Y-90 PET/MR imaging optimization with a Bayesian penalized likelihood reconstruction algorithm.

Positron Emission Tomography (PET) imaging after 90 Y liver radioembolization is used for both lesion identification and dosimetry. Bayesian penalized likelihood (BPL) reconstruction algorithms are an alternative to ordered subset expectation maximization (OSEM) with improved image quality and lesion detectability. The investigation of optimal parameters for 90 Y image reconstruction of Q.Clear, a commercial BPL algorithm developed by General Electric (GE), in PET/MR is a field of interest and the subject of this study. The NEMA phantom was filled at an 8:1 sphere-to-background ratio. Acquisitions were performed on a PET/MR scanner for clinically relevant activities between 0.7 and 3.3 MBq/ml. Reconstructions with Q.Clear were performed varying the ß penalty parameter between 20 and 6000, the acquisition time between 5 and 20 min and pixel size between 1.56 and 4.69 mm. OSEM reconstructions of 28 subsets with 2 and 4 iterations with and without Time-of-Flight (TOF) were compared to Q.Clear with ß = 4000. Recovery coefficients (RC), their coefficient of variation (COV), background variability (BV), contrast-to-noise ratio (CNR) and residual activity in the cold insert were evaluated. Increasing ß parameter lowered RC, COV and BV, while CNR was maximized at ß = 4000; further increase resulted in oversmoothing. For quantification purposes, ß = 1000-2000 could be more appropriate. Longer acquisition times resulted in larger CNR due to reduced image noise. Q.Clear reconstructions led to higher CNR than OSEM. A ß of 4000 was obtained for optimal image quality, although lower values could be considered for quantification purposes. An optimal acquisition time of 15 min was proposed considering its clinical use.

Image reject analysis and rejection causes in digital radiography at a university hospital through estimates of patient doses.

The introduction of digital radiography has improved image acquisition. However, rejection of images remains a matter of concern. Reject analysis is part of the quality assurance program in radiology and helps identify potential errors or lack of training. A retrospective study was conducted at the radiology department of a university hospital. The reject rate was calculated both using the number of examinations, $r_n$, and the dose-area product, $r_d$. A reject rate $r_n$ of 3.3% for paediatric units and 4.5% for adults was found. The corresponding values of rd were 4.4 and 8.4%, respectively. The main rejection cause was patient motion, being 50.2% of rejected examinations in adults and 63.7% in children. The contribution of exposure errors was minor, as expected in digital radiography units. A discrepancy between reject rates $r_n$ and $r_d$ was observed, suggesting dosimetric quantities could be considered in reject analysis for further assessment of patient radiation burden.

Mouse intestinal villi as a model system for studies of norovirus infection.

Noroviruses (NoV) are enteric caliciviruses that have been detected in multiple species of mammals, including humans. Establishing an efficient in vitro cell culture system for human norovirus (HuNoV) remains a challenge; however, its replication has been reported in 3D cultured Caco-2 cells and a clone of Caco-2 cells (C2BBe1), human enteroids and human B cells. Isolated mouse intestinal villi, with large diversity of intestinal epithelial cells, are a primary cellular model that has been shown to be permissive for the infection and replication of enteric viruses such as rotaviruses. We hypothesized that they could allow the infection and replication of the human noroviruses. In this report, we indicate that the isolated villi model of the mouse intestine is effective for the infection study and replication of the human noroviruses from faeces and environmental matrices (water, vegetables and air). For successful infection, the virus needs to be activated with trypsin. The virus has an average replicative cycle of 10 h, although viral particles with infectious capacity are found already at 2 hours post infection (2 h.p.i.). The model is efficient in obtaining abundant biological material and is ideal for studying the biological activity of the human noroviruses in the same cell model or for generating antibodies. Keywords: human norovirus; intestinal epithelial cells; intestinal villus isolation; norovirus isolated from water; norovirus isolated from plants; norovirus isolated from air.

