A bisphosphonate for F-19-magnetic resonance imaging

19F-magnetic resonance imaging (MRI) is a promising technique that may allow us to measure the concentration of exogenous fluorinated imaging probes quantitatively in vivo. Here, we describe the synthesis and characterisation of a novel geminal bisphosphonate (19F-BP) that contains chemically-equivalent fluorine atoms that show a single and narrow 19F resonance and a bisphosphonate group that may be used for labelling inorganic materials based in calcium phosphates and metal oxides. The potential of 19F-BP to provide contrast was analysed in vitro and in vivo using 19F-MRI. In vitro studies demonstrated the potential of 19F-BP as an MRI contrast agent in the millimolar concentration range with signal-to-noise ratios (SNR) comparable to previously reported fluorinated probes. The preliminary in vivo MRI study reported here allowed us to visualise the biodistribution of 19F-BP, showing uptake in the liver and in the bladder/urinary system areas. However, bone uptake was not observed. In addition, 19F-BP showed undesirable toxicity effects in mice that prevent further studies with this compound at the required concentrations for MRI contrast. This study highlights the importance of developing 19F MRI probes with the highest signal intensity achievable

Rolul litotriţiei extracorporeale cu unde de şoc ESWL în tratamentul calculilor renali

Scopul lucrării a fost evaluarea rezultatelor tratamentului calculilor renali prin litotriţie extracorporală cu unde de şoc. În studiu au fost incluşi 74 de pacienţi cu litiază renală, supuşi tratamentului cu unde de şoc (ESWL). Am obţinut o rată de succes de 50,14 % la sfârşitul şedinţei, la o lună dupa tratament rata de ”stone free” a atins valoarea de 92,2%. Eşecul s-a înregistrat în 7,8% cazuri, care au fost rezolvate prin şedinţa repetată de ESWL. Au fost înregistrate următoarele complicaţii: febră după tratament – 9 (12,1%) cazuri, colică renală – 11(14,9%), infecţie urinară – 3(4%), pielonefrită acută – 1(1,4%), ”steinstrasse” – 4 (5,4%) cazuri. ESWL este o metodă efi cientă în tratamentul calculilor renali de dimensiuni mici şi medii, fi ind o metodă minim invazivă, care poate fi repetată fără consecinţe majore. Litotriţia extracorporală rămâne a fi procedeul de elecţie în tratamentul calculilor renali sub 2 cm, neobstructivi

Gastroesophageal reflux disease: diagnosis and treatment references

Department of Pharmacology and Clinical Pharmacology Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Introduction. Gastroesophageal reflux disease is a common clinical pathology of the upper digestive tract, due to the reflux of the gastric or duodenal content within the esophagus, caused by a failure of the antireflux mechanisms, namely the lower esophageal sphincter.Aim of the study. To study the clinical features, the diagnostic methods and the therapeutic treatment in patients with gastroesophageal reflux disease Materials and methods. The retrospective study was conducted on 120 patients, admitted at the Department of Gastroenterology, within "Timofei Moșneaga" Republican Clinical Hospital. The study included two groups of patients: 60 patients, hospitalized during 2017- 2018 years and 60 patients admitted during 2018-2019, aged between 18- 80 years old. The data regarding the patients’ complaints, anamnesis, methods of diagnosis and treatment outcomes have been studied and interpreted. Results. The study showed a higher incidence of female patients in both study groups. According to the age criterion, 33.33% of patients were aged between 51 -70 years old and only 1.66% - aged under 20. The most common patients ‘complaints (more than 50%) included as following: 85.8% of cases presented epigastric pain, 53.3% - belching and 52.5%- heartburn , followed by 48.3%- mouth bitterness, 44.1 % - nausea and 30.8% -bloating. The least recorded complaints were regurgitations in 5% of cases and dysphagia - 4.1%. Both groups of patients were diagnosed based on the presence of the classic symptoms of GERD, positive response to PPI treatment, upper digestive endoscopy and chest X-ray assessment. According to the study, during the period 2017 -2018, the treatment of patients with GERD was mainly aimed at reducing the gastric acid secretion by administering omeprazole - 71.7% and pantoprazole - 18.4%. In 2018-2019 years, patients with GERD underwent a treatment for increasing the intestinal motility, by administrating metoclopramide - 68.4%, followed by the proton pump inhibitors -pantoprazole - 30%, omeprazole - 21.7% and antacids - 28.4%. Conclusions. The study of the gastroesophageal reflux disease particularities in patients from the Department of Gastroenterology has proved that the diagnosis should be based on the presence of the classic symptoms, changes detected in the upper digestive endoscopy and the presence of the reflux on the chest X-Ray assessment. The treatment regimens included both the suppression of gastric acidic secretion and the increase of the intestinal motility, thus diminishing the action of the harmful factors on LES and esophageal mucosa

Quantitative MRI in cardiometabolic disease: From conventional cardiac and liver tissue mapping techniques to multi-parametric approaches

Cardiometabolic disease refers to the spectrum of chronic conditions that include diabetes, hypertension, atheromatosis, non-alcoholic fatty liver disease, and their long-term impact on cardiovascular health. Histological studies have confirmed several modifications at the tissue level in cardiometabolic disease. Recently, quantitative MR methods have enabled non-invasive myocardial and liver tissue characterization. MR relaxation mapping techniques such as T1, T1ρ, T2 and T2* provide a pixel-by-pixel representation of the corresponding tissue specific relaxation times, which have been shown to correlate with fibrosis, altered tissue perfusion, oedema and iron levels. Proton density fat fraction mapping approaches allow measurement of lipid tissue in the organ of interest. Several studies have demonstrated their utility as early diagnostic biomarkers and their potential to bear prognostic implications. Conventionally, the quantification of these parameters by MRI relies on the acquisition of sequential scans, encoding and mapping only one parameter per scan. However, this methodology is time inefficient and suffers from the confounding effects of the relaxation parameters in each single map, limiting wider clinical and research applications. To address these limitations, several novel approaches have been proposed that encode multiple tissue parameters simultaneously, providing co-registered multiparametric information of the tissues of interest. This review aims to describe the multi-faceted myocardial and hepatic tissue alterations in cardiometabolic disease and to motivate the application of relaxometry and proton-density cardiac and liver tissue mapping techniques. Current approaches in myocardial and liver tissue characterization as well as latest technical developments in multiparametric quantitative MRI are included. Limitations and challenges of these novel approaches, and recommendations to facilitate clinical validation are also discussed