Cómo integrar la información cuantitativa en el informe radiológico del paciente oncológico / How to integrate quantitative information into imaging reports for oncologic patients

En la actualidad, tanto las imágenes como los datos que generan y los informes que se emiten son digitales y constituyen una fuente de datos fiable. Los informes pueden clasificarse, en función de su contenido, formato y tipo de datos, como organizado (texto libre en lenguaje natural), predefinido (con plantillas y guías construidas con campos previamente determinados con lenguaje natural tipo BI-RADS y PI-RADS) y estructurado (con desplegables en forma de preguntas, con diversas posibles respuestas, previamente pactadas en el equipo multidisciplinario, con léxicos estandarizados y estructurado como base de datos, con información trazable y explotable mediante herramientas estadísticas y de minería de datos). Este informe estructurado, compatible con MRRT (Management of Radiology Report Templates), permite incorporar información cuantitativa relacionada con el análisis digital de los datos de las imágenes adquiridas para describir, mediante radiómica (características y parámetros), las propiedades y el comportamiento de los tejidos con exactitud y veracidad. En conclusión, los datos digitales estructurados (imágenes, texto, mediciones, radiómica, biomarcadores de imagen) deben integrarse en un informe informatizado que permita su indexación en grandes repositorios. Estos bancos de datos radiológicos son fundamentales en la medicina personalizada para explotar la información sanitaria, fenotipificar las lesiones y enfermedades, y extraer conclusiones

Nowadays, the images and information generated in imaging tests, as well as the reports that are issued, are digital and represent a reliable source of data. Reports can be classified according to their content and to the type of information they include into three main types: organized (free text in natural language), predefined (with templates and guidelines elaborated with previously determined natural language like that used in BI-RADS and PI-RADS), or structured (with drop-down menus displaying questions with various possible answers that have been agreed on with the rest of the multidisciplinary team, which use standardized lexicons and are structured in the form of a database with data that can be traced and exploited with statistical tools and data mining). The structured report, compatible with Management of Radiology Report Templates (MRRT), makes it possible to incorporate quantitative information related with the digital analysis of the data from the acquired images to accurately and precisely describe the properties and behavior of tissues by means of radiomics (characteristics and parameters). In conclusion, structured digital information (images, text, measurements, radiomic features, and imaging biomarkers) should be integrated into computerized reports so that they can be indexed in large repositories. Radiologic databanks are fundamental for exploiting health information, phenotyping lesions and diseases, and extracting conclusions in personalized medicine

Idh1 protects murine hepatocytes from endotoxin-induced oxidative stress by regulating the intracellular NADP(+)/NADPH ratio.

Isocitrate dehydrogenase-1 (Idh1) is an important metabolic enzyme that produces NADPH by converting isocitrate to α-ketoglutarate. Idh1 is known to reduce reactive oxygen species (ROS) induced in cells by treatment with lipopolysaccharide (LPS) in vitro. Here, we used Idh1-deficient knockout (Idh1 KO) mice to investigate the role of Idh1 in antioxidant defense in vivo. Idh1 KO mice showed heightened susceptibility to death induced by LPS and exhibited increased serum levels of inflammatory cytokines such as tumor necrosis factor-α and interleukin-6. The serum of LPS-injected Idh1 KO mice also contained elevated levels of AST, a marker of inflammatory liver damage. Furthermore, after LPS injection, livers of Idh1 KO mice showed histological evidence of elevated oxidative DNA damage compared with livers of wild-type (WT) mice. Idh1 KO livers showed a faster and more pronounced oxidative stress than WT livers. In line with that, Idh1 KO hepatocytes showed higher ROS levels and an increase in the NADP(+)/NADPH ratio when compared with hepatocytes isolated from WT mice. These results suggest that Idh1 has a physiological function in protecting cells from oxidative stress by regulating the intracellular NADP(+)/NADPH ratio. Our findings suggest that stimulation of Idh1 activity may be an effective therapeutic strategy for reducing oxidative stress during inflammatory responses, including the early stages of septic shock.

A low-cost, sustainable, second generation system for surveillance of people living with HIV in Spain: 10-year trends in behavioural and clinical indicators, 2002 to 2011.

A second-generation surveillance system of people infected with human immunodeficiency virus (HIV) has been implemented in Spain. Behavioural and clinical data were collected between 2002 and 2011 through an annual one-day, cross-sectional survey in public hospitals, including all in- and outpatients receiving HIVrelated care on the survey day. Mean age increased over time (from 38.7 years in 2002 to 43.8 years in 2011) and 68.4% of the 7,205 subjects were male. The proportion of migrants increased from 6.1% to 15.9%, while people who inject or used to inject drugs (PWID and Ex-PWID) decreased and men who have sex with men (MSM) and heterosexuals increased. Unprotected intercourse at last sex increased among MSM and PWID/Ex-PWID. Patients receiving antiretroviral treatment increased significantly from 76.0% to 88.2% as did those with CD4 T-cell counts ≥350 (from 48.2% to 66.9%) and viral copies <200 (from 47.0% to 85.2%). HIV-infected people with hepatitis C virus RNA decreased from 36.0% in 2004 to 29.9% in 2011, while those with HBsAg remained stable at around 4.4%. Implementation of a low-cost, sustainable system for second-generation surveillance in people living with HIV is feasible. In Spain, the information obtained has helped to define and refine public health policy and document treatment effectiveness.

