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1.
Sci Total Environ ; 902: 166003, 2023 Dec 01.
Article in English | MEDLINE | ID: mdl-37549707

ABSTRACT

The accumulation of microplastics (MPs) in the environment as well as their presence in foods and humans highlight the urgent need for studies on the effects of these particles on humans. Polylactic acid (PLA) is the most widely used bioplastic in the food industry and medical field. Despite its biodegradability, biocompatibility, and "Generally Recognized As Safe" (GRAS) status, recent animal model studies have shown that PLA MPs can alter the intestinal microbiota; however, to date, no studies have been reported on the possible gut and health consequences of its intake by humans. This work simulates the ingestion of a realistic daily amount of PLA MPs and their pass through the gastrointestinal tract by combining the INFOGEST method and the gastrointestinal simgi® model to evaluate possible effects on the human colonic microbiota composition (16S rRNA gene sequencing analysis) and metabolic functionality (lactic acid and short-chain fatty acids (SCFA) production). Although PLA MPs did not clearly alter the microbial community homeostasis, increased Bifidobacterium levels tended to increase in presence of millimetric PLA particles. Furthermore, shifts detected at the functional level suggest an alteration of microbial metabolism, and a possible biotransformation of PLA by the human microbial colonic community. Raman spectroscopy and field emission scanning electron microscopy (FESEM) characterization revealed morphological changes on the PLA MPs after the gastric phase of the digestion, and the adhesion of organic matter as well as a microbial biofilm, with surface biodegradation, after the intestinal and colonic phases. With this evidence and the emerging use of bioplastics, understanding their impact on humans and potential biodegradation through gastrointestinal digestion and the human microbiota merits critical investigation.


Subject(s)
Gastrointestinal Microbiome , Microplastics , Humans , Animals , Plastics , RNA, Ribosomal, 16S , Polyesters , Digestion
2.
Radiologia (Engl Ed) ; 65(1): 12-21, 2023.
Article in English | MEDLINE | ID: mdl-36842781

ABSTRACT

OBJECTIVE: To contribute our results to increase the scientific evidence about the use of radioembolization in the management of patients with hepatocellular carcinoma. MATERIAL AND METHODS: This retrospective review included 53 patients with hepatocellular carcinoma treated with radioembolization at our center. Patients were classified according to the BCLC algorithm in detail according to their Child-Pugh functional status. We analyzed survival using the Kaplan-Meier method. We used Cox regression analysis to determine clinically significant parameters, including the doses administered in the parameters studied. RESULTS: Patients ranged in age from 28 to 86 years (mean, 60 years). A total of 61 procedures were done. The mean activity administered was 2.8GBq (0.7-6.4GBq), with a mean dose of 229.9Gy (74-425.9Gy) administered in the tumor. Progression-free survival was 6.7 months and overall survival was 12.8 months. Differences in disease-free survival according to BCLC and Child-Pugh classification were not significant (p=0.848 and p=0.252, respectively). The clinical parameters that were significantly different with respect to overall survival were bilirubin levels (p<0.001), pretreatment transaminase levels (AST) (p=0.022), Child-Pugh subclassification (p=0.003), and dose administered in the tumor (p=0.001). Only one patient had a severe adverse reaction, developing posttreatment liver failure resulting in death. CONCLUSIONS: Radioembolization is safe and efficacious in the treatment of patients with hepatocellular carcinoma. Liver function and the doses received by the tumor are key parameters for the efficacy of treatment. The increase in the scientific evidence supports the inclusion of this technique in treatment guidelines.


Subject(s)
Carcinoma, Hepatocellular , Embolization, Therapeutic , Liver Neoplasms , Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/radiotherapy , Liver Neoplasms/radiotherapy , Disease-Free Survival , Retrospective Studies , Embolization, Therapeutic/methods
3.
Radiología (Madr., Ed. impr.) ; 65(1): 12-21, ene.-feb. 2023. tab
Article in Spanish | IBECS | ID: ibc-215019

