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Abstract: Background: In vitro studies have shown that genistein inhibits the CYP240 enzyme, which is involved in the degradation of 1,25-dihydroxycholecalciferol and its precursor 25-hydroxycholecalciferol, and increases their plasma levels. However, no clinical studies have primarily assessed the synergistic effect of isoflavones on vitamin D levels. The aim of this study was to evaluate the possible additive effect of genistein supplementation on vitamin D levels, calcium metabolism and bone remodeling markers in healthy postmenopausal women during the spring-summer months. Patients and methods: We made a prospective, double-blind study with 150 healthy postmenopausal women that were randomized to three groups. One received placebo, another received calcium (1000 mg/day) and vitamin D (cholecalciferol, 800 U/day) and the third received calcium (1000 mg/day), vitamin D (cholecalciferol, 800 U/day) and genistein (90 mg/day). The study period was from May to September (spring-summer). Vitamin D, PTH, CTX and P1NP were determined by electrochemiluminescence at baseline and after 12 weeks. Results: Vitamin D levels increased in all groups: placebo (23±9 ng/ml vs. 29±10 ng/ml, p

Research question Hox genes are involved in limb formation during normal embryological development. Their modulation by circulating maternal oestrogens and androgens determines the length of the second and fourth fingers of the adult hand. Do these same intrauterine hormone levels also determine fertility outcomes in the adult? Design To study the association between the length of the second and fourth fingers of both partners undergoing IVF (as a surrogate of their previous intrauterine exposure to oestrogens and androgens) with treatment outcome after IVF, data corresponding to 256 IVF cycles were analysed. Finger length was normalized to the individual height. Results In the female partner, a longer normalized second finger length of the left (2DLN) hand, reflecting a high intrauterine exposure to oestrogens, was independently and significantly (P = 0.011) associated with obtaining at least one top-quality embryo in a multivariate model. Conversely, in the male partner a longer normalized fourth finger length of the left hand (4DLN), reflecting a high intrauterine exposure to androgens, was independently and significantly (P = 0.032) associated with obtaining at least one top-quality embryo in the same multivariate model. In the female partner, 2DLN was inversely and significantly (P = 0.01) associated with achievement of pregnancy. Conclusions Intrauterine exposure to high levels of oestrogens and androgens in females and males, respectively, predisposes to the production of higher-quality embryos under in-vitro conditions during adulthood. Paradoxically, this also seems to result in a lower pregnancy rate.

Resumen Objetivo El sindrome de desmoralizacion (SD) es una situacion psicoemocional que se caracteriza por la desesperanza, el desamparo, la perdida de sentido y el distres existencial. Pretendemos conocer la prevalencia del SD en nuestro medio en pacientes avanzados atendidos por un equipo de cuidados paliativos. Metodologia Se incluyeron de manera consecutiva 100 pacientes en situacion avanzada atendidos por el Equipo de Soporte Domiciliario de Cuidados Paliativos que dieron su consentimiento informado. Mantenian unas condiciones fisicas y neuropsicologicas suficientes para completar una entrevista semiestructurada y los cuestionarios especificos (ESASr, termometro de malestar emocional, PPS, Barthel, HADS). Como criterios diagnosticos del SD se emplearon los de Kissane. El estudio recibio la aprobacion del Comite Etico del Area de Salud. Resultados Se encontraron 4 casos de SD, lo que supone una prevalencia del 4% (IC 95%: 2-10%). Estos enfermos que se mostraron diferentes del resto de la muestra en las siguientes caracteristicas: edad Conclusion En nuestro medio hemos encontrado una prevalencia de SD unicamente del 4% en una poblacion de pacientes atendidos por un Equipo Domiciliario de Cuidados Paliativos. Es probable que las condiciones para entrar en el estudio y el empleo de criterios diagnosticos relativamente estrictos hayan influido en este resultado.

