Impact of previous glucocorticoid therapy on diagnostic accuracy of [18F] FDG PET-CT in giant cell arteritis.

OBJECTIVE: To evaluate the impact of prior glucocorticoid (GC) treatment on the diagnostic accuracy of 18F-FDG PET-CT in giant cell arteritis (GCA). METHODS: Retrospective study of a consecutive cohort of 85 patients with proven GCA who received high-dose GC before PET-CT. RESULTS: Thirty-nine patients previously treated with methylprednisolone (MP) boluses, of whom 37% were PET-CT (uptakes grade 3 or 2) positive. The positivity rate was 80% with MP doses of 125 mg, 33% with 250 or 500 mg, and 0% with doses of 1 g.  If we also classify as positive those cases with a grade 1 uptake (with a circumferencial uptake and smooth linear or long segmental pattern, possibly indicative of "apparently inactive" vasculitis), the positivity rate increases to 62% (100%, 50-60%, and 33% for the different MP doses, respectively). In patients with new-onset GCA treated with high-dose oral GC, PET-CT positivity was 54.5% in patients treated for less than two weeks, 38.5% in those treated for 2 to 4 weeks, and 25% in those treated for 4 to 6 weeks (increasing to 91%, 77%, and 50%, respectively, if we include cases with grade 1 uptake and these characteristics). In patients with relapsing/refractory GCA, or who developed GCA having a prior history of PMR, PET-CT positivity reached 54% despite long-term treatment with low-to-moderate doses of GC (68% including cases with a grade 1 uptake). CONCLUSION: A late 18F-FDG PET-CT (beyond the first 10 days of treatment) can also be informative in a considerable percentage of cases.

Inflammatory pseudotumour of the infratemporal fossa visualized with 18F-FDG PET/CT.

The inflammatory pseudotumour of the head and neck is a benign lesion, extremely rare outside the cranial orbits. A case is presented of an inflammatory pseudotumour not associated with the IgG4-related disease. The pseudotumour was found as a solitary mass in the infratemporal fossa of a young woman who complained of otalgia and hearing loss. A clear image of the lesion was obtained using an 18F-fluoro-deoxy-glucose (18F-FDG) PET. After the histopathological diagnosis, and treatment with corticosteroids, a second 18F-FDG PET was performed. The metabolic image had returned to normal, and the previously observed mass disappeared. A brief review is presented of the studies examining this type of lesion.

Levofloxacin versus azithromycin for treating legionella pneumonia: a propensity score analysis.

OBJECTIVES: Concerns have arisen regarding the equivalence of levofloxacin and some macrolides for treating community-acquired legionella pneumonia (LP). We aimed to compare the outcomes of current patients with LP treated with levofloxacin, azithromycin and clarithromycin. METHODS: Observational retrospective multicentre study of consecutive patients with LP requiring hospitalization (2000-2014) conducted in two hospitals. The primary outcome assessed was 30-day mortality. To control for confounding, therapy was assessed by multivariate analysis. RESULTS: We documented 446 patients with LP, of which 175 were treated with levofloxacin, 177 with azithromycin and 58 with clarithromycin. No significant differences in time to defervescence (2 (interquartile range (IQR) 1-4) versus 2 (IQR 1-3) days; p 0.453), time to achieve clinical stability (3 (2-5) versus 3 (2-5) days; p 0.486), length of intravenous therapy (3 (2-5.25) versus 4 (3-6) days; p 0.058) and length of hospital stay (7 (5-10) versus 6 (5-9) days; p 0.088) were found between patients treated with levofloxacin and those treated with azithromycin. Patients treated with clarithromycin had longer intravenous antibiotic treatment (3 (2-5.25) versus 5 (3-6.25) days; p 0.002) and longer hospital stay (7 (5-10) versus 9 (7-14) days; p 0.043) compared with those treated with levofloxacin. The overall mortality was 4.3% (19 patients). Neither univariate nor multivariate analysis showed a significant association of levofloxacin versus azithromycin on mortality (4 (2.3%) versus 9 (5.1%) deaths; p 0.164). The results did not change after incorporation of the propensity score into the models. CONCLUSIONS: In our study, no significant differences in most outcomes were found between patients treated with levofloxacin and those treated with azithromycin. Due to the small number of deaths, results regarding mortality should be interpreted with caution.

Variability in the prevalence of premenstrual asthma.