ABSTRACT

Objetivo Contribuir con la presentación de los resultados de nuestro estudio a ampliar la evidencia científica sobre el empleo de la radioembolización en el manejo de pacientes con hepatocarcinoma. Material y método Se trata de una revisión retrospectiva realizada en nuestro centro que incluye a 53 pacientes con hepatocarcinoma tratados con radioembolización. Los pacientes fueron clasificados según el algoritmo del BCLC (Barcelona Clinic Liver Cancer) y de forma pormenorizada por su estado funcional siguiendo la clasificación de Child-Pugh. Se realizó un estudio de supervivencia siguiendo la metodología de Kaplan-Meier. Se empleó el método de regresión de Cox para la determinación de parámetros clínicos significativos, incluyendo dosis administradas en los parámetros estudiados. Resultados La serie evaluada comprende a pacientes con una media de edad de 60 años (rango 28-86). Se llevaron a cabo un total de 61 procedimientos. La actividad media administrada fue de 2,8 GBq (0,7-6,4 GBq), administrando una dosis media en tumor de 229,9 Gy (74-425,9 Gy). El tiempo libre de progresión fue de 6,7 meses desde el momento del tratamiento y la supervivencia global fue de 12,8 meses. La clasificación de los pacientes según BCLC (p=0,848) y Child-Pugh (p=0,252) no resultó significativa respecto al tiempo libre de enfermedad. Los parámetros clínicos que resultaron con diferencias significativas en cuanto a supervivencia global fueron los niveles de bilirrubina (p<0.001) y las cifras de transaminasas (GOT) pretratamiento (p=0.022), la subclasificación Child-Pugh (p=0.003) y la dosis recibida por el tumor (p=0,001). Tan solo uno de los pacientes tratados presentó un efecto adverso grave, con fallo hepático posterapia y resultado de muerte... (AU)


Objective To contribute our results to increase the scientific evidence about the use of radioembolization in the management of patients with hepatocellular carcinoma. Material and methods This retrospective review included 53 patients with hepatocellular carcinoma treated with radioembolization at our center. Patients were classified according to the BCLC algorithm in detail according to their Child-Pugh functional status. We analyzed survival using the Kaplan-Meier method. We used Cox regression analysis to determine clinically significant parameters, including the doses administered in the parameters studied. Results Patients ranged in age from 28 to 86 years (mean, 60 years). A total of 61 procedures were done. The mean activity administered was 2.8 GBq (0.7-6.4 GBq), with a mean dose of 229.9Gy (74-425.9Gy) administered in the tumor. Progression-free survival was 6.7 months and overall survival was 12.8 months. Differences in disease-free survival according to BCLC and Child-Pugh classification were not significant (p=0.848 and p=0.252, respectively). The clinical parameters that were significantly different with respect to overall survival were bilirubin levels (p<0.001), pretreatment transaminase levels (AST) (p=0.022), Child-Pugh subclassification (p=0.003), and dose administered in the tumor (p=0.001). Only one patient had a severe adverse reaction, developing posttreatment liver failure resulting in death. Conclusions Radioembolization is safe and efficacious in the treatment of patients with hepatocellular carcinoma. Liver function and the doses received by the tumor are key parameters for the efficacy of treatment. The increase in the scientific evidence supports the inclusion of this technique in treatment guidelines. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/radiotherapy , Liver Neoplasms/radiotherapy , Brachytherapy/methods , Yttrium Radioisotopes/therapeutic use , Kaplan-Meier Estimate , Treatment Outcome , Retrospective Studies
4.
Adv Exp Med Biol ; 1384: 43-61, 2022.
Article in English | MEDLINE | ID: mdl-36217078

ABSTRACT

Obstructive sleep apnea (OSA) is a heterogeneous disease with many physiological implications. OSA is associated with a great diversity of diseases, with which it shares common and very often bidirectional pathophysiological mechanisms, leading to significantly negative implications on morbidity and mortality. In these patients, underdiagnosis of OSA is high. Concerning cardiorespiratory comorbidities, several studies have assessed the usefulness of simplified screening tests for OSA in patients with hypertension, COPD, heart failure, atrial fibrillation, stroke, morbid obesity, and in hospitalized elders.The key question is whether there is any benefit in the screening for the existence of OSA in patients with comorbidities. In this regard, there are few studies evaluating the performance of the various diagnostic procedures in patients at high risk for OSA. The purpose of this chapter is to review the existing literature about diagnosis in those diseases with a high risk for OSA, with special reference to artificial intelligence-related methods.


