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4.
Clin Exp Dermatol ; 49(9): 1002-1006, 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-38430106

RESUMEN

BACKGROUND: Bullous pemphigoid (BP) is the most common autoimmune blistering disease. Most patients are older and have associated multiple comorbidities. Topical and systemic corticosteroids are considered the first-line treatment for BP, and immunosuppressants are used as steroid-sparing treatments. However, both have side-effects and contraindications, which are even more common in this older population. New treatments targeting interleukins and receptors related to BP pathogenesis have been proposed to decrease these side-effects while achieving equal or better effectiveness and response rates. Omalizumab is a monoclonal antibody that targets IgE and has been proposed for the treatment of BP due to the evidence that IgE autoantibodies play an essential role in BP pathogenesis. OBJECTIVES: To assess the efficacy and safety of omalizumab for the treatment of BP. METHODS: We carried out a multicentre, retrospective, observational study including patients diagnosed with BP who received omalizumab for ≥ 3 months from 15 tertiary hospitals in Spain. IgE levels prior to treatment were measured, and we evaluated the possible correlation with clinical response. We excluded patients treated with omalizumab for < 3 months, as we consider this duration to be insufficient for a comprehensive assessment of its efficacy. To evaluate the effectiveness of the treatment, we used the percentage of body surface area improvement. RESULTS: We included 36 patients. The vast majority had associated multiple comorbidities, and all patients had used other systemic therapies apart from corticosteroids before omalizumab. In total, 83% experienced some kind of treatment response and 42% of all patients treated achieved complete response. We did not find any correlation between higher IgE levels and a better response (P = 0.2). All patients tolerated omalizumab without reported side-effects. CONCLUSIONS: Omalizumab is a good therapeutic alternative for BP as it provided clinical response in most patients, and nearly one-half of the cases achieved complete response. It showed no side-effects, which is crucial in older patients with BP.


Asunto(s)
Omalizumab , Penfigoide Ampolloso , Humanos , Omalizumab/uso terapéutico , Omalizumab/efectos adversos , Penfigoide Ampolloso/tratamiento farmacológico , Femenino , Masculino , Anciano , Estudios Retrospectivos , Anciano de 80 o más Años , España , Resultado del Tratamiento , Persona de Mediana Edad , Inmunoglobulina E/sangre
5.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 43(1): 31-38, ene.- fev. 2024.
Artículo en Español | IBECS | ID: ibc-229452

RESUMEN

Objetivo Determinar la utilidad de los cocientes neutrófilos/linfocitos (N/L) y plaquetas/linfocitos (P/L), así como de parámetros cuantitativos de la PET/TC con [18F]FDG, como factores pronósticos para la supervivencia global (SG), la supervivencia cáncer específica (SCE) y la supervivencia libre de progresión (SLP) en pacientes con carcinoma escamoso de cabeza y cuello (CyC) Material y métodos Se valoraron retrospectivamente 66 pacientes (56 hombres) diagnosticados de CyC durante un intervalo de 8años. Se determinaron los parámetros SUV máximo (SUVmax), volumen metabólico tumoral (MTV) y glucólisis tumoral total (TLG) del estudio PET/TC al diagnóstico. Tras tratamiento con quimiorradioterapia, se valoró la supervivencia de los pacientes. El modelo de regresión de Cox y el método de Kaplan-Meier se utilizaron para analizar factores pronósticos y curvas de supervivencia. Resultados El seguimiento medio fue de 50,4meses, produciéndose 39 recurrencias-progresiones y 39 fallecimientos. En el análisis univariante los parámetros metabólicos, excepto el SUVmax, fueron factores predictivos para las tres supervivencias, y los dos parámetros sanguíneos lo fueron para la SG y la SCE. La TLG fue el único factor predictivo en el análisis multivariante. Las tres curvas de supervivencias fueron significativamente diferentes para los parámetros metabólicos y la curva de SG para el cociente N/L. Se apreciaron correlaciones entre el cociente N/L, el MTV y la TLG. No se demostraron correlaciones entre el cociente P/L y los parámetros metabólicos. Conclusión El uso de marcadores hematológicos y metabólicos permitiría identificar pacientes con un alto riesgo de recurrencias y pobre supervivencia e individualizar el tratamiento aplicando terapias más agresivas (AU)


