Breast cancer in the 21st century: from early detection to new therapies. / El cáncer de mama en el siglo XXI: de la detección precoz a los nuevos tratamientos.

The analysis of the causes that have given rise to a change in tendency in the incidence and mortality rates of breast cancer in the last few decades generates important revelations regarding the role of breast screening, the regular application of adjuvant therapies and the change of risk factors. The benefits of early detection have been accompanied by certain adverse effects, even in terms of an excessive number of prophylactic mastectomies. Recently, several updates have been published on the recommendations in breast cancer screening at an international level. On the other hand, the advances in genomics have made it possible to establish a new molecular classification of breast cancer. Our aim is to present an updated overview of the epidemiological situation of breast cancer, as well as some relevant issues from the point of view of diagnosis, such as molecular classification and different strategies for both population-based and opportunistic screening.

Bowel ultrasonography in acute abdomen: beyond acute appendicitis. / Ecografía intestinal y abdomen agudo: más allá de la apendicitis aguda.

Acute abdomen is a common reason for consultation in the emergency department. A broad spectrum of entities, including diverse diseases of the gastrointestinal tract, can cause acute abdomen. Although computed tomography is the technique most widely used to evaluate acute abdomen in the emergency department, abdominal ultrasound is often performed first and allows bowel disease to be suspected. This article describes the ultrasound features of diverse bowel diseases that can cause acute abdomen, such as acute diverticulitis, bowel obstruction, gastrointestinal perforation, bowel ischemia, intraabdominal fat necrosis, and miscellaneous processes such as endometriosis, foreign bodies, or vasculitis. Radiologists must be familiar with the different features of abnormal bowel that can be detected incidentally in patients without clinical suspicion of bowel disease. This article focuses on ultrasonographic signs of bowel disease; other articles in this series cover the ultrasonographic signs of acute appendicitis, inflammatory bowel disease, and infectious diseases.

A bibliometric study of the journal Radiología during the period 2010-2019. / Análisis bibliométrico de la revista Radiología en el periodo 2010-2019.

BACKGROUND AND AIMS: Bibliometrics makes it possible to measure the relative importance of a scientific journal in its field. The current study analyzed the scientific publications in Radiología and the bibliometric parameters of the journal in the period comprising 2010 through 2019. MATERIALS AND METHODS: We reviewed the bibliometrics for Radiología through information obtained from three sources: Scopus, the online version of the journal, and the publisher (Elsevier). We retrospectively analyzed aspects related to the editorial process (final decision and speed), the articles published (type, subspecialty of radiology, and imaging technique), the trends in citation and various indices (CiteScore, SNIP, and SJR), visibility, downloads, author characteristics (geographical origin and institutional collaboration), and the most cited articles. RESULTS: The number of articles published in Radiología gradually decreased during the decade, and the time to publication increased. Original research articles account for the largest share of the articles published. The most common subject areas were radiology of the digestive tract and neuroradiology. Nevertheless, the bibliometric indicators and the number of downloads of articles increased every year. Regarding the authorship of the articles published, although authors from Spain predominate, the participation of authors from other countries became increasingly common. Collaboration among different institutions also became increasingly common in the period analyzed. CONCLUSIONS: This review shows the progression of the journal's scientific work and some aspects that must be addressed to favor the growth of Radiología.

Bowel ultrasound: examination techniques and normal and pathologic patterns. / Ecografía intestinal: técnicas de examen, patrones normales y patológicos.

Ultrasound is being increasingly used to study the digestive tract because it has certain advantages over other techniques such as endoscopy, CT enterography, and MR enterography. Ultrasound can be used to evaluate the bowel wall and the elements that surround it without the need for contrast agents; its ability to evaluate the elasticity and peristalsis of these structures is increasing interest in its use. This article describes the techniques and modalities of bowel ultrasound, as well as the normal features of the bowel wall and contiguous structures. It uses a practical approach to review the main pathological findings and their interpretation, and the different patterns of presentation, which will help orient the diagnosis.

The Dissociation between Polarity, Semantic Orientation, and Emotional Tone as an Early Indicator of Cognitive Impairment.