Our aim is to analyse the differences in the prevalence of premenstrual asthma (PMA) according to a set of criteria, the relationship between them and the influence of asthma severity. The answer "Yes" to "Does your asthma get worse before menstruation?" was considered subjective PMA. A daily respiratory symptoms register of fertile asthmatic females was taken during two consecutive menstrual cycles. For the semi-objective diagnosis, an exacerbation of > or =20% was required in the symptoms register. Objective diagnosis was a premenstrual worsening of > or =20% of peak flow. We selected 103 patients. Subjective premenstrual deterioration was perceived in 43.7%. The semi-objective deterioration of symptoms in the first cycle occurred in 44.7%, and in 22.3% in both cycles. A total of 54.3% of females with semi-objective criteria in the first cycle perceived a subjective deterioration of symptoms, versus 35.1% of those without semi-objective criteria (p = 0.05). PMA was present at all levels of asthma severity, with no clear link to the degree of severity. The detection of PMA prevalence, the subjective perception of this deterioration and its presence at all levels of asthma severity lead us to urge research into possible premenstrual deterioration in all fertile asthmatic females.

El alga marina Sargassum (Sargassaceae): una alternativa tropical para la alimentación de ganado caprino / The seaweed Sargassum (Sargassaceae) as tropical alternative for goats’ feeding

The nutritive value of seaweed (Sargassum spp.) was studied in Baja California Sur, Mexico. Twenty female Nubian goats (43-weeks old) were randomly distributed into two groups of 10 goats each and were housed in individual pens. One group was fed with a control diet and the other with a diet supplemented with 25% of Sargassum spp. Feed and water intake were recorded daily and individually for 60 days. The weight of each goat was recorded every 15 days. The nutritional content of Sargassum spp. was 89% dry mater, 8% crude protein, 31% ash, 2% ether extract, and 39% carbohydrates. Fiber fractions, minerals, vitamins, fatty acids, and antinutritional factors were also determined. There were no significant differences in body weight (8.6 kg control and 9 kg experimental), feed intake (1.3 kg control and 1.6 kg experimental), and feed conversion rate (11.1 control and 12.6 experimental). Water consumption was greater in the goats that ate the Sargassum diet (5.3 l). From these results,Sargassum spp.can be considered as an alternative feedstuff for goats.

Se estudió el valor nutricional de varias algas del género Sargassum. Veinte cabras hembras (Nubia) en crecimiento (43 semanas)se distribuyeron aleatoriamente en dos grupos de 10 cabras y se alojaron en corraletas individuales. Un grupo fue alimentado con una dieta testigo elaborada con insumos regionales y el otro con una dieta que incluyó el 25% de Sargassum spp. Durante 60 días se midieron diariamente y en forma individual, el alimento y agua consumidos, el peso corporal se cuantificó cada 15 días. La composición química proximal de Sargassum fue de: 89% materia seca, 7.7% proteína, 31% cenizas, 2% extracto etéreo y 39% de carbohidratos. También se determinaron las fracciones de fibra, minerales, vitaminas, ácidos grasos y factores antinutricios. No se encontraron diferencias significativas en el peso corporal (8.6 kg grupo control y 9 kg experimental), alimento consumido (1.31 kg grupo control y 1.6 experimental)y tasa de conversión alimenticia (11.1 grupo control y 12.6 experimental) entre los tratamientos. El consumo de agua fue mayor en el grupo alimentado con la dieta que incluyó Sargassum spp (5.1 l). De los resultados se deduce que las algas marinas de este género pueden ser utilizadas como un forraje alternativo de mediana calidad para el ganado caprino.

[The seaweed Sargassum (Sargassaceae) as tropical alternative for goats' feeding]. / El alga marina Sargassum (Sargassaceae): una alternativa tropical para la alimentación de ganado caprino.

The seaweed Sargassum (Sargassaceae) as tropical alternative for goats' feeding. The nutritive value of seaweed (Sargassum spp.) was studied in Baja California Sur, Mexico. Twenty female Nubian goats (43-weeks old) were randomly distributed into two groups of 10 goats each and were housed in individual pens. One group was fed with a control diet and the other with a diet supplemented with 25% of Sargassum spp. Feed and water intake were recorded daily and individually for 60 days. The weight of each goat was recorded every 15 days. The nutritional content of Sargassum spp. was 89% dry mater, 8% crude protein, 31% ash, 2% ether extract, and 39% carbohydrates. Fiber fractions, minerals, vitamins, fatty acids, and antinutritional factors were also determined. There were no significant differences in body weight (8.6 kg control and 9 kg experimental), feed intake (1.3 kg control and 1.6 kg experimental), and feed conversion rate (11.1 control and 12.6 experimental). Water consumption was greater in the goats that ate the Sargassum diet (5.3 1). From these results, Sargassum spp. can be considered as an alternative feedstuff for goats.