Aim To determine the usefulness of neutrophil/lymphocyte (N/L) and platelet/lymphocyte (P/L) ratios as well as quantitative [18F]FDG PET/CT parameters as prognostic factors for overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) in patients with head and neck squamous cell carcinoma (HyN). Material and methods Sixty-six patients (56 men) diagnosed with HyN carcinoma were retrospectively assessed over an 8-year interval. Maximum SUV (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) parameters were determined from the PET/CT study at diagnosis. After treatment with chemoradiotherapy, patient survival was assessed. The Cox regression model and the Kaplan-Meier method were used to analyse prognostic factors and survival curves. Results Median follow-up was 50.4months, with 39 recurrences-progressions and 39 deaths. In the univariate analysis, metabolic parameters, except SUVmax, were predictive factors for all three survivals and the two blood parameters were predictive for OS and EFS. TLG was the only predictive factor in the multivariate analysis. The three survival curves were significantly different for the metabolic parameters and the OS curve for the N/L ratio. Correlations were seen between N/L ratio, MTV and TLG. No correlations were demonstrated between P/L ratio and metabolic parameters. Conclusion The use of haematological and metabolic markers would allow to identify patients with a high risk of recurrences and poor survival and to individualise treatment by applying more aggressive therapies (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Radiofármacos , Tomografía Computarizada por Tomografía de Emisión de Positrones , Pronóstico , Estudios Retrospectivos , Análisis de Supervivencia
6.
Australas J Dermatol ; 65(2): 153-162, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38058123

RESUMEN

BACKGROUND: Dupilumab has shown to be an effective and safe treatment for patients with moderate-to-severe atopic dermatitis (AD). OBJECTIVE: To evaluate the predictive factors of response (PRF) in patients with moderate-to-severe AD treated with dupilumab. METHODS: Observational, retrospective and multicentre study conducted on adult patients diagnosed with moderate-to-severe AD treated with dupilumab, with a post-treatment follow-up of at least 16 weeks. The primary endpoints were EASI-75 and the IGA scale at week 52. RESULTS: A total of 198 patients were included in the analysis. Mean age was 38 ± 15.1 years and 116 (58.6%) were men. The most prevalent AD-predominant phenotypes were flexural eczema (45.3%), head-and-neck eczema (18.2%) and erythroderma (17.7%). At week 52, 140 (86.4%) patients achieved EASI-75 and 119 (93.0%) achieved an improvement in ≥2 points from baseline in IGA score. Women were 3.6 times more likely to achieve EASI-75 response than men (Odds ratio: 3.58; p = 0.020). While increased body mass index significantly reduced the probability of obtaining an improvement of ≥2 points in the IGA scale at week 52 (odds ratio: 0.88; p = 0.049). CONCLUSIONS: Dupilumab was an effective treatment in patients with moderate-to-severe AD. Additionally, sex and body mass index were significantly associated with achieving EASI-75 and an improvement of ≥2 points in the IGA scale, respectively, at week 52.


Asunto(s)
Anticuerpos Monoclonales Humanizados , Dermatitis Atópica , Eccema , Adulto , Masculino , Humanos , Femenino , Adulto Joven , Persona de Mediana Edad , Dermatitis Atópica/tratamiento farmacológico , Dermatitis Atópica/diagnóstico , Estudios Retrospectivos , Método Doble Ciego , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Inmunoglobulina A
7.
J Clin Med ; 12(22)2023 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-38002648

RESUMEN

Our objective is to analyze retinal changes using optical coherence tomography angiography (OCT-A) in patients with mild cognitive impairment (MCI) to characterize structural and vascular alterations. This cross-sectional study involved 117 eyes: 39 eyes from patients with MCI plus diabetes (DM-MCI), 39 eyes from patients with MCI but no diabetes (MCI); and 39 healthy control eyes (C). All patients underwent a visual acuity measurement, a structural OCT, an OCT-A, and a neuropsychological examination. Our study showed a thinning of retinal nerve fiber layer thickness (RNFL) and a decrease in macular thickness when comparing the MCI-DM group to the C group (p = 0.008 and p = 0.016, respectively). In addition, an increase in arteriolar thickness (p = 0.016), a reduction in superficial capillary plexus density (p = 0.002), and a decrease in ganglion cell thickness (p = 0.027) were found when comparing the MCI-DM group with the MCI group. Diabetes may exacerbate retinal vascular changes when combined with mild cognitive impairment.

