Caso de pseudo-Meigs, signo guía de afección ginecológica subyacente / Case of Pseudo-Meigs, Guide Sign of Underlying Gynecological Condition

Introducción: El síndrome de Meigs consiste en la asociación de tumor benigno de ovario tipo fibroma con ascitis e hidrotórax, que se resuelven tras la extirpación del tumor. El síndrome de pseudo-Meigs secundario al leiomioma uterino es una entidad rara. Presentación de caso: Mujer de 68 años que presentó una historia de un mes con sensación de opresión torácica y disnea. La radiografía de tórax reveló derrame pleural derecho. En la tomografía axial computarizada de abdomen y región pelviana se aprecia ascitis y un gran mioma uterino subseroso. Se sometió a una histerectomía abdominal total con salpingo-ooforectomía bilateral. Conclusiones: La ascitis y el derrame pleural desaparecieron rápidamente en el postoperatorio. Tras 20 meses de seguimiento, no hay recidiva de la enfermedad(AU)

Introduction: Meigs syndrome consists of the association of a benign tumor of the ovary "fibroma type" with ascites and hydrothorax, which resolve after the tumor is removed. The pseudo-Meigs syndrome secondary to uterine leiomyoma is a rare entity. Case report: A 68-year-old woman refered having a month with a sensation of chest tightness and dyspnea. Chest X-ray revealed right pleural effusion. Computed axial tomography of the abdomen and pelvic region shows ascites and a large subserous uterine myoma. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Conclusions: Ascites and pleural effusion disappeared rapidly in the postoperative period. After 20 months of follow-up, there is no recurrence(AU)

Reliable methods for determination of triazine herbicides and their degradation products in seawater and marine sediments using liquid chromatography-tandem mass spectrometry.

Triazines and their degradation products are transported to the aquatic environment, and once there, the probability to reach the marine environment is very high. In this paper, solid phase extraction (SPE) and extraction by matrix solid phase dispersion (MSPD) to analyse nine triazines (ametryn, atrazine, cyanazine, prometryn, propazine, simazine, simetryn, terbuthylazine and terbutryn) and eight degradation products (desethylatrazine, desethyldesisopropylatrazine, desethyl-2-hydroxyatrazine, desethylterbuthylazine, desisopropylatrazine, desisopropyl-2-hydroxyatrazine, 2-hydroxyatrazine and 2-hidroxyterbuthylazine) in seawater and marine sediments samples were used. The analysis was carried out using liquid chromatography with tandem mass spectrometry (LC-ESI-MS/MS). The methods were optimized and validated to achieve a selective and sensitive determination of the analytes from different sample, regardless of its complexity. Under the optimum conditions, the proposed methods provided adequate limits of quantification (0.05-0.45 µg L-1 and 0.23-4.26 µg kg-1 in seawater and marine sediments, respectively). Intra- and inter-day relative standard deviation were below 1.41% for all compounds. Recoveries were evaluated, and acceptable values that ranged from 87.5-99.4 and 60.9-99.7% for the seawater and sediment samples, respectively, were obtained. The proposed methods were applied to the analysis of the target compounds in seawater samples and marine sediments from a coastal area of Galicia (NW of Spain).

On-line solid-phase extraction method for determination of triazine herbicides and degradation products in seawater by ultra-pressure liquid chromatography-tandem mass spectrometry.

A fast, simple, selective and sensitive method has been developed for the determination of nine triazine herbicides (ametryn, atrazine, cyanazine, prometryn, propazine, simazine, simetryn, terbuthylazine and terbutryn) and eight degradation products (desethyl atrazine, desethyl-desisopropyl atrazine, desethyl 2-hydroxyatrazine, desethyl terbuthylazine, desisopropyl atrazine, desisopropyl 2-hydroxyatrazine, 2-hydroxyatrazine and 2-hidroxyterbuthylazine) in seawater samples. On-line solid-phase extraction coupled with ultra-pressure liquid chromatography-tandem mass spectrometry was employed for simultaneous analysis of all compounds in 11min. Validation parameters were studied through the estimation of the limits of detection and quantification, calibration curves and precision. Limits of quantification ranged from 0.023 to 0.657µgL-1. Good linearity was obtained for all compounds with R2>0.99 in all cases. Furthermore, inter-day precision (0-2.1%) and intra-day precision (0-3.9%) were shown to be satisfactory. On-line solid-phase extraction recoveries in spiked unpolluted seawater sample were evaluated and acceptable values (80.3-99.8%) with adequate RSD (0.1-3.1%) were found. Finally, the proposed method was applied to the analysis of the target compounds in seawater samples collected from seawater nearby a zone of intensive horticulture of Matosinhos (Portugal). The concentrations of the herbicides were below the limit of detection in all cases.

