Nitrous oxide versus lidocaine versus no analgesic for in-office hysteroscopy: a randomised clinical trial.

OBJECTIVE: To compare the effect of inhaled nitrous oxide (INO) on pain control during in-office hysteroscopy with 1% lidocaine paracervical infiltration and no analgesic. DESIGN: Single-blind stratified randomised clinical trial with masked assessment by a third party. SETTING: Department of Obstetrics and Gynaecology in a Spanish hospital. POPULATION: Women who underwent hysteroscopy. METHODS: Patients were stratified into three groups according to the purpose of the hysteroscopy (biopsy, polypectomy or tubal sterilisation) and then assigned to different treatment groups through a permuted-blocks randomisation within strata. Pain scale was provided by a gynaecologist totally blinded to procedures and treatments. Effects were assessed using a one-way analysis of variance following an intention-to-treat approach. MAIN OUTCOME MEASURES: Visual analogue scale (VAS) from 0 to 100 mm. RESULTS: A total of 314 women were included: 105 to INO, 104 to 1% lidocaine and 105 to no analgesic. Baseline characteristics were comparable. Mean VAS score after the procedure was 34.7 ± 25.8 mm, 36.1 ± 22.9 mm (P = 1.0) and 47.3 ± 28.2 mm (P = 0.001) for INO, 1% lidocaine and no analgesic, respectively. No adverse events were reported in 91 (86.7%) patients in the INO group compared with 79 (76%) in the 1%-lidocaine group (P = 0.04) and 85 (81%) in the no-analgesic group (P = 0.26). CONCLUSION: INO was as effective as 1% lidocaine in pain control for in-office hysteroscopy and was better tolerated. The no-analgesic group presented the poorer results, so was the least recommended clinical option.

Thermal transport in epitaxial Si1-x Ge x alloy nanowires with varying composition and morphology.

We report on structural, compositional, and thermal characterization of self-assembled in-plane epitaxial Si1-x Ge x alloy nanowires grown by molecular beam epitaxy on Si (001) substrates. The thermal properties were studied by means of scanning thermal microscopy (SThM), while the microstructural characteristics, the spatial distribution of the elemental composition of the alloy nanowires and the sample surface were investigated by transmission electron microscopy and energy dispersive x-ray microanalysis. We provide new insights regarding the morphology of the in-plane nanostructures, their size-dependent gradient chemical composition, and the formation of a 5 nm thick wetting layer on the Si substrate surface. In addition, we directly probe heat transfer between a heated scanning probe sensor and Si1-x Ge x alloy nanowires of different morphological characteristics and we quantify their thermal resistance variations. We correlate the variations of the thermal signal to the dependence of the heat spreading with the cross-sectional geometry of the nanowires using finite element method simulations. With this method we determine the thermal conductivity of the nanowires with values in the range of 2-3 W m-1 K-1. These results provide valuable information in growth processes and show the great capability of the SThM technique in ambient environment for nanoscale thermal studies, otherwise not possible using conventional techniques.

Effects of magnetic field gradients on the aggregation dynamics of colloidal magnetic nanoparticles.

We have used low-field (1)H nuclear-magnetic resonance (NMR) spectroscopy and molecular dynamics (MD) to investigate the aggregation dynamics of magnetic particles in ionic ferrofluids (IFFs) in the presence of magnetic field gradients. At the beginning of the experiments, the measured NMR spectra were broad and asymmetric, exhibiting two features attributed to different dynamical environments of water protons, depending on the local strength of the field gradients. Hence, the spatial redistribution of the magnetic particles in the ferrofluid caused by the presence of an external magnetic field in a time scale of minutes can be monitored in real time, following the changes in the features of the NMR spectra during a period of about an hour. As previously reported [Heinrich et al., Phys. Rev. Lett., 2011, 106, 208301], in the homogeneous magnetic field of a NMR spectrometer, the aggregation of the particles of the IFF proceeds in two stages. The first stage corresponds to the gradual aggregation of monomers prior to and during the formation of chain-like structures. The second stage proceeds after the chains have reached a critical average length, favoring lateral association of the strings into hexagonal zipped-chain superstructures or bundles. In this work, we focus on the influence of a strongly inhomogeneous magnetic field on the aforementioned aggregation dynamics. The main observation is that, as the sample is immersed in a certain magnetic field gradient and kept there for a time τinh, magnetophoresis rapidly converts the ferrofluid into an aggregation state which finds its correspondence to a state on the evolution curve of the pristine sample in a homogeneous field. From the degree of aggregation reached at the time τinh, the IFF sample just evolves thereafter in the homogeneous field of the NMR spectrometer in exactly the same way as the pristine sample. The final equilibrium state always consists of a colloidal suspension of zipped-chain bundles with the chain axes aligned along the magnetic field direction.