8.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 42(4): 249-254, jul.- ago. 2023. tab
Artículo en Español | IBECS | ID: ibc-223281

RESUMEN

Objetivo Identificar la frecuencia de errores en los documentos de consentimiento informado en cirugía radioguiada en un hospital de tercer nivel y detectar posibles causas o factores asociados a un mayor riesgo de error. Material y método Se analizaron los consentimientos informados de un total de 369 intervenciones de cirugía radioguiada, cumplimentados por los servicios de Medicina Nuclear y Cirugía General, y se analizó el grado de cumplimentación de los mismos y su correlación con facultativos responsables, tipo de enfermedad e intervención, tiempo de espera y cumplimentación del consentimiento de la otra especialidad. Resultados Se identificaron errores en 22 consentimientos de Medicina Nuclear y 71 consentimientos de Cirugía General. El error más común fue la ausencia de identificación del facultativo responsable (17 en Medicina Nuclear, 51 en Cirugía General), y el segundo más común la ausencia de documento (2 en Medicina Nuclear, 20 en Cirugía General). Existieron diferencias significativas en los errores cometidos en función del médico responsable, sin encontrarse correlación significativa con el resto de las variables. Conclusiones Los médicos responsables fueron el principal factor asociado a un mayor riesgo de error en la cumplimentación de consentimientos informados. Serían recomendables nuevos estudios para analizar factores casuales y posibles intervenciones para minimizar errores (AU)


Objective To identify the frequency of errors in the informed consent documents in radioguided surgery in a third level hospital and to detect possible causes or factors associated with a greater risk of error. Material and method The informed consents of a total of 369 radioguided surgery interventions, completed by the Nuclear Medicine and General Surgery services, were analyzed, as well as their degree of completion and its correlation with responsible physicians, type of pathology and intervention, waiting time and completion of the consent of the other specialty. Results Errors were identified in 22 consent forms for Nuclear Medicine and 71 consent forms for General Surgery. The most common error was the absence of identification of the responsible physician (17 in Nuclear Medicine, 51 in General Surgery), and the second most common was the absence of a document (2 in Nuclear Medicine, 20 in General Surgery). There were significant differences in the errors made depending on the doctor in charge, without finding a significant correlation with the other variables. Conclusions The responsible physicians were the main factor associated with a greater risk of error in the completion of informed consent. New studies would be recommended to analyze causal factors and possible interventions to minimize errors (AU)


Asunto(s)
Humanos , Consentimiento Informado , Medicina Nuclear , Cirugía Asistida por Computador , Procedimientos Quirúrgicos Operativos/métodos , Factores de Riesgo
9.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 42(3): 163-170, mayo - jun. 2023. ilus, tab
Artículo en Español | IBECS | ID: ibc-219925

RESUMEN

Objetivo Valorar la utilidad clínica de los criterios PERCIST, Hopkins y de los cambios en los parámetros cuantitativos de la PET/TC con [18F]FDG como factores pronósticos para la supervivencia libre de progresión (SLP) y la supervivencia cáncer específica (SCE) en pacientes con cáncer escamoso de cabeza y cuello tratados mediante quimiorradioterapia. Material y métodos Se valoraron retrospectivamente 40 pacientes (34 hombres) diagnosticados de cáncer escamoso de cabeza y cuello durante un intervalo de 8 años. Se utilizaron los criterios PERCIST y Hopkins para determinar la respuesta al tratamiento. Así mismo, se cuantificaron las variaciones de los parámetros metabólicos SUV máximo (ΔSUVmax), volumen metabólico tumoral (ΔMTV) y glicólisis tumoral total (ΔTLG) entre los estudios PET/TC pre- y postratamiento. El modelo de regresión de Cox, las curvas ROC y el método de Kaplan-Meier se aplicaron para el análisis de factores pronósticos y curvas de supervivencia. Resultado El seguimiento medio fue de 39,4 meses produciéndose 24 recidivas-progresiones y 22 muertes. Tanto los criterios PERCIST y Hopkins como los tres parámetros metabólicos fueron factores predictivos en análisis univariante y solo el ΔSUVmax en el multivariante. El análisis de supervivencia mostró curvas de SLP y SCE significativamente diferentes para los cinco parámetros considerados. Conclusión La aplicación de los criterios PERCIST y Hopkins, así como los ΔSUVmax, ΔMTV y ΔTLG de los estudios PET/TC demostraron ser factores pronósticos para la supervivencia en pacientes de nuestro entorno tratados por cáncer de cabeza y cuello. Los resultados podrían ayudar a personalizar el tratamiento (AU)