Resumen Fundamento y objetivo Describir la patologia autoinmune al inicio y en el seguimiento asociadas a la diabetes mellitus tipo 1 (DM1), asi como exponer la importancia del cribado al comienzo y en el seguimiento de la DM1 en nuestro entorno de trabajo. Pacientes y metodos Estudio observacional descriptivo transversal del periodo 2001-2011 de pacientes con inicio de DM1 menores de 19 anos, correspondientes al Area de Salud Oeste de Valladolid. A todos los pacientes de nuestra muestra durante el periodo estudiado se realizaron estudios para las enfermedades comorbiles de la DM1 (sindromes autoinmunes poliendocrinos, enfermedad de Addison, anemia perniciosa, vitiligo, enfermedad tiroidea, enfermedad celiaca). Resultados Se realizaron anticuerpos antitiroideos al ingreso (anticuerpos antiperoxidasa, anti-TPO) en el 85,9% de los pacientes (67 casos), siendo positivos en el 23,9% (16 casos) tanto al inicio como en el seguimiento. La patologia tiroidea mas comun fue la tiroiditis linfocitaria cronica. Se realizo al inicio de la DM1 el cribado de la enfermedad celiaca en el 75,6% (59 casos) de los pacientes, siendo positivos el 3,4% de los pacientes (2 casos), y el 1,7% (un caso) en el seguimiento. Ningun paciente de nuestra poblacion presento sindromes autoinmunes poliendocrinos, enfermedad de Addison, anemia perniciosa, ni vitiligo. Conclusiones Quiza con las recomendaciones internacionales actuales y el consenso medico se pueda realizar el cribado rutinario de las enfermedades autoinmunes comorbiles con DM1 de manera estandarizada. Es conveniente realizar el cribado de enfermedades autoinmunes relacionadas con la DM1, tanto en el momento del diagnostico de la enfermedad como periodicamente en el seguimiento posterior.

Aim To present a method of screening for irregular astigmatism with an autorefractor and its determinants compared to corneal topography. Methods This cross-sectional validity study was conducted in 2013 at an eye hospital in Spain. A tabletop autorefractor (test 1) was used to measure the refractive status of the anterior surface of the cornea at two corneal meridians of each eye. Then corneal topography (test 2) and Bogan's classification was used to group eyes into those with regular or no astigmatism (GRI) and irregular astigmatism (GRII). Test 1 provided a single absolute value for the greatest cylinder difference (Vr). The receiver operating characteristic (ROC) were plotted for the Vr values measured by test 1 for GRI and GRII eyes. On the basis a Vr value of 1.25 D as cut off, sensitivity, specificity were also calculated. Results The study sample was comprised of 260 eyes (135 patients). The prevalence of irregular astigmatism was 42% [95% confidence interval (CI): 36, 48]. Based on test 2, there were 151 eyes in GRI and 109 eyes in GRII. The median Vr was 0.75 D (25% quartile, 0.5 D) for GRI and 1.75 D (25% quartile, 1.25 D) for GRII. The area under curve was 0.171 for GRI and 0.83 for GRII. The sensitivity of test I was 78.1% and the specificity was 76.1%. Conclusion A conventional autorefractor can be effective as a first level screening method to detect irregular corneal astigmatism in places where corneal topography facilities are not available.

