization), Charlson comorbidity index evaluation and Clavien-Dindo classification for procedural complications were reviewed. Successful removal of permanent urinary catheter was analyzed at one month after the procedure.ResultsA total of 26 patients were included in the review. The median age was 85 years with a median prostate volume of 90mL. A Charlson comorbidity score above 7 was obtained in 88.5% of the subjects. Only one patient had one Clavien-Dindo III complication. Of the 26 subjects, 17 (65.4%) had spontaneous micturition and a postvoid residual lower than 100mL at one month post procedure. Overall, catheter removal was achieved in 19 out of 26 subjects (73.1%). (AU)

Manufacturability and Stress Issues in 3D Silicon Detector Technology at IMB-CNM.

This paper provides an overview of 3D detectors fabrication technology developed in the clean room of the Microelectronics Institute of Barcelona (IMB-CNM). Emphasis is put on manufacturability, especially on stress and bow issues. Some of the technological solutions proposed at IMB-CNM to improve manufacturability are presented. Results and solutions from other research institutes are also mentioned. Analogy with through-silicon-via technology is drawn. This article aims at giving hints of the technology improvements implemented to upgrade from a R&D process to a mature technology.

Aplicación de la termografía infrarroja en medicina legal. ¿Prueba válida para la objetivación de los síndromes dolorosos? Disfunción temporomandibular / Application of Infrared thermography in legal medicine. Is it a valid test for an objective assessment of painful syndromes? Temporomandibular disorder

Uno de los objetos de estudio de la Medicina Legal y Forense es la evaluación de las lesiones causadas a las personas en distintas circunstancias: accidentes de tráfico, accidentes laborales, agresiones físicas, etc... La utilización de pruebas complementarias ha sido, es y seguirá siendo un pilar fundamental para la valoración objetiva de las consecuencias que estas lesiones tienen en quien las sufre. Nuestros informes periciales deben aportar las pruebas necesarias con el fin de justificar la sintomatología residual referida por los lesionados. Uno de los puntos más polémicos es la objetivación del dolor referido por los lesionados. En este sentido, la termografía infrarroja (TIR) se ha convertido en una herramienta complementaria muy útil para la evaluación de los procesos dolorosos, permitiendo identificar alteraciones fisiopatológicas del medio interno que justifican la clínica dolorosa manifestada por los pacientes. Sus aplicaciones médicas son múltiples y actualmente su uso se encuentra regulado y estandarizado por sociedades científicas que velan por el control de la calidad de los estudios. Con el fin de introducir y divulgar la utilización de esta prueba complementaria en el ámbito médico legal, exponemos un caso en que la TIR permitió la identificación de alteraciones en el equilibrio térmico de los músculos masticatorios en una paciente que redfería dolor en la articulación temporomandibular derecha tras un traumatismo craneoencefálico moderado-grave (AU)

One of the aims of Forensic Medicine is the assessment of injuries suffered by patients on different situations (i.e., traffic collisions, work accidents, physical aggression, etc.). The use of complementary tests has always been a key factor for an objective assessment of those injuries’ consequences and our expert reports should include all required evidences to prove the residual symptoms reported by patients. One of the most controversial issues has been and continues to be the verifying referred pain by our patients. In that sense infrared thermography has become a useful tool in the assessment of painful processes allowing us to identify pathophysiological changes in the internal environment that can prove the painful condition. In addition to its multiple medical applications, its use is currently regulated and standardized by scientific associations that ensure the compliance of quality standards. In order to introduce and spread the use of this complementary test in the forensic field, we report a case on which the use of infrared thermography allowed to identify abnormalities in thermal equilibrium of chewing muscles on a patient that reported right temporomandibular joint pain after suffering a moderate to severe head injury (AU)

Estudio retrospectivo de las denuncias por malpraxis* médica en la provincia de Málaga / Retrospective study of medical malpractice suits in the province of Malaga (Spain)

Las denuncias contra los médicos son cada vez más frecuentes. Un hecho que hasta hace poco era relativamente anecdótico, se ha convertido en una situación jurídica habitual en la actualidad. El propósito de este estudio es recopilar los datos que desde nuestro punto de vista son más relevantes, de los existentes en los archivos del IML de Málaga, correspondientes a las denuncias por malpraxis en esta provincia. El objetivo es realizar una aproximación global, dada la nueva estructura del trabajo medico legal, a determinados aspectos periciales y aportar nuevos criterios a la hora de realizar dichas periciales. Al mismo tiempo se analiza la práctica de la medicina en esta provincia y su relación con los pacientes

Suits against doctors are now more frequent than ever. A situation that was almost anecdotic some years ago have become very common nowadays. The aim of this study is to compile main data which, from our point of view, are more relevant of the obtained from the files of the Institute of Legal Medicine of Malaga (Spain) related to the medical malpractice suits in this province. The objective is to carry out an approach, taken into account the new structure of the medico-legal work, to some expert witness report and to propose new criteria to perform those evaluations. At the same time, the practice of medicine in this province and its relation with the patients are analyzed

[An analysis of the reliability of a data-gathering form. An interobserver concordance study]. / Análisis de la fiabilidad de una hoja de recogida de datos. Estudio de concordancia interobservador.

OBJECTIVES: To measure the reliability of a data-gathering from by analysing the concordance between observers, and to check the efficacy of the corrective measures applied to improve it. DESIGN: A pre-test/post-test design, without a control. SETTING: Urban Health Centre. PATIENTS AND OTHER PARTICIPANTS: Random selection of 50 clinical records from the list of Type 2 diabetics in the centre's computerised files. INTERVENTIONS: Alterations in the data-gathering form in order to improve concordance between two independent observers, measured by means of the Kappa index for qualitative variables and absolute concordance for quantitative ones. The quality criteria defined by the Diabetes in Primary Health Care Study Group were applied. MEASUREMENTS AND MAIN RESULTS: The Kappa index average improved after the intervention from 0.71 to 0.89 (p = 0.019). There were no significant changes in concordance for quantitative variables (6 out of 8 items with 100% concordance at start and finish). CONCLUSIONS: It is important to verify the reliability of the measuring instruments. Our results justify this concern: two independent observers do not always obtain the same reading from the same source. Concordance improved significantly when the form was altered, so guaranteeing greater data-gathering reliability and improving the overall quality of the research.