International cooperation in radiology training: A multipronged approach.

INTRODUCTION: Medical imaging has undergone significant technical advancements in recent years, posing a considerable challenge for radiologists to stay up-to-date with emerging modalities and their applications in daily practice. This challenge is even more daunting in developing countries with limited resources compared to the US and other developed nations with greater economic assets. The collaboration between the United States and other advanced nations with radiological institutions in Latin America has been a significant achievement in the pursuit of new opportunities for continuous medical education. The aim of this study was to evaluate the effectiveness of international collaborations among Spanish-speaking Latin American institutions and radiologists through a survey. MATERIALS AND METHODS: A group of radiologists and institutions from various countries, including the USA, Spain, and Argentina, who have been working together for several years to improve Radiology education across Latin America, were selected. An online survey was conducted. The survey included questions about interest in the activities, participation, and impact of radiologic education during these educational efforts. RESULTS: The survey received responses from 166 participants, all of whom reported knowledge of at least one type of educational activity. The most well-known activity was ALAT Webinars. The primary motivators for participation were the quality of the content and the opportunity to learn new information. Additionally, improving local education in radiology and receiving expert advice on radiology issues were identified as priorities for participation in international collaborations. The Cronbach alpha coefficient was calculated for individual and global Likert questions, resulting in a global score of 0.96. CONCLUSION: The study confirms the significance of a multifaceted approach to address gaps in radiology education. While traditional models have relied on hosting international visitors or sending US teachers abroad, the results suggest that using a variety of methods will have a greater impact than relying on a single technique for those who benefit most from collaborative efforts.

Meniscocapsular release technique to reduce chronic and challenging bucket-handle meniscus tear.

Several surgical procedures for the repair of bucket handle meniscus tears have been reported in the literature. However, even the most skilled surgeon can find it difficult to treat chronic and locked lesions, which typically result in meniscectomies. Therefore, a repair method for bucket-handle meniscus tears that are chronic and locked is shown, along with a case series where this procedure was used. The technique consists of a release of the joint capsule attachment to the meniscal body, which increases the mobility of the meniscus and facilitates the reduction of the injury, allowing subsequent repair through a combination of both all-inside and inside-out repair techniques. The main objective of this technique is to reduce the need for meniscectomies in difficult cases of bucket-handle meniscus tears, protect the meniscal tissue, and slow the progression of osteoarthritis in the process.

Navigating between two figured worlds: A constructivist grounded theory study on residents' workplace experiences with health care management tasks.

INTRODUCTION: Medical residents may be required to handle health care management (HCM) tasks alongside their clinical duties, despite not having received training to perform them. However, little research has been done on how medical residents acquire HCM skills at the workplace and how these experiences impact their learning. METHODS: We completed a qualitative research study using the Constructivist Grounded Theory approach inform by the Figured World theory. To gather data, we held focus groups and conducted semi-structured interviews with 22 medical residents from various disciplines and learning levels at Pontificia Universidad Javeriana. We utilised iterative data collection and analysis, constant comparison methods and theoretical sampling to construct our findings. RESULTS: We constructed two different worlds to represent how residents acquire HCM skills: the non-managing physician and the physician-as-manager. The former was characterised by a discourse that underplayed the role of the HCM tasks as part of residents' training, was full of negative interactions with the health care team and limited residents' agency. In the latter, residents collaborated and learned from health care team members, had supervisors who modelled how to incorporate HCM tasks into daily activities and expanded residents' agency. Residents developed their professional identity according to the world they were introduced into. DISCUSSION: Educational leaders must understand that the non-managing physician figured world gives residents a feeling of uprooting and discomfort when carrying out this type of tasks. To transform this world into the physician-as-manager, it is necessary to reconfigure some workplace hierarchies, consolidate interprofessional collaborations and change the discourse perpetuated by influential role models. Supervisors must also strengthen their knowledge of HCM and improve its integration into clinical practice. Any effort to train residents on HCM competencies could be lost if the workplace underscores their value in patient care.

Early preoperative progressive pneumoperitoneum for a symptomatic giant abdominal incisional hernia.

