Molecular Identification of Human Papillomavirus DNA in Thyroid Neoplasms: Association or Serendipity?

BACKGROUND: Human papillomavirus (HPV) is recognized as the most important cofactor in the etiology of cancers of the cervix, esophagus, larynx, and nasopharynx. Experimental evidence suggests that HPV could have an oncogenic influence on thyroid follicular cells; however, to the best of our knowledge, there is no record of its role in human thyroid gland neoplasms. OBJECTIVE: The purpose of this study is to describe the frequency and the types of HPV present in neoplastic thyroid tissue by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). METHODS:  Over 157 samples were analyzed of paraffin-embedded tissue from malignant and benign thyroid tumors. All the paraffin blocks were selected consecutively from the Pathology Tissue Bank archive of the Western Medical Center. The molecular detection and typing were performed at the Molecular Microbiology Laboratory of the Biomedical Research Center, Mexican Institute of Social Security. RESULTS:  The frequency of HPV findings was 2.5% (four cases). HPV-6 was found in two cases of thyroid hyperplasia (2.5%), and HPV-33 in two cases of papillary cancer (4.6%). CONCLUSION: The presence of HPV is not frequent in thyroid neoplasms, at least in the studied population. Due to the low prevalence of this virus in our sample, it is not possible to reach conclusions. Further research is needed.

Fibrinogen and thrombin concentrations are critical for fibrin glue adherence in rat high-risk colon anastomoses.

OBJECTIVE: Fibrin glues have not been consistently successful in preventing the dehiscence of high-risk colonic anastomoses. Fibrinogen and thrombin concentrations in glues determine their ability to function as sealants, healers, and/or adhesives. The objective of the current study was to compare the effects of different concentrations of fibrinogen and thrombin on bursting pressure, leaks, dehiscence, and morphology of high-risk ischemic colonic anastomoses using fibrin glue in rats. METHODS: Colonic anastomoses in adult female Sprague-Dawley rats (weight, 250-350 g) treated with fibrin glue containing different concentrations of fibrinogen and thrombin were evaluated at post-operative day 5. The interventions were low-risk (normal) or high-risk (ischemic) end-to-end colonic anastomoses using polypropylene sutures and topical application of fibrinogen at high (120 mg/mL) or low (40 mg/mL) concentrations and thrombin at high (1000 IU/mL) or low (500 IU/mL) concentrations. RESULTS: Ischemia alone, anastomosis alone, or both together reduced the bursting pressure. Glues containing a low fibrinogen concentration improved this parameter in all cases. High thrombin in combination with low fibrinogen also improved adherence exclusively in low-risk anastomoses. No differences were detected with respect to macroscopic parameters, histopathology, or hydroxyproline content at 5 days post-anastomosis. CONCLUSIONS: Fibrin glue with a low fibrinogen content normalizes the bursting pressure of high-risk ischemic left-colon anastomoses in rats at day 5 after surgery.

Fibrinogen and thrombin concentrations are critical for fibrin glue adherence in rat high-risk colon anastomoses

OBJECTIVE: Fibrin glues have not been consistently successful in preventing the dehiscence of high-risk colonic anastomoses. Fibrinogen and thrombin concentrations in glues determine their ability to function as sealants, healers, and/or adhesives. The objective of the current study was to compare the effects of different concentrations of fibrinogen and thrombin on bursting pressure, leaks, dehiscence, and morphology of high-risk ischemic colonic anastomoses using fibrin glue in rats. METHODS: Colonic anastomoses in adult female Sprague-Dawley rats (weight, 250-350 g) treated with fibrin glue containing different concentrations of fibrinogen and thrombin were evaluated at post-operative day 5. The interventions were low-risk (normal) or high-risk (ischemic) end-to-end colonic anastomoses using polypropylene sutures and topical application of fibrinogen at high (120 mg/mL) or low (40 mg/mL) concentrations and thrombin at high (1000 IU/mL) or low (500 IU/mL) concentrations. RESULTS: Ischemia alone, anastomosis alone, or both together reduced the bursting pressure. Glues containing a low fibrinogen concentration improved this parameter in all cases. High thrombin in combination with low fibrinogen also improved adherence exclusively in low-risk anastomoses. No differences were detected with respect to macroscopic parameters, histopathology, or hydroxyproline content at 5 days post-anastomosis. CONCLUSIONS: Fibrin glue with a low fibrinogen content normalizes the bursting pressure of high-risk ischemic left-colon anastomoses in rats at day 5 after surgery. .

