Iodinated Contrast Enhancement of Breast Cancer on Prone Multidetector Computed Tomography-Preliminary Findings.

OBJECTIVES: Contrast-enhanced breast imaging has gained increasing importance in the diagnosis and management of breast cancer. The aim of this study was to assess breast cancer enhancement after contrast administration on prone multidetector computed tomography (MDCT). MATERIALS AND METHODS: This retrospective, unicentric, institutional review board-approved study included patients with newly diagnosed breast cancer who were submitted to contrast-enhanced MDCT in prone position, with image acquisition before and after nonionic iodinated contrast administration. RESULTS: Sixty breast cancer patients aged between 31 and 74 years (mean, 49 years) were included. Most patients (n = 50, 83.3%) had no special type invasive breast carcinoma and luminal subtype (n = 45, 75%). All index breast tumors were identified on prone MDCT. Forty-three cases (70.5%) presented as mass, 13 (21.3%) as nonmass enhancement and 4 (6.6%) as both mass and nonmass enhancement. Mean tumor density was 37.8 HU and 87.9 HU on precontrast and postcontrast images, respectively. Mean contrast enhancement was 50.2 HU (range, 20-109 HU). There were no statistically significant differences in tumor enhancement according to histological type, molecular subtype, nuclear grade, tumor size, or imaging presentation. CONCLUSIONS: Our results show that breast cancer usually can be identified and have significant contrast enhancement on prone MDCT images. This method could be used as an alternative when other contrast-enhanced breast imaging methods are not available.

Adsorptive Capacity, Inhibitory Activity and Processing Techniques for a Copper-MOF Based on the 3,4-Dihydroxybenzoate Ligand.

Due to the fast, emerging development of antibiotic-resistant bacteria, the need for novel, efficient routes to battle these pathogens is crucial; in this scenario, metal-organic frameworks (MOFs) are promising materials for combating them effectively. Herein, a novel Cu-MOF-namely 1-that displays the formula [Cu3L2(DMF)2]n (DMF = N,N-dimethylformamide) is described, synthesized by the combination of copper(II) and 3,4-dihydroxybenzoic acid (H3L)-both having well-known antibacterial properties. The resulting three-dimensional structure motivated us to study the antibacterial activity, adsorptive capacity and processability of the MOF in the form of pellets and membranes as a proof-of-concept to evaluate its future application in devices.

Automated Notification of Relevant Expected or Incidental Findings in Imaging Exams in a Verticalized Healthcare System.

To describe the implementation of a standardized code system for notification of relevant expected or incidental findings in imaging exams and use of an automated textual mining tool of radiological report narratives, created to facilitate directing patients to specific lines of care, reducing the waiting time for interventions, consultations, and minimizing delays to treatment. We report our 12-month initial experience with the process. A standardized code was attached to every radiology report when a relevant finding was observed. On a daily basis, the notifications was sent to a dedicated medical team to review the notified abnormality and decide a proper action. Between October 1, 2020, and September 30, 2021, 40,296 sectional examinations (CT and MR scans) were evaluated in 35,944 patients. The main findings reported were calcified plaques on the trunk of the left coronary artery or trunk like, pulmonary nodule/mass and suspected liver disease. Data of follow-up was available in 10,019 patients. The age ranged from 24 to 101 years (mean of 71.3 years) and 6,626 were female (66.1%). In 2,548 patients a complementary study or procedure was indicated, and 3,300 patients were referred to a specialist. Customized database searches looking for critical or relevant findings may facilitate patient referral to specific care lines, reduce the waiting time for interventions or consultations, and minimize delays to treatment.

Multifunctionality in an Ion-Exchanged Porous Metal-Organic Framework.

Porous robust materials are typically the primary selection of several industrial processes. Many of these compounds are, however, not robust enough to be used as multifunctional materials. This is typically the case of Metal-Organic Frameworks (MOFs) which rarely combine several different excellent functionalities into the same material. In this report we describe the simple acid-base postsynthetic modification of isotypical porous rare-earth-phosphonate MOFs into a truly multifunctional system, maintaining the original porosity features: [Ln(H3pptd)]·xSolvent [where Ln3+ = Y3+ (1) and (Y0.95Eu0.05)3+ (1_Eu)] are converted into [K3Ln(pptd)]·zSolvent [where Ln3+ = Y3+ (1K) and (Y0.95Eu0.05)3+ (1K_Eu)] by immersing the powder of 1 and 1_Eu into an ethanolic solution of KOH for 48 h. The K+-exchanged Eu3+-based material exhibits a considerable boost in CO2 adsorption, capable of being reused for several consecutive cycles. It can further separate C2H2 from CO2 from a complex ternary gas mixture composed of CH4, CO2, and C2H2. This high adsorption selectivity is, additionally, observed for other gaseous mixtures, such as C3H6 and C3H8, with all these results being supported by detailed theoretical calculations. The incorporation of K+ ions notably increases the electrical conductivity by 4 orders of magnitude in high relative humidity conditions. The conductivity is assumed to be predominantly protonic in nature, rendering this material as one of the best conducting MOFs reported to date.

