Contrast-enhanced mammography-guided biopsy: technical feasibility and first outcomes.

OBJECTIVES: To evaluate the feasibility of contrast-enhanced mammography (CEM)-guided biopsy at Hospital del Mar, a Spanish university hospital. METHODS: We retrospectively reviewed all consecutive women with a suspicious enhancing finding eligible for CEM-guided biopsy, who were prospectively enrolled in a pre-marketing clinical validation and feasibility study (October 2019 to September 2021). CEM-guided biopsy is a stereotactic-based procedure that, by using intravenous iodinated contrast media administration and dual-energy acquisition, provides localisation of enhancing lesions. All the biopsies were performed using a vacuum-assisted device. We collected procedural characteristics (patient position and type of approach), and histopathological results. Feasibility endpoints included success (visualisation of the enhancing lesion, post-procedural biopsy changes and clip placement), procedural time, number of scout acquisitions and complications. RESULTS: A total of 66 suspicious enhancing lesions (18.0% foci, 44.0% mass, 38.0% non-mass enhancement; median size 8.5 mm) in 64 patients (median age 59 years, mostly minimal [48.4%] or mild [32.8%] background parenchymal enhancement) were referred for CEM-guided biopsy in the study period. The success rate was 63/66 (95.4%). Amongst successful procedures, patients were most frequently seated (52/63, 82.5%) and the preferred approach was horizontal (48/63, 76.2%). Median total time per procedure was 15 min. Median number of acquisitions needed before targeting was 2 (range 1-4). Complications consisted of hematoma (17/63, 27%) and vasovagal reaction (2/63, 3.2%). At histology, the malignancy rate was 25/63 (39.7%). CONCLUSION: In this first patient series, CEM-guided breast biopsy was feasible, with success and complication rates similar to those previously reported for magnetic resonance guidance. KEY POINTS: • CEM may be used to guide biopsy of enhancing lesions through a stereotactic-based procedure combined with intravenous iodinated contrast media administration and dual-energy acquisition. • In this first patient series (n = 64), the success rate of CEM-guided biopsy was above 95%, the only complications were hematoma (22.2%) and vasovagal reaction (3.2%), and median total time per procedure was 15 min. • CEM-guided biopsy is feasible and could potentially be a widely available biopsy technique for enhancing-only lesions.

Prescripción del ejercicio en el paciente oncológico. Revisión sistemática / Prescription of exercise in cancer patients. Systematic review

Antecedentes y objetivo El cáncer es una enfermedad considerada como la segunda causa de muerte a nivel mundial; sus diferentes subtipos requieren una variedad de intervenciones que dependen de factores pronósticos, lo que obliga a que, dentro de los componentes propios de la prescripción del ejercicio, sea necesario brindar atención a la especificidad del entrenamiento y considerar las diferencias entre los pacientes de cáncer, para adaptar los programas de ejercicio físico de acuerdo a la condición particular de cada usuario. El presente estudio establece los parámetros de prescripción del ejercicio físico en diferentes condiciones de cáncer según lo reportado en la literatura científica en el periodo 2011-2019. Materiales y métodos Se realizó una revisión sistemática, con búsqueda de artículos en las principales bases de datos biomédicas. Los términos de búsqueda comprendieron combinaciones de descriptores de ciencias de la salud – DeCS en idioma español e inglés. Se aceptaron artículos correspondientes a estudios de investigación de diferente diseño, realizados en pacientes con patología oncológica de cualquier naturaleza en los que la intervención fisioterapéutica fuera basada en la prescripción del ejercicio. Resultados Se incluyeron 16 estudios, de los cuales se obtuvieron datos concluyentes respecto a variables de prescripción del ejercicio a tenerse en cuenta en el momento de establecer un programa orientado a pacientes oncológicos, cuyos efectos se potencian con ejercicios aeróbicos y de resistencia muscular, desarrollados en un periodo mínimo de 3 sesiones semanales, durante 24 semanas. La intensidad del ejercicio aeróbico y de resistencia se establece a partir de variables objetivas como la frecuencia cardíaca máxima y la resistencia máxima (AU)

