In this paper, we developed and evaluated a robust single-lead electrocardiogram (ECG) delineation system based on the wavelet transform (WT). In a first step, QRS complexes are detected. Then, each ...QRS is delineated by detecting and identifying the peaks of the individual waves, as well as the complex onset and end. Finally, the determination of P and T wave peaks, onsets and ends is performed. We evaluated the algorithm on several manually annotated databases, such as MIT-BIH Arrhythmia, QT, European ST-T and CSE databases, developed for validation purposes. The QRS detector obtained a sensitivity of Se=99.66% and a positive predictivity of P+=99.56% over the first lead of the validation databases (more than 980,000 beats), while for the well-known MIT-BIH Arrhythmia Database, Se and P+ over 99.8% were attained. As for the delineation of the ECG waves, the mean and standard deviation of the differences between the automatic and manual annotations were computed. The mean error obtained with the WT approach was found not to exceed one sampling interval, while the standard deviations were around the accepted tolerances between expert physicians, outperforming the results of other well known algorithms, especially in determining the end of T wave.
The aim of the present study was to investigate if 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) outperforms conventional imaging techniques for excluding ...distant metastases prior to neoadjuvant chemotherapy (NAC) treatment in patients with stage II and III breast cancer. Second, we assessed the clinical importance of false positive findings. One hundred and fifty four patients with stage II or III breast cancer, scheduled to receive NAC, underwent an 18F-FDG PET/CT scan and conventional imaging, consisting of bone scintigraphy, ultrasound of the liver, and chest radiography. Suspect additional lesions at staging examination were confirmed by biopsy and histopathology and/or additional imaging. Metastases that were detected within 6 months after the PET/CT scan were considered evidence of occult metastasis, missed by staging examination. Forty-two additional distant lesions were seen in 25 patients with PET/CT and could be confirmed in 20 (13%) of 154 patients. PET/CT was false positive for 8 additional lesions (19%) and misclassified the presence of metastatic disease in 5 (3%) of 154 patients. In 16 (80%) of 20 patients, additional lesions were exclusively seen with PET/CT, leading to a change in treatment in 13 (8%) of 154 patients. In 129 patients with a negative staging PET/CT, no metastases developed during the follow-up of 9.0 months. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT in the detection of additional distant lesions in patients with stage II or III breast cancer are 100, 96, 80, 100, and 97%, respectively. FDG PET/CT is superior to conventional imaging techniques in the detection of distant metastases in patients with untreated stage II or III breast cancer and is associated with a low false positive rate. PET/CT may be of additional value in the staging of breast cancer prior to NAC.
Seven hundred and fourteen pigs were monitored from transport to slaughter in July in three treatments: 8, 16 and 24 transport hours; lairage time for the three groups was of 8
h. Transport duration ...significantly (
P
<
0.05) affected live-weight gain during the rest period. Weight gain percentages at lairage were 0.05%, 0.78% and 1.15% for treatments 1, 2 and 3, respectively. Transport to slaughter loss percentage was 2.7%, 4.3% and 6.8% for each of the treatments. Short transport periods significantly increased carcass pH below normal values. Animals transported under acute stress (8
h) showed pale carcasses (high possibilities of transforming into PSE meat). On the contrary, pigs transported for 24
h had more dark red carcasses. Transport from farm to the slaughterhouse should take no more than 16
h in order to improve carcass quality and animals’ welfare.
Introduction
Lymphatic drainage patterns from the breast have been described in the past. Drainage may change after treatment of a breast or axilla, and this may have implications for lymphatic ...mapping. The aim of this study was to determine the lymphatic drainage patterns in breast cancer patients with a previously treated ipsilateral breast.
Methods
Between January 1999 and November 2008, 115 sentinel node procedures were performed in breast cancer patients who had undergone treatment of the ipsilateral breast in the past. Lymphatic drainage patterns were analyzed based on preoperative lymphoscintigraphy and sentinel lymph node biopsy. Patients were divided into subgroups according to their previous treatment.
Results
Sentinel nodes were found in 84% of the patients: in 81 patients (70%) in the axilla, 43 patients (37%) had drainage to more than one site, and in 18 patients (16%) no drainage was detected. The percentage of drainage outside the axilla was higher than in a series of untreated breast cancer patients from our institution (51% versus 33%,
P
= 0.01). The 16% nonidentification rate was also higher than the 3.1% in patients without previous treatment (
P
= 0.003). Four patients (3.5%) had lymphatic drainage to the contralateral axilla. Twelve patients (10%) had involved sentinel nodes; these were harvested from the contralateral axilla in two of them. No lymph node recurrences were observed during a median follow-up time of 39 months.
Conclusion
Lymphatic mapping yields a lymph node in 84% of breast cancer patients who have undergone previous treatment of the breast. Nonidentification and extra-axillary nodes are more frequently encountered than in patients without treatment of the breast in the past. The finding of involved nodes suggests that sentinel node biopsy improves staging. Long-term follow-up will determine the sensitivity of the procedure in this specific situation.
