Flying across Europe: the case of the spread of Chaunocephalus ferox on a black stork (Ciconia nigra).

The annual migration of birds involves a very large number of inter-continental and intra-continental movements in which thousands of bird species participate. These migrations have been associated with the spread of pathogens worldwide, including bacteria, viruses and parasites. This study describes the case of a black stork (Ciconia nigra) that was ringed at the nest in Latvia and died five months later in the south-east of the Iberian Peninsula. Post-mortem examination revealed that the cause of death was electrocution. In addition, a massive infection by the trematode Chaunocephalus ferox (Digenea: Echinostomatidae) causing severe granulomatous lesions throughout the small intestine was detected. This is the first report of C. ferox infection in a black stork in the Iberian Peninsula, a trematode that, due to the severe lesions it causes, can affect the health of C. ferox-infected wild birds, particularly in severely infected long-distance migrants. The dispersal of platyhelminths associated with migratory birds is discussed. After the ringing at the nest, the black stork was sighted in Central Europe one month before its capture, and the trematodes found by necropsy were mostly mature adults. Consequently, we estimate that this juvenile animal acquired the infection during its migration in a European area other than the Iberian Peninsula, evidencing a long-distance parasite spread through its migratory host. Our study highlights that bird ringing can be used to understand the epidemiological implications that bird migratory behaviour may have on the dispersal of parasites.

Fármacos potencialmente útiles en el tratamiento de la COVID-19 en Atención Primaria / Potentially useful drugs in the treatment of COVID-19 in Primary Care

Las consecuencias de la pandemia por el SARS-CoV-2 han desbordado cualquier previsión realizada. Hoy sabemos que el nivel de gravedad de la infección en sus fases iniciales se va a corresponder con la evolución y la presencia de secuelas en el futuro. No existen tratamientos específicos que hayan demostrado evidencia suficiente que permita su recomendación, especialmente en las fases leves-moderadas de la enfermedad. La vacunación anti-COVID está demostrando claros beneficios, tanto en la prevención de la enfermedad como en la evolución de la misma, con la consiguiente mejoría en las cifras de afectados por la pandemia. A pesar de ello, el número de nuevos contagios persiste en cifras inaceptables. Se ha propuesto el uso de distintos fármacos utilizados en otras indicaciones como posibles tratamientos beneficiosos para la COVID-19 que, en caso de utilizarse, se prescribirán de forma individualizada atendiendo a las características y la situación del paciente, a la fase evolutiva de la enfermedad, así como a las limitaciones propias de la falta de evidencia en su administración (AU)

The consequences of the SARS-CoV-2 pandemic have exceeded any forecast made. Today we know that the level of severity of the infection in its initial stages will correspond to the evolution and the presence of sequelae in the future. There are no specific treatments that have shown sufficient evidence to allow their recommendation, especially in the mild-moderate stages of the disease. The anti-Covid vaccination is showing clear benefits, both in the prevention of the disease and in its evolution, with the consequent improvement in the numbers of those affected by the pandemic. The use of different drugs used in other indications has been proposed as possible beneficial treatments for COVID-19 that, if used, will be prescribed individually taking into account the characteristics and situation of the patient, the evolutionary phase of the disease as well as well as the limitations of the lack of evidence in its administration (AU)

First report of a hawfinch (Coccothraustes coccothraustes) parasitized by Harpirhynchus nidulans in the Iberian Peninsula.

Some avian Harpirhynchidae mites live under the skin and develop cutaneous cysts. Despite the obvious lesions that these parasites can produce, little is currently known about the behavioural disturbances that cyst-forming mites may cause in infected wild birds. We report an infection by Harpirhynchidae mites in a hawfinch (Coccothraustes coccothraustes) in southeast Spain. The bird was easily captured due to its inability to fly. During clinical examination it was found to have multiple severe traumatic injuries, possibly due to a blow or a fall, as result of which the bird was euthanized. At necropsy, the hawfinch was found to be in good body condition. Two yellowish and friable mite-filled cysts were detected in the subalar region of both wings. Mites were morphologically identified as Harpirhynchus nidulans, and histological analysis of the cystic lesions was also performed. This is the first time that the occurrence of a hawfinch infected by H. nidulans in the Iberian Peninsula has been reported.