Caracterização da droga vegetal e solução extrativa obtidos a partir de Syzygium cumini (l. ) skeels para futuro desenvolvimento de formas farmacêuticas / Characterization of the plant drug and extractive solution obtained from Syzygium cumini (l. ) skeels for future development of pharmaceutical forms / Caracterización de la droga vegetal y de la solución extractiva obtenida de Syzygium cumini (l. ) skeels para el futuro desarrollo de formas farmacéuticas

Syzygium cumini (L.) Skeels é uma árvore popularmente conhecida como "jamelão" ou "azeitona-roxa", é um vegetal frutífero de grande porte, pertencente à família Myrtaceae e de origem asiática, teve sua expansão em diversas regiões do mundo, no Brasil é encontrada no Nordeste, Norte e Sudeste. Quando aplicada na medicina tradicional apresenta diversas propriedades farmacológicas contidas em suas folhas, frutos, sementes e caule, com isso torna-se uma espécie bastante promissora para a indústria farmacêutica e alimentícia, pois além de conter características benéficas possui um alto poder econômico. Desta forma, este trabalho visa caracterizar físicoquimicamente a droga vegetal e solução extrativa obtidos a partir das partes aéreas de Syzygium cumini (L.) Skeels para futuro desenvolvimento de forma farmacêutica. O material vegetal de Syzygium cumini (L.) Skeels foi coletado na região de Araçoiaba-PE. Suas partes aéreas foram secas e trituradas. A solução extrativa foi obtida através da maceração da matéria-prima utilizando o etanol como solvente e as caracterizações foram realizadas de acordo com a Farmacopeia Brasileira 6° edição.

Syzygium cumini (L.) Skeels is a tree popularly known as "jamelão" or "olive-purple", is a large fruiting plant, belonging to the Myrtaceae family and of Asian origin, had its expansion in several regions of the world, in Brazil is found in the Nor- theast, North and Southeast. When applied in traditional medicine it presents several phar- macological properties contained in its leaves, fruits, seeds and stem, thus becoming a very promising species for the pharmaceutical and food industry, because besides contai- ning beneficial characteristics it has a high economic power. Thus, this work aims to physicochemically characterize the plant drug and extractive solution obtained from the aerial parts of Syzygium cumini (L.) Skeels for future development of pharmaceutical form. The plant material of Syzygium cumini (L.) Skeels was collected in the region of Araçoiaba-PE. Its aerial parts were dried and triturated. The extractive solution was obtained by maceration of the raw material using ethanol as solvent and the characteriza- tions were performed according to the Brazilian Pharmacopeia 6th edition.

Syzygium cumini (L.) Skeels es un árbol conocido popularmente como "ja- melão" o "oliva-púrpura", es una planta fructífera de gran tamaño, perteneciente a la fa- milia Myrtaceae y de origen asiático, tuvo su expansión en varias regiones del mundo, en Brasil se encuentra en el Nordeste, Norte y Sudeste. Cuando se aplica en la medicina tradicional tiene varias propiedades farmacológicas contenidas en sus hojas, frutos, se- millas y tallo, convirtiéndose así en una especie muy prometedora para la industria far- macéutica y alimentaria, ya que además de contener características beneficiosas tiene un alto poder económico. Así, este trabajo tiene como objetivo caracterizar fisicoquímica- mente la droga vegetal y la solución extractiva obtenida de las partes aéreas de Syzygium cumini (L.) Skeels para el futuro desarrollo de forma farmacéutica. El material vegetal de Syzygium cumini (L.) Skeels fue recolectado en la región de Araçoiaba-PE. Sus partes aéreas fueron secadas y trituradas. La solución extractiva se obtuvo por maceración de la materia prima utilizando etanol como solvente y las caracterizaciones se realizaron de acuerdo con la Farmacopea Brasileña 6ª edición.

van Manen's phenomenology of practice: How can it contribute to nursing?

Phenomenology of practice is a useful, rigorous way of deeply understanding human phenomena. Therefore, it allows research to be conducted into nursing's most sensitive and decisive aspects. While it is a widely used research approach and methodology in nursing, it is seldom addressed and made use of in its practical and applied value. This article aimed to approach the global outlook of van Manen's hermeneutic-phenomenological method to better understand its theoretical background and to address and support the contribution this method can make to nursing, if rigorously applied. For a professional discipline like nursing, van Manen's approach is especially interesting because, in addition to contributing to the body of knowledge of nursing, it provides a special kind of knowledge that allows nurses to act in a more reflective manner, and with tact and skill, in certain situations and relationships that arise in their daily practice. A more in-depth understanding of this research methodology may help nurse-researchers make good use of it and also harness knowledge derived from this type of research. This comes as a result of assuming that phenomenological texts, the final product of the research, have tremendous educational potential for people who read them carefully.