INTRODUCTION AND IMPORTANCE: Early preoperative progressive pneumoperitoneum (PPP) is a technique that helps large eventrations with loss of domain to reintroduce protruded organs. However, a standardized technique has not been developed. This technique has been proved in elective patients, but the evidence is scarce in patients with a high risk of incarceration/strangulation. CLINICAL FINDINGS AND INVESTIGATIONS: We present a 61-year-old patient with history of a thoracoabdominal aneurysm repair, developed a massive incisional hernia with loss of domain. At admission, he presented with abdominal pain and inability to reduce the hernia by himself, however it reduced after clinical examination. Aortic syndromes were excluded. INTERVENTIONS AND OUTCOME: After a multidisciplinary meeting, early PPP was initially performed. Later he was taken to surgery and admitted in the ICU to prevent abdominal hypertension. Medical complications resolved within 14 days. The patient did not report long-term complications. RELEVANCE AND IMPACT: PPP is a technique that pursues the prevention of abdominal hypertension syndrome in patients with large hernias with loss of domain electively. For patients with high risk of hernia complications, the evidence is limited regarding the applicability of early PPP. A multidisciplinary team can improve decision making and therefore reduce the risk of long-term complications. We show a case where PPP was performed in an acute painful, reducible hernia with a high risk of incarceration, showing that this approach can be an option for acutely ill patients.

Angiotomografía en la evaluación de arterias perforantes para reconstrucción mediante colgajos: lo que el cirujano quiere saber y el radiólogo debe informar / Computed tomography angiography for perforator flaps: What the surgeon needs to know and the radiologist should inform

Resumen Desde la introducción del concepto de «angiosomas¼ se describieron las arterias perforantes y su potencial para el uso en colgajos. La angiotomografía es un método excelente para la valoración preoperatoria en cirugías reconstructivas y es clave en la valoración prequirúrgica. Es un estudio multidisciplinario en cuyo análisis participan el radiólogo y el cirujano plástico. Es importante incluir en el reporte radiológico el origen de la arteria, detallar su curso, cuantificar el calibre y determinar su emergencia para facilitar al cirujano la planeación prequirúrgica y la realización del procedimiento quirúrgico. Otra de las principales ventajas es que el uso de este método disminuye los tiempos quirúrgicos y las posibles complicaciones de las cirugías reconstructivas. El radiólogo debe estar familiarizado con los tipos de colgajos más comúnmente utilizados, la anatomía de las arterias y sus perforantes para guiar al cirujano en la planeación prequirúrgica y la toma de decisiones.

Abstract Since the introduction of the concept of "angiosomes", the perforating arteries and their potential for use in flaps was described. Angiotomography is an excellent imaging modality for preoperative evaluation in reconstructive surgery and is very important in presurgical assessment. This imaging technique requires a multidisciplinary approach in which the radiologist and the plastic surgeon participate. The radiological report must include the origin of the artery, detail it's course, quantify the caliber and determine the position where it emerges through the fascial plane to give the surgeon the possible information in presurgical planning and surgical procedure. The main advantage of this technique is the reduction of surgical timing and possible complications. The radiologist should be familiar with the most commonly used types of flaps, the anatomy of the arteries and their perforators to guide the plastic surgeon in presurgical planning and decision making.

Formación de un divertículo epifrénico como complicación de la cirugía antirreflujo: importancia de la fluoroscopia / Development of an epiphrenic diverticulum as a complication of antireflux surgery: importance of fluoroscopy

En este artículo se muestran los hallazgos radiológicos en el esofagograma del divertículo epifrénico en un paciente con disfagia para sólidos y pérdida de peso, con antecedente de cirugía antirreflujo. Además, se encuentra una plicatura muy apretada y, como consecuencia, la formación del divertículo epifrénico, entidad de rara presentación. Las técnicas de fluoroscopia siguen vigentes para la valoración anatómica y funcional del tracto gastrointestinal

This article demonstrates the radiological findings in the esophagogram of the epiphrenic diverticulum in a patient with solid dysphagia and weight loss with a history of antireflux surgery. In this case, a very tight plication was found and as a consequence the formation of the epiphrenic diverticulum, a rare entity Fluoroscopy techniques are still used for anatomical and functional evaluation of the gastrointestinal tract.

