[Impact of SARS-CoV-2 immunization on a breast screening programme.] / Impacto de la vacunación frente al SARS-CoV-2 en una unidad de cribado de cáncer de mama.

OBJECTIVE: A common secondary effect after SARS-CoV-2 immunization is an increased in size of the axillary lymph nodes ipsilateral to the vaccinated site. Eventually, an increased in size of the axillary lymph nodes may lead to a misinterpretation of the breast screening mammogram, performed in asymptomatic women between the age 50 to 69 years old for early breast cancer diagnosis. The aim of our research was to evaluate the impact of the vaccination for SARS-CoV-2 in the breast screening programmes in terms of recall rates and number of false positive results. As a secondary purpose we would analysed the protocols adopted by different breast screening units around the world after SARS-CoV-2 vaccination. METHODS: Observational and retrospective study analysing breast screening mammograms from a single Breast Cancer Screening Unit in Madrid. The mammograms of previously vaccinated women were analysed, reviewing the axillary lymph nodes and the re-call rate secondary to axillary lymphadenopathies. RESULTS: Four hundred and twenty three screening mammograms were performed in May 2021 in the University Hospital Ramon y Cajal in Madrid, which is part of the Breast Screening Programme in Madrid, Spain. None of the women previously vaccinated for SARS-CoV-2 were recalled for complementary studies due to an increased in the axillary lymph nodes. CONCLUSIONS: The protocol stablished by the Spanish Society of Breast Image that stands up for a routine breast screening mammogram after SARS-CoV-2 immunization, has no increase in the recall rate or increase in number of false positives.

OBJETIVO: Tras la vacunación por SARS-CoV-2 se ha descrito como efecto secundario leve un aumento de tamaño de los ganglios axilares ipsilaterales al punto de vacunación. Esto puede contribuir a una interpretación errónea de la mamografía de cribado que se realiza a todas las mujeres entre los 50 y los 69 años para la detección precoz del cáncer de mama. El objetivo de nuestro estudio fue valorar si la vacunación por SARS-CoV-2 influye en el número de rellamadas y falsos positivos del programa de cribado de cáncer de mama. Así, se analizaron los protocolos aceptados y adaptados en las diferentes unidades de cribado a nivel nacional e internacional. METODOS: Se trata de un estudio observacional y retrospectivo en el que se analizan las mamografías realizadas en una unidad de cribado de cáncer de mama en pacientes con vacunación reciente por SARS-CoV-2, valorando la presencia de adenopatías axilares y el número de rellamadas realizadas para su caracterización. Se efectuó un estudio descriptivo de los datos obtenidos. RESULTADOS: En una serie de 423 mamografías de cribado realizadas en el Hospital Universitario Ramón y Cajal, que pertenece a la red de cribado de cáncer de mama de la Comunidad de Madrid, no se detectaron adenopatías axilares que precisaran una rellamada ni un estudio dirigido. Por lo tanto, no se vio afectado el número de rellamadas ni aumentaron los falsos positivos en el programa de cribado tras la vacunación por SARS-CoV-2. CONCLUSIONES: El protocolo aceptado por la Sociedad Española de Imagen Mamaria, que aboga por continuar con la frecuencia habitual de la mamografía de cribado tras la vacunación, puede ser adaptado por las unidades de cribado de cáncer de mama, sin miedo a un aumento del número de falsos positivos.

Impacto de la vacunación frente al SARS-CoV-2 en una unidad de cribado de cáncer de mama / Impact of SARS-CoV-2 immunization on a breast screening programme

FUNDAMENTOS: Tras la vacunación por SARS-CoV-2 se ha descrito como efecto secundario leve un aumento de tamaño de los ganglios axilares ipsilaterales al punto de vacunación. Esto puede contribuir a una interpretación errónea de la mamografía de cribado que se realiza a todas las mujeres entre los 50 y los 69 años para la detección precoz del cáncer de mama. El objetivo de nuestro estudio fue valorar si la vacunación por SARS-CoV-2 influye en el número de rellamadas y falsos positivos del programa de cribado de cáncer de mama. Así, se analizaron los protocolos aceptados y adaptados en las diferentes unidades de cribado a nivel nacional e internacional. MÉTODOS: Se trata de un estudio observacional y retrospectivo en el que se analizan las mamografías realizadas en una unidad de cribado de cáncer de mama en pacientes con vacunación reciente por SARS-CoV-2, valorando la presencia de adenopatías axilares y el número de rellamadas realizadas para su caracterización. Se efectuó un estudio descriptivo de los datos obtenidos. RESULTADOS: En una serie de 423 mamografías de cribado realizadas en el Hospital Universitario Ramón y Cajal, que pertenece a la red de cribado de cáncer de mama de la Comunidad de Madrid, no se detectaron adenopatías axilares que precisaran una rellamada ni un estudio dirigido. Por lo tanto, no se vio afectado el número de rellamadas ni aumentaron los falsos positivos en el programa de cribado tras la vacunación por SARS-CoV-2. CONCLUSIONES: El protocolo aceptado por la Sociedad Española de Imagen Mamaria, que aboga por continuar con la frecuencia habitual de la mamografía de cribado tras la vacunación, puede ser adaptado por las unidades de cribado de cáncer de mama, sin miedo a un aumento del número de falsos positivos.(AU)

