Respuesta de los hemangiomas hepáticos inducida por la quimioterapia adyuvante empleada en el tratamiento de los tumores germinales

Liver hemangiomas are the most common benign primary tumors of the liver. Due to their high prevalence, incidental finding of hemangiomas during radiological workup of oncologic patients is not uncommon. We present the case of a patient diagnosed of an ovarian immature teratoma and hepatic lesions with typical radiological appearance of hemangiomas that decreased in size during adjuvant chemotherapy with BEP regimen (cisplatin, etoposide and bleomycin). Chemotherapy-induced shrinkage of hepatic hemangiomas can mimic the response of liver metastases to chemotherapy and may induce erroneous interpretations. The purpose of this report is to describe a chemotherapy-induced response of liver hemangiomas, especially when BEP combination is used. To date this observation has been barely reported in the literature and, to our knowledge, this is the first documented case of chemotherapy-induced response of liver hemangiomas in a patient diagnosed of an ovarian immature teratoma.     

El nuevo formato de los documentos de evaluación de la formación sanitaria especializada: una revolución inadvertida

The recent publication of the resolution through which the basic directives about the contents of the documents to accredit the assessments of specialists in training maintains the model but incorporates new elements that enable important changes in the assessment.The resolution has errors and is confusing because the rules are hidden in the instructions for filling out the forms and in footnotes. Nevertheless, the resolution is more than a simple change in the forms: it is a step toward a more current assessment based on the evaluation of residents’ competence. The most significant changes are a stronger role for collaborating teachers, an increase in the number of possible reasons for negative assessments, and the establishment of the rotation as the basic unit of analysis.     

Neurolinfomatosis de los nervios ciático y mediano como presentación inicial del linfoma de linfocitos B

Neurolymphomatosis (NL) is the infiltration of cranial nerves or nerves and roots from the peripheral nervous system by lymphoma, usually by B-cell non-Hodgkin's lymphoma. It is uncommon as initial presentation of the disease and can lead to extremely heterogeneous clinical manifestations. We report the case of a 72-year old male who presented with numbness of the right hand, progressive weakness in both lower limbs and weight loss. 18F-FDG PET/CT showed bilateral hypermetabolic adrenal masses, gastric ulcer, small hypermetabolic adenopathies, multiple focal bone marrow uptake and intense uptake in both sciatic nerves and right median nerve. A node and gastric biopsy confirmed diffuse large-B-cell lymphoma, activated B cell type, with posterior resolution of peripheral nerves uptake after beginning chemotherapy.     

Sintomatología derivada de los pares craneales: Clínica y topografía

The detection of pathological conditions related to the twelve cranial pairs represents a significant challenge for both clinicians and radiologists; imaging techniques are fundamental for the management of many patients with these conditions. In addition to knowledge about the anatomy and pathological entities that can potentially affect the cranial pairs, the imaging evaluation of patients with possible cranial pair disorders requires specific examination protocols, acquisition techniques, and image processing.This article provides a review of the most common symptoms and syndromes related with the cranial pairs that might require imaging tests, together with a brief overview of the anatomy, the most common underlying processes, and the most appropriate imaging tests for different indications.     

Valoración del grado de resección de los macroadenomas hipofisarios en la resonancia magnética posquirúrgica inmediata

Objective

To evaluate if it is possible to determine the extent of pituitary macroadenomas resection in the immediate postoperative pituitary magnetic resonance imaging (MRI).

Manejo práctico de los nódulos pulmonares en las neoplasias pediátricas más frecuentes

In pediatric patients with sarcomas, hepatoblastomas, or other types of primary tumors, lung metastases are often found at diagnosis or during follow-up. The wide variety of primary tumors and clinical situations makes management and follow-up of these patients challenging. Chest CT is the best way to detect the dissemination of disease to the lungs. Many pulmonary nodules are nonspecific, and many might not be pathological. Others have characteristics that make them suspicious. Although there are some general features that indicate that a pulmonary nodule is likely to be a metastasis, sometimes the meaning of these features depends on the primary tumor. Furthermore, metastases can develop during the course of the disease, and the protocols for follow-up are different for different primary tumors. We review the different protocols used at our hospital for the primary tumors that most often metastasize to the lungs, including the criteria for lung metastases and the follow-up for each primary tumor.     

Metástasis única en los huesos carpianos como primera manifestación clínica de un hepatocarcinoma

Hepatocellular carcinoma is the most common primary tumor of the liver. Spreading outside the liver usually takes place in advanced stages of the disease, and bone is the third most common site of metastases. We present a case of hepatocellular carcinoma in which the first clinical manifestation was a single metastasis to the carpal bones. The interest of this case lies in the way this hepatocellular carcinoma manifested as well as in the unusual site of the metastasis.     

