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1.
Foods ; 12(14)2023 Jul 11.
Article in English | MEDLINE | ID: mdl-37509757

ABSTRACT

The global market for plant-based drinks is experiencing rapid growth driven by consumer demand for more sustainable diets, including vegetarian and vegan options. Soy beverages in particular are gaining popularity among individuals with lactose intolerance and milk protein allergies. They are considered an excellent source of high-quality protein, vitamin B, unsaturated fatty acids, and beneficial phytochemicals such as phytosterols, soy lecithins, and isoflavones. This review presents a comprehensive market survey of fifty-two soy beverages available in Spain and other European countries. The predominant category among those evaluated was calcium and vitamin-fortified drinks, accounting for 60% of the market. This reflects the need to address the nutritional gap compared to cow's milk and meet essential dietary requirements. The review covers the technological aspects of industrial soy milk production, including both traditional methods and innovative processing techniques. Additionally, it analyzes multiple studies and meta-analyses, presenting compelling evidence for the positive effects of soy beverages on various aspects of health. The review specifically examines the contributions of different components found in soy beverages, such as isoflavones, proteins, fiber, and oligosaccharides. Moreover, it explores controversial aspects of soy consumption, including its potential implications for growth, puberty, fertility, feminization, and the thyroid gland.

3.
Sci Total Environ ; 846: 157475, 2022 Nov 10.
Article in English | MEDLINE | ID: mdl-35868394

ABSTRACT

In the Esteros del Iberá Wetland Area (EIWA, NE Argentina), the southern sector of the transboundary Guarani Aquifer System (SAG) is overlain by the Ramsar listed Iberá Wetlands and several rivers, that combined extend across 37,930 km2 and represent one of the largest freshwater systems on the South American continent. Previous hydrogeological studies encompassing the entire SAG proposed preferential discharge of groundwater of various origins and ages to the EIWA. In this study, a multi-tracer study using major ionic species, δ18O, δ2H and 222Rn was conducted in lagoons, rivers, wells, and boreholes in the EIWA to confirm if discharge from the transboundary SAG is contributing to the surface water system. End-member Mixing Analysis (EMMA) determined the existence of four main end-members: groundwater from the SAG, more saline groundwater from the deeper Pre-SAG, and two poorly mineralised end-members from shallow, Post-SAG. EMMA calculations clearly illustrated complex binary and ternary mixing patterns involving the four end-members and highlighted the role of geological structures, specifically regional steep faults, in controlling the mixing patterns. 222Rn activities allowed in-situ identification of preferential deep groundwater discharge into both surface waters and shallow groundwaters. These findings provide strong evidence for the widespread existence of upward flows along major faults in this sector of the SAG, inducing complex mixing flow patterns and explaining the presence of old groundwater in shallow aquifers. Mapping the sources of water and the hydrological interactions are relevant for improving water balance estimates and develop management policies towards the preservation of these wetlands.


Subject(s)
Groundwater , Water Pollutants, Chemical , Environmental Monitoring , Groundwater/chemistry , Water , Water Pollutants, Chemical/analysis , Wetlands
4.
J Hematol Oncol ; 15(1): 4, 2022 01 10.
Article in English | MEDLINE | ID: mdl-35012608

ABSTRACT

BACKGROUND: There is an urgent need for highly efficacious antiviral therapies in immunosuppressed hosts who develop coronavirus disease (COVID-19), with special concern for those affected by hematological malignancies. CASE PRESENTATION: Here, we report the case of a 75-year-old male with chronic lymphocytic leukemia who was deficient in CD19+CD20+ B-lymphocyte populations due to previous treatment with anti-CD20 monoclonal antibodies. The patient presented with severe COVID-19 pneumonia due to prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and was treated with two courses of the antiviral plitidepsin on a compassionate use basis. The patient subsequently achieved an undetectable viral load, and his pneumonia resolved. CONCLUSIONS: Treatment with plitidepsin was well-tolerated without any further hematological or cardiovascular toxicities. This case further supports plitidepsin as a potential antiviral drug in SARS-CoV-2 patients affected by immune deficiencies and hematological malignancies.


