José Manuel Olmos Martínez

Mercurialis annua: characterization of main allergens and cross-reactivity with other species.

A multicentric study was conducted to evaluate the frequency of Mercurialis annua pollen sensitization in several areas of Spain and to select a population sample to characterize the main allergenic components in M. annua pollen. Patients were recruited from six hospitals in Spain. Out of 420 patients sensitized to pollens, 195 (46.4%) showed positive skin tests to M. annua, thus evidencing the high level of sensitization to the pollen of this plant in Spain. Thirty-seven sera with RAST class values to M. annua > or = 3 were selected for SDS-PAGE immunoblotting analysis. Two main allergenic components with molecular weights of 15.8 and 14.1 kD were detected in 59 and 51% of the sera, respectively, and they were identified as profilins. Isolation of the relevant allergens was made by affinity chromatography on a poly-L-proline-Sepharose column, followed by gel filtration and anion exchange chromatography in the micropreparative SMARTs System. A significant but low antigenic cross-reactivity between M. annua and Olea europaea, Fraxinus elatior, Ricinus communis, Salsola kali, Parietaria judaica and Artemisia vulgaris was demonstrated by several in vitro techniques.

DiagnÓstico de osteoporosis mediante la radiografía lateral de tÓrax

Fundamento La radiografia lateral de torax, mediante la deteccion de deformidades vertebrales, puede ayudar a identificar tempranamente a los enfermos con esteoporosis. En este trabajo hemos querido ver con que frecuencia los radiologos refieren en sus informes de radiografias laterales de torax algun dato que permita al clinico sospechar una osteoporosis, y en que porcentaje de casos el clinico, ante estos informes, llega a diagnosticar la enfermedad. Pacientes Y metodo Se han revisado los informes de las radiografias laterales de torax de 3.500 pacientes consecutivos, asi como sus informes de alta. Resultados Los informes radiologicos hicieron referencia a la existencia de osteoporosis solo en un 20% de los casos potencialmente diagnosticables; los informes clinicos lo hicieron en un 6,3% (un tercio de los casos con informe radiologico positivo); solo se trato adecuadamente al 4% (dos tercios de los casos diagnosticados por el clinico). Conclusiones La osteoporosis es una enfermedad desatendida por radiologos y clinicos. Las radio-grafias laterales de torax constituyen una herramienta diagnostica desaprovechada en la identificacion de pacientes con osteoporosis.

Relación entre la concentración plasmática de tirotropina y enfermedad cardiovascular (Cohorte Camargo)

BACKGROUND AND OBJECTIVE Age seems to modify the relationship between hypothyroidism and cardiovascular disease (CVD). Although hypothyroidism in very elderly subjects has been associated with longevity, subclinical hypothyroidism in people ≤ 65 years seems to be related with an increased cardiovascular risk (CVR). The aim of this study was to determine the explanatory power of plasmatic TSH (pTSH) for the CVD, in different strata determined by age (≤ 55, 56-74, ≥ 75 years), sex and CVR factors. PATIENTS AND METHODS Six hundred and sixty-four men and women were differentiated into 18 strata and their explanatory models were developed using the multiple linear regression analysis. The dependent variable is the abdominal aortic calcification (AAC) according to the AAC-24 scale. The independent variables are: pTSH, age, smoking, BMI, SBP, DBP, fasting glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol and C-reactive protein. RESULTS Age is the main explanatory factor of AAC. The highest explanatory value of the β-standardized coefficient of the pTSH is observed in males ≤ 55 years (β=0.235, P=.043) and in females ≥ 75 years (β=0.405, P=.042). With increasing age, the prediction power improves in women and decreases in men. In men ≥ 75 years there is a negative correlation between pTSH and AAC (rho-Spearman=-0.213, P=.049). CONCLUSIONS A positive association is observed between pTSH and CVD in males ≤ 55 years and in women ≥ 75 years. The combination of multiple regression and the stratified analysis shows the complex influence of age in the relation between both variables.

Osteoporosis tras la curación tumoral

La deteccion de secuelas tardias entre los supervivientes de distintos procesos oncologicos ha ido aumentando en los ultimos anos al mejorar los esquemas terapeuticos y conseguirse mayores y mas prolongadas tasas de remision tumoral. Entre las secuelas que pueden aparecer tras la curacion de un tumor cabe mencionar la osteoporosis. La perdida de masa osea y el riesgo de fracturas aumentan en los pacientes con cancer. Los factores que favorecen el desarrollo de la osteoporosis en los pacientes cancerosos son numerosos. Algunos guardan relacion con el propio tumor y otros con el tratamiento antitumoral. Por ello, conviene plantearse el diagnostico precoz de osteoporosis en los pacientes con antecedentes oncologicos, con objeto de adoptar las oportunas medidas preventivas.