An environmentally friendly method for the determination of triazine herbicides in estuarine seawater samples by dispersive liquid-liquid microextraction.

A fast, simple, sensitive and green chemistry method using dispersive liquid-liquid microextraction (DLLME) for the simultaneous determination of seven triazine herbicides (ametryn, atrazine, cyanazine, propazine, simazine, simetryn and terbuthylazine) in estuarine seawater samples has been developed. DLLME was carried out using a small volume of seawater (25 mL) and 300 µL of 1-octanol. Herbicide concentrations were determined by liquid chromatography-diode array detection, and results were confirmed by liquid chromatography-electrospray ionisation tandem spectrometry analysis. The analytical features of the proposed method were satisfactory with repeatability < ±5% and intermediate precision < ±10%, and recoveries ranged from 81-102% for all compounds. All the triazines exhibited linear matrix calibration curves with coefficients of determination >0.999 for all the analytes except for simazine (0.9975). Limits of quantification ranged between 0.19 and 1.12 µg L(-1). The method was applied to the analysis of seawater samples from ten points susceptible to contamination by triazines from estuary of A Coruña (Galicia, NW of Spain). The levels of the seven triazines were below the LODs in the analysed samples. Use of proposed method will allow for monitoring of triazines at levels below the regulatory limits set by the European Directive 2008/105/EC of 2 and 4 µg L(-1) for atrazine and simazine, respectively.

Development of a Matrix Solid Phase Dispersion methodology for the determination of triazine herbicides in mussels.

A method based on Matrix Solid Phase Dispersion (MSPD) for determination of nine triazines in mussels has been optimised in terms of the sorbents used for extracting and cleaning-up. Two dispersing agents: C18 and florisil, and eight cleanup co-sorbents: florisil, silica, silica/alumina, Envi™ Carb, Envi-Carb-II/PSA, SAX/PSA, Envi-Carb-II /SAX/PSA and C18 were assayed. Analytes were eluted using 20 mL of ethyl acetate and 5 mL of acetonitrile and finally the extract was concentrated to dryness, re-constituted with 1 mL methanol and determined by HPLC-DAD. The best results were obtained with C18 as dispersing agent and Envi-Carb-II/SAX/PSA as clean-up co-column. Recoveries ranged between 79% and 99% and repeatability and reproducibility were below than 16% for all compounds. The linearity of the calibration curves yielded the R(2)⩾0.9993. The LOQ values ranged from 0.10 to 0.18 mg kg(-1) dried sample. Finally the method was applied to the analysis of mussel samples from Galicia (NW Spain).

Determination of triazine herbicides in seaweeds: development of a sample preparation method based on Matrix Solid Phase Dispersion and Solid Phase Extraction Clean-up.

A method using dual process columns of Matrix Solid Phase Dispersion (MSPD) and Solid Phase Extraction (SPE) has been developed for extracting and cleaning-up of nine triazine herbicides (ametryn, atrazine, cyanazine, prometryn, propazine, simazine, simetryn, terbuthylazine and terbutryn) in seaweed samples. Under optimized conditions, samples were blended with 2g of octasilyl-derivatized silica (C8) and transferred into an SPE cartridge containing ENVI-Carb II/PSA (0.5/0.5 g) as a clean up co-sorbent. Then the dispersed sample was washed with 10 mL of n-hexane and triazines were eluted with 20 mL ethyl acetate and 5 mL acetonitrile. Finally the extract was concentrated to dryness, re-constituted with 1 mL methanol:water (1:1) and injected into the HPLC-DAD system. The linearity of the calibration curves was excellent in matrix matched standards, and yielded the coefficients of determination>0.995 for all the target analytes. The recoveries ranged from 75% to 100% with relative standard deviations lower than 7%. The achieved LOQs (<10 µg kg(-1)) for all triazines under study permits to ensure proper determination at the maximum allowed residue levels set in the European Union Legislation. Samples of three seaweeds were subjected to the procedure proving the suitability of MSPD method for the analysis of triazines in different seaweeds samples.

[Short-tau inversion-recovery (STIR) sequence magnetic resonance imaging evaluation of orbital structures in Graves' orbitopathy]. / Evaluación de la órbita mediante secuencias short-tau inversion-recovery (STIR) en resonancia nuclear magnética en la orbitopatía de Graves.

