RESUMO
This is a short review related with the current concepts and controversies in the diagnosis of intestinal bacterial overgrowth. This is a relatively complex entity present in diverse pathologies. Its adequate diagnosis has impact in the therapy and management of the patients with this condition. (AU)
Assuntos
Humanos , Intestino Delgado/patologia , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/microbiologia , Intestino Delgado/microbiologiaRESUMO
Background: Radiolabeled iodine uptake is a useful tool in the study of thyroid diseases. Aim: To obtain normal values for 131 Iodine thyroid uptake in healthy volunteers. Material and methods: A total of 105 subjects were included (52 males and 53 females), with a mean age of 45 years (range: 20 to 68, evenly distributed in decades). A questionnaire was applied and a clinical examination was performed to rule out endocrine diseases. Serum TSH and anti-thyroperoxidase antibodies were also measured. The oral 131I dose was 5-10 fiCi, and a Thyrad equipment was used for measurements at 2 and 24 h. Results: Mean global iodine uptake was 5.5 percent±1.8 percent (range: 2.3-12.0) at 2 h and 16.2±4.8 percent (range: 6.5-30.1) at 24 h. The values at 2 h among women and men were 6.0±1.8 and 4.9±1.6 percent, respectively, (p <0.02). At 24 h, the figures were 17.3±4.5 and 15.0±4.9 percent, respectively (p =0.01). Compared to their younger counterparts, radioactive iodine uptake was lower among volunteers older than 40 years, at 2 h (5.0±1.7 and 6.0±1.8, respectively, p <0.02) and at 24 h (14.9±4.4 and 17.6±4.9 percent, respectively, p <0.01). Conclusions: Normal thyroid uptake values in adults are influenced bygender and age. Normal thyroid iodine uptake values are slightly higher in females. Iodine thyroid uptake values decrease slightly in subjects aged more than 40years.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Radioisótopos do Iodo , Doenças da Glândula Tireoide , Glândula Tireoide , Tireotropina/sangue , Autoanticorpos/sangue , Índice de Massa Corporal , Iodeto Peroxidase/sangue , Radioisótopos do Iodo/farmacocinética , Estudos Prospectivos , Valores de Referência , Testes de Função Tireóidea , Glândula Tireoide/fisiologia , Fatores de Tempo , Adulto JovemRESUMO
BACKGROUND: Radiolabeled iodine uptake is a useful tool in the study of thyroid diseases. AIM: To obtain normal values for 131 Iodine thyroid uptake in healthy volunteers. MATERIAL AND METHODS: A total of 105 subjects were included (52 males and 53 females), with a mean age of 45 years (range: 20 to 68, evenly distributed in decades). A questionnaire was applied and a clinical examination was performed to rule out endocrine diseases. Serum TSH and anti-thyroperoxidase antibodies were also measured. The oral 131I dose was 5-10 microCi, and a Thyrad equipment was used for measurements at 2 and 24 h. RESULTS: Mean global iodine uptake was 5.5%+/-1.8% (range: 2.3-12.0) at 2 h and 16.2+/-4.8% (range: 6.5-30.1) at 24 h. The values at 2 h among women and men were 6.0+/-1.8 and 4.9+/-1.6%, respectively, (p<0.02). At 24 h, the figures were 17.3+/-4.5 and 15.0+/-4.9%, respectively (p=0.01). Compared to their younger counterparts, radioactive iodine uptake was lower among volunteers older than 40 years, at 2 h (5.0+/-1.7 and 6.0+/-1.8, respectively, p<0.02) and at 24 h (14.9+/-4.4 and 17.6+/-4.9%, respectively, p<0.01). CONCLUSIONS: Normal thyroid uptake values in adults are influenced by gender and age. Normal thyroid iodine uptake values are slightly higher in females. Iodine thyroid uptake values decrease slightly in subjects aged more than 40 years.
Assuntos
Radioisótopos do Iodo , Doenças da Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/diagnóstico por imagem , Tireotropina/sangue , Adulto , Idoso , Autoanticorpos/sangue , Índice de Massa Corporal , Feminino , Humanos , Iodeto Peroxidase/sangue , Radioisótopos do Iodo/farmacocinética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Cintilografia , Valores de Referência , Testes de Função Tireóidea , Glândula Tireoide/fisiologia , Fatores de Tempo , Adulto JovemRESUMO
El PET-FDG es una técnica que evalúa el metabolismo glucídico celular. Su mayor utilidad es en oncología, ya que permite distinguir tumores malignos de benignos, seleccionar los sitios de biopsia, etapificar las neoplasias, determinar la respuesta a tratamiento y distinguir entre cicatriz y enfermedad residual post tratamiento. En niños, las principales indicaciones son linfomas, tumores del sistema nervioso central, sarcomas de tejidos blandos, osteosarcoma y sarcoma de Ewing, neuroblastoma y nefroblastoma. Existen otros tumores menos comunes que también pueden ser evaluados eficazmente con FDG tales como: tumores de la vaina de nervios periféricos, hepatoblastomas, tumor de Wilms y cáncer de tiroides. Hay pocas publicaciones en esta población debido al pequeño número de pacientes estudiados y la baja incidencia de cáncer. Es importante considerar las variaciones en la distribución normal del trazador respecto al adulto para optimizar la interpretación de las imágenes. El objetivo de este artículo es efectuar una revisión de las indicaciones del PETFDG y presentar nuestra casuística inicial en población pediátrica.