Subject(s)
Atrial Fibrillation , Sleep Apnea, Obstructive , Aged , Artificial Intelligence , Atrial Fibrillation/complications , Comorbidity , Humans , Polysomnography/methods , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/epidemiology
5.
Entropy (Basel) ; 22(12)2020 Dec 12.
Article in English | MEDLINE | ID: mdl-33322747

ABSTRACT

Positional obstructive sleep apnea (POSA) is a major phenotype of sleep apnea. Supine-predominant positional patients are frequently characterized by milder symptoms and less comorbidity due to a lower age, body mass index, and overall apnea-hypopnea index. However, the bradycardia-tachycardia pattern during apneic events is known to be more severe in the supine position, which could affect the cardiac regulation of positional patients. This study aims at characterizing nocturnal heart rate modulation in the presence of POSA in order to assess potential differences between positional and non-positional patients. Patients showing clinical symptoms of suffering from a sleep-related breathing disorder performed unsupervised portable polysomnography (PSG) and simultaneous nocturnal pulse oximetry (NPO) at home. Positional patients were identified according to the Amsterdam POSA classification (APOC) criteria. Pulse rate variability (PRV) recordings from the NPO readings were used to assess overnight cardiac modulation. Conventional cardiac indexes in the time and frequency domains were computed. Additionally, multiscale entropy (MSE) was used to investigate the nonlinear dynamics of the PRV recordings in POSA and non-POSA patients. A total of 129 patients (median age 56.0, interquartile range (IQR) 44.8-63.0 years, median body mass index (BMI) 27.7, IQR 26.0-31.3 kg/m2) were classified as POSA (37 APOC I, 77 APOC II, and 15 APOC III), while 104 subjects (median age 57.5, IQR 49.0-67.0 years, median BMI 29.8, IQR 26.6-34.7 kg/m2) comprised the non-POSA group. Overnight PRV recordings from positional patients showed significantly higher disorderliness than non-positional subjects in the smallest biological scales of the MSE profile (τ = 1: 0.25, IQR 0.20-0.31 vs. 0.22, IQR 0.18-0.27, p < 0.01) (τ = 2: 0.41, IQR 0.34-0.48 vs. 0.37, IQR 0.29-0.42, p < 0.01). According to our findings, nocturnal heart rate regulation is severely affected in POSA patients, suggesting increased cardiac imbalance due to predominant positional apneas.

6.
Radiologia (Engl Ed) ; 2020 Nov 27.
Article in English, Spanish | MEDLINE | ID: mdl-33257052

ABSTRACT

OBJECTIVE: To contribute our results to increase the scientific evidence about the use of radioembolization in the management of patients with hepatocellular carcinoma. MATERIAL AND METHODS: This retrospective review included 53 patients with hepatocellular carcinoma treated with radioembolization at our center. Patients were classified according to the BCLC algorithm in detail according to their Child-Pugh functional status. We analyzed survival using the Kaplan-Meier method. We used Cox regression analysis to determine clinically significant parameters, including the doses administered in the parameters studied. RESULTS: Patients ranged in age from 28 to 86 years (mean, 60 years). A total of 61 procedures were done. The mean activity administered was 2.8 GBq (0.7-6.4 GBq), with a mean dose of 229.9Gy (74-425.9Gy) administered in the tumor. Progression-free survival was 6.7 months and overall survival was 12.8 months. Differences in disease-free survival according to BCLC and Child-Pugh classification were not significant (p=0.848 and p=0.252, respectively). The clinical parameters that were significantly different with respect to overall survival were bilirubin levels (p<0.001), pretreatment transaminase levels (AST) (p=0.022), Child-Pugh subclassification (p=0.003), and dose administered in the tumor (p=0.001). Only one patient had a severe adverse reaction, developing posttreatment liver failure resulting in death. CONCLUSIONS: Radioembolization is safe and efficacious in the treatment of patients with hepatocellular carcinoma. Liver function and the doses received by the tumor are key parameters for the efficacy of treatment. The increase in the scientific evidence supports the inclusion of this technique in treatment guidelines.

