Safety and efficacy of Holmium-166 selective internal radiotherapy of primary and secondary liver cancer confirmed by real-world data.

Purpose: Holmium-166 has emerged as a promising option for selective internal radiotherapy (SIRT) for hepatic malignancies, but data on routine clinical use are lacking. The purpose of this study was to describe the safety and effectiveness of Holmium-166 SIRT in real-world practice through retrospective analysis of a multicenter registry. Methods: Retrospective analysis was conducted on Holmium-166 SIRT procedures performed between July 15, 2019, and July 15, 2021, across seven European centers. Treatment planning, treatment realization and post-treatment follow-up were conducted according to routine local practice. Safety and effectiveness data were extracted from the patients' health records. Primary endpoint analysis was assessed for the entire study population with separate analysis for subgroups with hepatocellular carcinoma, metastatic colorectal cancer and intrahepatic cholangiocarcinoma. Results: A total of 167 SIRT procedures in 146 patients (mean age 66 ± 11 years, 68% male) were retrospectively evaluated. Most common tumor entities were hepatocellular carcinoma (n=55), metastatic colorectal cancer (n=35), intrahepatic cholangiocarcinoma (n=19) and metastatic neuroendocrine tumors (n=10). Nine adverse events grade ≥ 3 according to Common Terminology Criteria for Adverse Events were recorded, including one fatal case of radioembolization-induced liver disease. Response rates and median overall survival for the above mentioned subgroups were comparable to results from previous Holmium-166 trials as well as to results from Yttrium-90 registries. Conclusion: This study confirms that the safety and effectiveness of Holmium-166 SIRT derived from prospective trials also applies in routine clinical practice, reinforcing its potential as a viable treatment option for primary and secondary liver cancer.

Assessing the genetic contribution of cumulative behavioral factors associated with longitudinal type 2 diabetes risk highlights adiposity and the brain-metabolic axis.

While genetic factors, behavior, and environmental exposures form a complex web of interrelated associations in type 2 diabetes (T2D), their interaction is poorly understood. Here, using data from ~500K participants of the UK Biobank, we identify the genetic determinants of a "polyexposure risk score" (PXS) a new risk factor that consists of an accumulation of 25 associated individual-level behaviors and environmental risk factors that predict longitudinal T2D incidence. PXS-T2D had a non-zero heritability (h2 = 0.18) extensive shared genetic architecture with established clinical and biological determinants of T2D, most prominently with body mass index (genetic correlation [rg] = 0.57) and Homeostatic Model Assessment for Insulin Resistance (rg = 0.51). Genetic loci associated with PXS-T2D were enriched for expression in the brain. Biobank scale data with genetic information illuminates how complex and cumulative exposures and behaviors as a whole impact T2D risk but whose biology have been elusive in genome-wide studies of T2D.

Utilidad del SPECT-CT en la biopsia del ganglio centinela tras quimioterapia neoadyuvante en cáncer de mama y axila positiva / The usefulness of SPECT-CT in sentinel lymph nodes identification after neoadjuvant chemotherapy in patients with breast cancer and axillary involvement

Objetivo Valorar la utilidad de los estudios híbridos SPECT-CT en la biopsia del ganglio centinela (BGC) post quimioterapia neoadyuvante (QNA) en pacientes cN+. Método Estudio transversal de los resultados obtenidos en un grupo de 25 pacientes tratadas en la Unidad Funcional de Mama del HUGTIP desde marzo de 1918 a septiembre de 2020. La metodología específica para este estudio incluye: 1)ecografía axilar y colocación de marcador ecovisible en el ganglio afecto antes de iniciar la QNA; 2)tras QNA, colocación de marcador ferromagnético (Magseed®) en ganglio marcado previamente (GM); 3)valoración del estado axilar tras la QNA, que incluye estudio linfogammagráfico axilar con SPECT-CT; BGC y exéresis del ganglio marcado (GM) si es distinto al ganglio centinela (GC), y vaciado ganglionar axilar (VGA). Resultados La valoración de los SPECT-CT permitió verificar la coincidencia entre el GM y el GC en 14 casos (56%). En 3 casos no se encontró GC y en 8 casos el marcador magnético no estaba en un GC. La biopsia selectiva de los ganglios (GC y/o GM) fue negativa en 12 pacientes (2 con VGA positivo) y positiva en 13 (4 con VGA positivo). Conclusión El estudio SPECT-CT aportó información adicional sobre la localización y la concordancia del ganglio marcado y el ganglio centinela previa a la cirugía, mejorando la planificación de la misma. (AU)