Small-Caliber Lead Failure After Generator Exchange.

The Sprint Fidelis defibrillator lead (Medtronic) was recalled in 2007 due to an increased risk of failure. The generator exchange (GE) procedure has been associated with the development of Fidelis lead dysfunction. The aim of this study was to compare the rate of dysfunction between Sprint Fidelis and other defibrillator leads during the first year after GE.

Fiabilidad del método de Lane en la evaluación radiológica de la espondiloartrosis

espanolObjetivo. La escala de Lane es un metodo ampliamente utilizado en la evaluacion de la espondiloartrosis radiologica. Disenada para el nivel lumbar, analiza la osteofitosis (OF) y la disminucion del espacio intervertebral (DEI). Los escasos datos sobre concordancia interobservador usando este metodo senalan un acuerdo elevado, que disminuye al evaluar la artrosis toracica. El objetivo ha sido conocer en detalle el grado de fiabilidad que aporta esta escala en la columna toracica (CT) y lumbar (CL). Material y metodo. 3 observadores evaluaron 110 radiografias laterales de CT y CL de 55 sujetos. En cada par de observadores fueron analizadas 4 imagenes (OF-CT, OF-CL, DEI-CT, DEI-CL); se calcularon 3 coeficientes: el kappa ponderado (KP) y Tau-B de Kendall (ambos, con valor maximo ideal = 1) y la distancia al maximo kappa alcanzable (DMK) (con valor ideal = 0). Se realizo asimismo un analisis de las discrepancias. Resultados. El mayor grado de acuerdo fue observado al evaluar la DEI-CL (KP=0,80-0,82; Tau-B=0,73-0,77), mientras que el menor acuerdo fue observado al evaluar la DEI-CT (KP=0,60-0,76; Tau-B=0,50-0,72). El valor de DMK oscilo entre 0,06 (OF-CT) y 0,43 (DEI-CT). Conclusiones. El metodo de Lane permite una elevada concordancia entre observadores; es mas fiable al aplicarse sobre la CL. La fiabilidad disminuye al evaluar la CT, y especialmente la DEI-CT, en que solo cuando la afectacion es moderada-grave el acuerdo es similar al observado con las restantes imagenes. Para mejorar el grado de reproducibilidad sobre la CT se puede considerar la utilizacion de especificaciones descriptivas o de referencias morfometricas radiologicas. EnglishObjective. Lane’s scale is a widely used method in the evaluation of radiological spine osteoarthritis on plain radiographs. It was designed for lumbar spine (LS) and is addressed to evaluate osteophytosis (OPH) and disc space narrowing (DSN). Limited data available on reliability of this method indicate a high interobserver agreement, that significantly decreases when evaluating thoracic spine (TS). Our aim was to get a detailed knowledge about the degree of reliability that Lane’s scale provides at TS and LS. Material and method. 3 raters analyzed 110 lateral thoracic and lumbar spine radiographs from 55 participants. Four images (TS-OPH, TS-DSN, LS-OPH, LS-DSN) were analyzed in each pair of raters, calculating 3 coefficients: Weighted kappa (WK) and Kendall’s Tau-B, with an ideal value of 1, and the difference between kappa and maximum attainable kappa (DMK), with an ideal value of 0. An analysis of discrepancies was also performed. Results. The highest level of agreement was observed in LS-DSN (WK=0.80-0.82; Tau-B=0.73-0.77), whereas the least level of agreement was observed in TS-DSN (WK=0.60-0.76; Tau-B=0.50-0.72). The DMK values ranged from 0.06 (TS-OPH) to 0.43 (TS-DSN). Conclusions. Lane’s method allows a high level of interobserver agreement, being more reliable when evaluating the LS. Reliability decreases when assessing the TS, specially TS-DSN. Only a moderate-severe grade in TS-DSN allows a similar agreement than observed with the other images. Descriptive specifications and morphometric radiological references may be of interest to improve the reliability of this scale when evaluating the TS.

Osteoporosis e infección por el virus de la inmunodeficiencia humana

Life expectancy and quality of life among human immunodeficiency virus (HIV-1)-infected patients has dramatically improved with the advent of highly active antiretroviral therapy (HAART). However, with the transformation of HIV infection into a chronic disease, a series of long-term consequences, including osteoporosis, has emerged. Bone mass is lower in patients with HIV-1 infection than in healthy individuals and the prevalence of osteopenia and osteoporosis is higher. The incidence and prevalence of fragility fractures does not appear to be on the increase; however, as the HIV-infected population ages, an increase in fragility fractures can be expected. The causes that favor the occurrence of bone-related disorders are multiple and are related to HIV infection and its treatment.