Search

Introduction: Cytological samples obtained by endobronchial ultrasound (EBUS) are capital for diagnosis, staging and molecular profile in non-small cell lung carcinoma (NSCLC). Objective: To assess the success rate of complete, partial and individual of molecular analysis in samples obtained by EBUS-guided transbronchial needle aspiration (TBNA) and/or by oesophageal ultrasound-guided fine needle aspiration with an echobronchoscope (EUS-B-FNA) in patients with NSCLC. Methods: Prospective study including 90 patients with non-squamous NSCLC, or non-smoking squamous. Cytological samples were classified into two groups. Group 1: PEN membrane slide and/or cell blocks for the determination of mutations of EGFR, KRAS, ERBB2 and BRAF. Group 2: silane coated slides or cell blocks for rearrangements of ALK, ROS1 and MET amplification. Results: The success rate was 78.6% for 4 molecular alterations (EGFR, KRAS, ALK and ROS1), and 44% for 7 determinations. The individual success rate for EGFR was 97%, KRAS 96.3%, ALK 85%, ROS1 82.3%, ERBB2 71.4%, BRAF 67.7% and MET 81.1%. There were no significant differences (p = 0.489) in the number of molecular analyses (1–3 vs. 4) in group 1, depending on the types of samples (cell block vs. PEN membrane slide vs. cell block and PEN membrane slide). Conclusions: In patients with NSCLC, the cytological material obtained by ultrasound-guided needle aspiration is sufficient for individual and partial molecular analysis in the vast majority of cases. Membrane slides such as cell blocks are valid samples for molecular analysis.

Urban flooding is one of the major issues in many parts of the world, and its management is often challenging. One of the challenges highlighted by the hydrology and related communities is the need for more open data and monitoring of floods in space and time. In this paper, we present the development phases and experiments of an Internet of Things (IoT)-based wireless sensor network for hydrometeorological data collection and flood monitoring for the urban area of Colima-Villa de Álvarez in Mexico. The network is designed to collect fluvial water level, soil moisture and weather parameters that are transferred to the server and to a web application in real-time using IoT Message Queuing Telemetry Transport protocol over 3G and Wi-Fi networks. The network is tested during three different events of tropical storms that occurred over the area of Colima during the 2019 tropical cyclones season. The results show the ability of the smart water network to collect real-time hydrometeorological information during extreme events associated with tropical storms. The technology used for data transmission and acquisition made it possible to collect information at critical times for the city. Additionally, the data collected provided essential information for implementing and calibrating hydrological models and hydraulic models to generate flood inundation maps and identify critical infrastructure. HIGHLIGHTS IoT-based wireless sensor network for hydrometeorological data collection and flood monitoring has been developed for Colima-Villa de Álvarez in Mexico.; Real-time data is transferred over 3G cellular network and Wi-Fi.; Tests of the network on three separate tropical storm events showed robustness of the network during extreme events.;

Purpose of Investigation: Retained products of conception (RPOC) is the leading cause of postpartum or post-abortion hemorrhage. RPOC showing high vascularity at ultrasound assessment (HV-RPOC) showed an enhanced hemorrhagic risk following blind surgical uterine emptying. The authors describe the clinical outcome of patients suffering from HV-RPOC undergoing hysteroscopic removal. Material and Methods: Cohort of symptomatic patients suffering from HV-RPOC following miscarriages, pregnancy terminations, and term deliveries. After ultrasound selection based on color-Doppler showing HV-RPOC, all patients underwent hysteroscopic resection. Results: Twenty-seven patients met the selection criteria. HV-RPOC were found in 14 and six women after first and second trimester pregnancy termination, respectively. In seven women RPOC were found after term delivery. In 18 women (66.6%) RPOC were found firmly adherent to myometrium. Neither intra- nor postoperative complications were recorded. Hysteroscopy follow-up was carried-out in 16 patients. Normal findings were found in 15 women, in one case a mild adhesion was observed. Conclusion: HV-RPOC are often characterized by abnormally adherent placenta, suggesting that an accreta can be an underlying etiology. A reliable management can be accomplished by hysteroscopic resection.