Pulsioximetría: papel en el paciente COVID-19 domiciliario / Pulse oximetry: Role in the COVID-19 patient at home

La COVID-19 se comporta como una enfermedad heterogénea. Algunos pacientes pueden presentar hipoxemia sin disnea durante su evolución (hipoxemia silente). La pulsioximetría juega un papel crucial en la detección de la hipoxemia en estos pacientes, especialmente cuando permanecen en su domicilio. Pacientes con niveles de SpO2 ≤ 92% o desaturaciónes ≥ 3% tras el ejercicio precisan de ingreso hospitalario. Los descensos progresivos de la saturación que alcancen niveles SpO2 < 96% precisan de valoración clínica estricta (estudio radiológico, analítica sanguínea) para lo que será enviado a un centro sanitario (AU)

COVID-19 behaves like a heterogeneous disease. Some patients may develop dyspnea-free hypoxemia during its evolution (silent hypoxemia). Pulse oximetry plays a crucial role in detecting hypoxemia in these patients, especially when they remain at home. Patients with SpO2 levels ≤ 92% or desaturations ≥ 3% after exercise test require hospital admission. Progressive saturation declines reaching SpO2 levels < 96% require strict clinical assessment (radiological study, blood test) for which it will be sent to a health center (AU)

[Potentially useful drugs in the treatment of COVID-19 in Primary Care]. / Fármacos potencialmente útiles en el tratamiento de la COVID-19 en Atención Primaria.

The consequences of the SARS-CoV-2 pandemic have exceeded any forecast made. Today we know that the level of severity of the infection in its initial stages will correspond to the evolution and the presence of sequelae in the future. There are no specific treatments that have shown sufficient evidence to allow their recommendation, especially in the mild-moderate stages of the disease. The anti-Covid vaccination is showing clear benefits, both in the prevention of the disease and in its evolution, with the consequent improvement in the numbers of those affected by the pandemic. The use of different drugs used in other indications has been proposed as possible beneficial treatments for COVID-19 that, if used, will be prescribed individually taking into account the characteristics and situation of the patient, the evolutionary phase of the disease as well as well as the limitations of the lack of evidence in its administration.

[Pulse oximetry: Role in the COVID-19 patient at home]. / Pulsioximetría: papel en el paciente COVID-19 domiciliario.

COVID-19 behaves like a heterogeneous disease. Some patients may develop dyspnea-free hypoxemia during its evolution (silent hypoxemia). Pulse oximetry plays a crucial role in detecting hypoxemia in these patients, especially when they remain at home. Patients with SpO2 levels ≤ 92% or desaturations ≥ 3% after exercise test require hospital admission. Progressive saturation declines reaching SpO2 levels < 96% require strict clinical assessment (radiological study, blood test) for which it will be sent to a health center.

Trastorno dismórfico corporal del adolescente / Adolescent Body Dysmorphic Disorder

El Trastorno Dismórfico Corporal (TDC) es un trastorno caracterizado por la preocupación por defectos físicos corporales no existentes, o apenas perceptibles, que generan un gran malestar psicológico o un deterioro en el funcionamiento de la persona que lo padece. La prevalencia de este trastorno oscila entre el 1,7 y 2,5% en la población general, siendo las dos terceras partes de los casos de inicio en la adolescencia. Existen diferencias significativas a la hora de clasificar este trastorno. Mientras que la CIE-10 lo hace dentro de los trastornos somatomorfos, el DSM-5 y la futura CIE-11 lo clasifican dentro del Trastorno obsesivo compulsivo (TOC) y Trastornos relacionados. Así mismo, a nivel clínico, pueden surgir dudas diagnósticas con los trastornos psicóticos o con los trastornos de la conducta alimentaria. Presentamos el caso de una paciente de 16 años, cuya sintomatología planteaba los interrogantes previamente descritos, decantándonos finalmente por el diagnóstico de TDC en la forma en que lo hacen el DSM-5 y la futura CIE-11 (TOC y trastorno relacionados), siendo tratada como tal y evolucionando de forma favorable. Este artículo tiene dos objetivos principales. En primer lugar, actualizar al lector en el novedoso cambio nosológico del TDC en la CIE-11, que se aproxima cada vez más a la orientación americana, siendo ésta la que hemos usado como referente para nuestro trabajo. En segundo lugar, profundizar en el diagnóstico diferencial de esta entidad, ya que no resulta una tarea sencilla y prueba de ello es el cambio clasificatorio anteriormente mencionado