Conditions of enzyme-assisted extraction to increase the recovery of flavanone aglycones from pectin waste.

The citrus pectin by-product (CPB), generated from pectin industry, is a rich-source of flavanones, but not explored until now. As most of these compounds are inside vacuoles or bound to cell wall matrix, enzymatic hydrolysis was applied on their recovery, followed by hydroalcoholic and ultrasound extraction. Different parameters were studied: enzymes (ß-glucosidase, tannase, and cellulase), their concentration (5, 10, and 20 U g-1 CPB), and reaction time (6, 12, and 24 h). Extracts were characterized in total phenolic content (TPC), antioxidant capacity (ORAC and DPPH assays), and polyphenolic profile (HPLC-DAD). All enzymatic treatments significantly improved CPB antioxidant capacity and TPC, compared with hydroalcoholic and ultrasound extraction. ß-glucosidase (5 U) for 24 h was the most effective in polyphenol extraction and bioconversion, followed by ß-glucosidase (5 U) for 12 h and tannase (5 U) for 24 h. Thus, the concentration of these enzymes was increased (10 and 20 U) to improve flavanones extraction. ß-glucosidase at 20 U offered the highest amount of naringenin (77.63 mg 100 g-1 of CPB) and hesperetin (766.44 mg 100 g-1) obtained so far by biological processes. According to Person's correlation analysis, TPC and antioxidant activity were highly correlated with CPB contents of hesperetin and naringenin. The aglycone flavanones are rarely found in natural sources and have higher biological potential than their glycosylated forms. Our results indicated enzyme-assisted extraction as a good choice for recovering aglycone flavanones from CPB, and increased knowledge on the biological activity of this agroindustrial waste, amplifying their application in food and pharmaceutical field.

Patterns of breast, prostate and cervical cancer incidence and mortality in Colombia: an administrative registry data analysis.

BACKGROUND: Cancer is widely recognized as a global public health problem. Breast, prostate, and cervical cancer are among the most frequent types in developing countries. Assessing their incidence and mortality by regions and municipalities is important to guide evidence-based health policy. Our aim was to describe the incidence and mortality trends for breast, cervical, and prostate cancer across regions and municipalities in Colombia during 2018. METHODS: We performed a cross-sectional analysis with data from people with breast, prostate, or cervical cancer, reported to the National Administrative Cancer Registry during 2018. A descriptive analysis was performed. Age-standardized incidence and mortality rates were estimated at national, regional, and municipal levels. Finally, we identify the regions and municipalities with significantly higher or lower incidence and mortality rates compared to national estimations. RESULTS: Breast cancer was the most frequent type among all new cases and deaths in Colombia. Breast, prostate and cervical cancer incidence and mortality rates per 100,000 were: 18.69 (CI 95%: 18.15-19.25) and 10.48 (CI 95%: 10.07-10.91); 11.34 (CI 95%: 10.90-11.78) and 7.58 (CI 95%: 7.22-7.96); 5.93 (CI 95%: 5.62-6.25) and 4.31 (CI 95%: 4.05-4.58), respectively. Eastern region had both, incidence and mortality rates, significantly lower than national for all types of cancer. By municipalities, there was a heterogeneous pattern. Nonetheless, Agua de Dios (Cundinamarca), had one of the highest incidence rates for all types. CONCLUSIONS: We observed clear differences in cancer incidence and mortality across regions and municipalities, depending on each type of cancer. Our findings are important to improve screening coverage, early detection, and treatment in the country.

Space-time clustering of childhood leukemia in Colombia: a nationwide study.

BACKGROUND: Leukemia is the most common cancer in childhood. The estimated incidence rate of childhood leukemia in Colombia is one of the highest in America and little is known about its spatial distribution. PURPOSE: To explore the presence of space-time clustering of childhood leukemia in Colombia. METHODS: We included children less than 15 years of age with confirmed diagnosis of acute leukemia reported to the national surveillance system for cancer between 2009 and 2017. Kulldorff's spatio-temporal scan statistics were used with municipality and year of diagnosis as units for spatial and temporal analysis. RESULTS: There were 3846 cases of childhood leukemia between 2009 and 2017 with a specific mean incidence rate of 33 cases per million person-years in children aged 0-14 years. We identified five spatial clusters of childhood leukemia in different regions of the country and specific time clustering during the study period. CONCLUSION: Childhood leukemia seems to cluster in space and time in some regions of Colombia suggesting a common etiologic factor or conditions to be studied.