Neural restrictive silencer factor and choline acetyltransferase expression in cerebral tissue of Alzheimer's Disease patients: A pilot study.

Decreased Choline Acetyltransferase (ChAT) brain level is one of the main biochemical disorders in Alzheimer's Disease (AD). In rodents, recent data show that the CHAT gene can be regulated by a neural restrictive silencer factor (NRSF). The aim of the present work was to evaluate the gene and protein expression of CHAT and NRSF in frontal, temporal, entorhinal and parietal cortices of AD patient brains. Four brains from patients with AD and four brains from subjects without dementia were studied. Cerebral tissues were obtained and processed by the guanidine isothiocyanate method for RNA extraction. CHAT and NRSF gene and protein expression were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting. CHAT gene expression levels were 39% lower in AD patients as compared to the control group (p < 0.05, U test). ChAT protein levels were reduced by 17% (p = 0.02, U test). NRSF gene expression levels were 86% higher in the AD group (p = 0.001, U test) as compared to the control group. In the AD subjects, the NRSF protein levels were 57% higher (p > 0.05, U test) than in the control subjects. These findings suggest for the first time that in the brain of AD patients high NRSF protein levels are related to low CHAT gene expression levels.

Incremento del factor de crecimiento transformante B en las lesiones de vías biliares luego de la colecistectomía / Hepatic and systemic transforming growth factor B expression in post-cholecystectomy bile duct injury

Introducción: La lesión de vías biliares es un problema clínico importante, se manifiesta por activación de moléculas inflamatorias y fibrogénicas. Objetivo: Evaluar la expresión hepática y sistémica del factor de crecimiento transformante beta (TGF-ß) en la lesión de vías biliares luego de la colecistectomía. Pacientes y métodos: Grupo 1 (control), 3 sujetos sanos; grupo 2, 37 pacientes con lesión de vías biliares poscolecistectomía. Al grupo 2 se le realizó reconstrucción biliodigestiva a 8 semanas de la lesión. Se midió en suero la expresión de TGF-ß por ELISA. La biopsia hepática se sometió a análisis histopatológico e inmuhistoquímica con el anticuerpo anti-TGF-ß, se cuantificó la expresión mediante soporte digital AxioVision 4.6.3. Resultados: El promedio de los niveles séricos de TGF-ß del grupo 1 fue 904.49 ± 227.24 pg/ml contra el grupo 2 con 44 365.71 ± 20 260.61 pg/ml, 48 veces más expresión (p < 0.0001, t de Student). La actividad inflamatoria hepática fue diversa en el grupo 2, mostró grado 4 en 4 (11%); de 3, 15 (40%); de 2, 18 (49%). En el grupo 1 la actividad inflamatoria fue de grado 0. La expresión hepática del TGF-ß en el grupo 1, es de un promedio de 537.15 ± 330.96 μm2; en el grupo 2, 1 768.09 ± 1 024.50 μm2, 2.3 más expresión (p = 0.0473, t de Student). Conclusión: La expresión hepática y sistémica de TGF-ß se encontró aumentada en los pacientes con lesión de vías biliares poscolecistectomía.

