Spanish radiology residents' views on breast imaging.

OBJECTIVE: To evaluate radiology residents' opinions about breast imaging and the possibility of choosing this subspecialty after completing their residency. MATERIAL AND METHODS: We elaborated a 15-question survey aimed at radiology residents in Spain. The survey was approved by the Spanish Society of Breast Imaging (SEDIM) and the Spanish Society of Medical Radiology (SERAM), and it was disseminated by the SERAM through links to Google Forms via social networks and emails. Responses sent between February 21, 2020 and July 31, 2020 were accepted. RESULTS: A total of 72 residents responded to the survey (7.83% response rate); 69.44% of these were third- or fourth-year residents. Of the respondents, 73.61% knew about the SEDIM, and 18.06% knew about the European Society of Breast Imaging. The duration of training programs was three months for 70.83% of respondents. In 7.84% of the responses, residents stated that their supervision was less than 50%, and 70.59% of the residents stated that the rotation exceeded their expectations. One-third of the respondents would consider a fellowship in breast imaging. In all hospitals, residents did diagnostic mammography and breast ultrasound; not all did interventional procedures. Aspects of breast imaging that were rated negatively included the lack of CT studies and the possible legal repercussions of errors. Aspects that were rated positively were dynamics, interventionism, and the role of the radiologist in the process of care for patients with breast cancer. CONCLUSIONS: Most residents considered that their rotations in breast imaging exceeded their expectations; however, only a small percentage of residents would consider specializing in the field.

Spanish radiology residents' views on breast imaging. / Visión del residente de radiodiagnóstico en España sobre la radiología mamaria.

OBJECTIVE: To evaluate radiology residents' opinions about breast imaging and the possibility of choosing this subspecialty after completing their residency. MATERIAL AND METHODS: We elaborated a 15-question survey aimed at radiology residents in Spain. The survey was approved by the Spanish Society of Breast Imaging (SEDIM) and the Spanish Society of Medical Radiology (SERAM), and it was disseminated by the SERAM through links to Google Forms via social networks and emails. Responses sent between February 21, 2020 and July 31, 2020 were accepted. RESULTS: A total of 72 residents responded to the survey (7.83% response rate); 69.44% of these were third- or fourth-year residents. Of the respondents, 73.61% knew about the SEDIM, and 18.06% knew about the European Society of Breast Imaging. The duration of training programs was three months for 70.83% of respondents. In 7.84% of the responses, residents stated that their supervision was less than 50%, and 70.59% of the residents stated that the rotation exceeded their expectations. One-third of the respondents would consider a fellowship in breast imaging. In all hospitals, residents did diagnostic mammography and breast ultrasound; not all did interventional procedures. Aspects of breast imaging that were rated negatively included the lack of CT studies and the possible legal repercussions of errors. Aspects that were rated positively were dynamics, interventionism, and the role of the radiologist in the process of care for patients with breast cancer. CONCLUSIONS: Most residents considered that their rotations in breast imaging exceeded their expectations; however, only a small percentage of residents would consider specializing in the field.

Value of an abbreviated protocol of breast magnetic resonance imaging for screening high-risk patients. / Valor del protocolo abreviado de resonancia magnética mamaria en el cribado de pacientes de alto riesgo.

OBJECTIVE: Value the utility of breast MRI abbreviated protocols for the screening of breast cancer in high-risk patients compared to the full protocol. METHODS: We performed a retrospective review of 157 breast MRI of 82 high-risk patients practiced in our hospital between January 2011 and January 2017. Clinical, radiological and anatomopathological parameters were analyzed. Reading of the different protocols (MIP, abbreviated and full) was made by an expert radiologist. Subsequent statistical analysis was done. RESULTS: A total amount of 12 findings classified as BI-RADS 4 and 5 were identified and performed a biopsy, resulting 11 of them to be malignant (91.67%) and 1 benign (8.33%). The malignant wounds included 4 intraductal carcinoma (33.33%) and 7 infiltrating ductal carcinoma (58.33%). All injuries were detected with the three protocols and no significant differences were found between their respective area under the ROC curve (p=0.0650). CONCLUSIONS: In our study there are no significant differences between the different protocols (MIP, abbreviated and full), which places the abbreviated protocol as a promising tool for breast cancer screening in high-risk patients.