Functional and metabolic imaging in transthoracic biopsies guided by computed tomography.

OBJECTIVES: CT-guided biopsy of indeterminate lung lesions sometimes provides insufficient histological results due to tumor necrosis. Functional and metabolic methods such as DWI-MR and PET-CT may help by directing sample collection to a lesion area of greater biological representativeness. The objective is to evaluate the histopathological results based on findings on ADC and SUV levels in lung lesions suspected for primary cancer. METHODS: Tissue samples were evaluated after undergoing biopsies guided by either DWI-MR or PET-CT findings. In each patient, sample collection from two lesion areas was guided by local ADC and SUV. Values were used to define areas of low vs. high suspicion for cancer. RESULTS: Patients who underwent DWI-MR had median lesion size of 78.0 mm. Areas of higher suspicion (HSA) had a median ADC of 1.1 × 10-3 mm2/s, while areas of lower suspicion (LSA) had median ADC of 1.8 × 10-3 mm2/s (p = 0.0001). All HSA samples and 71.43% of LSA samples were positive for cancer (p = 0.0184). Patients who performed PET-CT had median lesion size of 61.0 mm. Median SUV was 7.1 for HSA and 3.9 for LSA (p = 0.0002). Positivity for cancer was observed in 76.9% of samples for both HSA and LSA (p = 0.0522). CONCLUSION: Use of DWI-MR and PET-CT showed that tumors are functional and metabolically heterogeneous and that this heterogeneity has implications for histopathological diagnosis. KEY POINTS: • Lung cancer is heterogeneous regarding functional and metabolic imaging. • Tumor heterogeneity may have implications in histopathological diagnosis. • Intralesional lower levels of ADC target highly suspected areas with a significant improvement in lung cancer diagnosis.

CT-guided biopsy of breast lesions: When should it be considered?

Mammography, ultrasound, and magnetic resonance imaging (MRI) are the most commonly used modalities for interventional radiology procedures involving the breast. Computed tomography (CT) is rarely used for breast imaging yet it is able to detect breast lesions and can often provide safe and effective access to breast lesions. The aim of this study was to demonstrate situations in which CT should be considered as an alternative guidance method for the biopsy of breast lesions that are not accessible with conventional imaging modalities.

JOURNAL CLUB: Preparative Fasting for Contrast-Enhanced CT in a Cancer Center: A New Approach.

OBJECTIVE: Most diagnostic imaging centers ask patients to fast for 4-6 hours before contrast-enhanced CT. Previous studies have shown that prolonged fasting can be harmful. In addition, manufacturers of contrast agents claim that there is no special preparation needed before examination. The aim of this study was to evaluate the effects of preparative fasting on contrast-enhanced CT at a cancer center. SUBJECTS AND METHODS: Outpatients (n = 3206) were prospectively evaluated and randomly assigned to two groups: the 1619 patients in group 1 fasted for at least 4 hours before the examination, whereas the 1587 patients in group 2 received a light meal. Adverse symptoms observed before and after contrast agent administration were compared between groups. RESULTS: Adverse symptoms occurring after IV contrast agent administration were reported by 45 patients (1.5%) in group 1 and 30 patients (0.9%) in group 2. The most common symptoms were nausea (n = 32), weakness (n = 12), and vomiting (n = 5). The frequency of symptoms did not differ statistically significantly between groups (p > 0.05). CONCLUSION: In this sample of patients with cancer undergoing contrast-enhanced CT, very few adverse symptoms were reported regardless of preparative fasting. These results support the idea that preparation for contrast-enhanced CT can be simplified, decreasing the discomfort and inconvenience experienced by patients.

Biochemical characterization and evaluation of invertases produced from Saccharomyces cerevisiae CAT-1 and Rhodotorula mucilaginosa for the production of fructooligosaccharides.

