The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish population / Dimensiones del arco posterior de C2 para el guiado de tornillos translaminares. Estudio radiológico en población española

BACKGROUND: To describe the feasibility of the posterior arch of C2 accepting two crossing screws in the Spanish population. METHODS: One hundred and fifty patients who underwent a routine neck CT scan for non-cervical pathology were enrolled. Submillimeter slices (thickness 0.7 mm) every 0.4 mm were performed with a 64 multi-detector CT scan, which allows isometric measurements. We measured the length and height of the cortical and cancellous (endomedullar) region of the lamina and the spinous process, inclination, maximal screw length and spinolaminar angle. RESULTS: The average (standard deviation) measurements of the lamina were: width of the left cortical 7.2 (1.5) mm, right cortical 6.9 (1.3) mm, width of the cancellous part of the left lamina 4.8 (1.5) mm, right side 4.6 (1.4) mm. The mean left cortical height was 13.0 (1.5) mm and 13.1 (1.6) mm for the right. The mean height of the cancellous part was 9.0 mm for both sides. The average measurements of the spinous process were: cortical length 15.7 (3.5) mm, endomedullar length 12.5 (3.9) mm; cortical height 11.9 (2.2) mm, endomedullar height 8.4 (2.1) mm; spinolaminar angle 49º (4); the maximum screw length 3.18 cm, and the inclination angle 143º. CONCLUSION: A CT scan with submillimeter slices is necessary in order to avoid malpositioning of the screws. The outer cortical measurements are 2 to 4 mm bigger than the endomedullar ones. Taking into account the dimensions of the spinous process, 24% of the population would not be candidates for this crossing screw technique

FUNDAMENTO: Describir la capacidad del arco posterior de C2 en población española para colocar dos tornillos cruzados translaminares. MÉTODO: Se reclutaron 150 pacientes a los que se les realizó un escáner del cuello por patología no cervical. Para el estudio se utilizó un 64 multi-detector TAC realizando cortes submilimétricos (0,7 mm de grosor) cada 0,4 mm, permitiendo obtener medidas isométricas. Se midieron anchura y altura cortical y endomedular de la lámina y de la espinosa, inclinación de la lámina, máxima longitud de tornillo y ángulo espinolaminar. RESULTADOS: Las media (desviación estándar) de las medidas de la lámina fueron: anchura cortical izquierda 7.2 (1,5) mm, cortical derecho 6,9 (1,3) mm, anchura endomedular izquierda 4,8 (1,5) mm, derecha 4,6 (1,4) mm La altura media cortical izquierda fue 13,0 (1,5) mm y de 13,1 (1,6) mm para la derecha. La altura media endomedular fue de 9,0 mm en ambos lados. Las medidas medias de la espinosa fueron: longitud media cortical 15,7 (3,5) mm, longitud endomedular 12,5 (3,9) mm; altura cortical 11,9 (2,2) mm, altura endomedular de 8,4 (2,1) mm; ángulo espinolaminar 49º (4); la longitud máxima de tornillo 3,18 cm; y el ángulo de inclinación 143º. CONCLUSIONES: Para evitar la colocación errónea de los tornillos es necesario un estudio de TAC con cortes submilimétricos. La diferencia entre las medidas corticales y endomedulares oscila entre 2 y 4 mm. Teniendo en cuenta las dimensiones de la espinosa, un 24% de la población no sería candidato a esta técnica de tornillos cruzados translaminares

The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish population.

