Desprendimientos de retina serosos bilaterales asociados a glomerulonefritis primaria por depósito de Inmunoglobulina A / Bilateral serous retinal detachments associated with IgA nephropathy

CASO CLÍNICO: Mujer de 41 años de edad con disminución de la agudeza visual bilateral y antecedentes de enfermedad glomerular primaria por depósito de IgA. A la exploración oftalmológica presentaba desprendimientos de neuroepitelio bilaterales que se resolvieron por completo tras 4 meses de diálisis peritoneal. DISCUSIÓN: Los desprendimientos de retina serosos bilaterales son una manifestación rara de la nefropatía IgA, cuya etiología es probablemente multifactorial y cuyo tratamiento es el de la enfermedad de base

CASE REPORT: A 41-year-old woman with a bilateral loss of visual acuity and a history of IgA nephropathy. The ophthalmic examination revealed bilateral neurosensory detachments that resolved completely after four months of peritoneal dialysis. DISCUSSION: Bilateral serous retinal detachments are a rare manifestation of IgA nephropathy, in which the etiology is probably multifactorial and their resolution depends on the underlying disease

Tomografía computarizada de pitch alto en estudios de triple descarte: dosis de radiación y calidad de la imagen comparada con la de la tomografía computarizada multidetector / High pitch CT in triple rule-out studies: radiation dose and image quality compared to multidetector CT

Objetivo. Comparar la calidad de imagen y dosis de radiación de la TC de doble fuente (128-TCDF) con pitch alto y la adquisición retrospectiva con TC de 64 filas de detectores (64-TCMD) en estudios de triple descarte. Material y métodos. Estudiamos retrospectivamente 60 pacientes con dolor torácico agudo: 30 con una adquisición ECG-retrospectiva con 64-TCMD y 30 con 128-TCDF y pitch alto. Analizamos cuantitativamente la calidad de la imagen calculando la densidad vascular (DV), densidad muscular (DM), ruido y cocientes densidad vascular/ruido (CDVR) y contraste/ruido (CCR). Valoramos cualitativamente los artefactos en la vena cava, aorta y coronarias. Calculamos la dosis de radiación efectiva estimada (DRE) con el producto dosis-longitud. Resultados. No hubo diferencias significativas en la DV. Con 128-TCDF los CDVR y CCR fueron mayores en la aorta (CDVR: 28,9 ± 11,7 y 20 ± 5,5; CCR: 24,4 ± 10,9 y 16,8 ± 5,4; p < 0,01), arterias pulmonares (CDVR: 25,5 ± 10 y 20,6 ± 6,5; CCR: 24,5 ± 5,4 y 17,4 ± 6,4; p < 0,01) y coronarias (CDVR: 25,9 ± 8,2 y 18,9 ± 4,9; CCR: 24,9 ± 8,2 y 15,6 ± 4,6; p < 0,01). Los artefactos coronarios (3 y 34 segmentos no diagnósticos p < 0,001) y la DRE (13,77 ± 4 y 2,77 ± 0,6 mSv; p < 0,001) fueron menores con 128-TCDF. Conclusión. El pitch alto en el triple descarte disminuye la dosis de radiación y mejora la calidad de la imagen con respecto a la adquisición retrospectiva con 64-TCMD (AU)

Objective. To compare the image quality and radiation dose from high pitch dual source CT (128-DSCT) versus those from retrospective acquisition with 64-row multidetector CT (64-MDCT) in triple rule-out studies. Material and methods. We retrospectively studied 60 patients with acute chest pain: 30 with a retrospective EKG acquisition with 64-MDCT and 30 with high pitch 128-DSCT. We quantitatively analyzed the image quality by calculating the vascular density, muscular density (DM), noise, vascular density/noise ratio (VDNR), and contrast/noise ratio (CNR). We qualitatively evaluated the artifacts in the vena cava, aorta, and coronary arteries. We estimated the effective dose (ED) of radiation by means of the dose-length product. Results. There were no significant differences between 128-DSCT and 64-MDCT in the vascular density. The VDNR and CNR were higher on 128-DSCT than on 64-MDCT in the aorta (VDNR: 28.9 ± 11.7 vs. 20 ± 5.5; CNR: 24.4 ± 10.9 vs. 16.8 ± 5.4; P < .01), in the pulmonary arteries (VDNR: 25.5 ± 10 vs. 20.6 ± 6.5; CNR: 24.5 ± 5.4 vs. 17.4 ± 6.4; P < .01), and in the coronary arteries (VDNR: 25.9 ± 8.2 vs. 18.9 ± 4.9; CNR: 24.9 ± 8.2 vs. 15.6 ± 4.6; P < .01). There were fewer artifacts in the coronary arteries on 128-DSCT than on 64-MDCT (3 vs. 34 nondiagnostic segments; P < .001), and the ED in 128-DSCT was lower than in 64-MDCT (13.77 ± 4 vs. 2.77 ± 0.6 mSv; P < .001). Conclusion. In triple rule-out studies, high pitch 128-DSCT delivers a lower dose of radiation and provides better image quality than retrospective acquisition with 64-MDCT (AU)

