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Biomedical subjects

A Oriol

Publications and source records attributed to A Oriol.

At least 19 recordsLinked to original sources
PubMed1995

[Primary extralymphatic non-Hodgkin's lymphomas: the response to treatment and prognostic factors in 73 patients].

BACKGROUND: The aim of the present study was to determine the prognostic factors for treatment response, relapse-free survival (RFS) and overall survival (OS) in a series of 73 patients with primary extranodal lymphomas (PEL). METHODS: All the patients diagnosed with PEL in one center from January 1984 to December 1993 were studied. The Working Formulation was used for histologic classification and the stage was determined according to the Ann Arbor classification modified by Mushoff. Age, sex, localization of the lymphoma, the presence of B symptoms, the existence of bulky disease, human immunodeficiency virus (HIV) infection, the main hematological and biochemical parameters, the histologic grade of malignancy, the immunologic phenotype and stage were reported. Univariate and multivariate analyses of prognostic factors for complete response (CR), RFS and OS were carried out. RESULTS: The most frequent localization of PEL was the gastrointestinal tract (43 cases). Fourteen cases had HIV infection. CR was obtained in 37 out of the 55 patients (67%) of whom 8 (21%) had relapsed. Serum LDH level was the main prognostic factor for CR attainment (p = 0.01). The variables which negatively affected RFS were the presence of HIV infection (p = 0.02), advanced age (p = 0.018) and the existence of B symptoms (p = 0.02). OS was shorter in patients with high LDH levels (p = 0.004) and more aggressive histologic subtype (p = 0.0002). CONCLUSIONS: The prognostic factors observed in the patients with primary extranodal lymphomas are the same as those found in nodal non Hodgkin's lymphomas. The stage is not a factor of bad prognosis if chemotherapy is included in the treatment.

Adult↗
PubMed1994

Quantitative assessment of valvular function after cardiac transplantation by pulsed Doppler echocardiography.

In 31 patients who had undergone cardiac orthotopic transplantation, valvular regurgitation was studied by echocardiographic and pulsed Doppler over 2 years. The first week after cardiac transplantation, transplant recipients had an increase in the severity of tricuspid, mitral (group II), and aortic regurgitation, as well as a greater number of simultaneously regurgitating valves when compared with those in a group of 60 normal subjects of similar age to heart donors: transplant recipients, trivalvular regurgitation 48% (95% confidence interval [CI] 30 to 66) vs control group, 5% (CI 1 to 13; p < 0.001). Moderate-severe tricuspid regurgitation (TR) was the most frequent occurrence (55%, CI 36 to 73) followed by pulmonary (PR) (42%, CI 25 to 61), moderate mitral (MR) (32%, CI 15 to 51), and mild aortic (AR) (23%, CI 10 to 43) regurgitation. These regurgitations were asymptomatic at rest except for TR. TR was associated with right-sided heart failure in 76% of patients in the early postoperative period and controlled with diuretic drugs. This regurgitation correlated with persistence of post-transplant pulmonary hypertension (r = 0.6) and was not related to pulmonary hypertension before cardiac transplant. There was also no relation found between donor ischemia time or episodes of cardiac rejection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Non-Hodgkin's lymphomas in patients with human immunodeficiency virus infections. Clinicopathologic characteristics, treatment response and prognosis in 40 patients].

BASIS: Non-Hodgkin lymphoma (NHL) is one of the commonest neoplasms appearing in subjects infected by the human immunodeficiency virus (HIV). The purpose of this work was to analyse the clinical and laboratory characteristics, along with the clinical course, response to therapy and prognosis in a series of 40 patients with NHL and HIV infection treated in a single institution between 1985 and 1993. METHODS: The following variables at onset were analysed: age, sex, risky behaviour, NHL location, presence of "B" symptoms, haemoglobin value, platelet count, total number of lymphocytes and CD4-positive lymphocyte count, erythrocyte sedimentation rate, LDH levels, serum albumin, beta 2-microglobulin, NHL type and staging. The following variables during follow-up were also examined: treatment administered, achievement of remission and remission duration, date of relapse and death or date of the last control, relapse-free survival (RFS) and overall survival (OS). A multivariate study of the prognostic factors associated to the achievement of remission, RFS and OS were carried out as well. RESULTS: The frequency of NHL amongst the HIV-positive subjects was 4.4%. Thirty cases had high-grade lymphoma, 20 were stage IV and 33 had extranodal locations. Anaemia was the commonest blood impairment and CD4-positive lymphocyte count was below 0.2 x 10(9)/L in 72% of the cases. Twenty-eight patients with systemic NHL received chemotherapy (CHOP in 25 instances, MACOP-B in 3), and of them 6 were alive, 5 in maintained remission, as for this paper's writing. The median RFS was 7 months and the median OS was 11 months. Increased serum LDH was associated with lesser probability of attaining both remission (p = 0.03) and RFS (p = 0.03). Response to therapy was the main factor in determining survival (p = 0.002); after excluding such factor, increased serum LDH and low serum albumin rates correlated negatively with OS (p = 0.004 and p = 0.007, respectively). CONCLUSIONS: HIV-positive patients, when affected by NHL, usually have high-grade lymphoma, frequently in advanced stages and with extra-nodal involvement. They show poor response to therapy. Increased serum LDH level is the main prognostic factor.

