20 research outputs found

    SPECT/TC con análogos de la somatostatina en el diagnóstico de los tumores neuroendocrinos

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    Owing to the recent introduction of gamma cameras with integrated computed tomography imaging capability, which combine functional and anatomical imaging in one device, the direct acquisition of co-registered images has become possible. Multiple studies have concluded that single photon emission computed tomography/computed tomography (SPECT/CT) provides an important added value to the conventional somatostatin receptor scintigraphy imaging in the diagnosis of neuroendocrine tumours.Debido a la reciente aparición de equipos híbridos SPECT/CT que combinan imágenes de tomografía por emisión de fotón único (SPECT) e imágenes de tomografía computarizada (TC), es posible adquirir imágenes funcionales e imágenes anatómicas en una única sesión. Numerosos estudios han mostrado el valor añadido del SPECT/TC a la gammagrafía de receptores de somatostatina en el diagnóstico de los tumores neuroendocrinos

    Frequency of lower extremity artery disease in type 2 diabetic patients using pulse oximetry and the ankle-brachial index

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    Observational study[Abstract] Objectives: To determine the of undiagnosed lower extremity artery disease using the pulse oximetry in a type 2 diabetic population sample. Methods: Observational, cross-sectional, descriptive study that included 594 type 2 diabetic patients, with no previous history of lower extremity artery disease. Medical history, physical examination, determination of the ankle-brachial index (portable Doppler) and measurement of oxygen saturation in upper and lower extremities (pulse oximeter) were performed. Results: Frequency of lower extremity artery disease determined by ankle-brachial index was 18.4%. No significant correlations were detected between oxygen saturation and the ankle-brachial index except for the relationship between ankle-brachial index vs. oxygen saturation at 30 cm lower limb elevation vs. the supine position at no elevation (0 cm) in subjects under the age of 40. Pulse oximetry showed little diagnostic value in the screening of lower extremity artery disease. A relationship between lower extremity artery disease and age has been found. Its diagnosis was associated with a lower body mass index and lower systolic blood pressure in the lower extremities and higher in the upper extremities. Conclusions: We conclude that pulse oximetry is not useful in the screening for asymptomatic lower extremity artery disease in type 2 diabetics

    Effect of the TNF -308 G/A Polymorphism on the Changes Produced by Atorvastatin in Bone Mineral Density in Patients with Acute Coronary Syndrome

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    Producción CientíficaAims: To evaluate the effect of atorvastatin on bone mass and markers of bone remodeling in patients with acute coronary syndrome depending on the tumor necrosis factor- (TNF )-308 G/A polymorphism. Methods: Sixty-two patients with acute coronary syndrome (35 males and 27 females), average age 60 8 10 years, were included. Patients were given low (10–20 mg) and high doses (40–80 mg) atorvastatin according to their baseline levels of cholesterol and triglycerides and their index of vascular risk. Patients were studied during hospital admission (baseline) and at 12 months of follow-up. Cholesterol, triglycerides, total calcium, phosphorus, magnesium, osteocalcin and urinary deoxypyridinoline were determined in all patients at baseline and at 12 months of follow-up. Densitometric studies were conducted in the lumbar spine (L 2 –L 4 ), femoral neck and trochanter using an X-ray densitometer. The TNF -308 G/A polymorphism was determined by the polymerase chain reaction. Results: Forty-five patients were homozygous for G/G (72.5%) and 17 were heterozygous for G/A (27.5%). The prevalence of osteoporosis (T score ^ 2.5 in the lumbar spineand/or hip) was 33% for the G/G genotype and 35% for the G/A genotype, with no statistically significant differences between groups. There was a statistically significant increase in bone mineral density (BMD) in the lumbar spine (1.107 8 0.32 vs. 1.129 8 0.23; p = 0.0001) in patients with the G/G genotype. No changes were observed in patients with the G/A genotype. Conclusion: In patients with acute coronary syndrome, atorvastatin increases lumbar spine BMD solely in patients with the G/G genotype of the TNF -308 G/A polymorphism

    Levels of DKK1 in patients with acute myocardial infarction and response to atorvastatin

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    Producción CientíficaThe atherosclerosis that appears in coronary, cerebrovascular and peripheral arterial disease is responsible for most cardiovascular diseases. It is characterized by chronic arterial inflammation caused and exacerbated by disorders of the lipidic metabolism and other clearly identified risk factors [1]. Calcification, which is initiated by an active process in which inflammatory cytokines and other mediators that regulate the phospho-calcium metabolism intervene, is characteristic of atherosclerosis [2]. These mechanisms can intervene in an opposite phenomenon that takes place at the level of the bone characterized by a reduction in bone mineral content and alterations in the microarchitecture that define osteoporosis. The association between the two diseases, which share mechanisms but have a different expression, is noteworthy

    Allergic hypersensitivity to cannabis in patients with allergy and illicit drug users

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    Producción Científica: Cannabis is the illicit drug most widely used by young people in high-income countries. Allergy symptoms have only occasionally been reported as one of the adverse health effects of cannabis use. Objectives: To study IgE-mediated response to cannabis in drug users, atopic patients, and healthy controls. Methods: Asthmatic patients sensitised to pollen, and all patients sensitised to tobacco, tomato and latex, considered as cross-reacting allergens, were selected from a data base of 21,582 patients. Drug users attending a drug-rehabilitation clinic were also included. Controls were 200 non-atopic blood donors. Specific IgE determination, prick tests and specific challenge with cannabis extracts were performed in patients and controls

