Purpose. To investigate the clinical utility of molecular breast imaging (MBI) in patients with proven invasive breast cancer scheduled for. Lukas Teixeira Ferreira, Lulzim Hushi, Lussjen Corti, Macio Barbosa Vincenzo Riccio, Vincenzo Silvestri, Vincenzo Sommese, Vincenzo Torrente. Oct 5, "Take a seat on the flying carpet and let you be DerMinimal Kustiger. satvikkatyal. macio marques. Tama. Torrente. 96 reposts. J COLE PLAYLIST FOREST HILLS DRIVE TORRENT But Daisy perpetrator program my instructions vegetables. And by used monitor every single visible before has ended or be network business more. And Contact: developers, Phone:.
He returned to Mexico, however, entering at the port of Progreso from which, via Isla de Mujeres and Belize , he travelled south to progressive Guatemala City. He took residence in the prosperous suburb of Ciudad Vieja , home of Guatemala's artists and intelligentsia of the day, on Cuarta Avenida Fourth Avenue , 3 km south of Guatemala City. He met personally the president, Justo Rufino Barrios , about this project.
His repertory of original work included plays, a novel, poetry, a children's magazine, La Edad de Oro , and a newspaper, Patria , which became the official organ of the Cuban Revolutionary party ". Throughout this work, he preached the "freedom of Cuba with an enthusiasm that swelled the ranks of those eager to strive with him for it". On June 30 his wife and son arrived in New York. He intervened in the commemorative acts of The Independents, causing the Spanish consul in New York to complain to the Argentine and Uruguayan governments.
In October he published his book Versos Sencillos. On November 26 he was invited by the Club Ignacio Agramonte , an organization founded by Cuban immigrants in Ybor City , Tampa, Florida , to a celebration to collect funding for the cause of Cuban independence. There he gave a lecture known as "Con Todos, y para el Bien de Todos" , which was reprinted in Spanish language newspapers and periodicals across the United States.
He began the process of organizing the newly formed party. To raise support and collect funding for the independence movement, he visited tobacco factories, where he gave speeches to the workers and united them in the cause. On December 16 he was poisoned in Tampa. His visits were received with a growing enthusiasm and raised badly needed funds for the revolutionary cause. In he continued traveling for propagation and organizing the revolutionary movement. On January 27 he published "A Cuba!
In August he prepared and arranged the armed expedition that would begin the Cuban revolution. On January 12, , the North American authorities stopped the steamship Lagonda and two other suspicious ships, Amadis and Baracoa , at the port of Fernandina in Florida, confiscating weapons and ruining Plan de Fernandina Fernandina Plan.
The uprising finally took place on February 24, The volumes were to be arranged in the following way: volumes one and two, North Americas; volume three, Hispanic Americas; volume four, North American Scenes; volume five, Books about the Americas this included both North and South America ; volume six, Literature, education and painting. Another volume included his poetry. Once there, they made contact with the Cuban rebels, who were headed by the Maceo brothers, and started fighting against Spanish troops.
The revolt did not go as planned, "mainly because the call to revolution received no immediate, spontaneous support from the masses. The Spanish took possession of the body, buried it close by, then exhumed the body upon realization of its identity.
To him, it was unnatural that Cuba was controlled and oppressed by the Spanish government, when it had its own unique identity and culture. They are nourished by a different system of trade, have links with different countries, and express their happiness through quite contrary customs. There are no common aspirations or identical goals linking the two peoples, or beloved memories to unite them.
Peoples are only united by ties of fraternity and love. In a speech to Cuban immigrants in Steck Hall, New York, on January 24, , he stated that the war against Spain needed to be fought, recalled the heroism and suffering of the Ten Years' War , which, he declared, had qualified Cuba as a real nation with a right to independence. Spain had not ratified the conditions of the peace treaty, had falsified elections, continued excessive taxation, and had failed to abolish slavery.
Cuba needed to be free. But he was aware that there were social divisions in Cuba, especially racial divisions, that needed to be addressed as well. The establishment of the patria fatherland with a good government would unite Cubans of all social classes and colours in harmony. The military would have to subordinate themselves to the interests of the fatherland.
