Individualized evaluation of the total dose received by radiotherapy patients: Integrating in-field, out-of-field, and imaging doses.

Purpose: To propose a methodology for integrating the out-of-field and imaging doses to the in-field dose received by radiotherapy (RT) patients. In addition, the impact of considering the total dose in planning and radiation-induced second malignancies (RISM) risk assessment will be evaluated in several scenarios comprising photon and proton treatments.

Methods: The total dose is the voxel-wise sum of the doses from the different radiation sources (accounting for the radiobiological effectiveness) produced during the whole RT chain.

Evaluating Medical Therapy Failure in Microbial Keratitis: Risk Factors and Management Alternatives.

Purpose: To describe the treatments used in cases of infectious keratitis and determine the risk factors associated with treatment failure, including prolonged infection duration, treatment modifications, and the need for surgical intervention.

Patients And Methods: This retrospective case series includes culture-proven microbial keratitis cases treated in nine hospitals in the region of Galicia, Spain, between 2010 and 2020.

Results: A total of 654 patients were included.

Microbial keratitis in north-western Spain: a review of risk factors, microbiological profile and resistance patterns.

Purpose: To review the risk factors, clinical characteristics, and microbiological profiles of microbial keratitis cases, as well as the antibiotic resistance patterns of bacterial isolates in the region of Galicia, Spain.

Methods: This retrospective case series includes patients with culture-positive non-viral microbial keratitis between 2010 and 2020, treated at nine hospitals within the region of Galicia, North-West Spain. The standard protocol involved Gram staining for bacterial infections and calcofluor white staining for fungal or amoebal infections, identification by MALDI-TOF mass spectrometry or microscopy, and antimicrobial susceptibility interpreted according to EUCAST or CLSI guidelines.

Simultaneous therapy with pressure-controlled intermittent coronary sinus occlusion and left ventricular support during high-risk percutaneous coronary intervention: a case report.

Background: Previous studies in patients with ST-segment elevation acute myocardial infarction treated with primary angioplasty and supported by the PiCSO® system have shown a modest yet significant absolute reduction in the infarcted myocardial area. However, the simultaneous use of PiCSO® and Impella CP® during high-risk percutaneous coronary intervention (PCI) procedures has not been reported.

Case Summary: A 76-year-old Caucasian man presented with severe and highly calcified left main coronary disease and severely depressed left ventricular function.

Ramipril After Transcatheter Aortic Valve Implantation in Patients Without Reduced Ejection Fraction: The RASTAVI Randomized Clinical Trial.

Background: Patients with aortic stenosis may continue to have an increased risk of heart failure, arrhythmias, and death after successful transcatheter aortic valve implantation. Renin-angiotensin system inhibitors may be beneficial in this setting. We aimed to explore whether ramipril improves the outcomes of patients with aortic stenosis after transcatheter aortic valve implantation.

Recommendations from the Galician Oncological Society and the Galician Society of Nuclear Medicine for the use of Lu-PSMA-617 radioligand-therapy in prostate cancer.

Theragnostic is a type of precision medicine that uses molecules linked to radioactive isotopes for the diagnosis and treatment of diseases. In recent years, it has gained significant importance to treat neuroendocrine tumors and is currently being used in prostate cancer. Various radiopharmaceuticals have emerged for diagnosing and detecting lesions showing prostate-specific membrane antigen (PSMA) positivity on the Positron emission tomography/computed tomography scan, being the most widely used labeled with [Ga] and [F].

SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY INSIGHTS INTO IDIOPATHIC EPIRETINAL MEMBRANE SURGERY OUTCOMES.

Purpose: The aim of this study is to assess the prognostic value of a classification system that includes the presence of ectopic inner foveal layers and other anatomical variables identified in spectral-domain optical coherence tomography for idiopathic epiretinal membrane (ERM) surgery.

Methods: A descriptive-analytic, longitudinal, retrospective study was conducted on patients with idiopathic ERMs treated with pars plana vitrectomy from January 2017 to December 2021. Clinical data and spectral-domain optical coherence tomography images were reviewed presurgery and 12 months postsurgery.

Complete versus incomplete revascularization in patients with a non-ST-elevation myocardial infarction: Analysis from the e-ULTIMASTER registry.

Background: Incomplete revascularization (ICR) has been associated with a worse prognosis after a percutaneous coronary intervention (PCI). In NSTEMI patients with multivessel disease (MVD) however, the benefit of a complete revascularization (CR) remains unclear.

Methods: Patients presenting with an NSTEMI and MVD were selected from the global e-ULTIMASTER registry and grouped according to completeness of revascularization at index hospitalization discharge.

Multidisciplinary consensus on the use of hydroxychloroquine in patients with systemic lupus erythematosus.

Background: Hydroxychloroquine (HCQ) is the first-line treatment for systemic lupus erythematosus (SLE); however, there is heterogeneity in its clinical use. This consensus aims to bridge the gap in SLE treatment by providing practical and valuable recommendations for health professionals.

Methods: The methodology used is based on a systematic literature review and a nominal group technique (NGT).

Type I Interferons induce endothelial destabilization in Systemic Lupus Erythematosus in a Tie2-dependent manner.