Bilateral serous retinal detachments associated with IgA nephropathy.

CASE REPORT: A 41-year-old woman with a bilateral loss of visual acuity and a history of IgA nephropathy. The ophthalmic examination revealed bilateral neurosensory detachments that resolved completely after four months of peritoneal dialysis. DISCUSSION: Bilateral serous retinal detachments are a rare manifestation of IgA nephropathy, in which the etiology is probably multifactorial and their resolution depends on the underlying disease.

High pitch CT in triple rule-out studies: Radiation dose and image quality compared to multidetector CT.

OBJECTIVE: To compare the image quality and radiation dose from high pitch dual source CT (128-DSCT) versus those from retrospective acquisition with 64-row multidetector CT (64-MDCT) in triple rule-out studies. MATERIAL AND METHODS: We retrospectively studied 60 patients with acute chest pain: 30 with a retrospective EKG acquisition with 64-MDCT and 30 with high pitch 128-DSCT. We quantitatively analyzed the image quality by calculating the vascular density, muscular density (DM), noise, vascular density/noise ratio (VDNR), and contrast/noise ratio (CNR). We qualitatively evaluated the artifacts in the vena cava, aorta, and coronary arteries. We estimated the effective dose (ED) of radiation by means of the dose-length product. RESULTS: There were no significant differences between 128-DSCT and 64-MDCT in the vascular density. The VDNR and CNR were higher on 128-DSCT than on 64-MDCT in the aorta (VDNR: 28.9 ± 11.7 vs. 20 ± 5.5; CNR: 24.4 ± 10.9 vs. 16.8 ± 5.4; P<.01), in the pulmonary arteries (VDNR: 25.5 ± 10 vs. 20.6 ± 6.5; CNR: 24.5 ± 5.4 vs. 17.4 ± 6.4; P<.01), and in the coronary arteries (VDNR: 25.9 ± 8.2 vs. 18.9 ± 4.9; CNR: 24.9 ± 8.2 vs. 15.6 ± 4.6; P<.01). There were fewer artifacts in the coronary arteries on 128-DSCT than on 64-MDCT (3 vs. 34 nondiagnostic segments; P<.001), and the ED in 128-DSCT was lower than in 64-MDCT (13.77 ± 4 vs. 2.77 ± 0.6 mSv; P<.001). CONCLUSION: In triple rule-out studies, high pitch 128-DSCT delivers a lower dose of radiation and provides better image quality than retrospective acquisition with 64-MDCT.

Comparación de la calidad de imagen y dosis de radiación en angio-tomografía computarizada de arterias periféricas con 80 y 100 kV / Comparison of image quality and radiation dose in computed tomography angiography of the peripheral arteries using tube voltage of 80 kV versus 100 kV