Objective To evaluate the usefulness of SPECT-CT hybrid studies in the biopsy of sentinel lymph node (SLNB) after neoadjuvant chemotherapy (NAC) in patients with axillary metastatic disease (N+). Methods Cross-sectional study of 25 patients treated in the HUGTIP Breast Functional Unit from March 2018 to September 2020. All patients included in the study were submitted to: (1)axillary ultrasound (US) and US visible marker placement in the affected node before starting the NAC; (2)placement of a ferromagnetic marker in the previously marked lymph node (MLN) after NAC; (3)assessment of axillary status after NAC: it includes SPECT-CT lymphoscintigraphy; SLNB and excision of the MLN whether different from the sentinel lymph node (SLN); and axillary lymph node dissection (ALND). Results In 14 patients (56%) the MLN corresponded with the SLN. In 3 cases it was not possible identify the SLN and in 8 cases the MLN was not a SLN. The biopsy of MLN and SLN was negative for metastasis in 12 patients (2 of them had a positive ALND) and was positive for metastasis in 13 patients (4 of them had a positive ALND). Conclusion The SPECT-CT study provided additional information about the identification and the concordance of the MLN and the SLN improving the surgical planning. (AU)

Assessing the user experience and usability of the PRECIOUS system: a randomized controlled trial in obese patients.

Objective To assess users' usability, satisfaction, acceptance and effectiveness of the PRECIOUS system to promote behavior change toward healthier lifestyles. Design: Thirty-one adult patients with BMI>30 (M = 44.23, SD = 5.91) were recruited and randomized into three conditions for a longitudinal study (3 months length): 1) Control group (TAU + biofeedback + follow-ups); 2) PRECIOUS only (app + biofeedback + follow-ups); 3) PRECIOUS + MI (app + biofeedback + motivational interviewing follow-ups). Main Outcome Measures: Usability, satisfaction, acceptance and effectiveness of PRECIOUS, and stages of change (S-Weight questionnaire). Results: The system was described as easy to use, flexible, fairly satisfying and good as a preventive health system. Participants rated biofeedback and the Physical Activity module as the most satisfying features. However, participants were unsatisfied with the Diet module. All additional features received acceptable scores in terms of satisfaction. Despite this, the PRECIOUS only group reported that they would probably recommend the system to others because it meets its purposes quite well. Conclusion: PRECIOUS was found a usable and acceptable solution, although improving several features in the Diet module in successive versions of the app would promote sustained use and satisfaction among users, possibly increasing its effectiveness in promoting healthier lifestyles. Abbreviations: ADA American Diabetes Association; BG2: BodyGuard2; BMI: Body Mass Index; CBT: Cognitive-behavioral therapy; EMA: Ecological Momentary Assessment; eHealth: Electronic health; mHealth: Mobile health; MI: Motivational interviewing; NCD: Non-communicable diseases; PA: Physical activity; PRECIOUS: PREventive Care Infrastructure based On Ubiquitous Sensing.

Upscaling Reverse Electrodialysis.

Salinity gradient energy is a sustainable, renewable, and clean energy source. When waters with different salinities are mixed, the change in Gibbs free energy can be harvested as energy and only brackish water remains. Reverse electrodialysis is one of the technologies that can harvest this sustainable energy source. High power densities have been obtained in small lab scale systems, but translation to large industrial scale stacks is essential for commercialization of the technology. Moreover, power density is an important parameter, and efficiency, i.e., the amount of energy harvested compared to the amount of energy available in the feed waters, is critical for commercial processes. In this work, we systematically investigate the influence of stack size and membrane type on power density, thermodynamic efficiency, and energy efficiency. Results show that the residence time is an excellent parameter for comparing differently sized stacks and translating lab scale experimental results to larger pilot stacks. Also, the influence of undesired water permeability and co-ion diffusion (as reflected in permselectivity) is clearly visible when measuring the thermodynamic efficiency. An averaged thermodynamic efficiency of 44.9% is measured using Fujifilm Type 10 anion exchange and cation exchange membranes that have low water permeability and high permselectivity. This value comes close to the thermodynamic maximum of 50%.

PREventive Care Infrastructure based On Ubiquitous Sensing (PRECIOUS): A Study Protocol.