BACKGROUND: A common secondary effect after SARS-CoV-2 immunization is an increased in size of the axillary lymph nodes ipsilateral to the vaccinated site. Eventually, an increased in size of the axillary lymph nodes may lead to a misinterpretation of the breast screening mammogram, performed in asymptomatic women between the age 50 to 69 years old for early breast cancer diagnosis. The aim of our research was to evaluate the impact of the vaccination for SARS-CoV-2 in the breast screening programmes in terms of recall rates and number of false positive results. As a secondary purpose we would analysed the protocols adopted by different breast screening units around the world after SARS-CoV-2 vaccination. METHODS: Observational and retrospective study analysing breast screening mammograms from a single Breast Cancer Screening Unit in Madrid. The mammograms of previously vaccinated women were analysed, reviewing the axillary lymph nodes and the re-call rate secondary to axillary lymphadenopathies. RESULTS: Four hundred and twenty three screening mammograms were performed in May 2021 in the University Hospital Ramon y Cajal in Madrid, which is part of the Breast Screening Programme in Madrid, Spain. None of the women previously vaccinated for SARS-CoV-2 were recalled for complementary studies due to an increased in the axillary lymph nodes. CONCLUSIONS: The protocol stablished by the Spanish Society of Breast Image that stands up for a routine breast screening mammogram after SARS-CoV-2 immunization, has no increase in the recall rate or increase in number of false positives.(AU)

Influence of profilin on sensitisation profiles determined by cutaneous tests and IgE to major allergens in polysensitised patients.

BACKGROUND: Profilin sensitisation is considered a diagnostic confounding factor in areas where patients are exposed to multiple pollens. The aim of this study is to assess pollen sensitisation profiles in adults and children and to evaluate, by means of component-resolved diagnosis (CRD) and skin prick testing (SPT), which pollens may be considered as risk factors of profilin sensitisation in order to establish the best diagnostic approach in polysensitised patients. METHODS: A total of 231 pollen-allergic patients (adults and children) were included, out of the pollen season, from an area with similar levels of pollen exposure. Allergological diagnosis was performed by SPT and determination of specific IgE (sIgE) to major allergen components (ADVIA-Centaur™). Patients had not received immunotherapy in the last 5 years and had to reside in the area for 5 consecutive years before entering the study. RESULTS: The relation between sensitisation measured by SPT and by sIgE was studied using a model of cases (patients with +sIgE to a specific allergen) and controls (patients with -sIgE to the same allergen). The outcome, in terms of odds-ratios (OR), was statistically significant for Olea (Ole e 1) (p = 0.0005), Salsola (Sal k 1) (p = 0.0118) and Platanus (Pla a 1+ 2) (p = 0.0372). While positivity of SPT to most pollens was statistically associated with a risk of profilin sensitisation, by CRD the association was statistically significant only for Ole e 1 (OR 3.5, CI 95 %, 1.6-7.6, p = 0.0014), and Phl p 5 (OR 11.9, CI 95 %, 4.1-35.2, p < 0.001). When analysing this association using a logistic regression model, Phl p 5 was the only allergen associated with the risk of being sensitised to profilin (p = 0.0023). CONCLUSIONS: In patients sensitised to profilin, the concordance between SPT and CRD is much lower than in those not sensitised to profilin. CRD is able to provide refined information about which pollens increase the risk of sensitisation to profilin.

Paragonimiasis pulmonar / Pulmonary Paragonimiasis

La paragonimiasis es una zoonosis de transmisión alimentaria causada por un trematodo del género Paragonimus1,2. Se trata de infestación excepcional en España, pero la afluencia de personas originarias de áreas endémicas debe hacernos tener presente esta entidad en el diagnóstico diferencial de nuestros pacientes2,5.Presentamos el caso de un paciente natural de Ecuador y residente en España desde hace 7 años con tuberculosis pulmonar activa a su llegada a España y posterior diagnóstico de paragonimiasis pulmonar a raíz de hemoptisis persistente. El diagnóstico se estableció por muestra quirúrgica pulmonar, objetivando granulomas, englobando los huevos del parásito, así como la visualización macroscópica del trematodo dentro de una cavidad. El tratamiento antituberculoso inicialmente y con prazicuantel en la actualidad controló ambas entidades(AU)

Paragonimiasis is a food-borne zoonosis caused by a trematode of the genus Paragonimus1,2. Infestation is rare in Spain, but the influx of people from endemic areas should make us keep this condition in the differential diagnosis of our patients2,5.We report the case a patient from Ecuador and resident in Spain for 7years with active pulmonary tuberculosis on arrival in Spain and later diagnosed with of pulmonary paragonimiasis due to persistent haemoptysis. The diagnosis was established by surgical lung specimen showing granulomas containing parasite eggs and the macroscopic view of the fluke within a lung cavity. Initial tuberculosis treatment and current treatment with praziquantel controlled both conditions(AU)

[Pulmonary paragonimiasis]. / Paragonimiasis pulmonar.

Paragonimiasis is a food-borne zoonosis caused by a trematode of the genus Paragonimus(1,2). Infestation is rare in Spain, but the influx of people from endemic areas should make us keep this condition in the differential diagnosis of our patients(2,5). We report the case a patient from Ecuador and resident in Spain for 7 years with active pulmonary tuberculosis on arrival in Spain and later diagnosed with of pulmonary paragonimiasis due to persistent haemoptysis. The diagnosis was established by surgical lung specimen showing granulomas containing parasite eggs and the macroscopic view of the fluke within a lung cavity. Initial tuberculosis treatment and current treatment with praziquantel controlled both conditions.