Endothelial cell (EC) dysfunction is a hallmark of Systemic Lupus Erythematosus (SLE) and Tie2 is a receptor essential for vascular stability. Inflammatory processes promote inhibition of Tie2 homeostatic activation, driving vascular dysfunction. In this work we determined whether type I Interferons (IFN) induce Tie2 signalling-mediated endothelial dysfunction in patients with SLE.

Radiation exposure assessment of nuclear medicine staff administering [Lu]Lu-DOTA-TATE with active and passive dosimetry.

Background: The use of lutetium-177 (Lu)-based radiopharmaceuticals in peptide receptor nuclear therapy is increasing, but so is the number of nuclear medicine workers exposed to higher levels of radiation. In recent years, [Lu]Lu-DOTA-TATE has begun to be widely used for the treatment of neuroendocrine tumours. However, there are few studies evaluating the occupational radiation exposure during its administration, and there are still some challenges that can result in higher doses to the staff, such as a lack of trained personnel or fully standardised procedures.

Transcatheter or Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis and Small Aortic Annulus: A Randomized Clinical Trial.

Background: The optimal treatment in patients with severe aortic stenosis and small aortic annulus (SAA) remains to be determined. This study aimed to compare the hemodynamic and clinical outcomes between transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with a SAA.

Methods: This prospective multicenter international randomized trial was performed in 15 university hospitals.

Cerebral embolic protection during transcatheter heart interventions.

Stroke remains a devastating complication of transcatheter aortic valve replacement (TAVR), with the incidence of clinically apparent stroke seemingly fixed at around 3% despite TAVR's significant evolution during the past decade. Embolic showers of debris (calcium, atheroma, valve material, foreign material) are captured in the majority of patients who have TAVR using a filter-based cerebral embolic protection device (CEPD). Additionally, in systematic brain imaging studies, the majority of patients receiving TAVR exhibit new cerebral lesions.

Amniotic Membrane Transplantation in the Management of Corneal Ulceration Following Infectious Keratitis.

Purpose: To report on the outcomes of amniotic membrane transplantation (AMT) for corneal ulceration following infectious keratitis.

Method: In this retrospective cohort study of 654 patients with culture-proven infectious keratitis from 8 hospitals in Galicia (Spain), a total of 43 eyes of 43 patients (6.6%) underwent AMT for postinfectious corneal ulceration.

Persistently elevated serum concentrations of human chorionic gonadotropin (hCG).

Objectives: We describe a woman with constantly elevated hCG levels in serum. Since assay interference, pregnancy or cancer did not explain the elevated levels, we measured the concentrations of hCG, its β subunit (hCGβ) and its core fragment (hCGβcf) in serum and urine using specific assays, to understand the nature of the elevated hCG levels.

Methods: We used 3 assays for total hCG (these assays also recognize hCGβ and to various degrees hCGβcf), 3 for intact hCG heterodimer, 3 for free hCGβ and one for hCGβcf.

Foveal microvascular features following inverted flap technique for closure of large macular holes.

Purpose: To describe the anatomical and functional outcomes following use of the inverted flap technique (IFT) to close idiopathic macular holes (MH) of diameter greater than 400 μm. To compare the changes in the macular microvascularization following surgery in operated and healthy fellow eyes.

Methods: Retrospective study of 24 patients who underwent vitrectomy and IFT for large MH closure.

Cardiovascular Complications in Patients Hospitalized for COVID-19: A Cohort Study in Havana, Cuba.

Introduction And Objective: At least one in ten patients infected with COVID develop cardiovascular complications during hospitalization, increasing the number of deaths from this cause. However, the determinants of risk are not clearly elucidated. This study aims to determine whether there is a relationship between in-hospital cardiac complications and cardiovascular history and hospital evolution.

Central nervous system involvement in systemic lupus erythematosus: Data from the Spanish Society of Rheumatology Lupus Register (RELESSER).

Objectives: To analyze the prevalence, incidence, survival and contribution on mortality of major central nervous system (CNS) involvement in systemic lupus erythematosus (SLE).

Methods: Patients fulfilling the SLE 1997 ACR classification criteria from the multicentre, retrospective RELESSER-TRANS (Spanish Society of Rheumatology Lupus Register) were included. Prevalence, incidence and survival rates of major CNS neuropsychiatric (NP)-SLE as a group and the individual NP manifestations cerebrovascular disease (CVD), seizure, psychosis, organic brain syndrome and transverse myelitis were calculated.

Occupational radiation exposure assessment during the management of [Ga]Ga-DOTA-TOC.

Background: Since it was first approved in Europe in 2016, the gallium-68 (Ga) radiopharmaceutical [Ga]Ga-DOTA-TOC has been widely used for imaging of somatostatin receptor (SSTR) positive tumours using positron emission tomography-computed tomography (PET/CT). Significant patient benefits have been reported, so its use is rapidly increasing. However, few studies have been published regarding occupational doses to nuclear medicine personnel handling this radiopharmaceutical, despite its manual usage at low distances from the skin and the beta-emission decay scheme, which may result in an increased absorbed dose to their hands.

Patients' knowledge about their involvement in clinical trials. A non-randomized controlled trial.

Background: Nowadays, good clinical practice should be established in human research. Patient's rights and autonomy must be respected above the interest of the researcher, making mandatory to raise patient's awareness on the implications of participating in a clinical study. Contrary to popular belief, this is not always the case.