Body dysmorphic disorder (BDD) is characterized by preoccupation with non existent or slight defects in physical appearance, that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Point prevalence of BDD is 1,7-2,5% in general population, with two thirds of the cases beginning in adolescence. There are significant classificatory differences to take into account. Whereas ICD-10 classifies it among Somatoform Disorders, DSM-5 and future ICD-11 do it among obsessive compulsive Disorder (OCD) and related Disorders. Furthermore, diagnostic doubts may arise with psychotic disorders or eating disorders. We present the case of a 16-years old girl, whose symptoms raised the questions previously exposed. We finally opted for BDD diagnosis, according to DSM-5 and ICD-11 classifications (OCD and related disorders). The patient was treated accordingly and she has progressed favorably. There are two main objectives in this article. First, to update the reader on the classificatorychange of BDD in the ICD-11, which resembles the American point of view of this disorder, that is the one which we base our study on. Second, to deepen on the differential diagnosis, as it is not an easy task and this is evidenced by the classificatory change previously mentioned

Posicionamiento para el manejo de la hipertensión arterial en atención primaria a partir del análisis crítico de las guías americana (2017) y europea (2018). Sociedad Española de Médicos de Atención Primaria (EMERGEN) / Positioning for the management of arterial hypertension in Primary Care from the critical analysis of the American (2017) and European (2018) guidelines. Spanish Society of Primary Care Physicians (SEMERGEN)

Parece necesario que las sociedades científicas de AP, ámbito en el cual la prevalencia de HTA es considerable, evalúen periódicamente las directrices internacionales para el manejo de la HTA, sobre todo ante recomendaciones dispares que dificultan la toma de decisiones, en la práctica clínica diaria. El presente documento tiene como objetivo analizar los cambios y novedades propuestos en la guía del American College of Cardiology y de la American Heart Association (ACC/AHA 2017) y en la guía de la European Society of Cardiology y de la European Society of Hypertension (ESC/ESH 2018). Además, analizar las posibles diferencias, limitaciones y su aplicabilidad a la AP de España. En definitiva, se trata de extraer la información más relevante disponible y pertinente, e integrarla para homogeneizar la asistencia al paciente hipertenso desde una perspectiva crítica, pero también razonada. Las discrepancias entre ambas GPC en aspectos tan trascendentales como el manejo de la enfermedad obligan a la recopilación y análisis crítico de la información que nos permita tomar posición como sociedad científica, interesada en trasladar a todos los médicos de AP las recomendaciones más relevantes, pero a la vez sensatas, de ambas GPC

The Scientific Societies of Primary Care, being the area in which there is a considerable prevalence of Arterial Hypertension (AHT), need to periodically evaluate the international guidelines for its management. This is particularly relevant when disparate guidelines make it difficult to make decisions in daily clinical practice. The present document has as its aim to analyse the changes and new developments proposed in the guidelines of the American College of Cardiology and the American Heart Association (ACC/AHA 2017), as well as in the guidelines of the European Society of Cardiology and European Society of Hypertension (ESC/ESH 2018). An analysis will be made of any differences, limitations, and their applicability to Primary Care in Spain. Finally, the most relevant available and appropriate information is extracted and integrated in order to homogenise the care of the hypertensive patient, from a critical, but also a reasoned, perspective. The discrepancies between the recommendations in such essential aspects as the management of the disease, require the compiling and critical analysis of the information that enables us as scientific society, interested in providing all PC physicians with the most relevant, and at the same time, sensible, recommendations of all the guidelines

[Positioning for the management of arterial hypertension in Primary Care from the critical analysis of the American (2017) and European (2018) guidelines. Spanish Society of Primary Care Physicians (SEMERGEN)]. / Posicionamiento para el manejo de la hipertensión arterial en atención primaria a partir del análisis crítico de las guías americana (2017) y europea (2018). Sociedad Española de Médicos de Atención Primaria (SEMERGEN).

