Phosphonomycin, a new antibiotic produced by strains of streptomyces.

Phosphonomycin is a newly discovered antibiotic produced by streptomycetes. It is effective, when administered by the oral route, to mice infected with Gram-positive or Gram-negative microorganisms. The antibiotic is bactericidal and inhibits cell-wall synthesis.

Anomalous inferior vena cava with lumbar vein thrombosis: CT diagnosis.

A case of thrombosis of the ascending right lumbar vein in a patient with infrahepatic interruption of the inferior vena cava and azygos-hemiazygos continuation is reported and the CT findings are described.

The azygos lobe: normal variants that may simulate disease.

In this paper we describe the normal appearance of the azygos lobe on conventional radiography and CT, presenting variants that may simulate pathology on the chest radiograph. We describe the signs that allow identification of such variants and the role of CT in explaining the findings and excluding a pathological process.

Benign pleural diseases.

The pleural space is a potential space under normal physiologic circumstances. It envelops the lung, the mediastinum, the diaphragm and the chest wall. A thin film of pleural fluid provides lubrication for the two pleural layers; only 2-10 ml of pleural fluid is present in healthy people. For the purposes of this review, pleural abnormalities will be divided into pleural effusion, pneumothorax, and pleural calcification.

CT findings in a case of polypoid-like metastasis in the ileum from extraosseous osteosarcoma.

We describe a case of ileal metastasis from an extraosseous osteosarcoma which has not been previously reported in the English radiological literature. The metastasis had a polypoid-like appearance. The CT scan disclosed an intraluminal mass surrounded by contrast material and mesenteric fat inside the pseudopedicle.

Epithienamycins-novel beta-lactams related to thienamycin. I. Production and antibacterial activity.

The epithienamycins are cell wall active antibiotics structurally related to N-acetylthienamycin. We have found forty-three isolated of Streptomyces flavogriseus which are capable of producing members of the epithienamycin family. Six major epithienamycin components, and xanthomycin, have been isolated from fermentation broth. Fermentation conditions can be varied to enrich for certain members of the epithienamycin family. All six components show activity in vitro versus a broad spectrum of bacterial species. The weight potencies vary 27 fold from the most active to least active.

CT recognition of traumatic herniation of the stomach: the "sandwich" sign.

We describe a new sign of traumatic herniation of the stomach. Computed tomography (CT) shows the herniated stomach as two semicircular loops separated by a band of soft-tissue attenuation somewhat resembling a sandwich. This appearance is the axial representation of the herniated stomach.

[Aortic subvalvular annular aneurysm after closed thoracic traumatism. Presentation of a case]. / Aneurisma anular subvalvular aórtico postraumatismo torácico cerrado. Presentación de un caso.

A case of a 29 year old man with congenital aortic stenosis who developed a subvalvular annular aneurysm of the left ventricle after being run by a car is presented. At surgery his aortic valve was replaced and the opening of the aneurysm was closed with a patch of Dacron. Due to the dense adhesions to the aorta and left atrium no attempts were made to excise the sac, that was not compromising the dynamics of any one of these structures.

[Bronchiolitis obliterans organizing pneumonia: the usefulness of the transbronchial biopsy as a diagnostic technic]. / Bronquiolitis obliterante con neumonía organizativa: utilidad de la biopsia transbronquial como técnica diagnóstica.

Bronchiolitis obliterans organizing pneumonia (BOOP) is a recently described entity characterized by cough, fever and dyspnea. To date, only a few cases have been published in the literature. Currently, the diagnosis is established by open lung biopsy. We hereby present a case of BOOP diagnosed through transbronchial biopsy (TBB); we discuss the potential benefits of the thoracic radiography and computerized tomography scan (CT scan). Finally, we underline that in our patient, the bronchoalveolar lavage fluid (BAL) restored to normal before the resolution of the radiological images.

Changes of body composition in patients with BMI 23-50 after tailored one anastomosis gastric bypass (BAGUA): influence of diabetes and metabolic syndrome.

BACKGROUND: The use of bariatric surgery to treat diabetes mellitus (DM) requires procedures developed for morbid obese in patients with normal and over-weight. Therefore, we started tailoring one anastomosis gastric bypass (BAGUA) adapted to each patient. This study analyzes changes in body composition (BC) of patients with BMI 23-50 after BAGUA as well as influence of DM and MS. METHODS: We studied 79 (37 diabetic and 42 non-diabetic) patients (BMI 23-50) who completed all evaluation appointment (preoperative, 10 days, 1, 3, 6, and 12 months) after tailored BAGUA for obesity, diabetes, or diabesity. Patients were classified according to BMI (23-29, 30-34, 35-50) and bearing or not diabetes. Variables are components of BC as well as DM and MS. RESULTS: Preoperatively, mean values of weight varied 37 kg (78-115 kg), muscle mass (MM) 8 kg (54-62 kg), while fat mass (FM) 30 kg (22-53 kg). Basal metabolism (BM) was higher in diabetic. After surgery, percentage (%) of excess weight loss (%EWL) ranged from 76 % (BMI 35-50) to 128 % (BMI 23-29), FM 56 % (BMI 23-29) to 65 % (BMI 35-50), without differences bearing DM. MM 12 % (non-diabetics BMI 30-34) to 17 % (diabetics BMI 35-50) and visceral fat (VF) 50 % (diabetics BMI 30-34) to 56 % (non-diabetics BMI 35-50). CONCLUSIONS: After tailored BAGUA, MM maintains steady while FM is highly reduced and variable. BM is reduced in all groups. Diabetics lose less weight and VF but more MM than non-diabetic patients. Preoperative presence of MS influences the changes in BC.