Diagnóstico precoz del cáncer de cérvix: correlación entre citología, colposcopia y biopsia / Early diagnosis of cervix cancer: Correlation between cytology, colposcopy and biopsy

Objetivo: Determinar la concordancia entre citología, colposcopia y biopsia cervical ante una citología alterada. Material y métodos: Se realizó un estudio observacional transversal, de base clínica, en un único centro. La población seleccionada consistió en 416 mujeres, de entre 25 y 65 años, con citología alterada, del 1 de agosto de 2014 al 30 de septiembre de 2016, y remitidas para estudio colposcópico y anatomopatológico al Hospital Reina Sofía de Córdoba. Se realizaron análisis estadísticos, utilizando el índice de Kappa para el grado de concordancia entre citología, colposcopia y biopsia. Resultados: Se encontró una concordancia insignificante entre citología y colposcopia (k=0,16; IC 95% 0,09-0,22); una concordancia moderada entre colposcopia y biopsia (k=0,57; IC 95% 0,47-0,68); y una concordancia insignificante entre citología y biopsia (k=0,21; IC 95% 0,08-0,34). Conclusiones: El grado de acuerdo fue mejor entre colposcopia y biopsia que entre citología y biopsia o entre citología y colposcopia

Objective: To determine the concordance between cytology, colposcopy and cervical biopsy in abnormal cytologies. Material and methods: An observational cross-sectional, clinically based, single center study was performed. The selected population consisted of 416 women between the ages of 25 and 65 who had undergone colposcopy for abnormal cytologies at the Reina Sofía Hospital, Córdoba, between August 1st, 2014, and September 30th, 2016. Statistical analysis was performed using the Kappa index for the degree of concordance between cytology, colposcopy and biopsy. Results: There was an insignificant concordance between cytology and colposcopy (k=0.16; 95% CI 0.09-0.22), a moderate concordance between colposcopy and biopsy (k=0.57; 95% CI 0.47-0.68) and an insignificant concordance between cytology and biopsy (k=0.21 (95% CI 0.08-0.34). Conclusions: Better concordance was found between colposcopy and biopsy than between either cytology and biopsy or cytology and colposcopy

[Early diagnosis of cervix cancer: Correlation between cytology, colposcopy and biopsy]. / Diagnóstico precoz del cáncer de cérvix: correlación entre citología, colposcopia y biopsia.

OBJECTIVE: To determine the concordance between cytology, colposcopy and cervical biopsy in abnormal cytologies. MATERIAL AND METHODS: An observational cross-sectional, clinically based, single center study was performed. The selected population consisted of 416 women between the ages of 25 and 65 who had undergone colposcopy for abnormal cytologies at the Reina Sofía Hospital, Córdoba, between August 1st, 2014, and September 30th, 2016. Statistical analysis was performed using the Kappa index for the degree of concordance between cytology, colposcopy and biopsy. RESULTS: There was an insignificant concordance between cytology and colposcopy (k=0.16; 95% CI 0.09-0.22), a moderate concordance between colposcopy and biopsy (k=0.57; 95% CI 0.47-0.68) and an insignificant concordance between cytology and biopsy (k=0.21 (95% CI 0.08-0.34). CONCLUSIONS: Better concordance was found between colposcopy and biopsy than between either cytology and biopsy or cytology and colposcopy.

Conducting phenomenological research: Rationalizing the methods and rigour of the phenomenology of practice.

AIMS: To offer a complete outlook in a readable easy way of van Manen's hermeneutic-phenomenological method to nurses interested in undertaking phenomenological research. BACKGROUND: Phenomenology, as research methodology, involves a certain degree of complexity. It is difficult to identify a single article or author which sets out the didactic guidelines that specifically guide research of this kind. In this context, the theoretical-practical view of Max van Manen's Phenomenology of Practice may be seen as a rigorous guide and directive on which researchers may find support to undertake phenomenological research. DESIGN: Discussion paper. DATA SOURCES: This discussion paper is based on our own experiences and supported by literature and theory. Our central sources of data have been the books and writings of Max van Manen and his website "Phenomenologyonline". IMPLICATIONS FOR NURSING: The principal methods of the hermeneutic-phenomenological method are addressed and explained providing an enriching overview of phenomenology of practice. A proposal is made for the way the suggestions made by van Manen might be organized for use with the methods involved in Phenomenology of Practice: Social sciences, philosophical and philological methods. Thereby, nurse researchers interested in conducting phenomenological research may find a global outlook and support to understand and conduct this type of inquiry which draws on the art. CONCLUSION: The approach in this article may help nurse scholars and researchers reach an overall, encompassing perspective of the main methods and activities involved in doing phenomenological research. Nurses interested in doing phenomenology of practice are expected to commit with reflection and writing.

