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PURPOSE: We performed a cross-sectional study of neurocognitive function in non-brain cancer patients treated with long-term bevacizumab. METHODS/PATIENTS: From 2015 to 2017, we included patients with different types of cancer treated with bevacizumab with or without chemotherapy (BEV; N = 20) or only chemotherapy (ChT; N = 19) for at least 34 weeks, patients who received non-brain radiotherapy (RxT; N = 19), and healthy controls (HC; N = 19) were assessed once at week 34 of treatment (BEV and ChT) or at completion of radiotherapy. Neurocognition was evaluated with the Hopkins Verbal Learning Test-Revised (HVLT-R) total and delayed recall, the Trail Making Test A and B, and the Controlled Oral Word Association Test in the four groups. Non-parametric tests were used to assess differences between groups. RESULTS: The BEV, ChT, and RxT groups scored significantly lower than the HC group on all tests and especially on the HVLT-R total recall. In no case were the mean scores of the BEV group significantly lower than those of the ChT or RxT groups. CONCLUSIONS: Neurocognitive impairment was seen even in patients treated with local non-brain radiotherapy. Treatment with bevacizumab for a long period of time does not seem to worsen neurocognitive function to a greater extent than chemotherapy.

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BACKGROUND: PET/CT (Positron Emission Tomography/Computed Tomography) is widely used in nodal and metastatic staging of lung cancer patients. AIM: To analyze PET/CT detection of metastatic disease in patients with lung cancer. MATERIAL AND METHODS: We reviewed retrospectively F18Fluorodeoxyglucose PET/CT scans performed between December 2008 and December 2013. We selected 143 patients aged 30 to 92 years (63% males) with confirmed lung cancer referred for staging, with no previous treatment. We reviewed whole body PET/CT and brain magnetic resonance images. SUVmax (Standardized Uptake Value maximum) of primary pulmonary lesion, hilar/mediastinal nodes, and distant metastases were calculated. RESULTS: Histological types encountered were adenocarcinoma in 55%, squamous-cell in 15%, small-cell in 8%, large-cell in 6% and adeno-squamous in 2%. In 22 cases (15%) histology was not available. Nodal involvement was observed in 60% of patients (44% hilar and 48% mediastinal). Skip metastases (mediastinal involvement without hilum involvement) were encountered in 17% of cases, and were significantly more common among high uptake lung tumors (p < 0.01). Best SUVmax cut-off for node involvement was 4.4 for hilum and 4.0 for mediastinum (sensibility: 86.4%, specificity: 99.8%). Sixty six patients (46.2%) showed distant metastases on PET/CT. The most common metastases were osseous in 22%, adrenal in 16%, hepatic in14%, pulmonary in 14% and cerebral in 12%. PET/CT detected a second unexpected synchronic cancer in eight patients (6%). CONCLUSIONS: PET/CT is accurate for nodal staging using an uptake index as SUVmax. Distant metastases are common, especially in bone, adrenal glands and liver.

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Background: PET/CT (Positron Emission Tomography/Computed Tomography) is widely used in nodal and metastatic staging of lung cancer patients. Aim: To analyze PET/CT detection of metastatic disease in patients with lung cancer. Material and Methods: We reviewed retrospectively F18Fluorodeoxyglucose PET/CT scans performed between December 2008 and December 2013. We selected 143 patients aged 30 to 92 years (63% males) with confirmed lung cancer referred for staging, with no previous treatment. We reviewed whole body PET/CT and brain magnetic resonance images. SUVmax (Standardized Uptake Value maximum) of primary pulmonary lesion, hilar/mediastinal nodes, and distant metastases were calculated. Results: Histological types encountered were adenocarcinoma in 55%, squamous-cell in 15%, small-cell in 8%, large-cell in 6% and adeno-squamous in 2%. In 22 cases (15%) histology was not available. Nodal involvement was observed in 60% of patients (44% hilar and 48% mediastinal). Skip metastases (mediastinal involvement without hilum involvement) were encountered in 17% of cases, and were significantly more common among high uptake lung tumors (p < 0.01). Best SUVmax cut-off for node involvement was 4.4 for hilum and 4.0 for mediastinum (sensibility: 86.4%, specificity: 99.8%). Sixty six patients (46.2%) showed distant metastases on PET/CT. The most common metastases were osseous in 22%, adrenal in 16%, hepatic in14%, pulmonary in 14% and cerebral in 12%. PET/CT detected a second unexpected synchronic cancer in eight patients (6%). Conclusions: PET/CT is accurate for nodal staging using an uptake index as SUVmax. Distant metastases are common, especially in bone, adrenal glands and liver.