The aim of the study was to assess the contribution of 111In-pentetreotide single-photon emission computed tomography/computed tomography (SPECT/CT) imaging to conventional somatostatin receptor scintigraphy (SRS) in terms of lesion characterization and localization in the detection of neuroendocrine tumours (NETs).A total of 107 patients with suspected or confirmed NET underwent SRS and SPECT/CT after the injection of 148-222 MBq of 111In-pentetreotide. SRS and SPECT/CT images were interpreted independently. Each site of abnormal tracer uptake was recorded according to the anatomical localization, and as being consistent or not with NET. The findings were confirmed with pathological and/or clinical/imaging follow-up data.A final diagnosis of NET was achieved in 49/107 patients (45.8%). No evidence of NET was found in the rest. SPECT/CT resulted in a significant reduction of indeterminate cases [14/107 (13.1%) vs. 1/107 (0.9%); P0.001] and correctly reclassified one patient as negative for NET and another as positive for NET. SPECT/CT had 87.8% sensitivity and 96.6% specificity on a patient-based analysis, statistically higher than SRS (P0.001). A total of 160 foci were detected (108 NETs and 52 physiological/benign tumours). SRS correctly classified 105/160 foci (65.6%) and remained inaccurate for 55 lesions. These 55 included 31 indeterminate lesions, 12 lesions detected only by SPECT/CT and 12 false-positive lesions. The number of foci correctly classified on the SPECT/CT images was 151/160 (94.4%), whereas two remained indeterminate and seven were false-positive findings.SPECT/CT provides incremental diagnostic value over SRS, mainly because of a precise anatomical localization that helps discriminate between tumour lesions and physiological uptake. SPECT/CT may detect unsuspected lesions in a small proportion of patients.

Introduccion y objetivos La troponina T (TnT) es un marcador muy especifico de dano miocardico. Nuestro objetivo fue describir el comportamiento de la TnT despues de la realizacion de la ecocardiografia con dobutamina (EDOB) y valorar su utilidad para mejorar el poder diagnostico de la EDOB. Metodos Los niveles en sangre de TnT fueron obtenidos basalmente y a las 3, 6, 12 y 24 h despues de hacer una EDOB en 63 pacientes (edad media: 69 ± 9 anos; 38 varones). Se realizo coronariografia en 36 de ellos. Resultados La EDOB fue positiva en 29 pacientes y en 15 de ellos hubo un incremento de TnT respecto a los niveles basales (51%); la EDOB fue negativa en 34 pacientes y solo en 7 se elevo la TnT (20%; p Conclusion La elevacion de la TnT durante la EDOB indica que esta prueba puede provocar dano miocardico que se asocia a la aparicion de alteraciones de la contractilidad durante la administracion de dobutamina.

Objectives: We have contributed to the Design Validation Protocol of the new Abbott AxSYM Testosterone assay with a study on reference values and methods comparison. Design and methods: For reference values a population of 45 women and 30 men was tested. In methods comparison, 132 samples for the AxSYM vs. ACS-180, and 30 for the AxSYM vs. Elecsys were used. Pearson and intraclass concordance coefficients and Passing-Bablock test were performed for overall group, men and women. Results: Reference values were 0.9 ‐3.1 (females) and 1.0 ‐30.2 nmol/L (males). Globally, a good agreement between methods in both the AxSYM vs. ACS-180 (slope: 0.88, y-intercept: 0.67, r 5 0.961) and the AxSYM vs. Elecsys (slope: 1.08, y-intercept: 0.31, r 5 0.935) studies was found. Slightly worse results were observed for women. Conclusions: The reference range of testosterone by the AxSYM system matches with those published for other methods. An acceptable agreement between the AxSYM Testosterone assay and both a classical (ACS-180) and a more recent (Elecsys) methodology was observed. Copyright © 2000 The Canadian Society of Clinical Chemists

Acute appendicitis is the most common surgical emergency during childhood. Accurate early diagnosis is important to avoid complications and unnecessary interventions. In 2002, Samuel developed the Pediatric Appendicitis Score (PAS) based on a series of data obtained from anamnesis, physical examination, and laboratory tests. The main purpose of this study was to check the validity of PAS and its applicability to our population.Prospective observational study, carried out at Hospital Río Hortega (Valladolid, Spain), between June 2009 and May 2010. Data from 101 patients who presented to the emergency department experiencing abdominal pains were recovered.A total of 101 patients were included in the study: 55 were boys and 46 girls. The mean age was 9.51 (2.76) years. Diagnosis was acute appendicitis in 28 patients, adenitis in 8 patients, nonspecific abdominal pain in 51 patients, and other diagnoses in 14 patients. The mean (SD) PAS for children with and without appendicitis was 7.43 (1.79) and 4.97 (1.67), respectively (P0.001).With a cutoff PAS of 3 or lower, there were no patients diagnosed with acute appendicitis; hence, these patients could be discharged without any image studies. If all the patients with a PAS of 8 or higher undergo surgery, we would find in our sample a 4.95% rate of negative appendicectomy, less than other studies have shown. The application of this score in the emergency department could help in the decision making process, aiding in the identification of patients with a low risk of having appendicitis and enabling a better use of resources by avoiding unnecessary diagnostic tests.

