Detección de grasa parda en la PET/TC con 18F-FDG: diferencias entre la población adulta y pediátrica en una experiencia de 12 años / 18F-FDG PET/CT brown fat detection: differences between adult and pediatric population in a 12 year experience

OBJETIVO: Analizar las características epidemiológicas y antropométricas de los pacientes con activación de la grasa parda detectada por tomografía por emisión de positrones con fluoruro 18-fluorodeoxiglucosa/tomografía computarizada (18F-FDG PET/TC). MATERIAL Y MÉTODOS: De 2005 a 2017, se incluyeron retrospectivamente 818 estudios PET/TC con 18F-FDG positivos para detección de grasa parda, 742 exámenes realizados en población adulta y 76 PET/TC en población pediátrica. Se realizó una prueba de Chi cuadrado para comparar la distribución de las características entre pacientes adultos y pediátricos. RESULTADOS: Los adultos mostraron una tasa más alta de detección de grasa parda en mujeres (79% vs.61%, p < 0,001) y en pacientes con hiperglucemia (> 100mg/dl) (24% vs.16%, p = 0,02), no se encontraron diferencias significativas considerando el sobrepeso (IMC>25kg/m2) (22% vs.20%, p = 0,55). Teniendo en cuenta solo a mujeres, los adultos mostraron una tasa más alta de detección de grasa parda tanto en pacientes con hiperglucemia (83% frente a 42%, p < 0,001), como en pacientes con sobrepeso (80% frente a 67%, p = 0,005). En ambas poblaciones, la activación de la grasa parda ocurrió con mayor frecuencia en las estaciones frías; no hubo diferencias significativas en la distribución considerando la temporada de nacimiento (p = 0,2). CONCLUSIONES: El sexo, la glucemia y el IMC desempeñan un papel importante en la predicción de la activación de la grasa parda, con diferencias significativas entre adultos y niños. Se confirma que la exposición al frío es un factor de predicción importante, mientras que la temporada de nacimiento no es significativa

PURPUSE: To analyze epidemiological and anthropometric features of patients with brown adipose tissue (BAT) activation detected by fluorine18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). MATERIAL AND METHODS: From 2005 to 2017, 818 18F-FDG PET/CT studies positive for BAT detection were retrospectively included, 742 examinations performed on the adult population and 76 PET/CT on the pediatric population. A Chi-squared test was performed to compare features distribution between the adult and pediatric patients. RESULTS: Adults showed a higher rate of BAT detection in females (79% vs.61%, p < 0.001) and in hyperglycaemic patients (>100mg/dL) (24% vs.16%, p = 0.02), no significant difference was found with regard to overweight patients (BMI>25kg/m2) (22% vs.20%, P=.55). Considering females only, the adults showed a higher rate of BAT detection both in hyperglycaemic (83% vs.42%, p < 0.001) and overweight patients (80% vs.67%, p = 0.005). In both populations BAT activation happened more frequently in cold seasons; there was no significant distribution difference with regard to season of birth (p = 0.2). CONCLUSIONS: Sex, glycemia and BMI play a major role in predicting BAT activation, with significant differences between adults and pediatric patients. Cold exposure is confirmed as an important predicting factor, while season of birth is not significant

18F-FDG PET/CT brown fat detection: Differences between adult and pediatric population in a 12 year experience. / Detección de grasa parda en la PET/TC con 18F-FDG: diferencias entre la población adulta y pediátrica en una experiencia de 12 años.

PURPOSE: To analyze epidemiological and anthropometric features of patients with brown adipose tissue (BAT) activation detected by fluorine18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). MATERIAL AND METHODS: From 2005 to 2017, 818 18F-FDG PET/CT studies positive for BAT detection were retrospectively included, 742 examinations performed on the adult population and 76 PET/CT on the pediatric population. A Chi-squared test was performed to compare features distribution between the adult and pediatric patients. RESULTS: Adults showed a higher rate of BAT detection in females (79% vs. 61%, P<0.001) and in hyperglycaemic patients (>100mg/dL) (24% vs. 16%, P=0.02), no significant difference was found with regard to overweight patients (BMI>25kg/m2) (22% vs. 20%, P=.55). Considering females only, the adults showed a higher rate of BAT detection both in hyperglycaemic (83% vs. 42%, P<0.001) and overweight patients (80% vs. 67%, P=0.005). In both populations BAT activation happened more frequently in cold seasons; there was no significant distribution difference with regard to season of birth (P=0.2). CONCLUSIONS: Sex, glycemia and BMI play a major role in predicting BAT activation, with significant differences between adults and pediatric patients. Cold exposure is confirmed as an important predicting factor, while season of birth is not significant.