Abstract Mountain social‐ecological systems (MtSES) are vital to humanity, providing ecosystem services to over half the planet's human population. Despite their importance, there has been no global assessment of threats to MtSES, even as they face unprecedented challenges to their sustainability. With survey data from 57 MtSES sites worldwide, we test a conceptual model of the types and scales of stressors and ecosystem services in MtSES and explore their distinct configurations according to their primary economic orientation and land use. We find that MtSES worldwide are experiencing both gradual and abrupt climatic, economic, and governance changes, with policies made by outsiders as the most ubiquitous challenge. Mountains that support primarily subsistence‐oriented livelihoods, especially agropastoral systems, deliver abundant services but are also most at risk. Moreover, transitions from subsistence‐ to market‐oriented economies are often accompanied by increased physical connectedness, reduced diversity of cross‐scale ecosystem services, lowered importance of local knowledge, and shifting vulnerabilities to threats. Addressing the complex challenges facing MtSES and catalyzing transformations to MtSES sustainability will require cross‐scale partnerships among researchers, stakeholders, and decision makers to jointly identify desired futures and adaptation pathways, assess trade‐offs in prioritizing ecosystem services, and share best practices for sustainability. These transdisciplinary approaches will allow local stakeholders, researchers, and practitioners to jointly address MtSES knowledge gaps while simultaneously focusing on critical issues of poverty and food security.

Se propone una metodología para obtener un “precio social y ambiental óptimo” que pueda aplicarse al agua de riego en la Comunidad Foral de Navarra (CFN) de modo que maximice la internalización de los costes ambientales asociados al consumo no contemplados en el actual precio sin que el nivel general de la economía regional se resienta. Para ello se elabora un modelo económico sobre un Sistema de Información Geográfica (SIG) que permite cuantificar y valorar los costes ambientales en cada una de las subcuencas de la Comunidad. Para valorar íntegramente el agua, los elementos que se tienen en cuenta son: volumen, calidad y riesgo de afectar a los ecosistemas acuáticos y de ribera. Estos valores son estimados mediante métodos de valoración económico ambiental. Se construye una curva de demanda para los regantes y un modelo de matrices de cuentas sociales (MCS). A partir de estos elementos se estudia el impacto que sobre la economía de la región tendría un incremento en el precio del agua. Se establece un rango potencial de precios del agua de riego desde el que minimiza los impactos económicos negativos –precio social óptimo- hasta el que internaliza totalmente los costes ambientales del agua- precio ambiental óptimo-.

Safety and quality foods of animal origin are extremely important for consumers. The aim of this work was to evaluate the feasibility of a method to track the breed origin of sheep meat all along the production chain using molecular genetics tools. A total of 800 samples evenly distributed among seven Italian sheep breeds have been typed at 19 STR markers, together with 90 samples from both imported sheep animals and local crossbred animals withdrawn at slaughterhouses. A maximum likelihood assignment test was adopted to evaluate STR ability to allocate samples to their true breed of origin. Sarda animals were all correctly allocated, as well as more than 98% of samples from the other breeds. Only slightly worst allocation performances were observed for imported and crossbred animals. Preliminary results seem quite promising, though further analyses will be needed in order to better understand the statistical power of such an assignment test before implementation in the sheep meat production chain.

The understanding of present atmospheric transport processes from Southern Hemisphere (SH) landmasses to Antarctica can improve the interpretation of stratigraphic data in Antarctic ice cores. In addition, long range transport can deliver key nutrients normally not available to marine ecosystems in the Southern Ocean and may trigger or enhance primary productivity. However, there is a dearth of observational based studies of dust transport in the SH. This work aims to improve current understanding of dust transport in the SH by showing a characterization of two dust events originating in the Patagonia desert (south end of South America). The approach is based on a combined and complementary use of satellite retrievals (detectors MISR, MODIS, GLAS, POLDER, OMI), transport model simulation (HYSPLIT) and surface observations near the sources and aerosol measurements in Antarctica (Neumayer and Concordia sites). Satellite imagery and visibility observations confirm dust emission in a stretch of dry lakes along the coast of the Tierra del Fuego (TdF) island (~54° S) and from the shores of the Colihue Huapi lake in Central Patagonia (~46° S) in February 2005. Model simulations initialized by these observations reproduce the timing of an observed increase in dust concentration at the Concordia Station and some of the observed increases in atmospheric aerosol absorption (here used as a dust proxy) in the Neumayer station. The TdF sources were the largest contributors of dust at both sites. The transit times from TdF to the Neumayer and Concordia sites are 6–7 and 9–10 days respectively. Lidar observations and model outputs coincide in placing most of the dust cloud in the boundary layer and suggest significant deposition over the ocean immediately downwind. Boundary layer dust was detected as far as 1800 km from the source and ~800 km north of the South Georgia Island over the central sub-Antarctic Atlantic Ocean. Although the analysis suggests the presence of dust at ~1500 km SW of South Africa five days after, the limited capabilities of existing satellite platforms to differentiate between aerosol types do not permit a definitive conclusion. In addition, the model simulations show dust lifting to the free troposphere as it travels south but it could not be confirmed by the satellite observations due to cloudiness. This work demonstrates that complementary information from existing transport models, satellite and surface data can yield a consistent picture of the dust transport from the Patagonia desert to Antarctica. It also illustrates the limitation of using any of these approaches individually to characterize the transport of dust in a heavily cloudy area.