BACKGROUND: To describe the feasibility of the posterior arch of C2 accepting two crossing screws in the Spanish population. METHODS: One hundred and fifty patients who underwent a routine neck CT scan for non-cervical pathology were enrolled. Submillimeter slices (thickness 0.7 mm) every 0.4 mm were performed with a 64 multi-detector CT scan, which allows isometric measurements. We measured the length and height of the cortical and cancellous (endomedullar) region of the lamina and the spinous process, inclination, maximal screw length and spinolaminar angle. RESULTS: The average (standard deviation) measurements of the lamina were: width of the left cortical 7.2 (1.5) mm, right cortical 6.9 (1.3) mm, width of the cancellous part of the left lamina 4.8 (1.5) mm, right side 4.6 (1.4) mm. The mean left cortical height was 13.0 (1.5) mm and 13.1 (1.6) mm for the right. The mean height of the cancellous part was 9.0 mm for both sides. The average measurements of the spinous process were: cortical length 15.7 (3.5) mm, endomedullar length 12.5 (3.9) mm; cortical height 11.9 (2.2) mm, endomedullar height 8.4 (2.1) mm; spinolaminar angle 49º (4); the maximum screw length 3.18 cm, and the inclination angle 143º. CONCLUSION: A CT scan with submillimeter slices is necessary in order to avoid malpositioning of the screws. The outer cortical measurements are 2 to 4 mm bigger than the endomedullar ones. Taking into account the dimensions of the spinous process, 24% of the population would not be candidates for this crossing screw technique.

Familial dilated cardiomyopathy: A multidisciplinary entity, from basic screening to novel circulating biomarkers.

Idiopathic dilated cardiomyopathy has become one of the most prevalent inherited cardiomyopathies over the past decades. Genetic screening of first-degree relatives has revealed that 30-50% of the cases have a familial origin. Similar to other heart diseases, familial dilated cardiomyopathy is characterized by a high genetic heterogeneity that complicates family studies. Cli'nical screening, 12-lead electrocardiogram and transthoracic echocardiogram are recommended for patients and first-degree family members. Magnetic resonance also needs to be considered. Genetic technologies have become fundamental for the clinical management of this disease. New generation sequencing methods have made genetic testing feasible for extensive panels of genes related to the disease. Recently, new imaging modalities such as speckle-tracking, strain and strain rate or magnetic resonance, and circulating biomarkers such as non-coding RNAs, have emerged as potential strategies to help cardiologists in their clinical practice. Imaging, genetic and blood-based techniques should be considered together in the evaluation and testing of familial dilated cardiomyopathy. Here, we discuss the current procedures and novel approaches for the clinical management of familial dilated cardiomyopathy.

Low radiation and low-contrast dose pulmonary CT angiography: Comparison of 80 kVp/60 ml and 100 kVp/80 ml protocols.

AIM: To determine the image quality and diagnostic performance of an optimized pulmonary computed tomography angiography (CTA) protocol in terms of radiation and contrast volume saving. MATERIALS AND METHODS: Seventy consecutive patients weighting ≤80 kg with clinical suspicion of pulmonary embolism (PE) were prospectively enrolled. Two pulmonary CTA protocols (group A: n = 35, 80 kV/60 ml; group B: n = 35, 100 kV/80 ml) were compared. The presence of PE, image quality parameters [contrast attenuation, contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR)] and effective radiation dose (mSv) were assessed. RESULTS: PE was found in 11 patients (five of group A, six of group B). The total mean attenuation of the pulmonary arteries was significantly higher in group A (362.4 ± 100.2 HU) than in group B (262.4 ± 134.3 HU), whereas the CNR and SNR did not differ statistically (14.8 ± 7.4 and 16.3 ± 7.5 for group A and 12.5 ± 8.6 and 13.8 ± 9.1 for group B, respectively). The estimated effective radiation dose was significantly lower in group A (1.1 ± 0.7 mSv) than in group B (2.7 ± 1.2 mSv). CONCLUSION: In individuals weighting ≤80 kg, the evaluated pulmonary CTA protocol allows similar image quality to be achieved as compared with the conventional pulmonary CTA protocol while reducing radiation exposure by 60% and contrast media volume by 25%.

Isolation and identification of low molecular weight antioxidant compounds from fermented "chorizo" sausages.