Diferente captación de 123I-MIBG en los 2 lóbulos hepáticos principales: un misterio persistente sin resolver / Different uptake of 123I-MIBG in the two main liver lobes: A persistant unsolved mistery

Objetivo: Después de la inyección del radiofármaco se observa con frecuencia una concentración incrementada de 123I-MIBG en el lóbulo hepático izquierdo en comparación con el derecho, pero la razón de este hallazgo sigue siendo desconocida. Nuestro objetivo fue analizar retrospectivamente el patrón de absorción de 123I-MIBG entre los 2 lóbulos hepáticos y correlacionar nuestros resultados con algunas características epidemiológicas/clínicas. Material y métodos: Se seleccionaron 94 gammagrafías 123I-MIBG de 71 pacientes. Las regiones de interés se dibujaron en los lóbulos derecho e izquierdo utilizando secciones tomográficas transversales y se calcularon relaciones de actividad de izquierda a derecha (relación I/D) a las 6 y 24horas de la administración del radiofármaco. Resultados: Veintisiete exámenes fueron positivos para lesiones hipermetabólicas, mientras que los 67 restantes fueron negativos. En todos los casos las relaciones medias de I/D temprana y tardía fueron superiores a 1; la relación I/D temprana media fue de 1,37 y la relación I/D tardía de 1,52. La relación I/D tardía fue significativamente mayor que la precoz. No hubo diferencias en la relación I/D con respecto a la edad, sexo, enfermedad primaria y resultado de la gammagrafía. Conclusiones: La absorción de 123I-MIBG fue mayor en el lóbulo hepático izquierdo en comparación con el derecho, y esta relación no se correlacionó con ninguna característica epidemiológica o clínica. La razón de este metabolismo todavía no se ha explicado, y algunas hipótesis biomoleculares podrían ser probadas en modelos 3D dinámicos in vitro

Purpose: After radiopharmaceutical injection, a heightened 123I-MIBG concentration is frequently observed in the left hepatic lobe compared to the right one, but the reason of this finding remains unknown. Our aim was to retrospectively analyze the different 123I-MIBG uptake pattern between the two hepatic lobes and correlate our results with some epidemiological/clinical features. Material and methods: Ninety-four 123I-MIBG scintigraphies from 71 patients were selected. Regions of interest were drawn in the right and left lobes using transverse tomographic sections and left to right activity ratios (L/R ratio) were calculated at 6 and 24h after radiotracer administration. Results: Twenty-seven examinations were positive for hypermetabolic lesions while the remaining 67 were negative. In all cases mean early and delayed L/R ratios were greater than 1.00; average early L/R ratio was 1.37 and delayed L/R ratio 1.52. The delayed L/R ratio was significantly higher than the early one. There was no difference in the L/R ratios with regard to age, gender, primary disease and result of scintigraphy. Conclusions: 123I-MIBG uptake was higher in left hepatic lobe compared to right and this ratio did not correlate with any epidemiological or clinical feature. The reason of this metabolic is not yet explained and some biomolecular hypotheses could be tested in 3D dynamic in vitro models

Detección incidental de adenoma hipofisario con PET/TC con 18F-FDG y PET/TC con 18F-Colina en un mismo paciente / Incidental pituitary adenoma detected by 18F-FDG PET/CT and 18F-choline PET/CT in the same patien

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Different uptake of 123I-MIBG in the two main liver lobes: A persistant unsolved mistery. / Diferente captación de 123I-MIBG en los 2 lóbulos hepáticos principales: un misterio persistente sin resolver.

PURPOSE: After radiopharmaceutical injection, a heightened 123I-MIBG concentration is frequently observed in the left hepatic lobe compared to the right one, but the reason of this finding remains unknown. Our aim was to retrospectively analyze the different 123I-MIBG uptake pattern between the two hepatic lobes and correlate our results with some epidemiological/clinical features. MATERIAL AND METHODS: Ninety-four 123I-MIBG scintigraphies from 71 patients were selected. Regions of interest were drawn in the right and left lobes using transverse tomographic sections and left to right activity ratios (L/R ratio) were calculated at 6 and 24h after radiotracer administration. RESULTS: Twenty-seven examinations were positive for hypermetabolic lesions while the remaining 67 were negative. In all cases mean early and delayed L/R ratios were greater than 1.00; average early L/R ratio was 1.37 and delayed L/R ratio 1.52. The delayed L/R ratio was significantly higher than the early one. There was no difference in the L/R ratios with regard to age, gender, primary disease and result of scintigraphy. CONCLUSIONS: 123I-MIBG uptake was higher in left hepatic lobe compared to right and this ratio did not correlate with any epidemiological or clinical feature. The reason of this metabolic is not yet explained and some biomolecular hypotheses could be tested in 3D dynamic in vitro models.

