Breast Arterial Calcification on screening mammography can predict significant Coronary Artery Disease in women.

INTRODUCTION: Breast Arterial Calcification (BAC) on digital mammography has been associated with an increased risk of Coronary Artery Disease (CAD). We aimed to investigate the association of BAC with findings on Coronary Computed Tomography Angiography (CCTA) within a cohort of women from the national breast screening program. METHODS: Symptomatic women (chest pain) aged between 50 and 65 who underwent a CCTA and who also had a screening mammography between 2014 and 2015 were recorded. BAC and CAD-RADS™: Coronary Artery Disease-Reporting and Data System were scored by separate blinded specialist radiologists. Cardiac risk factors were recorded. Patients' cardiac follow up (with Exercise Stress Test, Percutaneous Coronary Intervention or echocardiography) and cardio-protective medications were also documented. RESULTS: 219 eligible women underwent a CCTA. Of these, 104 patients also underwent digital mammography. Using standard linear regression BAC was identified as a significant predictor of CAD-RADs ≥3 disease. Using binomial logistic regression, BAC remained associated with CAD-RADs ≥3 (p=0.023). A significantly higher proportion of patients with BAC >1 were on cardio-protective medications (p=0.041) and had medications initiated or changed, or had further cardiac investigation (p=0.037 and p=0.019, respectively) than those with no BAC, after a mean follow-up of 20.6 (range 15-27) months. CONCLUSION: BAC diagnosed on 2 yearly screening mammography predicts CAD-RADs ≥3 disease in symptomatic patients.

A quantitative and qualitative evaluation of an automatic occlusion device for tracheoesophageal speech: the Provox FreeHands HME.

This study aimed to evaluate a new automatic tracheostoma valve: the Provox FreeHands HME (manufactured by Atos Medical AB, Sweden). Data from four laryngectomee participants using automatic and also manual occlusion were subjected to acoustic and perceptual analysis. The main results were a significant decrease, from the manual to automatic occlusion condition, in maximum phonation time, mean intensity of read speech and percentage pause time. There was an increase in random noise in the speech signal and a significant increase in extraneous noise caused by the device. Perceptual analysis revealed no clear functional impact of these differences. Data from a questionnaire and diary suggested the main advantage of automatic occlusion was the freedom to speak while performing manual tasks. The principal disadvantage appeared to be a decrease in base-plate seal duration. The results suggest that, for some clients, the FreeHands valve is a useful option for use alongside manual occlusion.