Diagnóstico inesperado de nefronoptisis en estudio genético de hipertensión por diagnóstico histológico de nefroangioesclerosis benigna evolucionada en paciente joven caucásico / Unexpected diagnosis of nephronopthisis in the genetic study of hypertension due to histological diagnosis of benign nephroangioesclerosis evolved in a young caucasian patient

Se presenta el caso de un paciente joven de raza caucásica, con una enfermedad renal de causa no clara, con un diagnóstico final establecido por biopsia renal de nefroangioesclerosis benigna evolucionada. Debido a la posibilidad de haber tenido hipertensión arterial en edad pediátrica (sin estudio ni tratamiento), con los hallazgos de biopsia renal, el estudio genético de hipertensión mostró polimorfismos de riesgo en los genes APOL1 y MYH9 y, además, un diagnóstico inesperado de una deleción completa del gen NPHP1 en homocigosis, asociada al desarrollo de nefronoptisis. En conclusión, este caso ilustra la importancia de hacer estudio genético, sobre todo en pacientes jóvenes con enfermedad renal de causa no clara, incluso teniendo un diagnóstico histológico de nefroangioesclerosis. (AU)

We present the case of a young Caucasian patient with renal disease of unclear cause, with a final diagnosis of advanced benign nephroangiosclerosis established by renal biopsy. Due to the possibility of having hypertension in pediatric age (without study or treatment), with the renal biopsy findings, the genetic study showed polymorphisms risk in the APOL1 and MYH9, and also an unexpected diagnosis of a complete deletion of the NPHP1 gene in homozygosis, associated with the development of nephronophthisis. In conclusion, this case illustrates the importance of carrying out a genetic study in youngs patients with renal disease unclear cause, even having a histological diagnosis of nephroangiosclerosis. (AU)

[Unexpected diagnosis of nephronopthisis in the genetic study of hypertension due to histological diagnosis of benign nephroangioesclerosis evolved in a young caucasian patient]. / Diagnóstico inesperado de nefronoptisis en estudio genético de hipertensión por diagnóstico histológico de nefroangioesclerosis benigna evolucionada en paciente joven caucásico.

We present the case of a young Caucasian patient with renal disease of unclear cause, with a final diagnosis of advanced benign nephroangiosclerosis established by renal biopsy. Due to the possibility of having hypertension in pediatric age (without study or treatment), with the renal biopsy findings, the genetic study showed polymorphisms risk in the APOL1 and MYH9, and also an unexpected diagnosis of a complete deletion of the NPHP1 gene in homozygosis, associated with the development of nephronophthisis. In conclusion, this case illustrates the importance of carrying out a genetic study in youngs patients with renal disease unclear cause, even having a histological diagnosis of nephroangiosclerosis.

Surgery in a Patient with Haemophilia A and Lymphoma.

An increased incidence of haematologic malignancies and other cancer types among patients with haemophilia compared with matched controls has been reported in several longitudinal studies. Tumours initially misdiagnosed as haematomas and conversely haematomas mistaken for tumours have been reported. Here, we describe the case of a 43-year-old man with severe haemophilia A and a diffuse large B-cell lymphoma, originally diagnosed as a haematoma, who underwent a splenectomy and several associated surgeries as part of his lymphoma treatment. Perioperative treatment with octanate® (human coagulation factor VIII) enabled the successful performance of all surgical interventions required in the context of lymphoma treatment. Nevertheless, differential diagnosis of posttraumatic haematoma in patients with haemophilia should include the consideration of malignancy.