Escuchar con los ojos: evaluación por tomografía axial computarizada de la pérdida auditiva / Listening with your eyes: computed tomography assessment of hearing loss

Múltiples patologías pueden afectar el funcionamiento del aparato auditivo. El conocimiento anatómico de los compartimentos del hueso temporal en la tomografía axial computarizada (TAC) conduce a una mejor comprensión de estas entidades y mejora el enfoque clínico hacia la pérdida auditiva conductiva o neurosensorial. Un diagnóstico preciso significa un inicio rápido del tratamiento, lo cual puede modificar el pronóstico del paciente

Multiple pathologies can affect the function of the auditory apparatus. Anatomical knowledge of the temporal bone compartments on computed tomography leads to a better understanding of these entities and improves the clinical approach toward conductive or sensorineural hearing loss. An accurate diagnosis means a rapid initiation of treatment, which can change the patient's prognosis.

Pre- and postsurgical imaging findings of abdominal wall hernias based on the European Hernia Society (EHS) classification.

Abdominal wall hernias are common and can present as technical challenges to surgeons. When large, hernias diminish quality of life. Various classifications of incisional hernias have been proposed; however, there are many terms, sometimes causing confusion (1). Radiologists must know the normal anatomy of the abdominal wall, the CT protocol, and what if any maneuvers can be performed to better identify an abdominal wall defect. The description of the radiological approach for primary and incisional wall hernias is based on the 2007 European Hernia Society classification, with particular emphasis on presurgical and postsurgical imaging findings. This classification provides a simple and reproducible method to describe hernias to offer proper surgical management. We highlight this classification so that radiologists and surgeons can have a unified language.

Manifestaciones torácicas y dermatológicas de las enfermedades sistémicas: claves para el radiólogo general / Thoracic and Cutaneous Involvement in Systemic Diseases: Clues for the General Radiologist

Hay una gran cantidad de enfermedades con manifestaciones en tórax y en piel. Dentro de ellas es muy importante la identificación de patrones radiológicos en tomografía computarizada multidetector (TCMD) y su correlación con la clínica, con énfasis en las manifestaciones cutáneas. En este artículo se hace una revisión de las principales entidades infecciosas, inflamatorias, enfermedades de tejido conjuntivo, enfermedades hereditarias y adquiridas. Se brinda información sobre las presentaciones radiológicas más frecuentes en el tórax, como la enfermedad intersticial pulmonar en la que predominan los patrones NINE, NIU y NO, cuya frecuencia varía según la enfermedad y que, a su vez, son diferentes de los patrones radiológicos en TCMD. Se destaca su importancia en pacientes con patologías dermatológicas. Se plantean hallazgos dermatológicos y radiológicos claves para sospechar el diagnóstico de estas patologías, lo que permite al radiólogo entregar una mayor información para definir el tratamiento y seguimiento de dichos pacientes.

There are many diseases with manifestations in the chest and on the skin. Within this great variety of diseases, it is important the identification of pathological patterns in Multidetector Computed Tomography (MDCT) and its correlation with cutaneous manifestations. In this article, we present a review of the main entities: infectious, inflammatory, connective tissue diseases, hereditary and acquired diseases. Information is provided on the most frequent radiological presentations of these diseases in the thorax, being one of the most frequent presentations the pulmonary interstitial disease where NSIP, UIP, and NO are the predominant patterns, whose frequency varies according to the disease and which, in turn, are different from the radiological patterns in MDCT. The importance of the Multidetector Computed Tomography in patients with dermatological pathologies is highlighted. Key dermatologic and radiologic findings to suspect the diagnosis in any of these pathologies are presented, which allows the radiologist to provide more information to define the treatment and follow-up of these patients.

Compromiso torácico de la sarcoidosis en tomografía computarizada: claves clínicas y radiológicas / Thoracic Involvement of Sarcoidosis in Computed Tomography: Radiological Manifestations and Key Findings

La sarcoidosis es una enfermedad crónica y multisistémica de etiología poco clara. La presentación es variable, de acuerdo con la procedencia geográfica del paciente, pero predomina en personas afrodescendientes y escandinavas. Las anormalidades torácicas son muy frecuentes en los pacientes con sarcoidosis; la afectación más común es ganglionar y la menos común es la del corazón. Las manifestaciones radiológicas más frecuentes en el compromiso torácico por sarcoidosis son las adenomegalias hiliares y mediastinales, así como nódulos pulmonares de distribución perilinfática.

