La fragilitat de la felicitat humana en Eurípides. Un estudi comparat d'Hècuba i d'Electra

Aquest treball analitza la fragilitat de la felicitat de dues dones, Hècuba i Electra, que pateixen una pèrdua del seu estatus social (desclassament) i es veuen obligades a viure una vida indigna de la seva condició. Mitjançant l'anàlisi exhaustiva de les tragèdies homònimes d'Eurípides, s'ofereix, d'una banda, un estudi aprofundit del lèxic relacionat amb la felicitat i el motiu del desclassament com a rerefons comú en ambdues obres; de l'altra, s'analitza com s'enfronten les dues heroïnes a llurs destins respectius i quins girs inesperats els porten a recuperar -o no- la felicitat perduda.This paper analyzes the fragility of human happiness of Hecuba and Electra, two women who undergo the loss of their former social status (cat. 'desclassament') and are forced to live a life unworthy of their condition. Through an exhaustive analysis of the homonymous plays by Euripides, I offer a study of the lexicon on happiness and on the motif of the desclassament as a mutual background in the two tragedies. In addition, I also analyze the way the heroines face their fates and what twists of fate help them win -or not- their lost happiness

Localization of Metastases from Medullary Thyroid Carcinoma Using Different Methods

We analyzed the efficiency of three different noninvasive methods in the localization of recurrent medullary thyroid carcinoma (MTC). Nine patients (six females and three males) with biochemical evidence of disease after primary surgery were subjected to anti-carcinoembryonic antigen (anti-CEA) antibody, meta-iodo-benzylguanidine (MIBG), and computed tomography. Another female patient, in biochemical remission for six years after initial surgery, was also studied using the same methods. Three of the ten patients had negative results with all three methods (including the patient in remission). The other seven patients showed abnormal uptake of labeled anti-CEA antibody in various localizations: only two of these patients had a corresponding pathological image by computed tomography and only one by 131I MIBG. These preliminary results suggest that 131I anti-CEA scanning may be the most sensitive noninvasive method for the localization of MTC recurrences

Intestinal Mucosal Triacylglycerol Accumulation Secondary to Decreased Lipid Secretion in Obese and High Fat Fed Mice

The ectopic deposition of fat in liver and muscle during obesity is well established, however surprisingly little is known about the intestine. We used the ob/ob mouse and C57BL6/J mice fed a high fat (HF) diet to examine the effects of obesity and the effects of HF feeding, respectively, on intestinal mucosal triacylglycerol (TG) accumulation. Male C57BL6/J (wild-type, WT) mice were fed low fat (LF; 10% kcal as fat) or HF (45%) diets, and ob/ob mice were fed the LF diet, for 3 weeks. In this time frame, the WT–HF mice did not become obese, enabling independent examination of effects of the HF diet and effects of obesity. Analysis of intestinal lipid extracts from fed and fasted animals demonstrated that the mucosa, like other tissues, accumulates excess lipid. In the fed state, mucosal triacylglycerol (TG) levels were threefold and fivefold higher in the WT–HF and ob/ob mice, respectively, relative to the WT–LF mice. In the fasted state, mucosa from ob/ob mice had threefold higher TG levels relative to WT–LF mucosa. q-PCR analysis of mucosal mRNA from fed state mice showed alterations in the expression of several genes related to both anabolic and catabolic lipid metabolism pathways in WT–HF and ob/ob mice relative to WT–LF controls. Fewer changes were found in mucosal samples from the fasted state animals. Remarkably, oral fat tolerance tests showed a striking reduction in the plasma appearance of an oral fat load in the ob/ob and WT–HF mice compared to WT–LF. Overall, the results demonstrate that the intestinal mucosa accumulates excess TG during obesity. Changes in the expression of lipid metabolic and transport genes, as well as reduced secretion of dietary lipid from the mucosal cells into the circulation, may contribute to the TG accumulation in intestinal mucosa during obesity. Moreover, even in the absence of frank obesity, HF feeding leads to a large decrease in the rate of intestinal lipid secretion

Marked ventricular repolarization abnormalities in highly trained athletes’ electrocardiograms: clinical and prognostic implications

