The diagnostic value of adiponectin multimers in healthy men undergoing screening for prostate cancer.

BACKGROUND: Adiponectin has been reported to have a prohibitory effect on prostate cancer. The goal of this study was to evaluate the diagnostic value of adiponectin multimers for prostate cancer. METHODS: Total adiponectin, high- and low-molecular-weight (HMW, LMW), ratios of these measures, and body mass index (BMI) were compared in a prospective prostate cancer-screened cohort. Multivariable logistic regression was used to assess the association between adiponectin measures, their interaction with BMI, and risk of prostate cancer and Gleason score upgrading from biopsy to prostatectomy. RESULTS: A total of 228 prostate cancer cases and 239 controls were analyzed: 72 (31.6%) of the cancer cases were high grade (Gleason grade ≥7). Only percent HMW had a statistically significant relationship with prostate cancer (P = 0.04). Among normal and overweight men, the risk of prostate cancer increased as percent HMW increased [OR = 1.24 for a doubling of percent HMW, 95% confidence interval (CI), 0.41-3.75 and OR = 1.81; 95% CI, 1.02-3.20, respectively], whereas among obese men, the risk of prostate cancer decreased (OR = 0.62; 95% CI, 0.32-1.18). Among 97 patients who underwent radical prostatectomy, there was no association between Gleason score upgrading and any of the adiponectin multimers. CONCLUSION: This study was unable to confirm the utility of total adiponectin as a biomarker for prostate cancer risk. For the adiponectin multimers, only HMW showed increases with prostate cancer but not in all weight classes. IMPACT: Although adiponectin may play a role in the pathogenesis of prostate cancer, our results do not support adiponectin multimers as biomarkers of detection.

Paclitaxel coated-stent for early-onset thrombosis after liver transplantation.

Hepatic artery thrombosis (HAT) is the most common vascular complication of orthotopic liver transplantation (OLT) and constitutes a potential emergency during the postoperative period. Surgical revascularization and retransplantation are the treatments of choice for this condition. The aim of this report is to present long-term follow-up on survival and graft function of three patients with paclitaxel-coated hepatic artery stents placed percutaneously after earlyonset HAT. Three patients developed early onset HAT after cadaveric-donor OLT in a tertiary care center in Mexico. These patients were treated percutaneously with balloon angioplasty and paclitaxel-coated stents. After 24 months or more of follow-up, 2 patients present total occlusion of the stent and one patient, intra-stent stenosis; interestingly, all patients have normal graft function and excellent quality of life. In conclusion, although balloon angioplasty and stent placement may be a therapeutic option for suitable patients with early-onset HAT after OLT, longterm patency is unlikely even with the use of paclitaxel- coated materials.

Punción de nódulos tiroideos guiada por ecografía con aguja fina (PAAF): nuestra experiencia / Sonographically guided biopsy of thyroid nodules

El objetivo de éste trabajo es comparar nuestra experiencia sobre las punciones aspirativas de nódulos tiroideos guiada con ecografía con la de otros trabajos publicados. Estudiamos retrospectivamente 183 pacientes sometidos a punciones biópsicas de nódulos tiroides (en un período de 27 meses). Las mismas se realizaron sin anestesia local, sin test de coagulación ni anatomopatológo en la sala. El 9,2 por ciento de los nódulos fueron malignos, 69 por ciento benignos, 14,7 por ciento acelular, sólo material coloide, y el 7,1 por ciento insuficiente. Nuestro trabajo coincide con el resto de la bibliografía en cuanto a que la punción tiroidea guiada por ecografía es un método simple, de bajo costo, con escasas complicaciones y con alta efectividad diagnóstica. Sugerimos punzar los nódulos mixtos ya que el 29,5 por ciento en nuestro estudio fueron malignos. Recomendamos que sea efectuada por personal capacitado, con anatomopatólogo en la sala y sin coagulación previa

Fibrosis diabética de la mama: presentación de tres casos y revisión de la literatura / Diabetic fibrous breast disease: a report of three cases and literature review

La mastopatía diabética es una entidad benigna poco conocida, que se presenta como masa palpable en pacientes con diabetes mellitus insulino dependiente. Propósito: describir los hallazgos clínicos, mamográficos, ecográficos e histopatológicos en tres casos y comparar nuestros hallazgos con la literatura. Material y métodos: entre enero de 1999 y marzo de 2001 se estudiaron 3 pacientes diabéticas insulino dependiente, con masa mamaria palpable, mediante mamografía, ecografía y exámen histopatológico (core biopsia en dos, biopsia escisional en la restante). Resultados: la mamografía mostró elevada densidad en los tres casos. El US evidenció áreas heterogéneas, con marcada atenuación posterior. Las biopsias fueron negativas para células neoplásicas, con hallazgos compatibles con fibrosis diabética de la mama. Conclusión: se debe considerar como diagnóstico diferencial, ésta enfermedad benigna en pacientes diabéticas premenopaúsicas. El diagnóstico puede realizarse con biopsia, evitando una cirugía innecesaria