Objetivos: Describir en un Hospital de Media y Larga Estancia (HMLE) los resultados iniciales tras la implantación de un programa de valoración e intervención sobre la disfagia y conocer que variables mostraban diferencias significativas entre los enfermos con y sin disfagia así detectados. Métodos: Estudio descriptivo retrospectivo de la valoración realizada a los pacientes con sospecha de disfagia y de la intervención posterior en los que esta se confirmó. Se usó para dicha valoración un método clínico estandarizado que utiliza diferentes viscosidades y volúmenes. Tras su confirmación se llevaron a cabo cuidados dietéticos, posturales y formativos. Se recogieron variables demográficas, clínicas y de laboratorio. Resultados: Se incluyó a 146 pacientes, describiéndose sus correspondientes valoraciones y las intervenciones en los 110 que presentaron disfagia. Esto representó una prevalencia de disfagia del 14,8% de los pacientes ingresados. En el análisis univariante entre los pacientes con y sin disfagia, los primeros presentan al ingreso mayor presencia de sonda de alimentación (p 0,011) y menor proporción de deterioro cognitivo leve (p 0,048); y al alta menor recuperación funcional (p < 0,01) y mayor presencia de sonda de alimentación (p 0,028), de desnutrición (p < 0,01) y de mortalidad (p 0,02). Conclusiones: Para mejorar la calidad asistencial en HMLE es recomendable la implantación de un programa de atención a la disfagia, dada su frecuente presencia e importantes repercusiones clínicas. La disfagia detectada se relacionó con la presencia de sonda de alimentación y tuvo claras implicaciones evolutivas a nivel funcional, nutricional y de pronóstico vital.Objectives: To describe the initial results of the implementation of a dysphagia assessment and intervention programme and to know which variables showed significant differences between patients with and without dysphagia detected by this way at an intermediate and long stay hospital. Methods: Descriptive and retrospective study on the assessment performed to patients suspected of having dysphagia and of the subsequent intervention done on those in whom it was confirmed. A standardized clinical method using different viscosities and volumes was used. After confirming the condition, different dietary, postural, and educational cares were undertaken. Demographical, clinical, and analytical variables were registered. Results: 146 patients were included, 110 of them presenting dysphagia of whom the corresponding assessments and interventions were described. This represented a dysphagia prevalence of 14.8% among all admitted patients. The univariate analysis between patients with and without dysphagia showed that the former presented at the time of admission a higher prevalence of a feeding tube (p = 0.011) and a lower proportion of mild cognitive impairment (p = 0.048); and at the time of hospital discharge, lower functional recovery (p < 0.01) and higher presence of a feeding tube (p = 0.028), hyponutrition(p < 0,01), and mortality (p = 0.02). Conclusions: Given its frequent presentation and important clinical repercussion, and in order to improve health care quality at ILSH, the implementation of a dysphagia care programme is advisable. The dysphagia detected was correlated with the presence of a feeding tube and had clear implications on the clinical course at a functional and nutritional level and vital prognosis.