Subject(s)
Antibodies, Monoclonal/therapeutic use , B-Lymphocytes/drug effects , COVID-19/prevention & control , Depsipeptides/therapeutic use , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Peptides, Cyclic/therapeutic use , SARS-CoV-2/drug effects , Virus Replication/drug effects , Aged , Antibodies, Monoclonal, Humanized/therapeutic use , Antigens, CD20/immunology , B-Lymphocytes/metabolism , COVID-19/complications , COVID-19/virology , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Lymphocyte Depletion/methods , Male , SARS-CoV-2/genetics , SARS-CoV-2/physiology , Treatment Outcome
5.
Sci Total Environ ; 754: 142258, 2021 Feb 01.
Article in English | MEDLINE | ID: mdl-33254946

ABSTRACT

Groundwater plays an important role in the economic development of the Chaco-Pampean Plain (Argentina), where industry, agriculture and cattle farming are the main economic activities. The 66% of the country's population lives in this area. The low slopes of this region condition the water movement and the occurrence of physical and chemical processes. The aim of this work is to update the hydrological conceptual model of the Del Azul Creek basin (Buenos Aires Province), a sub-humid and continental plain, using environmental tracers. In total, the study was based on the analysis of 201 samples (stable isotopes) and 184 samples (chemical data) including rainwater, surface water and groundwater. The temporal and spatial variation in the isotopic composition of rainfall and the hydrological physical-processes, evaporation, surface water-groundwater interaction and recharge were studied. Isotopic compositions of rainfall revealed a seasonal variation across the basin. Low δ18O rainfalls occur during the coldest seasons, while high δ18O rainfalls occur during the warmest seasons. The isotopic compositions of rainfall varied only during the cold period in the upper basin. At this time, the lowest δ18O rainfall fell in the upper basin, while in the other areas and during the warmer seasons, no differences were observed. Evaporation was a relevant process in the flatter area of the basin, mainly during the warmest seasons. Samples taken from the wetlands and from the lower section of the Del Azul Creek were strongly evaporated. In the first 30 m depth of the aquifer, groundwater reflected the isotopic composition of rainfall from the warmest seasons, thus revealing seasonal preferential recharge and a good hydraulic connection. This study provides direct evidence showing that both evaporation and the surface water-groundwater interaction are processes that play a key role in the control of the isotopic and chemical composition of water.

6.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(7): 567-573, sept. 2020. tab, graf
Article in Spanish | IBECS | ID: ibc-201798

ABSTRACT

El grado de conocimiento y aplicación de las guías de práctica clínica sobre el manejo de la dermatitis atópica son desconocidos en nuestro entorno. El objetivo de este estudio es elaborar indicadores de calidad basados en las guías de práctica clínica existentes, para mejorar la atención de los pacientes. Tras una búsqueda bibliográfica de guías de práctica clínica, un grupo de 11 panelistas seleccionó las de mayor calidad mediante el instrumento AGREE II. Posteriormente se extrajeron recomendaciones con alto nivel de evidencia y propusieron un indicador de calidad asistencial asociado a un estándar para medir el grado de cumplimiento de cada recomendación. De los 150 indicadores propuestos, se obtuvo consenso en 21 de ellos tras la realización del método Delphi modificado. La implementación de los indicadores consensuados en este estudio pretende estandarizar las actuaciones de los profesionales sanitarios para mejorar la calidad asistencial de los pacientes con dermatitis atópica