Objetivo. Comparar la calidad de imagen y la dosis de radiación en 2 grupos de pacientes a los que se realiza angio-TC de extremidades inferiores con 80 y 100 kV. Material y métodos. Se realizó angio-TC de miembros inferiores a 60 pacientes con sospecha de enfermedad arterial periférica aleatorizados en 2 grupos, en uno la TC se realizó con 80 kV y en el otro con 100 kV. Los demás parámetros de adquisición se mantuvieron constantes. Se analizaron las imágenes cuantificando la densidad vascular (DV) y el ruido (R), y se calcularon los cocientes densidad vascular/ruido (CDVR) y contraste/ruido (CCR). Dos radiólogos evaluaron independientemente la calidad subjetiva de las imágenes. Se calculó la dosis efectiva estimada (DEE) basada en el producto dosis-longitud (DLP). Resultados. El grupo de 80 kV presentó valores significativamente más elevados de la DV (462,5 UH ± 95,6 vs. 372 UH ± 100,9; p < 0,001) y del CDVR (241,9 ± 48,1 vs. 194,3 ± 49,6; p < 0,001) y diferencias no significativas del R (21,3 UH ± 13 vs. 16,3 UH ± 3,5; p = 0,098) y el CCR (21,4 ± 12,1 vs. 22,9 ± 9,1; p = 0,15). No hubo diferencias significativas en la calidad subjetiva de la imagen y la dosis efectiva fue significativamente menor en el grupo de 80 kV (4,73 mSv ± 1,1 vs. 9,6 mSv ± 2,2; p < 0,001). Conclusión. La utilización de 80 kV en el estudio de angio-TC de miembros inferiores disminuye la dosis de radiación sin afectar a la eficacia diagnóstica del estudio respecto a la utilización de 100 kV (AU)

Objective. To compare the image quality and dose of radiation in two groups of patients undergoing CT angiography of the lower limbs, one with tube voltage of 80 kV and the other with tube voltage of 100 kV. Material and methods. We performed CT angiography of the lower limbs in 60 patients with suspected peripheral arterial disease. Patients were randomly assigned to one of two groups; in one group, CT angiography was performed using a tube voltage of 80 kV, whereas in the other it was performed using 100 kV. The remaining acquisition parameters were the same in both groups. The images were analyzed by quantifying vascular density (VD) and noise (N) and by calculating the quotients density/noise (QVDN) and contrast/noise (QCN). Two radiologists working independently evaluated the subjective quality of the images. We calculated the estimated effective dose (EED) based on the dose-length product (DLP). Results. In the group studied at 80 kV, VD was significantly higher (462.5 UH ± 95.6 vs. 372 UH ± 100.9; P <. 001), QVDN was significantly higher (241.9 ± 48.1 vs. 194.3 ± 49.6; P < .001), and there were trends toward higher N (21.3 UH ± 13 vs. 16.3 UH ± 3.5; P = .098) and toward higher QCN (21.4 ± 12.1 vs. 22.9 ± 9.1; P = .15). No significant differences were found in the subjective quality of the images. The EED was significantly lower in the group studied at 80 kV (4.73 mSv ± 1.1 vs. 9.6 mSv ± 2.2; P <. 001). Conclusion. Using 80 kV instead of 100 kV for CT angiography of the lower limbs reduces the dose of radiation without affecting the diagnostic efficacy of the study (AU)

Obstrucción de rama venosa retiniana bilateral: a propósito de un caso raro / Bilateral retinal branch vein occlusion: A rare case report

Objetivos: se presenta un caso clínico de trombosis de rama venosa bilateral, una manifestación rara de esta patología. Caso clínico: paciente mujer de 84 años de edad. Antecedentes sistémicos de enfermedad cardiovascular y oftalmológicos de glaucoma. Es remitida al Servicio de Oftalmología para valoración de uso intravítreo de antiangiogénicos para tratar un edema macular crónico bilateral. En la exploración del fondo de ojo se aprecia una obstrucción de rama venosa bilateral y un edema macular crónico secundario. Dada la cronicidad del cuadro y la Agudeza Visual estable, se descarta tratamiento con antiangiogénicos y se realiza profilaxis de neovascularización con fotocoagulación del sector afecto. Conclusiones: la obstrucción de rama venosa retiniana es relativamente infrecuente en los pacientes mayores de 40 años, 1%, siendo su forma bilateral una presentación anecdótica. No se ha descrito ningún tratamiento efectivo, si bien las inyecciones intravítreas con antiangiogénicos y corticoesteroides han sido utilizadas asociando una mejoría temporal de la agudeza visual, el único tratamiento que previene de la formación de neovasos es la fotocoagulación con láser (AU)

Objectives: we report a case of bilateral retinal branch vein occlusion, a relative rare disease. Report. A 84 year-old woman with cardiovascular events and ophthalmology history of glaucoma is sent to Ophthalmology office for evaluating treatment with intravitreal agents to solve chronic bilateral macular edema. In the funduscopy, it is shown an bilateral retinal branch vein occlusion secondary to a bilateral ischemia. Due to the chronicity and the stable visual acuity , it is discard the antiVEGF agents and it is perform a neovascular profilaxis with photocoagulation of the affected sector with laser. Conclusions. Occlusion of retinal vein branch is relatively rare disease in patients older than 40 years old, 1%, being bilateral type very sparse. It is no effective treatment described, even though, antiangiogenic and corticoesteroid intravitreal injections have been used related to a temporal improve of visual acuity, the only (AU)

Comparison of image quality and radiation dose in computed tomography angiography of the peripheral arteries using tube voltage of 80 kV versus 100 kV.