Improvement of C peptide zero BMI 24-34 diabetic patients after tailored one anastomosis gastric bypass (BAGUA).

BACKGROUND: Although bariatric surgery proved to be a very effective method in the treatment of patients in whose pancreas still produce insulin (type 2 diabetes), the accompanied metabolic syndrome and their diabetes complications, there is no information on the effect of this type of surgery in BMI24-34 patients when pancreas do not produce insulin at all (type 1, LADA and long term evolution type 2 diabetes among others). PATIENTS AND METHODS: We report preliminary data of a serie of 11 patients all with a C-peptide values below 0.0 ng/ml. They were followed for 6 to 60 months (mean 19 months) after surgery. We studied the changes in glycemic control, evolution of the metabolic syndrome and diabetes complications after one anastomosis gastric bypass (BAGUA). RESULTS: All values relative to glycemic control were improved HbA1c (from 8.9 ± 0.6 to 6.7 ± 0.2%), FPG (Fasting Plasma Glucose) [from 222.36 ± 16.87 to 94 ± 5 (mg/dl)] as well as the daily insulin requirement of rapid (from 40.6 ± 12.8 to 0 (U/d) and long-lasting insulin (from 41.27 ± 7.3 U/day to 15.2 ± 3.3 U/day). It resolved 100% of the metabolic syndrome diseases as well as severe hypoglycaemia episodes present before surgery and improved some serious complications from diabetes like retinopathy, nephropathy, neuropathy, peripheral vasculopathy and cardiopathy. CONCLUSIONS: Tailored one anastomosis gastric bypass in BMI 24-34 C peptide zero diabetic patients eliminated the use of rapid insulin, reduced to only one injection per day long-lasting insulin and improved the glycemic control. After surgery disappear metabolic syndrome and severe hypoglycaemia episodes and improves significantly retinopathy, neuropathy, nephropathy, peripheral vasculopathy and cardiopathy.

Introducción: Aunque la cirugía bariátrica ha demostrado ser un método muy eficaz en el tratamiento de pacientes diabéticos cuyo páncreas aún es capaz de producir insulina (diabetes tipo 2), así como del síndrome metabólico y las complicaciones relacionadas con la diabetes, no hay información sobre el efecto de este tipo de cirugía en pacientes IMC 24-34 cuando el páncreas no produce insulina en absoluto (tipo 1, tipo LADA y diabetes tipo 2 de larga evolución, entre otros). Métodos: Presentamos datos preliminares de una serie de 11 pacientes todos con valores de Péptido C < 0,0 ng/ml. El seguimiento postoperatorio varia de 6 y 60 meses (media 19 meses). Estudiamos los cambios en el control de la glucemia, evolución del síndrome metabólico y complicaciones relacionadas con la diabetes tras bypass de una anastomosis (BAGUA). Resultados: Mejoraron todos los valores relativos al control glucémico HbA1c (de 8,9 ± 0,6 a 6,7 ± 0,2%), FPG (Glucosa Plasmática Ayunas) (de 222,36 ± 16,87 a 94 ± 5 (mg/dl)) así como el requerimiento diario de insulina, tanto de insulina rápida (de 40,6 ± 12,8 a 0 U/día) como de insulina retardada (41,27 ± 7,3 U/día a 15,2 ± 3,3 U/día). Se resolvieron el 100% de las comorbilidades estudiadas y se mejoraron algunas complicaciones graves derivadas de la diabetes como retinopatía o nefropatía. Conclusiones: El bypass gástrico de una anastomosis adaptado a pacientes diabéticos IMC24-34 con péptido C cero elimina el uso de insulina de acción rápida, reduce a una sola inyección diaria la insulina retardada y mejora el control glucémico. Tras la cirugía desaparecen el síndrome metabólico y los episodios severos de hipoglucemia, y mejora significativamente la retinopatía, neuropatía, nefropatía, vasculopatía periférica y cardiopatía.

Resolution of diabetes mellitus and metabolic syndrome in normal weight 24-29 BMI patients with One Anastomosis Gastric Bypass.

INTRODUCTION: Diabetes mellitus type 2 (DMT2) is a major cause of death in the world. The medical therapy for this disease has had enormous progress, but it still leaves many patients exposed to the complications developed from the disease. It is well known the beneficial effects of bariatric surgery in obese diabetic patients, however it is important to investigate if the same principles of bariatric surgery that improve diabetes in obese patients, could be applied to non obese normal weight diabetics. MATERIAL AND METHODS: Thirteen diabetic patients operated by One Anastomosis Gastric Bypass (BAGUA), were evaluated in the preoperative period and 1,3 and 6 months after surgery. Body weight and composition, Fasting Plasma Glucose, HbA1c levels, blood pressure and serum lipids levels were analyzed, as well as the monitoring of the immediate postoperative treatment necessities for Diabetes and other metabolic syndrome comorbidities. RESULTS: After the surgery the 77% of the patients resolves its T2DM, 46% from surgery, and rest noted an significant improvement of the disease in spite of having a C peptide level near to zero some of the patients. The comorbidities, mainly hypertension and lipid abnormalities experience improvement early. All patients reduce their weight and the amount of fat mass until values consistent with their age and height. CONCLUSIONS: The One Anastomosis Gastric Bypass leads to resolution or improvement of T2DM in non obese normal weight patients. The best results are obtained in patients with few years of diabetes, without or short term use of insulin treatment and high C-peptide levels.