No information is currently available on whether the available clinical practice guidelines on the management of atopic dermatitis are known or being applied in Spain. The aim of this study was to improve the care of patients with atopic dermatitis by developing a set of quality indicators based on existing clinical practice guidelines. Relevant clinical practice guidelines identified through a literature search were submitted to a panel of 11 specialists, who selected the highest quality guidelines using the AGREE (Appraisal of Guidelines for Research & Evaluation) II instrument. The panel then defined a subset of the recommendations supported by a high level of evidence and proposed a health care quality indicator for each one together with a standard for measuring degree of adherence. Consensus was achieved on 21 of the 150 proposed indicators using the modified Delphi method. The aim of implementing the indicators that achieved consensus in this study is to standardize the actions of health professionals providing care for patients with atopic dermatitis and ultimately to improve the quality of the care delivered


Subject(s)
Humans , Consensus Development Conferences as Topic , Dermatitis, Atopic/diagnosis , Dermatitis, Atopic/therapy , Quality Assurance, Health Care , Societies, Medical
7.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 46(4): 270-276, mayo-jun. 2020. tab, graf
Article in Spanish | IBECS | ID: ibc-197306

ABSTRACT

La urticaria es un motivo frecuente de consulta en Atención Primaria (AP); sin embargo, el correcto abordaje de esta enfermedad resulta controvertido y con frecuencia no está bien establecido. Por esta razón, se necesita esclarecer sus causas y desarrollar protocolos de tratamiento para mejorar el manejo de la urticaria en AP. Con este objetivo se ha realizado este trabajo. Un grupo de expertos en AP y dermatología, con experiencia en el tratamiento de la urticaria, han revisado las principales guías y publicaciones en urticaria con motivo de desarrollar recomendaciones claras e interdisciplinares sobre el manejo de la urticaria en AP. En este artículo presentamos nuestras recomendaciones basadas en el consenso de expertos, incluyendo algoritmos de diagnóstico y tratamiento simples y prácticos. Estas guías pueden ayudar a optimizar el manejo del paciente con urticaria, incrementar su calidad de vida y reducir los costes socioeconómicos asociados


Urticaria is a common cause for patient consultations in Primary Care (PC). However, the optimal approach to managing urticaria in PC is controversial and not well-established. For this reason, there is a clear need to clarify the causes of urticaria and to develop treatment protocols to improve urticaria management in the PC setting. The present work has been developed with this objective. A group of experts in PC and dermatology, with specific expertise in treating urticaria, have reviewed the main clinical guidelines and publications on urticaria in order to develop clear, interdisciplinary recommendations on managing urticaria. In this article, consensus-based recommendations are presented that include simple, practical diagnostic, and treatment algorithms. These guidelines will help to optimise the management of patients with urticaria, increasing their quality of life and reducing the socioeconomic costs associated with this illness


Subject(s)
Humans , Urticaria/diagnosis , Urticaria/drug therapy , Histamine Antagonists/therapeutic use , Dermatitis, Contact/diagnosis , Hypersensitivity/diagnosis , Hypersensitivity, Immediate/diagnosis , Primary Health Care/methods , Chronic Disease/therapy , Pruritus/diagnosis , Quality of Life/psychology , Sickness Impact Profile , Dermatitis, Contact/drug therapy , Hypersensitivity/drug therapy , Hypersensitivity, Immediate/drug therapy
8.
Actas Dermosifiliogr (Engl Ed) ; 111(7): 567-573, 2020 Sep.
Article in English, Spanish | MEDLINE | ID: mdl-32401727

ABSTRACT

No information is currently available on whether the available clinical practice guidelines on the management of atopic dermatitis are known or being applied in Spain. The aim of this study was to improve the care of patients with atopic dermatitis by developing a set of quality indicators based on existing clinical practice guidelines. Relevant clinical practice guidelines identified through a literature search were submitted to a panel of 11 specialists, who selected the highest quality guidelines using the AGREE (Appraisal of Guidelines for Research & Evaluation) II instrument. The panel then defined a subset of the recommendations supported by a high level of evidence and proposed a health care quality indicator for each one together with a standard for measuring degree of adherence. Consensus was achieved on 21 of the 150 proposed indicators using the modified Delphi method. The aim of implementing the indicators that achieved consensus in this study is to standardize the actions of health professionals providing care for patients with atopic dermatitis and ultimately to improve the quality of the care delivered.


