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1.
Rev Esp Enferm Dig ; 2023 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-36896927

RESUMEN

The case was a 47-year-old male, asymptomatic, with a personal history of splenectomy in childhood. He was referred to our outpatient clinic to complete the study of space-occupying liver lesion. The initial diagnostic suspicion was liver adenoma, given its behavior on magnetic resonance imaging and the absence of previous liver disease. We performed an intravascular contrast-enhanced ultrasound (CEUS) (SonoVue©). The lesion showed rapid centripetal enhancement, remaining enhanced in the portal phase with dim washout in the late venous phase. Given the therapeutic implications of the diagnosis of a hepatic adenoma, an ultrasound-guided percutaneous biopsy with an 18-gauge core needle was performed. The anatomopathological study confirmed the presence of hepatic splenosis. Hepatic splenosis can present as isolated or multiple foci (1). There is little published information on the behavior of hepatic splenosis in CEUS (2, 3, 4), which prevents any behavior from being generalized. The most frequently described behavior is hyperenhancement in the arterial phase without subsequent washout, not a specific behavior that can lead to the misdiagnosis of other entities such as hemangioma. In our case, it was caused by an isolated focus of splenosis that did not show the most frequent described behavior at CEUS, since it presented a faint washout in the venous phase, making it necessary to rule out malignancy.

2.
J Cell Physiol ; 237(2): 1498-1508, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34698372

RESUMEN

Asthma is a chronic respiratory disease produced by an aberrant immune response that originates with breathing difficulties and cough, through airway remodeling. The above pathophysiological events of asthma emerge the regulators of effectors, like epigenetics, which include microRNAs (miRNAs) who perform post-transcriptional regulation, controlling diverse pathways in respiratory diseases. The objective of the study was to determine how miR-185-5p regulates the secretion of periostin by airway structural cells, and smooth muscle cells contraction, both related to airway remodeling in asthma. We used miR-185-5p mimic and inhibitors in bronchial smooth muscle cells (BSMCs) and small airway epithelial cells (SAECs) from healthy subjects. Gene expression and protein levels of periostin (POSTN), CDC42, and RHOA were analyzed by RT-PCR and ELISA/Western blot, respectively. BSMC contractility was analyzed using cell-embedded collagen gels and measurement of intracellular calcium was performed using Fura-2. Additionally, miR-185-5p and periostin expression were evaluated in sputum from healthy and asthmatics. From these experiments, we observed that miR-185-5p modulation regulates periostin mRNA and protein in BSMCs and SAECs. A tendency for diminished miR-185-5p expression and higher periostin levels was seen in sputum cells from asthmatics compared to healthy, with an inverse correlation observed between POSTN and miR-185-5p. Inhibition of miR-185-5p produced higher BSMCs contraction induced by histamine. Calcium mobilization was not modified by miR-185-5p, showing that miR-185-5p role in BSMC contractility is performed by regulating CDC42 and RhoA pro-contractile factors instead. In conclusion, miR-185-5p is a modulator of periostin secretion by airway structural cells and of smooth muscle contraction, which can be related to asthma pathophysiology, and thus, might be a promising therapeutic target.


Asunto(s)
Asma , MicroARNs , Remodelación de las Vías Aéreas (Respiratorias)/genética , Asma/metabolismo , Calcio/metabolismo , Proliferación Celular/genética , Humanos , MicroARNs/genética , MicroARNs/metabolismo , Contracción Muscular/genética , Miocitos del Músculo Liso/metabolismo
3.
J Emerg Med ; 57(6): 780-790, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31591077

RESUMEN

BACKGROUND: Nontraumatic headache is a frequent complaint in the emergency department (ED). Cranial computed tomography (CT) is a widely available test for the diagnostic work-up, despite the risk of exposure to ionizing radiation. OBJECTIVES: We sought to develop and evaluate a cranial CT request computerized decision support system (CDSS) for adults with their first presentation of unusual severe nontraumatic headache in the ED. METHODS: Electronic database searches identified clinical decision and prediction rules and studies delineating risk factors in nontraumatic headache. A long list of risk factors extracted from these articles was reduced by a 30-member multidisciplinary expert panel (radiologists, emergency physicians, methodologists), using a 90% agreement threshold. This shortlist was used to develop the algorithm for the cranial CT request CDSS, which was implemented in March 2016. Impact evaluation compared CT scan frequency and diagnostic yield of pathologic findings before (March-August 2015) and after (March-August 2016) implementation. RESULTS: From the 10 selected studies, 10 risk factors were shortlisted to activate a request for cranial CT. Before implementation, 377 cranial CTs were ordered (15.3% of 2469 CT scans) compared with 244 after (9.5% of 2561 CT scans; pre-post difference 5.74%; 95% confidence interval [CI] 3.92-7.56%; p < 0.001), corresponding to a 37.6% relative reduction in the test ordering rate (95% CI 25.7-49.5%; p < 0.001). Despite the reduction in cranial CT scans, we did not observe an increase in pathological findings after introducing the decision support system (70 cases before [18.5%] vs. 35 cases after [14.3%]; pre-post difference -4.0% [95% CI -10.0 to 1.6%]; p = 0.170). CONCLUSION: In nontraumatic headache among adults seen in the ED, CDSS decreased the cranial CT request rate but the diagnostic yield did not improve.