Aim
To investigate the association between medication use and long‐term all‐cause mortality in a Brazilian stroke cohort.
Methods
Both ischemic and hemorrhagic stroke were evaluated. Medication use ...was assessed as: never, only pre‐stroke, only post‐stroke, and continuous use. We evaluated anti‐hypertensives, anti‐diabetics, lipid‐lowering drugs, anti‐platelets, and anti‐coagulants. Cox regression models were adjusted for sociodemographic and cardiovascular risk factors.
Results
Among 1173 incident stroke cases (median age: 68; 86.8% were ischemic, 70% first‐ever stroke), medication use was low (overall: 17.5% pre‐stroke, 26.4% post‐stroke, and 40% were under continuous use). Anti‐hypertensives and anti‐platelets (aspirin) were the continuous cardiovascular medications used most often, at 83.5% and 72%, respectively, while statins (39.7%) and anti‐diabetics (31.3%) were the least used. Medication use (pre‐stroke, post‐stroke and continuous use) was associated with a reduction in all‐cause mortality risk, particularly among those under continuous use (multivariable hazard ratio, 0.52; 95% confidence interval (CI), 0.46–0.66) compared with never‐users. Among ischemic stroke patients, this effect was similar (multivariable hazard ratio, 0.52; 95% CI, 0.40–0.68). No significant associations were evident among hemorrhagic stroke patients.
Conclusions
The risk of all‐cause mortality was reduced by 48% among those with ischemic stroke under continuous use of medications. Secondary prevention should be emphasized more strongly in clinical practice. Geriatr Gerontol Int 2022; 22: 715–722.
Survivin is an oncogene associated with a decrease in apoptosis, an increase in tumor growth, and poor clinical outcome of diverse malignancies. A correlation between obesity, cancer, and survivin is ...reported in the literature. To date, the impact of weight loss on change in survivin levels is understudied. This study was aimed at: (1) comparing survivin levels in adipose tissue (AT) from lean and obese animal models and evaluating changes after weight loss induced by energy restriction and/or exercise; (2) comparing survivin levels in normal weighted and obese humans and evaluating changes in survivin levels after weight loss induced by a very-low-calorie ketogenic diet (VLCKD) or bariatric surgery in AT and/or blood leukocytes (PBL/PBMCs).
Survivin expression was evaluated in subcutaneous (SAT) and visceral (VAT) AT derived from animal models of monogenic (Zucker rats) and diet-induced obesity (Sprague Dawley rats and C57BL/6J mice) and after a 4-week weight-loss protocol of energy restriction and/or exercise. Plasma was used to measure the inflammatory status. Survivin expression was also evaluated in PBMCs from patients with obesity and compared with normal weight, in PBLs after VLCKD, and in SAT and/or PBLs after bariatric surgery.
Survivin expression was specifically higher in VAT from obese that lean animals, without differences in SAT. It decreased after weight loss induced by energy restriction and correlated with adiposity and inflammatory markers. In humans, the correlation between being obese and higher levels of survivin was confirmed. In obese subjects, survivin levels were reduced following weight loss after either VLCKD or bariatric surgery. Particularly, a decrease in PBMCs expression (not in SAT one) was found after surgery.
Weight loss is effective in decreasing survivin levels. Also, PBL/PBMC should be regarded as appropriate mirror of survivin levels in VAT for the identification of an obesity-related protumoral microenvironment.
Preliminary data have shown encouraging results of a single intratumoral radiopharmaceutical injection that enables both sentinel node biopsy and probe-guided excision of the primary tumor in ...patients with nonpalpable breast cancer. The aim of the study was to evaluate this approach in a large group of patients.
Lymphoscintigraphy was performed in 368 patients with nonpalpable breast cancer after intratumoral injection of (99m)Tc-nanocolloid (.2 mL, 123 MBq, 3.3 mCi) guided by ultrasound or stereotaxis. The sentinel node was pursued with the aid of vital blue dye (1.0 mL, intratumoral) and a gamma ray detection probe. In case of breast-conserving surgery, the probe was used to guide the excision.
At least one sentinel node could be identified intraoperatively in 357 patients (97%), of whom 69 had involved nodes (19%). Age over 60 years was associated with less frequent nonaxillary lymphatic drainage and absence of internal mammary chain dissemination. Tumor-free margins were obtained in 262 (89%) of the 293 patients who underwent segmental excision. Re-excision of the primary tumor bed was performed in six patients (2%). During a median follow-up of 22 months, one breast recurrence and one axillary recurrence were observed.
Lymphatic mapping and probe-guided tumor excision of nonpalpable breast cancer by intralesional administration of a single dose of (99m)Tc-nanocolloid and blue dye resulted in 97% identification of the sentinel node and in tumor-free margins in 89% of the patients who underwent breast-conserving surgery. Longer follow-up is needed to substantiate the accuracy and safety of this technique.
