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Purpose Low-dose radiation therapy (LD-RT) has been shown to have an anti-inflammatory effect, and preliminary results suggest it is feasible to treat patients with coronavirus disease 2019 (COVID-19) pneumonia. Materials and Methods We conducted a prospective, single-arm, phase 1/2 clinical trial enrolling patients aged ≥50 years, who were coronavirus disease 2019 (COVID-19) positive, at phase 2 or 3 with lung involvement at imaging study and oxygen requirement. Patients received 100 cGy to total lungs in a single fraction. Primary outcome was radiologic response using severity and extension score on baseline computed tomography (CT), at days 3 and 7 after LD-RT. Secondary outcomes were toxicity using Common Terminology Criteria for Adverse Events v.5.0, duration of hospitalization, blood work evolution, and oxygen requirements using SatO2/FiO2 index (SAFI), at days 3 and 7 after LD-RT. Results Nine patients were included. Median age was 66 (interquartile range, 57-77). Severity score was stable or decreased in the third CT but was not statistically significant (P = .28); however, there were statistically significant changes in the extension score (P = .03). SAFI index significantly improved 72 hours and 1 week after LD-RT (P = .01). Inflammatory blood parameters decreased 1 week after RT compared with baseline; only lactate dehydrogenase decreased significantly (P = .04). Two patients presented grade 2 lymphopenia after RT and another (with baseline grade 3) worsened to grade 4. Overall, the median number of days of hospitalization was 59 (range, 26-151). After RT the median number of days in the hospital was 13 (range, 4-77). With a median follow-up after RT of 112 days (range, 105-150), 7 patients were discharged and 2 patients died, 1 due to sepsis and the other with severe baseline chronic obstructive pulmonary disease from COVID-19 pneumonia. Conclusions Our preliminary results show that LD-RT was a feasible and well-tolerated treatment, with potential clinical improvement. Randomized trials are needed to establish whether LD-RT improves severe pneumonia.

Loneliness is a common social phenomenon across countries with negative effects in health. Thus, the measurement of loneliness is of paramount importance. The Three-Item Loneliness Scale (TILS) was designed to be used in large-population surveys as a quick measure of loneliness. The aim of this study is to provide a Spanish validation of the TILS. A representative sample of the Spanish population (N = 1951) was used. We analysed the psychometric properties, factor structure, and distribution demographics characteristics of the Spanish TILS. Analyses showed differences regarding age, gender, educational level, employment status, household composition and annual gross income in line with previous literature. The confirmatory factor analysis revealed a unifactorial structure, with significant moderate correlations between the TILS and depression, anxiety, paranoia and well-being, and mild significant correlations with belongingness and mistrust. The internal consistency of the Spanish TILS was good (α = 0.82). Our study indicates that the TILS is a valid and reliable measure of loneliness in the Spanish population. Loneliness is a modern epidemic and a precursor of mental and health problems that reduced the quality of life. Therefore, it is important to have reliable measures of this phenomenon.