Síndrome del microftalmos posterior-drusas papilares-retinosis pigmentaria asociado a puntos blancos. Caso clínico / Posterior microphthalmos, retinitis pigmentosa and optic disc drusen with white dots. A case report

Objetivo: Presentar el caso de un paciente con un síndrome del microftalmos posterior-drusas papilares-retinosis pigmentaria asociado por primera vez a puntos blancos en el polo posterior. Material: El síndrome del microftalmos posterior-drusas papilares-retinosis pigmentaria fue descrito por primera vez en la literatura en 1991. Posteriormente se asoció a un patrón de engrosamiento foveolar o foveosquisis. Distintas formas de mutaciones en los cromosomas 11 y 14 han sido identificadas como responsables de la aparición de este síndrome, sin que se haya podido esclarecer, hasta el momento, un patrón de herencia determinado. Discusión: Presentamos el caso de un varón de 37 años, sin antecedentes personales ni familiares de interés, con este síndrome asociado a puntos blancos en el polo posterior. Esta asociación morfológica nunca ha sido descrita en la literatura. Conclusión: El síndrome del microftalmos posterior-drusas papilares-retinosis pigmentaria es una entidad muy poco común y nunca ha sido descrita asociada a puntos blancos en el polo posterior. Es necesaria más casuística para establecer patrones claros tanto de la enfermedad como en su herencia (AU)

Objective: To present the case of a patient with a posterior microphthalmos-optic disc drusen-retinitis pigmentosa syndrome associated, for the first time, with white dots in the posterior pole. Methodology: The posterior microphthalmos, retinitis pigmentosa and optic disc drusen syndrome was described for the first time in literature in 1991. Later, it was associated with a pattern of foveal thickening and/or foveoschisis. Different forms of mutations on chromosomes 11 and 14 have been identified as being responsible for the appearance of this syndrome, but the inheritance pattern is unknown. Discussion: The case is reported of a 37 year-old man, with no personal or family history of interest, diagnosed with this syndrome in association with white dots in the posterior pole. Such a morphological association has never been published before in literature. Conclusion: The posterior microphthalmos, retinitis pigmentosa and optic disc drusen syndrome is a very rare entity, and has never been described associated with white dots in the posterior pole. More case reports are needed to establish clear patterns of both the disease and inheritance (AU)

Modelo murino experimental de cáncer renal / Experimental murine model of renal cancer

Introducción: El objetivo fue conocer la reproductibilidad en modelo murino de tumores renales de diferentes estirpes histológicas que podría ser útil para investigar la respuesta a fármacos diana. Material y métodos: Desarrollo y análisis del modelo in vivo: xenoinjerto tumoral de carcinoma de células renales con ratones atímicos nude Balb/c. Se implanta tejido renal humano no tumoral en la región interescapular de 5 ratones, tumor renal tipo cromófobo en 5 ratones que tras comprobarse su crecimiento se preparó para implante en otros 10 ratones y tumor renal tipo carcinoma renal de células claras (CRCC) Fuhrman 2 en 5 ratones que también se implantó posteriormente en 10 ratones. Se monitoriza el tamaño tumoral, la aparición de metástasis y el aumento de tamaño y número de las mismas. Cuando alcanza tamaño igual o superior a carcinoma localmente avanzado o metastásico los animales son sacrificados para estudio anatomopatológico, inmunohistoquímico y segunda fase de implante. Resultados: El xenoinjerto subcutáneo del tejido sano no creció, se sacrificaron a los 6 meses sin hallar tejido renal. El carcinoma renal de células cromófobas creció en la primera fase (100%), pero en la segunda fase se observó reacción inflamatoria crónica linfomonocitaria y a cuerpo extraño. El CRCC creció a los 5-8 meses, tanto en la primera como en la segunda fase (100%), manteniendo el tipo y el grado tumoral. Conclusiones: El modelo con ratones atímicos nude Balb/c es útil para reproducir CRCC, con las mismas características y agresividad histológica al tumor humano nativo, alentando al desarrollo de la segunda fase experimental

