Respuesta: Respuesta a: Estudio comparativo de la ecografía Doppler frente a la biopsia de arteria temporal en el diagnóstico de la arteritis de células gigantes / Reply: Response to: A Comparative study of doppler ultrasound against temporal artery biopsy in the diagnosis of giant cell arteritis

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Estudio comparativo de la ecografía Doppler frente a la biopsia de arteria temporal en el diagnóstico de la arteritis de células gigantes / A comparative study of doppler ultrasound against temporal artery biopsy in the diagnosis of giant cell arteritis

INTRODUCCIÓN: La arteritis de células gigantes (ACG) es una vasculitis que afecta a arterias de mediano y gran calibre. La biopsia de la arteria temporal es la técnica diagnóstica de elección. Atendiendo a la demanda asistencial que supone, pretendemos evaluar la utilidad de la ecografía Doppler en los pacientes con sospecha de ACG, su sensibilidad y especificidad como prueba diagnóstica y si puede suplir a la biopsia. MATERIALES Y MÉTODOS: Se ha realizado un estudio prospectivo de 57 pacientes entre febrero de 2015 y julio de 2016, que han sido diagnosticados con exploración mediante ecografía Doppler y biopsia de arteria temporal. RESULTADOS: Fueron incluidos 57 pacientes, de los cuales 3 fallecieron durante el seguimiento y una paciente fue excluida del estudio al negarse a la biopsia. Otros 21 pacientes fueron diagnosticados de ACG por un especialista reumatólogo tras un mínimo de 6 meses de seguimiento. Presentaron ecografía positiva 22 pacientes, de los cuales 8 fueron diagnosticados de ACG y 4 de polimialgia reumática. En nuestro estudio, la sensibilidad de la ecografía es del 42,6% y la especificidad es del 65,7%. Otros 19 pacientes presentaron biopsia positiva: todos ellos fueron diagnosticados de ACG. La biopsia presentó una sensibilidad de un 73,7% y una especificidad de un 100%. CONCLUSIONES: Según nuestro estudio, la utilidad de la ecografía es limitada y son necesarias nuevas investigaciones para determinar su papel en esta entidad

BACKGROUND: Giant cell arteritis (GCA) is a vasculitis that affects medium- and large-sized arteries. Temporal artery biopsy is the gold standard for diagnosis. In view of the high demand for temporal biopsies, the purpose of this study is to evaluate the usefulness of Doppler ultrasonography in patients with suspected giant cell arteritis, to determine its sensitivity and specificity as a diagnostic test and to determine whether it would be possible to substitute biopsy for ultrasonography. MATERIALS AND METHODS: A prospective study was undertaken including 57 patients from February 2015 to July 2016, who have undergone both ultrasonography and temporal biopsy. RESULTS: A total of 57 patients were included, 3of whom died during the follow-up, and a patient was excluded from the study when she refused to have the biopsy. Another 21 patients were diagnosed with GCA by a rheumatologist after a minimum of 6 months of follow-up and 22 patients had positive ultrasonography, 8 of whom were diagnosed with GCA and 4 with polymyalgia rheumatica. In our study, the sensitivity of ultrasonography was 42.6%, and the specificity was 65.7%. A total of 19 patients had a positive biopsy, all of them were diagnosed with GCA. In our study, the sensitivity of the biopsy was 73.7% and the specificity was 100%. CONCLUSIONS: In view of the data from our study, the usefulness of ultrasonography is questionable, and research about the role of ultrasonography in this disease should be further studied

Beneficial Effects of Bariatric Surgery-Induced by Weight Loss on the Proteome of Abdominal Subcutaneous Adipose Tissue.

Bariatric surgery (BS) is the most effective treatment for obesity and has a positive impact on cardiometabolic risk and in the remission of type 2 diabetes. Following BS, the majority of fat mass is lost from the subcutaneous adipose tissue depot (SAT). However, the changes in this depot and functions and as well as its relative contribution to the beneficial effects of this surgery are still controversial. With the aim of studying altered proteins and molecular pathways in abdominal SAT (aSAT) after body weight normalization induced by BS, we carried out a proteomic approach sequential window acquisition of all theoretical mass spectra (SWATH-MS) analysis. These results were complemented by Western blot, electron microscopy and RT-qPCR. With all of the working tools mentioned, we confirmed that after BS, up-regulated proteins were associated with metabolism, the citric acid cycle and respiratory electron transport, triglyceride catabolism and metabolism, formation of ATP, pyruvate metabolism, glycolysis/gluconeogenesis and thermogenesis among others. In contrast, proteins with decreased values are part of the biological pathways related to the immune system. We also confirmed that obesity caused a significant decrease in mitochondrial density and coverage, which was corrected by BS. Together, these findings reveal specific molecular mechanisms, genes and proteins that improve adipose tissue function after BS characterized by lower inflammation, increased glucose uptake, higher insulin sensitivity, higher de novo lipogenesis, increased mitochondrial function and decreased adipocyte size.

A Comparative Study of Doppler Ultrasound against Temporal Artery Biopsy in the Diagnosis of Giant Cell Arteritis. / Estudio comparativo de la ecografía Doppler frente a la biopsia de arteria temporal en el diagnóstico de la arteritis de células gigantes.

BACKGROUND: Giant cell arteritis (GCA) is a vasculitis that affects medium- and large-sized arteries. Temporal artery biopsy is the gold standard for diagnosis. In view of the high demand for temporal biopsies, the purpose of this study is to evaluate the usefulness of Doppler ultrasonography in patients with suspected giant cell arteritis, to determine its sensitivity and specificity as a diagnostic test and to determine whether it would be possible to substitute biopsy for ultrasonography. MATERIALS AND METHODS: A prospective study was undertaken including 57 patients from February 2015 to July 2016, who have undergone both ultrasonography and temporal biopsy. RESULTS: A total of 57 patients were included, 3of whom died during the follow-up, and a patient was excluded from the study when she refused to have the biopsy. Another 21 patients were diagnosed with GCA by a rheumatologist after a minimum of 6 months of follow-up and 22 patients had positive ultrasonography, 8 of whom were diagnosed with GCA and 4 with polymyalgia rheumatica. In our study, the sensitivity of ultrasonography was 42.6%, and the specificity was 65.7%. A total of 19 patients had a positive biopsy, all of them were diagnosed with GCA. In our study, the sensitivity of the biopsy was 73.7% and the specificity was 100%. CONCLUSIONS: In view of the data from our study, the usefulness of ultrasonography is questionable, and research about the role of ultrasonography in this disease should be further studied.

Feet sunk in molten aluminium: The burn and its prevention.

Nowadays, despite improvements in safety rules and inspections in the metal industry, foundry workers are not free from burn accidents. Injuries caused by molten metals include burns secondary to molten iron, aluminium, zinc, copper, brass, bronze, manganese, lead and steel. Molten aluminium is one of the most common causative agents of burns (60%); however, only a few publications exist concerning injuries from molten aluminium. The main mechanisms of lesion from molten aluminium include direct contact of the molten metal with the skin or through safety apparel, or when the metal splash burns through the pants and rolls downward along the leg. Herein, we report three cases of deep dermal burns after 'soaking' the foot in liquid aluminium and its evolutive features. This paper aims to show our experience in the management of burns due to molten aluminium. We describe the current management principles and the key features of injury prevention.