A comparative study on the quality of in vivo labeled red blood cell radionuclide ventriculography images employing different freeze-dried reagents.

Radionuclide ventriculography or Multi Gated Acquisition (MUGA) employing [ 99m Tc]Technetium red blood cell (RBC) labeling is considered the gold standard for cardiotoxicity assessments in cancer patients undergoing chemotherapy. This in-vivo RBC labeling technique involves the reduction of [ 99m Tc]Technetium by the stannous chloride present in freeze-dried reagent kits, with the pyrophosphate kit (PYP) being the most employed for this purpose. The literature, however, describes diethylenetriaminepentaacetic acid (DTPA) as an alternative to PYP, although a lack of comparative data from MUGA images between both reagents is noted. A retrospective cross-sectional observational study was conducted at the Brazilian National Cancer Institute Nuclear Medicine Service concerning 80 randomized MUGA images, 20 obtained employing DTPA between 2020 and 2023 and 60 obtained employing PYP between 2017 and 2020, applying the mean count per pixel (ct/pixel) and heart background (C/F) ratios as quality image indicators. Although the heart ct/pixel ratio was statistically lower in the DTPA images compared with PYP ( P  = 0.02), the C/F ratio was statistically similar when comparing both radiopharmaceuticals ( P  = 0.697). A semi-quantitative analysis of MUGA images obtained with DTPA and PYP indicates similar image quality, supporting the use of DTPA as an alternative to PYP without compromising diagnostic interpretations.

The influence of interstitial cells of Cajal density in the outcomes of pyeloplasty in adults: A prospective analysis.

PURPOSE: To evaluate if the density of interstitial cells of Cajal (ICC) in the ureteropelvic junction (UPJ) influences the outcomes of pyeloplasty in adults. METHODS: Twenty-three patients with the diagnosis of ureteropelvic junction obstruction (UPJO) that underwent laparoscopic dismembered pyeloplasty were included. ICC density was measured using immunohistochemistry reaction for c-KIT expression in the resected UPJ segment. Pyeloplasty outcome was evaluated by patient self-report pain, urinary outflow using DTPA renogram and hydronephrosis assessment using ultrasound (US) at 12 months of follow-up. A logistic regression analysis was performed to assess the association of pyeloplasty outcomes and ICC density. RESULTS: Low, moderate, and high ICC density were present in 17.4%, 30.4%, and 52.2% of the patients, respectively. Complete pain resolution was observed in 100%, 85.7%, and 75% of patients with low, moderate and high ICC density, respectively (p = 0.791). DTPA renogram improved in 75%, 85.7%, and 91.7% of patients with low, moderate and high ICC density, respectively (p = 0.739). Hydronephrosis improved in 25%, 85.7%, and 91.7% of patients with low, moderate and high ICC density, respectively (p = 0.032). CONCLUSIONS: Patients with high ICC density have a significant amelioration of hydronephrosis after pyeloplasty. However, ICC density is not associated with functional outcomes.

Potentially toxic elements in iron mine tailings: Effects of reducing soil pH on available concentrations of toxic elements.

Tailings from iron mining are characterized by high concentrations of iron and manganese oxides, as well as high pH values. With these characteristics, most of the potentially toxic elements (PTE) contained in the tailings are somewhat unavailable. The aim of the present study was to evaluate how a reduction in the pH of iron mine tailings may affect PTE availabilities. The tailings were collected on the banks of the Gualaxo do Norte River (Mariana, MG, Brazil), one of the main areas impacted by the rupture of the Fundão Dam (Barragem de Fundão). A completely randomized experimental design was used, including five pH values (6.4, 5.4, 4.3, 3.7, and 3.4) and five replications. The concentrations of the PTE (Ba, Cr, Cd, Co, Cu, Fe, Mn, Pb, Ni, and Zn) were determined after extraction following different methodologies: USEPA 3051A, DTPA, Mehlich-1, Mehlich-3, and distilled water. A comparison of the available concentrations of the elements in the tailings with those in a soil not impacted by tailings shows that Cr, Cd, Cu, Fe, Mn, Ni, Ba, and Co were higher in the soil impacted by the tailings. The different methods used for evaluating the availability of PTE in the tailings at various pH exhibited the following decreasing order in relation to the quantity extracted: Mehlich-3 > Mehlich-1 > DTPA > distilled water. However, regarding sensitivity to change in pH, the order was DTPA > water > Mehlich-1 > Mehlich-3. The increases in the concentrations of PTE due to the reduction in the pH of the tailings did not lead to concentrations that exceed the limits of Brazilian regulations. The DTPA extractant exhibited higher coefficients of correlation between the PTE concentrations and the pH of the tailings, proving to be suitable for use in areas affected by the deposition of iron mine tailings.