Adult↗
PubMed1993

Effects of adrenaline on ventricular function and coronary haemodynamics in relation to catecholamine handling in transplanted human hearts.

We investigated cardiovascular and coronary responses to intravenous infusions of adrenaline, which raised arterial concentrations in a stepwise fashion from basal to about 5-6 nmol.l-1, in 11 non-rejecting heart transplanted patients, and in eight intact innervated subjects. Cardiac adrenaline extraction and noradrenaline release rate were also measured. The transplanted patients showed larger increases in heart rate (36 +/- 11% vs 16 +/- 6%, P < 0.0001) and cardiac index (80 +/- 30% vs 56 +/- 19%, P < 0.05), while stroke volume increments were similar in the two groups (32 +/- 17% vs 35 +/- 13%). The study groups did not differ with respect to changes in arterial pressure, cardiac work or peripheral resistances. Coronary sinus blood flow increased to a greater extent in the transplanted group (75 +/- 35% vs 48 +/- 31%, P < 0.05) and myocardial oxygen consumption also tended to increase more in these patients (78 +/- 42% vs 48 +/- 34%, NS). Myocardial adrenaline extraction was greatly reduced in the transplant patients (-6 +/- 25% vs 64 +/- 18%, P < 0.001), while forearm adrenaline extraction was similar in the two groups (41 +/- 22% vs 40 +/- 23%, NS). Cardiac noradrenaline overflow tended to be lower in the transplanted group (12 +/- 62 vs 48 +/- 43 pmol.min-1, NS). There was a wide range of noradrenaline overflow values (-64 to 147 pmol.min-1) and definite high values in three patients. Cardiac noradrenaline overflow was not correlated to heart rate responsiveness to adrenaline. We conclude that patients with cardiac transplantation respond to adrenaline with exaggerated increases in heart rate and thus in cardiac output. High values of cardiac noradrenaline overflow are seen in some transplant recipients and may suggest reinnervation. Signs of reinnervation are not associated with consistently lower heart rate responses to beta-adrenergic stimulation.

Adult↗
PubMed1993

[Evaluation of the System 9000-AX autoanalyzer].

PURPOSE: The aim of this study was to evaluate the haematologic autoanalyser System-9000 AX (Serono-Baker Diagnostics), which provides 15 parameters of red, white and platelet series and three histograms showing the cellular distribution curves according to the volume of each series. MATERIAL AND METHODS: The accuracy, precision, linearity, carry-over, effective speed and the effect of sample storage on results were studied. Moreover, the leucocyte differential count (LDC), false positive and negative results of the automated differential count and sensitivity, specificity and efficiency of LDC were analysed and compared with conventional methods: a Coulter VCS analyser and a Coulter S-Plus STKR. RESULTS: The accuracy of the results of three haematologic series was very good. In the LDC, the results for the middle and big cells were better in comparison with the manual method (r > 0.80) than the Coulter VCS, (r = 0.28 and 0.48 respectively). The percentage of LDC revisions and the false negative was higher in hospitalized patients than in outpatients (28.14 and 8.46% versus 12.56 and 2.18%). The most common anomalies were the left deviation, monocytosis and eosinophilia. The results of sensitivity, specificity and efficiency were greater than 80% in all cases, except for the sensitivity and efficiency of hospitalized patients, because of the greater number of false negatives. Precision and linearity were excellent in all the parameters studied. No significant contamination was observed among the samples (low carry-over percentage). The samples were stable for 24 hours at 4 degrees C. CONCLUSION: The System 9000 AX is a reliable analyser, which is fast and easy to operate. These characteristics allow this analyser to be a very useful tool for laboratories that require a rapid testing of samples.

Blood Cell Count↗
PubMed1992

Two-year follow-up after laser thermal balloon angioplasty (LTBA) in lower extremities: initial experience.