Effect of Carbon Coating on the Physicochemical and Electrochemical Properties of Fe2O3 Nanoparticles for Anode Application in High Performance Lithium Ion Batteries.

Nanoparticulate Fe2O3 and Fe2O3/C composites with different carbon proportions have been prepared for anode application in lithium ion batteries (LIBs). Morphological studies revealed that particles of Fe2O3 in the composites were well-dispersed in the matrix of amorphous carbon. The properties of the γ-Fe2O3 nanoparticles and the correlation with the particle size and connectivity were studied by electron paramagnetic resonance, magnetic, and Mössbauer measurements. The electrochemical study revealed that composites with carbon have promising electrochemical performances. These samples yielded specific discharge capacities of 1200 mAh/g after operating for 100 cycles at 1C. These excellent results could be explained by the homogeneity of particle size and structure as well as the uniform distribution of γ-Fe2O3 nanoparticles in the in situ generated amorphous carbon matrix.

In-plane thermal conductivity of sub-20 nm thick suspended mono-crystalline Si layers.

We measure the thermal conductivity of a 17.5-nm-thick single crystalline Si layer by using a suspended structure developed from a silicon-on-insulator wafer, in which the Si layer bridges the suspended platforms. The obtained value of 19 Wm(-1) K(-1) at room temperature represents a tenfold reduction with respect to bulk Si. This design paves the way for subsequent lateral nanostructuration of the layer with lithographic techniques, to define different geometries such as Si nanowires, nanostrips or phononic grids. As a proof of concept, nanostrips of 0.5 × 10 µm have been defined by focused ion beam (FIB) in the ultrathin Si layer. After the FIB cutting process with Ga ions at 30 kV and 100 pA, the measured thermal conductivity dramatically decreased to 1.7 Wm(-1) K(-1), indicating that the structure became severely damaged (amorphous). Re-crystallization of the structure was promoted by laser annealing while monitoring the Raman spectra. The thermal conductivity of the layer increased again to a value of 9.5 Wm(-1) K(-1) at room temperature, below that of the single crystalline material due to phonon scattering at the grain boundaries.

Probing local strain and composition in Ge nanowires by means of tip-enhanced Raman scattering.

Local strain and Ge content distribution in self-assembled, in-plane Ge/Si nanowires grown by combining molecular beam epitaxy and the metal-catalyst assisted-growth method were investigated by tip-enhanced Raman scattering. We show that this technique is essential to study variations of physical properties of single wires at the nanoscale, a task which cannot be achieved with conventional micro-Raman scattering. As two major findings, we report that (i) the Ge distribution in the (001) crystallographic direction is inhomogeneous, displaying a gradient with a higher Ge content close to the top surface, and (ii) in contrast, the (uncapped) wires exhibit essentially the same small residual compressive strain everywhere along the wire.

Sugar inhibits the production of the toxins that trigger clostridial gas gangrene.

Histotoxic strains of Clostridium perfringens cause human gas gangrene, a devastating infection during which potent tissue-degrading toxins are produced and secreted. Although this pathogen only grows in anaerobic-nutrient-rich habitats such as deep wounds, very little is known regarding how nutritional signals influence gas gangrene-related toxin production. We hypothesize that sugars, which have been used throughout history to prevent wound infection, may represent a nutritional signal against gas gangrene development. Here we demonstrate, for the first time, that sugars (sucrose, glucose) inhibited the production of the main protein toxins, PLC (alpha-toxin) and PFO (theta-toxin), responsible for the onset and progression of gas gangrene. Transcription analysis experiments using plc-gusA and pfoA-gusA reporter fusions as well as RT-PCR analysis of mRNA transcripts confirmed that sugar represses plc and pfoA expression. In contrast an isogenic C. perfringens strain that is defective in CcpA, the master transcription factor involved in carbon catabolite response, was completely resistant to the sugar-mediated inhibition of PLC and PFO toxin production. Furthermore, the production of PLC and PFO toxins in the ccpA mutant strain was several-fold higher than the toxin production found in the wild type strain. Therefore, CcpA is the primary or unique regulatory protein responsible for the carbon catabolite (sugar) repression of toxin production of this pathogen. The present results are analyzed in the context of the role of CcpA for the development and aggressiveness of clostridial gas gangrene and the well-known, although poorly understood, anti-infective and wound healing effects of sugars and related substances.