[Radiographic staging and bronchoalveolar lavage cell counts in sarcoidosis]. / Estadios radiológicos y lavado broncoalveolar en la sarcoidosis.

OBJECTIVE: Sarcoidosis is a multisystem granulomatous inflammatory disease of unknown etiology that mainly affects the lungs and lymph nodes. Bronchoalveolar lavage (BAL) is known to be useful in diagnosis of the disease but its value as a prognostic marker is unclear. The aim of this study was to assess whether there is a characteristic pattern in BAL cell counts according to radiographic stage and determine whether BAL offers information on disease course. PATIENTS AND METHODS: The study included 34 patients with untreated sarcoidosis. Data were collected on the following variables: age, sex, smoking habit, treatment type, radiographic stage, respiratory function, serological parameters, and BAL cell counts. The patients were classified into 3 groups according to functional and radiographic change at 12-month follow-up. RESULTS: No differences in age, sex, or smoking habit were found according to either radiographic stage or disease course. Although the proportion of lymphocytes in BAL fluid was higher in radiographic stage I than in stages II and III, the differences were not statistically significant. The differences in BAL cell counts between groups based on disease course were not statistically significant. CONCLUSIONS: No differences were found in the characteristics of BAL fluid according to radiographic stage. The differential cell count in BAL fluid does not appear to predict the course of sarcoidosis in the first 12 months.

Algas marinas de Baja California Sur, México: valor nutrimental / Marine algae of Baja California Sur, Mexico: nutritional value

The Baja California Peninsula is one of the richest regions of seaweed resources in México. The objective of this study was to determine the chemical composition of some marine algae species of Baja California Sur, with an economical potential due to their abundance and distribution, and to promote their use as food for human consumption and animal feeding. The algae studied were Green (Ulva spp., Enteromorpha intestinalis, Caulerpa sertularoides, Bryopsis hypnoides), Red (Laurencia johnstonii, Spyridia filamentosa, Hypnea valentiae) and Brown (Sargassum herporizum, S. sinicola, Padina durvillaei, Hydroclathrus clathrathus, Colpomenia sinuosa). The algae were dried and ground before analysis. In general, the results showed that algae had a protein level less than 11 per cent, except L. johnstonii with 18 per cent and low energy content. The ether extract content was lower than 1 per cent. However, the algae were a good source of carbohydrates and inorganic matter.

Elemental concentrations in different species of seaweeds from Loreto Bay, Baja California Sur, Mexico: implications for the geochemical control of metals in algal tissue.

Concentration levels of 21 elements were analyzed by instrumental neutron activation analysis (Rb, Cs, Ca, Sr, Ba, Sc, Cr, Fe, Co, Ni, Zn, Se, As, Sb, Th, U, Br, Hf, Ta, Zr, and Ag) in seven different seaweed species (Codium cuneatum, Sargassum sinicola, Padina durvillaei, Laurencia johnstonii, L. papillosa, Gracilaria pachidermatica and Hypnea pannosa), collected in a shallow coastal zone from Bahia de Loreto, Baja California Sur, Mexico. Measured concentrations in algal tissue spanned almost eight orders of magnitude (from 2.0 x 10(-3) microg g(-1) for Hf to 1.2 x 10(5) microg g(-1) for Ca). Ca was consistently the most abundant element in all analyzed seaweeds, followed by Fe and Sr. Brown algae showed a tendency to incorporate higher concentrations of elements than red and green algae. Additionally, there were significant linear correlations (P < 0.05 to P < 0.001) between a total of 76 different pairs of elements, some of them (e.g. Rb-Ni, Rb-Ag, Sc Cr, Sc-Fe, Sc Ni, Sc Hf, Cr Fe, Fe Ni, Fe-Hf and Ni-Th) highly correlated (r2 > 0.900). A significant correlation (r2 = 0.701, n = 18, P < 0.001) exists between our measurements in the tissue of algae and their corresponding average elemental concentrations in oceanic water from the North Pacific Ocean. Hence, overall elemental abundance in algal tissue apparently is controlled by the elemental abundance in oceanic water, whereas metabolic processes as well as environmental factors relevant to each region modify the final concentration of a given element in the body of a macroalgae.