Flavor and TASTE attributes and nutritional insights of maize tortillas from landraces of Mexican races.

Maize tortilla is the best-recognized food product of Mexican gastronomy. Artisanal maize tortillas (AMT) are prepared with native maize varieties and a traditional process. The aims of this study were to identify sensory attributes, texture, and color in AMT that allow them to be differentiated from commercial tortillas, and to determine the chemical and mineral composition of both types of tortillas. Six landraces related to four Mexican maize races were used. Two commercial tortillas were included as references (tortillería and supermarket). Tortillas were subjected to sensory analysis by the modified Flash technique, texture and color were measured objectively and chemical and mineral analysis of all tortillas were evaluated. Lime taste and lime smell attributes were relevant to differentiate AMT from commercial tortillas; aftertaste and fracturability attributes were highly associated to supermarket tortillas. The fracturability attribute of tortillas is consider undesirable for taco preparation. Five of the six AMT were characterized by the presence of a layer, a characteristic that is associated with traditional tortilla made by Mexican consumer. Regarding chemical composition, supermarket tortillas exhibited the highest dietary fiber content (17.09%), but showed 30% more Na than AMT, with the exception of tortillas from Purepecha native variety. Besides, supermarket tortilla had 48.9% less Ca than AMT. The sensory attributes relevant to differentiate native maize tortillas from the commercial maize tortilla references were appearance, smell, and taste, while textural and color attributes played a lesser role.

Excess mortality in 22 European countries in 2020 and 2021: relationship with socioeconomic indicators.

AIMS: For better understanding of the impact of COVID-19 pandemic on mortality in different countries, we studied the excess mortality from any cause during 2020 and 2021 in 22 European countries, and its relationship with three socioeconomic variables: life expectancy at birth in 2019, per capita income, and low education level. METHODS: Using an ecological design, we analyzed excess mortality data between January 2020 and December 2021 in 22 European countries, obtained from the EuroMOMO surveillance system. Using weekly Z-score data for each country, we estimated the annual average deviation in mortality during 2020 and 2021 for each country. We analyzed possible relationships between the excess mortality and three independent variables: gross domestic product per capita (GDPpc) in 2020, life expectancy at birth in 2019, and proportion of the population over age 18 years with a lower than secondary education level in 2018. RESULTS: In the 22 European countries analyzed, the total number of excess deaths in 2020 and 2021 was 800,011 (11%) more than expected, with deaths among those aged 65 years and over accounting for 87.66% of these. Excess mortality was higher in 2020, especially in Spain, UK, Italy, and France. In 2021, excess mortality was highest in Hungary, the Netherlands, France, and Germany. Excess mortality during 2021 was inversely correlated with life expectancy (r =-.489, p = .021) and income level (r =-.550, p = .008). CONCLUSION: Reducing socioeconomic inequalities among countries not only improves conditions of most disadvantages but also will help to reduce excess of mortality from future pandemics.

Memristive behaviour of Si-Al oxynitride thin films: the role of oxygen and nitrogen vacancies in the electroforming process.

The resistive switching properties of silicon-aluminium oxynitride (SiAlON) based devices have been studied. Electrical transport mechanisms in both resistance states were determined, exhibiting an ohmic behaviour at low resistance and a defect-related Poole-Frenkel mechanism at high resistance. Nevertheless, some features of the Al top-electrode are generated during the initial electroforming, suggesting some material modifications. An in-depth microscopic study at the nanoscale has been performed after the electroforming process, by acquiring scanning electron microscopy and transmission electron microscopy images. The direct observation of the devices confirmed features on the top electrode with bubble-like appearance, as well as some precipitates within the SiAlON. Chemical analysis by electron energy loss spectroscopy has demonstrated that there is an out-diffusion of oxygen and nitrogen ions from the SiAlON layer towards the electrode, thus forming silicon-rich paths within the dielectric layer and indicating vacancy change to be the main mechanism in the resistive switching.

Loss of RhoA promotes skin tumor formation and invasion by upregulation of RhoB.