Incidental meningioma detected by using 99mTc-MIBI SPECT/CT / Detección incidental de meningioma con 99mTc-MIBI SPECT/TC

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18F-FDG PET/CT follow-up of follicular dendritic cell sarcoma / 18F-FDG PET/TC en el seguimiento de un sarcoma de células dendríticas foliculares

Follicular dendritic cell sarcoma (FDCS) is a rare lymphoid neoplasm which occurs mainly in lymph nodes, especially cervical and mediastinal; it can be difficult to diagnose and often is misdiagnosed. Its pathogenesis is still not clear, like its evolution. We report a case of 60-year-old woman with FDCS of left lateral cervical node followed for almost 10 years, after a left selective neck dissection, who underwent five 18F-FDG PET/CT. This technique has proven to be an useful method for the management of this patient, mainly for the follow up, detection of relapse and therapy response evaluation (AU)

El sarcoma de células dendríticas foliculares (FDCS) es una rara neoplasia linfoide que se produce principalmente en los ganglios linfáticos, en especial los cervicales y mediastínicos; puede resultar difícil de diagnosticar, y su diagnóstico es a menudo erróneo. Su patogénesis no está aún clara, al igual que su evolución. Reportamos el caso de una mujer de 60 años con FDCS en un ganglio cervical lateral izquierdo a la que se realizó un seguimiento durante casi 10 años, tras una disección ganglionar selectiva laterocervical izquierda, y que fue sometida a cinco estudios 18F-FDG PET/TC. Esta técnica ha demostrado ser un método útil para el manejo de esta paciente, principalmente en lo relativo al seguimiento, detección de la recidiva, y evaluación de la respuesta a la terapia (AU)

18F-FDG PET/CT follow-up of follicular dendritic cell sarcoma.

Follicular dendritic cell sarcoma (FDCS) is a rare lymphoid neoplasm which occurs mainly in lymph nodes, especially cervical and mediastinal; it can be difficult to diagnose and often is misdiagnosed. Its pathogenesis is still not clear, like its evolution. We report a case of 60-year-old woman with FDCS of left lateral cervical node followed for almost 10 years, after a left selective neck dissection, who underwent five 18F-FDG PET/CT. This technique has proven to be an useful method for the management of this patient, mainly for the follow up, detection of relapse and therapy response evaluation.

18F-FDG PET/CT in staging and follow-up of adamantinoma / 18F-FDG PET/CT en la estadificación y seguimiento de un adamantinoma

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¹³¹I treatment of toxic nodular goiter under combined thyrostatic-thyromimetic medication is at low risk of late hypothyroidism.

AIM: Treatment of toxic nodular goiter with ¹³¹I is a first-line therapy for hyperthyroidism. To avoid a thyrotoxic storm, ¹³¹I is usually administered after pretreatment with antithyroid drugs, with thyroid-stimulating hormone (TSH) increase and functional recruitment of inhibited normal tissue. Therefore, both autonomous nodule(s) and normal tissue are irradiated. This may be a reason for late hypothyroidism occurring in 15-25% of patients. This study aimed at assessing different pretreatment modalities with combined methymazole and triiodothyronine, achieving euthyroidism with suppressed TSH. METHODS: After diagnosis of autonomously functioning toxic nodule, patients were subjected to thyrostatic medication. Two months later, TSH was checked; if >0.5 mU/L triiodothyronine treatment was associated. After 2 more months, if the TSH level was suppressed, patients received ¹³¹I-therapy. A total of 149 patients were consecutively enrolled, 41 of whom with uninodular and 108 with multinodular goiter. They were evaluated at diagnosis, pretreatment, 3 and 6 months after therapy and at late follow-up (6.8+/-4.2 years; range: 1-22 years). RESULTS: Administered activity was calculated according to ¹³¹I uptake and gland weight. Methymazole was discontinued 6 days before treatment and T3 was maintained until administration of ¹³¹I-therapy. Euthyroidism was achieved in 88% of patients. At late follow-up, subclinical hypothyroidism was observed in 10 patients (6.7%) and overt hypothyroidism in 5 patients (3.3%). No pathological consequences or side effects of ¹³¹I-therapy were found during the 6.8+/-4.2 year follow-up period. CONCLUSION: Treatment of toxic nodular goiter with ¹³¹I-therapy, under combined thyrostatic-thyromimetic treatment is a simple, safe, well-tolerated, and effective procedure.