9.
Nurse Educ Today ; 92: 104474, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32593857

ABSTRACT

BACKGROUND: The expectations of students regarding their studies have a strong influence on their academic performance and personal training, and they are closely related with their academic and professional future. OBJECTIVES: To analyze initial expectations and how they are fulfilled, in a cohort of nursing students during the four years of their degree program. DESIGN: Creation and validation of a questionnaire and longitudinal study. SETTING: University nursing school in Catalonia (Spain). PARTICIPANTS: 339 students of the nursing degree. METHODS: Two questionnaires were constructed with 10 items each, of a mixed nature: some items were previously validated in prior studies while other new items were made and included, following a review of the literature. The questionnaires were designed to assess the expectations of the students at the beginning of the academic year (CUDEX questionnaire) and the fulfillment of these at the end of the year (CUDEX-C questionnaire). RESULTS: Internal consistency (Cronbach's alpha) for the CUDEX questionnaire and the CUDEX-C was 0.70. Factorial analysis of the expectations questionnaires suggested a three-factor model, with an acceptable internal consistency for each of the factors. Statistically significant differences were found between the initial expectations and their fulfillment at the end of the academic year for all the factors and in all four years of the degree program. CONCLUSIONS: The three-factor model of the expectations (Academic adaptation, personal development, and academic performance) shows a good fit for the several samples and time points. The nursing students feel that not all of their expectations were fulfilled during their studies, and there were significant differences between their initial expectations and those fulfilled, in terms of all three factors.


Subject(s)
Students, Nursing , Humans , Longitudinal Studies , Motivation , Spain , Surveys and Questionnaires
10.
Sci Rep ; 10(1): 5332, 2020 03 24.
Article in English | MEDLINE | ID: mdl-32210294

ABSTRACT

The most appropriate physiological signals to develop simplified as well as accurate screening tests for obstructive sleep apnoea (OSA) remain unknown. This study aimed at assessing whether joint analysis of at-home oximetry and airflow recordings by means of machine-learning algorithms leads to a significant diagnostic performance increase compared to single-channel approaches. Consecutive patients showing moderate-to-high clinical suspicion of OSA were involved. The apnoea-hypopnoea index (AHI) from unsupervised polysomnography was the gold standard. Oximetry and airflow from at-home polysomnography were parameterised by means of 38 time, frequency, and non-linear variables. Complementarity between both signals was exhaustively inspected via automated feature selection. Regression support vector machines were used to estimate the AHI from single-channel and dual-channel approaches. A total of 239 patients successfully completed at-home polysomnography. The optimum joint model reached 0.93 (95%CI 0.90-0.95) intra-class correlation coefficient between estimated and actual AHI. Overall performance of the dual-channel approach (kappa: 0.71; 4-class accuracy: 81.3%) significantly outperformed individual oximetry (kappa: 0.61; 4-class accuracy: 75.0%) and airflow (kappa: 0.42; 4-class accuracy: 61.5%). According to our findings, oximetry alone was able to reach notably high accuracy, particularly to confirm severe cases of the disease. Nevertheless, oximetry and airflow showed high complementarity leading to a remarkable performance increase compared to single-channel approaches. Consequently, their joint analysis via machine learning enables accurate abbreviated screening of OSA at home.


Subject(s)
Monitoring, Ambulatory/methods , Pulmonary Ventilation/physiology , Sleep Apnea Syndromes/diagnosis , Adult , Aged , Algorithms , Female , Humans , Machine Learning , Male , Mass Screening/methods , Middle Aged , Oximetry/methods , Polysomnography/methods , Reproducibility of Results , Respiratory Physiological Phenomena , Sleep Apnea Syndromes/physiopathology , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/physiopathology , Spain/epidemiology
11.
Rev Chil Pediatr ; 90(4): 443-447, 2019 Aug.
Article in English, Spanish | MEDLINE | ID: mdl-31859718