Cellular movement is controlled by small GTPases, such as RhoA. Although migration is crucial for cancer cell invasion, the specific role of RhoA in tumor formation is unclear. Inducing skin tumors in mice with a keratinocyte-restricted loss of RhoA, we observed increased tumor frequency, growth and invasion. In vitro invasion assays revealed that in the absence of RhoA cell invasiveness is increased in a Rho-associated protein kinase (ROCK) activation and cell contraction-dependent manner. Surprisingly, loss of RhoA causes increased Rho signaling via overcompensation by RhoB because of reduced lysosomal degradation of RhoB in Gamma-aminobutyric acid receptor-associated protein (GABARAP)+ autophagosomes and endosomes. In the absence of RhoA, RhoB relocalized to the plasma membrane and functionally replaced RhoA with respect to invasion, clonogenic growth and survival. Our data demonstrate for the first time that RhoA is a tumor suppressor in 7,12-dimethylbenz[a]anthracene/12-O-tetradecanoylphorbol 13-acetate skin carcinogenesis and identify Rho signaling dependent on RhoA and RhoB as a potent driver of tumor progression.

Evaluation of antimicrobial persistent activity of alcohol-based hand antiseptics against bacterial contamination.

The purpose of this study was to evaluate persistent activity of three alcohol-based antiseptics widely used in the clinical routine containing chlorhexidine, triclosan or mecetronium after hand disinfection. Four tests were used to evaluate the antimicrobial activity of antiseptics on: (i) resident microbiota; (ii) nutrient agar plates (NAP) subsequently inoculated with a test organism; and transient microbiota acquired by contact with dry hands (iii), or (iv) a wet inert surface that had been artificially contaminated. Four reference strains (Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis) and an Acinetobacter baumannii strain responsible for a hospital outbreak were used as transient microbiota. Antimicrobial activity was calculated according to the CFUs reduction by reference to non-disinfected control hands. The antiseptics were applied according to European Standard EN1500. Solutions containing chlorhexidine or triclosan showed some persistent effects on transient microbiota on inert humid surfaces and NAP, but not on contaminated dry hands. Solutions containing mecetronium showed no persistent effect on transient flora in any of the trials. All alcohol-based antiseptics tested were more effective against resident flora than soap. No persistent activity was observed for A. baumannii in any of the trials. Chlorhexidine and triclosan are preferred when an antiseptic with persistent activity is desired, but a moist environment appears to be necessary for that antibacterial activity. Accordingly, relevant conclusions regarding the persistent activity of antiseptics for clinical practice and protection against bacterial contamination cannot be derived from this study for the alcoholic solutions tested.

Development of a non-heart-beating donor program and results after the first year.

Our lung transplant unit began activity in October 2008. We have performed 37 lung transplants with a hospital mortality of 2.7% (n = 1). The need for a greater number of donors and the presence of an already existent non-heart-beating donor (NHBD) program for abdominal grafts and tissues encouraged us to consider assessing lung grafts from these donors. It was necessary to develop a new multiorgan preservation methodology, "bithermia preservation." The clinical experience with which during the first year June 2010 to July 2011, including 15 NHBDs is presented herein. The chest x-ray was normal in 6 donors (40%) and 7 had pulmonary infiltrates. Bronchoscopy was normal in 8 donors (53%) but 3 had abundant bleeding airway secretions and signs of bronchoaspiration. Preservation procedures were performed in 6 donors. Pulmonary functional evaluation in 4 donors showed gas measurements to be adequate in 75% of cases. Three double-lung grafts were judged to be valid for implantation, among which we performed 3 lung transplantations, 1 bilateral and 2 unilaterals, while 2 grafts were offered to the National Transplant Organization for other units. No transplant suffered primary graft dysfunction; all 3 showed excellent function allowing early extubation in 2 cases. There was no in-hospital mortality. All 3 patients are alive and leading normal lives; none has bronchiolitis obliterans syndrome. In conclusion, the "bithermia preservation" methodology achieved adequate lung preservation in NHBDs, allowing liver, kidneys, and lungs to be obtained from the same donor.