Purpose/Objective(s) To evaluate the safety and efficacy of Low-Dose Radiation (LD-RT) to treat COVID-19 pneumonia. Materials/Methods We conducted a prospective phase I-II trial enrolling patients ≥ 50 years-old, COVID-19 positive, with lung involvement at imaging study and oxygen requirement. Patients received 100 cGy to total lungs in a single fraction. Dose planning goals were PTV95 > 80% with Dmax < 115%. Primary outcome was radiological response assessed as severity and extension scores at days 0, +3 and +7. Secondary outcomes were toxicity (CTCAE v5.0), days of hospitalization, changes in inflammatory blood parameters (ferritin, lymphocytes, C-reactive protein, d-dimer and LDH) and SatO2/ FiO2 index (SAFI) at +3 and +7 (normal SAFI > 315, mild respiratory failure < 300, and severe < 200). Descriptive analyses were summarized as means with standard deviation (SD) and medians with interquartile ranges (IQR). A Wilcoxon sign rank test for paired data was used to assess the CT scores and Chi Square was used to assess for comparison of categorical variables. Results Forty-one patients were included. Three patients died < 72h after LD-RT and were excluded from the analysis. Median age was 71 (IQR 60-84). Eighteen patients (47%) received previously any anti-COVID treatment (tocilizumab, lopinavir/ritonavir, remdesivir) and thirty-two patients (84%) received steroids (GC) during LD-RT. Extension score improved significantly (P = 0.02) on day +7; severity score was stable or slightly decreased (P = 0.1). Median SAFI on day 0 was 147 (IQR 118-264), 230 (IQR 120-343) on day +3 and 293 (IQR 121-353) on day +7 (P < 0.01). SAFI improvement was associated with overall survival (P = 0.01). Significant decrease was found in C-reactive protein on day +7 (P = 0.02) and in lymphocytes counts on day +3 and +7 (P = 0.02). Median time to receive RT from the date of admission was 19 days (ranging 2-87). Median number of days in hospital after RT was 11 (4-78) and overall was 37 days (range 11-155). With a median follow-up of 67 days after LD-RT, 24 (63%) patients were discharged, twelve (32%) died and two (5%) are still inpatients. Conclusion Our preliminary results show that LD-RT was feasible and well-tolerated treatment, with potential clinical improvement. Randomized trials are needed to establish whether LD-RT improves severe pneumonia.

Introduction/Background Retrospective evaluation of a cohort of patients diagnosed with metastatic endometrial cancer (EC) and to describe the treatment performed as well as the rates of overall survival (OS), progression free survival (PFS) and survival without locoregional recurrence. Methodology Between January 2002 and December 2018, all consecutive patients with EC stade IV were included; patients who did not receive any treatment (CT, RT or surgery) at the time of diagnosis were not included. All treatments performed [chemotherapy (CT), surgery and external radiotherapy (RT)] were collected. Results 56 patients were identified; the median age of the patients was 64 years (39–83); the median follow-up of patients was 4.4 years 95% CI95% [3.4–6]. 53 patients (95%) IVb and 3 patients (5%) Iva. 42 patients (74%) had an endometroid or type 1 histology and 14 patients (26%) had a non-endometroid or type 2 histology. All patients (56) received CT. 37 patients (66%) had surgery, 23 (62%) before CT and 14 (38%) after CT. 25 patients (45%) received adjuvant RT after surgery. 4 patients (7%) presented local-locoregional recurrence, 18 patients (32%) presented metastatic and local-locoregional recurrence and 21 patients (37,5%) isolated metastatic recurrence. The median survival time is 2.9 years 95% CI[1.7–4.8]. 5 year-OS is 33%. The median progression-free survival (PFS) rate is 1.5 years 95% CI [0.91–1.98]. 5 year-PFS is 19%. Cumulative incidence of local-regional recurrence at 1, 3 and 5 years is 17%, 41% and 45%. Conclusion Metastatic EC presents poor prognosis. The use of surgery and adjuvant RT in addition to CT may improve OS, PFS and loco regional recurrence in selected patients. Disclosure Nothing to disclose.

OBJECTIVES To compare the efficacy and safety of a combined treatment of percutaneous needle tunnelling (PNT) and a modified collagenase Clostridium histolyticum (CCH) protocol (PNT/CCH) vs the modified protocol alone (CCH) in the treatment of Peyronie's disease (PD). PATIENTS AND METHODS A prospective registry of patients treated with a modified CCH protocol was maintained between June 2014 and February 2018. The last 50 patients received PNT as an adjuvant therapy (PNT/CCH), and their data were compared with those of the other 94 patients treated previously (CCH). PNT involves the creation of multiple holes made percutaneously in the plaque before each injection. The modified protocol consisted of two collagenase injections, at 1-week intervals, followed by penile modelling. Patients used penile traction therapy, tadalafil and pentoxifylline for the next 2 months and were followed up for 6 months. The main outcome was improvement of curvature. Secondary outcomes were improvements in erectile function, PD symptoms, stretched penile length and satisfaction. RESULTS Improvement in curvature was greater in patients in the PNT/CCH group than in the CCH group (mean ± sd 19.2 ± 6.1° vs 12.7 ± 5.0°; P < 0.001 [36.2 ± 12.5% vs 28.1 ± 14.5%; P = 0.001]). Compared with baseline, both interventions were associated with significant improvement in secondary outcomes. The main complications were ecchymosis, bruising and penile pain, with no significant differences between groups. CONCLUSIONS Treatment of PD with CCH using our modified protocol in combination with PNT is safe and more effective than the modified protocol alone, with the potential for improved cost-effectiveness.

