Skin cancer is one of the most common forms of cancer worldwide and its early detection its key to achieve an effective treatment of the lesion. Commonly, skin cancer diagnosis is based on dermatologist expertise and pathological assessment of biopsies. Although there are diagnosis aid systems based on morphological processing algorithms using conventional imaging, currently, these systems have reached their limit and are not able to outperform dermatologists. In this sense, hyperspectral (HS) imaging (HSI) arises as a new non-invasive technology able to facilitate the detection and classification of pigmented skin lesions (PSLs), employing the spectral properties of the captured sample within and beyond the human eye capabilities. This paper presents a research carried out to develop a dermatological acquisition system based on HSI, employing 125 spectral bands captured between 450 and 950 nm. A database composed of 76 HS PSL images from 61 patients was obtained and labeled and classified into benign and malignant classes. A processing framework is proposed for the automatic identification and classification of the PSL based on a combination of unsupervised and supervised algorithms. Sensitivity and specificity results of 87.5% and 100%, respectively, were obtained in the discrimination of malignant and benign PSLs. This preliminary study demonstrates, as a proof-of-concept, the potential of HSI technology to assist dermatologists in the discrimination of benign and malignant PSLs during clinical routine practice using a real-time and non-invasive hand-held device.

The 2.4-km run and 20-m multistage fitness test (20MSFT) are common aerobic fitness tests in law enforcement. Previous research analyzed relationships between these tests in recruits, and indicated limited transferability due to disparate demands (direction changes, running intensity). However, the correlations between 2.4-km run and 20MSFT in recruits postacademy training may be different, where recruits should be fitter and able to complete highintensity running efforts. This study documented changes in and relationships between the 2.4km run and 20MSFT in law enforcement recruits post-academy training. Retrospective analysis on six academy classes (276 males, 50 females) from one agency was conducted. The 20MSFT and 2.4-km run were completed pre-and post-academy training. Estimated V O2max was derived from 2.4-km run time and the 20MSFT shuttle number. Paired-samples t-tests ascertained whether the 2.4-km run and 20MSFT improved post-academy. Correlations and linear regression derived relationships between the 2.4-km run and 20MSFT. Recruits improved in the 2.4-km run and 20MSFT (p < 0.01). There were significant correlations between the 2.4km run and 20MSFT for all recruits (r = -0.49), males (r = -0.48), and females (r = -0.29).However, the regression equations for all recruits (r 2 = 0.24), males (r 2 = 0.23) and females (r 2 = 0.08) were low. The results suggested there were disparate aspects to the 2.4-km run and 20MSFT in law enforcement recruits post-academy. Even though aerobic fitness improved, there are likely other aspects important to the 20MSFT not developed during academy (changeof-direction ability, high-intensity running). This could have impact the between-test relationship.

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Objective To evaluate if the intraoperative human papillomavirus (IOP‐HPV) test has the same prognostic value as the HPV test performed at 6 months after treatment of high‐grade squamous intraepithelial lesion (HSIL) to predict treatment failure. Design Prospective cohort study. Setting Barcelona, Spain. Population A cohort of 216 women diagnosed with HSIL and treated with loop electrosurgical excision procedure (LEEP). Methods After LEEP, an HPV test was performed using the Hybrid Capture 2 system. If this was positive, genotyping was performed with the CLART HPV2 technique. The IOP‐HPV test was compared with HPV test at 6 months and with surgical margins. Main outcome measure Treatment failure. Results Recurrence rate of HSIL was 6%. There was a strong association between a positive IOP‐HPV test, a positive 6‐month HPV test, positive HPV 16 genotype, positive surgical margins and HSIL recurrence. Sensitivity, specificity, and positive and negative predictive values of the IOP‐HPV test were 85.7, 80.8,24.0 and 98.8% and of the HPV test at 6 months were 76.9, 75.8, 17.2 and 98.0%. Conclusion Intraoperative HPV test accurately predicts treatment failure in women with cervical intraepithelial neoplasia grade 2/3. This new approach may allow early identification of patients with recurrent disease, which will not delay the treatment. Genotyping could be useful in detecting high‐risk patients. Tweetable abstract IOP‐HPV test accurately predicts treatment failure in women with CIN 2/3.

VF is a common complication in pyogenic VO that causes slower clinical recovery. Risk factors of VF are: osteopenia, a delayed diagnosis and dorsal involvement. Conservative management is probably appropriate for most cases, but spinal stabilisation should be considered in some specific cases.

A case of soft-tissue fibrosarcoma with pulmonary metastases in a dog is reported. Although three attempts of fine-needle aspiration (FNA) biopsy failed to provide definitive tumor diagnosis, results of angiography strongly indicated a soft-tissue sarcoma. Transcatheter arterial embolization (TAE) using particles of gelatin sponge was performed following selective angiography. The mass was decreased in size on reevaluation 2 weeks after embolization. The dog was euthanized on the request of the owners due to overall failing health. Necropsy and pathological study confirmed the diagnosis of soft-tissue fibrosarcoma with pulmonary metastases. In a review of the literature, angiographic findings of soft-tissue sarcoma in the dog of this report were similar to those in human beings, suggesting a potential role for angiography in the differential diagnosis of suspect soft-tissue fibrosarcomas and for guiding FNA or surgical biopsy. Previous reports have also shown therapeutic embolization to be an effective treatment both in experimental animal study and in clinical practice in the human; therefore, TAE could be an effective adjunctive treatment of soft-tissue fibrosarcoma in the dog.

A 52-year-old man underwent screening colonoscopy. A sessile serrated lesion (Paris 0-Is, NICE-1; 17 mm diameter) was observed in the right colon. After submucosal injection with gelofusine plus indigo carmine, en bloc cold endoscopic mucosal resection (cold-EMR) was attempted using a 25-mm braided snare (SnareMaster SD-210U-25; Olympus, Tokyo, Japan) (▶ Fig. 1). After snare closure, moderate traction of the snare sheath was applied to remove the lesion; however, the lesion remained trapped due to a large amount of tissue caught. The snare was repositioned slightly, and resection was successful. On inspection of the mucosal defect, the submucosal layer was observed with apparent "bubble sign" after waterjet irrigation (▶ Fig. 2 a, ▶ Video 1), followed by a "double string" sign, suggesting exposure of damaged muscle fibers (▶ Fig. 2 b). After insufflation and water irrigation, these muscle fibers separated showing deep muscular injury with visible serosa (▶ Fig. 2 c). The defect was immediately closed with endoscopic clips (▶ Fig. 2 d). The patient was monitored for 4 hours and discharged with prophylactic antibiotics and no symptoms. No complications occurred. Histology confirmed a 21 × 12 × 2 mm specimen and suspicion of serrated lesion without dysplasia. E-Videos Video 1 The "double string" sign and perforation after cold endoscopic mucosal resection. ▶ Fig. 1 Sessile serrated lesion Paris 0-Is, NICE-1, in the right colon. ▶ Fig. 2 The mucosal defect after cold endoscopic mucosal resection. a Submucosal layer with apparent "bubble sign" after waterjet irrigation. b Injured muscle layer, "double string" image. c Perforation site. d Complete endoscopic closure with clips. Nogales Óscar et al. The "double string" warning sign after cold EMR … Endoscopy