Exploiting the extemporaneousness of radiopharmaceuticals: Radiolabeling stability under diverse conditions.

Radiopharmaceuticals are radioactive drugs, with a very short shelf life, in most of the cases. The number of proceedings using radiopharmaceuticals increases each day worldwide and for many countries the price of radiopharmaceuticals can represent a limitation in the offer of this drug for more patients. Nonetheless, the shortage of important radionuclides is a serious issue and may also affect the use and distribution of these drugs for more patients globally, especially in low and middle income countries. In this direction, the need to avoid waste of these drugs is crucial. In this study we have evaluated the stability of two radiopharmaceuticals (MDP and DTPA) under different conditions in order to propose the extension of shelf life. The results showed that is possible to have stable radiopharmaceuticals (both MDP and DTPA) even 24hs post labeling process when storage properly. The data may represent an advance in the field of Radiopharmacy, providing news perspectives for radiopharmaceuticals shelf life.

Non-surgical management of vesicoureteral junction obstruction: a case report.

OBJECTIVE: To report the case of a pediatric patient with bilateral hydronephrosis due to vesicoureteral junction obstruction (VUJO) that was treated non-surgically and to discuss the approach of this anomaly. CASE DESCRIPTION: A 25-month-old boy was referred without complaints for consultation due to prenatal ultrasound showing kidneys with cysts. He was under antibiotic prophylaxis. No family history of kidney disease and/or inherited disorders was reported. Renal ultrasound (RUS) at 2 days of life showed bilateral hydronephrosis, thus ruling out the possibility of kidney cystic disease. Dynamic renal scintigraphy (DTPA) showed marked retention of the marker in the pyelocaliceal system bilaterally, with little response to diuretic drug. He was maintained under antibiotic prophylaxis, when a new RUS showed bilateral ureteral dilatation, abrupt stenosis in the ureterovesical transition region (0.2 cm caliber), moderate bilateral hydronephrosis, and slight renal cortical thickness, confirming the diagnosis of VUJO. At 2 years and 10 months of age, DTPA showed hydronephrosis and ureteral stasis in both kidneys secondary to stenosis at the vesicoureteral junction (VUJ) level, with preservation of kidney function and slow degree of emptying. We opted for a non-surgical approach. RUS at 10 years of age showed significant improvement of all parameters, with ureteral transverse diameter of 9 mm, preserved VUJ, and age-appropriate bilateral kidney development. COMMENTS: VUJO is a major cause of prenatal hydronephrosis and can trigger a deterioration of kidney function. Its treatment is still controversial but should take into account the importance of clinical follow-up and serial imaging evaluation.

Cuidado em saúde em adultos com hipertensão arterial autorreferida no Brasil segundo dados da Pesquisa Nacional de Saúde, 2013 / Health care in adults with self-reported hypertension in Brazil according to the National Health Survey, 2013

RESUMO: Objetivo: Descrever indicadores de cuidado em saúde em adultos com hipertensão arterial autorreferida no Brasil, segundo características sociodemográficas. Métodos: Foram utilizados dados da Pesquisa Nacional de Saúde 2013, estudo transversal de base populacional, referentes ao cuidado em saúde com a hipertensão arterial autorreferida quanto ao uso de serviços de saúde. As prevalências e seus intervalos de confiança de 95% (IC95%) foram calculados segundo sexo, idade, raça/cor e escolaridade, representativos para Brasil e grandes regiões. Resultados: A hipertensão arterial foi referida por 21,4% (IC95% 20,8 - 22,0) dos entrevistados, sendo maior em mulheres e em pessoas sem instrução e com ensino fundamental incompleto. Dentre estes, 45,9% (IC95% 44,0 - 47,7) referiram ter recebido assistência médica pela última vez em uma Unidade Básica de Saúde; 81,4% (IC95% 80,1 - 82,7) referiram tomar medicamentos para a hipertensão; e 92,0% (IC95% 91,2 - 92,8) referiram ter realizado todos os exames complementares que foram solicitados. Conclusão: É importante conhecer a cobertura e o acesso aos serviços de saúde para o cuidado aos indivíduos com hipertensão arterial, de modo a avançar na qualidade da assistência prestada e reduzir as desigualdades identificadas.

