Common coeliacomesenteric trunk: a computed tomography radiological study.

BACKGROUND: There is an increasing trend for administration of invasive radiological interventions, laparoscopic surgery, and transplantation procedures in recent years, and determining the vascular variations prior to these procedures is crucially important. Coeliacomesenteric trunk (CMT) is among these variations. This study aimed to retrospectively evaluate this rare anomaly by computed tomography (CT). MATERIALS AND METHODS: A total of 1000 CT angiography images were analysed retrospectively, and the patients with mesenteric and coeliac arteries arising from the abdominal aorta with a single root were identified. The level that CMT arose, and its branching patterns were determined individually for all patients. RESULTS: Ten patients (6 males and 4 females) with a mean age of 50.2 years (17-87 years) had CMT in CT images. CONCLUSIONS: The knowledge of variations in the CMT prior to vascular or laparoscopic interventions will contribute to early intervention in case of a complication, or to avoid from a potential damage.

Ameliorative effect of polydatin on oxidative stress-mediated testicular damage by chronic arsenic exposure in rats.

Arsenic causes lipid peroxidation leading to alterations in antioxidant status in organisms. In this study, the reproductive effects of chronic exposure to arsenic and the protective effects of polydatin (PD) were evaluated in 35 Wistar male rats, which were divided equally into five groups. The control group received a normal diet and tap water, arsenic (100 mg l(-1) , approximately 1/50 of oral LD50 ) was given via drinking water to experimental groups except control group, and PD was orally given to the other groups at dose of 50, 100 and 200 mg kg(-1) for 60 days. Arsenic administration decreased sperm motility, glutathione level, superoxide dismutase and catalase activities in testicular tissue of rats. In contrast, malondialdehyde level and DNA damage were found to be high levels in arsenic-treated group. Histopathologically, it was observed that decreased sperm concentration and degeneration of Sertoli cells in testicular tissue. PD administration, partially 200 mg kg(-1) , reversed arsenic-induced lipid peroxidation, DNA damage, antioxidant enzyme activity and cell integrity in testis of rats. These results demonstrate that PD decreases arsenic-induced lipid peroxidation, enhances the antioxidant defence mechanism and regenerates tissue damage in testis of rats.

Clinical behaviour of papillary thyroid cancer oncocytic variant: stage-matched comparison versus classical and tall cell variant papillary thyroid cancer.

OBJECTIVE: Papillary thyroid cancer (PTC) has many variants and most of them are mild tumors. Oncocytic variant (OV) is a rare subtype of PTC. There are controversial results about its prognosis in the literature. We investigated its aggressivity and clinical course by comparing it with classical variant (CV) and tall cell variant (TV) of PTC over a stage-matched design. MATERIAL AND METHODS: Pure 100 OV, 71TV and 1219 CV were included in this retrospective cohort study. OV was compared with CV and TV according to independent prognostic parameters. OV was also compared stage by stage with CV and TV for recurrence. RESULTS: Mean age was 46,8 years and male/female ratio 25/75 for OV. The recurrence rates in our study were 16% in OV, 13,5% in CV and 56% in TV. There is a statistically significant difference according to recurrence between stage I and stage IV OV and CV (p=0.023, p=0.03, respectively). There is also a statistically significant difference between stage I and stage IV OV and TV according to recurrence (p=0.001, p=0.024, respectively). OV can be supposed to behave between CV and TV, but very closer to CV. CONCLUSIONS: OV seems to be slightly more aggressive than CV. Despite an inadequate sample size for stage II and III, our findings imply an increased recurrence risk for OV than CV at the advanced stages (stage III and IV) and CV has an unfavorable prognosis than OV at early stages (stage I and II) according to stage-matched model.

The opinions of Turkish mental health nurses on physical health care for individuals with mental illness: A qualitative study.