BACKGROUND: mHealth has experienced a huge growth during the last decade. It has been presented as a new and promising pathway to increase self-management of health and chronic conditions in several populations. One of the most prolific areas of mHealth has been healthy lifestyles promotion. However, few mobile apps have succeeded in engaging people and ensuring sustained use. OBJECTIVE: This paper describes the pilot test protocol of the PReventive Care Infrastructure based on Ubiquitous Sensing (PRECIOUS) project, aimed at validating the PRECIOUS system with end users. This system includes, within a motivational framework, the Bodyguard2 sensor (accelerometer with heart rate monitoring) and the PRECIOUS app. METHODS: This is a pilot experimental study targeting morbidly obese prediabetic patients who will be randomized to three conditions: (1) Group 1 - Control group (Treatment as usual with the endocrinologist and the nurse + Bodyguard2), (2) Group 2 - PRECIOUS system (Bodyguard2 + PRECIOUS app), and (3) Group 3 - PRECIOUS system (Bodyguard2 + PRECIOUS app + Motivational Interviewing). The duration of the study will be 3 months with scheduled follow-up appointments within the scope of the project at Weeks 3, 5, 8, and 12. During the study, several measures related to healthy lifestyles, weight management, and health-related quality of life will be collected to explore the effectiveness of PRECIOUS to foster behavior change, as well as user acceptance, usability, and satisfaction with the solution. RESULTS: Because of the encouraging results shown in similar scientific work analyzing health apps acceptance in clinical settings, we expect patients to widely accept and express satisfaction with PRECIOUS. We also expect to find acceptable usability of the preventive health solution. The recruitment of the pilot study has concluded with the inclusion of 31 morbidly obese prediabetic patients. Results are expected to be available in mid-2017. CONCLUSIONS: Adopting and maintaining healthy habits may be challenging in people with chronic conditions who usually need regular support to ensure mid/long-term adherence to recommendations and behavior change. Thus, mHealth could become a powerful and efficient tool since it allows continuous communication with users and immediate feedback. The PRECIOUS system is an innovative preventive health care solution aimed at enhancing inner motivation from users to change their lifestyles and adopt healthier habits. PRECIOUS includes ubiquitous sensors and a scientifically grounded app to address three main components of health: physical activity, diet, and stress levels. TRIAL REGISTRATION: Clinicaltrials.gov NCT02818790; https://clinicaltrials.gov/ct2/show/NCT02818790 (Archived by WebCite at http://www.webcitation.org/6qfzdfMoU).

Caracterización por Ultrasound Tissue Characterization de los tendones rotulianos de jugadores de baloncesto; comparación entre profesionales versus formativos y asintomáticos versus sintomáticos / Patellar tendon analysis by ultrasound tissue characterization; comparison between professional and amateur basketball players. Asymptomatic versus symptomatic

Introducción: La ecografía convencional permite identificar los cambios macroscópicos que se producen en el tendón patológico, sin embargo, estos cambios no se correlacionan bien con los síntomas o la respuesta al tratamiento. La Ultrasound Tissue Characterization (UTC) evalúa la estructura del tendón en 3 dimensiones y la clasifica en 4 eco-tipos. El objetivo de este estudio fue investigar la estructura del tendón rotuliano de jugadores de baloncesto utilizando la técnica de la UTC y estudiar las diferencias entre jugadores profesionales y formativos, comparando la pierna dominante con la pierna no dominante, y sintomáticos con asintomáticos. Material y métodos: Un total de 40 tendones rotulianos (20 jugadores de baloncesto) se incluyeron en el estudio. La estructura del tendón rotuliano (proximal, medial y distal) se cuantificó mediante UTC en el inicio de la pretemporada. La fiabilidad inter e intraobservador se estudió mediante el coeficiente de correlación intraclase (CCI). Resultados: La edad media de los 10 jugadores profesionales y la de los 10 jugadores formativos fue de 28,1 años (DE 4,5) y 17,6 (DE 1,13), respectivamente. El espesor del tendón rotuliano fue mayor en los jugadores profesionales (p < 0,05), en la pierna dominante (p < 0,05) y en los tendones sintomáticos (p < 0,05). No se encontraron diferencias significativas para los eco-tipos, excepto en el caso del eco-tipo II del tendón rotuliano derecho en la porción proximal entre los jugadores profesionales y los académicos (p = 0,05), y en los eco-tipo III y IV del tendón derecho en su porción proximal entre los jugadores sintomáticos y los asintomáticos (p < 0,05). Se encontró una buena-alta fiabilidad con estas técnicas (CCI = 0,80-0,99). Conclusiones: Se ha caracterizado el patrón ecográfico de los tendones rotulianos de jugadores de baloncesto utilizando UTC. El espesor del tendón rotuliano es mayor en los jugadores profesionales que en los jugadores académicos. También se ha observado mayor grosor de los tendones sintomáticos que de los asintomáticos. No hubo diferencias importantes en el patrón de UTC entre los jugadores profesionales y los académicos ni entre los sintomáticos y los asintomáticos (AU)