ABSTRACT: Objective: To describe health care indicators in adults with self-reported hypertension in Brazil, according to socio-demographic characteristics. Methods: Data from the National Health Survey 2013, a cross-sectional population-based study, about health care of self-reported hypertension and health services were used. Prevalence and 95% confidence intervals (95%CI) were calculated for sex, age, race/color skin and schooling levels, representing Brazil and major regions. Results: Hypertension was reported by 21.4% (95%CI 20.8 - 22.0) of respondents, being higher in women and in people without instruction and incomplete middle school. Among these, 45.9% (95%CI 44.0 - 47.7) reported having received medical care for the last time in a basic health unit; 81.4% (95%CI 80.1 - 82.7) reported taking medication for high blood pressure; and 92.0% (95%CI 91.2 - 92.8) reported having taken all requested complementary examinations. Conclusion: It is important to know the coverage and access to health services for the care of patients with hypertension, in order to improve care quality and reduce identified inequalities.

Is there a role for peptide receptor radionuclide therapy in medullary thyroid cancer?

BACKGROUND: Medullary thyroid cancer (MTC) is a rare but potentially life-threatening disease with limited therapeutic options. As a neuroendocrine tumor, MTC expresses somatostatin receptors, and therefore, somatostatin-labeled radiopharmaceuticals could be used to treat patients with MTC. OBJECTIVE: The aims of this study were to evaluate tumor shrinkage after Lu-DOTATATE treatment, to analyze the impact on quality of life as accessed by the SF-36 questionnaire, and to demonstrate a possible prognostic role for In-DTPA-octreotide uptake in patients with MTC. PATIENTS AND METHODS: Patients with progressive MTC underwent evaluation using In-DTPA-octreotide. Patients who demonstrated In-DTPA-octreotide uptake were treated with 4 cycles of 200 mCi of Lu-DOTATATE and were evaluated using CT scans over 8 to 12 months of treatment. RESULTS: Of the 16 patients initially enrolled, 9 (56.25%) had lesions that were observed in the In-DTPA-octreotide scans and were eligible for therapy with Lu-DOTATATE. Three patients had a partial response, 3 patients were classified as having stable disease and, 1 patient had a progressive disease. All responders indicated improvement in quality of life 6 to 12 months after therapy. CONCLUSIONS: Treatment with Lu-DOTATATE seems to be an alternative therapy for somatostatin receptor-positive tumors, with very mild adverse effects and quality-of-life improvement, at least during a short-term period. Further studies are needed to determine long-term benefits and to identify which patients are more likely to respond to this modality of therapy.

Exposure of free-living jaguars to Toxoplasma gondii, Neospora caninum and Sarcocystis neurona in the Brazilian Pantanal / Exposição de onças-pintadas a Toxoplasma gondii, Neospora caninum e Sarcocystis neurona no Pantanal brasileiro

Toxoplasma gondii, Neospora caninum and Sarcocystis neurona are related apicomplexan parasites that cause reproductive and neurological disorders in a wide range of domestic and wild animals. In the present study, the immunofluorescence antibody test (IFAT) was used to investigate the presence of antibodies against T. gondii, N. caninum and S. neurona in the sera of 11 free-living jaguars (Panthera onca) in two protected areas in the Pantanal region of Mato Grosso state, Brazil. Ten jaguars (90.9%) showed seropositivity for T. gondii, eight (72.7%) for S. neurona, and seven (63.6%) for N. caninum antigens. Our findings reveal exposure of jaguars to these related coccidian parasites and circulation of these pathogens in this wild ecosystem. To the best of our knowledge, this is the first serological detection of N. caninum and S. neurona in free-living jaguars.

Toxoplasma gondii, Neospora caninum e Sarcocystis neurona são coccídios relacionados responsáveis por causar desordens reprodutivas e neurológicas em uma ampla variedade de animais domésticos e selvagens. No presente estudo, a Reação de Imunofluorescência Indireta (RIFI) foi utilizada para investigar a presença de anticorpos contra T. gondii, N. caninum e S.neurona em soros de 11 onças-pintadas de vida livre (Panthera onca), provenientes de duas áreas protegidas na região do Pantanal do Estado de Mato Grosso, Brasil. Dez (90,9%), sete (63,6%) e oito (72,7%) onças amostradas foram soropositivas para T. gondii, N. caninum e S. neurona, respectivamente. Os resultados indicam a exposição a esses coccídios relacionados entre as onças-pintadas e a circulação ambiental desses patógenos nesse ecossistema selvagem. Este é o primeiro relato da detecção sorológica de N. caninum e S. neurona em onças-pintadas de vida livre.