This work is focused on the determination of low molecular weight compounds extracted from samples of fermented sausages. The antioxidant activity of fractions isolated from chorizo extracts was tested by their ability to quench free radicals by the DPPH-radical scavenging assay. Natural dipeptides and metabolites characteristic of meat were abundant in the fractions isolated by RP-HPLC from chorizo extracts. Due to extensive degradation during the ripening of chorizo, the extracts did not contain many peptides in a concentration that allowed identification. However, many free amino acids were identified by LC-MS/MS and HILIC-MS/MS. The fractions with the most hydrophilic compounds showed the highest antioxidant activity.

Ergonomía del puesto de trabajo en radiología / Ergonomics of the workplace in radiology

La sustitución de la película convencional y los negatoscopios por monitores y ordenadores en los nuevos sistemas PACS ha cambiado por completo los puestos de trabajo en los servicios de radiodiagnóstico, suponiendo un avance claro en este campo. Estos sistemas ofrecen muchas ventajas como la mejora de la productividad de los radiólogos al reducir de forma global el tiempo necesario para la interpretación de imágenes. Por otro lado, su implantación ha provocado que factores como la posición de la silla y la mesa de trabajo, el ratón, el teclado, los monitores y el tipo de iluminación de la habitación cobren una especial relevancia para prevenir lesiones que puedan inhabilitar al radiólogo. La influencia de estos factores es habitualmente poco valorada a la hora de la planificación e implantación de los puestos de trabajo radiológico. El presente trabajo aporta recomendaciones para el correcto diseño de los mismos, basados en los datos aportados por la ergonomía, que es la ciencia que estudia su influencia en la actividad humana (AU)

The replacement of conventional films and view boxes with digital images and computer monitors managed by PACS has clearly improved the diagnostic imaging workplace. The new setup has many advantages, including increased productivity brought about by decreased overall time required for image interpretation. On the other hand, the implementation of the digital workplace has increased the importance of factors like background lighting and the position of the chair, work table, mouse, keyboard, and monitor to prevent lesions that can disable the radiologist. The influence of these factors is often undervalued in the design and implementation of the radiological workplace. This article provides recommendations for the design of the radiological workplace based on ergonomics, which is the science that studies interactions among humans and other elements of a system (AU)

[Ergonomics of the workplace in radiology]. / Ergonomía del puesto de trabajo en radiología.

The replacement of conventional films and view boxes with digital images and computer monitors managed by PACS has clearly improved the diagnostic imaging workplace. The new setup has many advantages, including increased productivity brought about by decreased overall time required for image interpretation. On the other hand, the implementation of the digital workplace has increased the importance of factors like background lighting and the position of the chair, work table, mouse, keyboard, and monitor to prevent lesions that can disable the radiologist. The influence of these factors is often undervalued in the design and implementation of the radiological workplace. This article provides recommendations for the design of the radiological workplace based on ergonomics, which is the science that studies interactions among humans and other elements of a system.

Tomografía computarizada de doble fuente en pacientes hospitalizados con dolor torácico de etiología incierta / Dual-source computed tomography in inpatients with atypical chest pain

Objetivo: Valorar la utilidad de la tomografía computarizada de doble fuente (TCDF) como técnica diagnóstica en pacientes hospitalizados con dolor torácico atípico de etiología incierta. Material y métodos: Se incluyeron 41 sujetos consecutivos hospitalizados en nuestro centro (25 varones, 16 mujeres; edad media 55,6±17,39 años) con dolor torácico atípico sin causa clínicamente reconocible en los que se indicó un estudio de TC para filiar su etiología. Los estudios se realizaron en un equipo TCDF con sincronización ECG retrospectiva tras administrar 120 ml de contraste iodado a 4 ml/s utilizando la técnica de bolus tracking. Los estudios fueron analizados por 2 observadores de forma consensuada. Resultados: Las exploraciones fueron diagnósticas en todos los pacientes. Se hallaron 5 casos de tromboembolismo pulmonar y 2 de patología aórtica (1 úlcera aórtica y 1 aneurisma sacular). Se objetivaron anomalías en las arterias coronarias en 15 sujetos, 2 de los cuales presentaron estenosis >50%. Como hallazgos extracardiovasculares se diagnosticaron 11 casos de neumonía, 1 sarcoidosis y 1 carcinoma no microcítico de pulmón. Además, se observó derrame pleural en 4 sujetos y derrame pericárdico en otros 4. El resultado fue negativo en un 22% de los sujetos. La evolución fue favorable en todos los pacientes y ninguno volvió a acudir por persistencia del dolor o episodio de dolor torácico de nueva aparición durante el período de seguimiento. Conclusión: La TCDF es una técnica útil para filiar la etiología y descartar las causas potencialmente más graves de dolor torácico en pacientes hospitalizados (AU)