Magneto-optical enhancement by plasmon excitations in nanoparticle/metal structures.

Coupling magnetic materials to plasmonic structures provides a pathway to dramatically increase the magneto-optical response of the resulting composite architecture. Although such optical enhancement has been demonstrated in a variety of systems, some basic aspects are scarcely known. In particular, reflectance/transmission modulations and electromagnetic field intensification, both triggered by plasmon excitations, can contribute to the magneto-optical enhancement. However, a quantitative evaluation of the impact of both factors on the magneto-optical response is lacking. To address this issue, we have measured magneto-optical Kerr spectra on corrugated gold/dielectric interfaces with magnetic (nickel and iron oxide) nanoparticles. We find that the magneto-optical activity is enhanced by up to an order of magnitude for wavelengths that are correlated to the excitation of propagating or localized surface plasmons. Our work sheds light on the fundamental principles for the observed optical response and demonstrates that the outstanding magneto-optical performance is originated by the increase of the polarization conversion efficiency, whereas the contribution of reflectance modulations is negligible.

Dynamics of the field-induced formation of hexagonal zipped-chain superstructures in magnetic colloids.

Combining nuclear magnetic resonance and molecular dynamics simulations, we unravel the long-time dynamics of a paradigmatic colloid with strong dipole-dipole interactions. In a homogeneous magnetic field, ionic ferrofluids exhibit a stepwise association process from ensembles of monomers over stringlike chains to bundles of hexagonal zipped-chain patches. We demonstrate that attractive van der Waals interactions due to charge-density fluctuations in the magnetic particles play the key role for the dynamical stabilization of the hexagonal superstructures against thermal dissociation. Our results give insight into the dynamics of self-organization in systems dominated by dipolar interactions.

On the assessment of hydroxyapatite fluoridation by means of Raman scattering.

Hydroxyapatite is the main mineral component of bones and teeth. Fluorapatite, a bioceramic that can be obtained from hydroxyapatite by chemical substitution of the hydroxide ions with fluoride, exhibits lower mineral solubility and larger mechanical strength. Despite the widespread use of fluoride against caries, a reliable technique for unambiguous assessment of fluoridation in in vitro tests is still lacking. Here we present a method to probe fluorapatite formation in fluoridated hydroxyapatite by combining Raman scattering with thermal annealing. In synthetic minerals, we found that effectively fluoride substituted hydroxyapatite transforms into fluorapatite only after heat treatment, due to the high activation energy for this first order phase transition.

Direct imaging of the visible emission bands from individual ZnO nanowires by near-field optical spectroscopy.

Room-temperature photoluminescence (PL) measurements have been performed on single-crystal ZnO nanowires grown on SiO2/Si and quartz substrates by the vapor transport method using Au as a catalyst. Two emission bands are apparent, one in the UV spectral region around 380 nm (3.26 eV) associated with exciton recombination processes and a much broader structure in the visible range from 420 to 700 nm, which exhibits two distinct peak-like features around 520 and 590 nm (2.38 and 2.10 eV). Spectrally resolved scanning near-field optical microscopy (SNOM) of single ZnO nanowires have been performed for a direct imaging of the PL emission with spatial resolution below 100 nm. SNOM results provide evidence that the yellow emission band observed at 590 nm is a unique property of the ZnO nanowires, being most likely related to radiative recombination processes associated with Au impurities introduced during the catalytic growth.

Crystallisation of amorphous germanium thin films.

