Pneumomicosi cronica (Aspergillosi?) con generalizzazione pluriviscerale

Riassunto Gli AA. descrivono un caso di pneumomicosi cronica, con generalizzazione pluriviscerale, assolutamente eccezionale.Per causa dell'insolito quadro clinico ed anatomico, che non ha riscontro nella letteratura, la natura della malattia non potè essere diagnosticata che con l'esame istologico delle lesioni.

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Summary The autors report on a case of chronic Pneumonomycosis, with an absolutely exceptional plurivisceral generalisation.Due to the unusual clinical and anatomical picture, hitherto not mentioned in the literature, the nature of the illness could be established only by the histological evidence of the alterations.

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Zusammenfassung Die Verfasser beschreiben einen Fall von chronischer Pneumomykose mit absolut ausserordentlicher plurivisceraler Generalisation.Infolge des ungewöhnlichen, klinischen und anatomischen Bildes, das bis heute in der Literatur nicht erwähnt worden ist, hat die Krankheit nur durch die histologische Beobachtung der Veränderungen diagnostiziert werden können.

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Résumé Les AA. décrivent un cas de pneumomycose chronique, avec généralisation pluriviscérale tout à fait exceptionnelle.A cause de ce tableau clinique et anatomique si extraordinaire, qui n'à pas encore été signalé dans la litérature, il n'à été possible d'en établir le diagnostic qu'au moyen de l'examen histologique des lésions.

     

Perfil lipídico en mujeres obesas y no obesas con síndrome de ovarios poliquísticos tratadas con metformina

ObjectiveTo compare lipid and lipoprotein concentrations between obese and non-obese women with a diagnosis of polycystic ovary syndrome (PCOS) treated with metformin for 6 months.MethodsSixty-five women with a diagnosis of PCOS were included. The presence of obesity, serum concentrations of cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c) were recorded before and after 6 months of metformin treatment. The women were divided in two groups of 34 obese women (group A; body mass index >27 kg/m²) and 31 non-obese women (group B; body mass index (<27 kg/m²).ResultsSignificant differences in body mass index, waist-hip ratio, cholesterol, triglycerides, LDL-c and HDL-c were found in group A compared with group B (p<0.05). In obese women, serum triglyceride and LDL-c concentrations were significantly reduced (p<0.05), while serum concentrations of HDL-c were significantly increased (p<0.05) after 6 months of treatment. In non-obese women, none of these lipid profile modifications were considered significant (p=ns).ConclusionMetformin use for 6 months modified triglyceride, LDL-c and HDL-c concentrations compared with initial values in obese women with PCOS while no significant modifications in lipid or lipoprotein concentrations were observed in non-obese women.     

Aspergilosis invasora en el paciente con enfermedad oncohematológica

Invasive aspergillosis is the most common invasive fungal infection in patients with acute hematological malignancies or treated with hematopoietic stem cell transplantation due to the marked alteration of the physiological mechanisms of antifungal immunity that takes place in these situations. For this reason, antifungal prophylaxis has a relevant role in these patients. The introduction of new antifungal agents has motivated the updating of recommendations for prophylaxis and treatment in different guidelines.The objectives of this chapter are a brief review of the mechanisms of immunity against fungi, the definition of risk for developing an invasive fungal infection and an update of the prophylaxis recommendations and treatment of invasive aspergillosis in the group of patients with hematological diseases.     

Calidad de vida y satisfacción con el tratamiento de sujetos con diabetes tipo 2: resultados en España del estudio PANORAMA

ObjectivesFew studies are available on quality of life and treatment satisfaction of patients with type 2 diabetes mellitus (T2DM). Both of them were the primary objectives of the PANORAMA (NCT00916513) study. Metabolic control, treatment patterns, and management by healthcare professionals were also evaluated.Material and methodsThis multicenter, cross-sectional, observational study randomly recruited>40 year-old patients with T2DM from Spanish healthcare centers. HbA1c was measured using the same technique in all patients, who also completed quality of life (EQ-5D and ADDQoL) and treatment satisfaction (DTSQ) questionnaires and the Hypoglycemia Fear Survey (HFS-II).ResultsFifty-four investigators recruited 751 patients, 60.3% of whom had HbA1c levels <7%. Approximately 25% of patients on monotherapy had HbA1c values ≥ 7%, Patients with longer disease duration and more complex treatments, especially with insulin, showed the poorer control. Despite good overall treatment satisfaction (mean 29.3±6.1, 0 to 36-point scale), patients with a poorer metabolic control, previous hypoglycemia episodes, and more complex therapies had a worse QoL and a greater fear of suffering hypoglycemia.ConclusionsDespite advances in metabolic control, there are still areas to improve. Early addition of safe drugs to monotherapy would help achieve control objectives without increasing the risk of hypoglycemia, and delaying the start of insulin therapy. This would also improve QoL and treatment satisfaction.     

