Experiencia con rosiglitazona como tratamiento rediferenciador en un caso de carcinoma papilar de tiroides con metástasis pulmonares y ausencia de captación de radioyodo / Redifferentiation therapy with rosiglitazone in a case of differentiated thyroid cancer with pulmonary metastases and absence of radioiodine uptake

En el manejo de los pacientes con recidiva o metástasis de carcinoma diferenciado de tiroides, el tratamiento con radioyodo (RDI) es un tratamiento efectivo. Sin embargo, algunos de estos pacientes, a pesar de tener niveles elevados de TGB en sangre, no presentan captación de RDI en el rastreo corporal y, por tanto, pierden la capacidad de responder al tratamiento con él. Actualmente se están estudiando diferentes fármacos con posible efecto rediferenciador, entre los que se encuentran la rosiglitazona y diferentes retinoides. Su objetivo es aumentar la captación de RDI por las células tumorales. Se presenta el caso de una paciente que se sometió a tratamiento con rosiglitazona como tratamiento rediferenciador (8mg/día durante 2 meses) y con se logró captación de RDI por las metástasis pulmonares, con posterior disminución del tamaño de las mismas(AU)

Treatment with radioiodine (RDI) has been shown to be an effective option in patients with differentiated thyroid cancer with recurrent or metastatic disease. However, in spite of having elevated levels of thyroglobulin in blood, in some of these patients, the whole body scan does not detect radioiodine uptake due to loss of differentiation of the neoplastic cells, thus leading to loss of efficacy of the treatment. That is why drugs with potential differentiating properties, like rosiglitazone or retinoids, are being studied. The aim of these drugs is to improve RDI uptake by the tumor cells. In this work, we have described the case of a patient in whom uptake of RDI by the pulmonary metastases, with subsequent decrease of their size, was achieved after treatment with rosiglitazone (8mg/day for 2 months) as redifferentation therapy(AU)

Epidemiología infecciosa en centros gerontológicos / Infection epidemiology in gerontology centres

Introducción. Los procesos infecciosos en centros gerontológicos (CG) constituyen una de las causas importantes de mortalidad y descompensación de patologías crónicas concomitantes. Para conocer su magnitud y distribución, se inició un sistema de vigilancia epidemiológica. Material y métodos. Durante los años 2006-2009 se realizó un estudio de prevalencia en 4 CG de Fundación Matia. Se midió la prevalencia realizando un corte anual, recogiendo: tipo de infección, datos demográficos, factores de riesgo y uso de antibióticos. La incidencia se midió en un CG como centro piloto durante 2 años, recogiendo: tipo de infección y uso de antibióticos. Resultados. La prevalencia en los CG osciló entre el 4,80 y el 6,44%. La densidad de incidencia de infección en el estudio piloto estuvo entre 3,45-5,77 infecciones por 1.000 residentes-día. La localización infecciosa más frecuente, y en este orden, fue la respiratoria, la urinaria y la cutánea. La incidencia de infección respiratoria es mayor de manera estadísticamente significativa ante la presencia de disfagia, malnutrición y enfermedad pulmonar obstructiva crónica. Sin embargo, en la incidencia infección urinaria no se aprecia relación significativa con los diferentes factores de riesgo analizados. Conclusiones. La frecuencia y las repercusiones de las infecciones nosocomiales en este tipo de centros pone de relieve la necesidad de controles epidemiológicos periódicos para adaptar planes de intervención y desarrollar medidas preventivas adecuadas(AU)

Introduction. Infection processes in gerontology centres (GC) are one of the main causes of mortality and aggravation of concomitant chronic diseases. An epidemiological surveillance system was set up to find out their magnitude and distribution. Material and methods. A prevalence study was conducted during the years 2006-2009 in 4 GCs of the Matia Foundation. Prevalence was measured by making an annual cut-off, recording: infection type, demographic data, risk factors and antibiotic use. The incidence was measured for two years in one GC as a pilot centre, recording: infection type and antibiotic use. Results. The prevalence in the GCs varied between 4.8% and 6.44%. The infection incidence density in the pilot study was between 3.45-5.77 infections per 1,000 resident days. The most common infection location and in this order were, respiratory, urinary and cutaneous. The incidence of respiratory infection is more statistically significant in the presence of dysphagia, malnutrition and COPD. However, no significant relationship was seen in the incidence of urinary infection with the different risk factors analysed. Conclusions. The frequency and repercussions of nosocomial infections in GCs demonstrate the need for intervention plans and the development of adequate prevention measures(AU)

[Infection epidemiology in gerontology centres]. / Epidemiología infecciosa en centros gerontológicos.

INTRODUCTION: Infection processes in gerontology centres (GC) are one of the main causes of mortality and aggravation of concomitant chronic diseases. An epidemiological surveillance system was set up to find out their magnitude and distribution. MATERIAL AND METHODS: A prevalence study was conducted during the years 2006-2009 in 4 GCs of the Matia Foundation. Prevalence was measured by making an annual cut-off, recording: infection type, demographic data, risk factors and antibiotic use. The incidence was measured for two years in one GC as a pilot centre, recording: infection type and antibiotic use. RESULTS: The prevalence in the GCs varied between 4.8% and 6.44%. The infection incidence density in the pilot study was between 3.45-5.77 infections per 1,000 resident days. The most common infection location and in this order were, respiratory, urinary and cutaneous. The incidence of respiratory infection is more statistically significant in the presence of dysphagia, malnutrition and COPD. However, no significant relationship was seen in the incidence of urinary infection with the different risk factors analysed. CONCLUSIONS: The frequency and repercussions of nosocomial infections in GCs demonstrate the need for intervention plans and the development of adequate prevention measures.

