Hepatosplenic brucelloma: clinical presentation and imaging features in six cases.

BACKGROUND: We conducted a retrospective analysis of the clinical presentation and the computed tomographic (CT) and ultrasound (US) findings in six episodes of hepatosplenic brucelloma in five patients. METHODS: In four episodes, the diagnosis was based on clinical history, serology, and characteristic imaging findings. In the other two episodes in the same patient, the diagnosis was suspected after a biopsy was taken. CT was performed in all six cases and US in five. RESULTS: On US, brucellomas were iso- or hypoechogenic with the liver. Hyperechogenic masses were seen in one patient. Brucellomas were very poorly defined and contained small scattered cystic areas. All lesions showed central or marginal gross focal calcification, except multiple lesions in one patient. Contrast-enhanced CT showed predominantly solid masses with irregular borders and fine or thick enhancing trabeculations separating hypodense solid areas and/or small cystic areas. Two patients showed transdiaphragmatic lung invasion by brucelloma, a complication not previously published. CONCLUSION: In regions where brucellosis is endemic, brucelloma should be included in the differential diagnosis if a hepatic or splenic mass with irregular borders and central or marginal gross focal calcification is detected, and contrast-enhanced CT shows enhancing trabeculations that separate hypodense solid areas and/or small liquid collections.

Cinc y enfermedad pulmonar obstructiva crónica / Zinc and chronic pulmonary obstructive disease

Fundamento. Evaluar las concentraciones orgánicas de cinc en la enfermedad pulmonar obstructiva crónica (EPOC) y en controles sanos, así como evidenciar si existen diferencias entre ambos grupos. Determinar si las concentraciones de cinc plasmático se correlacionan con las halladas en hematíes y faneras. Pacientes y métodos. Se estudian 40 pacientes con EPOC, varones, edad media de 62 ñ 7 años e índice de masa corporal (IMC) de 27 ñ 4. El grupo control lo forman 40 individuos; edad media de 57 ñ 9 años e IMC de 24 ñ 5. Se excluyeron los pacientes con patologías concomitantes o en tratamientos que pudieran aumentar la excreción de cinc. A todos los pacientes se les ha realizado historia clínica y exploración física completas, analítica general con hemograma, bioquímica con parámetros hepáticos y lipídicos y determinación del cinc ungueal, plasmático, en cabellos y en hematíes, mediante espectrofotometría de absorción atómica. El método estadístico empleado ha sido el análisis de la varianza de una vía y el coeficiente de correlación lineal de Pearson para estudiar la asociación entre variables. Resultados. El cinc plasmático, intraeritrocitario y ungueal fue similar en los sujetos sanos y en los pacientes; en cambio, la concentración media en cabellos resultó significativamente menor en los pacientes (156 ñ 46) respecto al grupo control (185 ñ 64) con p < 0,05. No se han encontrado diferencias significativas entre fumadores y no fumadores, ni entre bebedores y no bebedores respecto a las concentraciones de cinc orgánico. Conclusión. Los pacientes con EPOC tienen unas concentraciones de cinc en pelo inferiores a la de los sujetos sanos, mientras que el cinc en hematíes, plasma y a nivel ungueal fue similar en ambos grupos. La determinación de cinc en cabellos puede ser un buen método para detectar deficiencias crónicas y asintomáticas de este metal en el organismo. No se ha encontrado correlación entre la determinación de cinc plasmática y las determinaciones en hematíes y faneras. (AU)

[Nocturnal arterial pressure and the cardiovascular risk factors in patients with arterial hypertension]. / Presión arterial nocturna y factores de riesgo cardiovascular en pacientes con hipertensión arterial.

BACKGROUND: Blood pressure (BP) has a circadian rhythm. Most of the people presents a BP fall between 10-20% during nighttime hours (dipper condition). Measurement of these circadian variations is performed by continuous blood pressure ambulatory monitoring. We have studied the possible relation between blood pressure nocturnal fall and cardiovascular risk factors in hypertensive patients. METHODS: We selected 100 hypertensive patients from the Hypertension and Lipids Unit of San Cecilio University Hospital of Granada, Spain. They were divided into two groups: dippers group and non-dippers, depending of whether or not the fall of nocturnal systolic and diastolic BP was > 10%. All patients included in the study underwent complete clinical history, exhaustive physical examination, complementary examinations, urine and hematology tests, and continuous blood pressure ambulatory monitoring by the Space Labs system. RESULTS: The heart rate was found to be significantly higher (p = 0.0253) in the hypertensive dippers group than in the non-dippers. The latter showed higher plasma creatinine values (p = 0.0343) and lower potassemia values (p = 0.0140) than the dippers group. The dippers group presented concentrations of HDL-cholesterol significantly higher (p = 0.008) and diurnal diastolic BP values (p = 0.0211) also higher than the other group. CONCLUSIONS: Non dippers hypertensive patients present a higher number of cardiovascular risk factors as well as a higher tendency to renal lesions, and worse prognosis than the dippers group.

[Zinc and chronic obstructive pulmonary disease]. / Cinc y enfermedad pulmonar obstructiva crónica.

BACKGROUND: To evaluate the zinc organic concentration in the chronic obstructive pulmonary disease (COPD) in relation to a control group. Also, to analyze if the serum zinc levels are related with zinc concentration in erythrocyte, nail and hair. PATIENTS AND METHODS: Forty patients of COPD have been studied, all males, average age 62 +/- 7 years and body mass index (BMI) of 27 +/- 4. Forty patients were included in the control group, with average age 57 +/- 9 years and BMI of 24 +/- 5. The patients with concomitant disease or booth treatment that could increase the zinc excretion were excluded. In all patients clinical history and examination, hematology and biochemistry tests, hepatic and lipid parameters, and nail, plasma, hair and erythrocyte zinc levels by atomic absorption spectrophotometry were done. Variance analysis and Pearson test were done. RESULTS: Blood, intraerythrocyte and nail zinc were similar in healthy subjects and patients; however, the median concentration of zinc in hair was significantly lower in patients (156 +/- 46 micrograms/g versus control group (185 +/- 64 micrograms/g) (p < 0.05). No differences were found between smokers and no smokers, and drinkers and no drinkers in relation with body concentration of zinc. CONCLUSION: The zinc concentration in hair can be a good method to evaluate the chronic deficiency in the human body. The COPD patients could be susceptible to develop zinc deficiency; the situation increases the possibility of infection diseases.