AbstractOBJECTIVEWe sought to study the functional, clinical and prognostic implications of marked repolarization abnormalities (MRA) sometimes seen in athletes’ electrocardiograms (ECGs).BACKGROUNDThe clinical meaning of ECG MRA in athletes is unknown. No relationship has been drawn between either training intensity or any particular type of sport and MRA. Athletes are usually symptom free and do not show any decrease in their physical performance. It is as yet unclear whether MRA may have a negative effect on the performance of such athletes in competitive sports.METHODSWe studied 26 athletes with MRA (negative T waves ≥2 mm in three or more ECG leads at rest). No athletes presented clinical symptoms of cardiac disease or decrease in their physical performance. Clinical and physical examinations, ECG at rest, exercise test and echocardiographic and antimyosin studies were performed in all athletes. Rest/exercise myocardial perfusion single-photon emission computed tomography studies were performed in 17 athletes. The follow-up ranged from 4 to 20 years (mean 6.7 years).RESULTSFour athletes were excluded due to hypertrophic cardiomyopathy. Echocardiographic studies showed right and left normal ventricular dimensions for highly conditioned athletes. In the exercise test, heart rate was 166 ± 12.4 beats/min, and exercise tolerance was 15.2 ± 2.7 metabolic equivalents of the task. All athletes had ECG at rest simulating myocardial ischemia or “pseudoischemia” with a tendency to normalize during exercise. Myocardial perfusion studies were normal in the studied athletes. Antimyosin studies showed mild and diffuse myocardial radiotracer uptake in 15 athletes (68%). No adverse clinical events were observed in the follow-up.CONCLUSIONSThese results suggest that MRA have no clinical or pathological implications in athletes and should, therefore, not preclude physical training or participation in sporting events

Leucemia aguda linfoblástica en niños. Epidemiología y factores pronóstico.

La leucemia linfoblástica aguda es el cáncer más frecuente en niños. En Aragón no existía ninguna revisión sobre los niños afectos por esta enfermedad. Se ha realizado un estudio retrospectivo, descriptivo y analítico desde el año 2001 al 2012, revisando las historias clínicas de los pacientes, recogiendo variables epidemiológicas, clínicas, analíticas y de seguimiento. Se ha clasificado a los pacientes según criterios del grupo PETHEMA. Un total de 67 pacientes han sido estudiados. La edad media ha sido de 6,05 años (DS ±4,06) con una relación 1,48:1 casos varones respecto mujeres. La fiebre ha sido el síntoma de presentación más frecuente, sobretodo en los niños más pequeños. La citomorfología más común según la FAB ha sido L2 y la mutación genética más frecuente la t(12;21). Los datos recogidos son similares a los publicados en la literatura. La supervivencia libre de eventos (SLE) del total de pacientes ha sido de 80,6%, con una media de seguimiento de 140,6 meses (DS ±7,48), siendo algo peor para los varones. El grupo de bajo riesgo presenta una SLE de 83,8%, el de riesgo intermedio de 80% y el de alto riesgo del 60%, diferencias no significativas. Tampoco existen diferencias significativas según datos analíticos al diagnóstico ni según ingresos producidos por neutropenia febril. Estos datos reflejan la similitud de nuestra muestra con las publicadas. Futuros estudios son necesarios para comparar estos datos con los actuales y poder desarrollar nuevos protocolos que aumenten aún más la supervivencia y disminuían los efectos secundarios producidos por el tratamiento

Response to 223 Ra-dichloride in castration-resistant prostate cancer with bone metastasis : A case report

Painful bone metastases are common in prostate cancer, with current treatments including non-steroidal analgesics and opiates, surgery, external beam radiotherapy and bone-targeting β-emitting radiopharmaceuticals. The α-emitting isotope 223 Ra-dichloride (Ra-223) has been associated with improved overall survival and increased time to first skeletal-related events in patients with castration-resistant prostate cancer (CRPC) presenting with symptomatic bone metastases. The current study reports the case of a 70-year-old male patient, who was diagnosed with prostate cancer in 1999 upon presentation with increased prostate-specific antigen (PSA) levels and painful bone metastases in the context of CRPC. In November 2010, subsequent to undergoing hormonal blockage, the patient was treated with ketoconazole (200 mg/8 h) followed by 10 cycles of docetaxel (75 mg/m 2 every 3 weeks). Following disease progression, the patient received 6 doses of Ra-223 (50 kBq/kg; 1 dose/4 weeks). During this treatment period, an improvement in the patient's symptoms, and levels of bone alkaline phosphatase (BAP) and PSA were noted. Furthermore, Ra-223 was well-tolerated without any relevant bone marrow toxicity. However, 2 months after the administration of the final dose of Ra-223, PSA and BAP levels increased again, and bone pain deteriorated. A bone scan showed stable disease in the previously observed metastatic lesions; however, new lesions simultaneously appeared in different locations, indicating progressive disease

The multi-modality cardiac imaging approach to the Athlete's heart: an expert consensus of the European Association of Cardiovascular Imaging