Asunto(s)
Técnicas de Apoyo para la Decisión , Cefalea/diagnóstico por imagen , Tomografía Computarizada por Rayos X/clasificación , Distribución de Chi-Cuadrado , Servicio de Urgencia en Hospital/organización & administración , Servicio de Urgencia en Hospital/normas , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Cefalea/clasificación , Cefalea/etiología , Humanos , Masculino , Tomografía Computarizada por Rayos X/métodos , Tomografía Computarizada por Rayos X/estadística & datos numéricos
4.
Cancer Diagn Progn ; 3(4): 433-438, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37405211

RESUMEN

BACKGROUND/AIM: The optimal imaging test for delineation of the gross tumor volume (GTV) in hepatocellular carcinoma has not been defined. The hypothesis is that magnetic resonance imaging (MRI) allows for better visualization of the extent of tumor and will optimize the accuracy of tumor delineation for liver stereotactic radiotherapy compared with computed tomography (CT) only. We evaluated the interobserver agreement in GTV of hepatocellular carcinoma in a multicenter panel and compared MRI and CT in GTV delineation. MATERIALS AND METHODS: After the institutional review boards approved the study, we analyzed anonymous CT and MRI obtained from five patients with hepatocellular carcinoma. Eight radiation oncologists at our center used CT and MRI to delineate five GTVs of liver tumors. In both CT and MRI, the GTV volumes were compared. RESULTS: The median GTV volume on MRI was 2.4 cm3 (range=0.59-15.6 cm3) compared to 3.5 cm3 (range=0.52-24.9 cm3) on CT (p=0.36). The GTV volume as defined on MRI was larger or at least as large as the GTV volume on CT in two cases. Variance and standard deviation between observers in CT and MRI were minor (6 vs. 7.87 cm3, and 2.5 vs. 2.8 cm3 respectively). CONCLUSION: In cases with well-defined tumors, CT is easier and reproducible. In cases with no defined tumor in CT, other tools are needed and MRI can be complementary. The interobserver variability in target delineation of hepatocellular carcinoma in this study is noteworthy.

6.
Front Immunol ; 13: 858722, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35432357

RESUMEN

MicroRNAs are non-coding molecules that act both as regulators of the epigenetic landscape and as biomarkers for diseases, including asthma. In the era of personalized medicine, there is a need for novel disease-associated biomarkers that can help in classifying diseases into phenotypes for treatment selection. Currently, severe eosinophilic asthma is one of the most widely studied phenotypes in clinical practice, as many patients require higher and higher doses of corticosteroids, which in some cases fail to achieve the desired outcome. Such patients may only benefit from alternative drugs such as biologics, for which novel biomarkers are necessary. The objective of the study was to study the expression of miR-144-3p in order to discover its possible use as a diagnostic biomarker for severe asthma. For this purpose, miR-144-3p was evaluated in airway biopsies and serum from asthmatics and healthy individuals. mRNA was studied in asthmatic biopsies and smooth muscle cells transfected with miR-144-3p mimic. An in silico regulation of miR-144-3p was performed using miRSystem, miRDB, STRING, and ShinyGO for pathway analysis. From our experimental procedures, we found that miR-144-3p is a biomarker associated with asthma severity and corticosteroid treatment. MiR-144-3p is increased in asthmatic lungs, and its presence correlates directly with blood eosinophilia and with the expression of genes involved in asthma pathophysiology in the airways. When studied in serum, this miRNA was increased in severe asthmatics and associated with higher doses of corticosteroids, thereby making it a potential biomarker for severe asthma previously treated with higher doses of corticosteroids. Thus, we can conclude that miR-144-3p is associated with severe diseases in both the airways and serum of asthmatics, and this association is related to corticosteroid treatment.