The present study aims to identify early cognitive impairment through the efficient use of therapies that can improve the quality of daily life and prevent disease progress. We propose a methodology based on the hypothesis that the dissociation between oral semantic expression and the physical expressions, facial gestures, or emotions transmitted in a person's tone of voice is a possible indicator of cognitive impairment. Experiments were carried out with phrases, analyzing the semantics of the message, and the tone of the voice of patients through unstructured interviews in healthy people and patients at an early Alzheimer's stage. The results show that the dissociation in cognitive impairment was an effective indicator, arising from patterns of inconsistency between the analyzed elements. Although the results of our study are encouraging, we believe that further studies are necessary to confirm that this dissociation is a probable indicator of cognitive impairment.

Electrophoretic transfer of viral proteins to nitrocellulose sheets and detection with peroxidase-bound lectins and protein A.

Peroxidase-bound protein A and lectins in combination with precipitable substrates were used to detect viral proteins and glycoproteins on 'Western blots'. The sensitivity of various methods was compared, including radioiodinated protein A, enzyme immunosorbent assay and peroxidase staining with DAP. The sensitivity of the peroxidase reaction, its rapidity and low cost compared with other methods make this a useful choice for developing protein bands transferred to nitrocellulose paper. In addition, a procedure was devised to clarify and fix nitrocellulose sheets for direct quantification of the precipitated substrate by densitometric analysis.

Munchausen syndrome by proxy complicating ear surgery.

Munchausen syndrome by proxy (MSBP) is a form of child abuse in which a parent or caretaker produces or simulates illness in a child. Often great lengths are undertaken to diagnose and treat the myriad of symptoms and problems in these children. Unnecessary examinations, treatments, and hospitalizations ensure. Unfortunately, some victims of this syndrome die. Munchausen syndrome by proxy is a form of child abuse and should be reported appropriately. The diagnosis of MSBP is difficult to make and must be done with caution as the implications for those involved are serious. Therefore, care must be taken in properly identifying cases. We present a case of MSBP complicating the postoperative course of a boy after undergoing ear surgery for cholesteatoma. Characteristics and potential clues to the diagnosis of MSBP are discussed. The goal of our article is to inform otolaryngologists of this syndrome so they may develop a high index of suspicion to better detect its occurrence.

Management of malignant head and neck tumors in children.

This article describes the symptomatology of the most commonly encountered malignancies of the head and neck in children. Information is being made available on practically a daily basis from the areas of cytogenetics, tumor markers, and oncogenes. The role of surgery and radiation in the management of these malignancies is also considered and reevaluated.

Processing of adenoid and tonsil specimens in children: a national survey of standard practices and a five-year review of the experience at the Children's Hospital of Pittsburgh.

The best means of pathologically examining routine tonsillectomy and adenoidectomy specimens in children remains controversial. Otolaryngologists fear missing an unsuspected diagnosis. However, the cost-effectiveness of microscopic analysis, given the rare incidence of unsuspected diagnosis, is questionable. If a significant pathologic diagnosis is missed, the medicolegal implications could be significant. A questionnaire was sent to 111 members of the American Society of Pediatric Otolaryngology. Additionally, we reviewed our experience at the Children's Hospital of Pittsburgh for the 5-year span from 1989 to 1994 to determine our incidence of unsuspected pathologic diagnoses. Sixty-five questionnaires were returned (59% response rate). More than half (56%) of the respondents stated that microscopic analysis was routinely performed on all specimens, and 42% replied that only gross examination was performed, reserving microscopic examination for selected cases. Three respondents said that they discarded their specimens in the operating room. From March 1989 to October 1994, in 1985 children undergoing bilateral tonsillectomy and adenoidectomy at the Children's Hospital of Pittsburgh, no significant pathologic diagnoses were found. Twenty-seven additional children who underwent only tonsillectomy between January 1991 and October 1994 were also reviewed. One lymphoma, suspected before surgery, and a glycogen storage disorder, not suspected before surgery, were diagnosed. Therefore, in a total of 2012 children, we found only one clinically significant unsuspected diagnosis. In conclusion, we found no national consensus governing the best way to examine routine adenotonsillectomy specimens in children. Given that unsuspected diagnoses are rare, reserving microscopic analysis for specific clinical indications may be both more cost-effective and medically feasible.