The term 'athlete's heart' refers to a clinical picture characterized by a slow heart rate and enlargement of the heart. A multi-modality imaging approach to the athlete's heart aims to differentiate physiological changes due to intensive training in the athlete's heart from serious cardiac diseases with similar morphological features. Imaging assessment of the athlete's heart should begin with a thorough echocardiographic examination. Left ventricular (LV) wall thickness by echocardiography can contribute to the distinction between athlete's LV hypertrophy and hypertrophic cardiomyopathy (HCM). LV end-diastolic diameter becomes larger (>55 mm) than the normal limits only in end-stage HCM patients when the LV ejection fraction is <50%. Patients with HCM also show early impairment of LV diastolic function, whereas athletes have normal diastolic function. When echocardiography cannot provide a clear differential diagnosis, cardiac magnetic resonance (CMR) imaging should be performed. With CMR, accurate morphological and functional assessment can be made. Tissue characterization by late gadolinium enhancement may show a distinctive, non-ischaemic pattern in HCM and a variety of other myocardial conditions such as idiopathic dilated cardiomyopathy or myocarditis. The work-up of athletes with suspected coronary artery disease should start with an exercise ECG. In athletes with inconclusive exercise ECG results, exercise stress echocardiography should be considered. Nuclear cardiology techniques, coronary cardiac tomography (CCT) and/or CMR may be performed in selected cases. Owing to radiation exposure and the young age of most athletes, the use of CCT and nuclear cardiology techniques should be restricted to athletes with unclear stress echocardiography or CMR

Efficacy of augmented immunosuppressive therapy for early vasculopathy in heart transplantation

AbstractObjectives. The present study was undertaken to prospectively and comparatively evaluate the role of serial myocardial perfusion imaging and coronary angiography for the detection of early vasculopathy in a large patient population and also to determine the short- and long-term efficacy of augmented immunosuppressive therapy in the potential reversal of the early vasculopathy.Background. Allograft vasculopathy is the commonest cause of death after the first year of heart transplantation. Anecdotal studies have reported the efficacy of augmented immunosuppressive therapy after early detection of vascular involvement. However, no prospective study has evaluated the feasibility of early detection and treatment of allograft vasculopathy.Methods. In 76 cardiac allograft recipients, 230 coronary angiographic and 376 scintigraphic studies were performed in a follow-up period of 8 years. Angiography was performed at 1 month and every year after transplantation, and thallium-201 scintigraphy at 1, 3, 6 and 12 months after transplantation and twice a year thereafter. Prospective follow-up of 76 patients showed that 18 developed either angiographic or scintigraphic evidence of coronary vasculopathy. All episodes were treated with 3-day methylprednisolone pulse and antithymocyte globulin.Results. Twenty-two episodes of vasculopathy were diagnosed and treated in these 18 patients. Of these 22 episodes, two were detected only by angiography, seven by both angiography and scintigraphy, four by scintigraphy and histologic evidence of vasculitis and nine episodes only by thallium-201 scintigraphy studies. Angiographic and/or scintigraphic resolution was observed in 15 of the 22 episodes (68%) with augmented immunosuppression. The likelihood of regression was higher when treatment was instituted within the first year of transplantation (92%) than after the first year (40%) (p = 0.033). Eighty percent of patients who responded to follow-up.Conclusions. The present study suggests that early detection of allograft coronary vasculopathy is feasible with surveillance myocardial perfusion or coronary angiographic studies. When identified early after transplantation, immunosuppressive treatment may result in regression of coronary disease

Memòria Digital de Catalunya

Localització: Barcelona, Biblioteca de Catalunya, ms. 1064/1 (f. 1-21)Núm. 1476, a port.Còpia de representacióData aprox. deduïda de les dates dactivitat literària de lautor i de les característiques del documentFuente de ingreso: Compra a Elisa Castells, Vda. de Joan Almirall i ForastéPublicaciones: Bibl.: E. Mut i Remola, Pau Estorch i Siqués, un metge olotí del s. XIX, Gimbernat 1 (1984), p. 204-21

Variations in 123I-metaiodobenzylguanidine (MIBG) late heart mediastinal ratios in chronic heart failure: a need for standardisation and validation

BACKGROUND: There is lack of validation and standardisation of acquisition parameters for myocardial (123)I-metaiodobenzylguanidine (MIBG). This lack of standardisation hampers large scale implementation of (123)I-MIBG parameters in the evaluation of patients with chronic heart failure (CHF). METHODS: In a retrospective multi-centre study (123)I-MIBG planar scintigrams obtained on 290 CHF patients (82% male; 58% dilated cardiomyopathy; New York Heart Association [NYHA classification] > I) were reanalysed to determine the late heart-to-mediastinum ratio (H/M). RESULTS: There was a large variation in acquisition parameters. Multivariate forward stepwise regression showed that a significant proportion (31%, p < 0.001) of the variation in late H/M could be explained by a model containing patient-related variables and acquisition parameters. Left ventricular ejection fraction (p < 0.001), type of collimation (p < 0.001), acquisition duration (p = 0.001), NYHA class (p = 0.028) and age (p = 0.034) were independent predictors of late H/M. CONCLUSIONS: Acquisitions parameters are independent contributors to the variation of semi-quantitative measurements of cardiac (123)I-MIBG uptake. Improved standardisation of cardiac (123)I-MIBG imaging parameters would contribute to increased clinical applicability for this procedur