Chronic hepatitis C infection: An independent risk factor for subclinical atheromatosis. / Infección crónica por el virus de la hepatitis C: un factor de riesgo independiente para la ateromatosis subclínica.

BACKGROUND: The association between subclinical atheromatosis and chronic hepatitis C virus (HCV) infection is unknown but is relevant now that antivirals are improving the survival of patients with the infection. OBJECTIVES: To determine whether HCV is an independent risk factor for subclinical atheromatosis and to analyse the changes in lipid profiles according to viral RNA levels and hepatic fibrosis. PATIENTS AND METHODS: We conducted an observational, cross-sectional study that included 102 HCV-positive patients and 102 HCV-negative patients with parity in terms of sex and age, with no history of cardiovascular or kidney disease or diabetes. Atheromatosis (the presence of atheromatous plaques) and the carotid intima-media thickness (CIMT) were assessed using ultrasonography of the carotid and femoral arteries. RESULTS: There was a greater presence of atheromatosis in any vascular territory in HCV-positive patients than in the patients without infection (58.8% vs. 28.4%, p<.0001). In the multivariate analysis, the factors significantly associated with atheromatosis included HCV infection (OR, 14.37 [5.5-37.3]; p<.001), age (OR, 1.12 [1.1-1.2]; p<.001), male sex (OR, 4.32 [1.9-9.5]; p<.001) and the triglyceride/HDL cholesterol coefficient (TG/HDL-indirect indicator of insulin resistance) (OR, 1.34 [1.1-1.6]; p=.007). The HCV-positive patients with atheromatous plaques had a higher TG/HDL coefficient but no significant differences in terms of the viral load or degree of hepatic fibrosis and with a 'low risk' lipid profile. CONCLUSIONS: HCV infection is an independent risk factor for subclinical atheromatosis. Systemic arterial ultrasonography for this population improves the cardiovascular risk assessment beyond lipid profile abnormalities and the risk calculation using SCORE tables.

Telomeric repeat factor 1 protein levels correlates with telomere length in colorectal cancer.

BACKGROUND: colorectal cancer is the third cancer cause of death in Spain. It is important to investigate new tumoral markers for early diagnosis, disease monitoring and prevention strategies. Telomeres protect the chromosome from degradation by nucleases and endto-end fusion. The progressive loss of the telomeric ends of chromosomes is an important mechanism in the timing of human cellular aging. Telomeric Repeat Factor 1 (TRF1) is a protein that binds at telomere ends. PURPOSE: to measure the concentrations of TRF1 and the relationships among telomere length, telomerase activity, and TRF1 levels in tumor and normal colorectal mucosa. METHOD: from normal and tumoral samples of 83 patients who underwent surgery for colorectal cancer we analyzed TRF1 protein concentration by Western Blot, telomerase activity, by the fluorescent-telomeric repeat amplification protocol assay and telomere length by Southern Blot. RESULTS: high levels of TRF1 were observed in 68.7% of tumor samples, while the majority of normal samples (59%) showed negative or weak TRF1 concentrations. Among the tumor samples, telomere length was significantly associated with TRF1 protein levels (p = 0.023). CONCLUSIONS: a relationship was found between telomere length and TRF1 abundance protein in tumor samples, which means that TRF1 is an important factor in the tumor progression and maybe a diagnostic factor.

Telomerase activity and telomere length in the colorectal polyp-carcinoma sequence.