We describe the results obtained with the use of laser thermal balloon angioplasty (LTBA) in the treatment of atherosclerosis obliterans of the lower limbs in 37 patients (34 males, 3 females, mean age 58 +/- 9 years) with occlusive arterial disease (Fontaine stages II-IV) presenting 39 significant lesions. Immediate results and two years of clinical follow-up are analyzed. Initial ankle/brachial Doppler index was 0.51 +/- 0.17. Eighteen lesions were located in the iliac area (13 stenoses 2.3 +/- 1 cm and 5 occlusions 4.2 +/- 3 cm) and 21 lesions in the femoropopliteal area (5 stenoses 2.6 +/- 2 cm and 16 occlusions 5.7 +/- 3 cm). A percutaneous procedure was used in 38 cases. In only one case was femoral dissection needed. The laser source was argon in 26 cases and Nd-YAG in 13. Initial success was 85% (89% in iliac lesions and 81% in femoropopliteal lesions; 100% in stenoses and 70% in occlusions). The presence of occlusion (p less than 0.01) and/or calcium (p less than 0.05) negatively influenced the immediate results. No major complications were observed; seven (17%) minor complications occurred. Ankle/brachial Doppler index after treatment was 0.82 +/- 0.21. Cumulative clinical patency for successfully treated patients after two-year follow-up was 91%. LTBA thus represents an effective and less aggressive way of treating peripheral atherosclerosis obliterans. In spite of some limitations, it is useful in selected patients. The results of this study are very much like those in the literature for similar series and early experience.

Adult↗
PubMed1991

Left ventricular dynamics and plasma catecholamines during isometric exercise in patients following cardiac transplantation.

Haemodynamics and plasma catecholamine responses to isometric exercise were evaluated invasively in 11 orthotopic heart transplant recipients and seven control subjects. Differences in haemodynamic responses between the two groups were already apparent after one min of handgrip at 30% of maximal voluntary contraction, and very pronounced at the end of the fourth minute. At this point transplanted patients showed smaller increments in heart rate (4.8 +/- 3.2 vs 20.4 +/- 14.1 beats.min-1, P less than 0.001), mean arterial pressure (13.7 +/- 7.2 vs 31.5 +/- 12.2 mmHg, P less than 0.001) and cardiac index (0.51 +/- 0.22 vs 1.02 +/- 0.53 L.min-1.m-2, P less than 0.01), whereas left ventricular end-diastolic pressure increased to a greater extent (8.8 +/- 4.9 vs 2.2 +/- 1.8 mmHg, P less than 0.01). Stroke volume index increased similarly (3.8 +/- 1.8 vs 2.0 +/- 3.5 ml beat-1.m-2, NS) and systemic vascular resistance remained unchanged in both groups. The slopes of the left ventricular function curves (ratio of change in left ventricular work to change in left ventricular end-diastolic pressure) indicated depressed left ventricular function in the transplanted patients. The two groups showed similar increments in mixed venous plasma norepinephrine and epinephrine indicating normal sympathoadrenal activation in the transplanted patients. In conclusion, transplanted hearts respond to handgrip with attenuated increases in heart rate, cardiac output and arterial pressure and by increasing left ventricular filling pressure, suggesting a poor contractile reserve probably due to denervation. Circulating catecholamines, especially epinephrine, probably contribute to the cardiac responses to isometric exercise.

Adult↗
PubMed1989

Five years of angiographic and clinical follow-up after successful percutaneous transluminal coronary angioplasty.

The first 67 consecutive patients (77 lesions) who underwent successful coronary angioplasty (PTCA) at our hospital were clinically followed with serial exercise testing over a 5-year (4 to 7) observation period. Two sequential angiographic controls were performed 6.9 +/- 4.6 (64 patients) and 49.5 +/- 21.6 (42 patients) months after PTCA. The 5-year risk of cardiac death was 8%, of myocardial infarction 2%, or coronary artery bypass grafting 16% and of repeat PTCA 8%. At 5 years, 67% of the patients remain asymptomatic. Restenosis greater than or equal to 70% diameter was observed within the first year after PTCA in 30% of the patients. Progression of coronary artery disease (CAD) was observed in 13 patients (20%). In the first angiographic control, CAD progression was 4% (3/77) in dilated and 3% (3/115) in non-dilated arteries (ns). In the second angiographic control, it was 7% (3/45) and 10% (8/81), respectively (ns). Thus good clinical and angiographic results are still observed after 5 years. Restenosis is an early, self-limited, time-restricted phenomenon that occurs in 30% of patients. Angioplasty does not appear to accelerate CAD progression.

Angina Pectoris↗