Introduction: Conventional ultrasound helps to identify the macroscopic changes produced in the injured tendon. However, these changes do not correlate well with the symptoms or the response to treatment. The ‘characterization of tissues by ultrasound’ (UTC) evaluates the structure of the tendon in 3 dimensions and classifies it into 4 echo-types. The aim of this study was to investigate the structure of the patellar tendon in basketball players using the UTC technique, and to study the differences between professional and amateur players by comparing the dominant leg with the non-dominant one, and the asymptomatic with the asymptomatic ones. Material and methods: The study included 40 patellar tendons (20 basketball players). The structure of the patellar tendon (proximal, medial, and distal) was quantified by means of UTC at the beginning of the pre-season. The within and between observer reliability was measured using the intraclass correlation coefficient (ICC). Results: The mean ages of the 10 professional players and 10 amateur players were 28.1 years (SD 4.5) and 17.6 years (SD 1.3), respectively. The thickness of the patellar tendon was greater in the professional players (P < .05), in the dominant leg (P < .05), and in symptomatic tendons (P < .05). There were no significant differences in the echo-types, except in the case of echotype II in the proximal portion of the right patellar tendon, between professional and amateur players (P = .05). Similarly, there was a difference in echo-type III and IV of the proximal portion of the right tendon between symptomatic and asymptomatic players (P < .05). A good, high reliability was found with these techniques (ICC = .80-.99). Conclusions: The ultrasound pattern of the patellar tendons of basketball players has been characterised using UTC. The thickness of the tendon is greater in professional players than in amateur players. It has also been observed that the symptomatic tendons are thicker than in asymptomatic ones. There were no significant differences in the UTC patterns between professional and amateur players, or between symptomatic and asymptomatic ones (AU)

Utilidad del parche cutáneo de hioscina en el tratamiento del sialocele persistente posparotidectomía: observación clínica / Utility of transdermal hyoscine in the treatment of persistent postparotidectomy sialocele: a case report

No disponible

Individual recovery profiles in basketball players.

In the sport context, recovery has been characterized as a multifactor process (physiological, psychological, behavioral, social, etc.). This study takes a multidisciplinary approach to find psychophysiological markers of the stress-recovery process. It aims to determine how athletes' specific recovery actions relate to their perceptions of recovery, and Heart Rate Variability (HRV). A total of 196 assessments were analyzed from 6 players on a men's professional basketball team within the Liga LEB Oro basketball federation (2012/2013 season). Perceptions of recovery, recovery strategies, and HRV were recorded. The results show a pattern of individual differences in behavior related to athletes' recovery actions and HRV profiles throughout the season (p < .05). Moreover, we observed that each player had different recovery needs. In light of these results, we suggest an individualistic approach to evaluating and monitoring recovery to attend more accurately to each player's recovery needs.

Individual recovery profiles in basketball players

In the sport context, recovery has been characterized as a multifactor process (physiological, psychological, behavioral, social, etc.). This study takes a multidisciplinary approach to find psychophysiological markers of the stress-recovery process. It aims to determine how athletes’ specific recovery actions relate to their perceptions of recovery, and Heart Rate Variability (HRV). A total of 196 assessments were analyzed from 6 players on a men’s professional basketball team within the Liga LEB Oro basketball federation (2012/2013 season). Perceptions of recovery, recovery strategies, and HRV were recorded. The results show a pattern of individual differences in behavior related to athletes’ recovery actions and HRV profiles throughout the season (p < .05). Moreover, we observed that each player had different recovery needs. In light of these results, we suggest an individualistic approach to evaluating and monitoring recovery to attend more accurately to each player’s recovery needs (AU)

No disponible

Resfriado-gripe: pérdida grave del olfato a largo plazo / Long term serious olfactory loss in colds and/or flu

