Comparative study of the sensitivity of MAMMI-PET in the diagnosis of breast cancerwith regard to other imaging tests

Introducción:el empleo de dispositivos de tomografía por emisión de positronesmamodedicados (dbPET) mejora la resolución espacial respecto a la PET corporal total. Lamamografía mediante imagen molecular PET (MAMMI-PET) es una nueva técnica, pero losestudios clínicos realizados son escasos. El objetivo del trabajo es determinar la sensibilidad,especificidad, los valores predictivos positivos y negativos de la MAMMI-PET, así como compararel dispositivo con las pruebas de imagen tradicionales.Material y métodos:estudio observacional prospectivo y analítico sobre una muestra depacientes con cáncer de mama confirmado histológicamente, atendidas en el Hospital Generalde Valencia (enero 2017-noviembre 2018).Se realizó un estudio preoperatorio con ecografía, mamografía, resonancia magnética nuclear yMAMMI-PET. Se consideró a la anatomía patológica como el patrón oro del número y tipo delesiones existentes en cada mama. Se comprobó si el diagnóstico del MAMMI-PET para cada lesióncoincidió con el resultado de la anatomía patológica.Se comparó la sensibilidad de cada prueba con la del MAMMI-PET empleando la prueba de Chicuadrado con nivel de significación de 0,05.Resultados:se evaluaron los datos de 32 pacientes y 44 lesiones (36 malignas y 8 benignas). Dospacientes fueron excluidas del estudio. Se obtuvo una sensibilidad del 75% para el MAMMI-PET.La mejor sensibilidad se obtuvo para la resonancia magnética nuclear con 85,3% mientras que para la ecografía y la mamografía fue de 77,8 y 69,4%, respectivamente. No se evidenciarondiferencias estadísticamente significativas en el estudio comparativo entre el MAMMI-PET y elresto de las pruebas de imagen.Conclusiones:la sensibilidad del MAMMI-PET (75%) para el diagnóstico de cáncer de mama fuesimilar a las otras pruebas de imagenIntroduction:The use of mammo dedicated breast PET (dbPET) scanners improves spacialresolution compared to Whole Body Pet images (WBPET). Mammography with Molecular ImagingPET (MAMMI-PET) is a new device with hardly any clinical studies. The aim of the study is toestimate the sensitivity of MAMMI-PET and compare it with classic imaging devices.Material and methods:A prospective and analytical observational study was carried out in asample of patients with histologically confirmed breast cancer who were treated at our hospitalbetween January 2017 and November 2018. Preoperative study of patients was performed withultrasound, mammography, Magnetic Resonance Imaging (MRI) and MAMMI-PET. Findings(number and benignant/malignant lesions) of the anatomopathological (AP) study were usedas the gold standard. Results between MAMMI-PET and AP were compared. The sensitivity ofeach test was compared with that of the MAMMI-PET using the Chi square test with a significancelevel of 0.05.Results:Data from 32 patients and 44 lesions (36 malignant and 8 benign) were evaluated. Twopatients were excluded. The MAMMI-PET sensitivity was 75%. The best sensitivity was obtainedfor MRI with 85.3%, while for ultrasound and mammography it was 77.8% and 69.4% respectively.No statistically significant differences were found between the sensitivity of MAMMIPET and therest of the imaging tests.Conclusions:The sensitivity obtained for the MAMMI-PET scanner (75%) was similar to the otherimaging testsEl trabajo recibió una beca del propio centro «PremiosFundación Investigación Hospital General Universitario» ensu edición de 2016 por valor de 10.000€Medicin

Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Encuesta sobre nación y supranacionalidad

In this academic survey a group of Constitutional Law Professors answer some questions about the concept of nation, its role in the historical evolution of constitutionalism and of nationalist movements, and its relation nowadays with the idea of constitution; about the meaning of the term «nation» in the Spanish constitution and of the term «nationalities»; and finally about the idea of supranationality that defines the European integration process and its relationship with the concept of nation.En esta encuesta un grupo de profesores de Derecho Constitucional contestan un conjunto de preguntas sobre el concepto de nación, el papel que ha desempeñado tal concepto en el desarrollo histórico del constitucionalismo y en el desarrollo de los movimientos nacionalistas, y la relación actual que mantiene con la idea de constitución; sobre el significado del término «nación» en la constitución española, y el del término «nacionalidades»; y, finalmente, sobre la idea de supranacionalidad que define el proceso de integración europea y su relación con el concepto de nación.In this academic survey a group of Constitutional Law Professors answer some questions about the concept of nation, its role in the historical evolution of constitutionalism and of nationalist movements, and its relation nowadays with the idea of constitution; about the meaning of the term «nation» in the Spanish constitution and of the term «nationalities»; and finally about the idea of supranationality that defines the European integration process and its relationship with the concept of nation

Perioperative pain management in cardiac surgery: a systematic review

Every year, more than 1.5 million patients, who undergo cardiac surgery worldwide, are exposed to a series of factors that can trigger acute postoperative pain associated with hemodynamic instability, respiratory complications, and psychological disorders. Through an evaluation of literature data about postoperative pain in cardiac surgery we define unmet needs and potential objectives for future research on this often underestimated problem

Molecular dynamics of targeting CD38 in multiple myeloma

Multiple functions of CD38 need exploring to expand clinical application of anti-CD38 antibodies in multiple myeloma (MM). We investigated membrane dynamics of MM cells and subsequent events when CD38 is targeted by therapeutic antibodies. Human MM cells (BF01) were co-cultured in vitro with therapeutic antibody (or control immunoglobulin G) and analysed using gene expression profiling. Microvesicles from antibody-exposed cells were analysed for differential gene and microRNA (miRNA) expression, and for phenotypic characterisation. Exposure of BF01 cells to anti-CD38 antibody resulted in CD38 membrane redistribution, upregulation of metabolism-related genes and downregulation of genes involved in cell cycle processes. Microvesicles derived from antibody-exposed cells showed increased CD73 and CD39 expression, presence of programmed death-ligand 1 and significant up-/down-modulation of miRNAs. Microvesicles accumulated around immunoglobulin Fc receptor-positive (FcR+) cells. Upon internalisation, natural killer cells displayed significantly increased expression of genes related to activation and immune response, and downregulation of genes involved in the cell cycle. Cells may use microvesicles to transmit signals distally as part of a survival strategy. Microvesicles are equipped on their surface with enzymatic machinery leading to production of tolerogenic adenosine. Further, they are internalised in FcR+ cells with significant functional modifications. These observations have relevance for improving anti-CD38 therapeutic antibodies through targeting this mechanism and its sequelae