OBJECTIVE: To compare the image quality and dose of radiation in two groups of patients undergoing CT angiography of the lower limbs, one with tube voltage of 80 kV and the other with tube voltage of 100 kV. MATERIAL AND METHODS: We performed CT angiography of the lower limbs in 60 patients with suspected peripheral arterial disease. Patients were randomly assigned to one of two groups; in one group, CT angiography was performed using a tube voltage of 80kV, whereas in the other it was performed using 100 kV. The remaining acquisition parameters were the same in both groups. The images were analyzed by quantifying vascular density (VD) and noise (N) and by calculating the quotients density/noise (QVDN) and contrast/noise (QCN). Two radiologists working independently evaluated the subjective quality of the images. We calculated the estimated effective dose (EED) based on the dose-length product (DLP). RESULTS: In the group studied at 80 kV, VD was significantly higher (462.5 UH ± 95.6 vs. 372 UH ± 100.9; P<.001), QVDN was significantly higher (241.9 ± 48.1 vs. 194.3 ± 49.6; P<.001), and there were trends toward higher N (21.3 UH ± 13 vs. 16.3 UH ± 3.5; P=.098) and toward higher QCN (21.4 ± 12.1 vs. 22.9 ± 9.1; P=.15). No significant differences were found in the subjective quality of the images. The EED was significantly lower in the group studied at 80 kV (4.73 mSv ± 1.1 vs. 9.6 mSv ± 2.2; P<.001). CONCLUSION: Using 80 kV instead of 100 kV for CT angiography of the lower limbs reduces the dose of radiation without affecting the diagnostic efficacy of the study.

Hepatotoxicidad por gabapentina / Hepatotoxicity by gabapentin

No disponible

Brain aging and neurotransplantation. I. Nigral cell suspension graft to aged rodent striatum and motor disabilities.

The possibilities of neural transplantation were studied in functional motor recovery of 21-23-month-old Sprague-Dawley male rats. Age-dependent functional losses of rats were evaluated using the Marshall scale for swimming abilities, narrow bridge task and suspension on horizontal wire. Fifteen rats exhibited motor disabilities when were compared with young control rats. Deficient rats were divided in two groups: one group received dissociated fetal dopaminergic cells from ventral mesencephalon (E12-E14) to striatum, whereas the other group having the same level of impairment, was followed without any graft and served as age-matched controls. Cell survival and behavior were evaluated twelve weeks after grafting by immunocytochemistry (tyrosine hydroxylase=TH) and the same behavioral test battery.

[Purification and properties of beta-N-acetylglucosaminidase from Mytilus edulis L. gonads (author's transl)]. / Purificación y propiedades de una beta-N-acetilglucosaminidasa aislada de las gónadas del Mytilus edulis (mejillón).

beta-N-Acetylglucosaminidase (beta-2-acetamido-2-deoxy-D-glucoside acetamidodeoxyglucohydrolase EC 3.2.1.30) from Mytilus edulis gonads and a homogenous protein was obtained from it by ion-exchange chromatography, gel filtration and disc electrophoresis. The apparent molecular weight, determined by gel filtration was 140,000 +/- 5,000. Two subunits were identified. The molecular weights of both subunits calculated by disc-electrophoresis were 70,000 and 75,000 + 2,000. Maximal activity for pH was 4.2. At 50 degrees C the enzyme was still active; at 60 degrees C inactive. The values of the apparent Km's proved to be 0.57 mM and 0.076 mM for p-nitrophenyl-beta-D-N-acetylglucosaminide and p-nitrophenyl-beta-D-N-acetylgalactosaminide as substrates. In the incubation of the enzyme with hyaluronic acid, chitin, deacetilated glycol-chitin and p-nitrophenyl-beta-D-glucuronide, N-acetyl-beta-D-glucosamine and glucuronic acid were not liberated. N-acetylgluconolactone and N-acetylgalactonolactone are competitive inhibitors for the enzyme.