Manejo perioperatorio de la enfermedad de Parkinson / Perioperative management of Parkinson’s disease

Una de las características singulares de la enfermedad de Parkinson (EP) es la gran variabilidad clínica en relación con el tratamiento que puede acontecer en un mismo paciente. Esto sucede tanto con el tratamiento específico para la EP como con otra serie de fármacos que pueden empeorar la función motora. Por esta razón, el manejo perioperatorio de la EP requiere experiencia y sobre todo una planificación adecuada. En este artículo se revisan las peculiaridades de la EP y su tratamiento, y se plantea una estrategia para el perioperatorio de estos pacientes (AU)

One of the particular characteristics of Parkinson's disease (PD) is the wide clinical variation as regards the treatment that can be found in the same patient. This occurs with specific treatment for PD, as well as with other drug groups that can make motor function worse. For this reason, the perioperative management of PD requires experience and above all appropriate planning. In this article, the peculiarities of PD and its treatment are reviewed, and a strategy is set out for the perioperative management of these patients (AU)

Cáncer oculto de la mama. Caso clínico y revisión de la literatura / Occult breast cancer. Case report and literature review

Se presenta el caso clínico de una paciente con un cáncer oculto de la mama. La situación clínica en la que se detectan ganglios axilares afectos por metástasis de adenocarcinoma pero sin evidenciarse tumor en la mama no es frecuente: entre el 0,3 y 0,8% de todos los tumores de la mama. En esta revisión se subraya la importancia que está adquiriendo el PET como técnica de elección en la detección del tumor primario así como en la monitorización de la respuesta a la quimioterapia neoadyuvante. Asimismo, se repasan los diferentes y controvertidos tratamientos propuestos. La tendencia actual es de máxima conservación, preconizando la disección axilar con radioterapia y tratamiento sistémico posteriores. En este último adquiere especial importancia el análisis inmunohistoquímico de la metástasis ganglionar para un diseño adecuado de la quimioterapia y los agentes anti-diana (AU)

We report the case of a patient with occult cancer of the breast. A finding of metastatic adenocarcinoma to the axillary nodes with no apparent mass in the breast is rare, occurring in 0.3% to 0.8% of all breast tumors. This review of the literature highlights the importance of positron emission tomography, which is becoming the gold standard in the detection of primary tumors and in monitoring response to neoadjuvant chemotherapy. The various treatments proposed and their controversies are also discussed. The current trend is breast conservation. Axillary dissection, adjuvant radiotherapy and systemic treatment are recommended. In the latter, immunohistochemical analysis of lymph node metastases is particularly important for the appropriate design of chemotherapy and anti-target agents (AU)

Under-notification of cryptosporidiosis by routine clinical and laboratory practices among non-hospitalised children with acute diarrhoea in Southern Spain.

INTRODUCTION: In a prevalence study of 400 stool samples from non-hospitalised children under 7 years of age with diarrhoea, the presence of Cryptosporidium was evaluated. METHODS: In addition to standard microbiological analyses used for testing for bacteria, parasites, adenoviruses and reoviruses, all samples were re-evaluated for the presence of Cryptosporidium by means of microscopy using a modified acid-fast staining technique, a rapid immunoassay for the qualitative detection of C. parvum and Giardia lamblia, the ImmunoCard STAT! test, and nested polymerase chain reaction (PCR). For identifying the genotypes of Cryptosporidium, the gene 18S ssu rRNA was amplified and sequenced. RESULTS: Thirty-two samples were positive by microscopy, 26 by immunoassay and 61 by nested PCR. Twenty-seven of these organisms were identified as Cryptosporidium hominis, 31 as Cryptosporidium parvum and, in four samples, it was impossible to identify the species. C. parvum was significantly more frequent in girls and C. hominis was significantly more frequent in boys (Fisher's exact test, p = 0.034). Although Cryptosporidium is only notified in a very small number of patients (1-4%) with diarrhoea in Spain, the microorganism was identified by nested PCR in 15.1% of the samples. CONCLUSION: This study, therefore, highlights the under-notification of infections caused by Cryptosporidium in Southern Spain and poses the question of whether its routine testing should be carried out in cases of gastroenteritis in children.

[Perioperative management of Parkinson's disease]. / Manejo perioperatorio de la enfermedad de Parkinson.

One of the particular characteristics of Parkinson's disease (PD) is the wide clinical variation as regards the treatment that can be found in the same patient. This occurs with specific treatment for PD, as well as with other drug groups that can make motor function worse. For this reason, the perioperative management of PD requires experience and above all appropriate planning. In this article, the peculiarities of PD and its treatment are reviewed, and a strategy is set out for the perioperative management of these patients.

Recent long-distance transgene flow into wild populations conforms to historical patterns of gene flow in cotton (Gossypium hirsutum) at its centre of origin.