WHAT IS KNOWN ON THE SUBJECT: Individuals with mental illness have significantly higher mortality and morbidity than the general population due to physical illnesses. Mental health nurses play a key role in providing care for common physical problems and protecting and promoting healthy lifestyles. Little is known from previous studies in the international literature about the attitudes, behaviours and thoughts of mental health nurses on providing physical health care. WHAT THIS PAPER ADDS TO THE EXISTING KNOWLEDGE: Mental health nurses mostly focus on the existing physical health problems of individuals with mental illness. However, mental health nurses do not include practices of disease prevention and physical health promotion for individuals with mental illness. The desire to see positive changes in individuals with mental illness, receiving positive feedback, feeling useful and happy, and feeling satisfied with their profession motivate mental health nurses in terms of providing physical health care. WHAT ARE THE IMPLICATIONS FOR PRACTICE: The knowledge and skill required of mental health nurses to provide physical health care need to be increased. Institutions should employ expert nurses who are able to guide mental health nurses to provide physical health care. It is important to provide adequate physical infrastructure and human resources to provide better physical health care in mental health services. ABSTRACT: Background Mental health nurses play an important role in improving the physical health of individuals with mental illnesses. However, there are limited studies of their attitudes and practices about physical health. Therefore, there is a need for qualitative studies to clarify the issue. AIM: The aim of this study was to determine mental health nurses' opinions about physical health care for individuals with mental illness. METHODS: This study was carried out in Turkey. A qualitative descriptive approach was taken in the study. The sample consisted of twelve mental health nurses selected by purposeful sampling. In-depth interviews were conducted using a semi-structured interview format. A thematic analysis was used to evaluate the interviews. RESULTS: Four main themes were determined. (1) The barriers to physical healthcare theme included barriers related to patients, illness and treatment, barriers related to patients' caregivers, barriers related to health professionals and barriers related to the healthcare system. (2) The physical healthcare practices theme included common physical health problems and current nursing practices. (3) Motivators theme included the desire to see positive changes in a patient, receiving positive feedback, feeling useful and happy, having a sense of conscience and feeling satisfied with their profession. (4) The needs for better physical healthcare theme included the nurses' recommendations for better physical health care. CONCLUSION: Mental health nurses believe that the physical health care provided to individuals with mental illness is not adequate. Many barriers to providing care for physical health, such as having psychiatric symptoms that are not seen as a priority by patients and health personnel, were determined. IMPLICATIONS FOR PRACTICE: Mental health nurses should integrate physical healthcare practices into their routine care. In addition, mental health nurses' knowledge and skills about physical health care should be improved.

Can metabolic tumor parameters on primary staging 18F-FDG PET/CT aid in risk stratification of primary central nervous system lymphomas for patient management as a prognostic model? / ¿Pueden contribuir los parámetros tumorales metabólicos, establecidos mediante 18F-FDG PET/TC para estadificación primaria, a la estratificación del riesgo de los linfomas del sistema nervioso central, para el tratamiento del paciente como modelo pronóstico?

OBJECTIVE: Primary central nervous system (CNS) lymphoma is an aggressive and fatal extranodal non-Hodgkin lymphoma jailed in CNS at initial diagnosis. Its prognosis is poor and the disease has a fatal outcome when compared with systemic non-Hodgkin lymphoma. A few baseline risk stratification scoring systems have been suggested to estimate the prognosis mainly based on serum lactate dehydrogenase level,age, Karnofsky performance score, involvement of deep brain structures and cerebrospinal fluid protein concentration. 18F-FDG PET/CT has a high prognostic value with respect to overall survival and disease-free survival in many cancers and lymphomas. We aimed to investigate metabolic tumor indexes on primary staging 18F-FDG PET/CT as prognostic markers in primary CNS lymphoma. MATERIAL AND METHODS: Fourteen patients with primary CNS diffuse large B-cell lymphoma (stage i) were enrolled in this retrospective cohort study. Primary staging 18F-FDG PET/CT was performed and quantitative parameters like maximum standardized uptake value, average standardized uptake value, metabolic tumor volume and total lesion glycolysis (TLG) were calculated for all patients before the treatment. Cox regression models were performed to determine their relation with survival time. RESULTS: In the evaluation of all potential risk factors impacting recurrence/metastases (age, sex, serum lactate dehydrogenase, involvement of deep brain structures, maximum standardized uptake value, average standardized uptake value, metabolic tumor volume, and TLG) with univariate analysis, TLG remained statistically significant (P=.02). CONCLUSION: Metabolic tumor parameters are useful in prognosis estimation of primary CNS lymphomas, especially TLG, which is the most important one and may play a role in patient management.