A chronology called EDML1 has been developed for the EPICA ice core from Dronning Maud Land (EDML). EDML1 is closely interlinked with EDC3, the new chronology for the EPICA ice core from Dome-C (EDC) through a stratigraphic match between EDML and EDC that consists of 322 volcanic match points over the last 128 ka. The EDC3 chronology comprises a glaciological model at EDC, which is constrained and later selectively tuned using primary dating information from EDC as well as from EDML, the latter being transferred using the tight stratigraphic link between the two cores. Finally, EDML1 was built by exporting EDC3 to EDML. For ages younger than 41 ka BP the new synchronized time scale EDML1/EDC3 is based on dated volcanic events and on a match to the Greenlandic ice core chronology GICC05 via 10Be and methane. The internal consistency between EDML1 and EDC3 is estimated to be typically ~6 years and always less than 450 years over the last 128 ka (always less than 130 years over the last 60 ka), which reflects an unprecedented synchrony of time scales. EDML1 ends at 150 ka BP (2417 m depth) because the match between EDML and EDC becomes ambiguous further down. This hints at a complex ice flow history for the deepest 350 m of the EDML ice core.

The EPICA (European Project for Ice Coring in Antarctica) Dome C drilling in East Antarctica has now been completed to a depth of 3260 m, at only a few meters above bedrock. Here we present the new EDC3 chronology, which is based on the use of 1) a snow accumulation and mechanical flow model, and 2) a set of independent age markers along the core. These are obtained by pattern matching of recorded parameters to either absolutely dated paleoclimatic records, or to insolation variations. We show that this new time scale is in excellent agreement with the Dome Fuji and Vostok ice core time scales back to 100 kyr within 1 kyr. Discrepancies larger than 3 kyr arise during MIS 5.4, 5.5 and 6, which points to anomalies in either snow accumulation or mechanical flow during these time periods. We estimate that EDC3 gives accurate event durations within 20% (2σ) back to MIS11 and accurate absolute ages with a maximum uncertainty of 6 kyr back to 800 kyr.

A common time scale for the EPICA ice cores from Dome C (EDC) and Dronning Maud Land (EDML) has been established. Since the EDML core was not drilled on a dome, the development of the EDML1 time scale for the EPICA ice core drilled in Dronning Maud Land was based on the creation of a detailed stratigraphic link between EDML and EDC, which was dated by a simpler 1D ice-flow model. The synchronisation between the two EPICA ice cores was done through the identification of several common volcanic signatures. This paper describes the rigorous method, using the signature of volcanic sulfate, which was employed for the last 52 kyr of the record. We estimated the discrepancies between the modelled EDC and EDML glaciological age scales during the studied period, by evaluating the ratio R of the apparent duration of temporal intervals between pairs of isochrones. On average R ranges between 0.8 and 1.2 corresponding to an uncertainty of up to 20% in the estimate of the time duration in at least one of the two ice cores. Significant deviations of R up to 1.4–1.5 are observed between 18 and 28 kyr before present (BP), where present is defined as 1950. At this stage our approach does not allow us unequivocally to find out which of the models is affected by errors, but assuming that the thinning function at both sites and accumulation history at Dome C (which was drilled on a dome) are correct, this anomaly can be ascribed to a complex spatial accumulation variability (which may be different in the past compared to the present day) upstream of the EDML core.

A study of the electrostatic force between an Electrostatic Force Microscope tip and a dielectric thin film with finite conductivity is presented. By using the Thomas-Fermi approximation and the method of image charges, we calculate the electrostatic potential and force as a function of the thin film screening length, which is a magnitude related to the amount of free charge in the thin film and is defined as the maximum length that the electric field is able to penetrate in the sample. We show the microscope’s signal on dielectric films can change significantly in the presence of a finite conductivity even in the limit of large screening lengths. This is particularly relevant in determining the effective dielectric constant of thin films from Electrostatic Force Microscopy measurements. According to our model, for example, a small conductivity can induce an error of more than two orders of magnitude in the determination of the dielectric constant of a material. Finally, we suggest a method to discriminate between permittivity and conductivity effects by analyzing the dependence of the signal with the tip-sample distance.