Over 95% of the currently cultivated cotton was domesticated from Gossypium hirsutum, which originated and diversified in Mexico. Demographic and genetic studies of this species at its centre of origin and diversification are lacking, although they are critical for cotton conservation and breeding. We investigated the actual and potential distribution of wild cotton populations, as well as the contribution of historical and recent gene flow in shaping cotton genetic diversity and structure. We evaluated historical gene flow using chloroplast microsatellites and recent gene flow through the assessment of transgene presence in wild cotton populations, exploiting the fact that genetically modified cotton has been planted in the North of Mexico since 1996. Assessment of geographic structure through Bayesian spatial analysis, BAPS and Genetic Algorithm for Rule-set Production (GARP), suggests that G. hirsutum seems to conform to a metapopulation scheme, with eight distinct metapopulations. Despite evidence for long-distance gene flow, genetic variation among the metapopulations of G. hirsutum is high (He = 0.894 ± 0.01). We identified 46 different haplotypes, 78% of which are unique to a particular metapopulation, in contrast to a single haplotype detected in cotton cultivars. Recent gene flow was also detected (m = 66/270 = 0.24), with four out of eight metapopulations having transgenes. We discuss the implications of the data presented here with respect to the conservation and future breeding of cotton populations and genetic diversity at its centre of crop origin.

Antimicrobial effect of medical textiles containing bioactive fibres.

Over the last few years, the textile industry has developed different methods for obtaining fabrics and fibres with an antimicrobial action for use in hospital environments and for other purposes. This study evaluates the antimicrobial action of Bioactive(®)-treated fabric (BTF), a commercially available textile containing silver for use in healthcare environments. Unlike other biocides used in hospital fabrics, the prolonged use of silver has not been related to the appearance of resistant bacteria or cross-resistance to antibiotics, in spite of being extensively used in some treatments. Thirty-three hospital strains of bacteria were tested. This study showed the capacity of BTF for significantly reducing the number of microorganisms present, compared with the reduction observed in control fabrics (CF). The antimicrobial action of BTF was expressed as log(10) reduction (LR) from an initial inoculum of about 10(5) colony-forming units (cfu). According to the bacterial species, an LR of between 2.6 and 5.0, and 4.1 and 5.0 (5.0 indicating total inhibition of bacterial growth) were observed, respectively, after 24 and 48 h for BTF. Acinetobacter strains were the most resistant to CF after 72 h (0.8 LR). All of the microorganisms, except two strains of Enterococcus faecalis, were totally inhibited after 72 h on BTF.

Mastitis granulomatosa idiopática: revisión de 4 casos diagnosticados y tratados en una unidad de patología mamaria / No disponible

Objetivo: La mastitis granulomatosa idiopática es una enfermedad benigna inflamatoria de la mama poco común con ausencia de manifestaciones específicas. La importancia diagnóstica reside en el hecho que dicha entidad se presenta clínica y radiológicamente como una neoplasia maligna de mama. El diagnóstico de certeza se obtendrá con una biopsia de la lesión y los hallazgos histopatológicos típicos. Se pretende también, aportar nuestra experiencia en el manejo terapéutico dado que los resultados clínicos y estéticos fueron excelentes. Material y métodos: Presentamos 4 casos diagnosticados y entre junio de 2008 y enero de 2011. Resultados: La forma de presentación en 3 de los 4 casos fue la aparición de un nódulo mamario. En un caso la forma de presentación fue una ulceración cutánea con masa subyacente. En todos los casos tras exámenes radiológicos catalogados como de alta sospecha de malignidad se practicó biopsia de la lesión estableciendo el diagnóstico definitivo de mastitis granulomatosa. En 3 de los 4 casos se realizó tratamiento médico con prednisona en pauta descendente con remisión completa de la enfermedad y sin presencia de recidivas. En uno de los casos se procedió a la resección quirúrgica mediante tumorectomía obteniendo un resultado estético pobre con posterior recidiva que se trató exitosamente con corticoides. Conclusiones: La mastitis granulomatosa es un proceso inflamatorio mamario benigno infrecuente con expresión clínica y radiológica que conlleva a sospechar un proceso neoplásico mamario cuyo diagnostico definitivo es el examen histopatológico y con excelente respuesta al tratamiento médico con corticoides(AU)