A different scintigraphic approach to evaluate the glomerular filtration rate.

OBJECTIVE: Multiple nuclear medicine techniques for measuring renal glomerular filtration rate (GFR) are available but some of them are not practical in daily routine use and others have some accuracy issues. Hence the aim of the study was to design a new camera-based approach to measure the GFR and to compare our results with other measured GFR (mGFR) and estimated GFRs (eGFRs) derived from available measurements and equations used in daily clinical practice. MATERIAL AND METHODS: 34 patients were included in the study. ∼74MBq (2mCi) Technetium 99m diethylene-triamine-pentaacetic acid (99mTc-DTPA) was administered to the patients during 5min. A simple formula based on a dilution principle was used to measure GFR (ScinGFR). RESULTS: Our formula provided similar mGFR results in narrower range as creatinine clearance did and our results correlated well with results derived from other equations. When ScinGFR values were compared to others, there was a significant difference among them (p=0.031) due to difference between the ScinGFR and Cockroft-Gault. When the results of the ScinGFR compared to others without Cockroft-Gault, the difference among them was not significant (p=0.164). CONCLUSION: A simple formula considering the extracellular fluid volume was used to predict the split and global kidney functions and despite some discrepancies, good correlation among our results and those derived from available formulas was detected.

An unusual presentation of primary hyperparathyroidism: multiple brown tumors and coexisting thyroid carcinoma.

We present a patient with a complex clinical picture of primary hyperparathyroidism with multiple destructive skeletal lesions suspicious of bone metastases and concomitant multifocal papillary thyroid carcinoma with a metastatic central lymph node. He presented with progressively worsening right hip pain and restricted motion. Magnetic resonance imaging revealed multiple lytic lesions involving predominantly the right trochanter minor and the left inferior and posterior pubic rami. Biochemical tests were consistent with primary hyperparathyroidism. Neck ultrasound and parathyroid scintigraphy revealed a single parathyroid adenoma and a thyroid nodule, preoperative cytology of which confirmed papillary thyroid carcinoma, as did the final surgical specimen. Biochemical results, regarding hyperparathyroidism, declined to normal levels and his complaints gradually decreased after surgery. Postoperative whole body bone scintigraphy showed increased tracer uptakes at multiple sites, but they were proved to be metabolically inactive by fluorodeoxyglucose positron emission tomography/computed tomography.

The increased risk of globus pharyngeus in patients with chronic thyroiditis: a case control study.

OBJECTIVE: A correlation between globus pharyngeus and thyroid gland inflammation has been mentioned in previous studies. However, the potential risk of globus pharyngeus in chronic thyroiditis patients has not been shown so far. The aim of this study is to investigate a possible association between chronic thyroiditis and globus pharyngeus. PATIENTS AND METHODS: The study was performed in an ultrasound (US) center of a tertiary health care institution. Ninety-two patients who were under examination for suspected thyroid pathologies or undergoing follow-up for a previously diagnosed thyroid disease were enrolled in the study. The patients were divided into two groups according to the existence of globus symptoms. Subsequently, all patients underwent high-resolution thyroid ultrasounds. The patients whose ultrasound findings were suggestive of chronic thyroiditis constituted the second subgroup. The demographic data of the patients and other ultrasound findings including the volume of the thyroid glands and nodules, if any, were noted as well. RESULTS: Sixty-seven female (73%) and 25 male (27%) patients were enrolled in the study. Thirty-two (35%) of the 92 patients constituted the globus pharyngeus group according to their responses to the questionnaire and the US findings were concordant with chronic thyroiditis in 36 (39%) patients. The correlation between chronic thyroiditis and globus sensation was significant (p = 0.004), and the odds ratio was calculated as 3.7 (95% CI = 1.5-9.11). Other parameters including age, sex, thyroid volume and nodule status were not significantly related to globus pharyngeus in this particular patient series. CONCLUSIONS: In the presented study, the risk of globus pharyngeus occurrence was calculated as 3.7-fold higher in patients with chronic thyroiditis. Being a preliminary report, it is necessary to confirm this finding and understand the pathophysiological mechanism via further investigations with a larger patient series.