Exposure of free-living jaguars to Toxoplasma gondii, Neospora caninum and Sarcocystis neurona in the Brazilian Pantanal / Exposição de onças-pintadas a Toxoplasma gondii, Neospora caninum e Sarcocystis neurona no Pantanal brasileiro

Toxoplasma gondii, Neospora caninum and Sarcocystis neurona are related apicomplexan parasites that cause reproductive and neurological disorders in a wide range of domestic and wild animals. In the present study, the immunofluorescence antibody test (IFAT) was used to investigate the presence of antibodies against T. gondii, N. caninum and S. neurona in the sera of 11 free-living jaguars (Panthera onca) in two protected areas in the Pantanal region of Mato Grosso state, Brazil. Ten jaguars (90.9%) showed seropositivity for T. gondii, eight (72.7%) for S. neurona, and seven (63.6%) for N. caninum antigens. Our findings reveal exposure of jaguars to these related coccidian parasites and circulation of these pathogens in this wild ecosystem. To the best of our knowledge, this is the first serological detection of N. caninum and S. neurona in free-living jaguars.

Toxoplasma gondii, Neospora caninum e Sarcocystis neurona são coccídios relacionados responsáveis por causar desordens reprodutivas e neurológicas em uma ampla variedade de animais domésticos e selvagens. No presente estudo, a Reação de Imunofluorescência Indireta (RIFI) foi utilizada para investigar a presença de anticorpos contra T. gondii, N. caninum e S.neurona em soros de 11 onças-pintadas de vida livre (Panthera onca), provenientes de duas áreas protegidas na região do Pantanal do Estado de Mato Grosso, Brasil. Dez (90,9%), sete (63,6%) e oito (72,7%) onças amostradas foram soropositivas para T. gondii, N. caninum e S. neurona, respectivamente. Os resultados indicam a exposição a esses coccídios relacionados entre as onças-pintadas e a circulação ambiental desses patógenos nesse ecossistema selvagem. Este é o primeiro relato da detecção sorológica de N. caninum e S. neurona em onças-pintadas de vida livre.

Effects of nitric oxide synthase inhibition on glutamine action in a bacterial translocation model.

Glutamine may be a precursor for NO synthesis, which may play a crucial role in bacterial translocation (BT). The goal of the present study was to investigate the potential effects of glutamine on BT and the immunological response in an experimental model of NO synthase inhibition by NG-nitro-L-arginine methyl ester (l-NAME). Mice were randomly assigned to four groups: sham; intestinal obstruction (IO); IO+500 mg/kg per d glutamine (GLN); IO+GLN plus 10 mg/kg per d l-NAME (GLN/LN). The groups were pretreated for 7 d. BT was induced by ileal ligation and was assessed 18 h later by measuring the radioactivity of 99mTc-Escherichia coli in the blood and organs. Mucosal damage was determined using a histological analysis. Intestinal permeability (IP) was assessed by measuring the levels of 99mTc-diethylenetriaminepentaacetic acid in the blood at 4, 8 and 18 h after surgery. IgA and cytokine concentrations were determined by ELISA in the intestinal fluid and plasma, respectively. BT was increased in the GLN/LN and IO groups than in the GLN and sham groups. IP and intestinal mucosa structure of the sham, GLN and GLN/LN groups were similar. The GLN group had the highest levels of interferon-γ, while IL-10 and secretory IgA levels were higher than those of the IO group but similar to those of the GLN/LN group. The present results suggest that effects of the glutamine pathway on BT were mediated by NO. The latter also interferes with the pro-inflammatory systemic immunological response. On the other hand, IP integrity preserved by the use of glutamine is independent of NO.

2,4-Dichlorophenoxyacetic acid (2,4-D) degradation promoted by nanoparticulate zerovalent iron (nZVI) in aerobic suspensions.