Flotillin-2 deficiency leads to reduced lung metastases in a mouse breast cancer model.

Flotillin microdomains, specialized lipid raft domains in cell membranes, serve as physical platforms for many different molecules important in crucial intracellular signaling pathways. Flotillin-2 (Flot2), together with flotillin-1, is a marker for lipid raft microdomains distinct from caveolar lipid rafts, and has been implicated in the progression of cancer and metastasis formation. Based largely on studies in xenograft models, flotillin-2 has been implicated in the progression of multiple types of human tumors, including breast cancer. In our studies, we identified flotillin-2 as highly amplified in a high-throughput comparative genomic hybridization screen of human breast cancer cell lines and breast tumor samples. Short hairpin RNA-mediated reduction of flotillin-2 protein levels significantly reduced the tumorigenicity and metastatic capability of a human breast cancer cell line in vivo. We generated mice deficient for flotillin-2 and also found a reduction of flotillin-1 protein levels and complete absence of flotillin-specific membrane microdomains in these mice. To examine the role of Flot2 in mammary tumorigenesis and lung metastasis, we used an in vivo molecular genetics approach, crossing a well-characterized transgenic mouse model of breast cancer, the MMTV-PyMT (mouse mammary tumor virus-polyoma middle T antigen) mouse, with gene-targeted Flot2(-/-) mice. Flotillin-2 deficiency lead to a striking reduction in the number of lung metastasis observed, but had no influence on primary tumor formation in this model. Our results indicate, using a novel in vivo animal model approach, that Flot2 is an important regulator of mammary tumor-derived lung metastasis.

[Infant crying diary: a useful aid in distinguishing between normal and excessive crying behavior]. / Huildagboek bij zuigelingen; een nuttig hulpmiddel om onderscheid te maken tussen normaal en excessief huilgedrag.

Three infant girls aged 9, 10 and 8 weeks, who cried excessively according to their parents, were referred by the general practitioner to the paediatrician. Using a crying diary it was possible to ascertain that one infant fulfilled the criteria of infantile colic. The diary showed that a second infant was not crying excessively and her mother could be reassured that her baby's behaviour was normal. The third infant proved to be suffering from an organic disease (Alpha-I antitrypsin deficiency), which had not been obvious at clinical assessment. The crying diary provided clues that warranted further investigation. The parents of all 3 infants were reassured and the crying lessened over a period of several weeks. When parents complain that their child cries excessively, it is useful to chart the amount of crying time in a diary. Registration for one week is sufficient. If the child does not suffer from an organic disease, the mainstay of treatment is to explain normal crying behaviour and that it often helps if the infant is not offered too many stimuli. Parents can be reassured that spontaneous resolution will generally occur at the age of three months.

Multiresidue determination of pesticides in fruit and vegetables by gas chromatography/tandem mass spectrometry.

Pesticide residues in fruit and vegetables were determined by gas chromatography/tandem mass spectrometry (GC/MS/MS). Electron impact (EI)/MS/MS and chemical ionization (CI)/MS/MS were developed for 80 compounds, including organochlorine, organophosphorus, organonitrogen, and pyrethroids, providing unambiguous spectral confirmation for these complex matrixes. Residues were extracted from samples with acetone followed by a mixture of dichloromethane-petroleum ether. Two injections per sample were required for analysis of the entire pesticide list by EI/MS/MS and CI/MS/MS. Initial steps involving cleanup and concentration of extracts were eliminated. The excellent selectivity and good linearity allowed quantification and identification of low levels of pesticides in the most difficult matrixes. The method has been used for routine analysis of many vegetables.

Chemo- and stereoselective reduction of an alpha-cyanoketone by bakers' yeast at low temperature.

[formula: see text] The bakers' yeast mediated reduction of 3-oxo-3-phenylpropanenitrile (1) proceeds at 4 degrees C to give exclusively (S)-3-hydroxy-3-phenylpropanenitrile (3) in 59% yield. This is in contrast to the corresponding reaction at room temperature which yields a mixture of reduction and alkylation products. This work demonstrates the use of low temperature to improve yeast selectivity.

Dissipation of some citrus selective residual herbicides in an irrigation well.