By combining cross-sectional transmission and scanning electron microscopy with Raman scattering we have investigated the mechanism of nanocrystal formation in ultrathin amorphous SiO2/Ge/SiO2 trilayers grown by e-beam evaporation as a function of annealing temperature and a-Ge layer thickness. We observe that with decreasing a-Ge thickness the amorphous-to-crystalline (a-to-c) transition occurs at considerably higher temperatures, even avoiding crystallisation for very thin films below 2 nm thickness. Furthermore, we demonstrate that the formation of Ge nanocrystals by annealing at around 900 degrees C takes place driven by a liquid-mediated mechanism. As indicated by the observed microstructure, the metallic liquid film dewets from the surface forming droplets that upon cooling and under the influence of the SiO2 capping layer, solidify into barrel-type nanocrystals.

Real-time detection of transient cardiac ischemic episodes from ECG signals.

We propose a new algorithm to detect and classify transient cardiac ischemia episodes, designed with the goal of providing a real-time execution without penalizing the classifier accuracy much. The algorithm is based on a novel mixture of time-domain analysis and machine learning techniques, specifically bagging of decision trees, and it has been developed using a well-recognized and freely distributed database, namely the long-term ST database. The ST episode detection sensitivity/positive predictivity using the annotation protocol A for this database is 68.26%/74.91%. The sensitivity result increases until 93.97% for the most dangerous episodes in terms of duration and magnitude (annotated according to protocol C). The test of the algorithm over the freely distributed part of the European Society of Cardiology database has shown results of sensitivity and positive predictivity of 83.33% and 77.31%, respectively. Those results are close to the results obtained by related works that present approaches to detect ischemia episodes off-line, which is remarkable if we take into account that in our real-time approach, less information is available during the classification process.

[Isolated girdle weakness: expansion of the phenotypic spectrum of the MERRF 8344A>G mutation of mitochondrial DNA]. / Debilidad aislada de cinturas: ampliacion del espectro fenotipico de la mutacion MERRF 8344A>G del ADN mitocondrial.

INTRODUCTION: The differential diagnosis of diseases that are accompanied by adult-onset girdle weakness is broad and includes motor neurone, neuromuscular junction or muscular diseases. The 8344A>G mutation of the MTTK gene of mitochondrial DNA usually presents with involvement of multiple organs associated (or not) with girdle weakness. To date no cases of isolated girdle weakness have been reported as the presenting symptom of this mutation. CASE REPORT: A 57-year-old male, with a four-year history of isolated clinical signs of progressive girdle weakness. He is the brother of a 59-year-old woman with the same clinical features. Muscular biopsy played a decisive role in the diagnosis and was characteristic of mitochondrial myopathy. The genetic analysis revealed the 8344A>G mutation of the MTTK gene of mitochondrial DNA. CONCLUSIONS: The 8344A>G mutation of mitochondrial DNA can be associated with clinical signs and symptoms of adult-onset girdle weakness, and must therefore be included as part of its differential diagnosis.

TITLE: Debilidad aislada de cinturas: ampliacion del espectro fenotipico de la mutacion MERRF 8344A>G del ADN mitocondrial.Introduccion. El diagnostico diferencial de los trastornos que cursan con debilidad de cinturas de inicio en la edad adulta es amplio e incluye enfermedades de neurona motora, union neuromuscular o musculo. La mutacion m.8344A>G del gen MTTK del ADN mitocondrial suele presentarse con afectacion de multiples organos asociada o no a una debilidad de cinturas. No se han descrito hasta el momento casos de debilidad de cinturas aislada como sintoma de presentacion de esta mutacion. Caso clinico. Varon de 57 años, con clinica aislada de debilidad progresiva de cinturas, de cuatro años de evolucion. Hermano de una mujer de 59 años con la misma sintomatologia. La biopsia muscular fue decisiva en el diagnostico y es caracteristica de una miopatia mitocondrial. El analisis genetico objetivo la mutacion m.8344A>G del gen MTTK del ADN mitocondrial. Conclusiones. La mutacion 8344A>G del ADN mitocondrial puede cursar con un cuadro aislado de debilidad de cinturas de inicio en el adulto, por lo que debe de formar parte del diagnostico diferencial de este.