Diagnóstico precoz del cáncer de cérvix: correlación entre citología, colposcopia y biopsia / Early diagnosis of cérvix cancer: correlation between cytology, colposcopy and biopsy

Objetivo: determinar la concordancia entre citología, colposcopia y biopsia cervical ante una citología alterada. Material y métodos: se realizó un estudio observacional retrospectivo transversal, de base clínica, único centro. La población seleccionada fue 416 mujeres, entre 25 y 65 años con citología alterada, del 1 de agosto de 2014 al 30 de septiembre de 2016, y remitidas para estudio colposcópico y anatomopatológico al Hospital Reina Sofía, Córdoba. Se realizaron análisis estadísticos, utilizando el índice de Kappa para el grado de concordancia entre citología, colposcopia y biopsia. Resultados: se encontró una concordancia insignificante entre citología: colposcopia, k = 0,16 (IC 95% = 0,09- 0,22); una concordancia moderada entre colposcopia: biopsia, k = 0,57 (IC 95% = 0,47-0,68); y una concordancia insignificante entre citología: biopsia, k = 0,21 (IC 95%, 0,08-0,34). Conclusiones: el grado de acuerdo fue mejor entre colposcopia y biopsia; que entre citología y biopsia o entre citología y colposcopia (AU)

Objective: To determine the concordance between cytology, colposcopy and cervical biopsy in altered cytology. Material and methods: An observational cross-sectional, clinically based, single center study was performed. The selected population were 416 women between 25 and 65 years old with altered cytology, from August 1, 2014 to September 30, 2016, and submitted for colposcopic and anatomopathological study to the Reina Sofía Hospital, Córdoba. Statistical analyzes were performed using the Kappa index for the degree of concordance between cytology, colposcopy and biopsy. Results: There was an insignificant concordance between cytology: colposcopy, k = 0.16 (95% CI = 0.09-0.22), a moderate concordance between colposcopy: biopsy, k = 0.57 (95% CI = 0.47-0.68); And an insignificant concordance between cytology: biopsy, k = 0.21 (95% CI, 0.08-0.34). Conclusions: The degree of agreement was better between colposcopy and biopsy; that between cytology and biopsy or between cytology and colposcopy (AU)

Incontinencia urinaria 6 meses tras parto. Factores de riesgo asociados / Urinary incontinence since 6 months after delivery. Associated risk factors

Este estudio permite aproximarnos a la incidencia de incontinencia urinaria de esfuerzo a los 6 meses postparto en nuestro medio, lo que puede ser útil para proponer una actuación tanto a nivel de atención primaria como hospitalaria para poder disminuir el impacto que los posibles factores de riesgo ejercen, como por ejemplo un buen programa de entrenamiento de la musculatura pélvica con ejercicios de Kegel podría reducir la aparición de esta patología, de esta forma, se podría minimizar la morbilidad que sufren estas pacientes. Handa y cols. (21) concluyó que las pacientes que presentaban incontinencia urinaria o anal presentaban un moderado o alto impacto negativo en su vida diaria tras encuestar a 759 pacientes. Para finalizar, se concluye que existen diferentes evidencias en cuanto a los factores de riesgo asociados a la aparición de incontinencia urinaria postparto. El tipo de parto no tiene relación estadísticamente significativa con la aparición de esta sintomatología. No obstante, al existir literatura a favor y en contra de esta hipótesis se precisan más estudios que permiten concluir que vía del parto es la menos favorable para presentar incontinencia urinaria. Los autores, admiten que se podrían inferir más datos si se aumenta el número de pacientes evaluadas (AU)

This study allows us to approach the incidence of stress urinary incontinence at 6 months postpartum in our setting, which may be useful to propose a performance at both primary and hospital care levels, in order to reduce the impact that possible risk factors exert, such as for example, a good pelvic muscle training program with Kegel exercises could reduce the onset of this pathology, thus minimizing the morbidity of these patients. Handa et al. (21) concluded that patients with urinary incontinence or anal had a moderate or high negative impact in their daily lives after surveying 759 patients. Finally, we conclude that there is different evidence regarding the risk factors associated with the occurrence of postpartum urinary incontinence. The type of delivery has no statistically significant relationship with the appearance of this symptomatology. However, because there is literature for and against this hypothesis, more studies are needed to conclude that the way of delivery is the least favorable for presenting urinary incontinence. The authors admit that more data could be evidenced by increasing the number of patients evaluated (AU)