Introduction: The objective of this study was to determine the reproducibility in a murine model of renal tumours of various histological strains that could be useful for investigating the response to target drugs. Material and methods: Development and analysis of the «in vivo» model: tumour xenograft of renal cell carcinomas with Balb/c nude athymic mice. Nontumourous human renal tissue was implanted in the interscapular region of 5 mice, chromophobe renal cell carcinoma was implanted in 5 mice (which, after checking its growth, was prepared for implantation in another 10 mice) and Fuhrman grade 2 clear cell renal cell carcinoma (CCRCC) was implanted in 5 mice (which was also subsequently implanted in 10 mice). We monitored the tumour size, onset of metastases and increase in size and number of tumours. When the size had reached a point greater than or equal to locally advanced or metastatic carcinoma, the animals were euthanised for a pathological and immunohistochemical study and a second phase of implantation. Results: The subcutaneous xenograft of the healthy tissue did not grow. The animals were euthanised at 6 months and no renal tissue was found. The chromophobe renal cell carcinoma cells grew in the initial phase (100%); however, in the second phase, we observed a chronic lymphomonocyte inflammatory reaction and a foreign body reaction. The CCRCC grew at 5-8 months both in the first and second phase (100%), maintaining the tumour type and grade. Conclusions: The model with athymic Balb/c nude mice is useful for reproducing CCRCC, with the same histological characteristics and aggressiveness as native human tumours, promoting the development of the second experimental phase

Posterior microphthalmos, retinitis pigmentosa and optic disc drusen with white dots. A case report. / Síndrome del microftalmos posterior-drusas papilares-retinosis pigmentaria asociado a puntos blancos. Caso clínico.

OBJECTIVE: To present the case of a patient with a posterior microphthalmos-optic disc drusen-retinitis pigmentosa syndrome associated, for the first time, with white dots in the posterior pole. METHODOLOGY: The posterior microphthalmos, retinitis pigmentosa and optic disc drusen syndrome was described for the first time in literature in 1991. Later, it was associated with a pattern of foveal thickening and/or foveoschisis. Different forms of mutations on chromosomes 11 and 14 have been identified as being responsible for the appearance of this syndrome, but the inheritance pattern is unknown. DISCUSSION: The case is reported of a 37 year-old man, with no personal or family history of interest, diagnosed with this syndrome in association with white dots in the posterior pole. Such a morphological association has never been published before in literature. CONCLUSION: The posterior microphthalmos, retinitis pigmentosa and optic disc drusen syndrome is a very rare entity, and has never been described associated with white dots in the posterior pole. More case reports are needed to establish clear patterns of both the disease and inheritance.

Experimental murine model of renal cancer. / Modelo murino experimental de cáncer renal.

INTRODUCTION: The objective of this study was to determine the reproducibility in a murine model of renal tumours of various histological strains that could be useful for investigating the response to target drugs. MATERIAL AND METHODS: Development and analysis of the "in vivo" model: tumour xenograft of renal cell carcinomas with Balb/c nude athymic mice. Nontumourous human renal tissue was implanted in the interscapular region of 5 mice, chromophobe renal cell carcinoma was implanted in 5 mice (which, after checking its growth, was prepared for implantation in another 10 mice) and Fuhrman grade 2 clear cell renal cell carcinoma (CCRCC) was implanted in 5 mice (which was also subsequently implanted in 10 mice). We monitored the tumour size, onset of metastases and increase in size and number of tumours. When the size had reached a point greater than or equal to locally advanced or metastatic carcinoma, the animals were euthanised for a pathological and immunohistochemical study and a second phase of implantation. RESULTS: The subcutaneous xenograft of the healthy tissue did not grow. The animals were euthanised at 6 months and no renal tissue was found. The chromophobe renal cell carcinoma cells grew in the initial phase (100%); however, in the second phase, we observed a chronic lymphomonocyte inflammatory reaction and a foreign body reaction. The CCRCC grew at 5-8 months both in the first and second phase (100%), maintaining the tumour type and grade. CONCLUSIONS: The model with athymic Balb/c nude mice is useful for reproducing CCRCC, with the same histological characteristics and aggressiveness as native human tumours, promoting the development of the second experimental phase.