Application of the Microtox test and pollution indices to the study of water toxicity in the Albufera Natural Park (Valencia, Spain).

The toxic effects of waters collected from irrigation channels in a Mediterranean wetland (Albufera Natural Park, Valencia, Spain) were tested with the Microtox assay and compared with six pollution indices (PIs) defined from analytical parameters. Chemical oxygen demand (COD), biological oxygen demand (BOD), nutrients, heavy metals and pesticides were measured. The bioassay result (concentrations of the water sample (% V/V) that reduced light emission to 10%, 20% and 50%, EC10, EC20 and EC50, respectively (ECs)) was compared with the PIs. This comparison has demonstrated a general agreement between ECs and PIs, except in the case of irrigation channels affected by herbicides used in rice farming (molinate and thiobencarb). No pronounced inhibition was detected in the bioluminescence in relation to the eutrophic parameters in the irrigation waters for EC50 values, indicating that this parameter does not suffice to detect eutrophic waters. Data derived from irrigation water pollution and bioassay were assembled by multivariate statistical techniques (principal component analysis). These components were associated with various contamination sources.

Teratoid cyst of the floor of the mouth.

Because the term 'dermoid' is frequently used in the literature, some authors believe that this term should be used for all congenital cysts of the floor of the mouth. Three subclasses of congenital floor of the mouth cysts are described in the literature: (1) epidermoid (simple) cysts, (2) dermoid (complex) cysts and (3) teratoid (complex) cysts. The teratoid cyst is the least common. Most of these cases present during the second and third decades of life, thus presentation during infancy is extremely rare. Surgical excision is the treatment of choice. We present a 2-month old male who underwent expedient surgical excision for progressive airway compromise secondary to a teratoid cyst of the floor of the mouth. Radiographic and histopathologic evidence, as well as a review of the literature is presented.

Pharyngitis. When is aggressive treatment warranted?

Pharyngitis is one of the most common disorders seen by primary care physicians. Fortunately, most cases resulting from viral or bacterial infection respond well to symptomatic medications or antibiotics. However, aggressive treatment of pharyngitis due to group A beta-hemolytic streptococcus is crucial to avoid complications, such as rheumatic fever and acute poststreptococcal glomerulonephritis.

Aplasia of the epiglottis: a rare congenital anomaly.

Aplasia of the epiglottis is a rare laryngeal anomaly. We present a case of absence of the epiglottis in a child whose clinical course has been followed for nine years. She required a tracheostomy at two years of age for obstructive sleep apnea which resulted in heart failure; she was eventually decannulated at age seven. This case report highlights the clinical challenges faced in the identification and treatment of the sequelae of this defect. Both endoscopic and computed tomography (CT) documentation are provided. Embryological development and a review of the literature are also discussed.

Identification of Anopheles aquasalis as a possible vector of malaria in Guyana, South America.

Adult female mosquitoes were collected in Mahdia, Guyana, to determine the incidence of malaria in Anopheles species found during the month of June 2000. Centers for Disease Control miniature white (incandescent) light traps, model 512, and miniature black (ultraviolet) light traps, model 912, were used to capture female mosquitoes. Numbers of mosquitoes collected were compared between white and black light traps and between traps set outside and inside of buildings. Adult female Anopheles mosquitoes were identified and an ELISA dipstick test for Plasmodium vivax and Plasmodium falciparum was performed on each mosquito. An aquasalis, An oswaldoi, and An braziliensis were attracted to white light traps. An triannulatus and An darlingi were collected from black light traps. Approximately the same numbers of all female Anopheles mosquitoes 28/45 (62%) were caught inside buildings as outside. Numbers of female non-anopheles mosquitoes captured in light traps varied between the traps set outside of buildings and inside of buildings with bright light traps collecting 91/122 (75%). A total of 45 Anopheles mosquitoes were captured and 122 non-anopheles species. Of the two known vectors of malaria in Guyana, An darlingi mosquitoes were not infected with P vivax but An aquasalis was found to be a carrier. The findings of this study suggest a need for further surveying and identification of current malaria vectors in Guyana.