Mastitis granulomatosa idiopática complicada con absceso de mama producido por Gordonia sputi, caso clínico / Idiopathic granulomatous mastitis complicated with a breast abscess caused by Gornodia sputi, a case report

La mastitis granulomatosa idiopática es una entidad rara, benigna y crónica de causa desconocida que afecta a la mama. Es un diagnóstico de exclusión. Se deben descartar, entre otras etiologías, la tuberculosis, las infecciones, la sarcoidosis y otras enfermedades autoinmunes, como la arteritis de células gigantes. Los principales retos que plantea esta entidad son su diagnóstico diferencial con enfermedad maligna y su tratamiento. La afectación mamaria es anecdótica y ha sido solo reportada en relación con prótesis mamarias. Presentamos el caso de una paciente diagnosticada de mastitis granulomatosa idiopática complicada con un absceso de mama por Gordonia sputi.

Idiopathic granulomatous mastitis is a rare, benign, chronic entity of unknown cause affecting the breast. It is a diagnosis of exclusion. Among other aetiologies, tuberculosis, infections, sarcoidosis, and other autoimmune diseases such as giant cell arteritis must be ruled out. The main challenges posed by this entity are its differential diagnosis with malignant pathology and its treatment.Gordonia spp. are a group of emerging pathogens that are mainly associated with infections associated with medical devices, mainly catheters. Breast involvement is anecdotal and has only been reported in relation to breast prostheses.We present the case of a patient diagnosed with idiopathic granulomatous mastitis complicated with a breast abscess due to Gordonia sputi.

Cáncer sincrónico de carcinosarcoma uterino y carcinoma seroso tubárico. A propósito de un caso y revisión de la bibliografía / A synchronous diagnosis of uterine carcinosarcoma and serous tubal carcinoma. A case report and literature review

Exponemos el caso de una paciente de 74 años que consultó por sangrado posmenopáusico y finalmente se diagnosticó de carcinosarcoma uterino y carcinoma seroso tubárico, sincrónico.En la exploración se objetivó una formación polipoidea a través del cérvix y se visualizó en la ecografía transvaginal una imagen heterogénea intracavitaria.El resultado del estudio histológico de ambos hallazgos fue de carcinosarcoma.Tanto la resonancia magnética como la tomografía axial computarizada describieron una lesión en cuerpo uterino indicativa de mioma sin descartar degeneración sarcomatosa, además de una lesión cervical con características similares.Ante la sospecha de un carcinoma de endometrio tipo ii, se realizó, por vía laparoscópica, una histerectomía, una doble anexectomía, una omentectomía y una linfadenectomía pélvica y paraaórtica. Con el siguiente resultado anatomopatológico: carcinosarcoma uterino de 5cm con infiltración miometrial <50% y afectación del estroma cervical, con márgenes libres. Ambos anejos y tejido peritoneal presentaban infiltración por carcinoma seroso de alto grado de origen tubárico. Las linfadenectomías pélvica y paraaórtica sin evidencia de malignidad.Se concluye un estadificación de carcinosarcoma uterino estadio ii y carcinoma seroso tubárico estadio iiiB sincrónico.Se trata de una rara entidad; tenemos conocimiento de un único caso clínico similar documentado, siendo nuestro propósito presentar el manejo y tratamiento realizado.

We report a rare case of uterine carcinosarcoma involving a 74-year-old woman. The patient complained of posmenopausal bleeding. The disease was eventually diagnosed as simultaneous uterine carcinosarcoma and high-grade serous tubal carcinoma.Clinical examination found a cervical tumour and transvaginal ultrasound showed a heterogeneous intrauterine image. The histological result of both findings was carcinosarcoma.The computed tomography scan and magnetic resonance imaging reported similar findings for intrauterine and cervical tumour, with the same features as a possible myoma or mass with sarcomatous degeneration.Given the suspicion of a high-risk variant of endometrial adenocarcinoma, the primary management of carcinosarcoma is surgery. Complete surgical staging included total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic and para-aortic lymph node dissection.The pathological findings revealed a uterine carcinosarcoma tumour, invading less than half the myometrium and the stromal connective tissue of the cervix but not extending beyond the uterus. The histopathological studies of bilateral adnexectomy and the peritoneal biopsy demonstrated the presence of high-grade serous tubal carcinoma. The lymph study was negative for malignancy.We concluded a synchronous diagnosis of uterine carcinosarcoma stage II and high-grade serous tubal carcinoma stage IIIB.A detailed literature search and management of this entity are discussed.