Invertases are used for several purposes; one among these is the production of fructooligosaccharides. The aim of this study was to biochemically characterize invertase from industrial Saccharomyces cerevisiae CAT-1 and Rhodotorula mucilaginosa isolated from Cerrado soil. The optimum pH and temperature were 4.0 and 70 °C for Rhodotorula mucilaginosa invertase and 4.5 and 50 °C for Saccharomyces cerevisiae invertase. The pH and thermal stability from 3.0 to 10.5 and 75 °C for R. mucilaginosa invertase, respectively. The pH and thermal stability for S. cerevisiae CAT-1 invertase from 3.0 to 7.0, and 50 °C, respectively. Both enzymes showed good catalytic activity with 10% of ethanol in reaction mixture. The hydrolysis by invertases occurs predominantly when sucrose concentrations are ≤5%. On the other hand, the increase in the concentration of sucrose to levels above 10% results in the highest transferase activity, reaching about 13.3 g/L of nystose by S. cerevisiae invertase and 12.6 g/L by R. mucilaginosa invertase. The results demonstrate the high structural stability of the enzyme produced by R. mucilaginosa, which is an extremely interesting feature that would enable the application of this enzyme in industrial processes.

Catalytic and thermodynamic properties of ß-glucosidases produced by Lichtheimia corymbifera and Byssochlamys spectabilis.

The objective of the present study was to optimize parameters for the cultivation of Lichtheimia corymbifera (mesophilic) and Byssochlamys spectabilis (thermophilic) for the production of ß-glucosidases and to compare the catalytic and thermodynamic properties of the partially purified enzymes. The maximum amount of ß-glucosidase produced by L. corymbifera was 39 U/g dry substrate (or 3.9 U/mL), and that by B. spectabilis was 77 U/g (or 7.7 U/mL). The optimum pH and temperature were 4.5 and 55 °C and 4.0 and 50 °C for the enzyme from L. corymbifera and B. spectabilis, respectively. ß-Glucosidase produced by L. corymbifera was stable at pH 4.0-7.5, whereas the enzyme from B. spectabilis was stable at pH 4.0-6.0. Regarding the thermostability, ß-glucosidase produced by B. spectabilis remained stable for 1 h at 50 °C, and that from L. corymbifera was active for 1 h at 45 °C. Determination of thermodynamic parameters confirmed the greater thermostability of the enzyme produced by the thermophilic fungus B. spectabilis, which showed higher values of ΔH, activation energy for denaturation (Ea), and half-life t(1/2). The enzymes were stable in the presence of ethanol and were competitively inhibited by glucose. These characteristics contribute to their use in the simultaneous saccharification and fermentation of vegetable biomass.

Robust Multifunctional Yttrium-Based Metal-Organic Frameworks with Breathing Effect.

Phosphonate- and yttrium-based metal-organic frameworks (MOFs), formulated as [Y(H5btp)]·5.5H2O (1), [Y(H5btp)]·2.5H2O (2), (H3O)[Y2(H5btp)(H4btp)]·H2O (3), and [Y(H5btp)]·H2O·0.5(MeOH) (4), were prepared using a "green" microwave-assisted synthesis methodology which promoted the self-assembly of the tetraphosphonic organic linker [1,1'-biphenyl]-3,3',5,5'-tetrayltetrakis(phosphonic acid) (H8btp) with Y3+ cations. This new family of functional materials, isolated in bulk quantities, exhibits a remarkable breathing effect. Structural flexibility was thoroughly studied by means of X-ray crystallography, thermogravimetry, variable-temperature X-ray diffraction, and dehydration and rehydration processes, ultimately evidencing a remarkable reversible single-crystal to single-crystal (SC-SC) transformation solely through the loss and gain of crystallization solvent molecules. Topologically, frameworks remained unaltered throughout this interconversion mechanism, with all compounds being binodal 6,6-connected network with a Schäfli symbol of {413.62}{48.66.8}. Results show that this is one of the most stable and thermally robust families of tetraphosphonate-based MOFs synthesized reported to date. Porous materials 2 and 3 were further studied to ascertain their performance as heterogeneous catalysts and proton conductors, respectively, with outstanding results being registered for both materials. Compound 2 showed a 94% conversion of benzaldehyde into (dimethoxymethyl)benzene after just 1 h of reaction, among the best results registered to date for MOF materials. On the other hand, the protonic conductivity of compound 3 at 98% of relative humidity (2.58 × 10-2 S cm-1) was among the highest registered among MOFs, with the great advantage of the material to be prepared using a simpler and sustainable synthesis methodology, as well as exhibiting a good stability at ambient conditions (temperature and humidity) over time when compared to others.

Role of computed tomography at a cancer center emergency department.