Postmortem analysis in COVID-19 infected patients has shown diffuse alveolar damage with inflammatory infiltrate present. It has been suggested that COVID-19 can induce a cytokine release syndrome caused by a systemic inflammatory response. This pulmonary hyperinflammation would be associated with severe acute respiratory syndrome, which has been described as the main cause of COVID-19 mortality. Radiation therapy administered at low doses (LD-RT) has antiinflammatory properties such as lowering levels of proinflammatory cytokines, inhibiting endothelial-leukocyte interaction, and changing the polarization of macrophages. In addition, LD-RT was used for pneumonia in the first half of the 20th century with evidence suggesting potential efficacy. In this context, several institutions proposed trials to evaluate the safety and efficacy LDRT to treat COVID-19 pneumonia. We conducted a prospective phase I-II trial enrolling COVID-19 patients ≥ 50 years-old, with bilateral lung involvement at imaging study and oxygen requirement. Patients received 1 Gy to total lungs in a single fraction. Forty-one patients were included. Three patients died

This paper presents the results of simulation and validation of vanilla drying process in an indirect solar dryer prototype for 50 kg capacity designed and constructed at Universidad del Caribe in Cancun, Mexico. This work arises from the necessity of the vanilla agriculturists from the State of Quintana Roo to have a solar dryer capable of preserving the properties of the vanilla obtained with the traditional drying method. In previous work, simulation results are presented which showed only changes of airflow properties through the solar dryer prototype without vanilla. In this study, also are presented results from the drying tests for the vanilla pods.

The oceans function as large collectors of solar energy, which recently the human has had the interest to study. Ocean water retains approximately 15% of the totalof solar energy as thermal energy. The technology that allows generatingenergy through temperature differences the ocean is called Conversion Ocean Thermal Energy (otec). This type of energy is concentrated in the surface part of seawater and decreases exponentially with increasing depth, as the sea ​​bottom

Sanded nuclei are nuclei with eosinophilic inclusions identified by light microscopy in cases of chronic hepatitis B virus infection. In hematoxylin and eosin-stained sections, these inclusions have an almost homogeneous, finely granular texture giving a sandy appearance. They have been related to excess hepatitis B core antigen formation. We have studied liver biopsies from two HBsAg positive immunosuppressed patients with numerous sanded nuclei, morphologically identical to those previously described in hepatitis B. Immunohistochemically, sanded nuclei showed a strong nuclear positivity for delta antigen, but were negative for hepatitis B core antigen. Hepatitis B core particles were not demonstrable by electron microscopy. To our knowledge, this is the first time that sanded nuclei have been related to hepatitis delta virus (HDV) infection.

Cutaneous ultrasound is based on the application of the physical properties of ultrasound to the skin and cutaneous adnexae. Knowledge of ultrasound semiology, artifacts and the application of Doppler examination allows deeper study of the biology and diseases of the skin and its adnexae.

The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) recommends that ultrasound should be used systematically as an easy accessible and instructive educational tool in the curriculum of modern medical schools. Medical students should acquire theoretical knowledge of the modality and hands-on training should be implemented and adhere to evidence-based principles. In this paper we summarise EFSUMB policy statements on medical student education in ultrasound.

The results of a search for the 2[beta][sup +] and [ital K][beta][sup +] decay modes of [sup 78]Kr, in a coincidence experiment using a high pressure ionization chamber of enriched [sup 78]Kr inside an array of sodium iodine scintillators, are presented. After 4434 h of counting time, the half-life lower limits obtained are [ital T][sub 1/2]([ital K][beta][sup +])[sub 0[nu]][ge]5.1[times]10[sup 21] yr and [ital T][sub 1/2](2[beta][sup +])[sub 0[nu]+2[nu]][ge]2.0[times]10[sup 21] yr at 68% C.L.