Malformaciones fetales graves debidas a la secuencia de bandas amnióticas / Severe fetal malformations due to amniotic band sequence

La secuencia de bandas amnióticas es una entidad que puede presentarse como un amplio espectro de malformaciones fetales, cuyo origen está relacionado con la presencia de bandas amnióticas. Presentamos el caso de una gestante de 17+6 semanas, sin control gestacional previo, en la que se detectaron un gran número de malformaciones fetales con presencia de bandas amnióticas. El diagnóstico de esta entidad se realiza con la ecografía prenatal, sospechándose en presencia de malformaciones fetales diversas que no pertenecen a ningún síndrome conocido. La presencia de una brida amniótica constituye un elemento patognomónico, aunque no siempre está presente. Debemos conocer esta entidad, ya que existe un gran infradiagnóstico debido a su gran variedad clínica. Realizar el diagnóstico prenatal nos permite determinar el pronóstico, así como valorar la necesidad de intervenciones quirúrgicas tanto antes como después del nacimiento.

Amniotic band sequence can show a wide spectrum of fetal malformations, the origin of which is the presence of amniotic bands. We present the case of a pregnant woman of 17+6 weeks, without gestational control. Multiple fetal malformations with presence of amniotic bands were detected on ultrasonography. Echography plays a major role in the diagnosis, with the presence of diverse fetal malformations. The presence of an amniotic band is pathognomonic, but is not always present. We must be aware of this sequence because it is underdiagnosed due to its wide clinical spectrum. Prenatal diagnosis of this entity allows us to determine prognosis of the pregnancy. It also helps us to evaluate possible surgical interventions after and before birth.

Tratamiento del dolor pélvico crónico mediante terapia neuroadaptativa / Neuroadaptation therapy in chronic pelvic pain

Objetivo: Valorar el tratamiento de pacientes con dolor pélvico crónico mediante terapia neuroadaptativa. Material y métodos: Se presenta un estudio observacional, longitudinal y retrospectivo de 18 pacientes que presentaban dolor pélvico crónico refractario a tratamientos convencionales con analgesia y terapia física, y que fueron tratadas mediante terapia neuroadaptativa. Resultados: Se objetivaron antecedentes relacionables con el dolor en 15 casos: en siete (38,88%) pacientes, existió un parto reciente; en cinco (27,77%) pacientes, había una histerectomía reciente; en un (5,58%) caso, una fractura pélvica y en dos (11,16%) pacientes, protusiones discales. Se obtuvo una curación o respuesta completa en 15 (83,32%) pacientes, con una desaparición total de los síntomas tras tres (2-4) sesiones de tratamiento. En dos (11,16%) pacientes se obtuvo una respuesta parcial. La satisfacción obtenida en estos dos casos fue muy elevada, 10 (8-10), y la puntuación EVA bajó de 10 (9-10) a 3 (2-5), p < 0,01. Se consideró como fracaso un (5,58%) paciente, que no tuvo ninguna mejoría tras dos sesiones de tratamiento. Durante un seguimiento de 10 (6-13,50) meses, las dos pacientes con respuesta parcial mantuvieron su mejoría pero precisaron sesiones de recuerdo. De las 15 pacientes restantes, 12 (80%) pacientes permanecían sin dolor. Las tres pacientes restantes presentaron una recidiva parcial a los 13, 6 y 3 meses cada una. Se realizaron sesiones de rescate, obteniendo de nuevo una respuesta completa. No se objetivaron complicaciones. Conclusión: Con las limitaciones propias de unos resultados preliminares, la terapia neuroadaptativa parece ser un procedimiento eficaz para el tratamiento del dolor pélvico crónico de origen musculoesquelético.(AU)