Assuntos
Criança , Humanos , Neoplasias , Tomografia Computadorizada de Emissão , Compostos Radiofarmacêuticos/uso terapêuticoRESUMO
Se presenta el caso de un hombre de 57 años que presenta un cuadro degenerativo con afasia fluente y moderadas alteraciones de conducta, sin defecto semántico significativo, agnosia visual ni agrafia lexical y su estudio imagenológico cerebral. Se discuten los conceptos de afasia progresiva fluente y demencia semántica, concluyendo que la primera puede evolucionar hacia esta última. Nuestro caso se encontraría en esta situación. Se señala que la patología de las afasias progresivas es variable, siendo lo más frecuente una degeneración frontotemporal (con o sin inclusiones de proteína tau); con menor frecuencia corresponde a una enfermedad de Alzheimer o una degeneración corticobasal.
We report a 57-year-old man presenting with progressive fluent aphasia and behaviour disorder, with no visual semantic loss, visual agnosia, lexical agraphia, nor alexia. We include in this report the brain images, and we discuss the borders between fluent progressive aphasia and semantic dementia. We conclude that fluent progressive aphasia may be the first stage of semantic dementia, noting that the neuropathology of progressive fluent aphasia usually corresponds to frontotemporal lobar degeneration, with or without Tau protein inclusions, as in Alzheimer's Disease or corticobasal degeneration.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Afasia Primária Progressiva/etiologia , Demência , Doença de Alzheimer/etiologia , Semântica , Transtornos da Linguagem/etiologia , Agnosia/diagnóstico , Agnosia/etiologia , Transtornos Mentais , Comportamento SocialRESUMO
El PET-FDG es un estudio de imágenes de cuerpo entero que evalúa el metabolismo glucídico celular. Su mayor utilidad es en oncología tanto en adultos como en niños. Permite distinguir tumores malignos de benignos, seleccionar los sitios de biopsia, etapificar las neoplasias, determinar la respuesta al tratamiento y distinguir entre cicatriz y enfermedad residual post tratamiento. Diversos estudios han concluido que el PET-FDG es un examen útil en el manejo de la patología gineco-oncológica, destacando en cáncer de endometrio, cérvico uterino y ovárico. En este trabajo, se revisan las indicaciones de la técnica en las diversas patologías ginecológicas neoplásicas y su rendimiento. Asimismo, se presenta la experiencia chilena inicial realizada en el Hospital Militar de Santiago con equipo PET dedicado, donde se han estudiado más de 1.500 pacientes en su gran mayoría oncológicos.
FDG-PET is a whole body scan that evaluates glucose cell metabolism. Its main utility is in adult and children oncology. PET scan is useful differentiating benign from malignant neoplasm, selecting the site for biopsy, staging of the malignancy, evaluating response to therapy and distinguishing scar from residual neoplasm. Different studies have concluded that FDG-PET is a useful study in the gyneco-oncological management, especially in endometrial, cervical and ovarian cancer. This work reviews the principal indications of PET in this pathology and also the initial Chilean experience at the Military Hospital of Santiago with a dedicated PET, where we have studied more than 1,500 cases, most of them in cancer patients.
Assuntos
Humanos , Feminino , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons , Neoplasias dos Genitais Femininos/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Vaginais/diagnóstico por imagem , Neoplasias Vulvares/diagnóstico por imagem , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias das Tubas Uterinas/diagnóstico por imagemRESUMO
Due to the recent incorporation of positron technology (PET) it appears interesting to review the present indications of fluor-deoxyglucose (FDG) in neuropediatric pathology. The main indication is in the evaluation of refractory epilepsy mainly in cases with negative magnetic resonance or discordance with electroencephalography Some uses in tumors are also discussed, such as tumor characterization and differentiation between radionecrosis and recurrence. The experience between years 2003 and 2007 at the Santiago Military Hospital, using FDG in 66 children and adolescents cases with diverse neurological indications was reviewed.
La incorporación relativamente reciente en nuestro medio de la tecnología de positrones (PET) nos motivó a revisar el uso actual de la flúor-deoxiglucosa (FDG) en neuropediatría. La principal indicación es la evaluación de epilepsia refractaria, especialmente en casos de resonancia magnética negativa o discordancia de ésta con los hallazgos electroencefalográficos. Algunas utilizaciones en tumores también son discutidas, como la caracterización tumoralyla diferenciación entre radionecrosis y recurrencia. Se revisa la casuística del Centro PET del Hospital Militar de Santiago entre los años 2003 y 2007, que comprende 66 casos de niños y adolescentes estudiados con metabolismo glucídico con diversas patologías neurológicas.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Pediatria , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons , Doenças do Sistema Nervoso/diagnóstico por imagem , Neoplasias Encefálicas/diagnóstico por imagem , Epilepsia/diagnóstico por imagem , Hospitais MilitaresRESUMO
Depression is a serious and high-priority public health problem. In Chilean population, prevalence ranges from 5 to 27,3 percent. Therapy is based mainly in the use of selective serotonin reuptake inhibitors (SSRIs). Combination of thyroid hormone, sodium liothyronine, associated to traditional antidepressants to improve or accelerate therapeutic response is currently accepted. The use of this combination is based on hypothalamus-hypophysis-thyroid axis (HHT) alterations and on the peripheral conversion to active hormone, the triiodothyronine (T3), by type 2 and 3deiodinases (D2 and D3). Subtle changes in enzyme activity could have a strong impact in T3 brain availability. In major depression as high as a 25 percent of altered responses of HHT axis to the TRH stimulus may be observed. Certain polymorphisms of the D2 gene could be associated to enzyme activity changes. Isotopic studies are able to assess brain flow in diverse conditions, like global or specific regional perfusion variations in patients with mild hypothyroidism, pre and post T4 or SSRIs therapy in depressive patients.