Background and objective Cancer is a disease considered the second cause of death worldwide; its different subtypes require a variety of interventions that depend on prognostic factors. This means that within the components of the prescription of exercise, specificity of training and the differences between cancer patients must be considered to adapt physical exercise programmes according to the particular condition of each user. The present study establishes the prescription parameters of physical exercise in different cancer conditions as reported in the scientific literature in the period 2011-2019. Materials and methods A systematic review was carried out with search for articles. The search terms comprised combinations of health sciences descriptors - DeCS in Spanish and English. Articles corresponding to research studies of different design, carried out in patients with oncological pathology of any nature, in which the physiotherapeutic intervention was based on the prescription of exercise, were accepted. Results Sixteen studies were included, from which conclusive data were obtained regarding exercise prescription variables to be taken into account when establishing a programme for cancer patients, whose effects are enhanced with aerobic and muscular resistance exercises, developed over a minimum period of 3 weekly sessions, for 24 weeks. The intensity of aerobic and endurance exercise is established from objective variables such as maximum heart rate and maximum resistance. Conclusions Exercise is highlighted as a safe and beneficial complementary intervention strategy that seeks to promote an improved clinical, emotional and participatory condition, supervised by physiotherapy professionals (AU)

ESTUDIO ECONÓMICO DE LA INFECCIÓN POR Brucella abortus EN GANADO BOVINO DE LA REGIÓN DEL SUMAPAZ, COLOMBIA / ECONOMIC IMPACT OF Brucella abortus INFECTION IN CATTLE FROM THE SUMAPAZ REGION, COLOMBIA

La brucelosis bovina es una de las enfermedades zoonóticas de mayor prevalencia en Colombia y su impacto económico es poco conocido. El objetivo del presente estudio fue evaluar los costos generados por los casos de brucelosis registrados entre pequeños y medianos productores ganaderos de la región del Sumapaz, Colombia. Se realizó un estudio descriptivo basado en una encuesta que incluyó egresos registrados por los casos de brucelosis bovina con diagnóstico confirmado en 25 unidades productivas ganaderas. Las pérdidas económicas oscilaron entre $1.680.000 COP, ($588 USD) y $2.205.000 COP ($772 USD) en producción lechera y podrían llegar a los $6.885.000 ($2.412 USD) anuales por animal de acuerdo con los costos registrados en este estudio. Se concluye que la brucelosis tiene un alto impacto económico para los productores ganaderos de la región del Sumapaz. El costo-beneficio de la implementación de programas para la erradicación de enfermedades zoonóticas como la brucelosis podría contribuir significativamente al desarrollo económico y bienestar de la población ganadera de la región.

Bovine brucellosis is a zoonotic disease with a high prevalence and unknown economic loses in Colombia. Our aim was to evaluate the brucellosis costs recorded by middle and small livestock farmers from the Sumapaz region, Colombia. This descriptive study was conducted with expense records spent to control bovine brucellosis cases for 25 participant farmers. Economic losses ranged between $588 USD ($12680.000 COP) and $772 USD ($2'205.000 COP) in milk production and overall $2,412 USD ($6'885.000 COP) / cow per year according to our cost record. In conclusion, brucellosis has a high economic impact for livestock farmers from the Sumapaz region. The cost-benefit of eradication programs for zoonotic diseases such as brucellosis might contribute to the economic development and welfare of livestock farmer communities.

Teratoma inmaduro intramedular infantil / Immature childhood intramedullary teratoma

Los teratomas en la infancia son generalmente benignos; siendo los inmaduros los menos frecuentes. Son tumores intradurales; lo que supone el 10% de los tumores raquimedulares en el niño. Presentamos el caso clínico de un paciente varón afecto de lesión medular diagnosticada a los 2 años de edad sin déficit sensoriomotor. Tras extirpar la lesión quedaron secuelas que requirieron tratamiento neurorehabilitador: vejiga neurógena, paresia de extremidades inferiores. El estudio anatomopatológico diagnostica la lesión de teratoma inmaduro grado II/III de localización D11-L3. Existe además una recidiva de las lesiones intradurales; a pesar de lo cual la evolución es satisfactoria. Se realiza búsqueda bibliográfica sin encontrar ningún caso publicado con las características de nuestro paciente. Mediante este caso se demuestra la importancia de un seguimiento y tratamiento multidisciplinar para el tratamiento de estas lesiones; de modo que el papel del médico rehabilitador es actuar de forma precoz para minimizar las secuelas y conseguir el mayor grado de independencia posible(AU)

Teratomas in childhood are usually benign, the immature ones being the least frequent. They are intradural tumors, which account for 10% of all the spinal tumors in children. We present a case of a male whose lesion was detected when he was 2 years old with no sensory-motor deficit. Following the tumor excision, some sequels remained that required rehabilitation treatment: neurogenic bladder and lower limb paresis. The anatomy-pathology diagnosed an immature teratoma grade II/III located in D11-L3. There was also recurrence of the intradural lesions in spite of which the evolution was good. A bibliographic search was performed, without finding any case similar to our patient. The importance of a follow-up and multidisciplinary treatment for those lesions is demonstrated by this case. Thus, the role of the rehabilitation doctor is to act early to minimize the sequels and to the highest independence possible(AU)

Calcitonin gene-related peptide receptor expression in healthy and inflamed human pulp tissue.