Plurihormonal Cosecretion by a Case of Adrenocortical Oncocytic Neoplasm.

Adrenocortical oncocytic neoplasms (oncocytomas) are extremely rare; only approximately 159 cases have been described so far. The majority are nonfunctional and benign. We describe an unusual case of a functional oncocytoma secreting an excess of glucocorticoids (cortisol) and androgens (androstenedione and DHEAS), a pattern of plurihormonal cosecretion previously not reported in men, presenting with endocrine manifestations of Cushing's syndrome. The neoplasm was considered to be of uncertain malignant potential (borderline) according to the Lin-Weiss-Bisceglia criteria.

Diazepam and Jacobson's progressive relaxation show similar attenuating short-term effects on stress-related brain glucose consumption.

A non-pharmacological method to reduce anxiety is "progressive relaxation" (PR). The aim of the method is to reduce mental stress and associated mental processes by means of progressive suppression of muscle tension. The study was addressed to evaluate changes in brain glucose metabolism induced by PR in patients under a stressing state generated by a diagnostic medical intervention. The effect of PR was compared to a dose of sublingual diazepam, with the prediction that both interventions would be associated with a reduction in brain metabolism. Eighty-four oncological patients were assessed with 18F-fluorodeoxyglucose-positron emission tomography. Maps of brain glucose distribution from 28 patients receiving PR were compared with maps from 28 patients receiving sublingual diazepam and with 28 patients with no treatment intervention. Compared to reference control subjects, the PR and diazepam groups showed a statistically significant, bilateral and generalized cortical hypometabolism. Regions showing the most prominent changes were the prefrontal cortex and anterior cingulate cortex. No significant differences were identified in the direct comparison between relaxation technique and sublingual diazepam. Our findings suggest that relaxation induced by a physical/psychological procedure can be as effective as a reference anxiolytic in reducing brain activity during a stressful state.

Optimization of packaging and storage conditions of a freeze-dried Pantoea agglomerans formulation for controlling postharvest diseases in fruit.

AIMS: This study aimed to evaluate different packaging strategies to extend the shelf life of a freeze-dried formulation of the biocontrol agent Pantoea agglomerans strain CPA-2. METHODS AND RESULTS: Different materials and atmosphere packaging conditions (vacuum and air) were analysed on formulated P. agglomerans cells stored at 25, 5 and -20°C. Results showed the viability of CPA-2 cells stored at 5 or -20°C was significantly higher than when stored at 25°C. The highest viabilities were observed with the plastic material designated as Bottle 1, in nonvacuum packaging in all storage temperatures: 50% after 3 months at 25°C, 100% after 8 months at 5°C and 100 and 74% after 12 and 18 months, respectively, at -20°C; the final concentration was 10(12) CFU g(-1), a good concentration for a commercial product. The efficacy to control blue and green mould on apples and oranges, respectively, of these packed and stored cells was similar to fresh CPA-2 cells. CONCLUSIONS: This work showed a suitable packaging strategy for a freeze-dried formulation of the CPA-2, providing a good shelf life and efficacy against the major postharvest diseases of apples and citrus based on a plastic bottle stored at cold or frozen storage conditions. SIGNIFICANCE AND IMPACT OF THE STUDY: The last phase of the commercial development process for biocontrol agents is presented in this work. A bacterium-based product that ensures the efficacy, stability and easy application of the antagonist to control postharvest fungal diseases on fruit was successfully obtained.

[Post-dural (post-lumbar) puncture syndrome. Review and retrospective study at an emergency headache centre]. / Le syndrome post-ponction lombaire. Revue de la littérature et expérience des urgences céphalées.