OBJECTIVE: To evaluate the orbital structures and to establish correlations with disease activity and severity in patients with Graves' hyperthyroidism and orbitopathy (GO) using short-tau inversion-recovery (STIR) sequence magnetic resonance imaging (MRI). METHODS: Observational, cross-sectional, case-control study. Twenty-eight patients with euthyroid status after treatment and GO (GO group) and 15 control subjects (control group) were included. Patients underwent a complete ophthalmologic examination and were then assessed according to the EUGOGO (European Group on Graves' Orbitopathy) recommendations. Muscle cross-sectional areas, orbital tissue volumes and the signal intensity ratio (SIR) from the most inflamed extraocular muscle were calculated using a STIR-T2 weighted sequence MRI. Correlations between clinical and MRI measurements were analyzed. RESULTS: Enlargements in the cross-sectional areas and volumes were significant for most EOMs (P<.001), but not for the lateral rectus muscle cross-sectional area. A significant difference in SIR values between patients with GO and control subjects (P<.001) was found. No significant correlations were found between muscle cross-sectional areas, orbital tissue volumes, SIR values and the clinical activity parameters. CONCLUSIONS: Given the small sample size of our study, with the obvious need for larger clinical trials, we were unable to demonstrate that the STIR sequences in MRI are a sensitive tool in assessing patients with longstanding GO in order to detect inflammatory changes and activity follow-up, possibly because it is in inactive phase. Meanwhile, it is still necessary to continue performing a thorough clinical evaluation in the therapeutic management of GO.

Evaluación de la órbita mediante secuencias short-tau inversion-recovery (STIR) en resonancia nuclear magnética en la orbitopatía de Graves / Short-tau inversion-recovery (STIR) sequence magnetic resonance imaging evaluation of orbital structures in Graves’ orbitopathy

Objetivo: Evaluar las estructuras orbitarias mediante secuencias short-tau inversion-recovery (STIR) en resonancia nuclear magnética (RNM) y establecer correlaciones con los signos de actividad clínica (CAS) y severidad en pacientes con hipertiroidismo y orbitopatía Graves (OG). Métodos: Estudio clínico de casos y controles, observacional y transversal. Veintiocho pacientes en estatus eutiroideo postratamiento y OG (grupo OG) y 15 sujetos controles (grupo control) fueron evaluados. Se realizó una exploración oftalmológica completa a los participantes y se determinó la actividad y severidad de la OG, según recomendaciones EUGOGO (Grupo Europeo en Orbitopatía Graves). Áreas de sección transversal de los músculos extraoculares (MOE), volúmenes de los tejidos orbitarios y ratios (SIR) de intensidad de señal del MOE más inflamado fueron calculados usando secuencias STIR-T2 en RNM. Se establecieron correlaciones entre variables. Resultados: Los incrementos en las áreas de sección transversal y volúmenes fueron significativos en la mayoría de los MOE (p<0,001), pero no en el área de sección transversal del recto lateral. Se encontraron diferencias significativas en valores SIR entre ambos grupos (p<0,001). No se establecieron correlaciones significativas entre el área total de sección transversal de los MOE, volúmenes de los tejidos orbitarios, valores SIR y signos de actividad clínica. Conclusiones: Dado el tamaño muestral del estudio, con la necesidad obvia de estudios más amplios, no podemos demostrar que las secuencias STIR en RNM sean una herramienta sensible para evaluar cambios inflamatorios y actividad clínica en la OG de larga evolución, posiblemente debido a que se halle en fase inactiva(AU)

Objective: To evaluate the orbital structures and to establish correlations with disease activity and severity in patients with Graves’ hyperthyroidism and orbitopathy (GO) using short-tau inversion-recovery (STIR) sequence magnetic resonance imaging (MRI). Methods: Observational, cross-sectional, case-control study. Twenty-eight patients with euthyroid status after treatment and GO (GO group) and 15 control subjects (control group) were included. Patients underwent a complete ophthalmologic examination and were then assessed according to the EUGOGO (European Group on Graves’ Orbitopathy) recommendations. Muscle cross-sectional areas, orbital tissue volumes and the signal intensity ratio (SIR) from the most inflamed extraocular muscle were calculated using a STIR-T2 weighted sequence MRI. Correlations between clinical and MRI measurements were analyzed. Results: Enlargements in the cross-sectional areas and volumes were significant for most EOMs (P<.001), but not for the lateral rectus muscle cross-sectional area. A significant difference in SIR values between patients with GO and control subjects (P<.001) was found. No significant correlations were found between muscle cross-sectional areas, orbital tissue volumes, SIR values and the clinical activity parameters. Conclusions: Given the small sample size of our study, with the obvious need for larger clinical trials, we were unable to demonstrate that the STIR sequences in MRI are a sensitive tool in assessing patients with longstanding GO in order to detect inflammatory changes and activity follow-up, possibly because it is in inactive phase. Meanwhile, it is still necessary to continue performing a thorough clinical evaluation in the therapeutic management of GO(AU)