A case-control study of twin pairs discordant for Parkinson's disease: a search for environmental risk factors.

A previous study of twins with Parkinson's disease (PD) revealed low concordance, suggesting that genetic factors play a minor role in the etiology of PD. To identify possible environmental determinants of PD while maximally controlling for hereditary factors, 31 monozygotic twin pairs discordant for PD were interviewed by telephone. Information about possible risk factors was obtained from systematic and uniform interviews with cases and controls. The only statistically significant result was less cigarette smoking by PD patients (p less than 0.05). Thirteen dizygotic discordant twin pairs were evaluated with the same techniques, but there were no statistically significant differences between affected and unaffected twins.

Parkinson's disease in 65 pairs of twins and in a set of quadruplets.

Among 43 monozygotic (MZ) and 19 dizygotic (DZ) pairs in which an index case had definite Parkinson's disease (PD), only one MZ pair was definitely concordant for PD. When pairs with questionable clinical features were included, 4 of 48 MZ and 1 of 19 DZ pairs were concordant. The frequency of PD in MZ cotwins of index cases with PD was similar to that expected in an unrelated control group matched for age and sex. Although we were unable to identify a single environmental agent, we conclude that the major factors in the etiology of PD are nongenetic.

Effect of intraperitoneal immunoglobulin infusion on neutrophil function in CAPD children with and without peritonitis.

The present study was designed to assess the effect of intraperitoneal infusion of immunoglobulin (Ig) on neutrophil functions in uninfected and infected patients treated by continuous ambulatory peritoneal dialysis (CAPD). Fourteen children were included in the study. Healthy laboratory and medical personnel (n = 10) served as controls. Blood and peritoneal dialysate effluent (PDE) samples were obtained before and after Ig infusion. In all patients, chemotactic response of peripheral blood neutrophils (PBN) was significantly lower than in healthy controls. Peripheral blood neutrophils obtained from patients during peritonitis episodes (n = 10) showed significantly higher values compared to the values obtained from patients without peritonitis (n = 12). After the intraperitoneal infusion of Ig (100 mg/kg), chemotaxis of PBNs increased significantly in both patient groups. Chemiluminescence measures of PBN of the uninfected (n = 12) and infected patients (n = 7) were similar. They increased significantly in both groups after the Ig infusion, although they remained within the lower limits of the controls. The peritoneal neutrophils (PNs) showed significantly lower chemotactic activity in uninfected patients (n = 11) than in the infected ones (n = 10). The response of PNs to the Ig infusion was also more prominent in infected patients. Immunoglobulin infusion did not increase the chemiluminescence of PNs in infected patients (n = 7); the chemoluminescence of PNs did increase after Ig infusion in uninfected patients (n = 12). These data suggest the of administration intraperitoneal Ig for prophylaxis and/or treatment of peritonitis in CAPD patients.

Knowledge, attitudes and practices of anabolic steroid usage among gym users in Trinidad.