Obesity and insulin resistance are associated with cardiovascular risk factors. The aim of the present study was to explore the relation of visfatin with insulin resistance, cardiovascular risk factors and anthropometry in obese patients without comorbidities.A population of 270 obese patients was analyzed in a prospective way. In all patients we performed a biochemical analysis (lipid profile, insulin, HOMA and visfatina), and a nutritional evaluation (dietary intake, conventional anthropometry and bioimpedance).Patients were divided in two groups by median visfatin value (8,32 ng/ml), group I (patients with the low values, average value 7,11 (0,7) ng/ml) and group II (patients with the high values, average value 13,5 (10,1) ng/ml). Patients in the group I had higher weight, body mass index, waist circumference, and waist to hip ratio than patients in group II. Patients in group I had lower LDL-cholesterol and C reactive protein than patients in group II. Correlation analysis showed a positive correlation between visfatin levels and LDL cholesterol (r=0.194; p0.05) and C reactive protein (r=0.266; p0.05) and a negative corelation with weight (r=-0.162; p0.05). In the logistic analysis with age-, sex- and dietary intake- adjusted basal visfatin concentration as a dependent variable, the next variables remained in the model; weight with an odds ratio (OR) 0,97 (IC95% 0,95-0,99), LDL cholesterol 1,012(1,010-1.023) and C reactive protein 1,15 (1.03-1.3).LDL cholesterol and c reactive protein levels are positively correlated with visfatin levels. Weight is negatively correlated with visfatin levels, in an independent way and adjusted by age, sex and dietary intake.

The 385 C/A polymorphism of fatty acid amide hydrolase (FAAH) has recently been demonstrated to be associated with overweight and obesity. The aim of our study was to investigate the association between missense polymorphism (cDNA 385 C-A) of the FAAH gene and anthropometric parameters, cardiovascular risk factors and adipocytokines in morbidly obese patients.A sample of 66 morbidly obese patients was analyzed. In all patients, weight, blood pressure, fasting glycemia, lipoprotein(a), C-reactive protein, insulin, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, triglyceride and adipocytokine levels, as well as the genotype of the C358A polymorphism of FAAH, were determined.The mean age was 48.0(16.1) years and the mean body mass index was 44.4 (4.1). There were 17 males (25.8%) and 49 females (74.2%). Forty-five patients (8 males/37 females) (68.2%) were G358G (wild genotype) and 21 patients (4 males/17 females) were G358A (31.8%) (mutant group). Biochemical, anthropometrical and adipocytokine levels showed no statistically significant differences between the two genotypes.In patients with morbid obesity, the C358A polymorphism of FAAH was not associated with anthropometric parameters, biochemical markers or adipocytokine levels.

The aim of our work was to evaluate in obese patients with an indication of replacement surgery for degenerative osteoarthritis, the utility of a hypocaloric diet with Optisource vs nutritional counseling.Thirty six patients were randomized in both branches: diet I with lunch and dinner substituted by two Optisource (1109,3 kcal/day, 166,4g of carbohydrates (60%), 63g of proteins (23%), 21,3g of lipids 17%) and diet II with nutritional counselling with a decrease of 500 cal/day from the previous dietary intake. Before and 3 months after treatment, a nutritional and biochemical study was performed.Nineteen patients were randomized in group I and 17 patients in group II. 19 patients finished the study in group I and 14 in group II. Weight loss was higher in group I than II (7,7 [4,7] vs 3,92 [3,32] kg; P=.05), with a significant decrease of HOMA and diastolic blood pressure in group I. Decreases of body mass index (-2,9 [1,8] vs -1,4 [0,9]; P=.05), fat mass (-3,8 [3,4] vs -2,3 [1,7] kg; P=.0,05) and HOMA (-2,0 [2,2] vs -0,4 [1,82]; P=.05) were higher in group I than II.Obese patients with chronic osteoarthritis treated with a mixed diet supplemented with a commercial hypocaloric formula improved weight, fat mass and HOMA in a better way than patients treated with a dietary counselling alone.

