Amigdalitis complicada por partida doble / Doubly complicated tonsilitis

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Glycemic index, glycemic load, and pulse wave reflection in adults.

BACKGROUND AND AIMS: Diets with a high glycemic index (GI), high glycemic load (GL), or both, increase the risk of cardiovascular disease. This study examined the association of GI and GL in a regular diet with the peripheral augmentation index (i.e., a marker of vascular aging) in a sample of adults. METHODS AND RESULTS: Cross-sectional study. The findings presented in this manuscript are a subanalysis of the EVIDENT study whose purpose was to analyze the relationship between lifestyle and arterial aging. For the sample population, 1553 individuals aged 20-80 years were selected through random sampling from the patients of general practitioners at six health centers in Spain. GI and GL for each patient's diet were calculated from a previously validated, semi-quantitative, 137-item food frequency questionnaire. The peripheral augmentation index corrected for a heart rate of 75 bpm (PAIx75) was measured with pulse-wave application software (A-Pulse CASP). Based on a risk factor adjusted regression model, for every 5 unit increase in GI, the PAIx75 increased by 0.11 units (95% CI: 0.04-0.19). Similarly, for every increase in 10 units in GL, the PAIx75 increased by 1.13 (95% CI: 0.21-2.05). High PAIx75 values were observed in individuals with diets in the third GI tertile (i.e., the highest), and lower PAIx75 values in those with diets in the first tertile (i.e., the lowest), (93.1 vs. 87.5, respectively, p = 0.001). CONCLUSIONS: GI and GL were directly associated with PAIx75 values in adults without cardiovascular diseases regardless of age, gender, physical activity, and other confounders.

Resonancia magnética de mama: utilidad de la difusión para diferenciar entre lesiones benignas y malignas / Breast MRI: the usefulness of diffusion-weighted sequences for differentiating between benign and malignant lesions

Objetivo: Valorar la utilidad en la resonancia magnética (RM) de mama de la difusión y el coeficiente de difusión aparente (CDA) para diferenciar entre lesiones benignas y malignas. Material y métodos: Se estudian prospectivamente 88 pacientes, de 31 a 79 años, con 94 lesiones (80 malignas y 14 benignas), que fueron remitidas para un estudio prequirúrgico de extensión local, y a las que se realizó una RM de mama con estudio dinámico tras administrar contraste intravenoso y secuencia de difusión, valorando su correspondiente CDA. Se correlacionan los resultados obtenidos en difusión con la anatomía patológica. Resultados: El valor medio del CDA de las lesiones malignas (1,12±0,25×10−3mm2/s) fue significativamente inferior (p<0,001) al de las benignas (1,61±0,52×10−3mm2/s). No se obtuvieron diferencias significativas entre los diferentes subtipos de carcinomas invasivos y tampoco entre el carcinoma intraductal y el invasivo (p>0,05). Con un valor CDA<0,95×10−3mm2/s como indicador de malignidad, la sensibilidad es del 52% y la especifidad es del 100%.ConclusiónEn la RM de mama la difusión aporta información adicional en la caracterización de la benignidad y malignidad de las lesiones mejorando la especifidad de la técnica (AU)

Objective: To evaluate the usefulness of diffusion-weighted MRI sequences and of the apparent diffusion coefficient (ADC) to differentiate between benign and malignant breast lesions. Material and methods: We prospectively studied 88 patients (aged 31 to 79 years) with 94 lesions (80 malignant and 14 benign) who were referred for preoperative local staging. All patients underwent dynamic MRI examination after intravenous contrast administration and a diffusion-weighted sequence with ADC calculation. The results obtained at diffusion-weighted imaging were correlated with those obtained at histological examination. Results: The mean value of the ADC for malignant lesions (1.12±0.25×10−3mm2/s) was significantly lower (p<0.001) than for benign lesions (1.61±0.52×10−3mm2/s). No significant differences in ADC values were found between the different subtypes of invasive carcinomas or between intraductal carcinoma and invasive carcinoma (p>0.05). Using an ADC lower than 0.95×10−3mm2/s as a threshold for malignancy, the sensitivity is 52% and the specificity is 100%.ConclusionDiffusion-weighted sequences provide additional information in breast MRI that is useful for differentiating between benign and malignant lesions, thus improving the specificity of the technique (AU)

[Breast MRI: the usefulness of diffusion-weighted sequences for differentiating between benign and malignant lesions]. / Resonancia magnética de mama: utilidad de la difusión para diferenciar entre lesiones benignas y malignas.

OBJECTIVE: To evaluate the usefulness of diffusion-weighted MRI sequences and of the apparent diffusion coefficient (ADC) to differentiate between benign and malignant breast lesions. MATERIAL AND METHODS: We prospectively studied 88 patients (aged 31 to 79 years) with 94 lesions (80 malignant and 14 benign) who were referred for preoperative local staging. All patients underwent dynamic MRI examination after intravenous contrast administration and a diffusion-weighted sequence with ADC calculation. The results obtained at diffusion-weighted imaging were correlated with those obtained at histological examination. RESULTS: The mean value of the ADC for malignant lesions (1.12+/-0.25x10(-3)mm(2)/s) was significantly lower (p<0.001) than for benign lesions (1.61+/-0.52x10(-3)mm(2)/s). No significant differences in ADC values were found between the different subtypes of invasive carcinomas or between intraductal carcinoma and invasive carcinoma (p>0.05). Using an ADC lower than 0.95x10(-3)mm(2)/s as a threshold for malignancy, the sensitivity is 52% and the specificity is 100%. CONCLUSION: Diffusion-weighted sequences provide additional information in breast MRI that is useful for differentiating between benign and malignant lesions, thus improving the specificity of the technique.