AIM: To use radioreceptor analysis for comparing calcitonin gene-related peptide (CGRP) receptor expression in human pulp tissue samples collected from teeth having a clinical diagnosis of acute irreversible pulpitis, healthy pulps and teeth with induced inflammation. METHODOLOGY: Six pulp samples were obtained from teeth having a clinical diagnosis of acute irreversible pulpitis. Another eight pulp samples were obtained from healthy premolars where extraction was indicated for orthodontic purposes. In four of these premolars, inflammation was induced prior to pulp collection. All the samples were processed and labelled with 125I-CGRP. Binding sites were identified by 125I-CGRP and standard CGRP competition assays. RESULTS: CGRP receptor expression was found in all human pulp tissue samples. Most receptors were found in the group of pulps from teeth having a clinical diagnosis of acute irreversible pulpitis, followed by the group of pulps having induced inflammation. The least number of receptors was expressed in the group of healthy pulps. The Kruskal-Wallis and Mann-Whitney (post-hoc) tests showed statistically significant differences between the groups (P < 0.05). CONCLUSION: CGRP receptor expression in human pulp tissue is significantly increased during inflammatory phenomena such as acute irreversible pulpitis.

A factor with a zinc- and phorbol ester-binding domain is necessary for endosome fusion.

An inhibitory effect of several zinc chelators on endosome fusion reconstituted in an in vitro system has been recently reported (A. Aballay et al., 1995, Biochem. J. 312, 919-923). The factor that requires zinc for its activity is still unknown. Since the regulatory domain of protein kinase C (PKC) contains cysteine-rich motifs which coordinate zinc, we suspected that PKC or a PKC-like protein might be that factor. To test this hypothesis, we studied the effect of calphostin C, a specific inhibitor of PKC that interacts with the cysteine-rich motif, and PMA (phorbol 12-myristate 13-acetate), an activator of several PKC isoforms that bind to the same region, on endosome fusion. Calphostin C inhibited endosome fusion in a zinc-regulated manner, whereas PMA enhanced endosome fusion. Moreover, fusion was strongly stimulated when both PMA and zinc were added together to zinc-depleted fusion reactions. Inhibitors of the catalytic domain of PKC had no effect on the assay suggesting that the kinase activity is not required. In contrast, a glutathione S-transferase fusion protein containing a cysteine-rich region of the regulatory domain of PKCgamma inhibited endosome fusion in a PMA-dependent manner. Western blot analysis demonstrated the presence of proteins containing PKC-like cysteine-rich regions that are released from endosomal fractions by zinc chelators. These results indicate that the previously proposed zinc-dependent factor required for endosome fusion could be either a PKC isoform or a protein containing the phorbol ester-binding domain of PKC.

[An alternative methodology for the teaching of anatomy in nursing studies at the University of Carabobo]. / Una metodología alternativa para la enseñanza de la anatomía en los estudios de enfermería de la Universidad de Carabobo.

An alternative methodology for the teaching of Human Anatomy which contributes to improve academic yield by Nursing students at the Faculty of Health Sciences of the University of Carabobo is presented. A total of 50 first-year Nursing students who participated in the experiment were divided into 2 groups, control and experimental. This research project was of the almost-experimental type and the work methodology was experimental-evaluation. Three instruments were used to obtain data: an investigation of the Lickert school type consisting of 40 proposals related to the students attitude concerning the study of this discipline and in view of a teaching methodology (EAEAM), accompanied by the school of Interests of Thurstone and by the Psychometric Test of Raven, to determine relationships in accordance with the research objectives. In function of the empirical results of the experiment and of revision of the literature pertaining to this theme, a methodological proposal is presented for the teaching of Human Anatomy; its theoretical-practical nature demands: previous study, observation, discussion and, fundamentally, subdivision, as an alternative to improve academic yield by Nursing students.