Subject(s)
Dermatitis, Atopic , Dermatology , Venereology , Consensus , Dermatitis, Atopic/therapy , Humans , Quality Indicators, Health Care , Spain
9.
Semergen ; 46(4): 270-276, 2020.
Article in Spanish | MEDLINE | ID: mdl-32044200

ABSTRACT

Urticaria is a common cause for patient consultations in Primary Care (PC). However, the optimal approach to managing urticaria in PC is controversial and not well-established. For this reason, there is a clear need to clarify the causes of urticaria and to develop treatment protocols to improve urticaria management in the PC setting. The present work has been developed with this objective. A group of experts in PC and dermatology, with specific expertise in treating urticaria, have reviewed the main clinical guidelines and publications on urticaria in order to develop clear, interdisciplinary recommendations on managing urticaria. In this article, consensus-based recommendations are presented that include simple, practical diagnostic, and treatment algorithms. These guidelines will help to optimise the management of patients with urticaria, increasing their quality of life and reducing the socioeconomic costs associated with this illness.


Subject(s)
Urticaria , Chronic Disease , Consensus , Humans , Primary Health Care , Quality of Life , Referral and Consultation
10.
J Appl Microbiol ; 127(5): 1391-1402, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31386785

ABSTRACT

AIMS: This work aimed to evaluate the antimicrobial activity of pure (ZnO) and doped (ZnMgO) zinc oxide (ZnO) nanoparticles on bacterial pathogens and Saccharomyces cerevisiae to confirm their applicability as an alternative to antibiotics and to estimate their biocompatibility. METHODS AND RESULTS: Microbial growth inhibition on agar plates, microbial viability and adaptation tests in broth with ZnO nanoparticles, spore germination, random amplified polymorphic DNA and SDS-PAGE analysis were conducted to evaluate the effects of ZnO nanoparticles on cell morphology, viability, DNA damage and protein production. For this purpose, Escherichia coli, Salmonella, Listeria monocytogenes, Staphylococcus aureus, Bacillus subtilis and S. cerevisiae were studied after the addition of ZnO nanoparticles to the growth media. The contact with ZnO nanoparticles produced changes in morphology, shape, viability, DNA arrangement (DNA fingerprints) and protein content (SDS-PAGE) in treated cells. CONCLUSIONS: As reported in this study, ZnO nanoparticles have an antimicrobial effect on both prokaryotic and eukaryotic cells. Before using ZnO nanoparticles as antimicrobial agents, it is important to evaluate the target because their effect depends on their composition, size and dose. SIGNIFICANCE AND IMPACT OF THE STUDY: We believe that the results obtained can help to optimize manufactured metal oxide nanoparticles in terms of their composition, size and working concentration. The parameters obtained directly define the applicability and biocompatibility of ZnO nanoparticles and thus are essential for any utilization in food, medicine and industry where pathogen control is crucial.


Subject(s)
Anti-Infective Agents/pharmacology , Bacillus subtilis/drug effects , Escherichia coli/drug effects , Nanoparticles/toxicity , Saccharomyces cerevisiae/drug effects , Staphylococcus aureus/drug effects , Zinc Oxide/pharmacology , Anti-Infective Agents/chemistry , Bacillus subtilis/growth & development , Escherichia coli/growth & development , Listeria monocytogenes/drug effects , Listeria monocytogenes/growth & development , Microbial Sensitivity Tests , Microbial Viability/drug effects , Nanoparticles/chemistry , Saccharomyces cerevisiae/growth & development , Staphylococcus aureus/growth & development , Zinc Oxide/chemistry
11.
Article in English | MEDLINE | ID: mdl-31158574