Incremento del factor de crecimiento transformante B en las lesiones de vías biliares luego de la colecistectomía / Hepatic and systemic transforming growth factor B expression in post-cholecystectomy bile duct injury

Introducción: La lesión de vías biliares es un problema clínico importante, se manifiesta por activación de moléculas inflamatorias y fibrogénicas. Objetivo: Evaluar la expresión hepática y sistémica del factor de crecimiento transformante beta (TGF-ß) en la lesión de vías biliares luego de la colecistectomía. Pacientes y métodos: Grupo 1 (control), 3 sujetos sanos; grupo 2, 37 pacientes con lesión de vías biliares poscolecistectomía. Al grupo 2 se le realizó reconstrucción biliodigestiva a 8 semanas de la lesión. Se midió en suero la expresión de TGF-ß por ELISA. La biopsia hepática se sometió a análisis histopatológico e inmuhistoquímica con el anticuerpo anti-TGF-ß, se cuantificó la expresión mediante soporte digital AxioVision 4.6.3. Resultados: El promedio de los niveles séricos de TGF-ß del grupo 1 fue 904.49 ± 227.24 pg/ml contra el grupo 2 con 44 365.71 ± 20 260.61 pg/ml, 48 veces más expresión (p < 0.0001, t de Student). La actividad inflamatoria hepática fue diversa en el grupo 2, mostró grado 4 en 4 (11%); de 3, 15 (40%); de 2, 18 (49%). En el grupo 1 la actividad inflamatoria fue de grado 0. La expresión hepática del TGF-ß en el grupo 1, es de un promedio de 537.15 ± 330.96 μm2; en el grupo 2, 1 768.09 ± 1 024.50 μm2, 2.3 más expresión (p = 0.0473, t de Student). Conclusión: La expresión hepática y sistémica de TGF-ß se encontró aumentada en los pacientes con lesión de vías biliares poscolecistectomía.(AU)

P16INK4a immunohistochemistry improves the reproducibility of the histological diagnosis of cervical intraepithelial neoplasia in cone biopsies.

OBJECTIVE: Cervical cancer is currently the most frequently occurring cancer among women in Mexico. Mexican cervical cancer prevention programs have been unsatisfactory in part because the tests used to diagnose precursor lesions have poor reproducibility. The implementation of specific biomarkers may overcome these limitations. Here, we analyzed whether immunohistochemistry for p16(INK4a) could improve the reproducibility of histopathological diagnoses of cervical precancerous lesions. METHODS: Serial sections of 78 specimens were stained for H&E and p16(INK4a) and independently interpreted by three Mexican pathologists. Specimens were interpreted and categorized in two ways: 1) four diagnostic categories including negative lesions, CIN1, CIN2, and CIN3, or 2) two diagnostic categories; either lesions that do not require therapy (negative, CIN1), or lesions that require therapy (>or=CIN2). The agreement in diagnoses between pairs of observers was evaluated by kappa statistics. RESULTS: The best concordance in diagnosing was observed with two categories and p16(INK4a) staining. Interestingly, the overall diagnostic discordances of higher than one CIN grade were 26.1% for H&E and 9.20% for p16(INK4a) (P<0.001). Using four diagnostic categories, weighted kappa values for each pair of observers were 0.28, 0.15, and 0.36 for H&E and 0.34, 0.35, and 0.60 for p16(INK4a) stains. Using two diagnostic categories, kappa values were 0.36, 0.12, and 0.18 for H&E and 0.59, 0.70, and 0.59, p16(INK4a) stains. CONCLUSION: These data show that p16(INK4a) immunohistochemistry substantially improved the reproducibility of interpreting histological slides. This approach may result in more accurate diagnoses and improved clinical management of patients with cervical precancerous lesions in Mexico and elsewhere.

[Neoadjuvant treatment for locally advanced breast cancer. Comparison of two schemes based on docetaxel-epirubicin vs. 5-fluorouracil-epirubicin-cyclophosphamide]. / Tratamiento neoadyuvante del cáncer de mama localmente avanzado. Comparación de dos esquemas a base de docetaxel-epirrubicina versus 5-fluoraciloepirrubicina-ciclofosfamida.