The Scientific Societies of Primary Care, being the area in which there is a considerable prevalence of Arterial Hypertension (AHT), need to periodically evaluate the international guidelines for its management. This is particularly relevant when disparate guidelines make it difficult to make decisions in daily clinical practice. The present document has as its aim to analyse the changes and new developments proposed in the guidelines of the American College of Cardiology and the American Heart Association (ACC/AHA 2017), as well as in the guidelines of the European Society of Cardiology and European Society of Hypertension (ESC/ESH 2018). An analysis will be made of any differences, limitations, and their applicability to Primary Care in Spain. Finally, the most relevant available and appropriate information is extracted and integrated in order to homogenise the care of the hypertensive patient, from a critical, but also a reasoned, perspective. The discrepancies between the recommendations in such essential aspects as the management of the disease, require the compiling and critical analysis of the information that enables us as scientific society, interested in providing all PC physicians with the most relevant, and at the same time, sensible, recommendations of all the guidelines.

Resonancia magnética dinámica de mama: estudio comparativo de gadobutrol y Gd-DTPA / Dynamic magnetic resonance imaging of the breast: comparison of gadobutrol vs. Gd-DTPA

Objetivo. Evaluar el perfil farmacocinético del gadobutrol en comparación con el Gd-DTPA, en resonancia magnética de mama con contraste (RM-DC). El objetivo secundario es valorar la eficacia diagnóstica en la detección de lesiones adicionales tumorales en RM-DC, y el perfil de seguridad de ambos contrastes. Material y métodos. Estudio retrospectivo y observacional que incluyó 400 pacientes con diagnóstico histológico de cáncer mamario. A 200 pacientes se les realizó RM-DC con contraste Gd-DTPA (Magnevist®) y a las otras 200 con gadobutrol (Gadovist®). Se analizaron los parámetros farmacocinéticos y la intensidad de señal mediante una ROI (region of interest) en el área intralesional con mayor intensidad de señal en las secuencias poscontraste. Se compararon las variables farmacocinéticas (Ktrans, Kep y Ve) y las curvas de intensidad de señal-tiempo de ambos grupos, así como el número de lesiones adicionales tumorales detectadas con ambos contrastes. Resultados. El realce relativo de intensidad de señal es más alto con gadobutrol que con Gd-DTPA. El gadobutrol muestra significativamente menos lavado (46%) que el Gd-DTPA (58,29%) (p=0,0323). Se observan valores más altos de Ktrans, Kep y Ve para el gadobutrol, siendo la diferencia estadísticamente significativa para los dos primeros parámetros (p=0,001). No se encuentran diferencias en el número de lesiones adicionales malignas confirmadas histológicamente (p=0,387). Conclusiones. El gadobutrol tiene valores más altos de realce, mientras que el Gd-DTPA muestra un lavado más marcado. El gadobutrol no es inferior en cuanto a número de lesiones adicionales malignas detectadas. Ambos contrastes son seguros (AU)

Objective. To compare the pharmacokinetic profile of gadobutrol versus Gd-DTPA in dynamic contrast-enhanced MRI (DCE-MRI) in patients with breast cancer. Secondary objectives included comparing the safety profiles and diagnostic efficacy of the two contrast agents for detecting additional malignant lesions. Material and methods. This retrospective observational study included 400 patients with histologically confirmed breast cancer; 200 underwent DCE-MRI with Gd-DTPA (Magnevist®) and 200 underwent DCE-MRI with gadobutrol (Gadovist®). Pharmacokinetic parameters and signal intensity were analyzed in a region of interest placed in the area within the lesion that had greatest signal intensity in postcontrast sequences. We compared the two groups on pharmacokinetic variables (Ktrans, Kep, and Ve), time-signal intensity curves, and the number of additional malignant lesions detected. Results. The relative signal intensity (enhancement) was higher with gadobutrol than with Gd-DTPA. Washout was lower with gadobutrol than with Gd-DTPA (46% vs. 58,29%, respectively; p=0,0323). Values for Ktrans and Kep were higher for gadobutrol (p=0,001). There were no differences in the number of histologically confirmed additional malignant lesions detected (p=0,387). Conclusions. Relative enhancement is greater with gadobutrol, but washout is more pronounced with Gd-DTPA. The number of additional malignant lesions detected did not differ between the two contrast agents. Both contrasts are safe (AU)

Dynamic magnetic resonance imaging of the breast: Comparison of gadobutrol vs. Gd-DTPA. / Resonancia magnética dinámica de mama: estudio comparativo de gadobutrol y Gd-DTPA.