Sarcoidosis is a chronic, multisystemic disease of unclear etiology. The presentation is variable according to the geographical origin of the patient, predominantly in Afro-descendant and Scandinavian patients. Chest abnormalities are very frequent in patients with sarcoidosis, taking into account that the most common involvement is lymphatic and the least common is heart involvement. The most frequent radiological manifestations in thoracic involvement due to sarcoidosis are hilar and mediastinal adenomegalies as well as pulmonary nodules with perilymphatic distribution.

Approach to Pulmonary Hypertension: From CT to Clinical Diagnosis.

Pulmonary hypertension (PH) is a condition characterized by increased pressure in the pulmonary circulation. It may be idiopathic or arise in the setting of other clinical conditions. Patients with PH tend to present with nonspecific cardiovascular or respiratory symptoms. The clinical classification of PH was recently revised at the World Health Organization symposium in Nice, France, in 2013. That consensus statement provided an updated classification based on the shared hemodynamic characteristics and management of the different categories of PH. Some features seen at computed tomography (CT) can suggest a subtype or probable cause of PH that may facilitate placing the patient in the correct category. These features include findings in the pulmonary arteries (peripheral calcification, peripheral dilatation, eccentric filling defects, intra-arterial soft tissue), lung parenchyma (centrilobular nodules, mosaic attenuation, interlobular septal thickening, bronchiectasis, subpleural peripheral opacities, ground-glass opacities, diffuse nodules), heart (congenital lesions, left heart disease, valvular disease), and mediastinum (hypertrophied bronchial arteries). An approach based on identification of these CT features in patients with PH will allow the radiologist to play an important role in diagnosis and help guide the clinician in management of PH. ©RSNA, 2018.

Actualización de la enfermedad pulmonar obstructiva crónica: claves clínicas y hallazgos radiológicos en tomografía Computarizada / Update in Chronic Obstructive Pulmonary Disease: Clinical and Radiologic Findings in Computed Tomography

La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad prevenible y tratable, que se caracteriza por síntomas respiratorios persistentes secundarios a la exposición crónica a partículas. Los pilares fundamentales son la enfermedad de la vía aérea y la destrucción del parénquima pulmonar. Los cambios no siempre ocurren simultáneamente y progresan a diferentes velocidades en cada individuo. Las imágenes diagnósticas pueden ser consideradas como parte del diagnóstico y la valoración de los pacientes con EPOC, teniendo en cuenta que la radiografía de tórax no es útil para su diagnóstico, pero facilita la exclusión de los diagnósticos diferenciales, mientras que la tomografía computarizada se reserva para aquellos pacientes en quienes se debe valorar el parénquima pulmonar por sospecha de bronquiectasias o quienes por sus riesgos exposicionales tienen mayor probabilidad de desarrollar cáncer de pulmón. El enfisema, la bronquitis crónica y el asma son la clave para realizar un abordaje radiológico para el diagnóstico.

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by the presence of persistent respiratory symptoms secondary to chronic exposure to particles. The main factors are airway disease and destruction of the lung parenchyma. Parenchymal abnormalities do not always occur simultaneously and progress at different speeds in each individual. Diagnostic imaging can be considered as part of the diagnosis and assessment in patients with COPD, taking into account that chest radiography is not useful for the diagnosis of COPD but is useful for the exclusion of differential diagnosis, while computed tomography is reserved for those patients in whom pulmonary parenchyma should be assessed for suspected bronchiectasis or those who are more likely to develop lung cancer due to expositional risk factors. Emphysema, chronic bronchitis and asthma are key to perform a radiological approach for diagnosis.

Descripción de la microbiota bacteriana residente en el biosólido generado en la planta de tratamiento de aguas residuales San Fernando. Itagüí, Colombia / Description of bacterial microbiota in biosolids generated in the San Fernando wastewater treatment plant. Itagüí, Colombia