ABSTRACT

INTRODUCTION: Malignant Infantile Osteopetrosis (MIOP) is a rare and severe genetic disorder due to abnormal osteoclast activity. OBJECTIVE: To report an infant who presented Malignant Infantile Osteopetrosis, reviewing the most relevant diagnostic and therapeutic aspects. CLINICAL CASE: A ten- month-old male infant with diagnosis of MIOP confirmed after presenting thrombocytopenia and visceromegaly. He was the first child of non-consanguineous parents, and among the findings, he presented severe hepatosplenomegaly, thrombocytopenia, and anemia; visual and hearing impair ment, and repeated infections. The diagnosis was confirmed by genetic study, which identified two heterozygous mutations in the TCIRG1 gene. Hematopoietic stem cells were transplanted without hematological recovery. The patient died due to occlusive venous disease. DISCUSSION: MIOP is a rare, severe, and early-onset disease, with a high rate of suspicion necessary in the presence of hepa- tosplenomegaly and bone marrow failure. Early diagnosis and hematopoietic stem cells transplanta tion are the only potentially therapeutic interventions of this lethal entity.


Subject(s)
Hematopoietic Stem Cell Transplantation/methods , Osteopetrosis/diagnosis , Vacuolar Proton-Translocating ATPases/genetics , Fatal Outcome , Humans , Infant , Male , Mutation , Osteopetrosis/genetics , Osteopetrosis/physiopathology
12.
Ultrason Sonochem ; 48: 550-554, 2018 Nov.
Article in English | MEDLINE | ID: mdl-30080584

ABSTRACT

The consumption of crustaceans is correlated with certain health risks, particularly due to several highly toxic elements they contain, including cadmium (Cd). Although Cd content in one sole crab generally exceeds the total weekly recommended intake of cadmium as established by EFSA (especially in brown meat), efficient modern strategies to reduce Cd content in crabs still have not yet been developed. The objective of this research was therefore to evaluate the potential use of ultrasound technology in combination with temperature (50°-80 °C) with the purpose of releasing Cd from brown crab (Cancer pagurus), thereby reducing the Cd content in its meat. Female crabs were immersed in a water bath at 50, 65, and 80 °C in presence or absence of ultrasound; Cd concentration in the water was monitored along time. At the end of the process, Cd content in brown and white crab meat was likewise quantified. Treatment temperature did not bear an influence on the release of Cd in absence of ultrasound, but proved to be an important variable when ultrasound assisted the process. Ultrasound increased Cd release rates 8.7-, 2.1- and 2.7-fold in conjunction with the treatments at 50, 65 and 80 °C, respectively. The maximum percentage of Cd extracted (22.8%) was observed at 50 °C for an ultrasound input power of 200 W. These results have demonstrated for the first time that the application of ultrasound during the crab-cooking process could serve as an effective physical procedure for reducing the Cd content of crabs, thereby improving the product's safety for consumers.


Subject(s)
Brachyura/metabolism , Cadmium/isolation & purification , Hot Temperature , Ultrasonic Waves , Water Pollutants, Chemical/isolation & purification , Animals , Cadmium/metabolism , Water Pollutants, Chemical/metabolism
13.
Eur J Pharm Sci ; 111: 186-194, 2018 Jan 01.
Article in English | MEDLINE | ID: mdl-28923571

ABSTRACT

The purpose of this study was to compare the in vivo efficacy of several timolol (TM)-loaded liposomal formulations with current TM antiglaucoma treatment (aqueous 0.5% w/v eye drops). In this study, conventional liposomes (CL) and deformable liposomes, without (DL1) and with ethanol (DL2) were prepared and characterized. In addition, in vitro release and permeation studies, as well as in vivo lowering intraocular pressure (IOP) and biocompatibility studies were performed. It was found that the quali and quantitative lipid bilayer composition played a significant role in modifying the physical properties of vesicles. The deformability study and electronic microscopy images revealed that membrane elasticity of DL1 and DL2 was much higher than CL. However, in vitro permeation results showed that the flux and permeability coefficient were significantly higher in CL compared to DL. The IOP study revealed that TM-loaded CL showed the best pharmacological activity, in comparison to deformable vesicles. Compared to the eye drops, CL formulation could equally reduce the IOP but using a concentration 10-fold lower, whereas the effective time was significantly longer. In addition, the formulations showed no irritant effects after instillation on the ocular surface.