Carcinoma de salpinge: caso reporte y revisión bibliográfica / Salpinge carcinoma: case report and literature review

El cáncer primario de salpinge uterina es una neoplasia maligna rara del aparato genital femenino, corresponde al 0.1 a 1.8% de las neoplasias malignas ginecológicas. Se presenta sobre todo en pacientes menopáusicas o post menopáusicas, con mayor incidencia entre los 55-65 años de edad. Presentamos el caso de una paciente de 45 años de edad con el diagnostico de carcinoma primario de salpinge siendo que la paciente acude a consulta por dolor abdominal y presencia de flujo vaginal, con reporte ecográfico de masa anexial derecha, es ingresada a cirugía con el diagnóstico pre-operatorio de "tumor de ovario derecho", se realiza estudio trans-operatorio mismo que descarta lesión en ovario y postula lesión neoplásica primaria de salpinge , llegando al diagnóstico definitivo por histopatología e inmunohistoquimica de carcinoma seroso de alto grado, afecta capa muscular sin rebasarla. Asociado a focos de TIC (carcinoma intratubario). En ovario se evidenció: ocarcinoma seroso de alto grado metástasico de salpinge.

The primary fallopian tube cancer is a rare malignancy of the female genital tract, corresponds to 0.1 to 1.8% of gynecologic malignancies. It occurs mainly in menopausal or post-menopausal patients with the highest incidence among 55-65 years old. We report the case of a patient of 45 years with the diagnosis primary carcinoma of the fallopian tube being that the patient comes in for abdominal pain and presence of vaginal discharge, with sono-graphic report right adnexal mass is entered surgery with the diagnosis pre-operatorio of "right ovarian tumor," trans-operative same rule ovary injury study is conducted and postulates salpinge primary neoplastic lesion, reaching definitive diagnosis by histopathology and immunohistochemistry of high-grade serous carcinoma, affects muscle layer without going past . Foci associated with ICT. Ovarian serous carcinoma in high grade metastatic salpinge was evident.

Un melanoma amelanótico con metástasis a la glándula tiroides. Descripción clinico-patológica de un caso / Amelanotic anorectal melanoma metastatic to the thyroid gland. A case report

A pesar de su rico aporte vascular, las metástasis en la glándula tiroides son eventos raros. Los carcinomas renales, colorectales, de pulmón y mama son las fuentes más frecuentes de metástasis. Presentamos el caso de una mujer de 75 años de edad, con el antecedente de un melanoma anorrectal amelanótico avanzado, operado un año antes, que se presentó con un crecimiento nodular rápido de la glándula tiroides, por lo que fue sometida a una tiroidectomía parcial. Histopatológicamente, el lóbulo tiroideo mostró una infiltración difusa por melanoma amelánico. Aunque se han publicado algunos casos de metástasis de melanoma en la glándula tiroides, la mayoría de ellos son de origen cutáneo por lo que, a nuestro entender, nosotros presentamos el primer caso de un melanoma anorrectal con metástasis a la glándula tiroide (AU)

Despite its rich vascular supply, metastases to the thyroid gland are rare. Renal, colorectal, lung and breast carcinomas are the most frequent sources of metastases. We report the case of a 75-year-old woman who presented with a rapid nodular enlargement of the thyroid gland, for which she underwent a partial thyroidectomy. She had a history of advanced amelanotic anorectal melanoma surgically treated one year previously. Histopathologically, the thyroid lobe showed diffuse infiltration by an amelanotic melanoma. Although a few cases of metastases of melanoma to the thyroid gland have been reported, the majority are derived from a cutaneous primary; to the best of our knowledge, this is the first reported case of an anorectal melanoma with metastasis to the thyroid gland (AU)

Predictors of neurological deficit after endovascular treatment of cerebral arteriovenous malformations and functional repercussions in prospective follow-up.