The aim of this work was to study the behaviour of some of the main citrus selective residual herbicides in the water of an irrigation well. The chemicals used were: atrazine, simazine, terbuthylazine, terbutryn, terbumeton, bromacil and diuron. The simetric triazines and bromacil were analyzed by gas chromatography and diuron by HPLC. The mentioned pesticides were introduced in the well in order to simulate a point-source contamination. Levels of contamination of the well due to herbicide application were about 1 mg/l, however, dissipation of the herbicides was almost complete 8 days after application, except for bromacil and diuron which persisted longer than the s-triazines.

Bioconcentration and excretion of fenitrothion in the brain of the eel (Anguilla anguilla).

The bioconcentration of fenitrothion in the brain of the european eel (Anguilla anguilla) and its posterior elimination have been studied. Animals were exposed to a sublethal concentration of fenitrothion (0.04 mg/L) for 96 hours in a flow-through test system. After this pesticide exposure, animals were transferred to clean water for 72 hours more. Bioconcentration and elimination processes of fenitrothion were studied in blood and brain. This insecticide showed a strong tendency to bioconcentrate into selected tissues. A steady-state was observed in blood in few hours. Highest accumulation was detected in brain, where any steady-state could be observed. Elimination started rapidly from both tissues when a recovery period was allowed. Elimination kinetics were adjusted to one-compartment model. K2 of 0.015 and 0.044 hr-1 were calculated for fenitrothion in blood and brain. These K2 values were related with a relatively short half-live of fenitrothion in the analyzed tissues; probably due to the low biotransformation rate of this toxicant in the european eel. That fact would protect the animals against many biotransformation products even more toxic than the parent fenitrothion.

[Autologous bone marrow transplantation after purging by low molecular weight natural tumor suppressor in long-term marrow culture in vitro: report on 2 cases].

In the light of high sensitivity of fresh bone marrow blast progenitor of human myeloid leukemia (L-CFU) towards the action of low molecular tumor suppressor isolated from human fetal liver, massive bone marrow was aspirated from the patients suffering from acute myeloid leukemia at the stage of first complete remission and cocultured in a long-term bone marrow culture system for 9 days. The purged marrow cells were then re-infused into the patients after preconditioning with large doses of cytotoxin and acute ionizing irradiation. Hematopoiesis was reconstituted due to the autologous transplantation in vivo. After the autologous bone marrow transplantation without chemical treatment, two cases are still survival with the time of more than 17 and 15 months respectively.

Free amino acids in preterm and term milk from mothers delivering appropriate- or small-for-gestational-age infants.

Free amino acids were quantitated in human milk collected during the first month postpartum from mothers of appropriate preterm (26-32 and 33-36 wk gestation) and term (small or appropriate-for-gestational-age) infants. Glutamic acid and taurine were the most abundant amino acids in all four groups at all stages of lactation. The ratio of essential to nonessential amino acids was higher in colostrum than in mature milk although the total amino acid level of mature milk was double that of the colostrum. Nonprotein amino acids amount to approximately 40% of the free-amino acid pool in colostrum. Differences in the content and changes in free-amino acid levels during lactation among the groups were observed.

Bile salt-stimulated lipase activity in human colostrum from mothers of infants of different gestational age and birthweight.

The bile salt-stimulated lipase (BSSL) activity was measured in milk collected at 3-4 days postpartum (colostrum) from 36 mothers divided into three groups according to gestational age and birthweight of their infants. BSSL activity changed with the length of gestation. Preterm colostrum presented a mean activity significantly higher than the term groups (small-for-gestational age and appropriate-for-gestational age) which had similar values. The ratio of BSSL activity to the estimated fat content was 6.33 in colostrum of mothers who delivered preterm and 4.20 in colostrum of both groups of term mothers. These data suggest that preterm colostrum has a higher fat digesting potential than term colostrum and that it is the gestational age rather than the adequacy or non-adequacy of birthweight to gestational age that may influence the BSSL activity.

Proteins in preterm and term milk from mothers delivering appropriate or small-for-gestational age infants.

The concentrations of total protein, secretory immunoglobulin A (IgA), lactotransferrin (LTF) and serum albumin (SA) were measured in sequential samples of colostrum, transitional and mature milk from 53 mothers divided into four groups according to gestational age and birthweight of their infants. Individual proteins were determined by single radial immunodiffusion. From the covariance analysis of data controlling for the day of lactation and the milk volume it was found that these covariables were significantly negative correlated with total protein and IgA. The concentration of LTF was also significantly negative correlated with the day but positively with the volume; whereas the contrary occurs for SA although the correlation was not significant for the volume. Differences in the total protein and IgA contents have been found among the mothers. The LTF content varied among the groups. Mean protein contents did not change in a similar way in all groups during lactation. Preterm milk maintained a more constant level of proteins.