To evaluate the imaging methods used at the emergency department (ED) of a cancer center, with emphasis on computed tomography (CT). A descriptive, retrospective, single-center study was conducted by reviewing imaging exams and medical records, after approval of the institution's Ethics Review Board. The demographic data, cancer history, and imaging exam requested were evaluated for all patients and the indications and results of head, chest, and abdominopelvic CT scans were also evaluated. During the study period, there were 8710 visits to the ED, and 5999 imaging studies were requested in 3788 patients (43.5 % of total of visits). One thousand eight hundred twenty-nine CT exams were used in 1121 visits (12.9 % of total of visits). The mean age of patients was 57.7 years and most patients (93.2 %) had a known primary tumor. The most common indications for abdominopelvic CT were non-oncologic emergencies (26.7 %) and postoperative complications (19.2 %), and the results were negative in 36.6 %, positive for clinical suspicion in 49.0 %, and incidental positive in 14.5 %. The most frequent indication for chest CT was suspected pulmonary embolism (34.4 %); however, only 11.1 % confirmed the diagnosis. The results of head TC were negative in 72.9 % and the indications that had more positive findings were suspected metastasis (32.1 %) and focal neurological sign/altered level of consciousness (24.5 %). CT plays an important role in driving the cancer patients visiting the ED. However, the high rate of negative or discordant results causes a concern for the inadvertent and excessive use of this imaging modality.

Safety and efficacy of HepaSphere 50-100 µm in the treatment of hepatocellular carcinoma.

AIM: To evaluate the effects of HepaSphere 50-100 µm (Merit Medical) as a doxorubicin carrier and embolization agent for the treatment of hepatocellular carcinoma (HCC). MATERIAL AND METHODS: A prospective analysis of 18 patients recruited from a national cancer center was conducted. This analysis evaluated the efficacy and safety of HepaSphere, as expressed by the treatment response rate (measured by the modified Response Evaluation Criteria in Solid Tumors, mRECIST) and by the prevalence of treatment-related adverse events, respectively. RESULTS: The cohort was predominantly male, with a mean age of 69 years. The objective response rate (complete + partial response) was 53.3%. The variable most likely to be associated with objective response was Barcelona Clinic Liver Cancer (BCLC) staging. The most prevalent adverse events were nausea, vomiting and abdominal pain. CONCLUSION: HepaSphere chemoembolization yielded a substantial objective response rate with an acceptable toxicity profile and should be considered an option for HCC treatment.

A Lamellar Coordination Polymer with Remarkable Catalytic Activity.

A positively charged lamellar coordination polymer based on a flexible triphosphonic acid linker is reported. [Gd(H4 nmp)(H2 O)2 ]Cl⋅2 H2 O (1) [H6 nmp=nitrilotris(methylenephosphonic acid)] was obtained by a one-pot approach by using water as a green solvent and by forcing the inclusion of additional acid sites by employing HCl in the synthesis. Compound 1 acts as a versatile heterogeneous acid catalyst with outstanding activity in organic reactions such as alcoholysis of styrene oxide, acetalization of benzaldehyde and cyclohexanaldehyde and ketalization of cyclohexanone. For all reaction systems, very high conversions were reached (92-97 %) in only 15-30 min under mild conditions (35 °C, atmospheric pressure). The coordination polymer exhibits a protonic conductivity of 1.23×10(-5)  S cm(-1) at 98 % relative humidity and 40 °C.

Infectious Complications of Intrathecal Drug Administration Systems for Spasticity and Chronic Pain: 145 Patients From a Tertiary Care Center.

OBJECTIVES: Studies on the use of intrathecal perfusion devices (IPD) are still limited and therefore the aim of this study is to access the infectious complications associated to these devices. MATERIALS AND METHODS: A retrospective analysis of 145 patients who had an IPD implanted at the Chronic Pain Unit of Hospital de São João over the last 20 years. Mean follow-up time was 7.24 years (range: 0.47-17.41 years). Intrathecal antispastic drug perfusion was used in 123 patients (84.8%) and intrathecal analgesia in 22 patients. RESULTS: A total of 19 (8.71%) infections involving the IPD were identified of which, 14 (6.4%) were surgical site infections (SSIs). Methicillin-sensitive Staphylococcus aureus was the most commonly isolated bacteria in this group. Superficial SSIs were treated with oral antibiotic treatment or local wound care, while in deep SSI the pump was removed. Meningitis was identified in 5 (2.3%) patients and was always preceded by deep surgical site infections, some of which were already being treated with intravenous antibiotics. Median time to meningitis development was 2.2 months (IQR 82.58 months), after the introduction of the pump. Pump removal with anti-biotherapy were the treatment of choice. One patient died of a septic shock with associated meningitis and urinary tract infection. CONCLUSIONS: As seen in this study, infectious complications following implantation of IPD are not uncommon and include a variety of microorganisms. Antibiotic therapy without pump removal may be enough for superficial surgical site infections, but our data suggests that pump removal is the treatment of choice for deep infections as the infection may proceed to meningitis.