Valoración de los factores pronósticos radiopatológicos del cáncer de mama triple negativo y análisis del carcinoma in situ como factor pronóstico

ObjectivesTo analyze what factors in magnetic resonance imaging (MRI) and histological study of triple-negative breast cancers are related to tumor recurrence and to shorter disease-free survival. To analyze survival and recurrence in function of the presence of an in situ component.Material and methodsThis was a retrospective study of MRI staging examinations in 122 women with triple-negative breast cancer done from 2007 through 2014. In the MRI, we evaluated morphological variables (size, margins, morphology, internal signal in T2-weighted sequences) and dynamic variables (perfusion and diffusion). In the histological study, we evaluated Ki67, p53, CK5/6, nuclear grade, and Scarff-Bloom grade, as well as the presence of an in situ component and tumor grade (high grade or not high grade). We compared the variables between patients with tumor recurrence and those without, and we conducted a survival analysis.ResultsNon-nodular enhancement was more common in patients with tumor recurrence (p  = 0.038) and was associated with shorter disease-free survival (p = 0.023). Neither diffusion restriction (p = 0.079) nor ki67 (p = 0.052) was associated with a worse prognosis. An in situ component was detected in 44% of triple-negative tumors, and a greater proportion of patients in the group with tumor recurrence had an in situ component; however, the presence of an in situ component was not associated with shorter survival (p = 0.185).ConclusionNon-nodular enhancement was associated with a worse prognosis. Diffusion restriction, ki67, and the presence of an in situ component were not associated with shorter disease-free survival.     

Syndrome de loge chronique de l'avant-bras : proposition d'un test de provocation. À propos de deux observations

Objectives – Proposal a new dynamic test pour clinical diagnostic of chronic compartment syndrome of forearm.Methods – Anterio compartment syndrom of the forearm are not documented in the literature. Two observations of this syndromes are described concerning sportsmen the motocross practising. History and a new provacation test and finally tissue compartment pressure measurement leaded to confirm this pathology. Aponevrotomy was successfully achived, patients went to their previous activities.Conclusion – The this test of provocation impose it on a number of patients of validation of more important.     

Imagerie de la trachée de l'adulte

Imaging of normal and pathologic trachea at the thoracic and cervical levels is described extensively. Beside congenital abnormalities discovered in adulthood, acquired tracheal abnormalities are artificially divided in two subgroups. One group consists of diffuse abnormalities, with all but one diseases associated with a diffuse narrowing of the tracheal lumen. The other group comprises focal abnormalities that lead to tracheal stenoses of various lengths, with a postintubation stenosis as probably the most frequent cause, followed by tumours. The main modality for tracheal imaging is now multidetector-row spiral CT. This technique allows for faster volume coverage and higher spatial and temporal resolution. The improved spatial resolution impacts on both axial images and all reconstructions techniques that have become indispensable for interpretation of a vertical structure such as the trachea. Chest X-ray is no longer the frontline imaging technique. MRI has not yet reached all its potential as compared to CT.     

Percepciones de estudiantes de Medicina sobre el impacto de la inteligencia artificial en radiología

ObjectivesTo analyze medical students’ perceptions of the impact of artificial intelligence in radiology.Material and methodsA structured questionnaire comprising 28 items organized into six sections was distributed to students of medicine in Spain in December 2019.ResultsA total of 341 students responded. Of these, 27 (7.9%) included radiology among their three main choices for specialization, and 51.9% considered that they clearly understood what artificial intelligence is. The overall rate of correct answers to the objective true-or-false questions about artificial intelligence was 70.7%. Whereas 75.9% expressed their disagreement with the hypothesis that artificial intelligence would replace radiologists, only 41.9% disagreed with the hypothesis that the demand for radiologists would decrease in the future. Only 36.7% expressed concerns about the role of artificial intelligence related to choosing radiology as a specialty. A greater proportion of students in the early years of medical school agreed with statements that radiologists accept artificial-intelligence-related technological changes and work with the industry to apply them as well as with statements about the need to include basic training about artificial intelligence in the medical school curriculum.ConclusionsThe students surveyed are aware of the impact of artificial intelligence in daily life, but not of the current debate about its potential applications in radiology. In general, they think that artificial intelligence will revolutionize radiology without having an alarming effect on the employability of radiologists. The students surveyed think that it is necessary to provide basic training about artificial intelligence in undergraduate medical school programs.     

Effet de l’intensité de course sur la force de poussée en rugby

Introduction. – The rugby is a discipline requiring, in the same time, strength qualities and a high aerobic capacity for repeating intense exercises over 2 × 40 min.Synthesis of the facts. – Fourteen rugby players performed a maximal progressive test of journey (running) then two sequences of 40 min, respectively, to 60% and 80% of HR_max, interrupted with pushes on a yoke with constraint gauges. At 80% HR_max, the mean scrummaging force (1466 ± 244 N) was lower (P < 0.05) than at 60% HR_max (1523 ± 266 N).Conclusion. – The qualities of specific force are directly affected by the intensity of running. Therefore, there is a need to optimize the aerobic potential notably for the players of the first line directly concerned by the fight.