Reactive species generated by Fe(0) oxidation promoted by O2 (catalyzed or not by ligands) are able to degrade contaminant compounds like the herbicide 2,4-dichlorophenoxyacetic acid. The degradation of 2,4-D was influenced by the concentrations of zero valent iron (ZVI) and different ligands, as well as by pH. In the absence of ligands, the highest 2,4-D degradation rate was obtained at pH 3, while the highest percentage degradation (50%) was achieved at pH 5 after 120 min of reaction. Among the ligands studied (DTPA, EDTA, glycine, oxalate, and citrate), only ethylenediaminetetraacetic acid (EDTA) and diethylenetriaminepentaacetic acid (DTPA) significantly enhanced oxidation of 2,4-D. This increase in oxidation was observed at all pH values tested (including neutral to alkaline conditions), indicating the feasibility of the technique for treatment of contaminated water. In the presence of EDTA, the oxidation rate was greater at pH 3 than at pH 5 or 7. Increasing the EDTA concentration increased the rate and percentage of 2,4-D degradation, however increasing the Fe(0) concentration resulted in the opposite behavior. It was found that degradation of EDTA and 2,4-D occurred simultaneously, and that the new methodology avoided any 2,4-D removal by adsorption/coprecipitation.

Prevalencia de anticuerpos anti-toxina pertussis en puérperas, cordones y lactantes según antecedente de vacunación anti-pertussis en el embarazo / Pertussis toxin antibodies prevalence in pregnant women, cords and infants according to pertussis vaccination during pregnancy

INTRODUCCIÓN La coqueluche es una enfermedad prevenible que afecta a todos los grupos etarios. El aumento de la morbimortalidad en lactantes evidenciado en los últimos años obliga a analizar nuevas estrategias preventivas. Argentina implementó en 2012 la vacunación de embarazadas. OBJETIVOS Evaluar la seroprevalencia de anticuerpos anti-toxina pertussis (ac-TP) en puérperas y cordones según hayan o no recibido vacuna acelular durante el embarazo. Evaluar en hijos de madres vacunadas (HMV) la persistencia de anticuerpos maternos hasta los dos meses. MÉTODOS Se determinaron ac-TP mediante ensayo de ELISA. Se evaluaron 88 muestras pareadas P/C en madres vacunadas (MV) con dTpa, y se compararon con 112 pares P/C de madres no vacunadas (MnoV). Se calculó la media geométrica de la concentración (MGC) de anticuerpos y la razón de la MGC cordón/puérpera para evaluar el pasaje transplacentario (PTP). Se obtuvieron muestras de 36 HMV al mes y 32 a los 2 meses de vida (pre-vacunación). RESULTADOS La MGC IgG anti-TP fue 41,14 UE/mL en MV y 10,73 UE/mL en MnoV (p<0,0001). En sus cordones fue de 57,2 y 12,2 UE/mL (p<0,0001), respectivamente. Se detectaron niveles por debajo del protector (5 UE/mL) en el 2,2% de las MV y en el 17,85% de las MnoV (p=0,0009). Los cordones mostraron niveles <5 en el 2,2% y 12,5% de los casos, respectivamente (p=0,008). El PTP fue de 1,39 en MV y 1,14 en MnoV. El 97,8% de los cordones de MV presentaron títulos >5, y el 83%, >20 UE/mL, mientras que en C de MnoV hubo un 84% >5 y un 22,5% >20 UE/mL. En HMV la MGC IgG PT fue 17,7 EU/ml al mes y 11,6 UE/ml a los 2 meses de vida (69% y 79% menor a niveles en cordón de MV, respectivamente). DISCUSIÓN Los niveles de anticuerpos anti-TP son significativamente mayores en puérperas y cordones del grupo de MV. En HMV los anticuerpos descendieron rápidamente, pero mantuvieron niveles protectores hasta los 2 meses. Estos datos sustentarían la estrategia de vacunación en embarazadas para prevenir la morbimortalidad por coqueluche en lactantes pequeños.

Changes in the sorption, desorption, distribution, and availability of copper, induced by application of sewage sludge on Chilean soils contaminated by mine tailings.

The effect of mine tailings and sewage sludge was evaluated on sorption, desorption, availability and distribution of copper in two soils, one high (sandy soil) and one low in copper (clay soil). In both soils contaminated by mine tailings the copper sorption capacity and the affinity of the substrate for the metal decreased substantially compared to the uncontaminated soils, however, the sorption remained always high in the clay soil substrates. In the substrates with sandy soil, the high Cu content and lower clay content were determining factors in the lower magnitude of the sorption. Similarly, metal desorption was closely related to these two parameters, and it was higher in clay soil with lower pH. In general, the application of sewage sludge favored the sorption of Cu in soils contaminated and uncontaminated with mine tailings, and in all cases desorption decreased, an effect that remained for at least 30 days. Simple extraction of Cu with CaCl2 and diethylenetriaminepentaacetic acid gave contradictory results, so a careful choice of the procedure is required, depending on the level of metal in the soil and on the acting principle of the extracting agent. In that relation, more complete information on the changes in the metal forms was obtained by application of the sequential extraction procedure proposed by the European Community Bureau of Reference.