Aim To assess the clinical utility of PERCIST and Hopkins criteria and changes in [18F]FDG PET/CT quantitative parameters as prognostic factors for progression-free survival (PFS) and cancer-specific survival (CSS) in patients with head and neck squamous cell carcinoma treated by chemoradiotherapy. Material and methods Forty patients (34 men) diagnosed with head and neck squamous cell carcinoma were retrospectively assessed over an interval of 8 years. PERCIST and Hopkins criteria were used to assess response to treatment. Variations in the metabolic parameters maximum SUV (ΔSUVmax), metabolic tumor volume (ΔMTV) and total lesion glycolysis (ΔTLG) between pre- and post-treatment PET/CT studies were also determined. Cox regression model, ROC curves and Kaplan-Meier method were used for the analysis of prognostic factors and survival curves. Results The average follow-up was 39.4 months, with 24 progressions and 22 deaths. Both PERCIST and Hopkins criteria and the three metabolic parameters were predictive factors in the univariate analysis and only ΔSUVmax in the multivariate analysis. Survival analysis showed statistically significant differences in PFS and CSS curves for the five parameters considered. Conclusion Application of PERCIST and Hopkins criteria as well as ΔSUVmax, ΔMTV and ΔTLG from PET/CT studies proved to be prognostic factors for survival in patients in our setting treated for head and neck cancer. The results could help to personalize treatment (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/mortalidad , Neoplasias de Cabeza y Cuello/metabolismo , Neoplasias de Cabeza y Cuello/mortalidad , Tomografía Computarizada por Tomografía de Emisión de Positrones , Fluorodesoxiglucosa F18 , Estudios Retrospectivos , Estimación de Kaplan-Meier , Estudios de Seguimiento , Pronóstico
10.
Artículo en Inglés | MEDLINE | ID: mdl-37201658

RESUMEN

OBJECTIVE: To identify the frequency of errors in informed consent documents in radioguided surgery in a third level hospital and to detect possible causes or factors associated with a greater risk of error. MATERIAL AND METHODS: Informed consent forms of a total of 369 radioguided surgery interventions, completed by the Nuclear Medicine and General Surgery services, were analyzed, and the degree of completion of the forms and its correlation with the physicians responsible, type of pathology, intervention, and waiting time were compared with the completion of consent by another specialty. RESULTS: Errors were identified in 22 consent forms from Nuclear Medicine and 71 from General Surgery. The most common error was the absence of identification of the physician responsible (17 in Nuclear Medicine, 51 in General Surgery), and the second most common was the absence of a document (2 in Nuclear Medicine, 20 in General Surgery). There were significant differences in the errors made depending on the doctor in charge, with no significant correlation with the other variables. CONCLUSIONS: The physicians responsible were the main factor associated with a greater risk of error in the completion of informed consent forms. Further studies are needed to analyze the causal factors and possible interventions to minimize errors.