El empleo de dos mamarias ha demostrado mayor permeabilidad a largo plazo, aunque con un mayor riesgo de complicaciones esternales. Estudiaremos si la asociación de factores de riesgo (FR) de dehiscencia preoperatorios, especialmente la tríada obeso-EPOC/fumador-diabetes (OB-DM-EP) es motivo suficiente para descartar una revascularización con doble mamaria. Material y métodos: Analizamos enfermos sometidos sólo a revascularización coronaria durante 6 años según el número de mamarias: mamaria simple (MS) – doble mamaria (MD). Recopilamos sus FR: mujer, anciano, obeso, diabetes, EPOC, fumador, insuficiencia renal, enfermedad vascular periférica (EVP), shock preoperatorio, fracción de eyección (FE) deprimida, reintervención, técnica de disección. Definimos grupos de alto riesgo: a) tres o más FR, y b) tríada OB-DM-EP. Recopilando las complicaciones esternales y mortalidad. Resultados: Estudiamos 688 pacientes: MS 520 (75,58%), MD 168 (24,41%). Presencia tres o más FR: MS 149 (28,65%), MD 8,92% (p

Ex vivo fusion confocal microscopy (EVFCM) enables the rapid examination of breast tissue and has the potential to reduce the surgical margins and the necessity for further surgeries. Traditional methods, such as frozen section analysis, are limited by the distortion of tissue and artefacts, leading to false negatives and the need for additional surgeries. This study on observational diagnostic accuracy evaluated the ability of EVFCM to detect breast cancer. A total of 36 breast tissue samples, comprising 20 non-neoplastic and 16 neoplastic cases, were analysed using EVFCM and compared to the results obtained from routine histopathology. A Mohs surgeon experienced in EVFCM (evaluator A) and two breast pathologists unfamiliar with EVFCM (evaluators B and C) performed blinded analyses. EVFCM showed high concordance with the histopathology and the detection of neoplasia, with significant kappa values ( p < 0.001). Evaluator A achieved 100% sensitivity and specificity. Evaluators B and C achieved a sensitivity of >87%, a specificity of >94%, positive predictive values of >95%, and negative predictive values of 81% and 94%, respectively. EVFCM therefore offers a promising technique for the assessment of margins in breast-conserving surgery. Its widespread adoption could significantly reduce re-excisions, lower healthcare costs, and improve cosmetic and oncological outcomes.

Purpose: The lack of validated surrogate biomarkers is still an unmet clinical need in the management of early breast cancer cases that do not achieve complete pathological response after neoadjuvant chemotherapy (NACT). Here, we describe and validate the use of SAMHD1 expression as a prognostic biomarker in residual disease in vivo and in vitro., Methods: SAMHD1 expression was evaluated in a clinical cohort of early breast cancer patients with stage II-III treated with NACT. Heterotypic 3D cultures including tumor and immune cells were used to investigate the molecular mechanisms responsible of SAMHD1 depletion through whole transcriptomic profiling, immune infiltration capacity and subsequent delineation of dysregulated immune signaling pathways., Results: SAMHD1 expression was associated to increased risk of recurrence and higher Ki67 levels in post-NACT tumor biopsies of breast cancer patients with residual disease. Survival analysis showed that SAMHD1-expressing tumors presented shorter time-to-progression and overall survival than SAMHD1 negative cases, suggesting that SAMHD1 expression is a relevant prognostic factor in breast cancer. Whole-transcriptomic profiling of SAMHD1-depleted tumors identified downregulation of IL-12 signaling pathway as the molecular mechanism determining breast cancer prognosis. The reduced interleukin signaling upon SAMHD1 depletion induced changes in immune cell infiltration capacity in 3D heterotypic in vitro culture models, confirming the role of the SAMHD1 as a regulator of breast cancer prognosis through the induction of changes in immune response and tumor microenvironment., Conclusion: SAMHD1 expression is a novel prognostic biomarker in early breast cancer that impacts immune-mediated signaling and differentially regulates inflammatory intra-tumoral response., (© 2023. The Author(s).)