OBJECTIVE: The role of telomerase activity and telomere length in the adenoma-carcinoma sequence of colon carcinogenesis has not been well established. The objective of this study was to determine telomerase activity and telomere length patterns in patients with adenomatous polyps either associated or not with colorectal cancer, as well as the role of telomeric instability in the adenoma-carcinoma sequence. PATIENTS AND METHODS: We included in the study 14 patients who underwent surgery for colorectal cancer and/or polyps. In 6 of these patients fresh samples of tumor tissue, polyps, and normal mucosa were obtained; in the 8 remaining cases, we collected only polyps and normal mucosa. We used the fluorescent-telomeric repeat amplification protocol assay (TRAP-F) to determine telomerase activity and telomere length using Southern-blot testing. RESULTS: Telomerase activity was detected in 86% of polyps and 50% of associated normal mucosa. Mean telomerase activity in polyp tissue was 5.85; in the normal mucosa it was 0.58 TPG. Mean telomere length was 6.78 Kbp and 7.78, respectively. Polyps in patients without synchronous cancer had a telomerase activity that was significantly higher (9.4) than in those with cancer (1.1). CONCLUSIONS: Telomerase activity increases in the colorectal adenoma-carcinoma sequence, concurrently with a decrease in telomere length. The presence of synchronous cancer modifies telomerase activity in polyps.

Actividad de la telomerasa y longitud del telómero en la secuencia pólipo-carcinoma colorrectal / Telomerase activity and telomere length in the colorectal polyp-carcinoma sequence

Objetivo: el papel de la actividad de la telomerasa y la longitud del telómero en la secuencia adenoma-carcinoma de la carcinogénesis colónica no ha sido bien establecido. El objetivo fue determinar el comportamiento de la actividad de la telomerasa y la longitud del telómero en pacientes con pólipos adenomatosos asociados o no a cáncer colorrectal y conocer el papel de la inestabilidad telomérica en la secuencia adenoma-carcinoma. Pacientes y métodos: se estudiaron 14 pacientes intervenidos de cáncer colorrectal y/o pólipos. En 6 de ellos se recogieron muestra colónica tumoral, pólipo y muestra de mucosa colónica normal, mientras que en los 8 restantes se tomaron muestras de pólipos y mucosa normal. Se determinó la actividad de la telomerasa mediante el protocolo de amplificación de repeticiones teloméricas (TRAP-F) y la longitud del telómero por Southern-blot. Resultados: se detectó actividad de la telomerasa en un 86% de los pólipos y en un 50% de sus correspondientes mucosas normales. La actividad de la telomerasa en los pólipos fue de 5,85 y en la mucosa normal 0,58 TPG. La longitud del telómero fue 6,78 kbp y 7,78 respectivamente. Se observó que los pólipos de pacientes que no presentaban cáncer sincrónico mostraban una actividad de telomerasa significativamente superior (9,4) a aquellos con cáncer (1,1) (p = 0,02). Conclusiones: existe una actividad de la telomerasa creciente en la secuencia adenoma-carcinoma en la mucosa colónica así como una disminución de la longitud del telómero. La presencia de cáncer sincrónico modifica la actividad de telomerasa del pólipo(AU)

Objective: the role of telomerase activity and telomere length in the adenoma-carcinoma sequence of colon carcinogenesis has not been well established. The objective of this study was to determine telomerase activity and telomere length patterns in patients with adenomatous polyps either associated or not with colorectal cancer, as well as the role of telomeric instability in the adenoma-carcinoma sequence. Patients and methods: we included in the study 14 patients who underwent surgery for colorectal cancer and/or polyps. In 6 of these patients fresh samples of tumor tissue, polyps, and normal mucosa were obtained; in the 8 remaining cases, we collected only polyps and normal mucosa. We used the fluorescent-telomeric repeat amplification protocol assay (TRAP-F) to determine telomerase activity and telomere length using Southern-blot testing. Results: telomerase activity was detected in 86% of polyps and 50% of associated normal mucosa. Mean telomerase activity in polyp tissue was 5.85; in the normal mucosa it was 0.58 TPG. Mean telomere length was 6.78 Kbp and 7.78, respectively. Polyps in patients without synchronous cancer had a telomerase activity that was significantly higher (9.4) than in those with cancer (1.1). Conclusions: telomerase activity increases in the colorectal adenoma-carcinoma sequence, concurrently with a decrease in telomere length. The presence of synchronous cancer modifies telomerase activity in polyps(AU)

Modelo experimental de cáncer colorrectal / Experimental colorectal cancer model

No disponible

[Obstructive colitis: analysis of 7 patients]. / Colitis obstructiva: un análisis de 7 enfermos.