Background: Idiopathic granulomatous mastitis is a rare benign inflammatory breast disease with no specific manifestations. The diagnostic importance is the fact that this entity presents itself clinically and radiologically as a malignant breast neoplasm. Definitive diagnosis is obtained with a biopsy of the lesion and the typical histopathological findings. It is also intended to contribute the therapeutic management experience as the clinical and aesthetic results were excellent. Material and methods: We present 4 diagnosed and treated cases between June 2008 and January 2011. Results: The way of presentation in 3 of the 4 cases was the appearance of a breast lump. In one case the way of presentation was a skin ulceration with an underlying mass. In all cases after X-ray examinations classified as highly suspicious of malignancy underwent biopsy of the lesion establishing the definitive diagnosis of granulomatous mastitis. In 3 of the 4 patients underwent medical treatment with prednisone in decreasing doses to the complete remission of the disease and free of relapse. In one case we proceeded to surgical resection by lumpectomy obtaining a poor aesthetic outcome with subsequent relapse that was successfully treated with corticoids. Conclusions: Granulomatous mastitis is a rare benign inflammatory breast disease with clinical and radiological expression that leads to suspect a neoplastic breast process which definitive diagnosis is the histopathological examination with excellent response to medical treatment using corticoids(AU)

Monitorización de la respuesta a la terapia neoadyuvante en el carcinoma de mama localmente avanzado mediante métodos de imagen / No disponible

Objetivo: Establecer la validez diagnóstica de la mamografía, de la resonancia magnética y de la gammagrafía 99mTc-sestamibi en la valoración de la respuesta terapéutica de pacientes diagnosticadas de carcinoma de mama localmente avanzado. Pacientes y métodos: Estudio prospectivo observacional aprobado por el Comité Ético de nuestra institución en el que se han incluido 75 pacientes diagnosticadas de carcinoma de mama localmente avanzado por core biopsia (edad media: 52 años, rango: 26-80 años). Las pacientes fueron valoradas clínicamente, por mamografía, resonancia magnética y gammagrafía 99mTc-sestamibi antes de iniciar la terapia neoadyuvante y una vez finalizada la misma. Se han administrado regímenes terapéuticos basados en antraciclinas excepto en siete pacientes que recibieron hormonoterapia con inhibidores de la aromatasa. Para la valoración de la respuesta clínica se utilizaron los criterios RECIST y los mismos criterios, adaptados y consensuados, se emplearon para la valoración de la respuesta mediante técnicas de imagen e histología. Resultados: Tras cirugía se constató respuesta histológica, bien sea parcial o completa, en 61 pacientes (81,3%). Se evidenció conformidad entre la respuesta clínica y los hallazgos histológicos en el 80% de los casos, entre mamografía e histología en el 79,7% de casos, y esta fue del 78,9 % para la resonancia magnética y del 86,4% para la gammagrafía. La sensibilidad y especificidad fueron del 64,3 y del 83,8% para la mamografía, del 61,5 y 82,8% para la resonancia magnética, y del 58,3 y 92,6%, para la gammagrafía. Se pudo observar una concordancia del 88,8% entre resonancia y gammagrafía, del 75,7% entre esta y la mamografía y del 77,3 % entre gammagrafía y mamografía. Conclusiones: La resonancia magnética y la gammagrafía 99mTc-sestamibi demuestran su utilidad en la valoración de la respuesta tras la terapia neoadyuvante, si bien persiste la dificultad en la valoración de focos microscópicos de tumor o del componente in situ, y por tanto, en la definición de respuesta completa(AU)

Aim: To establish diagnostic validity of mammography, mammary magnetic resonance and 99mTc-sestamibi scintimammography to assess response to neoadjuvant therapy in patients with locally advanced breast cancer. Patients and methods: A prospective observational study was approved at our institution which included 75 women with core biopsy diagnostic of locally advanced breast cancer (mean age: 52 y, range 26-80 y). All patients had clinical, mammography, mammary magnetic resonance and 99mTc-sestamibi scintimammography assessment before and after receiving neoadjuvant therapy. Primary chemotherapy based on anthracyclines was administered except in seven patients who received endocrine therapy with aromatase inhibitors. RECIST criteria were considered for clinical response assessment, and the same criteria were adapted for imaging methods and pathologic response. Results: After surgery, 61 patients (81,3%) showed histologic response (complete or partial). Clinical assessment of tumour response was in concordance with histologic study in 80% of patients. Mammography, magnetic resonance and scintimammography agreed with pathology in 79,7, 78,9 and 86,4% of patients, respectively. Based on histologic response, sensitivity and specificity were 64,3 and 83,8% for mammography, 61,5 and 82,8% for magnetic resonance, and 58,3 and 92,6% for scintimammography, respectively. Agreement between magnetic resonance and scintimammography was 88,8%, between magnetic resonance and mammography 75,7%, and 77,3% between scintimammography and mammography. Conclusion: Magnetic resonance and scintimammography should be added to the diagnostic arsenal since they have shown more reliability than conventional methods for predicting histopathologic response to neoadjuvant therapy. Nevertheless, tumour size is critical for the detection of residual small lesions, usually microscopic and DCIS foci, or in others words, there is a limitation to define complete response(AU)