OBJECTIVE: To compare the pharmacokinetic profile of gadobutrol versus Gd-DTPA in dynamic contrast-enhanced MRI (DCE-MRI) in patients with breast cancer. Secondary objectives included comparing the safety profiles and diagnostic efficacy of the two contrast agents for detecting additional malignant lesions. MATERIAL AND METHODS: This retrospective observational study included 400 patients with histologically confirmed breast cancer; 200 underwent DCE-MRI with Gd-DTPA (Magnevist®) and 200 underwent DCE-MRI with gadobutrol (Gadovist®). Pharmacokinetic parameters and signal intensity were analyzed in a region of interest placed in the area within the lesion that had greatest signal intensity in postcontrast sequences. We compared the two groups on pharmacokinetic variables (Ktrans, Kep, and Ve), time-signal intensity curves, and the number of additional malignant lesions detected. RESULTS: The relative signal intensity (enhancement) was higher with gadobutrol than with Gd-DTPA. Washout was lower with gadobutrol than with Gd-DTPA (46% vs. 58,29%, respectively; p=0,0323). Values for Ktrans and Kep were higher for gadobutrol (p=0,001). There were no differences in the number of histologically confirmed additional malignant lesions detected (p=0,387). CONCLUSIONS: Relative enhancement is greater with gadobutrol, but washout is more pronounced with Gd-DTPA. The number of additional malignant lesions detected did not differ between the two contrast agents. Both contrasts are safe.

Report From the First and Second Spanish Killer Immunoglobulin-Like Receptor Genotyping Workshops: External Quality Control for Natural Killer Alloreactive Donor Selection in Haploidentical Stem Cell Transplantation.

An important factor affecting the success in the setting of related haploidentical hematopoietic stem cell transplantation (HSCT) is the graft-versus-leukemia effect mediated by natural killer (NK) cells when the donor displays NK alloreactivity versus the recipient. NK cell function is regulated by killer immunoglobulin-like receptors (KIR) and it has been described that donor KIR genotype influences transplantation outcome. This has led to a requirement of laboratories to have a quality assurance program for validation and control of their KIR genotyping methods. The goal of the 1st and 2nd Spanish KIR Genotyping Workshops was to provide an external proficiency testing program in KIR genotyping for Spanish immunology and transplant laboratories. These workshops were conducted during the years 2014-2016 and consisted of 17 participating laboratories typing a set of 20 samples. The presence/absence of 16 mandatory KIR loci (2DL1, 2DL2, 2DL3, 2DL4, 2DL5, 2DS1, 2DS2, 2DS3, 2DS4, 2DS5, 2DP1, 3DL1, 3DL2, 3DL3, 3DS1, and 3DP1) was evaluated per sample. Methods for KIR genotyping included polymerase chain reaction with the use of sequence-specific primers and sequence-specific oligoprobes. Consensus typing was reached in all samples, and the performance of laboratories in external proficiency testing was satisfactory in all cases. The polymorphism detected in the small sample studied in both workshops is indicative of an ample variety of KIR gene profiles in the Spanish population.

Use of gold nanoparticles as crosslink agent to form chitosan nanocapsules: study of the direct interaction in aqueous solutions.

A systematic study of the interaction between free anionic gold nanoparticles and chitosan in a solution is presented. A spectroscopic study of the interaction between 10nm gold nanoparticles and low molecular weight chitosan is reported as a function of the concentration and pH of the polymer in a solution. Zeta potential measurements and TEM images indicate the effective aggregation of the nanoparticles in the presence of chitosan. At the same time, anionic gold nanoparticles act as crosslink agents to form chitosan nanocapsules with an average molecular size of 260nm. The changes of the surface plasmon band due to the adsorption of the polymer on the nanoparticle surface allow using of the citrate gold nanoparticles as sensors of the polymer for analytical purposes. The limit of detection for chitosan biopolymer is 69nM. The optimum pH for the interaction between the biopolymer and the nanoparticles is found at a value of 6.4, obtained from spectrophotometric measurements and applying a deconvolution analysis of the experimental data. A simple model based on molecular surface electrostatic interactions is proposed to understand the pH dependence of the investigated system.