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D-004, a lipid extract of royal palm (Roystonea regia) fruits that contains a reproducible mixture of fatty acids, has been shown to prevent testosterone and phenylephrine-induced prostate hyperplasia in rodents. This study investigated the long-term oral toxicity of D-004 in rats. Rats from both sexes were randomized into four groups (20 rats sex/group): a control and three treated with D-004 (800, 1500 or 2000 mg/kg/day, respectively). At study completion, rats were sacrificed under anaesthesia. Determinations of blood biochemical and haematological parameters and organ weight were done. Also, necropsy and histopathological studies were performed. Four of 160 rats died before study completion. No clinical signs of toxicity were observed throughout the study. Food and water consumption, bodyweight, blood biochemical and haematological parameters, organ weight ratios and histopathological findings were similar in control and treated groups. The histological lesions found in treated animals are commonly present in this specie and strain according to literature and our historical data. In conclusion, long-term (12 months) oral treatment of rats with D-004 (800-2000 mg/kg/day) did not show evidences of D-004-related toxicity under our conditions. The highest dose tested (2000 mg/kg) was a no-observed adverse effect level in this study.

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El desarrollo de la resonancia magnética ha producido nuevos tipos de imágenes que pueden ser de utilidad en pacientes con manifestaciones visuales. Las imágenes estructurales potenciadas en T1 pueden ser procesadas, mediante diferentes tipos de software, para la obtención de nuevas imágenes que permiten separar distintas estructuras (segmentación), realizar estudios volumétricos cerebrales (volumetría) y medir el grosor de la corteza en distintas áreas, independiente de la complejidad de la superficie cerebral (espesor cortical). Además es posible "deformar" los cerebros para realizar estudios comparativos con poblaciones normales (normalización). Las imágenes de difusión muestran la movilidad de las molé- culas de agua al interior del cerebro, información que utilizamos para reconstruir los tractos neuronales principales (tractografía) y para dimensionar indirectamente la conectividad de distintas áreas (difusión multidireccional). Mediante resonancia magnética funcional es posible localizar las áreas elocuentes cerebrales (resonancia magnética funcional convencional) o representar la conexión funcional de un área cerebral específica (resonancia magnética resting state)

The development of MRI has led new types of images that can be useful in patients with visual manifestations. T1 structural images can be processed by different software to obtain new images for partitioning different neurological structures (segmentation), to do brain volumetric studies (volumetry) and to measure the cortical thickness in an independent way of the complexity of the brain surface (cortical thickness). It is also possible to "warp" the brains for comparative studies with normal populations (normalization). Diffusion images shows the mobility of water molecules in the brain that is used to reconstruct the main neural tracts (tractography) and to measure indirectly the connectivity of different areas (multidirectional diffusion). Functional magnetic resonance imaging can identify eloquent brain areas (tipical functional magnetic resonance) or represent the intrinsic connectivity of specific brain areas (resting state fMRI)

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La técnica híbrida PET/CT ha sido utilizada en el estudio inicial y seguimiento de neoplasia malignas, con óptima relación costo/beneficio.El objetivo de este trabajo fue evaluar la aparición de neoplasias no sospechadas en pacientes que se realizaron un PET/CT de cuerpo entero en nuestro Servicio.Método: Se revisaron 354 PET/CT realizados entre enero de 2009 y enero de 2010, registrándose aquellos exámenes de cuerpo entero que detectaron una neoplasia no sospechada, que no tenía relación con la indicación del examen.Resultados: Se pesquisaron 11 neoplasias no sospechadas en 11 pacientes que fueron derivados para estudio de otra patología, 9 de ellos con otro cáncer en etapificación o seguimiento.Los tumores pesquisados fueron Ca pulmonar (2), Ca tiroides (2), meningioma (2), Ca páncreas (1), Ca colon (1), TMPI Páncreas (1), Ca endometrio (1), y Ca mama (1).La ocurrencia de neoplasia detectada incidentalmente en la población total fue de 4,4 por ciento (11/252 excluyendo PET/CT por control de tratamiento), y en la población oncológica de4,2 por ciento (9/216 excluyendo pacientes no oncológicos y PET/CT controles).En conclusión, el PET/CT es de gran utilidad en el estudio inicial y seguimiento de pacientes oncológicos, permitiendo además pesquisar un segundo tumor primario

