Contrast-enhanced mammography-guided biopsy: technical feasibility and first outcomes

Objectives To evaluate the feasibility of contrast-enhanced mammography (CEM)-guided biopsy at Hospital del Mar, a Spanish university hospital. Methods We retrospectively reviewed all consecutive women with a suspicious enhancing finding eligible for CEM-guided biopsy, who were prospectively enrolled in a pre-marketing clinical validation and feasibility study (October 2019 to September 2021). CEM-guided biopsy is a stereotactic-based procedure that, by using intravenous iodinated contrast media administration and dual-energy acquisition, provides localisation of enhancing lesions. All the biopsies were performed using a vacuum-assisted device. We collected procedural characteristics (patient position and type of approach), and histopathological results. Feasibility endpoints included success (visualisation of the enhancing lesion, post-procedural biopsy changes and clip placement), procedural time, number of scout acquisitions and complications. Results A total of 66 suspicious enhancing lesions (18.0% foci, 44.0% mass, 38.0% non-mass enhancement; median size 8.5 mm) in 64 patients (median age 59 years, mostly minimal [48.4%] or mild [32.8%] background parenchymal enhancement) were referred for CEM-guided biopsy in the study period. The success rate was 63/66 (95.4%). Amongst successful procedures, patients were most frequently seated (52/63, 82.5%) and the preferred approach was horizontal (48/63, 76.2%). Median total time per procedure was 15 min. Median number of acquisitions needed before targeting was 2 (range 1-4). Complications consisted of hematoma (17/63, 27%) and vasovagal reaction (2/63, 3.2%). At histology, the malignancy rate was 25/63 (39.7%). Conclusion In this first patient series, CEM-guided breast biopsy was feasible, with success and complication rates similar to those previously reported for magnetic resonance guidance

How common is immobilization hypercalcaemia on a brain injury rehabilitation unit? a review of 337 patients

Abstracts from the 9th World Congress of International Society of Physical and Rehabilitation Medicine. June 19-23, 2015, Berlin, GermanyPostprint (published version

Pilot study for use of a virtual model for analyse paretic upper limb functional outcome evolution in acute stroke patients

Abstracts from the 9th World Congress of International Society of Physical and Rehabilitation Medicine. June 19-23, 2015, Berlin, GermanyPostprint (published version

Técnicas de ahorro de sangre en cirugía ortopédica

La cirugía ortopédica está asociada con frecuencia a la necesidad de transfusión de sangre homóloga, con los consiguientes riesgos que ello conlleva. En la actualidad se resalta la importancia de la disminución tanto de la transfusión como de la sobretransfusión en este tipo de cirugía. Dicho objetivo se puede alcanzar con el empleo de diversas técnicas de ahorro de sangre, que incluyan la potenciación del uso de sangre antóloga de métodos para disminuir el sangrado perioperatorio. La máxima eficacia para disminuir la necesidad de transfusión de sangre homóloga se deriva de la combinación de varias técnicas de ahorro, como son los programas de autotransfusión, la hipotensión controlada y el empleo de nuevos fármacos como eritropoyetina o aprotinina; todo ello sin olvidar la importancia de establecer unos criterios restrictivos, en consonancia con las directrices más actuales en este sentido, en el momento de indicar la necesidad de una transfusión sanguínea.Technique in orthopaedic surgery requires frequently transfusion of homologous blood which entails several risks. Nowadays, the importance of the decrease of both transfusion and overtransfusion has been proposed for this type of surgery. This aim can be reached by using different blood saving techniques including either the use of antologous blood or methods to minimize perioperative bleeding. The highest efficacy in order to diminish homologous blood transfusion combines several savings techniques as autotransfusion programs, controlled hypotension, and the use of new drugs such as erytropoyetin and aproinin. Restrictive criteria have to be established according to the more recent guidelines for blood transfusion

Intra-rater reliability and diagnostic accuracy of a new vaginal dynamometer to measure pelvic floor muscle strength in women with urinary incontinence