Asunto(s)
Medicina Nuclear , Cirugía Asistida por Computador , Consentimiento Informado , Hospitales
11.
Clin Exp Dermatol ; 48(9): 991-997, 2023 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-37098171

RESUMEN

BACKGROUND: Tralokinumab was recently approved for the treatment of moderate-to-severe atopic dermatitis (AD) and is the first selective interleukin (IL)-13 inhibitor that specifically neutralizes IL-13 with high affinity. OBJECTIVES: To determine the real-life short-term effectiveness and safety of tralokinumab treatment in patients with moderate-to-severe AD. METHODS: A multicentre retrospective study was conducted including adult patients with moderate-to-severe AD who started tralokinumab treatment from 1 April to 30 June 2022 in 16 Spanish hospitals. Demographic and disease characteristics, severity and quality of life scales were collected at the baseline visit and at weeks 4 and 16. RESULTS: Eighty-five patients were included. Twenty-seven patients (32%) were non-naive to advanced therapy (biological or Janus kinase inhibitors inhibitors). All included patients had severe disease with baseline Eczema Area and Severity Index (EASI) scores of 25.4 (SD 8.1), Dermatology Life Quality Index (DLQI) 15.8 (5.4) and peak pruritus numerical rating scale (PP-NRS) 8.1 (1.8) and 65% had an Investigator's Global Assessment (IGA) of 4. At week 16, there was improvement on all scales. The mean EASI decreased to 7.5 (SD 6.9, 70% improvement), SCORing Atopic Dermatitis improved 64% and PP-NRS, 57%. Also, 82%, 58% and 21% of the patients achieved EASI 50, 75 and 90, respectively. The percentage of EASI 75 responders was significantly higher among the naive vs. non-naive groups (67% vs. 41%). The safety profile was acceptable. CONCLUSIONS: Patients, with a long history of disease and prior multidrug failure, showed a good response to tralokinumab, confirming clinical trial results.


Asunto(s)
Dermatitis Atópica , Adulto , Humanos , Dermatitis Atópica/tratamiento farmacológico , Calidad de Vida , Estudios Retrospectivos , Resultado del Tratamiento , Prurito/tratamiento farmacológico , Índice de Severidad de la Enfermedad , Método Doble Ciego
12.
Artículo en Inglés | MEDLINE | ID: mdl-36858187

RESUMEN

AIM: To assess the clinical utility of PERCIST and Hopkins criteria and changes in [18F]FDG PET/CT quantitative parameters as prognostic factors for progression-free survival (PFS) and cancer-specific survival (CSS) in patients with head and neck squamous cell carcinoma treated by chemoradiotherapy. MATERIAL AND METHODS: Forty patients (34 men) diagnosed with head and neck squamous cell carcinoma were retrospectively assessed over an interval of 8 years. PERCIST and Hopkins criteria were used to assess response to treatment. Variations in the metabolic parameters maximum SUV (ΔSUVmax), metabolic tumor volume (ΔMTV) and total lesion glycolysis (ΔTLG) between pre- and post-treatment PET/CT studies were also determined. The Cox regression model, ROC curves and the Kaplan-Meier method were used for the analysis of prognostic factors and survival curves. RESULTS: The mean follow-up was 39.4 months, with 24 progressions and 22 deaths. Both PERCIST and Hopkins criteria and the three metabolic parameters were predictive factors in the univariate analysis and only ΔSUVmax was in the multivariate analysis. Survival analysis showed statistically significant differences in PFS and CSS curves for the five parameters considered. CONCLUSION: Application of PERCIST and Hopkins criteria as well as ΔSUVmax, ΔMTV and ΔTLG from PET/CT studies proved to be prognostic factors for survival in patients in our setting for treating head and neck cancer. The results may help to personalize treatment.


Asunto(s)
Neoplasias de Cabeza y Cuello , Tomografía Computarizada por Tomografía de Emisión de Positrones , Masculino , Humanos , Pronóstico , Carcinoma de Células Escamosas de Cabeza y Cuello/diagnóstico por imagen , Carcinoma de Células Escamosas de Cabeza y Cuello/terapia , Estudios Retrospectivos , Fluorodesoxiglucosa F18 , Radiofármacos , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/terapia
14.
J Neuroophthalmol ; 43(1): 116-125, 2023 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-36255105