ABSTRACT

Visceral leishmaniasis (VL) and Chagas disease (CD) are caused by kinetoplastid parasites that affect millions of people worldwide and impart a heavy burden against human health. Due to the partial efficacy and toxicity-related limitations of the existing treatments, there is an urgent need to develop novel therapies with superior efficacy and safety profiles to successfully treat these diseases. Herein we report the application of whole-cell phenotypic assays to screen a set of 150,000 compounds against Leishmania donovani, a causative agent of VL, and Trypanosoma cruzi, the causative agent of CD, with the objective of finding new starting points to develop novel drugs to effectively treat and control these diseases. The screening campaign, conducted with the purpose of global open access, identified twelve novel chemotypes with low to sub-micromolar activity against T. cruzi and/or L. donovani. We disclose these hit structures and associated activity with the goal to contribute to the drug discovery community by providing unique chemical tools to probe kinetoplastid biology and as hit-to-lead candidates for drug discovery.


Subject(s)
Antiprotozoal Agents/pharmacology , Chagas Disease/parasitology , Drug Discovery/methods , Leishmaniasis/parasitology , Animals , Antiprotozoal Agents/chemistry , Cell Line , Chagas Disease/drug therapy , Drug Discovery/instrumentation , Drug Evaluation, Preclinical , Humans , Leishmania donovani/drug effects , Leishmania donovani/growth & development , Leishmaniasis/drug therapy , Parasitic Sensitivity Tests , Rats , Structure-Activity Relationship , Trypanosoma cruzi/drug effects , Trypanosoma cruzi/growth & development
12.
Bull Entomol Res ; 108(6): 739-749, 2018 Dec.
Article in English | MEDLINE | ID: mdl-29345218

ABSTRACT

Prodiplosis longifila is reported as a pest of a wide range of species cultivated in America, including citrus, solanaceous species and asparagus. This species has different behavioural traits that are primarily centred on the oviposition habit and the feeding of larvae, which can change depending on the host. However, scarce information is available on population studies and the natural history of this insect, and uncertainty exists about the taxonomic identity and the geographic distribution of this species. The main objective was to perform a phylogenetic and genetic study of P. longifila populations and to define whether the North American and South American populations belong to the same species or whether a differentiation process had occurred due to geographic distance. A second objective was to determine whether this species showed genetic differentiation by host specialization in South America. The phylogenetic and population analyses based on DNA barcodes (cytochrome oxidase I gene) and a region of the ribosomal DNA (ITS2) revealed divergent clades attributable to geographic distance and host specificity. The North American and South American P. longifila insects were confirmed to be genetically distinct, and the genetic distances exceeded the values expected for intraspecific variation. In South America, the population analysis of P. longifila from tomato, sweet pepper (Solanaceae), Tahiti lime and key lime (Rutaceae) hosts evidenced high genetic differentiation between populations associated with different hosts and an absence of gene flow between these groups, suggesting the corresponding formation of cryptic species.


Subject(s)
Diptera/genetics , Evolution, Molecular , Genetic Speciation , Herbivory , Animal Distribution , Animals , Colombia , DNA, Mitochondrial/analysis , DNA, Ribosomal Spacer/analysis , Ecuador , Electron Transport Complex IV/analysis , Florida , Phylogeny , Phylogeography
13.
Crit Rev Food Sci Nutr ; 58(13): 2147-2163, 2018.
Article in English | MEDLINE | ID: mdl-28394630