The aim of our study was to describe the incidence of infectious complications of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) and to analyze the potential risk factors in a prospective cohort of patients., Methods: We conducted a prospective multicenter study, with all consecutive patients referred for an EBUS-TBNA with patients at risk of developing an infectious complication (considering>10 nodal samplings, known immunosuppression, bronchial colonization and cavitated or necrotic lesions) and a second group without any risk factor., Results: Three hundred seventy patients were included: 245 with risk factors and 125 without risk factors (as the control group). Overall, 15 patients (4.05%) presented an acute infectious complication: fourteen in cases (5.7%) and 1 in controls (0.8%). Of these, 4 patients presented pneumonia, 1 mediastinitis, 4 obstructive pneumonitis and 6 mild complications (respiratory tract infection that resolved with antibiotic). Also 7 (1.9%) patients had self-limited fever. One-month follow-up showed 1 mediastinitis at sixteenth day post-EBUS, which required surgical treatment, and 3 pneumonias and 3 respiratory tract infections at nineteenth day (1.9%). All patients had a good evolution and there were no deaths related with infectious complication. We observed an increased risk of complication in patients with risk factors and in patients with necrosis (p=0.018)., Conclusions: The incidence of infectious complications in a subgroup of patients with risk factors was higher than in patients without risk factors. Nevertheless, it remains low, and no fatal complication occurred, which reinforces the idea that EBUS-TBNA is a safe technique for the assessment of the mediastinum. Necrotic lesions are a risk factor of post-EBUS infection, and their puncture should be avoided., (Copyright © 2022 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)

HIV-infected individuals could be at a greater risk for developing lung cancer than the general population due to the higher prevalence in the former of human papillomavirus (HPV) in the oral cavity and higher smoking rates. Our aim was to assess HPV prevalence and E6 viral oncogene transcription in lung cancer samples from HIV-infected individuals. This was a single-center, retrospective study of a cohort of HIV-1-infected patients diagnosed with and treated for lung cancer. Pathological lung samples archived as smears or formalin-fixed paraffin-embedded blocks were subjected to HPV genotyping, detection of human p16 protein and assessment for HPV E6 mRNA expression. Lung cancer samples from 41 patients were studied, including squamous cell carcinoma (32%), adenocarcinoma (34%), non-small cell cancer (27%), and small cell cancer (7%). HPV DNA was detected in 23 out of 41 (56%, 95% CI 41-70%) of samples and high-risk (HR)-HPV types were detected in 16 out of 41 (39%, 95% CI 26-54%), HPV-16 being the most prevalent [13/16 (81.3%, 95% CI 57.0-93%]. In samples with sufficient material left: expression of p16 was detected in 3 out of 10 (30%) of HR-HPV DNA-positive tumors and in 3 out of 7 (43%) of the negative ones; and E6 mRNA was detected in 2 out of 10 (20%) of HPV-16-positive samples (squamous lung cancers). These two patients had a background of a previous HPV-related neoplasia and smoking. HR-HPV DNA detection was prevalent in lung cancers in HIV-infected patients. However, viral oncogene expression was limited to patients with previous HPV-related cancers., (© 2022. The Author(s).)

Introduction: Cytological samples obtained by endobronchial ultrasound (EBUS) are capital for diagnosis, staging and molecular profile in non-small cell lung carcinoma (NSCLC)., Objective: To assess the success rate of complete, partial and individual of molecular analysis in samples obtained by EBUS-guided transbronchial needle aspiration (TBNA) and/or by oesophageal ultrasound-guided fine needle aspiration with an echobronchoscope (EUS-B-FNA) in patients with NSCLC., Methods: Prospective study including 90 patients with non-squamous NSCLC, or non-smoking squamous. Cytological samples were classified into two groups. Group 1: PEN membrane slide and/or cell blocks for the determination of mutations of EGFR, KRAS, ERBB2 and BRAF. Group 2: silane coated slides or cell blocks for rearrangements of ALK, ROS1 and MET amplification., Results: The success rate was 78.6% for 4 molecular alterations (EGFR, KRAS, ALK and ROS1), and 44% for 7 determinations. The individual success rate for EGFR was 97%, KRAS 96.3%, ALK 85%, ROS1 82.3%, ERBB2 71.4%, BRAF 67.7% and MET 81.1%. There were no significant differences (p=0.489) in the number of molecular analyses (1-3 vs. 4) in group 1, depending on the types of samples (cell block vs. PEN membrane slide vs. cell block and PEN membrane slide)., Conclusions: In patients with NSCLC, the cytological material obtained by ultrasound-guided needle aspiration is sufficient for individual and partial molecular analysis in the vast majority of cases. Membrane slides such as cell blocks are valid samples for molecular analysis., (Copyright © 2020 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)