Valoración de un método automático de diagnóstico asistido por ordenador en la RM de pacientes con cáncer de mama / No disponible

Objetivo: Valorar y comparar entre el programa manualestándar y un nuevo programa de diagnóstico asistido por ordenador(CAD) en el estudio del cáncer de mama por RM.Material y métodos: Durante 24 meses se han estudiadode forma prospectiva 51 pacientes con 66 lesiones mamarias,57 malignas y 9 benignas, remitidas para la estadificación localprequirúrgica por RM de mama.Tras realizar el estudio dinámico tridimensional con contrasteendovenoso, se analiza el postprocesado de cada lesiónmediante el programa de análisis manual y el automático dediagnóstico asistido por ordenador (CADstream®), comparandolos resultados obtenidos y su correlación definitiva con anatomíapatológica.Resultados: El método automático de diagnóstico asistidopor ordenador en la valoración del cáncer de mama muestrauna sensibilidad (95%) ligeramente superior al método manual(89%) y con una especificidad igual con ambos métodos(66%). La fiabilidad es del 91 y 86% respectivamente, siendoestos resultados superiores debido a que el programa automáticovalora con más precisión la curva de captación en toda lalesión, pero sin variación en los hallazgos morfológicos.Ambos métodos modificaron la actitud terapéutica en un18% de los casos.El método automático consigue un elevado índice de correlaciónhistológica respecto al tamaño real del tumor (ligeramentesuperior al manual), reduce de forma significativa artefactosmejorando la calidad de imágenes y disminuyenotablemente el tiempo de análisis del radiólogo.Conclusiones: El método de diagnóstico asistido por ordenadoraplicado en RM mama es un método fiable y una herramientade trabajo muy útil en el análisis del postprocesado(AU)

Objective: To assess a new program for computer-aided diagnosisin breast MRI and to compare it with standard manualsoftware.Material and methods: We studied 66 breast lesions (57malignant and 9 benign) in 51 women referred for breast MRIfor preoperative local staging.After dynamic breast MRI with intravenous contrast andthree-dimensional reconstruction, we processed each lesionwith both standard manual software and the computer-aideddiagnosis program (CADstream®). We compared the twomethods on diagnostic accuracy and their correlations with thehistological findings.Results: The sensitivity of the computer-aided diagnosisprogram for staging breast was slightly higher than that of themanual method (95 vs. 89%); the specificity of the two techniqueswas similar (66%). The overall diagnostic accuracy was91% for the computer-aided method and 86% for the manualmethod. The automatic method is more accurate because itassesses the curve for the entire lesion better, without changesin the assessment of the morphological features.MRI examination modified the therapeutic approach in18 cases, regardless of the method used.The correlation of the automatic method with the histologicalfindings for tumor size was slightly higher than that of themanual method. The automatic method also yielded better imagequality with fewer artifacts and significantly reduced thetime radiologists needed to analyze the images.Conclusions: The computer-aided diagnosis program is reliableand useful for analyzing postprocessing breast MRI(AU)

Double-blind study on the activity of plafibride in the treatment of type IV hyperlipoproteinemia.

The effects of a new drug, N-2-(p-chlorophenoxy)-isobutyryl-N'-morpholinomethylurea (plafibride, ITA 104), were studied in a double blind study lasting four months on a group of 30 patients with a type IV hyperlipoproteinemia. In the patients treated with the active drug significant reductions in blood triglycerides were obtained, with a trend to normal. Reduction in blood cholesterol was inconsistent and not significant. As for the lipoproteinogram, a tendency towards a decrease in the pre-beta-lipoprotein fraction was observed and so was a non-significant tendency towards an increase in the alpha- and beta-lipoprotein fractions. Studies on the platelet functioning showed an obvious decrease in platelet aggregation in those patients treated with the active drug. This was very evident for the ADP and adrenaline inductors and rather less significant for collagen. Neither platelet adhesiveness nor aggregation rate changed. Tolerance of the drug was generally excellent. In one patient a decrease in some palpebral xanthelasmas was observed after two months of treatment with the active drug. In only one case there was heartburn and this was corrected with alkalines. In one other case an urticarial rash appeared, but disappeared spontaneously when the drug was temporarily stopped and did not reappear when it was administered again. During the trial no evidence of renal, hepatic or hematological malfunctions were observed. However, a slight tendency towards an increase in the GOT, GPT and LDH was observed, which was not statistically significant. The drug tested may be very useful in the treatment of type IV hyperlipoproteinemia, especially in those forms in which an increase in thromboembolic risk is suspected, either associated with, or secondary to, the actual atherosclerotic disease.