Self-administered questionnaires were completed by 1062 gym-users in 14 gyms in Trinidad from February 1997 to July 1997 to determine the knowledge, attitudes and practices regarding anabolic steroids (AS). Five hundred and sixty (52.7%) females and 502 (48.3%) males completed the questionnaire. Half of the total sample were individuals in the 20 to 29 year age group. From the 17 questions that tested knowledge about AS, the median number of correct responses was 7 with a mode of 8. Increased muscle mass was correctly identified as one of the effects of AS by 841 respondents (79.2%), while 249 (23.6%) of the total sample thought asthma was treated with AS. Most (872 or 82.1%) felt that their knowledge about AS was inadequate and 700 (66.0%) were of the opinion that AS should be banned from use in competitive sports. Similarly, 733 (70.0%) of the gym-users thought AS should only be available by prescription. Thirty respondents reported having used AS (2.9%, 95% CI 2.0-4.1). The prevalence of AS use was higher among males than females (p < 0.001). Improvement of physical appearance and not competitive advantage in sport was the main reason cited for AS use. Anabolic steroid users knew more about the adverse effects of AS than non-AS users but the therapeutic uses of AS were comparatively less well known. This study demonstrated a general lack of knowledge concerning AS use and that a small but significant proportion of persons using gyms admitted to abusing AS.

Comportamiento clínico de la variante oncocítica del cáncer papilar de tiroides: comparación de su evolución frente al cáncer papilar, variantes clásica y de células altas / Clinical behaviour of papillary thyroid cancer oncocytic variant: Stage-matched comparison versus classical and tall cell variant papillary thyroid cancer

Objetivo El cáncer papilar de tiroides (CPT) tiene diferentes variantes y la mayoría de ellas presentan diferencias sutiles. La variante oncocítica (VO) es un subtipo poco frecuente de CPT, sobre el pronóstico de la cual existen resultados controvertidos en la literatura. Investigamos su agresividad y curso clínico comparándolos con la variante clásica (VC) y la variante de células altas (CA) de CPT en diferentes estadios. Material y métodos En este estudio de cohortes retrospectivo se incluyeron: 100 muestras simples de VO, 71 de CA y 1.219 de VC. Las muestras VO se compararon con las VC y las de CA sobre la base de parámetros de pronóstico independientes. La recurrencia de la VO también se comparó estadio por estadio con la VC y CA. Resultados La edad media fue de 46,8 años y la relación hombres/mujeres de 25/75 para la VO. Las tasas de recurrencia en nuestro estudio fueron del 16% en VO; del 13,5% en VC y del 56% en CA. Existe una diferencia estadísticamente significativa con respecto a la recurrencia entre el estadio 1 y el estadio 4 comparando la VO y la VC (p=0,023; p=0,03, respectivamente). También hay una diferencia estadísticamente significativa con respecto a la recurrencia entre el estadio 1 y el estadio 4 comparando la VO y la CA (p=0,001; p=0,024, respectivamente). Se puede suponer que la VO tiene un comportamiento entre la VC y la CA, pero muy cercana a la CA. Conclusión La VO parece ser un poco más agresiva que la VC. A pesar de un tamaño de muestra inadecuado para los estadios 2 y 3, nuestros hallazgos implican un mayor riesgo de recurrencia para la VO que para la VC en los estadios avanzados (estadios 3 y 4) y la VC tiene un pronóstico más desfavorable que VO en estadios precoces (estadios 1 y 2), según el modelo de estadio pareado (AU)

Objective Papillary thyroid cancer (PTC) has many variants and most of them are mild tumors. Oncocytic variant (OV) is a rare subtype of PTC. There are controversial results about its prognosis in the literature. We investigated its aggressivity and clinical course by comparing it with classical variant (CV) and tall cell variant (TV) of PTC over a stage-matched design. Material and methods Pure 100 OV, 71 TV and 1,219 CV were included in this retrospective cohort study. OV was compared with CV and TV according to independent prognostic parameters. OV was also compared stage by stage with CV and TV for recurrence. Results Mean age was 46,8 years and male/female ratio 25/75 for OV. The recurrence rates in our study were 16% in OV, 13,5% in CV and 56% in TV. There is a statistically significant difference according to recurrence between stage 1 and stage 4 OV and CV (P = 0.023, P = 0.03, respectively). There is also a statistically significant difference between stage 1 and stage 4 OV and TV according to recurrence (P = 0.001, P = 0.024, respectively). OV can be supposed to behave between CV and TV, but very closer to CV. Conclusions OV seems to be slightly more aggressive than CV. Despite an inadequate sample size for stage 2 and 3, our findings imply an increased recurrence risk for OV than CV at the advanced stages (stage 3 and 4) and CV has an unfavorable prognosis than OV at early stages (stage 1 and 2) according to stage-matched model (AU)