Estudio colaborativo de abortos espontáneos: empleo de técnicas moleculares en muestras cuyo resultado citogenético no puede ser establecido / Colaborative study of spontaneus abortion: use of molecular techniques in failure culture samples

Introducción. El conocimiento de la causa de abortopermite ofrecer un adecuado consejo genético, además dereducir el estrés psicológico y el sentimiento de culpabilidadgenerado en la mujer tras sufrir un aborto. En la actualidadel estudio de abortos se realiza mediante técnicas citogenéticas,aunque muchas veces no es posible ofrecer un diagnósticodebido al fracaso de cultivo que acontece entre el5-42 % de los casos. En este trabajo se pretende evaluar lasensibilidad de las técnicas moleculares para el estudio dealteraciones cromosómicas en aquellos casos cuyo resultadocitogenético no puede ser establecido.Metodología. Se han estudiado 70 muestras de abortosdel primer y segundo trimestre de gestación mediante citogenéticay genética molecular (Quantitative FluorescentPolymerase chain Reaction [QF-PCR] y Multiplex ligationdependentProbe Amplification [MLPA]).Resultados. No se pudo establecer un resultado citogenéticoen el 37,2 % de las muestras. 44 fueron cariotipadas,obteniéndose 37 cariotipos normales y 7 anómalos. El estudiomolecular permitió establecer una dotación cromosómicaen el 100% de los casos, se encontraron alteraciones en10, de los cuales 3 carecían de resultado citogenético.Conclusiones. Se propone incluir en el protocolo de estudiode abortos el empleo de las técnicas citadas en casode fracaso del cultivo celular. La colaboración entre laboratoriosde citogenética y genética molecular especializados,permitiría ofrecer un resultado a la mayoría de las pacientes,esencial a la hora de poder establecer un adecuado consejogenético(AU)

Introduction. The knowledge of miscarriage causepermits offering an appropriate genetic counselling andmoreover, reduces psychological distress and self blamefeelings in women with a miscarriage. Nowadays, chromosomalstudy of abortions is mostly performed usingcytogenetic techniques. In few cases, no diagnosis can beestablished due to the high rate of culture failure (5-42%). Here, we try to evaluate the usefulness of moleculartechniques for the chromosomal study of those casesin which a cytogenetic result can not be established.Methods. A total of 70 miscarriage samples from thefirst and second trimesters of gestation have been studiedby karyotyping and molecular techniques (QF-PCRy MLPA).Results. The karyotype could not be established in37.2% of cases. Karyotype could be obtained in 44 samples,being 37 normal and 7 chromosomally abnormal.Molecular studies permitted to obtain a result in 100% ofthe cases, finding abnormalities in 10 of them, including3 in which the karyotype had not been established.Conclusions. We propose the use of molecular techniquesin those cases in which the culture fails. The collaborationbetween cytogenetic and molecular laboratorieswould permit to establish a result in the majority ofcases, which would represent an improvement for the offeringof an appropriate genetic counselling(AU)

Aplicaciones clínicas de la resonancia magnética en el cáncer de mama. Parte I / No disponible

La RM de mama es una modalidad de imagen que se ha incorporadoen los últimos años al diagnóstico de la patologíamamaria. La RM dinámica con contraste es la técnica auxiliarde imagen de mayor sensibilidad para el cáncer, aunque sus limitacionesen la especificidad obligan a emplearla para indicacionesrestringidas y siempre asociada a las demás modalidadesde imagen.Actualmente nos encontramos con una técnica sólida queya ha superado su fase de evaluación preclínica y se encuentraplenamente incorporada al proceso asistencial en los centrosque tienen disponibilidad y acceso a la misma.La alta capacidad de la RM con contraste para detectar unalesión nos va a permitir evaluar la extensión; la capacidad,aunque limitada, de tipificación puede permitirnos una buenaaproximación diagnóstica a una segunda lesión detectada demodo incidental, que se caracterizará correlacionándola conotras modalidades y, finalmente, mediante biopsia guiada porRM(AU)