Although immune dysfunction in cancer patients could be multifactorial, the immune system may be modulated by specific nutritional substrates, such as arginine. The aim of our study was to evaluate the effect of enteral nutrition supplemented with a high dose of arginine on c-reactive protein (CRP), interleukin 6 (IL6) and tumoral necrosis factor (TNF alpha) in surgical head and neck cancer patients.At surgery, patients were randomly allocated to two groups: (a) enteral diet supplements with arginine (group I, n=18); (b) isocaloric, isonitrogenous enteral formula (group II, n=23). Perioperatively and on the postoperative day 6 the following parameters were evaluated: serum values of prealbumin, transferrin, lymphocytes, IL6, TNF alpha and CRP.The mean age (standard deviation) was 60.9 (10.6) years. Prealbumin and transferrin improved in both groups, CRP decreased in both groups, (group I: 105.1 (62.8)mg/dl vs 53.2 (51)mg/dl: p0.05 and group II: 103.3 (62)mg/dl vs 61.9 (57.4)mg/dl: p0.05). IL6 improved in both groups (group I: 38.35 (14.2)pg/ml vs 15.6 (9.1)pg/ml: p0.05 and group II: 32.8 (35)pg/ml vs 6.8 (4.9)pg/ml: p0.05) TNF alpha and lymphocytes did not change.Both formulas improved IL6 and CRP levels. A high dose of enteral arginine in these patients did not add biochemical advantages as compared to a standard enteral formula.

The aim of our study was to compare the effect of a high fat and a high protein diet vs a fat restricted diet on weight loss in obese patients.A population of 74 obesity non diabetic outpatients was analyzed in a prospective way. Patients were randomly allocated to two groups: a) diet I (low fat diet: 1500kcal/day, 52% carbohydrates, 20% proteins, 27% fats) with a distribution of fats and b) diet II (high fat and high protein diet: 1507kcal/day, 38% carbohydrates, 26% proteins, 36% fats). After three months with diet, weight, blood pressure, glucose, C reactive protein, insulin, insulin resistance, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were evaluated.There were randomized 35 patients (4 males and 31 females) in the group I and 39 patients (6 males and 33 females) in diet group II. In group I, systolic pressure, BMI, weight, fat free mass, fat mass total body water, intracellular body water and waist circumference decreased significantly. In group II, glucose, total cholesterol, LDL cholesterol, systolic blood, BMI, weight, fat mass, total body water and waist circumference decreased significantly. Differences among averages of parameters before treatment with both diets were not detected.No differences were detected on weight loss between a fat-restricted diet and a high fat and high protein enhanced diet.