Objetive: To evaluate a neuroadaptive therapy in patients with chronic pelvic pain. Material and methods: A retrospective observational study including 18 patients with chronic pelvic pain that were managed using neuroadaptive therapy after they had failed a conventional approach with physiotherapy and analgesia. Results: Data associated with previous chronic pelvic pain were seen in 15 patients. These included 7 (38.88%) cases of recent labour and 5 (27.77%) cases with a previous hysterectomy. There was also 1 (5.58%) cases with a pelvic fracture and disc herniations in 2 (11.16%) cases. Complete response was achieved in 15 (83.32%) patients after 3 (2-4) treatment sessions. A partial response was seen in 2 (11.16%) cases. In these 2 patients’ satisfaction with the procedure was high, 10 (8-10) and pain evaluation using a VAS lower, down from 10 (9-10) to 3 (2-5), p < 0.01. No response was achieved in 1 (5.58%) patient after 2 treatment sessions. In the mean 10-month (6-13.50) follow-up there was a continuing partial response in 2 patients after reinforced sessions, and complete response in 12 (80%) patients. Partial relapses, at 12. 6 and 3 months follow up, were seen in 3 patients with a complete response. These 3 patients were treated again with neuroadaptive therapeuty sessions, and a new complete response was achieved in all 3 cases. No complications were seen. Conclusion: Though there is limited experience, neuroadaptive therapy seems to be a feasible procedure to manage chronic pelvic pain.(AU)

Tumor phyllodes de la mama: nuestra experiencia durante 11 años y revisión de la literatura / Phyllodes breast tumour: experience over 11 years and literature review

Objetivo: Analizar el perfil de las pacientes diagnosticadas de tumores phyllodes en nuestra área sanitaria. Material y métodos: Se presenta un estudio descriptivo retrospectivo de las pacientes diagnosticadas de tumor phyllodes en nuestro centro entre los años 2008 y 2019. Resultados: La edad media, el tamaño tumoral y la tasa de recidiva a 10 años fueron mayores en el grupo con tumores borderline-malignos. El tiempo medio de recidiva locorregional fue mayor en el grupo con tumores benignos que en el grupo borderline-maligno. El tipo histológico fue la única variable que demostró favorecer la recidiva local. El tamaño tumoral no se relacionó con el riesgo de recidiva locorregional. Conclusiones: El tipo histológico fue la única variable que demostró actuar como factor pronóstico de recidiva local. El tamaño tumoral no se relacionó con el riesgo de recidiva locorregional.(AU)

Objective: To analyse the profile of patients diagnosed with phyllodes tumours in a healthcare area. Material and methods: A retrospective descriptive study is presented on patients diagnosed with phyllodes tumour in a healthcare area between 2008 and 2019. Results: Mean age, tumour size, and recurrence rate at 10 years were higher in the group with borderline-malignant tumours. The mean time of locoregional recurrence was higher in the group with benign tumours than in the borderline-malignant group. The histological type was the only variable that showed to favour local recurrence. Tumour size was not related to the risk of locoregional recurrence. Conclusions: The histological type was the only variable that appeared to act as a prognostic factor for local recurrence. Tumour size was not related to the risk of locoregional recurrence.(AU)

Exercise recognition for Kinect-based telerehabilitation.

BACKGROUND: An aging population and people's higher survival to diseases and traumas that leave physical consequences are challenging aspects in the context of an efficient health management. This is why telerehabilitation systems are being developed, to allow monitoring and support of physiotherapy sessions at home, which could reduce healthcare costs while also improving the quality of life of the users. OBJECTIVES: Our goal is the development of a Kinect-based algorithm that provides a very accurate real-time monitoring of physical rehabilitation exercises and that also provides a friendly interface oriented both to users and physiotherapists. METHODS: The two main constituents of our algorithm are the posture classification method and the exercises recognition method. The exercises consist of series of movements. Each movement is composed of an initial posture, a final posture and the angular trajectories of the limbs involved in the movement. The algorithm was designed and tested with datasets of real movements performed by volunteers. We also explain in the paper how we obtained the optimal values for the trade-off values for posture and trajectory recognition. RESULTS: Two relevant aspects of the algorithm were evaluated in our tests, classification accuracy and real-time data processing. We achieved 91.9% accuracy in posture classification and 93.75% accuracy in trajectory recognition. We also checked whether the algorithm was able to process the data in real-time. We found that our algorithm could process more than 20,000 postures per second and all the required trajectory data-series in real-time, which in practice guarantees no perceptible delays. Later on, we carried out two clinical trials with real patients that suffered shoulder disorders. We obtained an exercise monitoring accuracy of 95.16%. CONCLUSIONS: We present an exercise recognition algorithm that handles the data provided by Kinect efficiently. The algorithm has been validated in a real scenario where we have verified its suitability. Moreover, we have received a positive feedback from both users and the physiotherapists who took part in the tests.