Breast MRI is an imaging modality that has been incorporatedinto the diagnostic algorithm for breast lesions in recentyears. Dynamic contrast-enhanced MRI is an adjuvant techniquewith greater sensitivity for cancer than other conventionaltechniques. However, its low specificity limits its indicationsand means that it must always be used together withother imaging modalities.Breast MRI is currently a well-established technique that hasmoved beyond the preclinical evaluation stage and has beencompletely incorporated into the process of care in centreswhere it is available. Contrast-enhanced MRI's high capacityfor detecting lesions enables us to evaluate the extension ofthe lesion; its capacity for characterizing lesions, although limited,enables a good diagnostic approach to a second lesiondetected incidentally, which can be characterized by correlatingthe findings with other modalities and with the histologicalfindings after MRI-guided biopsy(AU)

Aplicaciones clínicas de la resonancia magnética en el cáncer de mama. Parte II / No disponible

La RM de mama es una modalidad de imagen que se ha incorporadoen los últimos años al diagnóstico de la patologíamamaria. La RM dinámica con contraste es la técnica auxiliarde imagen de mayor sensibilidad para el cáncer, aunque sus limitacionesen la especificidad obligan a emplearla para indicacionesrestringidas y siempre asociada a las demás modalidadesde imagen.Actualmente nos encontramos con una técnica sólida queya ha superado su fase de evaluación preclínica y se encuentraplenamente incorporada al proceso asistencial en los centrosque tienen disponibilidad y acceso a la misma.La alta capacidad de la RM con contraste para detectar unalesión nos va a permitir evaluar la extensión; la capacidad,aunque limitada, de tipificación puede permitirnos una buenaaproximación diagnóstica a una segunda lesión detectada demodo incidental, que se caracterizará correlacionándola conotras modalidades y finalmente mediante biopsia guiada porRM(AU)

Breast MRI is an imaging modality that has been incorporated into the diagnostic algorithm for breast lesions in recent years. Dynamic contrast-enhanced MRI is an adjuvant technique with greater sensitivity for cancer than other, conventional techniques. However, its low specificity limits its indications and means that it must always be used together with other imaging modalities. Breast MRI is currently a well-established technique that has moved beyond the preclinical evaluation stage and has been completely incorporated into the process of care in centers where it is available. Contrast-enhanced MRI's high capacity for detecting lesions enables us to evaluate the extension of the lesion; its capacity for characterizing lesions, although limited, enables a good diagnostic approach to a second lesion detected incidentally, which can be characterized by correlating the findings with those of other modalities and with the histological findings after MRI-guided biopsy(AU)

Occurrence and bioaccumulation study of PCDD and PCDF from mineral feed additives.

Extraction of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) was evaluated in sepiolite matrices. Soxhlet extraction using different extracting strategies and acid treatment were tested. Acid treatment or Soxhlet extraction using a mixture of toluene:ethanol as solvent allowed to reach the minimum requirements for recovery rates. However, Soxhlet extraction using a mixture cyclohexane:toluene as extracting solvent did not allow to comply with these minimum requirements. Significant differences were obtained in TEQ units when acid treatment was applied in comparison to Soxhlet extraction. This fact can be explained because the use of drastic acid conditions allows removing strongly adsorbed analytes which can be uniquely extracted after a total destruction of the crystalline. On the contrary, Soxhlet extraction was not able to destroy the structure of sepiolite and as a consequence the PCDDs/Fs remain adsorbed in the internal structure of the mineral. A bioaccumulation study was also conducted to evaluate the transference of PCDDs/Fs from the sepiolite into the animal when fed with feed containing sepiolite. Four groups of chickens were exposed through diet to a control feed, feed with 3% w/w sepiolite, spiked feed contaminated with PCDDs/Fs and feed containing contaminated kaolinitic clay. Livers of animals were analyzed throughout the exposure period. Results of this trial showed that the performance of broilers was not affected by the presence of dioxins at levels tested, and chickens did not show any abnormal behaviour. Dioxins intentionally added to the diet were significantly absorbed and accumulated in liver, whereas the PCDDs/Fs from sepiolite were not available for chickens since livers from broilers fed 3% sepiolite presented similar WHO-TEQ values than those from broilers fed control diet.