The effect of boric acid on acethylcholine, bethanechol and potasssium-evoked responses on ileum of rat.

1 The aim of this study was to clarify the effect of boric acid on contractions of rat isolated ileum. 2 Contractile responses expressed as Emax and pD2 for acetylcholine (10(-3)-10(-8) m, Ach), bethanechol (10(-3)-10(-8) m) and potassium (10-80 × 10(-3) m, KCl) were determined in the absence and presence of boric acid (10(-3); 5 × 10(-4); 10(-4) m). 3 The contractile response to Ach in the presence of verapamil (10(-6) or 10(-8) m) or in calcium-free Tyrode's solution was also determined in the absence and presence of boric acid. 4 Boric acid did not affect the contractile response to Ach, bethanechol or KCl. Single or cumulative treatment of boric acid did not affect ileum muscle contraction evoked by KCl. The atropine-resistant component of Ach-induced contraction and 4-diphenyl-acetoxy-N-methyl-piperidine methiodide-resistant component of bethanechol-induced contraction were not inhibited by boric acid (10(-3) m). The contractile response to Ach was reduced in calcium-free Tyrode's solution, and the contractile response was not affected by (10(-8) m). The addition of boric acid (10(-3) m) in combination with verapamil (10(-8) m) did not significantly affect the contractile response to Ach. 5 In conclusion, boric acid does not affect contractions induced by Ach, bethanechol or potassium in rat isolated ileum.

¿Pueden contribuir los parámetros tumorales metabólicos, establecidos mediante 18F-FDG PET/TC para estadificación primaria, a la estratificación del riesgo de los linfomas del sistema nervioso central, para el tratamiento del paciente como modelo pronóstico? / Can metabolic tumor parameters on primary staging 18F-FDG PET/CT aid in risk stratification of primary central nervous system lymphomas for patient management as a prognostic model?

Objetivo. Los linfomas del sistema nervioso central (SNC) son linfomas no Hodgkin extranodales, agresivos y fatales, albergados en el SNC en el diagnóstico inicial. Su pronóstico es malo, teniendo la enfermedad un resultado fatal en comparación con el linfoma no Hodgkin sistémico. Se han indicado una serie de sistemas de estratificación del riesgo para estimar el pronóstico, basados principalmente en el nivel sérico de lactato deshidrogenasa, la edad, el índice de Karnofsky, el compromiso de las estructuras profundas del cerebro y la concentración proteica del líquido cefalorraquídeo. La PET/TC con 18F-FDG tiene un elevado valor pronóstico en cuanto a la supervivencia global y la supervivencia libre de enfermedad en muchos cánceres y linfomas. Nuestro objetivo fue investigar los índices tumorales metabólicos mediante 18F-FDG PET/TC para estadificación primaria, como marcadores pronósticos de los linfomas primarios del SNC. Material y métodos. Se incluyó en este estudio retrospectivo a una cohorte de 14 pacientes con linfoma primario de células B grandes del SNC (estadio i). Se realizó una PET/TC con 18F-FDG de estadificación primaria, calculándose en todos los pacientes, y con anterioridad al tratamiento, los parámetros cuantitativos tales como el valor estandarizado de captación máximo, el valor de captación medio, el volumen tumoral metabólico y la glucólisis tumoral total (TLG). Se realizaron modelos de regresión de Cox para determinar su relación con el tiempo de supervivencia. Resultados. En la evaluación de todos los factores de riesgo potencial con impacto sobre la recidiva/metástasis (edad, sexo, lactato deshidrogenasa sérico, compromiso de las estructuras profundas del cerebro, el valor estandarizado de captación máximo, el valor de captación medio, el volumen tumoral metabólico y la TLG), realizada mediante análisis univariante, el valor de TLG reflejó una significación estadística (p=0,02). Conclusión. Los parámetros tumorales metabólicos resultan de utilidad para la estimación pronóstica de los linfomas primarios del SNC. En especial, la TLG constituye el parámetro más importante, y puede desempeñar un papel en el tratamiento del paciente (AU)