Infección por Helicobacter pylori (13C-UBT) y factores nutricionales y socioeconómicos asociados en escolares de estratos bajos de la ciudad de Valencia. Venezuela / Helicobacter pylori infection (13C-UBT) and its relationship with nutritional and socioeconomic factors in low income school children from Valencia venezuela

La infección con Helicobacter pylori (Hp) está altamente diseminada a nivel mundial y es considerada una de las causas principales de gastritis crónica, úlceras pépticas y duodenales y cáncer gástrico. Trabajos recientes han mostrado que esta puede tener implicaciones nutricionales, principalmente sobre el estado de hierro y otros micronutrientes. El objetivo fue evaluar la prevalencia de infección con Hp y el patrón de infección según edad, sexo, estado nutricional y condiciones socioeconómicas, en niños que asistían a Unidad Educativa "Valentín Espinal" de Valencia. Se evaluaron 170 niños entre 3 y 14 años de edad, de ambos géneros. Se determinó: Infección por Hp (test de aliento con urea-C13), edad, estado nutricional según IMC y Talla-Edad, hemoglobina (cianometahemoglobina), ferritina sérica (ELISA), estrato socioeconómico (Graffar-Méndez-Castellano), condición de vivienda, número de personas y familias que viven en el hogar y calidad de los servicios. El 78,8 por ciento de los niños estaban infectados con Hp, no encontrándose correlación significativa con el género pero si con la edad; 25,9 por ciento presentaron déficit nutricional y 46,5 por ciento talla baja, El 98,1 por ciento de las familias se encontraban en situación de pobreza (estratos IV y V) y 98 por ciento de las viviendas presentaban deficiencias sanitarias; En promedio vivían 6,0±2,4 personas en el hogar (rango: 2 a 15) y 3,2 personas compartían un mismo dormitorio. Se encontró que la probabilidad de infección era mayor en aquellos niños que presentaban déficit de talla y que el estrato socioeconómico, el nivel de instrucción materno, las precarias condiciones de alojamiento y el hacinamiento se asociaban significativamente a la infección. La deprivación socioeconómica en la niñez esta asociada con una alta colonización del Hp, la edad, el hacinamiento y un bajo nivel de instrucción de la madre pueden aumentar el riesgo a esta infección

Dietary zinc effects on zinc, calcium, and magnesium content in bones of growing rats.

The aim of the present study was to assess dietary zinc effects on femur weight and mineral content in growing rats. For this purpose, 70 weanling Sprague-Dawley rats were divided into four groups. Each group was subject to a diet containing 2 (BZ), 5 (DZ), 10 (MZ), and 30 (CZ) ppm zinc. The calcium and magnesium content in all diets was 5 g/kg and 507 mg/kg, respectively. The animals were kept on this regime for 28 d and then sacrificed and their femurs were removed for analysis using atomic absorption spectrophotometry. The weights of the BZ and DZ groups were significantly different from the MZ and CZ groups (38.5+/-10.5, 89.9+/-13.7, 118.6+/-13.6, and 134+/-19.9 g, p<0.01) respectively. There were no differences between the MZ and CZ groups. Femur weight also varied with dietary zinc, as it was significantly different among all groups (BZ, 265+/-49 mg; DZ, 380+/-40 mg; MZ, 452+/-54 mg; CZ, 735+/-66 mg; p<0.01). The femur zinc content varied with diets, following a different pattern than the above parameters. Femur zinc from the BZ group (51.5+/-5.4 ppm) was significantly different from the MZ and CZ groups (115.9+/-14.2 and 175.0+/-13.5 ppm, respectively), whereas the DZ group (62.5+/-11.3 ppm) did not differ from the other three groups. The femur content of calcium (BZ, 83.2+/-9.8 mg/g; DZ, 88.0+/-9.2 mg/g; MZ, 90.2+/-13.6 mg/g; CZ, 83.1+/-14.7 mg/g) and magnesium (BZ, 1.82+/-0.13 mg/g; DZ, 1.98+/-0.09 mg/g; MZ, 1.93+/-14 mg/g; CZ, 1.83+/-0.19 mg/g) were not significantly different among the groups, nor was the calcium-magnesium ratio. These results suggest that although dietary zinc deficiency retards growth and causes bone fragility, bone deposition of calcium and magnesium and its ratio are not affected.

Iron bioavailability from fortified fluid milk and petit suisse cheese determined by the prophylactic-preventive method.

In this research, we measure the iron bioavailability of micronized ferric orthophosphate when it is used to fortify low-fat fluid milk enriched with calcium and petit suisse cheese using the prophylactic-preventive method in rats. Four groups of male weaned rats received a basal diet (control diet; 6.5 ppm Fe), a reference standard diet (SO4Fe; 18.2 ppm Fe), a basal diet using iron-fortified fluid milk as the iron source (milk diet; Fe ppm 17.9), and a basal diet using iron-fortified petit suisse cheese as the iron source (cheese diet; 18.0 ppm Fe) for 22 d. The iron bioavailability of the different sources was calculated as the ratio between the mass of iron incorporated into hemoglobin during the experiment and the total iron intake per animal. The relative biological values with regard to the reference standard (RBV%) were 61% and 69% for the milk and cheese diet, respectively. These results show that according to this method, the iron bioavailability in both fortified foods can be considered as medium bioavailability rates.