Abstract The current standard of care for locally advanced inoperable non-small cell lung cancer is high dose radiotherapy with concurrent chemotherapy. We report on a patient with stage IIIA NSCLC ...treated with concurrent chemoradiotherapy on the primary tumor and the 18-fluorodeoxyglucose positron emission tomography (18 FDG-PET) positive hilar and mediastinal lymph nodes. Six months after treatment this patient developed a single isolated contralateral mediastinal nodal relapse outside but in the proximity of the irradiated target volume. This patient was successfully re-irradiated to this isolated nodal relapse after reconstruction of the dose given to the localisation of this regional recurrence. This case describes the clinical problem of a regional recurrence after involved field radiotherapy that occasionally occurs. A possible explanation for those regional recurrences is an under staging of extension of the disease because the time-interval between the staging18 FDG-PET-CT scan and the start of the irradiation was too long. If the time-interval is 4 weeks or more, we strongly recommend a new18 FDG-PET-CT because of the possibility of upstaging of the disease.
Background
Lymphatic drainage may change after radiation of a breast or its regional lymph node basins, and this may have implications for lymphatic mapping afterward. The aim of this study was to ...determine the lymphatic drainage patterns in breast cancer patients who had undergone mantle field radiation for Hodgkin’s lymphoma in the past.
Methods
Between January 1999 and November 2008, 22 breast cancer patients underwent a sentinel node procedure after previous mantle field radiation. Lymphatic drainage patterns were analyzed based on lymphoscintigraphy and sentinel node biopsy. The results were compared with the drainage patterns in patients without previous treatment from an earlier study.
Results
Sentinel nodes were found in the axilla in 19 patients (86%) and 9 patients (41%) also had drainage toward extra-axillary regions. Sentinel nodes were more often found outside the axilla compared to the patients in our earlier study (33%,
P
= 0.04), and the nonidentification rate was also higher (14% vs. 3%,
P
= 0.01). Sentinel nodes were involved in 5 patients (23%). These were harvested from the internal mammary chain in two of them. No lymph node recurrences were observed during a median follow-up time of 49 months.
Conclusion
Lymphatic mapping is feasible and yields a lymph node in 86% of the breast cancer patients after previous mantle field radiotherapy for Hodgkin’s lymphoma. Nonvisualization and extra-axillary nodes are more frequently encountered than in patients without a history of mantle field radiation. The finding of involved nodes suggests that sentinel node biopsy improves staging. Long-term follow-up will determine the sensitivity of the procedure in this specific situation.
Este artículo muestra el camino recorrido junto a Stop Desahucios 15M Granada, un movimiento social amplio e inclusivo que lucha por el derecho a la vivienda en una ciudad del sur del Estado español, ...en nuestra tentativa de realizar una coinvestigación etnográfica, centrándonos en la reflexión epistemológica sobre la etnografía comprometida y colaborativa, a través de la experiencia vivida como hermanas y compañeras. Para ello, en primer lugar y tras una breve introducción para contextualizar la coinvestigación, se presenta una genealogía del movimiento articulada con la producción teórica en torno a la subjetivación política. En segundo lugar, desarrollamos algunas incertidumbres, límites y vulnerabilidades en el proceso de trabajo de campo. En tercer lugar, se abordan algunos ejemplos de coinvestigación, en los que las técnicas han sido primero subvertidas y luego reapropiadas para dar pie a procesos compartidos de análisis y reflexión al interior del movimiento, y posteriormente han dado paso a una forma de difusión y divulgación que es de utilidad para el mismo. Por último, se reflexiona en torno a la potencialidad que el proceso de subjetivación política tiene no solo para los movimientos sociales que reconceptualizan lo político, sino para el proyecto de la etnografía colaborativa en lo referente a la desidentificación de nuestros saberes-haceres-poderes, para instituirlos en común. PALABRAS CLAVE Etnografía colaborativa, Stop Desahucios, procesos de subjetivación política, saberes-haceres-poderes, vulnerabilidad. This article shows the path walked together with Stop Evictions 15M Granada, a broad and inclusive social movement that struggles for the right to housing in a city in the south of Spain, in our attempt to carry out an ethnographic co-research, focusing on epistemological reflection about committed and collaborative ethnography, through the lived experiences as sisters and companions. First of all, and after a brief introduction to contextualize the co-research, we present a movement genealogy articulated with the theoretical production around the political subjectivation processes. Second, we develop on some uncertainties, limits and vulnerabilities lived in the field-work process. Third, we address some cases of co-research through the idea of "knowledges-doings-powers" in which techniques have been first subverted and then re-appropriated to give rise to shared processes of analysis and reflection within the movement and have subsequently given way to a form of dissemination which is useful for the movement. Finally, we reflect on the potentiality that the political subjectivation process has not only for social movements that re-conceptualize the political, but for the collaborative ethnography project in relation to the de-identification of our "knowledges-doings-powers", to institute them in common. KEY WORDS Collaborative ethnography, Stop Evictions, political subjectivation processes, knowledge-doing-powers, vulnerability.
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