Objective. Primary central nervous system (CNS) lymphoma is an aggressive and fatal extranodal non-Hodgkin lymphoma jailed in CNS at initial diagnosis. Its prognosis is poor and the disease has a fatal outcome when compared with systemic non-Hodgkin lymphoma. A few baseline risk stratification scoring systems have been suggested to estimate the prognosis mainly based on serum lactate dehydrogenase level,age, Karnofsky performance score, involvement of deep brain structures and cerebrospinal fluid protein concentration. 18F-FDG PET/CT has a high prognostic value with respect to overall survival and disease-free survival in many cancers and lymphomas. We aimed to investigate metabolic tumor indexes on primary staging 18F-FDG PET/CT as prognostic markers in primary CNS lymphoma. Material and methods. Fourteen patients with primary CNS diffuse large B-cell lymphoma (stage i) were enrolled in this retrospective cohort study. Primary staging 18F-FDG PET/CT was performed and quantitative parameters like maximum standardized uptake value, average standardized uptake value, metabolic tumor volume and total lesion glycolysis (TLG) were calculated for all patients before the treatment. Cox regression models were performed to determine their relation with survival time. Results. In the evaluation of all potential risk factors impacting recurrence/metastases (age, sex, serum lactate dehydrogenase, involvement of deep brain structures, maximum standardized uptake value, average standardized uptake value, metabolic tumor volume, and TLG) with univariate analysis, TLG remained statistically significant (P=.02). Conclusion. Metabolic tumor parameters are useful in prognosis estimation of primary CNS lymphomas, especially TLG, which is the most important one and may play a role in patient management (AU)

A different scintigraphic approach to evaluate the glomerular filtration rate / Una técnica gammagráfica diferente para evaluar la tasa de filtración glomerular

Objective: Multiple nuclear medicine techniques for measuring renal glomerular filtration rate (GFR) are available but some of them are not practical in daily routine use and others have some accuracy issues. Hence the aim of the study was to design a new camera-based approach to measure the GFR and to compare our results with other measured GFR (mGFR) and estimated GFRs (eGFRs) derived from available measurements and equations used in daily clinical practice. Material and methods: 34 patients were included in the study. ∼74MBq (2mCi) Technetium 99m diethylene-triamine-pentaacetic acid (99mTc-DTPA) was administered to the patients during 5min. A simple formula based on a dilution principle was used to measure GFR (ScinGFR). Results: Our formula provided similar mGFR results in narrower range as creatinine clearance did and our results correlated well with results derived from other equations. When ScinGFR values were compared to others, there was a significant difference among them (p=0.031) due to difference between the ScinGFR and Cockroft-Gault. When the results of the ScinGFR compared to others without Cockroft-Gault, the difference among them was not significant (p=0.164). Conclusion: A simple formula considering the extracellular fluid volume was used to predict the split and global kidney functions and despite some discrepancies, good correlation among our results and those derived from available formulas was detected (AU)