Post-lumbar puncture headache (PLPH) is a well-known syndrome resulting from spinal fluid leakage and delayed closure of a dural defect. The main symptom of PLPH is headache in upright posture relieved by lying down. Outcome is usually benign and complications are uncommon. The functional impact can however be important, leading to delayed discharge, sick leave and, if information delivery is ineffective, iterative consultations. Preventive measures have been published, but the prevalence of PLPH remains high (15 to 40% after diagnostic lumbar puncture). Needle size and type are probably the most important factors for reducing the risk of PLPH. Recovery can be rapid, within a few days. If PLPH persists after four days, an epidural blood patch should be discussed. The objective of this review is to summarize the literature on PLPH, and share the experience of our emergency headache center with an atraumatic 25-gauge needle (pencan, 0.5×90mm or 0.5×103mm, Braun, Germany).

Clinical profile and epidemiological changes of clear cell renal carcinoma during 12 years in our health area.

OBJECTIVES: To investigate changes in the epidemiology and clinical profile of patients diagnosed with renal clear cell carcinoma in a community health area over 12 years. METHODS: Retrospective analysis of epidemiological characteristics and clinical profile of patients diagnosed with renal clear cell carcinoma in a health area composed of a population of 353.619 inhabitants from January 1999 to December 2010. Descriptive statistical and multivariate analysis, Fisher exact test and Chi-Square were utilized. p<0.05 was accepted as significant. RESULTS: 349 diagnoses of renal mass were reported; 165 of them were clear renal cell carcinoma. Median age was 70.41 years, and the Female/Male rate was 28% and 72%, respectively. 4% women and 30% men smoked ≥20 cigarettes/day, more frequently during the period 1999-2001. 52% women and 30% men had hypertension. Hematuria was the most frequent symptom (23%), more frequent in the period 2007-2010, followed by abdominal pain (16%) and renal colic(13%). Weight loss (12%) was more frequent between 1999-2000. Asthenia appeared as the first symptom in 8% of cases. The tumor was incidentally diagnosed in 20% of cases, more frequently in the period between 2007-2010. Diagnosis was established in the Urology Department in 36% of the cases. Stages T1-2 N0 were more frequent between 2007-2010, and M1 between 1999-2000. G3 was more frequent in the entire series. The relative cancer specific mortality of patients who were surgically treated was less in the last 2 years of the period. CONCLUSIONS: Clear renal cell carcinoma is the most frequent renal cancer and its incidence is increasing in our environment. It affects more frequently males than females, and at an earlier age. The last few years are showing a decrease in the habitual smoker males and an increase in HTN in females. A tendency has been detected to the early stage clinical diagnosis but with a higher histopathological grade. It is most frequent diagnosed by a non-Urology speciality.

Perfil clínico y cambios epidemiológicos del carcinoma renal de células claras a lo largo de 12 años en un área de salud / Clinical profile and epidemiological changes of clear cell renal carcinoma during 12 years in our health area

OBJETIVO: Investigar si se producen cambios en la epidemiología y en el perfil clínico de los pacientes diagnosticados de carcinoma renal de células claras (CRCC) en un área de salud a lo largo de 12 años. MÉTODOS: Se realiza un análisis retrospectivo de las características epidemiológicas y del perfil clínico (sexo, edad, factores de riesgo, estadio tumoral y supervivencia) de los pacientes diagnosticados de CRCC en un área de salud de 353619 habitantes desde enero de 1999 hasta diciembre de 2010. Se utiliza estadística descriptiva, t de Student, test exacto de Fisher y Chi-Square. p<0.05 se aceptó como significativo(AU)