Subject(s)
Adrenergic beta-Antagonists/administration & dosage , Liposomes/chemistry , Nanostructures/chemistry , Timolol/administration & dosage , Administration, Ophthalmic , Adrenergic beta-Antagonists/pharmacokinetics , Animals , Dose-Response Relationship, Drug , Ethanol/adverse effects , Ethanol/chemistry , Liposomes/adverse effects , Male , Nanostructures/adverse effects , Ophthalmic Solutions , Rabbits , Surface-Active Agents/adverse effects , Surface-Active Agents/chemistry , Timolol/pharmacokinetics
14.
Ultrason Sonochem ; 40(Pt A): 497-504, 2018 Jan.
Article in English | MEDLINE | ID: mdl-28946451

ABSTRACT

This study assesses the potential of incorporating ultrasound as a processing aid in the production of whole cooked brown crab (Cancer pagurus). The FDA recommended heat treatment to reduce Listeria monocytogenes by 6 log10 cycles in this product is a F707.5 of 2min. An equivalent F value was applied at 75°C in presence and absence of ultrasound in water alone or in water with 5% w/v NaCl added. Heat penetration, turbidity and conductivity of the cook water and also salt and moisture content of the crab meat (white and brown) were determined. Ultrasound assisted cooking allowed a reduction of the cooking time by up to 15% while still maintaining an F707.5 of 2min. Ultrasound also enhanced the rate and total amount of compounds released from the crab, which suggests that crabs cooked in the presence of ultrasound would be expected to be cleaner. Ultrasound also proved to be effective in reducing the salt content but hardly affected the final moisture content of the crab meat.


Subject(s)
Brachyura , Food Handling/methods , Ultrasonic Waves , Animals , Food Quality , Water/analysis
15.
PLoS One ; 12(11): e0188094, 2017.
Article in English | MEDLINE | ID: mdl-29176802

ABSTRACT

BACKGROUND: The coexistence of obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) leads to increased morbidity and mortality. The development of home-based screening tests is essential to expedite diagnosis. Nevertheless, there is still very limited evidence on the effectiveness of portable monitoring to diagnose OSAS in patients with pulmonary comorbidities. OBJECTIVE: To assess the influence of suffering from COPD in the performance of an oximetry-based screening test for moderate-to-severe OSAS, both in the hospital and at home. METHODS: A total of 407 patients showing moderate-to-high clinical suspicion of OSAS were involved in the study. All subjects underwent (i) supervised portable oximetry simultaneously to in-hospital polysomnography (PSG) and (ii) unsupervised portable oximetry at home. A regression-based multilayer perceptron (MLP) artificial neural network (ANN) was trained to estimate the apnea-hypopnea index (AHI) from portable oximetry recordings. Two independent validation datasets were analyzed: COPD versus non-COPD. RESULTS: The portable oximetry-based MLP ANN reached similar intra-class correlation coefficient (ICC) values between the estimated AHI and the actual AHI for the non-COPD and the COPD groups either in the hospital (non-COPD: 0.937, 0.909-0.956 CI95%; COPD: 0.936, 0.899-0.960 CI95%) and at home (non-COPD: 0.731, 0.631-0.808 CI95%; COPD: 0.788, 0.678-0.864 CI95%). Regarding the area under the receiver operating characteristics curve (AUC), no statistically significant differences (p >0.01) between COPD and non-COPD groups were found in both settings, particularly for severe OSAS (AHI ≥30 events/h): 0.97 (0.92-0.99 CI95%) non-COPD vs. 0.98 (0.92-1.0 CI95%) COPD in the hospital, and 0.87 (0.79-0.92 CI95%) non-COPD vs. 0.86 (0.75-0.93 CI95%) COPD at home. CONCLUSION: The agreement and the diagnostic performance of the estimated AHI from automated analysis of portable oximetry were similar regardless of the presence of COPD both in-lab and at-home. Particularly, portable oximetry could be used as an abbreviated screening test for moderate-to-severe OSAS in patients with COPD.