Estudio comparativo de la técnica del ganglio centinela entre los casos de carcinoma de mama multifocal y unifocal / Comparative study of sentinel node biopsy in patients with multifocal breast carcinoma versus in those with unifocal breast carcinoma

Objetivo valorar los resultados de la biopsia del ganglio centinela (BGC) en pacientes con cáncer de mama multifocal (CMMF) en comparación con el unifocal (CMUF). Pacientes y métodos se han realizado e incluido en una base de datos de manera prospectiva 1.535 BGC a pacientes de 9 centros hospitalarios. De ellos 174 presentaban CMMF. Para la BGC se utilizaron coloides de Tc-99m y la vía de administración fue mayoritariamente la profunda, repartiendo el trazador en los diferentes focos. Resultados el índice de detección global fue del 93,8%, sin encontrar diferencias entre ambos grupos (el 94,8% en CMMF frente al 93,4%). La media de GC detectados fue de 1,46, siendo mayor en el grupo CMMF (1,58 frente a 1,45; p=0,036). La localización fue extraaxilar en el 19,6%, más frecuente en el grupo CMMF (el 23,4 frente al 18,9%, no significativo) y más en el territorio de la cadena mamaria interna y en el nivel III axilar. La incidencia de metástasis en los GC biopsiados fue del 27,3%, mayor en el grupo CMMF (el 29,1 frente al 26,7%, no significativo), con una media de GC afectados mayor (0,42 frente a 0,32, no significativo). En la linfadenectomía axilar se identificó afectación de ganglios adicionales en una proporción igual en ambos grupos (29,7%). Conclusionesla BGC parece tener un rendimiento similar en tumores unifocales y multifocales. En tumores multifocales, parece haber un patrón de drenaje linfático específico, con mayor número de GC detectados y probablemente con mayor número de localizaciones de GC extraaxilares (AU)

Objective To evaluate the results for sentinel node biopsy (SNB) in patients with multifocal breast cancer (MBC) in comparison to in those with unifocal breast cancer (UBC). Patients and methods A total of 1535 prospective SNB (174 on patients with MBC) were performed at 9 hospitals. In most patients, Tc-99m album in colloids were injected intraparenchymally into each tumoral focus for SNB. Results The overall identification rate was 93.8%; no differences between groups were observed (94.8% in MBC vs 93.4% in UBC). The mean number of sentinel nodes detected was 1.46, being higher in the MBC group than in the UBC group (1.58 vs 1.45; p=0.036). Extra-axillary sentinel nodes were found in 19.6%; extra-axillary sentinel nodes were more common in the MBC group (23.4% vs 18.9%, ns) and in the internal mammary chain and in level III axillary lymph nodes. The incidence of sentinel node metastasis was 27.3% (29.1% MBC vs 26.7% UBC, ns), and the mean number of positive sentinel nodes was 0.42 in the MBC group vs 0.32 in the UBC group (p=ns). Axillary dissection identified the same rate of positive additional nodes (29.7%) in both groups. Conclusions The diagnostic yield of SNB seems similar in MBC and UBC. In MBC, there appears to be a specific pattern of lymphatic drainage, with a higher number of sentinel nodes detected and probably a higher number of extra-axillary sentinel nodes (AU)

[Comparative study of sentinel node biopsy in patients with multifocal breast carcinoma versus in those with unifocal breast carcinoma.]. / Estudio comparativo de la técnica del ganglio centinela entre los casos de carcinoma de mama multifocal y unifocal.