RESULTADOS: Se emitieron 349 diagnósticos de masa renal, de los cuales 165 casos corresponden a CRCC. La edad media fue de 70.41 años, y la distribución mujeres/varones fue 28/72%. El consumo de ≥20 cigarillos/día se presentó en el 4% de las mujeres y en el 30% de los hombres, siendo más frecuente en 1999-2001. El 52% de las mujeres y el 30 % de los hombres padecían hipertensión arterial (HTA). La hematuria fue el síntoma más frecuente, apareciendo en un 23%, más frecuente en 2007-2010 (p<0.034). Los siguientes síntomas en frecuencia fueron el dolor abdominal (16%) y las crisis renoureterales (13%). La pérdida de peso (12%) fue más frecuente entre los años 1999 y 2000. La astenia apareció como síntoma primero en un 8% de casos. El diagnóstico fue incidental en un 20% de los casos, más frecuente entre los años 2007 y 2010 (p<0.0081).Conocido tradicionalmente como el tumor del internista, corroboramos que solo el 36% de estos tumores fueron diagnosticados en Urología y el 64% en otras especialidades. En cuanto al estadio, T1-T2 y N0 fueron más frecuentes en los últimos 4 años respecto a 1999-2006 (p<0.016 y p<0.0002 respectivamente). M1 fue más frecuente que M0 en 1999-2000 (p<0.0021) y M0 más frecuente en 2004-2010 (p<0.0038). G3 fue más frecuente en toda la serie, más acentuado en 2008-2010 (p<0.0186). La mortalidad relativa cáncer-específica de los pacientes tratados quirúrgicamente fue menor en los dos últimos años del periodo (p<0.0314). CONCLUSIONES: El CRCC es el cáncer renal más frecuente y con incidencia en aumento en nuestro medio. Afecta más y a menor edad a hombres que a mujeres. En los últimos años se registra menos tabaquismo severo en hombres y más HTA en mujeres. Existe una tendencia al diagnóstico en estadio clínico más precoz pero con mayor grado histopatológico. El diagnóstico se realiza con mayor frecuencia en especialidad no urológica(AU)

OBJECTIVES: To investigate changes in the epidemiology and clinical profile of patients diagnosed with renal clear cell carcinoma in a community health area over 12 years. METHODS: Retrospective analysis of epidemiological characteristics and clinical profile of patients diagnosed with renal clear cell carcinoma in a health area composed of a population of 353.619 inhabitants from January 1999 to December 2010. Descriptive statistical and multivariate analysis, Fisher exact test and Chi-Square were utilized. p<0.05 was accepted as significant. RESULTS: 349 diagnoses of renal mass were reported; 165 of them were clear renal cell carcinoma. Median age was 70.41 years, and the Female/Male rate was 28% and 72%, respectively. 4% women and 30% men smoked ≥20cigarettes/day, more frequently during the period 1999-2001. 52% women and 30% men had hypertension. Hematuria was the most frequent symptom (23%), more frequent in the period 2007-2010, followed by abdominal pain (16%) and renal colic (13%). Weight loss (12%) was more frequent between 1999-2000. Asthenia appeared as the first symptom in 8% of cases. The tumor was incidentally diagnosed in 20% of cases, more frequently in the period between 2007-2010.Diagnosis was established in the Urology Department in 36% of the cases. Stages T1-2 N0 were more frequent between 2007-2010, and M1 between 1999-2000. G3 was more frequent in the entire series. The relative cancer specific mortality of patients who were surgically treated was less in the last 2 years of the period(AU)

CONCLUSIONS: Clear renal cell carcinoma is the most frequent renal cancer and its incidence is increasing in our environment. It affects more frequently males than females, and at an earlier age. The last few years are showing a decrease in the habitual smoker males and an increase in HTN in females. A tendency has been detected to the early stage clinical diagnosis but with a higher histopathological grade. It is most frequent diagnosed by a non-Urology speciality(AU)

Paraganglioma of prostatic origin.