Iron bioavailability from fortified petit suisse cheese determined by the prophylactic-preventive method.

In this research, we measured the iron bioavailability of ferrous gluconate stabilized with glycine (SFG) when it is used to fortify petit suisse cheese using the prophylactic-preventive method in rats. Three groups of male, weaned rats received a basal diet (control diet; 5.2 ppm Fe), a reference standard diet (SO4Fe; 9.2 ppm Fe), and a basal diet using iron-fortified petit suisse cheese as the iron source (cheese diet; 8.8 ppm Fe) for 22 d. The iron bioavailability was calculated as the ratio between the mass of iron incorporated into hemoglobin and the total iron intake per animal during the treatment. These values (BioFe) were 68% and 72% for SFG and ferrous sulfate, respectively. The value of the Relative Biological Value (RBV) was 95% for SFG in petit suisse cheese. These results show that according to this method, the iron bioavailability from industrial fortified petit suisse cheese can be considered as a high bioavailability rate.

[Helicobacter pylori infection (13C-UBT), and its relationship with nutritional and socioeconomic factors in low income school children from Valencia, Venezuela]. / Infección por helicobacter pylori (13C-UBT) y factores nutricionales y socioeconómicos asociados en escolares de estratos bajos de la ciudad de Valencia, Venezuela.

Helicobacter pylori infection (Hp) is widely spread around the world, and it is considered one of the main causes of chronic gastritis, peptic and duodenal ulcers, and gastric cancer. Recent research has shown that it can be associated with nutritional disorders, mainly with iron and other micronutrient deficiencies. The objective of this study was to assess the prevalence of Hp infection, and infection pattern according to age, sex, nutritional status, and socioeconomic conditions in children who attended the Unidad Educativa "Valentin Espinal" in the city of Valencia. 170 children, between 3 and 14 years of age were studied to assess Hpylori infection (13C-urea breath test), age, nutritional status according to BMI and Height for age, hemoglobin (cianometahemoglobin), serum ferritin (ELISA), socioeconomic status (Graffar-Méndez-Castellano), housing conditions, number of families and of people cohabitating in the same household, and quality of services. 78.8% of the children were infected with Hp, witch was significantly correlated with age but not gender. 25.9% of the sample had undernutrition, and 46.5% were stunted. 98.1% of the families lived in poverty, and 98% of the households showed sanitary deficiencies. A mean of 6.0 +/- 2.4 persons lived in each household (range: 2-15), and an average of 3.2 person shared bedrooms. The odds of being infected were higher in those children who were stunted. Also, socioeconomic status, mother's education level, and poor hosing conditions were significantly associated to being infected. Hpylori is highly prevalent among socially and economically deprived children, and age, overcrowding, and a low education level of the mother increases the risk of being infected.

Nutritional and technological behavior of stabilized iron-gluconate in wheat flour.

Food fortification has been shown to be an effective strategy to overcome iron malnutrition. When a new iron compound is developed for this purpose, it must be evaluated from a nutritional and technological point of view before adding it into foods. In this way, we have evaluated ferrous gluconate stabilized by glycine as a new iron source to be used in wheat flour fortification. We performed biological studies in rats as well as sensory perceptions by human subjects in wheat flour fortified with this iron source. The productions of pentane as a rancidity indicator as well as the change of the sensorial properties of the biscuits made with stabilized ferrous gluconate-fortified wheat flour were negligible. Iron absorption in water from this iron source was similar to the reference standard ferrous sulfate. Nevertheless, because of the phytic acid content, iron absorption from fortified wheat flour decrease 40% for both iron sources. The addition of zinc from different sources did not modify iron absorption from ferrous sulfate and stabilized ferrous gluconate in water and wheat flour. The iron absorption mechanism as well as the biodistribution studies demonstrate that the biological behavior of this iron source does not differ significantly from the reference standard. These results demonstrate that the iron source under study has adequate properties to be used in wheat flour fortification. Nevertheless, more research is needed before considering this iron source for its massive use in food fortification.

Determination of relative bioavailability of zinc in a petit suisse cheese using weight gain and bone zinc content in rats as markers.