RESUMEN

BACKGROUND: Optical coherence tomography (OCT) has enabled several retinal alterations to be detected in patients with Alzheimer disease (AD), alterations that could be potential biomarkers. However, the relationship between the retina and other biomarkers of AD has been underresearched. We gathered and analyzed the literature about the relationship between retinal and cerebral alterations detected via neuroimaging in patients with AD, mild cognitive impairment (MCI), and preclinical AD. METHODS: This systematic review followed the PRISMA Statement guidelines through the 27 items on its checklist. We searched in PubMed, BVS, Scopus, and the Cochrane Library, using the keywords: Alzheimer's disease, optical coherence tomography, white matter, cortex, atrophy, cortical thickness, neuroimaging, magnetic resonance imaging, and positron emission tomography. We included articles that studied the retina in relation to neuroimaging in patients with AD, MCI, and preclinical AD. We excluded studies without OCT, without neuroimaging, clinical cases, opinion articles, systematic reviews, and animal studies. RESULTS: Of a total of 35 articles found, 23 were finally included. Although mixed results were found, most of these corroborate the relationship between retinal and brain disorders. CONCLUSIONS: More rigorous research is needed in the field, including homogenized, longitudinal, and prolonged follow-up studies, as well as studies that include all stages of AD. This will enable better understanding of the retina and its implications in AD, leading to the discovery of retinal biomarkers that reflect brain alterations in AD patients in an accessible and noninvasive manner.


Asunto(s)
Enfermedad de Alzheimer , Disfunción Cognitiva , Humanos , Enfermedad de Alzheimer/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Retina/diagnóstico por imagen , Retina/patología , Disfunción Cognitiva/diagnóstico por imagen , Neuroimagen/métodos , Biomarcadores
15.
Eur J Dermatol ; 32(5): 629-631, 2022 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-36468733

RESUMEN

Background: The guidelines for the treatment of chronic spontaneous urticaria (CSU) recommend adding omalizumab to the treatment of patients with uncontrolled disease despite four-fold doses of second-generation antihistamines (AH). On the contrary, some studies revealed that omalizumab was effective without concomitant AH and several authors suggest tapering off AH when CSU is controlled with omalizumab. Objectives: The aim of our study was to evaluate the use of AH during treatment with omalizumab in patients with CSU in real clinical practice. Materials & Methods: This was a multicentre cross-sectional and observational study conducted by the Catalan and Balearic Chronic Urticaria Network (XUrCB) based on a cohort of 298 CSU patients treated with omalizumab. Results: In total, 23.5% of our patients decided themselves to stop taking AH during omalizumab treatment. The ratio of patients with CSU without concomitant inducible urticaria and the percentage of patients with a good response to omalizumab (UAS7≤6 and/or UCT ≥12) were higher in those who stopped taking AH. Conclusion: More studies are required to identify the phenotypic characteristics of patients responding to omalizumab as monotherapy in order to avoid overtreating with AH. Our study suggests that patients with CSU without concomitant inducible urticaria and those who achieve a good response to omalizumab tend to be controlled by omalizumab without AH. In order to establish guidelines on how to stop AH, further evidenced-based studies are required.


Asunto(s)
Urticaria Crónica , Urticaria , Humanos , Urticaria Crónica/tratamiento farmacológico , Omalizumab/uso terapéutico , Estudios Transversales , Antagonistas de los Receptores Histamínicos/uso terapéutico , Urticaria/tratamiento farmacológico
16.
Rev. ORL (Salamanca) ; 13(2): 147-158, junio 2022. ilus
Artículo en Español | IBECS | ID: ibc-211137

RESUMEN

El hiperparatiroidismo primario (HPTP) es la principal causa de hipercalcemia en pacientes no hospitalizados, estando causado en el 85-90% de los casos por un adenoma solitario. La cirugía radioguiada de paratiroides (CRGP), como técnica GOSTT (Guided intraOperative Scintigraphic Tumor Targeting), utiliza la SPECT-TC con 99mTc-MIBI como técnica de elección. La PET-TC con 18F-Colina (18FCH) puede emplearse en pacientes con 99mTc-MIBI negativo, obteniéndose sensibilidades próximas al 95%. El uso de la 18FCH en la CRGP es muy complejo recomendándose la utilización de otros trazadores como los 99mTc-Macroagregados (99mTc-MAA) o las semillas de Yodo-125 (125I-Semilla). La CRGP disminuye el tiempo quirúrgico, los costes hospitalarios y la morbilidad sobre el paciente, con una elevada efectividad y eficiencia. (AU)