BACKGROUND: Breast cancer is the most common type of cancer in women worldwide. In Mexico, >34% of patients are in locally advanced stages at the time of diagnosis. Neoadjuvant chemotherapy is administered to control local disease, make surgical resection possible and increase the possibility of breast tissue conservation. METHODS: We performed a double-blind, randomized clinical trial in patients with locally advanced breast cancer (stages IIB and IIIA) with two therapy schemes; 5-fluorouracil-epirubicin-cyclophosphamide (control group) vs. docetaxel-epirubicin (study group). Both were indicated in three preoperative cycles, and patients were submitted afterwards to surgery. Pathological response was measured. RESULTS: Forty one patients were included in our study. They were distributed in two homogeneous groups: 21 in the control group and 20 in the study group. Dimensional pathological response was higher in the study group than in the control one (p <0.05). Five patients in the control group and ten patients of the study group experienced complete pathological response (p <0.05). The most common secondary events were leucopenia, neutropenia and fever. Morbidity, number of lymph nodes, disease-free survival and general survival did not show significant differences between groups. No mortality was reported during a minimum follow-up of 28 months. CONCLUSIONS: Our results confirm the effectiveness of docetaxel-epirubicin to obtain complete pathological response. Neoadjuvant therapy has been shown to increase the pathological response when a taxane is added to an anthracycline. This combination presented more secondary events, but they can be effectively managed medically. Neoadjuvant docetaxel-epirubicin followed by surgery is an appropriate regimen for patients with locally advanced breast cancer.

Tratamiento neoadyuvante del cáncer de mama localmente avanzado: comparación de dos esquemas a base de docetaxel-epirrubicina versus 5-fluoraciloepirrubicina-ciclofosfamida / Neoadjuvant treatment for locally advanced breast cancer: comparison of two schemes based on docetaxel-epirubicin vs. 5-fluorouracil-epirubicin-cyclophosphamide

BACKGROUND: Breast cancer is the most common type of cancer in women worldwide. In Mexico, >34% of patients are in locally advanced stages at the time of diagnosis. Neoadjuvant chemotherapy is administered to control local disease, make surgical resection possible and increase the possibility of breast tissue conservation. METHODS: We performed a double-blind, randomized clinical trial in patients with locally advanced breast cancer (stages IIB and IIIA) with two therapy schemes; 5-fluorouracil-epirubicin-cyclophosphamide (control group) vs. docetaxel-epirubicin (study group). Both were indicated in three preoperative cycles, and patients were submitted afterwards to surgery. Pathological response was measured. RESULTS: Forty one patients were included in our study. They were distributed in two homogeneous groups: 21 in the control group and 20 in the study group. Dimensional pathological response was higher in the study group than in the control one (p <0.05). Five patients in the control group and ten patients of the study group experienced complete pathological response (p <0.05). The most common secondary events were leucopenia, neutropenia and fever. Morbidity, number of lymph nodes, disease-free survival and general survival did not show significant differences between groups. No mortality was reported during a minimum follow-up of 28 months. CONCLUSIONS: Our results confirm the effectiveness of docetaxel-epirubicin to obtain complete pathological response. Neoadjuvant therapy has been shown to increase the pathological response when a taxane is added to an anthracycline. This combination presented more secondary events, but they can be effectively managed medically. Neoadjuvant docetaxel-epirubicin followed by surgery is an appropriate regimen for patients with locally advanced breast cancer.

Usefulness of four prognostic indices in differentiated thyroid cancer.

OBJECTIVE: To report the follow up of 82 patients with differentiated thyroid cancer in order to evaluate patients' clinical and tumor characteristics of prognostic value. PATIENTS AND METHODS: A prospective and comparative study was performed in 82 patients with differentiated thyroid cancer followed for a mean of 84 months. They were classified and included into four prognostic indices (pTNM, DeGroot's, AGES and NTCTCS) stages I and II were considered as a low risk ones and stages III and IV as a high risk group. At the end of the follow up period the patients were evaluated and divided into two groups, those with tumor activity (persistence or recurrence) and those in remission. A correlation coefficient and concordance analysis between the prognostic indices was done. Sensitivity, specificity and positive and negative predictive values were calculated in accordance with the tumor activity or the remission status. RESULTS: The highest correlation coefficient (r = 0.91, CI 0.85 to 0.94) was found between NTCTCS and pTNM indexes. The highest sensitivity (78%) and specificity (85.7%) was obtained with the NTCTCS index. CONCLUSION: In our population, NTCTCS index was a good option to evaluate the prognosis of patients with differentiated thyroid cancer.