The aim of the study was to determine the relative bioavailability of zinc gluconate stabilized with glycine in a Petit Suisse cheese from an infant dessert. Weight gain and bone zinc content were the nutritional responses evaluated for the diets of different zinc content: 2 ppm (basal) and 5, 10, and 30 ppm from zinc gluconate stabilized with glycine and zinc sulfate. Nonlinear regression analysis of the fitted curves for weight gain determined a relative zinc bioavailability of 100% for the Ymax ratio and 96% for Ymax/t1/2 ratio for zinc gluconate stabilized with glycine (R2=0.7996 for zinc sulfate and 0.8665 for zinc gluconate stabilized with glycine). The slope ratio analysis from linear regression of femur zinc determined a relative zinc bioavailability of 93% for zinc gluconate stabilized with glycine (R2=0.8693 for zinc sulfate and 0.8307 for zinc gluconate stabilized with glycine). Zinc gluconate stabilized with glycine has similar bioavailability as zinc sulfate in a Petit Suisse cheese nutritional matrix, with the advantage that the stabilized compound does not modify the sensorial characteristics of the fortified cheese.

Normal growth rate in rats is recovered after a period of zinc deficiency by restoration of zinc supply by means of a zinc-fortified Petit Suisse cheese.

Fortification of a Petit Suisse cheese with zinc sulfate and zinc gluconate stabilized with glycine was used as a tool to overcome zinc-deficiency effects on total-body growth and skeletal growth. Animals were divided in 4 groups of 10 rats: basal (B), control (C), depletion-repletion 1 (DR1), and depletion-repletion 2 (DR2). These four groups were fed with four diets: basal (2 ppm Zn), control (30 ppm Zn), DR1, and DR2; they received a basal diet for 14 d and a control diet for the other 14 d of the experiment, using zinc sulfate for DR1 and zinc gluconate stabilized with glycine for DR2. After 28 d of the experiment, total-body weight and weight gain of the control and DR1 and DR2 animals were not statistically different (p<0.05), Femur weight and femur zinc content of DR1 and DR2 did not achieve the values of control animals (p<0.05), but they were higher than that of basal animals. Our results show that restoration of dietary zinc levels by means of food fortification normalized weight gain, as an indicator of total-body growth, and presented a trend to normalize bone weight, as a marker of skeletal growth, in young rats and independently of the zinc source used.

Review article: is there a link between micronutrient malnutrition and Helicobacter pylori infection?

Helicobacter pylori causes a chronic gastric infection, which is usually life-long. Many epidemiological studies have shown that this is probably one of the most common bacterial infections throughout the world involving 30% of the population living in developed countries and up to 80-90% of the population in developing regions. Concomitantly, developing regions also have high prevalence of micronutrient malnutrition. In the last few years, some studies have suggested that H. pylori infection may affect the homeostasis of different micronutrients including iron, vitamin B12, folic acid, alpha-tocopherol, vitamin C and beta-carotene. In this article, we discuss the current scientific information of the effect that H. pylori infection may produce on micronutrient malnutrition.

The usefulness of stable isotopes in nutrition and human health: the application of mass spectrometry and 13C-breath tests to detect helicobacter pylori infection.

The interest in Helicobacter pylori has escalated in recent years. H. pylori may produce a chronic gastric infection which is usually life-long and many epidemiological studies have shown that this is the most common bacterial infection throughout the world involving 50% of the world population. Thus, it is clear that the diagnosis of H. pylori infection represents at least a key step in the management of many of the patients referred to the gastroenterologist. Additionally, due to the wide range and relevance of pathologies possibly related to this infection, from micronutrient malnutrition and co-infections to malignancies, there is the potential for H. pylori to be a major health problem. Improved methods for the diagnosis and follow up treatment of the infection have been developed. Use of stable isotopes as non-invasive and safe diagnostic methods, namely (13C) breath tests, has been the key to a new era of research in H. pylori epidemiology and diagnosis as well as the establishment of eradication therapies. This non-invasive nuclear technique, that is considered the gold standard for the diagnosis of this bacterial infection, has successfully been standardized and implemented along Latin America. Taking into account the high prevalence of this bacterial infection, the impact of this technique in the whole region is very high. In this article we discuss several aspects of this methodology in order to harmonize the application of this method in developing regions.

Modification of the ferrozine technique to analyze iron contents in different foods: comparative study using an internal standard as reference methodology.

A methodology for the determination of iron in foods fortified with this element or in nutritional products is important and has to be sensitive and rapid. In developing countries, an inexpensive and reliable methodology is also required. For this purpose, the Gordon's Ferrozine technique was slightly modified and assayed with yogurt, dry powdered milk, and cereal mixtures, all of them fortified with iron, using an internal standard as the reference methodology. The obtained results demonstrate a close correlation between the standard curve interpolation method and the internal standard reference method (correlation coefficient r2 = 0.9950) in a wide range of concentrations. The slope (0.9998+/-0.0040) demonstrates that both procedures measure equal amounts of iron. The conclusion is that the proposed technique is a reliable, practical, and inexpensive methodology for iron determination in different foods fortified with iron.