INTRODUCTION: Paragangliomas are usually benign tumors arising from chromaffin cells located outside the adrenal gland. Prostatic paraganglioma is an unusual entity in adult patients, with only 10 cases reported in the medical literature. CASE REPORT: A 34-year-old male with a history of chronic prostatitis consulted for perineal pain. On digital rectal examination the prostate was enlarged and firm, without nodules. The PSA level was 0.8 ng/mL and the catecholamines in the urine were elevated. On ultrasound a retrovesical 9 cm mass of undetermined origin measuring was present. A PET-CT scan showed a pelvic lesion measuring 9 cm with moderate increase in glucidic metabolism localized in the area of the prostate. A biopsy of the prostate revealed a neuroendocrine tumor, possibly a prostatic paraganglioma. A body scintigraphy with MIBG I-123 ruled out the presence of metastases or multifocal tumor. A radical prostatectomy with excision of the pelvic mass was performed under adrenergic blockade. One year after surgery the patient is asymptomatic and disease free. DISCUSSION/CONCLUSIONS: Prostatic paraganglioma is a rare, usually benign tumor, which should be considered in the differential diagnosis of prostate tumors in young males. Its diagnosis is based on the determination of catecholamine in blood and 24-hour urine and in imaging studies principally scintigraphy with MIBG I-123. Diagnostic confirmation is by histopathological study. The treatment consists of radical resection under adrenergic blockade and volume expansion. Given the limited number of cases reported, it is difficult to establish prognostic factors. Malignancy is defined by clinical criteria, and requires life long follow-up.

Pruebas de diagnóstico por la imagen: ¿generan ansiedad? / Diagnostic imaging studies: do they create anxiety?

El cáncer constituye uno de los principales problemas de salud en los países occidentales. En el año 2008 fue la primera causa de muerte en varones y la segunda en mujeres. En el contexto de pacientes con sospecha o diagnóstico de cáncer, la realización de pruebas diagnósticas desempeña un papel central de la actividad clínica y puede tener un elevado impacto psicológico. Objetivo. Evaluar el grado de ansiedad que presentan los pacientes oncológicos que se realizan un estudio PET-TAC en un Servicio de Medicina Nuclear, mediante el cuestionario State Trait Anxiety Inventory (STAI). Material y método. Doscientos pacientes que se realizaron un estudio PET-TAC en un Servicio de Medicina Nuclear realizaron el cuestionario STAI para valorar el grado de ansiedad que genera la realización de esta prueba. El STAI es un cuestionario validado desarrollado como herramienta de investigación de la ansiedad en adultos sanos. Resultados. De los 200 pacientes, dos tercios (n=135; 67%) presentaban ansiedad. De los 133 que realizaron el estudio por primera vez, el 70% (n=93) estaba ansioso. De los 67 que ya se habían realizado el estudio con anterioridad un 62,7% (n=42) estaba ansioso. Los pacientes que presentaron mayor ansiedad son los que se realizaron el estudio para estadificar inicialmente la enfermedad. Conclusión. La realización de un estudio PET-TAC como método de estadificación inicial y/o para valorar una recurrencia tumoral es un importante generador de ansiedad, de forma estadísticamente significativa. Existe un elevado impacto emocional y cognitivo asociado a la participación de pruebas de diagnóstico(AU)

Cancer is one of the main health problems in western countries. In 2008, it represented the first cause of death in men and the second one in women. When there is a diagnosis or suspicion of cancer, performing diagnostic imaging studies has an important role in the clinical activity and may have an elevated psychological impact. Objective. The purpose of this study was to evaluate the level of anxiety in oncology patients during the performance of a nuclear medicine study (PET-CT) in a Nuclear Medicine Service, by means of the State Trait Anxiety Inventory (STAI). Material and methods. A total of 200 cancer patients who underwent a PET-CT study in a Nuclear Medicine Service were administered the STAI to evaluate the level of anxiety generated during this test. The STAI is a validated questionnaire developed as a research tool on anxiety in healthy adults. Results. Of the 200 patients, two thirds (n=135) (67%) of the patients evaluated had anxiety. Of the 133, 93 (70%) of the patients who underwent PET-CT study for the first time were anxious whereas 42 (62.7%) of the patients who had undergone the study on previous occasions were anxious. Those patients with the greatest anxiety were those in whom the study was performed to initially stage the disease. Conclusion. Performing the PET-CT study as an initial staging method and/or to evaluate tumor recurrence is an important and statistically significant generator of anxiety. There is a high emotional and cognitive impact associated to the participation of the diagnostic tests(AU)

[Diagnostic imaging studies: do they create anxiety?]. / Pruebas de diagnóstico por la imagen: ¿generan ansiedad?