Asunto(s)
Asma , Eosinofilia , MicroARNs , Corticoesteroides/uso terapéutico , Asma/diagnóstico , Asma/tratamiento farmacológico , Asma/genética , Biomarcadores , Humanos , MicroARNs/metabolismo
7.
Sci Rep ; 12(1): 21278, 2022 12 08.
Artículo en Inglés | MEDLINE | ID: mdl-36482106

RESUMEN

Respiratory viral infections (RVIs) are frequent in preterm infants possibly inducing long-term impact on respiratory morbidity. Immune response and respiratory barriers are key defense elements against viral insults in premature infants admitted to Neonatal Intensive Care Units (NICUs). Our main goals were to describe the local immune response in respiratory secretions of preterm infants with RVIs during NICU admission and to evaluate the expression and synthesis of lung barrier regulators, both in respiratory samples and in vitro models. Samples from preterm infants that went on to develop RVIs had lower filaggrin gene and protein levels at a cellular level were compared to never-infected neonates (controls). Filaggrin, MIP-1α/CCL3 and MCP-1 levels were higher in pre-infection supernatants compared to controls. Filaggrin, HIF-1α, VEGF, RANTES/CCL5, IL-17A, IL-1ß, MIP-1α and MIP-1ß/CCL5 levels were higher during and after infection. ROC curve and logistic regression analysis shows that these molecules could be used as infection risk biomarkers. Small airway epithelial cells stimulated by poly:IC presented reduced filaggrin gene expression and increased levels in supernatant. We conclude that filaggrin gene and protein dysregulation is a risk factor of RVI in newborns admitted at the NICU.


Asunto(s)
Citocinas , Proteínas Filagrina , Enfermedades Respiratorias , Virosis , Humanos , Recién Nacido , Citocinas/metabolismo , Recien Nacido Prematuro , Virosis/metabolismo , Proteínas Filagrina/metabolismo , Enfermedades Respiratorias/virología , Unidades de Cuidado Intensivo Neonatal
8.
J Pers Med ; 11(2)2021 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-33525548

RESUMEN

Severe eosinophilic asthma poses a serious health and economic problem, so new therapy approaches have been developed to control it, including biological drugs such as benralizumab, which is a monoclonal antibody that binds to IL-5 receptor alpha subunit and depletes peripheral blood eosinophils rapidly. Biomarkers that predict the response to this drug are needed so that microRNAs (miRNAs) can be useful tools. This study was performed with fifteen severe eosinophilic asthmatic patients treated with benralizumab, and serum miRNAs were evaluated before and after treatment by semi-quantitative PCR (qPCR). Patients showed a clinical improvement after benralizumab administration. Additionally, deregulation of miR-1246, miR-5100 and miR-338-3p was observed in severe asthmatic patients after eight weeks of therapy, and a correlation was found between miR-1246 and eosinophil counts, including a number of exacerbations per year in these severe asthmatics. In silico pathway analysis revealed that these three miRNAs are regulators of the MAPK signaling pathway, regulating target genes implicated in asthma such as NFKB2, NFATC3, DUSP1, DUSP2, DUSP5 and DUSP16. In this study, we observed an altered expression of miR-1246, miR-5100 and miR-338-3p after eight weeks of benralizumab administration, which could be used as early response markers.

9.
Urology ; 99: e9-e10, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27720974

RESUMEN

We describe the imaging findings of a case of an intra-abdominal gossypiboma (retained surgical sponge) in an asymptomatic 61-year-old man who underwent an emergency nephrectomy because of a Wunderlich syndrome secondary to a renal cell carcinoma. A follow-up computed tomography was performed 4 months after the emergency surgery and showed an extraperitoneal lesion with gas bubbles and radiopaque markings in the left hemiabdomen, consistent with a retained surgical sponge ("gossypiboma" or "textiloma") in the anterior pararenal space. The patient underwent scheduled surgery for extraction of the textiloma.

10.
Urology ; 100: e5-e6, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27890686

RESUMEN

We describe the positron emission tomography-computed tomography (PET-CT) findings of a patient who presented to the emergency room with chest pain and palpitations and underwent a radical cystectomy 6 months earlier because of a squamous cell carcinoma of the bladder (SCCB). Cardiac catheterization ruled out coronary artery occlusion, but PET-CT showed multiple F-18-fluorodeoxyglucose-avid lesions involving multiple skeletal muscles and the heart, consistent with metastases. A CT-guided biopsy of 1 skeletal muscle lesion confirmed a metastasis with the same pathologic features as the SCCB. To our knowledge, this is the first reported case of an SCCB with metastases to multiple skeletal muscles and myocardium detected with PET-CT.