Objetivo: Existen múltiples técnicas de medicina nuclear disponibles para medir la tasa de filtración glomerular (GFR), aunque algunas de ellas no resultan muy útiles en la rutina diaria, y otras no son muy precisas. Por tanto, el objetivo de este estudio fue diseñar una nueva técnica basada en el uso de una cámara para medir la GFR y comparar nuestros resultados con otras mediciones de GFR (mGFR) y estimaciones de GFR (eGFRs), derivadas de las mediciones disponibles y las ecuaciones utilizadas en la práctica clínica diaria. Material y métodos: Se incluyó en el estudio a 34 pacientes. Se infundió alrededor de 74MBq (2mCi) de 99mTc-ácido dietilen-triamin-pentaacético (99mTc-DTPA) a los pacientes durante 5min. Se utilizó una fórmula simple, basada en un principio de disolución, para medir la GFR (ScinGFR). Resultados: Nuestra fórmula aportó resultados similares de mGFR en el rango más estrecho logrado por la depuración de creatinina, guardando una correlación muy positiva con los resultados derivados de otras ecuaciones. Al comparar los valores de ScinGFR con otros valores, se produjo una diferencia estadísticamente significativa entre ellos (p=0.031), debido a la diferencia entre ScinGFR y Cockroft-Gault. Al comparar los resultados de ScinGFR con otros valores, sin considerar Cockroft-Gault, la diferencia entre ellos fue estadísticamente significativa (p=0.164) Conclusión: Se utilizó una fórmula simple considerando el volumen de líquido extracelular, para predecir las funciones globales e individuales renales y, a pesar de ciertas discrepancias, se detectó una buena correlación entre nuestros resultados y aquellos derivados de las fórmulas disponibles (AU)

An unusual presentation of primary hyperparathyroidism: multiple brown tumors and coexisting thyroid carcinoma / Presentación inusual de hiperparatiroidismo primario: múltiples tumores pardos y coexistencia de carcinoma tiroideo

We present a patient with a complex clinical picture of primary hyperparathyroidism with multiple destructive skeletal lesions suspicious of bone metastases and concomitant multifocal papillary thyroid carcinoma with a metastatic central lymph node. He presented with progressively worsening right hip pain and restricted motion. Magnetic resonance imaging revealed multiple lytic lesions involving predominantly the right trochanter minor and the left inferior and posterior pubic rami. Biochemical tests were consistent with primary hyperparathyroidism. Neck ultrasound and parathyroid scintigraphy revealed a single parathyroid adenoma and a thyroid nodule, preoperative cytology of which confirmed papillary thyroid carcinoma, as did the final surgical specimen. Biochemical results, regarding hyperparathyroidism, declined to normal levels and his complaints gradually decreased after surgery. Postoperative whole body bone scintigraphy showed increased tracer uptakes at multiple sites, but they were proved to be metabolically inactive by fluorodeoxyglucose positron emission tomography/computed tomography (AU)

Presentamos el caso de un paciente con un cuadro clínico de hiperparatiroidismo primario, con muchas lesiones óseas destructivas sospechosas de metástasis óseas y carcinoma tiroideo multifocal concomitante con un ganglio linfático metastásico central. Se presentó con agravamiento progresivo de dolor y restricción de movimiento en la cadera derecha. La resonancia magnética reveló múltiples lesiones líticas que implicaban principalmente al trocánter menor derecho y a las ramas púbicas izquierdas inferior y posterior. Las pruebas bioquímicas fueron consistentes con un hiperparatiroidismo primario. La ecografía cervical y la gammagrafía paratiroidea revelaron un único adenoma paratiroideo y un nódulo tiroideo, cuya citología preoperatoria confirmó un carcinoma papilar de tiroides, que fue confirmado también por la muestra final obtenida quirúrgicamente. Los resultados bioquímicos, en relación con el hiperparatiroidismo, descendieron a niveles normales tras la cirugía, y los dolores fueron remitiendo gradualmente. La gammagrafía ósea postoperatoria de cuerpo entero reflejó un incremento de captación del radiotrazador en múltiples localizaciones, que resultaron ser metabólicamente inactivas en la tomografía por emisión de positrones con fluorodesoxiglucosa/tomografía computarizada (AU)