Human papillomavirus DNA and protein in tissue samples of oesophageal cancer, Barrett's oesophagus and oesophagitis.

BACKGROUND: The risk of presenting with oesophageal cancer is associated with Barrett's oesophagus, with a higher prevalence in some Asian and African countries. Human papillomavirus (HPV) DNA has been identified in oesophageal carcinomas, which share common features with cervical cancers and originate in stratified epithelium. MATERIALS AND METHODS: Sixty-eight paraffin-embedded tissue biopsies were selected from Mexican patients: 17 from oesophageal cancers, 28 from cases of Barrett's oesophagus and 23 from cases of oesophagitis. HPV protein was detected immunohistochemically and the presence and types of HPV DNA were assessed by polymerase chain reaction. RESULTS: HPV DNA-positive results were found in 26% of samples of oesophagitis, 96% of samples of Barrett's oesophagus and 88% of samples of oesophageal cancers. HPV viral types 6 and 11 were prevalent. HPV protein was detected in 41 samples (60%). CONCLUSION: Mexico has a high prevalence of HPV in premalignant and malignant oesophageal diseases compared with other countries.

[Efficacy of two Helicobacter pylori eradication treatments in children with recurrent abdominal pain]. / Eficacia de dos esquemas de erradicación de Helicobacter pylori en niños con dolor abdominal recurrente.

OBJECTIVE: To compare clinical and bacteriologic efficacy of two therapeutic trials to eradicate Helicobacter pylori (H. pylori) in two series of pediatric patients with recurrent abdominal pain (RAP). MATERIALS AND METHODS: n = 36 children with RAP-associated H. pylori infection. Age 9.8 +/- 3.1 years, 19 boys and 17 girls. Clinical and bacteriologic efficacy of two therapeutic trials was compared: Group A (1996-1997), n = 9, amoxicillin, bismuth subsalicilate, and metronidazol, and group B (1991-1993), n = 27, omeprazol, amoxicillin, and clarithromycin. Initially and post-treatment, H. pylori evaluation was carried out with upper endoscopy and gastric biopsies. For statistics, we used Student t test, chi2, Fisher test, and Kruskal-Wallis analysis of variance (alpha = 0.05). RESULTS: We found that 33/36 cases had gastritis at endoscopy, two with duodenal ulcer; nodular gastritis was observed in more than one half of total cases. All cases fulfilled histologic criteria of gastritis according to Sydney Score. In group A eradication was achieved in 28.6%, while in group B eradication rose to 77.8% (p < 0.05). In group A, 8/9 and in group B 15/27 persisted with RAP (p = 0.113). CONCLUSIONS: High frequency of abnormal and histologic findings was observed in the series presented on children with RAP and H. pylori. Eradication efficacy in the omeprazol/amoxicillin/clarithromycin group was higher when compared with bismuth subsalicilate/amoxicillin/metronidazol trial. This efficacy is comparable to pediatric series treated with the same therapeutic trial.

Concordance between premortem and postmortem diagnosis in the autopsy: results of a 10-year study in a tertiary care center.

We describe the concordance between clinical diagnoses and autopsy findings in a tertiary care center. Clinical autopsy is a useful tool for the evaluation of accuracy of the clinical diagnoses. However, autopsy rates have declined around the world recently. We randomly evaluated 500 of 2,211 autopsies performed in the department of pathology of a tertiary care hospital during a 10-year period. We computed the sensitivity, specificity, predictive values, and concordance scores between premortem and postmortem diagnoses. The autopsy diagnoses were used as the "gold standard." Four-hundred twenty-two (84.4%) of the autopsies met inclusion criteria. Diseases of the respiratory tract were diagnosed in 44.1% (186) of all autopsy reports reviewed. The higher sensitivity for diagnosis was observed in congenital anomalies (87.5%), while the higher specificity was observed in diagnosis of complications of pregnancy, childbirth, and the puerperium (98.98%). The higher concordance between premortem and postmortem diagnosis was observed with the diagnoses of neoplasms (kappa = 0.76), and for the group of complications of pregnancy, childbirth, and the puerperium (kappa = 0.76). A clinical diagnosis successfully addressed the cause of death in 40% of the cases Low values for concordance between autopsy reports and clinical diagnoses were present in most of the autopsies reports reviewed. We encourage physicians to continue considering the autopsy as an important tool that extends our understanding of diseases.