Introducción: Las personas afectadas por pérdida olfativa total y de por vida se sitúan entre el 2 y el 3% de la población. Dos de las causas más frecuentes son los resfriados comunes y las gripes. El objetivo de este trabajo es mostrar el grado de afectación de las alteraciones olfativas sufridas, a largo plazo, a causa de un resfriado o una gripe. Métodos: Este estudio se ha basado en la asistencia a 240 pacientes, aquejados de pérdida olfativa por resfriado o gripe. Fueron excluidos todos aquellos que padecían otras enfermedades intercurrentes (66 pacientes), el resto (n = 174) estaba formado por 51 hombres (29,3%) y 123 mujeres (70,7%). Fueron sometidos a estudio olfatométrico ( I y V par craneal) y tomografía axial computarizada nasosinusal, y resonancia magnètica del sistema nervioso central (RM-SNC) comparándose el resultado con un grupo control (n = 120). Resultados: Se confirmó que la pérdida olfativa tanto para el nervio olfativo (p < 0,00001) como la alteración del nervio trigémino (p < 0,0001) eran muy significativas. Conclusiones: La pérdida del olfato, pasados más de 6 meses desde su inicio supone una reducción grave de las capacidades olfativas de las personas afectadas (AU)

Introduction: In the general population, we can find 2%–3% of lifelong olfactory disorders (from hyposmia to anosmia). Two of the most frequent aetiologies are the common cold and flu. The aim of this study was to show the degree of long-term olfactory dysfunction caused by a cold or flu. Methods: This study was based on 240 patients, with olfactory loss caused only by flu or a cold. We excluded all patients with concomitant illness (66 patients), the rest of patients (n = 174) consisted of 51 men (29.3%) and 123 women (70.7%). They all underwent olfactometry study ( I and V cranial nerve) and a nasal sinus computed tomography scan, as well as magnetic resonance imaging of the brain. Results were compared with a control group (n = 120). Results: Very significant differences in levels of olfactory impairment for the olfactory nerve (P<0.00001) and trigeminal nerve (P<0.0001) were confirmed. Conclusions: People who suffer olfactory dysfunction for more than 6 months, from flu or a cold, present serious impairment of olfactory abilities (AU)

Long term serious olfactory loss in colds and/or flu.

INTRODUCTION: In the general population, we can find 2-3% of lifelong olfactory disorders (from hyposmia to anosmia). Two of the most frequent aetiologies are the common cold and flu. The aim of this study was to show the degree of long-term olfactory dysfunction caused by a cold or flu. METHODS: This study was based on 240 patients, with olfactory loss caused only by flu or a cold. We excluded all patients with concomitant illness (66 patients), the rest of patients (n=174) consisted of 51 men (29.3%) and 123 women (70.7%). They all underwent olfactometry study (i and v cranial nerve) and a nasal sinus computed tomography scan, as well as magnetic resonance imaging of the brain. Results were compared with a control group (n=120). RESULTS: Very significant differences in levels of olfactory impairment for the olfactory nerve (P<.00001) and trigeminal nerve (P<.0001) were confirmed. CONCLUSIONS: People that suffer olfactory dysfunction for more than 6 months, from flu or a cold, present serious impairment of olfactory abilities.

Removal of emerging contaminants from municipal wastewater with an integrated membrane system, MBR-RO.

The presence of emerging contaminants in the aquatic environment and their potential effects on living organisms has become an issue of growing concern. Among emerging contaminants, pharmaceuticals may enter the aquatic environment due to their high consumption and their incomplete removal in conventional municipal wastewater treatment plants (WWTPs). The main goal of this study was the assessment of the removal efficiency of pharmaceuticals found in municipal wastewater of a coastal WWTP (Castell-Platja d'Aro, Spain) using an integrated pilot scale membrane system (MBR-RO). Twenty multiple-class pharmaceuticals (including psychiatric drugs, macrolide antibiotics, ß-blockers, sulfonamide and fluoroquinolone antibiotics, histamine H2 receptor antagonists, anti-inflammatories, nitroimidazole, ß-agonist and antiplatelet agent) were measured in real influent with the lowest average concentration for psychiatric drugs (0.017 µg L(-1)) to the highest for macrolide antibiotics (2.02 µg L(-1)). Although some contaminants were in relatively high concentrations (even up to 2.90 µg L(-1) in the case of ofloxacin). The combination of MBR and RO treatment showed excellent overall removal of target emerging contaminants with removal rates above 99% for all of them. For some compounds (metronidazole, hydrocodone, codein, ranitidine) MBR provided high removal efficiency (up to 95%). Additionally RO membrane showed removal rates always higher than 99%.

HRV based health&sport markers using video from the face.

Heart Rate Variability (HRV) is an indicator of health status in the general population and of adaptation to stress in athletes. In this paper we compare the performance of two systems to measure HRV: (1) A commercial system based on recording the physiological cardiac signal with (2) A computer vision system that uses a standard video images of the face to estimate RR from changes in skin color of the face. We show that the computer vision system performs surprisingly well. It estimates individual RR intervals in a non-invasive manner and with error levels comparable to those achieved by the physiological based system.