[Multicentre observational study on peristomal skin disorders. A proposal classification]. / Studio osservazionale multicentrico sulle alterazioni cutanee post-enterostomie (SACS) Classificazione delle alterazioni peristonali.

Disorders regarding peristomal skin have been more and more investigated in order to establish the impact on quality of life of ostomy patients. The aim of this classification is to provide an objective, standardized tool for the assessment of peristomal skin complication specifically designed on the description and localization of the lesion.

Fumonisins in foods from Cordoba (Argentina), presence and genotoxicity.

Fumonisins B(1), B(2)yB(3) (FB(1), FB(2)yFB(3)), are a group of toxins produced by different mold species, Fusarium moniliforme and Fusarium proliferatum being the most important ones. Its compounds were tested in chromosome aberrations (CA), sister chromatid exchange (SCE), and micronucleus (MN) in human lymphocytes, and, in Allium cepa (onion), the chromosomal aberrations (CA) assay was used. Moreover, the presence of fumonisins and their producer moulds was determined in different food substrata in Cordoba city, Argentina. Cytogenetic studies using FB(1), FB(2) and FB(3) levels gave positive results for the higher concentrations (5 and 10mug/g) with FB(1). As regards the cytogenetic aspect of FB(1), we found an increase in the incidence of genetic damage measured by chromosomal aberrations, sister chromatid exchange, micronuclei and chromosomal aberrations in Allium cepa. These results indicate that human lymphocytes cells and plants cells (Allium cepa) have a very sensitive cellular response to the mycotoxin fumonisin B(1) as observed at the highest concentrations.

[The role of the dentist in the pre- and postoperative treatment of the cancer patient]. / Il ruolo dell'odontoiatra nel trattamento pre- e post-chirurgico del paziente neoplastico.

The importance of an early diagnosis in neoplastic pathologies of the oral cavity is now universally recognised and accepted, and dental treatment in this field requires particular care and preparation. Having identified the suspected lesions, it is necessary to eliminate those conditions which might favour the onset of neoplasia in the oral cavity, and then follow the patient during the pre- and post-radiotherapeutic stages. Dentistry is also responsible for following and carrying out the prosthetic recovery of patients undergoing radical jaw surgery, in order to enable them to return to normal day-to-day and working life in esthetic and functional terms.

[The therapeutic activity of stepronin in viral hepatitis]. / Studio sull'attività terapeutica di stepronin in corso di epatite virale.

The therapeutic effect of stepronin in 5% glucosate solution has been evaluated in 55/110 viral hepatitis cases (10/55 of A type, 37/55 of B type and 8/55 of nA type nB type), versus other cases (8/55 of A type, 40/55 of B type of 7/55 of nA nB type), treated with 5% glucose solution only. In 18/110 viral hepatitis case of A type, final results with the two different therapies have not shown statistically significantly changes and were comparable. Particularly favourable, in the patients treated, the results obtained in viral hepatitis of B type and nA nB type, were very significant statistically at the end of therapy. In particular, the 2 transaminasic activities had a beneficial influence. Tolerance was very good: only in there cases nettlerash was observed and therapy interrupted in one patient. Therefore the validity of this sulphydryl pro-drug in the treatment of acute viral hepatitis of B and nA and nB type is confirmed.

[Kinetic and clinical studies on a new cephalosporin: Cefotiam]. / Ricerca cinetica e clinica su una nuova cefalosporina: Cefotiam.

Kinetic and clinical evaluation of cefotiam, a new cephalosporin, is reported. It was found that the drug is rapidly distributed to the tissues. Equilibrium between tissues and plasma is reached in about an hour. Some 90-91% of the dose administered is excreted in the urine, and accumulation does not occur. A clinical cure was obtained in 27 of a series of 35 patients (77.1%). Improvement was observed in 7 cases (20%). The antibiotic proved ineffective in the remaining cases (2.8%). Tolerance was excellent and there were no side-effects worthy of note.