Clasificación y características del cáncer de intervalo en el programa de detección precoz de cáncer de mama en el Principado de Asturias

Objective

To review and classify the interval cancers found in the Principality of Asturias's Breast Cancer Screening Program (PDPCM). A secondary objective was to determine the histological characteristics, size, and stage of the interval cancers at the time of diagnosis.

Material and methods

We included the interval cancers in the PDPCM in the period 2003-2007. Interval cancers were classified according to the breast cancer screening program protocol, with double reading without consensus, without blinding, with arbitration. Mammograms were interpreted by 10 radiologists in the PDPCM.

Results

A total of 33.7% of the interval cancers could not be classified; of the interval cancers that could be classified, 40.67% were labeled true interval cancers, 31.4% were labeled false negatives on screening, 23.7% had minimal signs, and 4.23% were considered occult. A total of 70% of the interval cancers were diagnosed in the year of the period between screening examinations and 71.7% were diagnosed after subsequent screening. A total of 76.9% were invasive ductal carcinomas, 61.1% were stage II when detected, and 78.7% were larger than 10 mm when detected.

Conclusions

The rate of interval cancers and the rate of false negatives in the PDPCM are higher than those recommended in the European guidelines. Interval cancers are diagnosed later than the tumors detected at screening. Studying interval cancers provides significant training for the radiologists in the PDPCM.     

Fracture de fatigue de l'humérus. À propos de trois cas

Three cases of stress fractures of the humeral shaft are reported. The first, a complete spiroid fracture, was observed after a rope climbing exercise following an intensive training period. The two others, radiologically not so spectacular, occurred during the first weeks of this training. The three fractures represent the three different clinical stages. Intensive training and repetitive stress won over an otherwise wonderfully adapted bone structure. Treatment remains orthopaedic, even in the case of the spiroid fracture, with a perfect functional result.     

Extravasación de medios de contraste intravenosos en el sitio de la punción: Protocolo de actuación

The incidence of contrast medium extravasation at the venipuncture site has increased with the generalized use of automatic injectors. Most extravasations only cause slight edema and erythema. Nevertheless, in some cases extravasation can result in severe skin lesions or even in compartment syndrome. Lesions caused by extravasation usually resolve spontaneously with conservative treatment. Although the complications of extravasation are well known, institutional protocols are normally lacking and the criteria for taking action and the type of treatment, whether based on the literature or personal preferences, tend to vary. In this article, we review the incidence, risk factors, clinical manifestations, and options for preventing and treating contrast medium extravasation in soft tissues. Finally, we present the protocol we use to manage extravasation at our hospital.     

Puissance critique de l’enfant prépubère et de l’adulte

Aim

The aim of the study was to compare aerobic and anerobic abilities of prepubertal children and adults with the critical power concept.

Methods

Sixteen children (10.3 ± 0.9 years) and 15 adults (23.5 ± 3.6 years) performed five tests: a maximal-graded test and four constant load exercises until exhaustion. Critical power (CP) and anaerobic-work capacity (CTA) were determined from the power-1/time (P-t) linear relationship.

Results

Determination coefficients for P-t were 0.94 ± 0.05 in children and 0.96 ± 0.04 in adults. PC values were significantly (p < 0.01) lower in children (2.7 ± 0.4 W/kg) than in adults (3.1 ± 0.3 W/kg). CTA values were significantly (p < 0.001) lower in children (136.4 ± 50.8 J/kg) than in adults (247.1 ± 45.7 J/kg).

Conclusion

Satisfying determination coefficients for CP and CTA were found in children and adults. Children have a lower CP and CTA than adults. This result is in accordance with literature.     

Técnicas de recanalización vertebrobasilar antes de la introducción de las endoprótesis recuperadoras: la reapertura no es sinónimo de buena evolución

Objectives

To evaluate the recanalization rate and clinical outcome three months after endovascular treatment for vertebrobasilar occlusion before the placement of stentrievers.

Material and methods

We reviewed all cases of basilar thrombosis treated with endovascular techniques at our center. We reviewed the clinical outcomes with the main objective of determining the recanalization rate and the secondary objective of evaluating the outcome using the modified Rankin scale (mRS) three months after treatment. We assessed clinical and angiographic variables and correlated them with outcome and complications.

Results

We reviewed a total of 27 consecutive patients (mean age, 58.1 ± 15.5 y; median National Institutes of Health Stroke Scale (NIHSS), 21, interquartile range, 18-29; median Glasgow coma score (GCS) 7, interquartile range, 4-9.5). The mean time between the onset of symptoms and endovascular treatment was 26.3 ± 41.7 hours. Complete or partial recanalization was achieved in 23 (85.1%) patients. Three months after treatment, 16 (59.2%) had died and 6 (22.2%) had good outcome (mRS ≤ 2).

Conclusion

Endovascular treatment achieved a high rate of recanalization of occlusions of the basilar artery. Nevertheless, a high percentage of the patients did not have a good outcome. New materials might improve the prognosis in these patients.