His speeches to Cuban tobacco workers in Tampa and Key West motivated and united them; this is considered the most important political achievement of his life. Faith in the cause could not die, and the military would not try for domination. All pro-independence Cubans would participate, with no sector predominating. From this he established the Cuban Revolutionary Party in early Through this medium he argued against the exploitative colonialism of Spain in Cuba, criticized the Home Rule Autonomista Party for having aims that fell considerably short of full independence, and warned against U.
His uncompromising belief in democracy and freedom for his fatherland is what characterized his political ideology. The United States desperately needed new markets for its industrial products because of the economic crisis it was experiencing, and the media was talking about the purchase of Cuba from Spain. Here [he] was surprised At the same time, he criticized the elitist educational systems of Cuba and the rest of Latin America.
Racism was abundant. Different races were being discriminated against; political life "was both cynically regarded by the public at large and widely abused by 'professional politicians'; industrial magnates and powerful labor groups faced each other menacingly". In May , while attending political meetings he heard "the call for revolution — and more specifically the destruction of the capitalist system".
The former was seen as "hardy, 'soulless', and, at times, cruel society, but one which, nevertheless, had been based upon a firm foundation of liberty and on a tradition of liberty". He insisted on the necessity of building institutions and laws that matched the natural elements of each country, and recalled the failure of the applications of French and American civil codes in the new Latin American republics.
In addition to producing newspaper articles and keeping up an extensive correspondence his letters are included in the collection of his complete works , he wrote a serialized novel, composed poetry, wrote essays, and published four issues of a children's magazine, La Edad de Oro  The Golden Age, His essays and articles occupy more than fifty volumes of his complete works.
The rest an enormous amount was left dispersed in numerous newspapers and magazines, in letters, in diaries and personal notes, in other unedited texts, in frequently improvised speeches, and some lost forever. Five years after his death, the first volume of his Obras was published. In , also in this edition, his third poetic collection that he had kept unedited: Versos Libres. Over the course of his journalistic career, he wrote for numerous newspapers, starting with El Diablo Cojuelo The Limping Devil and La Patria Libre The Free Fatherland , both of which he helped to found in in Cuba and which established the extent of his political commitment and vision for Cuba.
Here it is noted that after Cuba his interest was directed mostly to Guatemala, Mexico and Venezuela. The various sections of this part are about general matters and international conferences; economic, social and political questions; literature and art; agrarian and industrial problems; immigration; education; relations with the United States and Spanish America; travel notes". We shall tell them about everything which is done in factories, where things happen which are stranger and more interesting than the magic in fairy stories.
These things are real magic, more marvelous than any. We write for children because it is they who know how to love, because it is children who are the hope for the world". I cultivate a white rose In July as in January For the sincere friend Who gives me his hand frankly And for the cruel person who tears out the heart with which I live, I cultivate neither nettles nor thorns: I cultivate a white rose .
Within the poem, he talks about how regardless of the person, whether kind or cruel he cultivates a white rose, meaning that he remains peaceful. This coincides with his ideology about establishing unity amongst the people, more so those of Cuba, through a common identity, with no regards to ethnic and racial differences.
The kindness of one person should be shared with all people, regardless of personal conflict. He is considered a major contributor to the Spanish American literary movement known as Modernismo and has been linked to Latin American consciousness of the modern age and modernity. His poetry contained "fresh and astonishing images along with deceptively simple sentiments". More important than his style is how he uses that style to put into service his ideas, making "advanced" convincing notions.
Throughout his writing he made reference to historical figures and events, and used constant allusions to literature, current news and cultural matters. For this reason, he may be difficult to read and translate. This is his style to teach delightfully. Although he translated literary material for the sheer joy of it, much of the translating he did was imposed on him by economic necessity during his many years of exile in the United States. He continued translating for the rest of his life, including his time as a student in Spain, although the period of his greatest productivity was during his stay in New York from until he returned to Cuba in In New York he was what is known today as a " freelancer ," as well as an " in house " translator.
He translated several books for the publishing house of D. Appleton , and did a series of translations for newspapers. As a revolutionary activist in Cuba's long struggle for independence he translated into English a number of articles and pamphlets supporting that movement.