An accumulating body of evidence shows that modest weight loss (5%) through dietary changes and exercices is an effective means for managing obesity-associated disorders. As far as we kow, nobody has described the dietary response in insulin resistance and adipocytokines, analyzing the G308A variant of the tumor necrosis factor alpha (TNF-alpha) gene. The aim of our study was to investigate the influence of G308A polymorphism in the TNF-alpha gene on insulin resistance and weight loss secondary to a hypocaloric diet in obese patients.A population of 69 obese -body mass index (BMI)30 kg/m2- non diabetic outpatients was analyzed in a prospective way. Before and after 3 months of life style modification program, tetrapolar electrical bioimpedance, blood pressure, a serial assessment of nutritional intake with 3 days written food records and biochemical analysis were performed. The lifestyle modification program consisted of a hypocaloric diet 1,520 kcal.Sixty-nine patients completed the follow-up during 3 months, with a weight loss (standard deviation) of 2.96 (3.4) kg (3.3%). Fifty two patients (13 males and 39 females) (75.3%) had the genotype G308/G308 (wild group) with an average age of 44.9 (16.8) years, and 17 patients (5 males and 12 females) (24.7%) had the genotype G308/A308 (mutant group) with an average age of 48.3 (15.2) years, without statistical differences. In mutant type group, BMI, body weight and waist circumference decreased. Mutant type group had higher basal and after treatment weight than wild group.Weight loss is associated with different changes depending of TNF-alpha genotype. Carries of G308G variant of TNF-* gene have a better metabolic response than A308 obeses.

To investigate the influence of a arginine and omega3 fatty acids enhanced supplement in nutritional variables in postsurgical ambulatory patients with head and neck tumors.A population of 18 ambulatory postsurgical patients with oral and laryngeal cancer was studied. At hospital discharge, postsurgical head and neck cancer patients were asked to consume two units per day of a specially designed omega3 fatty acid enhanced supplement for a twelve week period.Eighteen patients were enrolled in the study. The mean age was 62.5 (11.4) years (1 females/17 males). Duration of supplementation was 90.5 (22) days. Significant increases of serum protein levels and lymphocites were detected. PCR levels decreased after supplementation (71.96 [21.7] md/dl vs 25.9 [11.1] mg/dl; p0.05). No differences were detected in weight and other anthropometric parameters. A positive correlation between omega3/omega6 ratio and kg of fat mass (r = 0.59; p0.05) and midarm circumference (r = 0.62; p0.05) were detected. When the population was divided in two groups, group I (ratio omega3/omega60.51) and group II (ratio omega3/omega60.51), group II showed higher fat mass than group I (17.32 [5.3] kg vs 13.8 [5.1] kg; p0.05).This immuno-enhanced formula could improve serum protein levels and PCR in ambulatory postoperative head and neck cancer patients. An increase in fat mass was detected in patients with a high omega3/omega6 intake of polyunsaturated fatty acids.

Reliable reference ranges are important in the interpretation of laboratory data, and it is incumbent on each laboratory to verify that the ranges they use are appropriate for the patient population they serve. The objective of this study was to determine population-specific reference ranges for thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3) and total triiodothyronine (TT3) on the Abbott ARCHITECT 12000 analyzer. For this study, we used human serum samples collected from a population in Castilla y León, Spain. Serum samples were collected from 304 individuals (male, n = 151; female, n = 153; age 12-94 years) representing outpatients (n=100), hospitalized patients (n = 104) and apparently healthy subjects (n = 100). Individuals taking any medications, with a history of thyroid disorder, or severe non-thyroidal illness were excluded from the study. For healthy subjects, the following reference intervals were determined: TSH, 0.51-5.95 mlU/l; fT4, 0.84-1.42 ng/dl (10.77- 18.21 pmol/l); fT3, 1.48-3.37 pg/ml (2.27-5.18 pmol/l); and TT3, 0.65-1.46 ng/ml (1.00-2.24 nmol/l). In this group, TSH and fT4 showed significant differences between men and women, but fT3 and TT3 did not. Conversely, fT3 and TT3 showed significant age-related differences, but TSH and fT4 did not. Within the outpatient group, no significant differences were seen between men and women for any of the hormones, but age-related differences were significant for fT3 and TT3. Within the hospitalized patient group, significant differences between men and women were found for TSH only, and age-related differences were significant for TSH, fT3 and TT3. Our findings are basically in accordance with previously published results for fT3, TT3 and TSH, but for fT4 our results differ from other data in the literature. This highlights the need for laboratories to confirm that the reference ranges they use are appropriate for the population they serve.