Preparation of [In-111]-labeled-DTPA-bombesin conjugates at high specific activity and stability: evaluation of labeling parameters and potential stabilizers.

The aim of the present work was to obtain stabilized high specific activity (HSA) (111)In-labeled bombesin conjugates for preclinical evaluations. Parameters influencing the kinetics of labeling were investigated and the effect of stabilizers on HSA radiopeptides stability at room temperature were systematically categorized applying chromatography techniques. A SA of 174 GBq/µmol was achieved with high radiochemical purity, but the labeled compounds exhibited low stability. The addition of stabilizers avoided their radiolysis and significantly increased their stability.

Reserva funcional renal mediante la depuración de ácido dietilen-triamino-pentaacético marcado con tecnecio-99men niños que padecieron síndrome urémico-hemolítico / Renal functional reserve in children with a history of hemolytic uremic syndrome through technetium-99m diethylene-triamine-penta-acetic acid clearance

Normalmente, la ingesta de carga proteica aumenta el filtradoglomerular, lo que implica reserva funcional renal. Cuando disminuye el número de nefronas pueden observarse filtrados glomerulares normales por hiperfiltración, lo que implica pérdida de reserva funcional, temprano indicador de daño renal y, probablemente, factor contribuyente a su progresión. Determinamos el filtrado glomerular mediante la curva de desaparición plasmática del ácido dietilen-triamino-pentaacético marcado con tecnecio-99m, en pacientes con proteinuria y depuración de creatinina normal, que padecieron síndrome urémico-hemolítico con antelación mayor de 1 año. En 33 niños, de 2-16 años de edad, se determinó la reserva funcional renal mediante filtrado glomerular basal y tras carga proteica. Considerando normal un aumento superior al 20 por ciento, 16 pacientes mostraron no tener reserva funcional renal. Esta prueba, por su seguridad y fácil realización, resulta particularmente útil en pacientes que necesitan especial control y tratamiento.(AU)

Reserva funcional renal mediante la depuración de ácido dietilen-triamino-pentaacético marcado con tecnecio-99men niños que padecieron síndrome urémico-hemolítico / Renal functional reserve in children with a history of hemolytic uremic syndrome through technetium-99m diethylene-triamine-penta-acetic acid clearance

Normalmente, la ingesta de carga proteica aumenta el filtradoglomerular, lo que implica reserva funcional renal. Cuando disminuye el número de nefronas pueden observarse filtrados glomerulares normales por hiperfiltración, lo que implica pérdida de reserva funcional, temprano indicador de daño renal y, probablemente, factor contribuyente a su progresión. Determinamos el filtrado glomerular mediante la curva de desaparición plasmática del ácido dietilen-triamino-pentaacético marcado con tecnecio-99m, en pacientes con proteinuria y depuración de creatinina normal, que padecieron síndrome urémico-hemolítico con antelación mayor de 1 año. En 33 niños, de 2-16 años de edad, se determinó la reserva funcional renal mediante filtrado glomerular basal y tras carga proteica. Considerando normal un aumento superior al 20 por ciento, 16 pacientes mostraron no tener reserva funcional renal. Esta prueba, por su seguridad y fácil realización, resulta particularmente útil en pacientes que necesitan especial control y tratamiento.

Reserva funcional renal mediante la depuración de ácido dietilen-triamino-pentaacético marcado con tecnecio-99men niños que padecieron síndrome urémico-hemolítico / Renal functional reserve in children with a history of hemolytic uremic syndrome through technetium-99m diethylene-triamine-penta-acetic acid clearance

