Ultrasonographic Identification of Shell Surface Types in Commercially Available Silicone Gel-Filled Breast Implants.

BACKGROUND: Breast implant safety issues have resulted in the need for global product recalls and medical device tracing. Conventional methods of breast implant tracing, have to date proven to be unsuccessful. This study aims to evaluate the effectiveness of high-resolution ultrasound (HRUS) screening in identifying implanted breast devices. METHODS: Data from 113 female patients undergoing preoperative ultrasound screening for secondary breast surgery between 2019 and 2022 was prospectively reviewed to evaluate the effectiveness of HRUS imaging with the aid of a sonographic surface catalog to identify the surface and brand type of implanted breast devices. To corroborate the findings and assess the reproducibility of the approach, further evaluations were replicated in New Zealand white rabbits and compared with the results found in humans. RESULTS: In the human recipients, implant surface and brand types were correctly identified by ultrasound imaging in 99% (112 of 113) and 96% (69 of 72) of the cases, either consultation-only or revision, respectively. This constituted an overall success rate of 98% (181 of 185). Furthermore, in a corroborating New Zealand white rabbit model where full-scale commercial implants were introduced and monitored over many months, from the total 28 analyzed, the surface was accurately identified in a total of 27 cases (the one failure being before generation of a sonograph surface catalogue), demonstrating an overall success rate of 96.4%. CONCLUSION: HRUS is, therefore, a valid and first-hand tool for breast implant imaging that can correctly evaluate both surface type and brand type alongside other variables such as implant placement, positioning, flipping, or rupture. CLINICAL RELEVANCE STATEMENT: HRUS is a valid and first-hand tool for the identification and traceability of breast implants that evaluates surface type and brand type. This low-cost, accessible, and reproducible practice provides patients with peace of mind and surgeons with a promising diagnostic tool.

Cáncer de mama inflamatorio: un reto diagnóstico y terapéutico / Inflammatory breast cancer: a diagnostic and therapeutic challenge

El cáncer de mama inflamatorio (IBC) es una rara enfermedad que afecta a mujeres a temprana edad. Actualmente a pesar de los esfuerzos para establecer criterios para el diagnóstico de IBC, es una entidad difícil de diagnosticar debido a su poca frecuencia de presentación, a los hallazgos clínicos, patológicos y radiológicos escasos, y a la carencia de estudios que describan el IBC por si solo y no como parte de cáncer de mama localmente avanzado (LABC). Por ende, usualmente es un diagnóstico tardío y debido a su agresividad, el pronóstico de IBC suele ser malo. El propósito de esta revisión es describir acerca del adecuado diagnóstico y los avances del manejo a través de los años, de esta frecuentemente olvidada enfermedad...

Inflammatory Breast Cancer (IBC) is a rare disease that affects women in an early age. Currently despite efforts to establish the criteria for IBC diagnosis, results a very difficult Cancer to diagnose because has no specific characteristic in clinical, pathological and image studies, in addition to the lack of investigations describing IBC itself and not as part of Locally Advanced Breast Cancer (LABC). Due to the motioned facts, IBC occurs as a delayed diagnosis, for this reason and its aggressiveness IBC has a poor survival. This review, pretends to describe the appropriate diagnose and new treatments of this often forgotten cancer...

Tosferina, una enfermedad prevalente / Whooping cough, a prevalent disease

El incremento a nivel mundial de vacunación contra tosferina ha reducido sustancialmente la morbilidad y mortalidad asociada a esta enfermedad. Sin embargo, en los últimos años, el patrón epidemiológico de esta en países con altas tasas de vacunación ha cambiado radicalmente. Se ha postulado que la pérdida de inmunidad en adolecentes y adultos ha permitido que estos actúen como reservorios transmitiendo así la enfermedad a la población más susceptible. Costa Rica no es la excepción, según datos del Ministerio de Salud la cantidad de casos reportados de tosferina ha aumentado notablemente en los últimos años. Existen múltiples test de laboratorio utilizados para el diagnóstico de la enfermedad, todos con sus ventajas y desventajas, por lo cual los expertos recomiendan el uso combinado de estos según la etapa en que se encuentra la enfermedad para aumentar así las probabilidades diagnósticas. Estos planteamientos así como los aspectos más importantes de esta enfermedad se discuten a continuación...

An increase on vaccionation worldwide has significantly reduced the sickness rate and mortality due to tosferine. However, during last years, the epidimiolgy of this disease in countries with high vaccination coverage has changed, with a trend to increase. It has been proposed the adolescents and adults that lose their inmunity function as reservoirs of the disease, increasing the contagion to more susceptible individual such as children. According to the Costa Rican Ministry of Health, the incidence of the disease has increased substantially during last years, becoming a public health problem. For the diagnosis of the disease there are multiple tests available, each one with its’ advantages and disadvantages, according to the experts the recommendation is to combine them so that a certain diagnostic can be achieved. These hypothesis and the key elements of tosferine are discussed in this article...