Correlation research demonstrates that an inflammatory diet is a risk factor for calcium oxalate renal stone formation.

BACKGROUND AND AIMS: Previous studies have demonstrated associations between the Dietary Inflammatory Index (DII®), an analytical tool which evaluates the inflammatory potential of the diet according to the pro- and anti-inflammatory properties of its components, and renal stone formation. However, these have not comprehensively addressed important parameters such as stone type, gender, DII scores in stone formers (SFs) and healthy controls (Cs) and associations of DII with urine and blood chemistries. These were adopted as the survey parameters for the present study, the purpose of which was to test whether the contributory role of an inflammatory diet on stone formation could be further confirmed. METHODS: 97 calcium oxalate (CaOx) SFs and 63 Cs, matched for age and gender each completed a semi-quantitative food frequency questionnaire from which nutrient composition was computed. These data were used to calculate the DII® score. To control the effect of energy intake, energy-adjusted DII scores were calculated per 1000 kcal consumed (E-DII™). A single blood sample and two consecutive overnight (8h) urine samples were collected from a subset (n = 59 SFs and n = 54 Cs) of the overall number of particpants (n = 160). These were analysed for renal stone risk factors. Data were analysed using regression models fit in R software. RESULTS: E-DII scores were found to fit the data better than DII, so they were used throughout. E-DII scores were significantly more positive (more pro-inflammatory) in SFs than in controls in the combined gender group (-0.34 vs. -1.73, p < 0.0001) and separately in males (-0.43 vs. -1.78, p = 0.01) and females (-0.26 vs. - 1.61, p = 0.05). In blood, a significant negative correlation was seen between E-DII and HDL cholesterol. In urine significant positive correlations were seen between E-DII and each of calcium (ρ = 0.25, p = 0.02), phosphate (ρ = 0.48, p < 0.001), magnesium (ρ = 0.33, p < 0.0001) and uric acid (ρ = 0.27, p = 0.004) concentrations. A significant negative correlation was seen between E-DII and urinary volume ρ = -0.27, p = 0.003). There was no correlation between E-DII scores and the relative supersaturations of urinary CaOx, calcium phosphate (brushite) and uric acid. CONCLUSIONS: Our findings provide hitherto unreported quantitative evidence in support of the notion that the diet of calcium oxalate renal stone patients is significantly more pro-inflammatory than that of healthy controls.

Utilidad de la resonancia magnética con espectroscopia en el diagnóstico del cáncer de próstata / Use of magnetic resonance spectroscopy in diagnosing prostate cancer

Introducción: El diagnóstico del cáncer de próstata (CaP) está basado inicialmente en una combinación del valor del antígeno prostático específico (PSA), el tacto rectal (TR) y los hallazgos de la ecografía transrectal de la próstata (ETR). La ETR ofrece la posibilidad de realizar biopsias aleatorias de la glándula prostática, que a menudo acaban siendo múltiples biopsias repetidas negativas en pacientes con elevación persistente del PSA, debido a la baja especificidad de este marcador. La resonancia magnética (RM) endorrectal es actualmente el mejor método de imagen para la detección del CaP. La espectroscopia por RM endorrectal (RMS) es una técnica no invasiva que complementa el diagnóstico del CaP mediante la detección de metabolitos intracelulares a nivel de la próstata, tales como la colina y el citrato. La RMS combinada con la RM endorrectal mejora de forma significativa la evaluación de la localización del CaP. Método: Se realizó un estudio para determinar la eficacia de la RMS en la detección precoz del CaP en pacientes con elevación del PSA, alteración del TR o ambos, candidatos a biopsia transrectal de próstata. Seleccionamos 51 pacientes entre 50-65 años con PSA entre 4-15 ng/ml con o sin alteración del TR, que debían ser sometidos a biopsia TR de próstata. La sospecha de tumor según la RM y RMS fue clasificada en una escala de 1-4, en la que 1 equivale a normal y 4 a cáncer. Comparamos 306 imágenes (6 por paciente) de RM y 306 curvas espectroscópicas con los valores de PSAt, índice de PSAt/PSAl, TR y la AP de cada uno de los sextantes. Resultados: Diagnosticamos CaP en 23 de 45 pacientes (45%) y en 78 de 306 sextantes (25%). El cociente CC/Ci fue significativamente superior en los pacientes con CaP (1.05 ± 0.41) en comparación con los pacientes en los que no se demostró CaP (0.51 ± 0.21). El índice PSAl/PSAt fue también significativamente inferior en los pacientes con CaP (11.35%) respecto de los pacientes sin CaP (16.55%)...