Objective: To evaluate the potential usefulness of dual-source CT (DSCT) in the diagnostic work-up of inpatients with atypical chest pain of unknown etiology. Material and methods: Forty-one consecutive inpatients (25 male, 16 female; mean age 55.6±17.39 years) with atypical chest pain underwent DSCT to determine the cause of pain. Images were acquired with retrospective ECG gating after the administration of 120ml of iodinated contrast medium at 4ml/s using the bolus tracking technique. Two readers analyzed the images in consensus. Results: DSCT was diagnostic in all patients. We detected pulmonary embolisms in five patients and aortic disease in two (one aortic ulcer and one sacular aneurysm). Anomalies of the coronary arteries were depicted in 15 patients, two of whom presented luminal stenosis >50%. Extracardiovascular findings at DSCT included pneumonia in eleven patients, sarcoidosis in one, and non-small cell lung carcinoma in one. Pleural effusion was detected in four patients and pericardial effusion in another four. No pathological findings were observed in 22% of subjects. Evolution was favorable in all patients. No patients were readmitted for persistent pain or new onset of acute chest pain during the follow-up period. Conclusion: DSCT can rule out most life-threatening clinical conditions that cause chest pain and is useful in determining the cause of chest pain in inpatients (AU)

[Dual-source computed tomography in inpatients with atypical chest pain]. / Tomografía computarizada de doble fuente en pacientes hospitalizados con dolor torácico de etiología incierta.

OBJECTIVE: To evaluate the potential usefulness of dual-source CT (DSCT) in the diagnostic work-up of inpatients with atypical chest pain of unknown etiology. MATERIAL AND METHODS: Forty-one consecutive inpatients (25 male, 16 female; mean age 55.6+/-17.39 years) with atypical chest pain underwent DSCT to determine the cause of pain. Images were acquired with retrospective ECG gating after the administration of 120ml of iodinated contrast medium at 4ml/s using the bolus tracking technique. Two readers analyzed the images in consensus. RESULTS: DSCT was diagnostic in all patients. We detected pulmonary embolisms in five patients and aortic disease in two (one aortic ulcer and one sacular aneurysm). Anomalies of the coronary arteries were depicted in 15 patients, two of whom presented luminal stenosis >50%. Extracardiovascular findings at DSCT included pneumonia in eleven patients, sarcoidosis in one, and non-small cell lung carcinoma in one. Pleural effusion was detected in four patients and pericardial effusion in another four. No pathological findings were observed in 22% of subjects. Evolution was favorable in all patients. No patients were readmitted for persistent pain or new onset of acute chest pain during the follow-up period. CONCLUSION: DSCT can rule out most life-threatening clinical conditions that cause chest pain and is useful in determining the cause of chest pain in inpatients.

Coronariografía mediante tomografía computarizada de doble fuente: calidad de imagen e intervalo de reconstrucción óptimo / Dual-source CT coronary angiography: image quality and optimal reconstruction interval