Like many professionals, he undertook for money translation tasks which had little intellectual or emotional appeal for him. The modernists, in general, use a subjective language. There is the deliberate intention and awareness to expand the expressive system of the language. The style changes the form of thinking.
Modernism mostly searches for the visions and realities, the expression takes in the impressions, the state of mind, without reflection and without concept. This is the law of subjectivity. Poetry, as he believes, is a language of the permanent subjective: the intuition and the vision.
The prose is an instrument and a method of spreading the ideas, and has the goal of elevating, encouraging and animating these ideas rather than having the expression of tearing up the heart, complaining and moaning. The prose is a service to his people.
These symbols claim their moral value and construct signs of ethic conduct. All his writing defines his moral world. One could also say that his ideological and spiritual sphere is fortified in his writing. This hard work was important in giving literature authentic and independent value and distancing it from mere formal amusement. Literature starts to apply itself the only hermeneutics able to resolve the enigmas of a Latin American identity. His writings have created a platform for all that he went through during the duration of this period in time.
His belief in the inseparability of Cuban and Latin American sovereignty and the expression thereof in his writings have contributed to the shape of the modern Latin American Identity. Through his beliefs for Cuban and Latin American sovereignty, Cuba revolted on former allies.
His works are a cornerstone of Latin American and political literature and his prolific contributions to the fields of journalism, poetry, and prose are highly acclaimed. In , the land was gifted to Cuba and the park was officially dedicated in From Wikipedia, the free encyclopedia. Cuban poet, philosopher and nationalist — This section may need to be rewritten to comply with Wikipedia's quality standards.
You can help. The talk page may contain suggestions. December Literature portal Poetry portal Cuba portal Biography portal. Retrieved 5 August Archived from the original on 8 September At our institute, US is used to characterize a palpable mass or to find a correlate for a mammographical lesion. According to this criterion, the radiologist performed US of a sole lesion and not of a quadrant of the breast nor the whole breast.
The additional breast lesions were classified as follows: 1 multifocal lesions when located in the same quadrant of the breast as the index tumor; 2 multicentric lesions when located in a different quadrant of the breast compared to the index tumor; and 3 contralateral lesions when located in the contralateral breast. The size of each additional lesion was measured on MBI corresponding to the maximum diameter mm of the pathological uptake. Histopathology was obtained from all additional MBI lesions after incisional needle-biopsy or surgical excision.
The biopsy was performed using US-guided biopsy when the lesion was visible on targeted US. In more detail, after performing MBI and finding an additional suspicious lesion, the patient returned to the radiology department to undergo targeted US. In most cases, the additional detected lesion was previously not picked up during diagnostic work-up, since no routine whole breast screening US was performed.
The radioactivity in the biopsy specimen was measured to prove that the lesion found on targeted US corresponded to the additional lesion found with MBI. Statistical analysis was performed using MedCalc Statistical Software version Based on T stage migration upstaging after MBI, the percentage of patients in who surgical management was adjusted based on the MBI results was calculated. Based on the biopsy-or excision-acquired pathological findings, all additional lesions with malignant histopathology like invasive tumor and ductal carcinoma in situ DCIS were considered true positive, while all additional lesions with benign histopathology were defined false positive.
Seventeen of these women, who had additional MBI-detected lesions without histopathological diagnosis, were excluded from the final analysis. In more detail, in 4 of these 17 patients the multidisciplinary team agreed upon that it was not necessary to prove the malignant nature of the lesion, because it was located nearby the index lesion and would not alter the treatment plan.
Since these patients were treated with neoadjuvant therapy, it was not possible to verify the nature of the additional lesion afterwards. Thirteen of 17 patients had focal MBI lesions classified as BI-RADS 4a, meaning that there was doubt about the real nature of the MBI finding, for example because it was visible in only one view and could be caused by over-projection or an artifact. In these 13 patients, the finding was considered benign because no correlate was found with targeted US.
The remaining patients who fulfilled the inclusion criteria were enrolled in this retrospective study. The characteristics of the patients are reported in Table 1. The mean age of the patients was 60 years range, 30—88 years. The mean morphological maximum tumor diameter, obtained with MG and US, was 18 mm range, 3—55 mm.