RESUMEN Objetivo Caracterizar la microbiota bacteriana presente en los biosólidos generados en una de las plantas de tratamiento de aguas residuales más grande de Colombia. Materiales y Métodos Se utilizó la plataforma de secuenciamiento 454 de la compañía Roche para secuenciar las regiones variables V1-V3 y V6-V9 del marcador molecular 16S rRNA y caracterizar la microbiota. Adicionalmente, se aplicaron estrategias filogenéticas para la identificación de especies bacterianas de importancia. Resultados Nuestros análisis muestran que los Phyla más abundantes son Chloro-flexi, Proteobacteria, Bacteroidetes, Actinobacteria y Firmicutes. Los géneros clasificados más abundantes fueron Pseudomonas, Dysgonomonas y Proteiniphilum. Sin embargo, el grupo dominante según la región variable V1-V3 es una Anaerolineaceae que no se ajusta a las especies descritas para esta familia. Conclusiones En las muestras de biosólido analizadas predominan bacterias ambientales que participan en los procesos de estabilización de la materia orgánica durante los tratamientos biológicos de tipo secundario y la digestión anaerobia. Se detectaron secuencias de especies dentro de la familia Anaerolineaceae, los análisis filogenéticos muestran que probablemente se trata de especies no descritas. En el momento del estudio, se encontró que en el sistema de digestión anaerobia se genera biosolido con una baja carga de bacterias potencialmente patógenas.(AU)

ABSTRACT Objective To describe bacterial microbiota in the biosolids generated in one of the largest wastewater treatment plants of Colombia. Materials and Methods Using NGS technology, 16S rRNA Gene Amplicon libraries were amplified and sequenced. The Roche 454 FLX Titanium platform was used, while the V1-V3 and V6-V9 hypervariable regions were amplified and analyzed independently. Amplicon processing and bacterial classification were performed using the AmpliconNoise pipeline and the RDP Classifier tool. Results The analysis showed that the most dominant Phyla in the biosolids were Chlo-roflexi, Proteobacteria, Bacteroidetes, Actinobacteria and Firmicutes. The most dominant genera were Pseudomonas, Dysgonomonas and Proteiniphilum; however, the dominant group according in the V1-V3 variable region was Anaerolineaceae, which does not conform to the species described for this family. Pathogenic bacteria such as Salmonella and E. coli/Shigella were not detected in the studied biosolid sample. Conclusions In the biosolids samples analyzed, environmental bacteria involved in organic matter stabilization processes during secondary biological treatments and anaerobic digestion were predominant. One of the dominant species in this sludge is a novel species of the Anaerolineaceae group. At the time of the study, it was found that the anaerobic digester system was able to maintain pathogenic bacteria at very low concentrations.(AU)

Nail unit ultrasound: a complete guide of the nail diseases.

INTRODUCTION: The nails have a functional and esthetic importance for patients. Almost always, the nail disorders are diagnosed on the basis of clinical findings, but imaging methods may be required for a better assessment. These imaging methods, such as ultrasound and magnetic resonance, may help to establish an accurate diagnosis. Magnetic resonance imaging is not widely available and sometimes may be very expensive; that is why, ultrasound is an excellent imaging modality. Our objective is to expose the nail unit anatomy, the nail unit anatomy in ultrasound, and some of the frequent pathologies found in our daily practice. METHODS: A review of the literature was done to review the anatomy, technical aspects, and different findings in normal and abnormal nail unit ultrasound. RESULTS: Ultrasound offers an appropriate alternative for the evaluation of the nail unit, allows a real-time evaluation of each one of the components of the nail unit with an optimal visualization of these structures, and allows the evaluation of the thickness of the components, the vascularity, and blood flow by Doppler application. In addition, the nail unit disorder, such as infectious diseases, inflammatory and rheumatologic conditions, nail tumors, among others, may be assessed, not only in the diagnosis but also in the follow-up. Pre-surgical evaluation, surgical follow-up, and some procedures, such as biopsies, may be done by this technique. CONCLUSIONS: Ultrasound is an excellent technique for evaluation of normal anatomy, diagnosis, and follow-up of patients with nail unit diseases. This is an alternative for other imaging methods and may be used for an accurate diagnosis approach.

Infracardiac type total anomalous pulmonary venous return with obstruction and dilatation of portal vein.

Total anomalous pulmonary venous return (TAPVR), also known as total anomalous pulmonary venous connection, is a congenital cardiovascular malformation that presents itself in the neonatal period, with cyanosis and tachypnea. There are 4 types of TAPVR with the mixed type being the least common. Any type of TAPVR may be associated with obstruction as result of flow redirection through the liver parenchyma before it may return to the heart, but infracardiac is the most common one. We report a case of a 10-hour-old female, with a mixed (cardiac and infracardiac) TAVPR with obstruction, that showed drainage to the coronary sinus and the portal vein, as the other classic findings in TAVPR, made with computed tomography angiography and echocardiogram. The patient was taken to surgical repair, but unfortunately died during the procedure because of multiple complications.