Objetivo: evaluar prospectivamente la relación entre frecuencia cardíaca y calidad de imagen, y determinar el intervalo de reconstrucción óptimo para las arterias coronarias en estudios de tomografía computarizada de doble fuente (TCDF). Material y métodos: se analizaron 28 sujetos consecutivos en que se realizó coronariografía mediante TCDF (Somatom Definition, Siemens). Las imágenes se reconstruyeron a lo largo del ciclo cardíaco en intervalos del 5% R-R. Dos observadores independientes evaluaron la calidad diagnóstica de las imágenes para las arterias coronarias (izquierda, circunfleja y derecha) (1=no evaluable; 4=calidad excelente). Resultados: la frecuencia cardíaca media de los pacientes fue 73,1±14,8lpm (rango, 49–107lpm). En el mejor intervalo de reconstrucción se obtuvo excelente calidad de imagen (4 puntos) en el 98,8% (83/84) de las arterias coronarias. La concordancia interobservador para la puntuación de calidad de imagen y selección del intervalo de reconstrucción óptimo fue muy buena (k=0,77 y k=0,86). La puntuación media de calidad para todo el árbol coronario fue 2,84±0,31. No se observó correlación entre la frecuencia cardíaca media y la calidad de la imagen de las arterias coronarias (r=0,108). No hubo diferencias estadísticamente significativas al comparar la calidad de imagen obtenida en las reconstrucciones sistólicas y diastólicas en cada paciente. Conclusiones: la TCDF permite obtener coronariografías de excelente calidad diagnóstica independientemente de la frecuencia cardíaca. Las reconstrucciones se pueden realizar tanto en sístole como en diástole sin que hayan diferencias estadísticamente significativas en la calidad, incluso con frecuencias cardíacas elevadase (AU)

Objective: To evaluate the effect of average heart rate on the quality of images of the coronary arteries and to determine the optimal reconstruction interval in nonselected patients undergoing DSCT coronary imaging. Materials and methods: We studied 28 consecutive subjects (26 men, 2 women; mean age 60±12 years) undergoing contrast-enhanced DSCT (Somatom Definition, Siemens) coronary angiography. Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent readers assessed the image quality of the whole coronary tree and of each coronary artery using a four-point scale (1: impossible to evaluate, 4: excellent quality). Results: Mean heart rate during scanning was 73.1±14.8bpm (range, 49–107bpm). In the best reconstruction interval, excellent diagnostic image quality (score 4) was achieved for 98.8% (83/84) of coronary arteries. Very good interobserver agreement was observed for image quality rating (k=0.77) and for selection of the optimal reconstruction interval (k=0.86). Mean image quality score for the whole coronary tree was 2.84±0.31. No significant correlation was found between the average heart rate and the mean quality scores (r=0.108). No significant differences were found in the quality of images of the coronary arteries in systolic and diastolic reconstructions in each patient. Conclusions: DSCT makes it possible to obtain excellent coronary angiograms independent of the heart rate. Reconstructions can be obtained in either the diastolic or systolic phase without significant differences in image quality, even at high heart rates (AU)

[Dual-source CT coronary angiography: image quality and optimal reconstruction interval]. / Coronariografía mediante tomografía computarizada de doble fuente: calidad de imagen e intervalo de reconstrucción óptimo.

OBJECTIVE: To evaluate the effect of average heart rate on the quality of images of the coronary arteries and to determine the optimal reconstruction interval in nonselected patients undergoing DSCT coronary imaging. MATERIALS AND METHODS: We studied 28 consecutive subjects (26 men, 2 women; mean age 60+/-12 years) undergoing contrast-enhanced DSCT (Somatom Definition, Siemens) coronary angiography. Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent readers assessed the image quality of the whole coronary tree and of each coronary artery using a four-point scale (1: impossible to evaluate, 4: excellent quality). RESULTS: Mean heart rate during scanning was 73.1+/-14.8 bpm (range, 49-107 bpm). In the best reconstruction interval, excellent diagnostic image quality (score 4) was achieved for 98.8% (83/84) of coronary arteries. Very good interobserver agreement was observed for image quality rating (kappa=0.77) and for selection of the optimal reconstruction interval (kappa=0.86). Mean image quality score for the whole coronary tree was 2.84+/-0.31. No significant correlation was found between the average heart rate and the mean quality scores (r=0.108). No significant differences were found in the quality of images of the coronary arteries in systolic and diastolic reconstructions in each patient. CONCLUSIONS: DSCT makes it possible to obtain excellent coronary angiograms independent of the heart rate. Reconstructions can be obtained in either the diastolic or systolic phase without significant differences in image quality, even at high heart rates.