PET/CT has been in the initial study follow-up of malignant tumors, shown optimal cost/benefit relation. The purpose of this study was to evaluate the occurrence of unexpected malignancies in patients who realize a PET/CT whole-body scan. Methodology: A total of 354 PET/CT scans were done from January 2009 to January 2010. The scans in which an unexpected malignancy was detected, that unrelated to the primary indication of exam, were recorded. Results: Eleven unexpected neoplasm were discovered in 11 patients, 9 of them with a known cancer in initial staging or follow-up. Tumors encountered were lung cancer (2), thyroid cancer (2), meningioma (2), pancreatic cancer (1), colon cancer (1), IPTM of the pancreas (1), endometrial cancer (1), and breast cancer (1).The occurrence of incidentally neoplasm in total group was 4,4 percent (11/252 excluding follow­up PET/CT scans 4,2 percent in oncologic population (9/216 excluding non oncologic patients and follow-up scans). In conclusion, PET/CT is a very helpful imaging procedure in the initial study and follow up of oncologic patients, allowing to detect a second primary malignancy

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D-003, a mixture of high aliphatic primary acids purified from sugar cane wax, has shown cholesterol-lowering, anti-platelet and antioxidant effects. Previous data demonstrated that D-003 was not toxic or carcinogenic when given orally to Sprague-Dawley rats up to 1500 mg/kg. This study investigated the potential long-term oral carcinogenicity of D-003 in a second rodent species. OF1 mice of both sexes were randomized into 4 groups treated for 18 months: a vehicle control group and three groups treated with D-003 at 50, 500 and 1500 mg/kg, respectively, orally gavaged 6 days per week. Mortality, clinical symptoms, weight gain, food consumption, organ weight, blood indicators and tumour incidence did not show significant differences between control and treated groups. D-003 did not increase the frequency of neoplastic or non-neoplastic lesions with respect to the controls. Lesions observed in the study were consistent with spontaneous lesions reported for this specie. It can be concluded that D-003 did not result toxic or carcinogenic when given orally to OF1 mice for 18 months and that the highest dose was a NOAEL, consistent with results of the oral carcinogenicity study of D-003 in rats.

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La espondilolistesis es un fenómeno frecuente de encontrar en los estudios de imágenes en pacientes con dolor lumbar. Puede tener diversas causas pero sólo unos pocos mecanismos fisiopatológicos. El concepto de inestabilidad juega un rol importante en la comprensión de esta patología. El diagnóstico por imágenes nos permite detectar la listesis y entrega información acerca de sus causas y mecanismos. Revisamos y mostramos estos conceptos mediante imágenes radiológicas convencionales, tomografía computada y resonancia magnética. Destaca el hecho de encontrar fenómenos displásicos en pacientes con espondilolistesis adquiridas.

Spondylolisthesis is a usual finding in patient with low back pain. It can have different causes and only a few pathophysiological mechanisms. Instability concept plays an important role in comprehension of this pathology. Medical images can detect listhesis and give us information about its causes and mechanisms. We review and show these concepts using conventional radiological images, computed tomography and magnetic resonance. It emphasizes the fact to find dysplastic phenomena in patients with acquired spondylolisthesis.

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D-003 is a mixture of high molecular weight sugarcane wax aliphatic primary acids with cholesterol-lowering, anti-platelet and antioxidant effects. This study investigated the long-term oral toxicity and carcinogenicity of D-003 in Sprague Dawley rats of both sexes, randomly distributed into four groups: a control group, treated only with the vehicle, and three treated with D-003 (50, 500 and 1500 mg/kg). All treatments were given orally for 24 months. Mortality (survival analysis), clinical symptoms, weight gain, food consumption, organ weights, time-to-tumour or tumour incidence data were not shown between group differences or trends. With the exception of serum cholesterol levels, lower in D-003-treated groups (500 and 1500 mg/kg) than in the controls, no other difference in blood indicators was found. D-003 did not increase the frequency of neoplastic and non-neoplastic lesions compared with the controls. The occurrence of all malignant and mammary tumours in D-003-treated females was lower than in the controls. The lesions observed were consistent with spontaneous lesions reported in this species. In conclusion, D-003 is not toxic or carcinogenic when given orally to Sprague Dawley rats up to 1500 mg/kg for 2 years, and 1500 mg/kg was a not-observable effect dose.

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