[Description of bacterial microbiota in biosolids generated in the San Fernando wastewater treatment plant. Itagüí, Colombia]. / Descripción de la microbiota bacteriana residente en el biosólido generado en la planta de tratamiento de aguas residuales San Fernando. Itagüí, Colombia.

OBJECTIVE: To describe bacterial microbiota in the biosolids generated in one of the largest wastewater treatment plants of Colombia. MATERIALS AND METHODS: Using NGS technology, 16S rRNA Gene Amplicon libraries were amplified and sequenced. The Roche 454 FLX Titanium platform was used, while the V1-V3 and V6-V9 hypervariable regions were amplified and analyzed independently. Amplicon processing and bacterial classification were performed using the AmpliconNoise pipeline and the RDP Classifier tool. RESULTS: The analysis showed that the most dominant Phyla in the biosolids were Chlo-roflexi, Proteobacteria, Bacteroidetes, Actinobacteria and Firmicutes. The most dominant genera were Pseudomonas, Dysgonomonas and Proteiniphilum; however, the dominant group according in the V1-V3 variable region was Anaerolineaceae, which does not conform to the species described for this family. Pathogenic bacteria such as Salmonella and E. coli/Shigella were not detected in the studied biosolid sample. CONCLUSIONS: In the biosolids samples analyzed, environmental bacteria involved in organic matter stabilization processes during secondary biological treatments and anaerobic digestion were predominant. One of the dominant species in this sludge is a novel species of the Anaerolineaceae group. At the time of the study, it was found that the anaerobic digester system was able to maintain pathogenic bacteria at very low concentrations.

OBJETIVO: Caracterizar la microbiota bacteriana presente en los biosólidos generados en una de las plantas de tratamiento de aguas residuales más grande de Colombia. MATERIALES Y MÉTODOS: Se utilizó la plataforma de secuenciamiento 454 de la compañía Roche para secuenciar las regiones variables V1-V3 y V6-V9 del marcador molecular 16S rRNA y caracterizar la microbiota. Adicionalmente, se aplicaron estrategias filogenéticas para la identificación de especies bacterianas de importancia. RESULTADOS: Nuestros análisis muestran que los Phyla más abundantes son Chloro-flexi, Proteobacteria, Bacteroidetes, Actinobacteria y Firmicutes. Los géneros clasificados más abundantes fueron Pseudomonas, Dysgonomonas y Proteiniphilum. Sin embargo, el grupo dominante según la región variable V1-V3 es una Anaerolineaceae que no se ajusta a las especies descritas para esta familia. CONCLUSIONES: En las muestras de biosólido analizadas predominan bacterias ambientales que participan en los procesos de estabilización de la materia orgánica durante los tratamientos biológicos de tipo secundario y la digestión anaerobia. Se detectaron secuencias de especies dentro de la familia Anaerolineaceae, los análisis filogenéticos muestran que probablemente se trata de especies no descritas. En el momento del estudio, se encontró que en el sistema de digestión anaerobia se genera biosolido con una baja carga de bacterias potencialmente patógenas.

Lesiones del opérculo torácico en TC y RM: Entre el cuello y el tórax / Lesions of the Thoracic Inlet on CT and MRI: Between the Neck and the Chest

El opérculo torácico se encuentra localizado entre los límites anatómicos del cuello y el tórax. En esta área se puede encontrar diversidad de patologías, entre ellas, de tipo vascular, del tracto digestivo y la vía aérea, de origen linfático y neural. Las lesiones tumorales de tipo benigno o maligno, que se originan en el cuello o en el tórax, pueden diseminarse a través del opérculo; las más comunes son el bocio de origen tiroideo y las neoplasias de origen linfoproliferativo. Es importante que el radiólogo conozca la anatomía y las patologías que se pueden encontrar en el opérculo torácico, pues, por su localización, muchas veces pasan inadvertidas.

The thoracic inlet is located in the anatomic boundaries between the neck and the thorax. There is a wide variety of entities that can be found in this area including lesions of vascular origin, pathology involving the digestive tract and airways, as well as entities affecting the lymphatics and neural structures. Benign and malignant tumors of the thorax and neck can spread through the thoracic inlet, with goiter and lymphoproliferative neoplasms being the most common. It is important for the radiologist to know the anatomy and pathology that can be found in the thoracic inlet as, given its location, it can often been unnoticed.