The remaining 16 patients 5. Five patients underwent unilateral mastectomy, 1 patient bilateral mastectomy, another 5 patients were treated with large lumpectomy, 2 patients received NAC before BCS, and 1 patient underwent quadrantectomy. A year-old woman patient 13, Table 2 with invasive breast cancer. The treatment changed from lumpectomy to mastectomy. Pathological findings revealed intracystic papillary adenocarcinoma and extralesional ductal carcinoma in situ with extension towards the nipple.
The median size of these lesions on MBI was 10 mm range: 7—35 mm. Histopathological features were obtained by needle-biopsy from 16 out of 21 lesions in 12 patients and by surgical excision from the other 5 lesions concerning another 5 patients. In more detail, 3 patients were converted to NAC and mastectomy, while 7 patients underwent ipsilateral mastectomy instead of BCS, 1 patient was treated with bilateral mastectomy, and 1 patient with bilateral BCS.
From the 18 additional proven malignant lesions true positives on MBI, 6 lesions were smaller than 10 mm range: mm. The remaining 3 additionally detected lesions on MBI were benign lesions false positives revealing mastopathy in one, one with fibroadenoma, and one with a mixed pattern of mastopathy and adenosis. A year-old woman patient 1, Table 3 with invasive ductal carcinoma of the right breast and two additional tumor foci 1 in ipsilateral breast and 1 in contralateral breast.
For both additional lesions, the patient underwent US-guided biopsy after targeted US that revealed invasive ductal carcinoma in the additional lesion in the right breast and ductal carcinoma in situ in the additional lesion in the left breast.
The treatment changed from local excision right breast to bilateral mastectomy. Flowchart showing the impact of preoperative MBI in the study population. In the present study, we evaluated the clinical impact of 99m Tc-sestamibi MBI, incorporated in the diagnostic work-up of patients with newly diagnosed breast cancer scheduled for BCS, as an adjunct modality to MG and US.
In our series, a larger disease extent as detected on MBI was mainly due to the visualization of DCIS located around the invasive tumor, which is in concordance with the findings of Spanu et al. Although it is not possible to distinguish carcinoma in situ from invasive tumor based on the 99m Tc-sestamibi uptake pattern, the total area of pathological 99m Tc-sestamibi uptake guided our surgeons during the surgical procedure, increasing the rate of complete surgical treatment and avoiding additional surgeries.
Therefore, we postulate that MBI offers the possibility to plan resection of the index lesion more accurately based on the extension of 99m Tc-sestamibi uptake. Two of these patients underwent MBI-guided biopsy since the additional lesions remained occult even after targeted US.
MBI-guided biopsy is a biopsy modality approved by the U. This tool is based on stereotactic localization of the 99m Tc-sestamibi avid lesion [ 21 , 22 ] and is currently used in our clinical work-up [ 23 ]. This is in line with the results reported in previous studies in the literature [ 20 , 24 , 25 , 26 , 27 , 28 , 29 ]. Lesion-related analysis demonstrated that 18 out of 21 additional lesions visualized on MBI resulted in true cancer.
This is in concordance with the relative high specificity of this technique as described in the literature [ 30 ]. A possible explanation is the highly specific uptake of 99m Tc-sestamibi by tumor cells as compared to the surrounding breast tissue [ 12 , 13 , 14 ]. Moreover, MBI detected 6 subcentimeter additional cancers in our series. This agrees with prior studies [ 20 , 27 , 28 ] reporting the ability of MBI to identify occult tumors smaller than 1 cm.
Recently, new MBI systems based on dual-head cadmium-zinc-telluride CZT detectors have been introduced offering improved sensitivity for detection of small tumors [ 11 ]. In our series the detection of additional tumors on MBI has led to the abandonment of lumpectomy in 11 women.
Additionally, MBI showed a low false-positive rate, thus avoiding unnecessary biopsies, complementary imaging, and patient anxiety. In the light of our results, MBI could be a valid adjunct modality to MG and US for detecting both the extent of index lesions and additional tumor foci. Presently, MRI is widely used in the clinical work-up of newly diagnosed breast cancer in women. Although MRI shows high sensitivity, its low specificity and high costs limit a wide application of this modality.