The term "obstructive colitis" is defined by the presence of ulcero-inflammatory lesions in a colonic area proximal to a potentially obstructive lesion. Seven cases retrospectively identified during a 5-year period are here reported. They illustrate the clinico-pathological spectrum of this entity. Most patients were women, with a mean age of 66 years and with history of chronic underlying disease (diabetes mellitus and arterial hypertension). Abdominal distension and pain, as well as acute constipation were the main clinical symptoms. An adenocarcinoma predominantly located at the rectosigmoidal region accounted for the obstructive nature in 100% of cases. Macroscopically the colitis area was moderately dilated and there were single or confluent ulcers in the luminal surface. Characteristically, there was always a transitional preserved area between the obstruction and the colitis area. Microscopically, the mucosa was totally replaced by a granulation tissue with a relevant inflammatory infiltrate involving up to the muscularis propria. The cytometric study revealed and increase in the cell cycle (S-phase) and proliferation index, at the level of the obstructive lesion, with marked aneuploidy in cases with advanced neoplastic invasion. The role of mural hypoperfusion with localized ischemia in the pathogenesis is discussed. The similarities with other colonic inflammatory diseases are emphasized.

Primary gastric plasmacytoma of rapid growth presenting with upper gastrointestinal bleeding.

We report a new case of primary gastric plasmacytoma. The presenting symptoms was upper gastrointestinal bleeding, and the diagnosis was made preoperatively by means of gastroscopically obtained biopsy material. The demonstration of a single type of IgA-kappa immunoglobulin in plasma cells infiltrating the gastric antrum is considered conclusive evidence of its neoplastic nature. Endoscopically, the gastric plasmacytoma progresses from a benign antral ulcer (0.5 cm in diameter) to an ulcerated mass (7 cm in diameter) in an 8-wk period, suggesting rapid tumoral growth of a kind not described in the revised literature.

[Eosinophilic gastroenteritis: review of the published cases in Spain and comparison with foreign literature]. / Gastroenteritis eosinofílica: revisión de los casos publicados en España y comparación con la literatura extranjera.

We review the Spanish literature on Eosinophilic Gastroenteritis. The data are compared with those of several foreign series. Abdominal pain, vomiting, diarrhea, and abdominal distension due to ascites were the most frequent clinical manifestations. In our country most cases had ascites. A history of allergy was reported by less than on half of patients. Peripheral eosinophilia with otherwise normal laboratory findings is the rule. However, peripheral eosinophilia was not essential for diagnosis, since it was absent in one quarter of patients. Small intestine barium studies were abnormal almost always, but the findings were not specific. The diagnosis is based on the endoscopic and/or peroral gastrointestinal biopsy. However, a false negative diagnosis can occur, since the disease can take up a patchy distribution, or a more profound involvement of the gastrointestinal layers without mucosal disease. The treatment of choice is corticosteroids, with a spectacular therapeutic response. Complete studies with biopsies taken at multiple levels of the gastrointestinal tract, are necessary to ascertain the extent and depth of the disease. The etiology is unknown, and although allergy causes can be elicited in some cases, they are absent in the majority of them. We encounter no essential differences in the eosinophilic gastroenteritis characteristics in our country in relation to other countries.

[Intestinal neurofibromatosis and recurrent digestive hemorrhage]. / Neurofibromatosis intestinal y hemorragia digestiva recurrente.

A case is presented of a woman with Von Recklinghausen's neurofibromatosis and intestinal affectation manifested as recurrent episodes of gastrointestinal bleeding. The literature is commented and a review is made of both the clinical manifestations and evolution of gastrointestinal affectation in this disease which, with other alterations, configure the ample pathologic spectrum that characterizes Von Recklinghausen's neurofibromatosis.