OBJECTIVE: To evaluate the results for sentinel node biopsy (SNB) in patients with multifocal breast cancer (MBC) in comparison to in those with unifocal breast cancer (UBC). PATIENTS AND METHODS: A total of 1535 prospective SNB (174 on patients with MBC) were performed at 9 hospitals. In most patients, Tc-99m albumin colloids were injected intraparenchymally into each tumoral focus for SNB. RESULTS: The overall identification rate was 93.8%; no differences between groups were observed (94.8% in MBC vs 93.4% in UBC). The mean number of sentinel nodes detected was 1.46, being higher in the MBC group than in the UBC group (1.58 vs 1.45; p=0.036). Extra-axillary sentinel nodes were found in 19.6%; extra-axillary sentinel nodes were more common in the MBC group (23.4% vs 18.9%, ns) and in the internal mammary chain and in level III axillary lymph nodes. The incidence of sentinel node metastasis was 27.3% (29.1% MBC vs 26.7% UBC, ns), and the mean number of positive sentinel nodes was 0.42 in the MBC group vs 0.32 in the UBC group (p=ns). Axillary dissection identified the same rate of positive additional nodes (29.7%) in both groups. CONCLUSIONS: The diagnostic yield of SNB seems similar in MBC and UBC. In MBC, there appears to be a specific pattern of lymphatic drainage, with a higher number of sentinel nodes detected and probably a higher number of extra-axillary sentinel nodes.

Antimicrobial efficacy in vivo of a new formulation of 2-butanone peroxide in n-propanol: comparison with commercial products in a cross-over trial.

The use of hand rub to obtain maximum decrease in bacterial load is important because the reduction needed to avoid transmission is unknown. The monomer of 2-butanone peroxide is a peroxygen derivative with potential biocidal use in hospitals. The aim of this study was to compare the efficacy of hand rub with an alcoholic solution of peroxide 2-butanone versus five antiseptic products, against E. coli K12 (CECT 433) transient flora acquired by hand immersion in a broth culture following the UNE-EN-1500 standard. Isopropanol 60% (control) obtained 99.99% reductions, driving down the bacterial load from 10(6) cfu/mL in the initial inocula to <100 cfu/mL. Products A, B and C (different alcoholic solutions ranging from 65% to 75% with low amounts of biguanidines and/or quaternary ammonium compounds) resulted in significantly lower amounts, reducing initial inocula to approximately 500 cfu/mL. Products D and E (70-75% alcohol solutions containing higher amounts of different quaternary ammonium compounds and triclosan in the case of product E) produced reductions similar to that of isopropanol, with significantly larger reductions than products A, B and C. The product with the solution of 2-butanone peroxide produced the same effect as products D and E with mean reductions of approximately 4log(10) (99.99%), driving the initial inocula down to < or = 100 cfu/mL, despite the low concentration (35%) of propanol in the solution. This novel peroxygen biocide offers high in-vivo cidal activity against acquired E. coli transient flora, offering an alternative to products with higher alcohol concentrations.

[Comparison between intratumoral and peritumoral injection of radiotracer for locating and biopsying the sentinel lymph node in nonpalpable breast cancer]. / Comparación entre la inyección intratumoral y peritumoral del radiotrazador para la localización y biopsia del ganglio centinela en cáncer de mama no palpable.

OBJECTIVE: To determine whether there are differences in the technical efficacy in detecting and biopsying the sentinel node after intratumoral or peritumoral administration of the radiotracer in patients with nonpalpable early-stage breast cancer. MATERIAL AND METHODS: This prospective, randomized study included 80 patients with nonpalpable breast cancer without axillary adenopathies who were scheduled for primary surgical treatment. Patients were randomized to one of two groups: the INTRA group (intratumoral radiotracer administration, n=35) or the PERI group (peritumoral radiotracer administration, n=45). Patients with suspicious axillary lymph nodes at clinical or ultrasonographic examination that had positive results after fine-needle aspiration cytology were excluded. RESULTS: The rates of sentinel node detection were 97.1% (34/35) for intratumoral injection and 84.4% (38/45) for peritumoral injection. Radiotracer migration failure occurred in 8 cases (one in the INTRA group and 7 in the PERI group). The sentinel node was detected in an extra-axillary location in 21.9% of cases (11/59 in the INTRA group and 16/64 in the PERI group). CONCLUSIONS: Our study found no statistically significant differences in the detection rates of axillary or extra-axillary sentinel lymph nodes between the two groups; however, we observed greater technical efficacy with intratumoral radiotracer administration.