Summary The value of ultrasound in testicular trauma with haematocele has been questioned inasmuch as the injured testis should always be explored surgically. Ultrasonography, however, plays an important role in the diagnosis and follow-up of patients with blunt scrotal trauma without haematocele. We have evaluated 17 such patients with real-time ultrasound. In 9 cases the testis and epididymis were normal to palpation, although in 6 of them parenchymal lesions, mainly subcapsular haematomas and parenchymal contusions not amenable to surgical intervention, were detected with ultrasonography. Seven patients presented with changes in the testicular or epididymal morphology at palpation and in 1 case the testes were not palpable. Ultrasonography was of great value, indicating surgery in 6 of these patients where physical examination alone was not sufficient to establish the need for surgical exploration.

Basis and objectives: Thyroid alterations are frequent during pregnancy and can be harmful to the development of the newborn. The objective of this paper is to assess the prevalence of thyroid disorder (functional and structural) in a group of pregnant women during the first trimester. Patients and methods: Descriptive observational survey, carried out within a health area in Toledo. The group of participants was composed of pregnant women from this area and a control group of non-pregnant women of similar age. TSH, free T4 and TPO levels were measured in pregnant women. In order to assess their thyroid volume, echoestructure and nodules, all women underwent a thyroid ecography. Results: 189 pregnant women and a control group of 169 non-pregnant women participated. The prevalence of hypothyroidism in the pregnants group was 9.5% [IC95% 6.0–14.7]. The thyroid volume was larger in the group of pregnants (12.2±5.6 mL) than in the control group (10.7±4.0 mL) [p=0.005]. 14 out of 18 hypothyroid pregnant women (77.8%) showed thyroid echoestructure alterations versus 9 (5.3%) in the non-hypothyroid group [p=0.000]. Thyroid nodules were found in 38.5% of the women from the control group and 33.2% of the pregnant women [p=0.290]. Conclusions: The prevalence of hypothyroidism is high, similar to what other Spanish papers have found. Testing thyroid hormones and TPO during the first pregnancy control should be considered. The prevalence of nodules is similar in both groups: control and pregnant women during the first trimester. Thyroid echoestructure alterations are significantly more frequent in pregnant women with hypothyroidism. The prevalence of nodules is similar both in pregnants in the first trimester and non-pregnants.

Cystic papillary pancreatic tumor is an infrequent neoplasm of unknown origin which is presented almost exclusively in young women. It is characterized by an anodyne clinical symptomatology with it frequently treated as an accidental finding. Ultrasonography and computerized axial tomography have a priority role in the study of this entity but the definitive diagnosis is based on the histologic findings. The treatment of choice is surgical removal and although it is a malignant tumor, good evolution is observed with recurrence not being expected. Two new cases of cystic papillary tumor are presented comparing the ultrasonographic appearance of the same with other pancreatic cystic neoplasms. Although the ultrasonographic findings are not characteristic they may be suggestive of papillary tumor.

We present the case of a patient with liver cirrhosis secondary to hepatitis C who developed a large (6 cms) hepatocellular carcinoma, diagnosed by raised alphafetoprotein (AFP) levels (10000 ng/ml) and imaging techniques (ultrasonography and abdominal CT with and without contrast). During follow-up there was normalization of the AFP levels and disappearance of the lesion on U.S. and CT. Spontaneous regression is exceptional in hepatocellular carcinoma. We describe the characteristics of our case and of the 10 patients described in the literature.

The results of a search for particle dark matter with a germanium detector at the Canfranc tunnel are reported. Contour limits for cross sections, masses, and local halo densities of dark matter particles interacting with Ge nuclei through spin-independent interactions are presented for an exposure of 130.7 kg day. The results and prospects of a search for the timing modulation of the signal are also reported.

Results of an on-going search for particle dark matter with a germanium detector at the Canfranc tunnel are reported. Contour limits for cross-sections, masses and local halo densities of particles interacting through spin-independent interactions are presented. Preliminary results and prospects of a search for timing modulation of the signal are also reported.