Normalmente, la ingesta de carga proteica aumenta el filtradoglomerular, lo que implica reserva funcional renal. Cuando disminuye el número de nefronas pueden observarse filtrados glomerulares normales por hiperfiltración, lo que implica pérdida de reserva funcional, temprano indicador de daño renal y, probablemente, factor contribuyente a su progresión. Determinamos el filtrado glomerular mediante la curva de desaparición plasmática del ácido dietilen-triamino-pentaacético marcado con tecnecio-99m, en pacientes con proteinuria y depuración de creatinina normal, que padecieron síndrome urémico-hemolítico con antelación mayor de 1 año. En 33 niños, de 2-16 años de edad, se determinó la reserva funcional renal mediante filtrado glomerular basal y tras carga proteica. Considerando normal un aumento superior al 20 por ciento, 16 pacientes mostraron no tener reserva funcional renal. Esta prueba, por su seguridad y fácil realización, resulta particularmente útil en pacientes que necesitan especial control y tratamiento.(AU)

Pretreatment with citrulline improves gut barrier after intestinal obstruction in mice.

BACKGROUND: Citrulline has been shown to be an important marker of gut function, regulator of protein metabolism, and precursor of arginine. The authors assessed the effects of citrulline on gut barrier integrity and bacterial translocation (BT) in mice undergoing intestinal obstruction. METHODS: Mice were divided into 3 groups: sham, intestinal obstruction (IO), and citrulline (CIT). The CIT group received a diet containing 0.6% citrulline; the IO and sham groups were fed a standard chow diet. On the eighth day of treatment, all animals received a diethylenetriamine pentaacetic acid (DTPA) solution labeled with (99m)Technetium ((99m)Tc-DTPA) by gavage for the intestinal permeability study. Terminal ileum was ligated except the sham group, which only underwent laparotomy. After 4, 8, and 18 hours, blood was collected to determine radioactivity. Samples of ileum were removed 18 hours after intestinal obstruction for histological analysis. In another set of animals, BT was evaluated. Animals received 10(8) CFU/mL of (99m)Tc-Escherichia coli by gavage; 90 minutes later, they underwent ileum ligation. Intestinal fluid and serum were collected to measure sIgA and cytokines. RESULTS: The CIT group presented decreased intestinal permeability and BT when compared with the IO group (P < .05). Histopathology showed that citrulline preserved the ileum mucosa. The sIgA concentration was higher in the CIT group (P < .05). The IO group presented the highest levels of interferon-γ (P < .05). CONCLUSIONS: Pretreatment with citrulline was able to preserve barrier integrity and also modulated the immune response that might have affected BT decrease.

Tecnetium-99m as alternative to produce somatostatin-labeled derivatives: comparative biodistribution evaluation with 111In-DTPA-octreotide.

Synthetic somatostatin (SST) analogues have been used in the preparation of receptor-specific radiopharmaceuticals for diagnostic and therapy of neuroendocrine tumors. This work studied the labeling conditions with (99m)Tc and biological distribution in Swiss mice of two SST analogs (HYNIC-Tyr(3)-Octreotide and HYNIC-Tyr(3)-Octreotate) and compared the biodistribution pattern with (111)In-DTPA-Octreotide. Biological distribution studies were performed after injection of radiopharmaceuticals on Swiss mice. Labeling procedures resulted on high radiochemical yield for all three preparations and the labeled products presented high in vitro stability. Biological distribution studies evidenced similar general biodistribution of (99m)Tc-labeled peptides when compared with indium-labeled peptide with fast blood clearance and elimination by urinary tract. Kidneys uptake of (99m)Tc-HYNIC-TATE are similar to (111)In-DTPA-Octreotide, and both are significantly higher than (99m)Tc-HYNIC-OCT. All labeled peptides presented similar uptake on liver, but the retention in time at intestines, particularly at large intestine, was more expressive for (111)In-labeled peptide. The %ID of (99m)Tc-HYNIC-OCT and (99m)Tc-HYNIC-TATE in organs with high density of SST receptors like pancreas and adrenals were significant and similar to obtained for (111)In-DTPA-Octreotide, confirming the affinity of these radiopharmaceuticals for the receptors.

Duropleural fistula revealed by neurological manifestations: an unusual cause of pleural effusion.

Symptomatic pleural collection of cerebrospinal fluid is a rare but accepted complication in hydrocephalic paediatric patients treated with ventriculopleural shunts. Few cases have been described in adults, usually as complication of trauma, tumours or spinal surgery, particularly post-laminectomy. It should be considered in the differential diagnosis of pleural effusion after neurosurgical procedures involving the spine. We describe two patients with large cerebrospinal fluid collections in the pleural cavity caused by postoperative duropleural fistula, who presented with neurological symptoms, cerebrospinal fluid pressure headache and meningitis.