Identification of DNA sequences and viral proteins of 6 human papillomavirus types in retinoblastoma tissue.

PURPOSE: To detect DNA and proteins of human papillomavirus (HPV) in paraffin-embedded retinoblastoma (RB) tissue, to identify the viral types present and to describe a possible association between the presence of HPV and a particular form of RB. MATERIALS AND METHODS: Fifty-one samples from ocular tissues of RB patients and of six controls enucleated for non-neoplastic reasons were obtained and analyzed by Polymerase Chain Reaction (PCR) with consensus primers to detect HPV. Viral type identification was performed by Restriction Fragment Length Polymorphisms (RFLP) analysis. To corroborate the presence of HPV, immunohistochemical analysis with a polyclonal anti-HPV antibody was performed in 10 RB cases and in all controls. RESULTS: Forty-two (82.3%) of the 51 samples were HPV-positive. HPV 6 was detected in 40 cases (95.2%), HPV 33 in 16 (38.1%), HPV 11 in 4 (9.5%) and HPV 31, 35 and 51 each in one case (2.3%). All controls were negative for HPV-DNA. The positive samples were PCR-tested for HPV 16 and 18 using specific primers, and were all negative. For immunohistochemical analysis, 7 out of 10 PCR-positive samples randomly chosen were positive; all six controls were negative. CONCLUSION: No differences in the HPV type distribution were found between the groups formed according to the tumor presentation or to the mode of inheritance.

Lack of cholesterol-lowering effect of graded doses of cholestyramine in children with Alagille syndrome: a pilot study.

BACKGROUND: There is controversy about the potential risk of sustained high concentrations of cholesterol and triglyceride in patients with cholestatic chronic liver disease. However, it is currently accepted that cholesterol-lowering therapy may reduce morbidity and mortality rates in hypercholesterolemic patients without preexisting coronary heart disease, as well as in those with coronary heart disease. The objective of this study was to evaluate the effect of cholestyramine on the serum lipid profile of a group of children with Alagille syndrome and hypercholesterolemia. METHODS: Five children with Alagille syndrome and basal serum cholesterol concentrations greater than 230 mg/dL were included. Total serum cholesterol, triglyceride, low-density, and high-density lipoprotein cholesterol concentrations were measured on days 0, 10, 20, and 30 after the administration of oral cholestyramine 100, 250, and 500 mg(kg.d), respectively. Lipid fractions were reported as mean +/- 1 SD. Statistical analysis was performed with Friedman analysis of variance. RESULTS: The basal values and those of the three 10-day subsequent 100-, 250-, and 500-mg(kg.d) cholestyramine periods were as follows: total cholesterol: 327.6 +/- 77.1, 305.4 +/- 52.1, 290.6 +/- 24.1, and 320.6 +/- 32.3, respectively (P = 0.668); triglyceride: 136.4 +/- 14.6, 144.8 +/- 41.3, 161 +/- 30.9, and 165.4 +/- 40.7, respectively (P = 0.356); low-density lipoprotein cholesterol: 245.4 +/- 57.8, 239.8 +/- 48.6, 242.2 +/- 68.6, and 246.4 +/- 49.5, respectively (P = 0.782); and high-density lipoprotein cholesterol: 44.4 +/- 11.2, 41.8 +/- 12.8, 44.6.2 +/- 13.2, and 47 +/- 8.5, respectively (P = 0.431). CONCLUSION: Under the conditions of the current study, no significant effect of variable doses of cholestyramine could be demonstrated on the serum lipid profile of a series of children with Alagille syndrome. While the controversy on the potential atherogenic risk of low-density lipoprotein hypercholesterolemia in patients with chronic liver disease persists, new, prospective pharmacologic or nutritional trials are required.