ABSTRACT

Proteins are a potential source of health-promoting biomolecules with medical, nutraceutical, and food applications. Nowadays, bioactive peptides production, its isolation, characterization, and strategies for its delivery to target sites are a matter of intensive research. In vitro and in vivo studies regarding the bioactivity of peptides has generated strong evidence of their health benefits. Dairy proteins are considered the richest source of bioactive peptides, however proteins from animal and vegetable origin also have been shown to be important sources. Enzymatic hydrolysis has been the process most commonly used for bioactive peptide production. Most commercial enzymatic preparations frequently used are from animal (e.g., trypsin and pepsin) and microbial (e.g., Alcalase® and Neutrase®) sources. Although the use of plant proteases is still relatively limited to papain and bromelain from papaya and pineapple, respectively, the application of new plant proteases is increasing. This review presents the latest knowledge in the use and diversity of plant proteases for bioactive peptides release from food proteins including both available commercial plant proteases as well as new potential plant sources. Furthermore, the properties of peptides released by plant proteases and health benefits associated in the control of disorders such as hypertension, diabetes, obesity, and cancer are reviewed.


Subject(s)
Peptide Hydrolases/metabolism , Peptides/metabolism , Plant Proteins/metabolism , Humans , Hydrolysis , Peptides/pharmacology
14.
Sci Total Environ ; 599-600: 2105-2120, 2017 Dec 01.
Article in English | MEDLINE | ID: mdl-28558433

ABSTRACT

The Úbeda aquifer system is a multi-layered aquifer intensively exploited for irrigation. It covers 1100km2 and consists of piled up sedimentary aquifer and aquitard layers from Triassic sandstones and clays at the bottom, to Jurassic carbonates (main exploited layer) in the middle, and Miocene sandstones and marls at the top. Flow network modification by intense exploitation and the existence of deep faults favour vertical mixing of waters from different layers and with distinct chemical composition. This induces quality loss and fosters risk of quantity restrictions. To support future groundwater abstraction management, a hydrogeochemical (major and some minor solutes) and isotopic (222Rn) study was performed to identify the chemical signatures of the different layers and their mixing proportions in mixed samples. The study of 134 groundwater samples allowed a preliminary identification of hydrochemical signatures and mixtures, but the existence of reducing conditions in the most exploited sector prevents the utility of sulphate as a tracer of Triassic groundwater in the Jurassic boreholes. The potential of 222Rn to establish isotopic signatures and to trace groundwater provenance in mixtures was tested. 222Rn was measured in 48 samples from springs and boreholes in most aquifer layers. At first, clear correlations were observed between 222Rn, Cl and SO4 in groundwater. Afterwards, very good correlations were observed between 222Rn and the chemical facies of the different layers established with End Member Mixing Analysis (EMMA). Using 222Rn as part of the signatures, EMMA helped to identify end-member samples, and to quantify the mixing proportions of water from the Triassic and the Deep Miocene layers in groundwater pumped by deep agricultural wells screened in the Jurassic. The incorporation of 222Rn to the study also allowed identifying the impact of irrigation returns through the association of moderate NO3, Cl, and Br contents with very low 222Rn activities.

15.
Sci Total Environ ; 599-600: 1417-1432, 2017 Dec 01.
Article in English | MEDLINE | ID: mdl-28531951

ABSTRACT

The Matanza-Riachuelo River Basin, in the Northeast of the Buenos Aires Province, is one of the most industrialized and populated region in Argentina and it is worldwide known for its alarming environmental degradation. In order to prevent further damages, the aquifer system, which consists of two overlaid aquifers, is being monitored from 2008 by the river basin authority, Autoridad de la Cuenca Matanza-Riachuelo. The groundwater chemical baseline has been established in a previous paper (Zabala et al., 2016), and this one is devoted to the identification of the main physical and hydrogeochemical processes that control groundwater chemistry and its areal distribution. Thirty five representative groundwater samples from the Upper Aquifer and thirty four from the deep Puelche Aquifer have been studied with a multi-tool approach to understand the origin of their chemical and isotopic values. The resulting conceptual model has been validated though hydrogeochemical modeling. Most of the aquifer system has fresh groundwater, but some areas have brackish and salt groundwater. Water recharging the Upper Aquifer is of the Ca-HCO3 type as a result of soil CO2 and carbonate dissolution. Evapotranspiration plays a great role concentrating recharge water. After recharge, groundwater becomes Na-HCO3, mostly due to cation exchange with Na release and Ca uptake, which induces calcite dissolution. Saline groundwaters exist in the lower and upper sectors of the basin as a result of Na-HCO3 water mixing with marine water of different origins. In the upper reaches, besides mixing with connate sea water other sources of SO4 exist, most probably gypsum and/or sulfides. This work highlights the relevance of performing detailed studies to understand the processes controlling groundwater chemistry at regional scale. Moreover, it is a step forward in the knowledge of the aquifer system, and provides a sound scientific basis to design effective management programs and recovery plans.