Nutritional intervention is a controversial area. The aim of the study was to compare the influence on nutritional status of nutritional supplementation with a standard polymeric formula as well as nutritional counselling versus isolated nutritional counselling in a group of HIV-infected patients.There were 70 patients, 66 of whom were fully evaluated for each study end point after application of prospectively determined evaluability criteria. Of these, 35 were randomized to group I (standard formula) and 35 were randomized to unsupplemented group II. Group I patients received standard enteral formula (3 cans/day, 250 ml per can). Patients were submitted to a prospective serial assessment of their nutrition status (anthropometric and biochemical status) and the nutritional intake was determined by means of 24-hours written food records. Determinations were performed at baseline and at 3 months.Treatment with oral supplements in group I resulted in a significant and sustained increase in weight (2.75%; p0.05) which was mostly due to fat mass (10.8%; p0.05). In contrast, no changes were detected in group II patients. The increase in body weight and tricipital skinfold was significant in group I. Total body water and fat free-mass remained without changes. CD4 counts and viral load remained stable in both groups.Oral nutritional supplements for a 3-months period resulted in body weight gain in HIV-infected patients, increasing the fat mass. An isolated nutritional counselling did not result in such an increase.

Introduction and objectives. Troponin T (TnT) is a very specific marker of myocardial damage. Our objective was to describe TnT behavior after dobutamine stress echocardiography (EDOB) and evaluate its usefulness for improving the diagnostic power of EDOB.Methods. Blood levels of TnT were measured at baseline and 3, 6, 12, and 24 h after EDOB in 63 patients (mean age: 69 9; 38 males). Coronary angiography was performed on 36 patients.Results. EDOB was positive in 29 patients and there was an increase over baseline values in 15 of them (51%); EDOB was negative in 34 patients and there was only a rise in TnT in 7 (20%; p0.01). The TnT increment was higher in patients with a positive response to EDOB (0.033 0.02 vs. 0.026 0.01; p0.01). The ischemia score index was higher in patients in which a significant increase in TnT values was later detected (0.41 0.31 vs. 0.38 0.20; p0.01). Coronariography was performed in 36 patients. EDOB was positive in 22 of the 29 patients with coronary artery disease (76%) and TnT was raised in 14 of them (48%; p0.05).Conclusion. The rise in TnT levels during EDOB suggests that this test may produce myocardial damage associated with the appearance of contractility disorders during dobutamine infusion.

Automated capillary zone electrophoresis (e.g., on the Paragon 2000 CZE, Beckman Instruments) is an alternative to conventional electrophoretic methods for the separation of serum proteins (1)(2)(3). The technique uses ultraviolet (UV) detection at 214 nm for direct quantification of peptide bonds, whereas conventional methods detect the protein fractions by staining with various reagents. CZE has the advantage of improved precision and a faster turnaround (4). Recent reports indicate, however, that the Paragon CZE 2000 masks deficiencies of α1-antitrypsin (5) and that some radio-opaque agents simulate a monoclonal component in the α2-globulin fraction in the CZE electropherogram (6)(7). We encountered an interference from the contrast medium Omnitrast®, which produced an unexpected peak in the α2-zone of the CZE electropherogram. We have now investigated the effect of 12 iodinated radio-opaque media (commercially available in Spain) on instrumentation (Paragon CZE 2000) operated as described by Bossuyt et al. (6). When we used the desalting method described …

Methods: This is a retrospective study of 322 resected locally advanced gastric cancer patients, analyzing the influence of histopathologic characteristics of the tumor in relation with patterns of disease failure. All patients had serosal involvement, with or without lymph node invasion, and absence of distant metastasis. One hundred and four patients underwent curative resection, with added following inclusion criteria: no macroscopic residue after resection, resection margins and no more than 15 infiltrators isolated lymph nodes in the surgical specimen. Thirty eight patients who died in the post-operative period were excluded from the analysis. Statistical comparison were made using Chi squared test, “t” test and UMann-Whitney test and multiple logistic regression.