Microcalcifications are detected through mammography screening and, depending on their morphology and distribution (BI-RADS classification), they can be considered one of the first indicators of suspicious cancer lesions. However, the formation of hydroxyapatite (HAp) calcifications and their relationship with malignancy remains unknown. In this work, we report the most detailed three-dimensional biochemical analysis of breast cancer microcalcifications to date, combining 3D Raman spectroscopy imaging and advanced multivariate analysis in order to investigate in depth the molecular composition of HAp calcifications found in 26 breast cancer tissue biopsies. We demonstrate that DNA has been naturally adsorbed and encapsulated inside HAp microcalcifications. Furthermore, we also show the encapsulation of other relevant biomolecules in HAp calcifications, such as lipids, proteins, cytochrome C and polysaccharides. The demonstration of natural DNA biomineralization, particularly in the tumor microenvironment, represents an unprecedented advance in the field, as it can pave the way to understanding the role of HAp in malignant tissues.

Objective: To review the embryology, the clinical findings and the appearance in multidetector computed tomography (MDCT) of complicated Meckel's diverticulum (DM) in adults., Conclusion: The presence of an MD in a MDCT should be suspected when a blind tubular structure connected to the terminal ileum by a neck of variable size is observed. Multiplanar 2D reconstructions images and CT enterography can help in the diagnosis. In patients with symptoms of obstruction or intestinal inflammation, the possibility of a complication secondary to a MD should be considered, especially when the terminal ileum and the vermiform appendix are normal. MDCT angiography, in cases of acute gastrointestinal bleeding, can identify contrast extravasation and accumulation of blood in the MD, and could demonstrate the persistent omphalomesenteric artery, which is diagnostic of MD. Other MDCT findings such as the presence of enteroliths or associated inflammatory changes around the MD can facilitate the preoperative diagnosis of MD complications., (Copyright © 2019. Publicado por Elsevier España, S.L.U.)

Objective: The study aim was to establish Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value (NPV), and Accuracy Values of both imprint cytology (IC) and the OSNA assay for intraoperative assessment of axillary sentinel node (SN) cancer involvement in breast cancer. Specifically, we wished to find out if true positive and false negative results of IC were associated to axillary lymphadenectomy (ALND). Also, we addressed a comparative cost analysis between techniques., Methods: 244 patients treated for breast cancer in the Breast Unit of Hospital Germans Trias i Pujol from 2011 to 2015 were prospectively included. A transversal, consecutive design was applied to assess IC compared to the reference test (OSNA). Inclusion criteria were: T1 and T2 tumors with negative nodes, both clinically and on ultrasound., Results: Sensitivity of IC for macrometastases was 70%. The NPV of IC for macrometastases was 95,75%. Accuracy of IC was 96,12%. In the comparative cost analysis, the release time of results for OSNA doubled that of IC and was associated with an increased cost of € 370., Conclusions: IC has been stated as a good technique for intraoperative cancer involvement SN with high sensitivity and NPV compared to the OSNA assay. It allows keeping the whole node tissue and thus the possibility of improved histopathological evaluation, which can be useful for adjuvant, and offers the advantage of being less time consuming. Cost analysis shows a higher cost for OSNA, which may exceed the benefit of sorting out false negatives from IC., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: In breast cancer patients, the expression statuses of oestrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) are crucial in the choice of treatment. Receptor expression in metastatic lesions can differ from the primary tumour. The aim of our study was to analyse the utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to obtain samples allowing the identification of ER, PR and HER2 expression in patients with mediastinal metastases of breast cancer., Patients and Methods: The clinical files of all patients with a final diagnosis of breast cancer mediastinal metastases diagnosed by EBUS-TBNA in our institution were retrospectively analysed. The ability of EBUS-TBNA to obtain samples that allowed hormone receptor and HER2 expression analysis was calculated., Results: Twenty-four patients were included. ER, PR and HER2 assessments could be performed in 22, 20 and 22 patients, respectively. In 20 of the 24 patients it was possible to investigate all three types of receptor expression. In the remaining four cases, where ER, PR or HER2 expression tests could not be performed, it was due to a lack of tissue. In cases with adequate results for EBUS-TBNA and the primary tumour agreement was greater for ER (16/19) and HER2 (12/14) than PR (8/17). Based on receptor status, there was a change in the choice of treatment for five patients., Conclusion: In patients with breast cancer mediastinal metastases, ER, PR and HER2 expression can be assessed in samples obtained by EBUS-TBNA whenever a sufficient tissue sample is collected., (© 2017 John Wiley & Sons Ltd.)