Diagnosis and quantification of fibrosis, steatosis, and hepatic siderosis through multiparametric magnetic resonance imaging. / Diagnóstico y cuantificación de fibrosis, esteatosis y hepatosiderosis por medio de resonancia magnética multiparamétrica.

BACKGROUND: The presence of liver fibrosis is the common denominator in numerous chronic liver diseases that can progress to fibrosis and hepatocellular carcinoma. Most important, with respect to frequency, are viral hepatitis and non-alcoholic fatty liver disease, the prevalence of which is increasing in epidemic proportions. Liver biopsy, albeit imperfect, continues to be the criterion standard, but in many clinical situations tends to be replaced with noninvasive imaging methods. OBJECTIVES: The aim of the present article was to describe our imaging department experience with magnetic resonance elastography and to analyze and discuss recently published results in gastroenterology, hepatology, and radiology from other authors in the literature, complemented with a PubMed search covering the last 10 years. RESULTS AND CONCLUSIONS: Magnetic resonance elastography is an efficacious, noninvasive method with results that are concordant with liver biopsy. It is superior to ultrasound elastography because it evaluates a much greater volume of hepatic tissue and shows the often heterogeneous lesion distribution. The greatest advantage of the magnetic resonance protocol described is the fact that it quantifies fibrosis, fat content, and iron content in the same 25min examination specifically directed for that purpose, resulting in a favorable cost-benefit ratio for the patient and/or institution.

[Study of 30 years on the change in the frequency of esophageal squamous cell carcinoma, esophageal adenocarcinoma and adenocarcinoma of the esophagogastric union]. / Estudio de 30 años sobre el cambio en la frecuencia de carcinoma epidermoide esofágico, adenocarcinoma esofágico y adenocarcinoma de la unión esofagogástrica.

UNLABELLED: Esophageal cancer mortality is high and the incidence of this neoplasm is increasing. OBJECTIVE: Our aim was to compare the frequency of esophageal adenocarcinoma cases (EA) and squamous cell carcinoma (SCC) cases in two study periods (1977-1988 vs. 1989-2006). METHOD: Patients with esophageal cancer or adenocarcinoma of gastroesophageal junction (AGEJ) referred to the Nation al Institute of Medical Sciences and Nutrition "Salvador Zubirán" during 1989-2006 were included. The frequency of EA, SCC was compared with the previously reported series of our institute during 1977-1988. Risk factors for esophageal cancer and AGEJ were investigated. RESULTS: From 1989 to 2006 82 patients were studied, 23 with SCC, 29 with EA and 29 with AGEJ. There was a significant association between gastroesophageal reflux disease (GERD) and EA (OR = 9.5; CI 95% 1.9-48.5, P = 0.0025), and also between GERD and AGEJ (OR 5.6; CI 95% 1.07-28.8, P = 0.03). The association between Barrett's esophagus and EA (OR 14; CI 95% 1.65-119.2, P = 0.0035) and for GEJC (RM 13.6; IC 95% 1.6-116, P = 0.004) was significant. There was an increase in the frequency of AE from 11% (6/57) in the first period to 56% (29/52) in the second period (P < 0.001). The rela tion SCC/EA change from 7:1 in the first period to 0.8:1 in the second. CONCLUSION: There has been an increase in EA, being now the predominant hystologic type of esophageal cancer.

Early hepatitis C virus changes and sustained response in patients with chronic hepatitis C treated with peginterferon alpha-2b and ribavirin.

BACKGROUND: Interferon-based therapy induces changes in viral dynamics in chronic hepatitis C (CHC) patients. AIMS: The aim of this study was to assess early hepatitis C virus (HCV)-RNA changes and evaluate its predictive value to achieve sustained viral response (SVR) in patients with CHC treated with peginterferon alpha-2b weekly plus ribavirin daily for 48 weeks. METHODS: HCV-RNA was measured at baseline, 48 h, 4, 12, 24 and 48 weeks of treatment and 24 weeks after treatment. RESULTS: Eighteen HCV genotype 1 patients were included (13 male, five female) with a mean age of 44.4+/-11.9 years. Nine patients achieved SVR (50%). Viral decline occurred as early as 48 h; the magnitude of decline was statistically different between both groups (P<0.01). Responders had a > or =1 log(10) drop in HCV-RNA at 48 h (positive predictive value (PPV) of 89% to achieve SVR) that persisted at week 4. By week 12, serum HCV-RNA was undetectable (PPV 100%). CONCLUSIONS: Our data indicate that peginterferon alpha-2b plus ribavirin treatment produces significant changes in HCV dynamics that can be detected as early as 48 h after the first dose of peginterferon alpha-2b and that these changes are useful in predicting response to therapy in CHC patients.

Modulation of short term and long term memory by steroid sexual hormones.

Many studies have evidenced a functional interrelation between the nervous and endocrine systems in the modulation of mnemonic processes, and others have established the role played by certain hormones in these processes; however, few studies have dealt with the effects of sexual steroids on learning and memory. The aim of this work was to determine whether short-term and long-term memory is subject to hormonal modulation. Male Wistar rats, randomly assigned to 13 groups, 1 control and 12 experimental groups, were trained on a one-trial passive avoidance conditioning. The control group received saline solution, and each of the 12 experimental groups received a treatment consisted in one of following pharmacological doses of: 5, 10, 20, 30 mg of testosterone enanthate, 0.2, 0.4, 0.8, 1.2 mg estradiol valeriate, or 1, 2, 4, 6 mg norandrostenolone decanoate, respectively. All substances were applied 45 min before the training session. Retention of the learned response was tested 10 min (short-term memory) and 24 h (long-term memory) after the training session. Results indicate that under these experimental conditions the short-term memory is facilitated with testosterone enanthate at doses of 20 and 30 mg, the estradiol valeriate at doses of 0.4 mg and the nor-androstenolone decanoate at doses of 4 mg, whereas the long-term memory is facilitated with testosterone enanthate at doses of 30 mg, estradiol valeriate at doses of 1.2 mg and the nor-androstenolone decanoate at doses of 4 mg. The other studied doses were no effective.