Endovascular therapy is a well-established approach to the treatment of cerebral arteriovenous malformations (AVMs). The objective of this study was to determine the predictive factors of neurological deficit following endovascular procedures. Seventy-one patients with cerebral AVMs who underwent 147 embolization sessions from 2006 to 2011 were followed up prospectively (average 31.1 ± 17.5 months). Functional neurological condition was documented by means of the modified Rankin scale. Factors found to be predictors of neurological deficit were the partial obstruction of drainage veins (OR = 197.6; IC = 2.76 -1416.0; P = 0.015), a positive result in the Propofol test (OR = 50.2; IC = 6.18 - 566.5; P = 0.000), AVM diameter under 3 cm (OR = 21.3; IC: 1.71 - 265.6; P = 0.018), the presence of intranidal aneurysms (OR = 11.2; IC = 1.09 - 114.2; P = 0.042), the absence of post-procedure hypotension (OR = 10.2; IC = 1.35 - 77.7; P = 0.003), deep venous drainage (OR = 7.14; IC = 1.15 - 44.4; P = 0.035), and devascularization in excess of 40% per session (OR = 3.3; IC = 1.11 - 16.8; P = 0.056). Fifty-six patients (78.9%) did not experience changes in their neurological condition after the treatment and 13 patients (18.3%) showed a new neurological deficit related to the treatment; 95.8 % of the patients did not show significant long-term incapacity. Partial obstruction of drainage veins, small AVMs, intranidal aneurysms, faulty hemodynamic control and extensive devascularization were found to be predictors of neurological deficit. A significant number of patients with neurological deficit improved in the long term.

Predictors of hemorrhagic complications from endovascular treatment of cerebral arteriovenous malformations.

Post-embolization hemorrhage is the most severe, dramatic and morbidity-mortality-related complication in the treatment of endovascular arteriovenous malformations (AVMs). The objective of this study was to determine predictive factors of post-embolization hemorrhage. This is a retrospective study in 71 patients with cerebral AVMs having undergone 147 embolization sessions with n-butyl cyanoacrylate (n-BCA), carried out between 2006 and 2011. Clinical-demographic, morphological and treatment data as well as results were recorded. The relationship of post-procedure hemorrhage with demographic and morphological factors, percentage devascularization per session, venous drainage and whether or not post-procedure hypotension had been induced was investigated. Six post-embolization hemorrhages occurred, all in sessions characterized by extensive devascularization without the induction of post-procedure hypotension; which disappeared after a limit to the extent of devascularization per session and post-procedure hypotension were introduced. In the multivariate analysis, hemorrhage predictors were: nidus diameter < 3 cm (OR= 45.02; CI=95%:1.17-203.79; P=0.005); devascularization > 40% (OR=32.4; CI=95%: 3.142- 518.6; P=0.009) per session; intranidal aneurysms (OR=7.5; CI=95%:1.19-341.3; P=0.041) and lack of post-procedure hypotension (OR=16.51; CI=95%:1.81-324.4; P=0.049) and the association of sessions with devascularization exceeding 40% with lack of post-procedure hypotension, showed an increase in the risk of hemorrhage (OR=36.4; CI=95%:3.67-362.4; P=0.002). Extensive devascularization and the absence of post-procedure hypotension increase the risk of hemorrhage. We suggest partial, 25-30%, devascularization per session and the induction of post-procedure hypotension, which produces a 20% decrease of the basal mean arterial pressure (MAP).

Predictors of total obliteration in endovascular treatment of cerebral arteriovenous malformations.

Endovascular therapy is a therapeutic option that can achieve total obliteration of cerebral arteriovenous malformations (AVMs). The objective of this study was to determine the predictive factors of total obliteration in the endovascular treatment of AVMs. A prospective study was carried out in 71 patients with cerebral AVMs having undergone 147 embolization sessions with n-BCA, performed between 2006 and 2011. A univariate analysis was carried out, followed by a logistic regression analysis to determine the predictive factors of total obliteration. Total obliteration was achieved in 18.3% of the patients and angiographic control after 12 months showed the permanency of total occlusion in 100% of the AVMs with initial total obliteration. Angiographic characteristics found favorable for total eradication were: AVM size under 3 cm and the presence of a single arterial pedicle. Predictive factors of total obliteration were an AVM diameter smaller than 3 cm (OR: 50.9; IC: 7.41 - 349, 0; P = 0.000), and opposing factors, a 3-6 cm diameter (OR: 11.7; IC: 2.49 - 55, 4; P = 0.002) and afferences of more than two vessels of the Willis polygon (OR: 7.0; IC: 1.12-43.9; P = 0.038). An AVM diameter smaller than 3 cm is a predictive factor of total obliteration. Total postembolization obliteration persisted in 100% of the cases after 12 months.