Subject(s)
Mass Screening , Oximetry/methods , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/diagnosis , Sleep Apnea Syndromes/complications , Sleep Apnea Syndromes/diagnosis , Automation , Databases as Topic , Demography , Female , Humans , Male , Middle Aged , Neural Networks, Computer , Polysomnography , ROC Curve
16.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 36(2): 116-119, mar.-abr. 2017. ilus
Article in English | IBECS | ID: ibc-160785

ABSTRACT

Ante un paciente con cáncer diferenciado de tiroides, el protocolo de tratamiento estándar a seguir es cirugía, ablación con 131Iodo (131I) de restos tiroideos y supresión de TSH. Pero en algunos casos, el tratamiento con 131I no es efectivo y deja de ser una opción terapéutica debido a la desdiferenciación celular con pérdida de la captación de 131I. Como otras opciones, se puede recurrir a tratamiento sistémico, si bien los pacientes no siempre son respondedores, pudiendo progresar la enfermedad y quedando sin opciones terapéuticas. Los tumores endocrinos pueden expresar receptores de la somatostatina, lo que se ha utilizado tanto para el diagnóstico como para su tratamiento mediante el marcaje de los análogos de la somatostatina con isótopos radiactivos. Presentamos el caso de una paciente con carcinoma folicular de tiroides yodorrefractario, con expresión de receptores de la somatostatina, tratada con 177Lu-DOTATATE, con excelente respuesta clínica y analítica (AU)


In a patient with a differentiated thyroid cancer the standard treatment protocol to be followed is surgery, ablation of thyroid remnants with 131Iodine (131I), and TSH suppression. However, the treatment with 131I is not effective in some cases, and it no longer becomes a therapeutic option due to cell de-differentiation with loss of 131I uptake. Systemic treatment can be used as other options, although patients are not always responsive; thus, the disease may progress and therapeutic options may run out. Endocrine tumours may express somatostatin receptors,and this characteristic has been used, not only for diagnosis, but also for their treatment through somatostatin analogue labelling with radioactive isotopes. This was the case of a patient suffering from iodine-refractory follicular thyroid carcinoma, with somatostatin receptors expression, treated with 177Lu-DOTATATE, showing an excellent clinical and analytical response (AU)


Subject(s)
Humans , Female , Middle Aged , Carcinoma/diagnosis , Carcinoma , Thyroid Neoplasms/drug therapy , Thyroid Neoplasms , Radiopharmaceuticals/therapeutic use , Trace Elements/therapeutic use , Somatostatin/analogs & derivatives , Iodine/therapeutic use , Radiopharmaceuticals/analysis , Neuroendocrine Tumors/drug therapy , Neuroendocrine Tumors , Quality of Life , Nuclear Medicine/methods
17.
Rev Esp Med Nucl Imagen Mol ; 36(2): 116-119, 2017.
Article in English, Spanish | MEDLINE | ID: mdl-27793633

ABSTRACT

In a patient with a differentiated thyroid cancer the standard treatment protocol to be followed is surgery, ablation of thyroid remnants with 131Iodine (131I), and TSH suppression. However, the treatment with 131I is not effective in some cases, and it no longer becomes a therapeutic option due to cell de-differentiation with loss of 131I uptake. Systemic treatment can be used as other options, although patients are not always responsive; thus, the disease may progress and therapeutic options may run out. Endocrine tumours may express somatostatin receptors,and this characteristic has been used, not only for diagnosis, but also for their treatment through somatostatin analogue labelling with radioactive isotopes. This was the case of a patient suffering from iodine-refractory follicular thyroid carcinoma, with somatostatin receptors expression, treated with 177Lu-DOTATATE, showing an excellent clinical and analytical response.