The first choice treatment in urinary incontinence (UI) is rehabilitation of the pelvic floor in order to improve muscle strength. However, no entirely reliable instruments for quantifying pelvic floor muscle (PFM) strength are currently available. Our aim was to test the intra-rater reliability and diagnostic accuracy of a new vaginal dynamometer for measuring PFM strength. Methods: Test-retest reliability study. One hundred and four women with stress urinary incontinence (SUI) were recruited. Patients were excluded if they had a history consistent with urge urinary incontinence or pelvic organ prolapse, pregnancy, previous urogynecological surgery, severe vaginal atrophy, or neurological conditions. The examination comprised digital palpation quantified by the modified Oxford scale and by two consecutive dynamometry measurements obtained using a new prototype dynamometer. This instrument comprises a speculum in which an inductive displacement sensor LVDTSM210.10.2.KTmodel, Schreiber) is attached to a spring of known stiffness constant (k). The intraclass correlation coefficient (ICC) was calculated to assess intra-rater reliability. Diagnostic accuracy was assessed using Receiver Operating Characteristics (ROC) curves analysis. Results: Of the 104 subjects included, 59.6% presented scores between 0–2 on the Oxford scale. Intra-rater reliability was 0.98 (95%CI: 0.97– 0.99). In the Bland & Altman plot, the distribution of disagreements was similar in the lowest and the highest strength values. The diagnostic accuracy of the dynamometer with regard to digital palpation showed an area under the curve of 0.85 (95%CI: 0.77–0.93). Conclusions: Our results suggest that this new vaginal dynamometer is a reliable and valid instrument for quantifying PFM strength.Peer ReviewedPostprint (published version

The effect of age on the acquisition and selection of cancer driver mutations in sun-exposed normal skin

BACKGROUND: The accumulation of somatic mutations contributes to ageing and cancer. Sunlight is the principal aetiological factor associated with skin cancer development. However, genetic and phenotypic factors also contribute to skin cancer risk. This study aimed at exploring the role of photoaging, as well as other well-known epidemiological risk factors, in the accumulation of somatic mutations in cancer-free human epidermis. MATERIAL AND METHODS: We deeply sequenced 46 genes in normal skin biopsies from 127 healthy donors, from which phenotypic data (including age, pigmentation-related genotype and phenotype) and sun exposure habits were collected. We determined the somatic mutational burden, mutational signatures, clonal selection and frequency of driver mutations in all samples. RESULTS: Our results reveal an exponential accumulation of UV-related somatic mutations with age, matching skin cancer incidence. The increase of mutational burden is in turn modified by an individual's skin phototype. Somatic mutations preferentially accumulated in cutaneous squamous cell carcinoma (cSCC) cancer genes and clonally expanded with age, with distinct mutational processes underpinning different age groups. Our results suggest loss of fidelity in transcription-coupled repair later in life. CONCLUSION: Our findings reveal that aging is not only associated with an exponential increase in the number of somatic mutations accumulated in normal epidermis, but also with selection and expansion of cancer-associated mutations. Aged, sun-exposed normal skin is thus an extended mosaic of multiple clones with driver mutations, poised for the acquisition of transforming events

Effect of Raw and Extruded Propionic Acid-Treated Field Beans on Energy and Crude Protein Digestibility (In-Vitro and In-Vivo), Growth and Carcass Quality in Grow-Finisher Pigs

The in-vitro ileal digestibility of dry matter (DM), organic matter (OM), and crude protein (CP) of field beans treated with propionic acid (trFB) and extruded trFB (exFB) was determined in experiment 1. The DE and dCP values of trFB and exFB were determined using the difference method in experiment 2. The effect of replacing SBM with trFB and exFB in grow-finisher diets on growth, carcass quality, apparent ileal digestibility (AiD), and total tract digestibility (ATTD) of DM, OM, gross energy (GE), and CP were investigated in experiment 3. In exp. 1, in-vitro digestibility of exFB compared to trFB was unchanged for DM (p = 0.12), increased for OM (p 0.05).info:eu-repo/semantics/publishedVersio

The effect of photoaging on the accumulation of somatic mutations in cancer-free human skin