Asunto(s)
Carcinoma de Células Escamosas/secundario , Neoplasias Cardíacas/secundario , Neoplasias de los Músculos/secundario , Músculo Esquelético , Neoplasias de la Vejiga Urinaria/patología , Carcinoma de Células Escamosas/diagnóstico por imagen , Femenino , Neoplasias Cardíacas/diagnóstico por imagen , Humanos , Persona de Mediana Edad , Neoplasias de los Músculos/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones
11.
Asian Cardiovasc Thorac Ann ; 25(9): 633-634, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28906135

RESUMEN

An 81-year-old woman who had undergone total hip arthroplasty 12 years earlier presented with a painful spontaneous hematoma in the proximal left thigh. A left hip radiograph showed a displaced cement fragment from the acetabular component of the hip prosthesis. Computed tomography confirmed an extruded cement fragment causing a large pseudoaneurysm of the deep femoral artery. The patient underwent successful percutaneous embolization of the pseudoaneurysm with coils.


Asunto(s)
Aneurisma Falso/etiología , Artroplastia de Reemplazo de Cadera/efectos adversos , Cementos para Huesos/efectos adversos , Arteria Femoral , Migración de Cuerpo Extraño/etiología , Anciano de 80 o más Años , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/terapia , Angiografía de Substracción Digital , Angiografía por Tomografía Computarizada , Embolización Terapéutica/instrumentación , Femenino , Arteria Femoral/diagnóstico por imagen , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/terapia , Humanos , Factores de Tiempo , Resultado del Tratamiento
13.
Clin Imaging ; 39(2): 311-4, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25457526

RESUMEN

A 62-year-old woman presented to our hospital with an anterior chest wall swelling. Computed tomography (CT) and magnetic resonance imaging showed findings consistent with an infectious arthritis of the manubriosternal joint, and CT images also demonstrated multiple centrilobular nodules in both lungs, suggesting an infectious bronchiolitis. A CT-guided fine needle aspiration of a presternal mass yielded growth of Mycobacterium tuberculosis. Bronchoalveolar lavage confirmed an active pulmonary tuberculosis. Septic arthritis of the manubriosternal joint is exceedingly rare.


Asunto(s)
Artritis Infecciosa/diagnóstico , Manubrio/microbiología , Esternón/microbiología , Tuberculosis Pulmonar/diagnóstico , Tuberculosis/diagnóstico , Femenino , Humanos , Imagen por Resonancia Magnética , Manubrio/diagnóstico por imagen , Manubrio/patología , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Esternón/diagnóstico por imagen , Esternón/patología , Pared Torácica/diagnóstico por imagen , Tomografía Computarizada por Rayos X
14.
Arch Bronconeumol ; 51(7): e36-9, 2015 Jul.
Artículo en Inglés, Español | MEDLINE | ID: mdl-25446870

RESUMEN

Exogenous lipoid pneumonia (ELP) is a rare (incidence 1.0%-2.5%), often under-diagnosed disease, caused by the aspiration and accumulation of exogenous lipids within the pulmonary alveoli. Various cases have been described due to inhalation of lubricants via the nasal passages and oropharynx, aspiration of mineral oils in laxatives in patients with eating disorders, application of lip gloss, occupational exposure to liquid paraffin or mineral oils ("fire-eaters", industrial use in washing of machinery, automobile workshops, plastic paints, etc.) and application of Vaseline during the insertion of nasogastric tubes and in the care of tracheotomy patients. ELP usually presents radiologically as areas of low-attenuation peribronchial consolidation and ground glass opacities, with a predominantly bibasal distribution. We present 5 cases of long-standing laryngectomy patients diagnosed with ELP who admitted using Vaseline in their tracheal stoma care.


Asunto(s)
Intubación/métodos , Laringectomía , Lubricantes/efectos adversos , Imagen Multimodal , Vaselina/efectos adversos , Neumonía por Aspiración/diagnóstico por imagen , Tomografía de Emisión de Positrones , Complicaciones Posoperatorias/diagnóstico por imagen , Estomas Quirúrgicos , Tomografía Computarizada por Rayos X , Traqueostomía , Anciano de 80 o más Años , Enfermedades Asintomáticas , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/secundario , Carcinoma de Células Escamosas/cirugía , Terapia Combinada , Femenino , Humanos , Neoplasias Laríngeas/tratamiento farmacológico , Neoplasias Laríngeas/radioterapia , Neoplasias Laríngeas/cirugía , Lípidos/análisis , Neoplasias Pulmonares/secundario , Macrófagos/química , Macrófagos/ultraestructura , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neumonía por Aspiración/inducido químicamente , Complicaciones Posoperatorias/inducido químicamente , Radioterapia Adyuvante , Tiroidectomía
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