UNLABELLED: Cancer is one of the main health problems in western countries. In 2008, it represented the first cause of death in men and the second one in women. When there is a diagnosis or suspicion of cancer, performing diagnostic imaging studies has an important role in the clinical activity and may have an elevated psychological impact. OBJECTIVE: The purpose of this study was to evaluate the level of anxiety in oncology patients during the performance of a nuclear medicine study (PET-CT) in a Nuclear Medicine Service, by means of the State Trait Anxiety Inventory (STAI). MATERIAL AND METHODS: A total of 200 cancer patients who underwent a PET-CT study in a Nuclear Medicine Service were administered the STAI to evaluate the level of anxiety generated during this test. The STAI is a validated questionnaire developed as a research tool on anxiety in healthy adults. RESULTS: Of the 200 patients, two thirds (n=135) (67%) of the patients evaluated had anxiety. Of the 133, 93 (70%) of the patients who underwent PET-CT study for the first time were anxious whereas 42 (62.7%) of the patients who had undergone the study on previous occasions were anxious. Those patients with the greatest anxiety were those in whom the study was performed to initially stage the disease. CONCLUSION: Performing the PET-CT study as an initial staging method and/or to evaluate tumor recurrence is an important and statistically significant generator of anxiety. There is a high emotional and cognitive impact associated to the participation of the diagnostic tests.

Chemosensory event-related potentials in early blind humans.

While the effects of early visual deprivation on auditory and tactile functions have been widely studied, little is known about olfactory function in early blind subjects. The present study investigated the potential effect of early blindness on the electrophysiological correlates of passive odour perception. Event-related potentials (ERPs) were recorded in eight early blind humans and eight sighted controls matched for age, sex and handedness during olfactory stimulation with 2-phenyl ethyl alcohol and trigeminal stimulation with CO2 Latencies, amplitudes and topographical distributions were analysed. As expected, the olfactory and trigeminal ERP components showed normal latencies, amplitudes and topography in both groups. Olfactory stimuli generated responses of smaller amplitude than those observed in response to trigeminal stimulation. In addition, ERP analyses did not reveal any major difference in electrocortical responses in occipital areas in early blind and sighted subjects. These results suggest that passive olfactory and trigeminal stimulation elicit the same electrophysiological responses in both groups, confirming that the neurophysiological correlates of the cross-modal compensatory mechanisms in early blind subjects do not appear during passive olfactory and trigeminal perception.

Steady-state and femtosecond photoinduced processes of blepharismins bound to alpha-crystallin.

The interaction of blepharismin (BP) and oxyblepharismin (OxyBP) with bovine alpha-crystallin (BAC) has been studied both by steady-state and femtosecond spectroscopy, with the aim of assessing the possible phototoxicity of these compounds toward the eye tissues. We showed that these pigments form with BAC potentially harmful ground-state complexes, the dissociation constants of which have been estimated to be 6 +/- 2 micromol L(-1) for OxyBP and 9 +/- 4 micromol L(-1) for BP. Irradiation with steady-state visible light of solutions of blepharismins in the presence of BAC proved to induce a quenching of both the pigment and the intrinsic protein fluorescences. These effects were tentatively rationalized in terms of structural changes of alpha-crystallin. On the other hand, femtosecond transient absorption spectroscopy was used to check the occurrence of any type I photoactivity of oxyblepharismin bound to alpha-crystallin. The existence of a particular type of fast photoinduced reaction, not observed in former studies with human serum albumin but present in the natural oxyblepharismin-binding protein, could here be evidenced but no specific reaction was observed during the first few nanoseconds after excitation. Partial denaturation of alpha-crystallin was however found to alter the excited-state behaviour of its complex with oxyblepharismin, making it partly resemble that of free oxyblepharismin in solution.