This is a pre-print of an article published in Annals of Oncology. The final authenticated version is available online at: https://doi.org/10.1016/j.annonc.2020.11.023Background: The accumulation of somatic mutations contributes to ageing and cancer. Sunlight is the principal aetiological factor associated with skin cancer development. However, genetic and phenotypic factors also contribute to skin cancer risk. This study aimed at exploring the role of photoaging, as well as other well-known epidemiological risk factors, in the accumulation of somatic mutations in cancer-free human epidermis. Material and methods: We deeply sequenced 46 genes in normal skin biopsies from 123 healthy donors, from which phenotypic data (including age, pigmentation-related genotype and phenotype) and sun exposure habits were collected. We determined the somatic mutational burden, mutational signatures, clonal selection and frequency of driver mutations in all samples. Results: Our results reveal an exponential accumulation of UV-related somatic mutations with age, matching skin cancer incidence. The increase of mutational burden is in turn modified by an individual's skin phototype. Somatic mutations preferentially accumulated in cutaneous squamous cell carcinoma cancer genes and clonally expanded with age, with distinct mutational processes underpinning different age groups. Our results suggest a loss of fidelity in transcription-coupled repair later in life. Conclusion: Our findings reveal that ageing is not only associated with an exponential increase in the number of somatic mutations accumulated in normal epidermis, but also with selection and expansion of cancer-associated mutations. Aged, sun-exposed normal skin is thus an extended mosaic of multiple clones with driver mutations, poised for the acquisition of transforming events

Mechanical performance of AlCrSiN and AlTiSiN coatings on inconel and steel substrates after thermal treatments

The objective of this study was to explore the mechanical properties of AlCrSiN and AlTiSiN coatings deposited on Inconel and steel substrates after thermal treatments of 500 °C and 800 °C. Nanoindentation was used to measure the hardness and elastic modulus of the coatings, and microindentation was used for observing the contact damage with Hertzian contact loadings. Microscratch and Mercedes tests were used to evaluate the adhesive strength between coating and substrate with both progressive and static loads, respectively. The surface damage was inspected by optical microscopy and scanning electron microscopy (SEM). Focus ion beams (FIB) were used to mill the cross-sections in order to detect the extent and mode of failure. The results show that AlCrSiN coatings and Inconel substrates exhibit better mechanical performance, even after thermal treatments.Peer ReviewedPostprint (published version

Systematic review and meta-analysis of the effect of feed enzymes on growth and nutrient digestibility in grow-finisher pigs: Effect of enzyme type and cereal source

peer-reviewedDietary supplementation of pig diets with exogenous enzymes has been suggested as a strategy to increase nutrient digestibility and improve feed efficiency in grow-finisher pigs. However, inconsistent results are found in the literature. Ingredient composition of the diets is one of the most important sources of variation that may affect enzyme efficacy and consistency of results. A systematic review and a meta-analysis was therefore conducted to determine which exogenous enzymes with which diet type most consistently improve pig growth, nutrient digestibility and feed efficiency. Enzyme type and dietary cereal source were the main explanatory variables included in the models. The mean difference effects of enzyme supplementation on average daily gain (ADG), average daily feed intake (ADFI), gain to feed (G:F), apparent ileal digestibility (AiD) and apparent total tract digestibility (ATTD) of dry matter (DM), crude protein (CP), and gross energy (GE) were calculated for each study and these were used as the effect size estimates in the meta-analysis. A dataset with 139 comparisons from 67 peer-reviewed publications was used in the meta-analysis. In response to enzyme supplementation, G:F was improved in 38 of the 120 comparisons reporting pig growth data, remained un-changed in 78 and deteriorated in 4. Overall, DM and GE AiD, and ATTD were improved by xylanase, xylanase + β-glucanase, mannanase and protease dietary supplementation (P < 0.05). Crude protein AiD was only improved by protease dietary supplementation (P < 0.001). Dietary supplementation with xylanase alone improved ADG of maize- (P < 0.05) and co-product- (P < 0.05) based diets but had no effect on the G:F of grow-finisher pigs. Dietary supplementation with xylanase + β-glucanase had no effect on ADG, ADFI and G:F. Protease supplementation tended to improve the ADG of grow-finisher pigs fed co-product-based diets (P = 0.08) but had no effect on G:F. Dietary supplementation with multi-enzyme complexes improved the ADG (P < 0.05) and G:F (P < 0.01) of maize-, wheat-, barley- and co-product-based diets. In conclusion, dietary supplementation with all enzyme types improved nutrient digestibility depending on ingredient content, while mannanase and multi-enzyme complex supplementation most consistently improved growth and feed efficiency