Primary hyperparathyroidism (PHPT) is the main cause of hypercalcemia in non-hospitalized patients, being caused in 85-90% of cases by a solitary adenoma. Radioguided parathyroid surgery (RGPS), as a GOSTT (Guided intraOperative Scintigraphic Tumor Targeting) technique, uses SPECT-TC with 99mTc -MIBI as the technique of choice. PET-TC with 18F-Choline (18FCH) can be used in patients with negative 99mTc-MIBI, obtaining sensitivities close to 95%. The use of 18FCH in CRGP is very complex, recommending the use of other tracers such as 99mTc-Macroaggregates (99mTc-MAA) or Iodine-125 seeds (125I-Seed). RGPS reduces surgical time, hospital costs and patient morbidity, with high effectiveness and efficiency. (AU)


Asunto(s)
Humanos , Cirugía General , Hiperparatiroidismo , Colina , Adenoma , Pacientes , Tomografía Computarizada por Tomografía de Emisión de Positrones
18.
ChemSusChem ; 14(16): 3333-3343, 2021 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-34165920

RESUMEN

A full lithium-ion-sulfur cell with a remarkable cycle life was achieved by combining an environmentally sustainable biomass-derived sulfur-carbon cathode and a pre-lithiated silicon oxide anode. X-ray diffraction, Raman spectroscopy, energy dispersive spectroscopy, and thermogravimetry of the cathode evidenced the disordered nature of the carbon matrix in which sulfur was uniformly distributed with a weight content as high as 75 %, while scanning and transmission electron microscopy revealed the micrometric morphology of the composite. The sulfur-carbon electrode in the lithium half-cell exhibited a maximum capacity higher than 1200 mAh gS -1 , reversible electrochemical process, limited electrode/electrolyte interphase resistance, and a rate capability up to C/2. The material showed a capacity decay of about 40 % with respect to the steady-state value over 100 cycles, likely due to the reaction with the lithium metal of dissolved polysulfides or impurities including P detected in the carbon precursor. Therefore, the replacement of the lithium metal with a less challenging anode was suggested, and the sulfur-carbon composite was subsequently investigated in the full lithium-ion-sulfur battery employing a Li-alloying silicon oxide anode. The full-cell revealed an initial capacity as high as 1200 mAh gS -1 , a retention increased to more than 79 % for 100 galvanostatic cycles, and 56 % over 500 cycles. The data reported herein well indicated the reliability of energy storage devices with extended cycle life employing high-energy, green, and safe electrode materials.

19.
Environ Sci Pollut Res Int ; 28(19): 24342-24354, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-32212082

RESUMEN

This study deals with the preparation of activated carbon (AC) from poly(ethylene terephthalate) (PET) waste and with the physicochemical characterization of AC and its use as adsorbent of bisphenol A (BPA) in aqueous solution. AC was prepared by chemical activation with KOH and by physical activation in steam. The activation with KOH was carried out by impregnation first of PET by wet and dry routes at the PET/KOH weight ratios of 1:1, 1:3, and 1:5 and by carbonization then of the resulting products at 850 °C for 2 h in N2 atmosphere. The activation in steam was performed by heating at 900 °C for 1 h. The ACs were characterized by N2 adsorption at - 196 °C, mercury porosity, mercury density measurements, FT-IR spectroscopy, and measurement of pH of the point of zero charge (pHpzc). The activation yield is 58.4-49.4% with KOH in aqueous solution, 75.8-23.9% with solid KOH, and 5.9% with steam. Using solid KOH, greater developments of a more heterogeneous porosity with increasing impregnation PET/KOH ratio are achieved. For SK1:5, SBET is 1990 m2 g-1 and the pore volumes are 0.71 cm3 g-1, micropores; 0.81 cm3 g-1, mesopores; and 1.77 cm3 g-1, macropores. The data of BPA adsorption fit better to the Ho and Mckay second order kinetic model than to the Lagergren first-order kinetic model and to the Langmuir equation than to the Freundlich equation. From the kinetic and thermodynamic standpoints, the adsorption process of BPA is more favorable for SK1:5.


Asunto(s)
Carbón Orgánico , Contaminantes Químicos del Agua , Adsorción , Compuestos de Bencidrilo , Cinética , Fenoles , Espectroscopía Infrarroja por Transformada de Fourier , Contaminantes Químicos del Agua/análisis
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