    Polymorphisms of the farnesyl diphosphate synthase gene modulate bone changes in response to atorvastatin

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    Producción CientíficaAlthough their primary therapeutic indications are different, aminobisphosphonates and statins target enzymes in the mevalonate pathway, which is critical for bone homeostasis. Previous studies have shown that some polymorphisms of the gene encoding farnesyl diphosphate synthase (FDPS), the main target of aminobisphosphonates, modulate the response to these drugs. In this study, we explored whether those single nucleotide polymorphisms (SNPs) also influence the changes in bone mineral density (BMD) following therapy with statins. Sixty-six patients with coronary heart disease were studied at baseline and after 1-year therapy with atorvastatin. BMD was measured by DXA. Three SNPs of the FDPS gene (rs2297480, rs11264359 and rs17367421) were analyzed by using Taqman assays. The results showed that there was no association between the SNPs and basal BMD. However, rs2297480 and rs11264359 alleles, which are in linkage disequilibrium, were associated with changes in hip BMD following atorvastatin therapy. Thus, patients with AA genotype at the rs2297480 locus had a 0.8 ± 0.8 % increase in BMD at the femoral neck, whereas in patients with AC/CC genotypes, BMD showed a 2.3 ± 0.8 % decrease (p = 0.02). Similar results were obtained regarding changes of BMD at the femoral trochanter and when alleles at the rs11264359 locus were analyzed. However, there was no association between BMD and rs17367421 alleles. In conclusion, these results suggest that polymorphisms of the FDPS gene may influence the bone response to various drugs targeting the mevalonate pathway, including not only aminobisphosphonates but also statins

    Relation of resistin levels with cardiovascular risk factors, insulin resistance and inflammation in naı¨ve diabetes obese patients

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    Producción CientíficaBackground: The aim of the present study was to explore the relationship of resistin levels with cardiovascular risk factors, insulin resistance and inflammation in naı¨ve diabetic patients. Subjects: A population of 66 naı¨ve diabetic patients with obesity was analyzed. A complete nutritional and biochemical evaluation was performed. Results: The mean age 56.9 11.6 years and the mean BMI was 37.8 6.3. Patients were divided in two groups by median resistin value (3.3 ng/ml), group I (patients with the low values, average value 2.5 0.5) and group II (patients with the high values, average value 4.8 1.8). Patients in the group I had lower waist circumference, total cholesterol, LDLcholesterol and C-reactive protein than patients in group II. Correlation analysis showed a significant correlation among resistin levels and the independent variables; BMI (r = 0.26; p < 0.05), waist circumference (r = 0.38; p < 0.05), fat mass (r = 0.28; p < 0.05), LDL-cholesterol (r = 0.3; p < 0.05), C-reactive protein (r = 0.28; p < 0.05). In the multivariate analysis, resistin concentration increase 0.024 ng/ml (CI 95%: 0.006–0.42) for each mg/dl of C-reactive protein. Conclusion: Circulating resistins are associated with C-reactive protein in an independent way in naı¨ve diabetic patients

    COVID-19 outbreaks in a transmission control scenario: challenges posed by social and leisure activities, and for workers in vulnerable conditions, Spain, early summer 2020

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    Severe acute respiratory syndrome coronavirus 2 community-wide transmission declined in Spain by early May 2020, being replaced by outbreaks and sporadic cases. From mid-June to 2 August, excluding single household outbreaks, 673 outbreaks were notified nationally, 551 active (>6,200 cases) at the time. More than half of these outbreaks and cases coincided with: (i) social (family/friends’ gatherings or leisure venues) and (ii) occupational (mainly involving workers in vulnerable conditions) settings. Control measures were accordingly applied

    Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

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    The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

    G308A polymorphism of TNF-alpha gene is associated with insulin resistance and histological changes in non alcoholic fatty liver disease patients

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    Some studies have pointed to a role of TNF-alpha in pathogenesis of non alcoholic fatty liver disease (NAFLD). The aim of our study was to investigate the influence of G308A polymorphism TNF alpha gene on the histological changes, insulin resistance and TNF-alpha levels in overweight patients. A population of 66 patients with NAFLD was recruited in a cross sectional study. A biochemical analysis of serum was measured. Genotype of TNF alpha gene G308A was studied. Fifteen patients (22.7%) had the genotype G308A (mutant type group) and 51 patients (77.3%) G308G (wild type group). Patients with mutant type group presented more moderate-severe portal inflammation (86.7%) in liver biopsy compared to patient with wild genotype (19.7%). Mutant type group had more moderate-severe fibrosis (73.3%) than wild type group (51.3%). The multivariate analysis adjusted by age, sex, BMI and genotype with the dependent variable (fibrosis) showed that HOMA remained in the model, with an increase of the probability to develop fibrosis of 1.78 (CI95%:1.06-3.2) and develop moderate-severe inflammation of 1.45 (CI95%:1.02-2.1) with each increase of one unit on HOMA levels. In conclusion, Patients with mutant genotype have more frequently moderate-severe portal inflammation and fibrosis than wild type genotype
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