Additionally, MRI is not applicable in patients with claustrophobia, overweight, implanted devices and renal insufficiency [ 31 ]. MBI has the potential to overcome these limitations becoming a useful tool for almost all newly diagnosed breast cancer patients. Additionally, MBI is easy to perform and is associated with low costs. On the other hand, MBI requires the intravenous injection of a radiotracer, like 99m Tc-sestamibi, which means radiation exposure for the patient.
However, one should keep in mind that the administered dose of 99m Tc-labeled sestamibi for MBI is similar to the dose used for other commonly applied diagnostic functional imaging examinations such as bone scintigraphy and myocardial perfusion imaging [ 32 , 33 ]. Moreover, recent technological advances in MBI allow a significant reduction of the injected dose of the radiopharmaceutical.
An administered dose of MBq 99m Tc-sestamibi leads to a significant reduction of absorbed dose to the breast 0. Finally, it is necessary to address the principal limitations of the present study. First, it concerns a retrospective study based on data collected in a single institution. Second, we retrospectively excluded a relative large amount of patients with positive MBI studies due to missing histopathological data.
This represents a potential bias of the presented MBI results. However, the excluded cases represented either patients in who the unexpected detection of additional lesions was not clinically relevant in the sense that it would not have altered the treatment plan , or patients with a relatively low probability of having additional malignant foci BI-RADS 4a abnormalities without correlate at targeted US.
Third, an injection dose of MBq was applied using a single-head detector. Since others have found comparable results using low-dose protocols — MBq for single-head MBI or — MBq for dual-head MBI versus high-dose protocols [ 15 , 16 , 17 ], it would be worthwhile to investigate the performance of the low-dose protocol in the studied patient population, since it could lead to a significantly lower radiation exposure.
On the other hand, the strength of this study is that it represents the first series evaluating the additional clinical value of MBI in a large population of patients with proven invasive breast cancer scheduled for breast-conserving surgery. The results of the present study support that MBI is a useful imaging modality, which reveals a high rate of multifocal or multicentric lesions and bilateral disease not visualized by mammography and ultrasound.
Additionally, MBI may play an important role in accurate delineation of the tumor extent during preoperative planning. Therefore, the incorporation of this modality to the clinical work-up may lead to better selection of patients who might benefit of BCS.
However, larger and prospective studies, preferably using low-dose MBI protocols, are needed to confirm these findings. Netherlands Cancer Registry. Accessed 02 Nov Accessed 03 Jan Ann Surg Oncol 17 5 — Article PubMed Google Scholar. CA Cancer J Clin 42 3 — J Nucl Med Technol 38 4 — J Nucl Med 43 7 — PubMed Google Scholar. Mayo Clin Proc 80 1 — J Nucl Med Technol 37 4 — Med Phys 36 3 — Part II.
Evaluation in patients. Med Phys 39 6 — Nucl Med Biol 29 7 —
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Action, Comedy. Santiago Segura. Dec 6, Neus Asensi Amparito. Carlos Areces Ricardito. Chus Lampreave Reme. Jorge D'Alessandro Trainer Argentinian team. Josep Pedrerol Sports commentarist. Xavier Deltell. Leonardo Dantes. Alec Baldwin John Marshall. Fernando Esteso. El Langui. Santiago Segura Director. Santiago Segura Writer. Play trailer Action Comedy. Director Santiago Segura. Santiago Segura. Top credits Director Santiago Segura. See more at IMDbPro.
Trailer Torrente 5. Photos Top cast Edit. Santiago Segura Torrente as Torrente. Alec Baldwin Marshall as Marshall. Carlos Areces Ricardito as Ricardito. Chus Lampreave Reme as Reme. Neus Asensi Amparito as Amparito. Jimmy Roca Mogutu as Mogutu. Fernando Esteso Cuadrado as Cuadrado. More like this. Storyline Edit. Did you know Edit. Gabino Diego , who originally played that character and also had a small cameo on the first movie Torrente, el brazo tonto de la ley has not returned to the franchise since Crazy credits At the end of the credits there's a brief scene where Sonsoles Cuadrado's wife , who is still tied and taped mouth in the hotel room, talks to the audience.
Also, Dominguero's voice from the WC can be heard asking for the soccer game score. Connections Follows Torrente, el brazo tonto de la ley User reviews 8 Review. Top review.
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