Effect of different cooking methods on lipid oxidation and formation of free cholesterol oxidation products (COPs) in Latissimus dorsi muscle of Iberian pigs.

The aim of this work was to study the influence of different cooking methods (grilled (GR), fried (FP), microwave (MW) and roasted (RO)) on lipid oxidation and formation of free cholesterol oxidation products (COPs) of meat from Iberian pigs that have been fed on an intensive system. Moisture and total lipid content, TBARs, hexanal and COPs were measured in Latissimus dorsi muscle samples. Cooking did not produce changes in total lipid content in meat but induced significantly higher lipid oxidation (TBARs and hexanal values) (p<0.001) and cholesterol oxidation (COPs) (p<0.01). When the different cooking methods were studied, the grilled method was the least affected by lipid oxidation (TBARs and hexanal) compared to the others. There were no significant differences among different cooking methods on COPs values. The most abundant cholesterol oxides were both 7α-hydroxycholesterol and 7ß-hydroxycholesterol in all groups studied.

Hiperplasia adenomatosa atípica pulmonar. A propósito de un caso / No disponible

La Hiperplasia adenomatosa atípica (HAA) es una entidad infrecuenteen la población general. Se manifi esta en TC como un nódulo pulmonaren vidrio deslustrado sin componente sólido y persistente a pesar detratamiento antibiótico. Se presenta un caso de HAA, descubierto a raízdel programa de detección precoz de cáncer de pulmón de la ClínicaUniversitaria de Navarra. Se muestran los hallazgos en TC y AnatomíaPatológica, así como la correlación radio patológica. Se planteael diagnóstico diferencial con otras entidades incluidas lesiones conpotencial maligno (carcinoma bronquioloalveolar y adenocarcinomade bajo grado). Se comenta el método empleado en el manejo de laslesiones nodulares en vidrio deslustrado en el contexto de este programade detección precoz(AU)

Atypical adenomatose hyperplasia (HAA) is an infrequent pathology ingeneral population. The CT fi ndings are ground glass opacity withoutsolid component and persistent regardless antibiotic treatment. Wepresent a case of HAA, detected on program of early detection of lungcancer program of the Clínica Universitaria de Navarra. We show the CTand histology fi ndings, and radiopathologic correlation. The differentialdiagnosis must include other lesions with potential malignity (bronquioalveolarcarcinoma and low grade adenocarcinoma). We show themethod applied in ground glass opacities management in an early lungdetection program context(AU)

Hiperplasia adenomatosa atípica pulmonar. A propósito de un caso / Atypical Adenomatous Hiperplasia. Report of a case

La Hiperplasia adenomatosa atípica (HAA) es una entidad infrecuente en la población general. Se manifi esta en TC como un nódulo pulmonar en vidrio deslustrado sin componente sólido y persistente a pesar detratamiento antibiótico. Se presenta un caso de HAA, descubierto a raíz del programa de detección precoz de cáncer de pulmón de la Clínica Universitaria de Navarra. Se muestran los hallazgos en TC y AnatomíaPatológica, así como la correlación radio patológica. Se plantea el diagnóstico diferencial con otras entidades incluidas lesiones con potencial maligno (carcinoma bronquioloalveolar y adenocarcinoma de bajo grado). Se comenta el método empleado en el manejo de laslesiones nodulares en vidrio deslustrado en el contexto de este programa de detección precoz

Atypical adenomatose hyperplasia (HAA) is an infrequent pathology in general population. The CT fi ndings are ground glass opacity without solid component and persistent regardless antibiotic treatment. Wepresent a case of HAA, detected on program of early detection of lung cancer program of the Clínica Universitaria de Navarra. We show the CTand histology fi ndings, and radiopathologic correlation. The differential diagnosis must include other lesions with potential malignity (bronquioalveolarcarcinoma and low grade adenocarcinoma). We show themethod applied in ground glass opacities management in an early lung detection program context