Comparison of three prognostic indexes in differentiated thyroid cancer

Se analizaron los datos clínicos y el coeficiente de correlación entre tres escalas pronósticas (TNM, AGES y la escala de DeGroot) en 82 pacientes con cáncer diferenciado de tiroides (edad promedio: 41.7 ñ 16.6 DE años, relación de sexo F8:M1). Setenta y ocho pacientes (95.1 por ciento) presentaron carcinoma papilar y cuatro (4.8 por ciento) cáncer folicular; cinco (6 por ciento) tuvieron tirotoxicosis. Las complicaciones quirúrgicas fueron: parálisis de cuerda vocal siete casos (8.4 por ciento), hipoparatiroidismo 10(12.2 por ciento) y ambas en cuatro (4.8 por ciento). No hubo complicaciones con la cirugía tiroidea limitada más frecuentemente utilizada (tiroidectomía subtotal y hemitiroidectomía). Al cabo de 54.5 ñ 44.5 meses un paciente había fallecido de cáncer de tiroides (1.2 por ciento) y dos casos (2.4 por ciento) tenían actividad tumoral. Se observó correlación positiva, así como concordancia entre las tres escalas pronósticas analizadas (k=0.2281, p=0.001). La prevalencia de cáncer folicular fue más baja que la informada en otros estudios. Se sugiere que las tres escalas analizadas tienen un valor pronóstico similar en el cáncer diferenciado de tiroides

Previene la octreótida el daño renal por isquemia y reperfusión? / Prevents octreotide the renal damage caused by ischemia and reperfusion?

La finalidad de este estudio fue valorar la utilidad de la octreótida para la prevención del daño renal por isquemia y reperfusión. Con esta finalidad se realizó un estudio experimental con 26 ratas Sprague Dawley, con las que se formaron tres grupos: el grupo A normal sin isquemia renal, el grupo B con isquemia sin tratamiento, y el grupo C con isquemia y con octreótida que se administró siete días del suceso isquémico a la dosis de 100 µg/m2 por vía subcutánea. Se realizó laparotomía y se identificaron ambas arterias renales, tras lo cual se produjo isquemia durante 40 minutos. Al finalizar este plazo se retiraron las pinzas vasculares y se reperfundió el riñón durante 30 minutos. Se tomó una muestra de sangre para analizar las concentraciones de creatinina, y se realizó nefroureterectomía bilateral para estudio histopatológico y para valorar el daño renal. En el grupo testigo la creatinina promedio fue de 34.3 µmol/dL, y el estudio de histopatología no demostró lesión. En el grupo B se encontró elevación de la creatinina en cinco ratas, y en el C esto sucedió sólo en una (p < 0.14). El daño histológico fue menor en el grupo C y mayor en el B (sin octreótida) (p < 0.03). Cabe concluir que la octreótida puede ser útil para la prevención del daño renal por isquemia y reperfusión

Síndrome de Budd-Chiari / Budd-Chiari syndrome: a five cases report

Se describen cinco niños con síndrome de Budd-chiari, observados en un período de tres años, con estudio histopatologíco confirmatorio. Su edad varió de 39 días a 15 años. El cuadro clínico se caracterizó por: ascitis y hepatomegalia, dolor abdominal y sangrado de tubo digestivo. Las pruebas de función hepática no mostraron anomalías importantes excepto la albúmina sérica que estuvo disminuida en cuatro de ellos; el ultrasonido resultó de utilidad diagnóstica en dos pacientes. Se estableció la causa del síndrome en dos niños, uno con hemoglobinuria paroxística nocturna y otro con neuroblastoma metastásico al hígado. Cuatro de los pacientes fallecieron; en uno se reconfirmó el diagnóstico en el estudio post mortem. El pronóstico dependerá de la oportunidad del diagnóstico, del origen de la enfermedad y del tratamiento oportuno que se establezca