Subject(s)
Adenocarcinoma, Follicular/radiotherapy , Bone Neoplasms/radiotherapy , Bone Neoplasms/secondary , Liver Neoplasms/radiotherapy , Liver Neoplasms/secondary , Lutetium/therapeutic use , Octreotide/analogs & derivatives , Organometallic Compounds/therapeutic use , Radioisotopes/therapeutic use , Radiopharmaceuticals/therapeutic use , Thyroid Neoplasms/radiotherapy , Adenocarcinoma, Follicular/blood , Adenocarcinoma, Follicular/drug therapy , Adenocarcinoma, Follicular/surgery , Aged , Antibiotics, Antineoplastic/therapeutic use , Biomarkers, Tumor/blood , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/drug therapy , Combined Modality Therapy , Doxorubicin/therapeutic use , Everolimus/therapeutic use , Female , Goiter, Nodular/complications , Goiter, Nodular/surgery , Humans , Indazoles , Iodine Radioisotopes/therapeutic use , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/drug therapy , Niacinamide/analogs & derivatives , Niacinamide/therapeutic use , Octreotide/therapeutic use , Palliative Care , Phenylurea Compounds/therapeutic use , Positron Emission Tomography Computed Tomography , Pyrimidines/therapeutic use , Sorafenib , Sulfonamides/therapeutic use , Thyroglobulin/blood , Thyroid Neoplasms/blood , Thyroid Neoplasms/surgery , Thyroidectomy
18.
Radiología (Madr., Ed. impr.) ; 58(6): 468-480, nov.-dic. 2016. tab, ilus
Article in Spanish | IBECS | ID: ibc-158680

ABSTRACT

La tomografía por emisión de positrones (PET) es una técnica de imagen que en los últimos años ha experimentado un gran crecimiento y se considera una herramienta básica de gran utilidad en el campo de la oncología, sin olvidar sus indicaciones en otras áreas como la neurología y la cardiología. Aunque la 18F-fluorodeoxyglucose (18F-FDG) es el radiofármaco más ampliamente utilizado en PET, disponer de nuevos radiotrazadores ha sido un elemento clave en la expansión de esta técnica porque han permitido estudiar diferentes dianas biológicas esenciales para un mayor conocimiento y una mejor caracterización de diferentes patologías, contribuyendo de esta forma a la investigación y el desarrollo de nuevos agentes terapéuticos. En este trabajo se hace una descripción de varios radiofármacos para PET, estructurada según su área de aplicación. Algunos de ellos ya están disponibles comercialmente, mientras que otros todavía están en fase de investigación o pendientes de autorización (AU)


Positron emission tomography (PET) is an imaging technique that has grown greatly in recent years. PET is considered a fundamental tool in oncology, and it also has indications in other fields such as neurology and cardiology. Although 18F-fluorodeoxyglucose (18F-FDG) is the radiopharmaceutical most widely used in PET, the availability of new radiotracers has been a key element in the expansion of the use of PET. These new radiopharmaceuticals have made it possible to study different biological targets that are essential for obtaining greater knowledge and better characterization of different diseases and have thus contributed to the research and development of different therapeutic agents. This article provides a description of different PET radiopharmaceutical, structured according to their areas of application. Some of these radiotracers are already commercially available, whereas others are still under research or pending approval by regulatory bodies (AU)


Subject(s)
Humans , Male , Female , Radiopharmaceuticals/administration & dosage , Radiopharmaceuticals/radiation effects , Positron-Emission Tomography/instrumentation , Positron-Emission Tomography/methods , Positron-Emission Tomography , Tomography, Emission-Computed/methods , 34944 , Neoplasms , Radiopharmaceuticals/chemistry , Magnetic Resonance Imaging/methods
19.
Radiologia ; 58(6): 468-480, 2016.
Article in English, Spanish | MEDLINE | ID: mdl-27592111

ABSTRACT

Positron emission tomography (PET) is an imaging technique that has grown greatly in recent years. PET is considered a fundamental tool in oncology, and it also has indications in other fields such as neurology and cardiology. Although 18F-fluorodeoxyglucose (18F-FDG) is the radiopharmaceutical most widely used in PET, the availability of new radiotracers has been a key element in the expansion of the use of PET. These new radiopharmaceuticals have made it possible to study different biological targets that are essential for obtaining greater knowledge and better characterization of different diseases and have thus contributed to the research and development of different therapeutic agents. This article provides a description of different PET radiopharmaceutical, structured according to their areas of application. Some of these radiotracers are already commercially available, whereas others are still under research or pending approval by regulatory bodies.


Subject(s)
Positron-Emission Tomography/methods , Radiopharmaceuticals , Forecasting , Heart Diseases/diagnostic imaging , Humans , Neoplasms/diagnostic imaging , Nervous System Diseases/diagnostic imaging , Positron-Emission Tomography/trends
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