[Microsomal oxidative metabolism in the liver of rats treated with vinorelbine: evaluation through antipyrine elimination]. / Evaluación del metabolismo oxidativo microsómico hepático en ratas tratadas con vinorelbina mediante la eliminación de antipirina.

BACKGROUND: Determination of the metabolic efficiency of the liver in neoplastic diseases in patients receiving highly toxic drugs is of great practical importance. METHODS: The effect of vinorelbine on the metabolic efficiency of the liver was evaluated by means of phenazone kinetics in rats. The test was compared with a battery of tests routinely used whenever hepatic dysfunction is suspected. RESULTS: Vinorelbine was administered to the rats and the pharmacokinetic parameters of antipyrine were compared with those in control rats. A statistically significant prolongation of the elimination half-life, as well as a decrease in the elimination constant and clearance of antipyrine were found in the rats receiving the anticancer drug in comparison with controls (p < 0.01). Statistically significant correlations were found between the elimination half-life of antipyrine and serum albumin values (p < 0.01) and prothrombin time (p < 0.001). CONCLUSIONS: Determination of antipyrine pharmacokinetics allows early detection of vinorelbine-induced hepatic dysfunction, with a sensitive scale.

Evaluación del metabolismo oxidativo microsómico hepático en ratas tratadas con vinorelbina mediante la eliminación de antipirina / Microsomal oxidative metabolism in the liver of rats treated with vinorelbine: evaluation through antipyrine elimination

Introducción: Conocer la eficacia metabólica del hígado de pacientes en tratamiento con fármacos altamente tóxicos es de gran importancia clínica. Material y métodos: En el presente trabajo se ha evaluado el efecto, en ratas, de la administración de vinorelbina sobre la eficacia metabólica del hígado mediante los parámetros farmacocinéticos de la fenazona. Asimismo se han comparado con pruebas habitualmente utilizadas cuando se sospecha una disfunción hepática. Resultados: Tras la administración de vinorelbina en ratas los parámetros farmacocinéticos de antipirina cambiaron significativamente al compararlos con los de ratas control. En las tratadas con vinorelbina se produjo una prolongación de la vida media de la antipirina, así como una disminución de la constante de eliminación y del aclaramiento, cambios que fueron estadísticamente significativos (p < 0,01). Al mismo tiempo, se hallaron relaciones estadísticamente significativas entre la vida media de la antipirina y las concentraciones de albúmina sérica (p < 0,01), al igual que con el tiempo de protrombina (p < 0,001). Conclusión: La prueba de antipirina permite la detección temprana de disfunción oxidativa, producida por vinorelbina, con una escala sensitiva

Background: Determination of the metabolic efficiency of the liver in neoplastic diseases in patients receiving highly toxic drugs is of great practical importance. Methods: The effect of vinorelbine on the metabolic efficiency of the liver was evaluated by means of phenazone kinetics in rats. The test was compared with a battery of tests routinely used whenever hepatic dysfunction is suspected. Results: Vinorelbine was administered to the rats and the pharmacokinetic parameters of antipyrine were compared with those in control rats. A statistically significant prolongation of the elimination half-life, as well as a decrease in the elimination constant and clearance of antipyrine were found in the rats receiving the anticancer drug in comparison with controls (p < 0.01). Statistically significant correlations were found between the elimination half-life of antipyrine and serum albumin values (p < 0.01) and prothrombin time (p < 0.001). Conclusions: Determination of antipyrine pharmacokinetics allows early detection of vinorelbine-induced hepatic dysfunction, with a sensitive scale

Antibodies against the donor antigen glutathione S-transferase T1 after renal transplantation.

The aim of the present study was to determine whether a kidney graft expressing the glutathione S-transferase T1 enzyme (GSTT1) could cause an alloimmune response in a recipient with the null GSTT1 genotype that was similar to that observed in liver transplant. We have found anti-GSTT1 antibodies in the sera of a number of patients and confirmed that only one of the four possible genetic combinations--positive donor/null receptor--could lead to the production of these antibodies. Nevertheless, the main finding of this study is that in kidney transplantation, this mismatch was not sufficient to trigger an immune reaction. Longer follow-up of the posttransplant evolution of the patients is required in order to clarify the contribution of the factors involved in this process.