鼻咽癌上皮细胞表面con A受体复合物侧向运动的研究

本文所用的鼻咽癌上皮细胞(CNE株)有能在常温和高温下生长的特性。常温和高温下生长的CNE细胞表面都有能与荧光标记的伴刀豆球蛋白A(conA)特异结合的受体。我们用激光漂白荧光恢复测量装置测定了这二类细胞表面conA受体复合物在光漂后的荧光恢复过程,发现膜上有半数以上的conA受体复合物的运动受到限制,或者说是不动的。可以运动的分子其运动形式是扩散运动,它们的侧向扩散系数是:CNE37在37℃和41℃下分别是4.0×10~(-11)cm~2s~(-1)和21.5×10~(-11)cm~2s~(-1)。CNE41在37℃和41℃下分别是2.3×10~(-11)cm~2s~(-1)和4.1×10~(-11)cm~2s~(-1)。本文对上述结果以及对激光漂白荧光恢复测定法本身进行了讨论。     

Mejoría de la capacidad funcional tras tratamiento con levotiroxina en pacientes con insuficiencia cardíaca crónica e hipotiroidismo subclínico

AimTo assess whether levothyroxine treatment improves functional capacity in patients with chronic heart failure (New York Heart Association class i-iii) and subclinical hypothyroidism.MethodsOne hundred and sixty-three outpatients with stable chronic heart failure followed up for at least 6 months were enrolled. A physical examination was performed, and laboratory tests including thyroid hormone levels, Doppler echocardiogram, radionuclide ventriculography, and Holter monitoring were requested. Functional capacity was assessed by of the 6-min walk test. Patients with subclinical hypothyroidism were detected and, after undergoing the s6-min walk test, were given replacement therapy. When they reached normal thyrotropin (TSH) levels, the 6-min walk test was performed again. The distance walked in both tests was recorded, and the difference in meters covered by each patient was analyzed.ResultsPrevalence of subclinical hypothyroidism in patients with heart failure was 13%. These patients walked 292 ± 63 m while they were hypothyroid and 350 ± 76 m when TSH levels returned to normal, a difference of 58 ± 11 m (P < .011). Patients with normal baseline TSH levels showed no significant difference between the 2 6-min walk tests.ConclusionsPatients with chronic heart failure and subclinical hypothyroidism significantly improved their physical performance when normal TSH levels were reached.     

Factores de riesgo cardiovascular en pacientes con hiperparatiroidismo primario asintomático

ObjectivesPatients with primary hyperparathyroidism (PHP), even asymptomatic, have an increased cardiovascular risk. However, data on reversibility or improvement of cardiovascular disorders with surgery are controversial. Our aims were to assess the prevalence of classic cardiovascular risk factors in patients with asymptomatic PHP, to explore their relationship with calcium and PTH levels, and analyze the effect of parathyroidectomy on those cardiovascular risk factors.Patients and methodsA retrospective, observational study of two groups of patients with asymptomatic PHP: 40 patients on observation and 33 patients who underwent surgery. Clinical and biochemical data related to PHP and various cardiovascular risk factors were collected from all patients at baseline and one year after surgery in the operated patients.ResultsA high prevalence of obesity (59.9%), type 2 diabetes mellitus (25%), high blood pressure (47.2%), and dyslipidemia (44.4%) was found in the total sample, with no difference between the study groups. Serum calcium and PTH levels positively correlated with BMI (r = .568, P = .011, and r = .509, P = .026 respectively) in non-operated patients. One year after parathyroidectomy, no improvement occurred in the cardiovascular risk factors considered.ConclusionsOur results confirm the high prevalence of obesity, type 2 diabetes mellitus, high blood pressure, and dyslipidemia in patients with asymptomatic PHP. However, parathyroidectomy did not improve these cardiovascular risk factors