Lipomas: de la cabeza a los pies / Lipomas: From Head to Toe

Introducción: En la práctica diaria, y la mayoría de veces de manera incidental, es frecuente encontrar lesiones lipomatosas de diferente origen que requieren una caracterización adecuada. Objetivo: Revisar y describir las lesiones lipomatosas benignas más frecuentes; analizar su origen, sus características en los diferentes métodos de imagen ­como ultrasonido (US), tomografía computarizada (TC) y resonancia magnética (RM)­ y su implicación en procesos de enfermedad. Métodos: Revisión bibliográfica de las lesiones lipomatosas de la cabeza a los pies con una revisión retrospectiva de casos de nuestra institución. Resultados: Los lipomas son tumores benignos usualmente diagnosticados de manera incidental. Es importante conocer sus características en imágenes para acercarse al diagnóstico apropiado.

Introduction: In daily practice, and in most cases incidentally, we often find lipomatous lesions of different origin which require proper characterization. Objective: Our goal is to review and describe the most frequently found benign lipomatous lesions, describing their origin and their characteristics in different imaging techniques such as ultrasound (US), Computed tomography (CT) and Magnetic resonance (MR), and their involvement in disease. Methods: We perform a bibliographic research in lipomatous lesions from head to toe and a retrospective review of cases from our institution. Results: Lipomatous lesions are benign tumors usually diagnosed incidentally. It is important to know its features in the different imaging methods for an accurate diagnosis.

Carcinoma lobular infiltrante para el radiólogo general: revisión en imágenes / Lobular Carcinoma of the Breast for the General Radiologist: Imaging Review

El carcinoma lobular infiltrante es la segunda neoplasia maligna más frecuente de la mama. Su presentación suele ser avanzada, ya que el diagnóstico imaginológico no es sencillo. En mamografía puede presentarse como una masa mal definida, distorsión de la arquitectura o asimetrías; sin embargo, es necesaria la valoración mediante ultrasonido y resonancia magnética para poder acercarse al diagnóstico. Las metástasis de este tipo de cáncer tienen una distribución diferente a las de su contraparte ductal, siendo más frecuentes en tracto gastrointestinal, peritoneo y anexos.

Infiltrating lobular carcinoma is the second most common malignancy of the breast. Its presentation is usually advanced given that the imaging diagnosis is not easy. In mammography it may be found as an ill-defined mass, architectural distortion or asymmetry. However, the assessment by ultrasound and magnetic resonance imaging is necessary for the diagnosis. The metastasis of this type of cancer has a different distribution than its ductal counterparts, being more common in gastrointestinal tract, peritoneum and annexes.

Microbiota bacteriana asociada al papel moneda de circulación en Colombia / Bacterial microbiota on circulating Colombian banknotes

Diariamente los seres humanos están en interacción con objetos de uso continuo, como el papel moneda, sin el conocimiento de que estos almacenan microorganismos y de que nos exponemos al contacto con potenciales patógenos. La composición de la comunidad bacteriana en un billete colombiano fue determinada mediante el secuenciamiento profundo de librerías de amplicones 16S. Se encontraron 233 géneros bacterianos; 12 de estos géneros corresponden a especies con potencial patogénico. El género más abundante fue Propionibacterium, seguido de Streptococcus, Staphylococcus Pseudomonas . Este es el primer reporte de la diversidad bacteriana que puede ser alojada en este objeto de alta circulación en Colombia. Pocos estudios en el mundo han mostrado este nivel de detalle de la microbiota en billetes de circulación y ofrece un panorama mucho más amplio de la exposición diaria a microorganismos al utilizar papel moneda en las condiciones en las que se utiliza en Colombia.

Commonly used objects such as currency paper can be colonised by bacteria and can serve as carriers of microbes. This colonisation might expose us to unnoticed pathogenic bacteria. In this study, the researchers obtained a detailed panorama of the microbes that can be carried on currency notes in Colombia by using 454 next-generation deep sequencing of 16S amplicón libraries. A total of 233 bacterial genera were detected and classified, 12 of which are potential human pathogens. The most abundant genera were Propionibacterium, Streptococcus, Staphylococcus and Pseudomonas. To date, this is the first in-depth analysis of the microbiota carried by circulating banknotes in our continent and it offers insights into daily exposure to microbes when using banknotes in Colombia.