Eurogin 2013 (Florencia, 3-6 noviembre 2013) / Eurogin 2013 (Florence, November 6-3 2013)

No disponible

Efficacy of Essure hysteroscopic sterilization--5 years follow up of 1200 women.

OBJECTIVE: To assess the efficacy of the Essure hysteroscopic birth control device after 5 years follow up. STUDY DESIGN: Retrospective analysis of case series. SETTING: Outpatient hysteroscopy facility in a large teaching hospital. SUBJECTS: One-thousand three-hundred and twenty-one women who underwent hysteroscopic sterilization with Essure device (Conceptus, Inc., Mountain View, CA) between January 2003 and May 2005. INTERVENTION(S): Hysteroscopic tubal sterilization using Essure system. MAIN OUTCOME MEASURE: Efficacy/effectiveness, failure rate. RESULTS: Satisfactory insertion was accomplished in the first attempt in 1166 women (97.16%). After the second attempt, successful insertion rate rise to 98.6%. (n = 31, 2.6%). Three pregnancies had been reported after 5 years follow up, which implies an overall absolute rate of 0.25%. This represents a Pearl index of 0.05 after 72,000 months of surveillance. All of them occurred in the first year of use of the microinsert. There has been no unintended pregnancy in the next 4 years. CONCLUSION(S): Essure has the lowest Pearl index never published being the most effective permanent birth control system to date. Unintended pregnancies tend to occur in the first year after the insertion, and can be avoided encouraging women to accomplish the protocol.

Displasia mesenquimática placentaria. Presentación de un caso / Placental mesenchymal dysplasia. A case report

La displasia mesenquimática placentaria es una patología caracterizada por placentomegalia, alteraciones vasculares y vellosidades edematizadas. Frecuentemente se confunde con la mola hidatiforme, pero a diferencia de esta última no tiene potencial de malignización y permite, salvo algunas complicaciones, el desarrollo normal de la gestación. En este artículo informamos un nuevo caso, diagnosticado después del parto, asociado a retardo en el crecimiento intrauterino. Discutimos también la fisiopatología, la utilidad de p57 y el diagnóstico diferencial de esta entidad(AU)

Placental mesenchymal dysplasia (PMD) is characterized by placentomegaly, vascular alterations and oedematous villi and is often confused with hydatidiform mole; however, unlike the latter, it has no malignant potential and normal gestation is possible although complications may occur. We report a case of PMD, diagnosed after delivery, which was associated with intrauterine growth restriction. The pathophysiology, usefulness of p57 and differential diagnosis of PMD is discussed(AU)

A clinical, pathologic, and molecular study of p53 and murine double minute 2 in penile carcinogenesis and its relation to prognosis.

Penile carcinoma constitutes up to 16% of male malignancies in developing countries. Changes in the p53 and murine double minute 2 pathway are important events in various cancers. Associate alterations in murine double minute 2 and p53 expression were evaluated by molecular techniques, with the clinical data of 297 cases of penile carcinoma. Automated immunohistochemistry was performed for murine double minute 2 and p53 using the primary antibodies SPM14 and DO7, respectively. Fluorescent in situ hybridization was performed using the probes murine double minute 2 at 12q15 and TP53 at 17p13.1. Slides were digitalized, and bright-field and fluorescent images were analyzed. TP53 was sequenced in 16 cases. The expression of p53 was higher in poorly differentiated, infiltrative border, corpus spongiosum, corpora cavernosa, and invasive urethral carcinomas. Patients who died of disease also expressed higher levels of p53. p53-negative tumors were associated with higher overall survival. Murine double minute 2 showed no difference of expression in any group of tumors, no correlation with p53 expression. No alterations in genes or chromosomes were observed. Mutations in TP53 were observed in 4 of 16 cases: p.T170M, p.L252P, p.C176Y, and the novel c.803_810del8; these changes correlated with p53 expression by immunohistochemistry. Murine double minute 2 is not useful in the prognosis of penile carcinoma by immunohistochemistry. Additional studies on the transcriptional, posttranscriptional, and epigenetic aspects are necessary to understand the interactions between p53 and murine double minute 2 because we did not observe any numeric alterations by fluorescent in situ hybridization. Examining p53 is helpful in identifying patients with more aggressive tumors and may be crucial in selecting the most suitable surgical procedure.