[Redifferentiation therapy with rosiglitazone in a case of differentiated thyroid cancer with pulmonary metastases and absence of radioiodine uptake]. / Experiencia con rosiglitazona como tratamiento rediferenciador en un caso de carcinoma papilar de tiroides con metástasis pulmonares y ausencia de captación de radioyodo.

Treatment with radioiodine (RDI) has been shown to be an effective option in patients with differentiated thyroid cancer with recurrent or metastatic disease. However, in spite of having elevated levels of thyroglobulin in blood, in some of these patients, the whole body scan does not detect radioiodine uptake due to loss of differentiation of the neoplastic cells, thus leading to loss of efficacy of the treatment. That is why drugs with potential differentiating properties, like rosiglitazone or retinoids, are being studied. The aim of these drugs is to improve RDI uptake by the tumor cells. In this work, we have described the case of a patient in whom uptake of RDI by the pulmonary metastases, with subsequent decrease of their size, was achieved after treatment with rosiglitazone (8 mg/day for 2 months) as redifferentiation therapy.

[Hepatic Toxocara infestation]. / Infestación hepática por Toxocara.

We describe the case of a patient with infestation of the liver by visceral larva migrans as the sole manifestation of the disease. The difficulties in the diagnosis if no other organs are affected is stressed. The diagnosis is made by ultrasound and CAT scan and serological tests by ELISA. Tiabendazol is the treatment of choice.

Effect of the raw legume Vicia ervilia on muscle and liver protein metabolism in growing rats.

Body weight gain (BWG), food intake, food efficiency rate (FER: food intake, g/protein intake, g), gastrocnemius muscle and liver weights, protein, RNA and DNA contents of gastrocnemius muscle and liver have been measured in growing rats (80-90 g initial body weight) fed ad libitum over a period of 11 days on 12.00% protein diets containing either heated and defatted Glycinae sojae (HSB) as control or the raw legume Vicia ervilia as the main sources of protein. It has been found that, as compared to HSB-fed rats, those fed the legume Vicia ervilia diet exhibited a significant reduction in growth, PER, FER, as well as, in RNA-activity (protein, g/day/RNA, g) and RNA/DNA ratio in both muscle and liver. Protein synthesis capacity (PSC:RNA, microgram/protein, mg), was found significantly increased in liver but not in muscle. The possible nature of these findings is discussed.

Muscle and liver protein synthesis and degradation in growing rats fed a raw field bean (Vicia faba L.) diet.

Body weight gain, food intake, gastrocnemius muscle and liver weight, protein and RNA content, as well as the fractional rates of muscle and liver protein synthesis (ks, according to the method of constant infusion of L-[14C]tyrosine), growth (kg) and degradation (kd), along with RNA activity (g of protein synthesized per day/g RNA) of both organs, were determined in growing male rats fed ad libitum over a period of 10 days on 18.7% protein diets containing either casein (5% of methionine added) (control) or the raw legume field bean (Vicia faba L.) as the sole sources of protein. It has been found that as compared to control rats, those fed the raw legume diet exhibited a significant reduction in the rate of growth, muscle RNA, ks, kg, kd and RNA activity, and a significant increase in liver ks, kd and RNA activity. All differences were statistically significant at least at the 5% level. The possible nature of these findings is discussed.

Liver and muscle proteolytic activity in male growing rats fed a field bean (Vicia faba L.) diet.

Total liver cathepsin A and D and gastrocnemius acid proteolytic activities have been evaluated in male growing rats fed ad libitum over periods of 15 and 30 days on 20%-protein diets containing either casein or raw field bean (Vicia faba L.) as protein sources. It has been found that, compared to the control casein-fed rats, those fed the legume diet exhibited a marked reduction (p less than 0.05) in the rate of growth and protein efficiency rate; liver proteolytic activity increased with ageing in the two dietary treatments and was found to be significantly higher (p less than 0.05) in the legume-fed rats. However, muscle proteolytic activity decreased with ageing and proved significantly increased (p less than 0.05) in the legume-fed rats.

Response of muscle, liver and whole-body protein turnover to two different sources of protein in growing rats.

A significant impairment in growth rate, food efficiency and weight of the gastrocnemius muscle was observed in rats fed a raw legume as the source of protein compared to casein-fed animals. No appreciable differences in chemical composition of the carcass were found. The source of dietary protein did not influence the ratio protein/DNA, DNA concentration or protein-synthesizing capacity (RNA/protein). The slower weight gain of animals fed the legume diet was attributed to a lower muscle protein synthesis, mediated by a depression of muscle RNA activity (grams protein synthesized/gram RNA) rather than changes in myofibrillar protein breakdown. In contrast liver protein synthesis appeared to be slightly increased in the legume-fed animals.