17.
Water Res ; 119: 136-149, 2017 08 01.
Article in English | MEDLINE | ID: mdl-28454009

ABSTRACT

Emerging contaminants (ECs) and regulated compounds (RCs) from three different WWTP effluents were measured in the current study. The efficiency of two tertiary treatments, Photobiotreatment (PhtBio) and Multi-Barrier Treatment (MBT), for removing contaminants was determined. Results indicated different percentages of removal depending on the treatment and the origin of the effluent. Risk Quotients (RQs) were determined for different species of algae, Daphnia, and fish. RQ results revealed diverse risk values depending on the bioindicator species. Tonalide, galaxolide (fragrances), and ofloxacin (antibiotic) were the most persistent and harmful substances in tested effluents. "Negligible risk" category was reached since a wide diversity of ECs were removed by MBT with high removal percentages. Contrarily, PhtBio was effective only in the depuration of certain chemical compounds, and its efficiency depended on the composition of the raw effluent.


Subject(s)
Risk Assessment , Wastewater , Water Pollutants, Chemical , Animals , Daphnia , Environmental Monitoring , Fishes , Waste Disposal, Fluid
19.
Musculoskelet Surg ; 101(2): 159-166, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28164254

ABSTRACT

STUDY DESIGN: A retrospective case review of patients who underwent 18F sodium fluoride PET/CT imaging of the spine with postoperative pain following vertebral fusion. OBJECTIVE: To determine the benefit of 18F sodium fluoride PET/CT imaging in the diagnosis of persistent pain in the postoperative spine. The diagnosis of pain generators in the postoperative spine has proven to be a diagnostic challenge. The conventional radiologic evaluation of persistent pain after spine surgery with the use of plain radiographs, MRI, and CT can often fall short of diagnosis in the complex patient. 18F sodium fluoride PET/CT imaging is an alternative tool to accurately identify a patient's source of pain in the difficult patient. METHODS: This retrospective study looked at 25 adult patients who had undergone 18F sodium fluoride PET/CT imaging. All patients had persistent or recurrent back pain over the course of a 15-month period after having undergone spinal fusion surgery. All patients had inconclusive dedicated MRI. The clinical accuracy of PET/CT in identifying the pain generator and contribution to altering the decision making process was compared to the use of CT scan alone. RESULTS: Of the 25 patients studied, 17 patients had increased uptake on the 18F sodium fluoride PET/CT fusion images. There was a high-level correlation of radiotracer uptake to the patients' pain generator. Overall 88% of the studies were considered beneficial with either PET/CT altering the clinical diagnosis and treatment plan of the patient or confirming unnecessary surgery. CONCLUSION: 18F sodium fluoride PET/CT proves to be a useful tool in the diagnosis of complex spine pathology of the postoperative patients. In varied cases, a high correlation of metabolic activity to the source of the patient's pain was observed.


Subject(s)
Fluorine Radioisotopes , Pain Measurement/methods , Pain, Postoperative/diagnostic imaging , Positron Emission Tomography Computed Tomography , Sodium Fluoride , Spinal Fusion , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Positron Emission Tomography Computed Tomography/methods , Radiopharmaceuticals , Retrospective Studies
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