Comparación entre la inyección intratumoral y peritumoral del radiotrazador para la localización y biopsia del ganglio centinela en cáncer de mama no palpable / Comparison between intratumoral and peritumoral injection of radiotracer for locating and biopsying the sentinel lymph node in nonpalpable breast cancer

Objetivo. Determinar si existen diferencias en la eficacia técnica en la detección y biopsia del ganglio centinela tras la administración del radiotrazador por vía intratumoral respecto a la vía peritumoral, en pacientes con cáncer de mama inicial no palpable. Material y métodos. Se realizó un estudio prospectivo y aleatorizado que incluyó a 80 pacientes con cáncer de mama no palpable, sin adenopatías axilares, programadas para tratamiento quirúrgico primario. Las pacientes fueron aleatorizadas en dos grupos según la vía de administración del radiotrazador: grupo INTRA (intratumoral, n = 35) y grupo PERI (peritumoral, n = 45). Fueron excluidas pacientes con ganglios axilares clínica o ecográficamente sospechosos con punción con aguja fina positiva. Resultados. Los índices de detección del ganglio centinela fueron del 97,1% (34/35) en la técnica de inyección intratumoral y 84,4% (38/45) en la vía peritumoral. Se dieron 8 fracasos de migración del radiotrazador (uno en el grupo INTRA y 7 en el PERI). En el 21,9% de casos se detectó el ganglio centinela en localización extraaxilar (11/59 en el gru - po INTRA y 16/64 en el grupo PERI). Conclusiones. Nuestro estudio no ha mostrado diferencias estadísticamente significativas en los índices de detección de los ganglios centinelas axilares ni extraaxilares entre los dos grupos, pero observó una mayor eficacia de la técnica en la administración intratumoral del radiotrazador

Objective. To determine whether there are differences in the technical efficacy in detecting and biopsying the sentinel node after intratumoral or peritumoral administration of the radiotracer in patients with nonpalpable early-stage breast cancer. Material and methods. This prospective, randomized study included 80 patients with nonpalpable breast cancer without axillary adenopathies who were scheduled for primary surgical treatment. Patients were randomized to one of two groups: the INTRA group (intratumoral radiotracer administration, n = 35) or the PERI group (peritumoral radiotracer administration, n = 45). Patients with suspicious axillary lymph nodes at clinical or ultrasonographic examination that had positive results after fine-needle aspiration cytology were excluded. Results. The rates of sentinel node detection were 97.1% (34/35) for intratumoral injection and 84.4% (38/45) for peritumoral injection. Radiotracer migration failure occurred in 8 cases (one in the INTRA group and 7 in the PERI group). The sentinel node was detected in an extra-axillary location in 21.9% of cases (11/59 in the INTRA group and 16/64 in the PERI group). Conclusions. Our study found no statistically significant differences in the detection rates of axillary or extra-axillary sentinel lymph nodes between the two groups; however, we observed greater technical efficacy with intratumoral radiotracer administration

[NUTRISOL: a computer programme for communitary and hospital nutritional evaluation of free access]. / NUTRISOL: un programa informático para la evaluación nutricional comunitaria y hospitalaria de acceso libre.

We have developed the computer programme NUTRISOL, a nutritional programme destined to analysis of dietary intake by means of the food transformation to nutrient. It has been performed under Windows operative system, using Visual Basic 6.0. It is presented in a CD-Rom. We have used the Spanish CSIC Food Composition Table and domestic food measures commonly used in Spain which could be modified and updated. Diverse kind of diets and reference anthropometric data are also presented. The results may be treated using various statistical programmes. The programme contains three modules: 1) Nutritional epidemiology, which allows to create or open a data base, sample management, analyse food intake, consultation of nutrient content and exportation of data to statistical programmes. 2) Analyses of diets and recipes, creation or modification of new ones. 3) To ask different diets for prevalent pathologies. Independent tools for modifying the original tables, calculate energetic needs, recommend nutrient intake and anthropometric indexes are also offered. In conclusion, NUTRISOL Programme is an application which runs in PC computers with minimal equipment in a friendly interface, of easy use, freeware, which may be adapted to each country, and has demonstrated its usefulness and reliability in different epidemiologic studies. Furthermore, it may become an efficient instrument for clinical nutrition and health promotion.