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Biomedical subjects

A Piñero

Publications and source records attributed to A Piñero.

At least 19 recordsLinked to original sources
PubMed2006

Malignant melanomas of the nasolacrimal duct.

Two patients with a history of epistaxis who were both found to have a nasolacrimal duct melanoma are presented. A literature review revealed that no previous cases of primary nasolacrimal duct melanoma have been reported. Current therapeutic modalities are discussed.

Aged↗
PubMed2006

Inducible and endothelial nitric oxide synthase genes polymorphism in inflammatory bowel disease.

To assess the influence of inducible and endothelial nitric oxide synthase gene (NOS2A and NOS3) polymorphisms in susceptibility to Crohn's disease (CD) and ulcerative colitis (UC). A total of 505 inflammatory bowel disease (IBD) patients (221 with UC and 284 with CD) and 332 ethnically matched controls were studied. Patients and controls were genotyped by polymerase chain reaction -based techniques for a multiallelic (CCTTT)(n) repeat and biallelic marker (TAAA)(n) in the promoter region of the NOS2A gene and for a T/C polymorphism at position -786 in the promoter region and a polymorphism in exon 7(298Glu/Asp) of the NOS3 gene. There was not association between NOS2A and NOS3 genotypes, alleles or haplotypes frequencies with UC, CD and controls. Our data suggest that NOS2A and NOS3 polymorphisms do not play a major role in IBD predisposition.

Case-Control Studies↗
PubMed2006

[National survey on vitreo-retinal surgery and the management of rhegmatogenous retinal detachments in Spain. Project retina 2].

PURPOSE: To obtain information throughout Spain on the current management of vitreo-retinal surgical diseases, the number of ophthalmologists involved in retinal surgical diseases care, and the urgent management of retinal detachments. METHODS: A 30 item questionnaire was sent by mail, on two separate occasions, to the heads of Ophthalmology Departments of 276 centers in Spain. RESULTS: A total response rate of 48.2% was achieved, however the answers from private centers represented only 9.4% of the total so these were excluded from the analysis. The centers most likely to respond were those in Teaching Hospitals (TH) (52.3%). Of these, 64% of hospitals responded that, in the last year, they performed pars plana vitrectomies (PPV) and 70% performed more than 100 PPVs in the year. In all, 77% of the centers that performed PPVs had also performed them urgently. A total of 75% of hospitals indicated that they had ophthalmologists mainly dedicated to retinal diseases care, with a median of 2 specialists per center, with this representing 23% of their total staff. Retinal surgery was performed by general ophthalmologists in 11.5% of centres. Only 40.3% of hospitals audit their results (37.5% TH). CONCLUSIONS: Despite the existence of a relatively low response rate, as well as some biases and methodological problems, data on the management of retinal surgical disease has been obtained for the first time at a national level. This data will facilitate later studies and must be taken into consideration in improving the planning and adequate management of these diseases in Spain.

Humans↗
PubMed2005

Extramammary Paget's disease of the breast: an unusual location with prognostic implications.

Extramammary Paget's disease is a neoplastic process of intraepidermal origin; its management and prognosis are very different from those of mammary Paget's disease. We present a case of extramammary Paget's disease located in the breast. This is an exceptional location, whose differential diagnosis is important because of its therapeutic and prognostic implications.

Breast Neoplasms↗
PubMed2005

CTLA4/CT60 polymorphism is not relevant in susceptibility to autoimmune inflammatory intestinal disorders.

The aim of this work was to investigate the possible influence of the recently described CT60 A/G dimorphism of the CTLA4 (cytotoxic T-lymphocyte antigen 4) gene in the susceptibility to two different autoimmune inflammatory intestinal disorders, inflammatory bowel disease (IBD) and celiac disease. We analyzed a case-control cohort composed of 528 Spanish patients with IBD (284 with Crohn disease and 244 with ulcerative colitis) and 454 unrelated healthy individuals, and additionally a group of 90 celiac disease families. CT60 genotyping was performed with a TaqMan 5' allelic discrimination assay. After comparing patients with IBD with the control population, we found no significant deviation in the distribution of the alleles or genotypes of CTLA4/CT60 dimorphism. In addition, by means of familial and case-control analysis, no evidence for a statistically significant association was observed between CTLA4/CT60 and celiac disease susceptibility. Therefore, our results suggest that the CTLA4/CT60 polymorphism does not play a major role in inflammatory intestinal disorders.

Antigens, CD↗
PubMed2005

The functional genetic variation in the PTPN22 gene has a negligible effect on the susceptibility to develop inflammatory bowel disease.

The aim of this study was to assess the possible association between the protein tyrosine phosphatase non-receptor 22 (PTPN22) gene 1858C-->T (rs2476601, encoding R620W) polymorphism and inflammatory bowel disease (IBD). Our study population consisted of 1113 IBD [544 ulcerative colitis (UC) and 569 Crohn's disease (CD)] patients and 812 healthy subjects. All the individuals were of Spanish white origin. Genotyping of the PTPN22 gene 1858C-->T polymorphism was performed by real time polymerase chain reaction technology, using TaqMan 5'-allelic discrimination assay. The frequency of the PTPN22 1858T allele in healthy subjects was 6.2% compared with 6.7% in the UC patients and 5.1% in Crohn's patients. No statistically significant differences were observed when the PTPN22 1858C-->T allele and genotype distribution among CD patients, UC patients and healthy controls were compared. These results indicate that the PTPN22 1858C-->T polymorphism does not appear to play a major role in IBD predisposition in our population.

Alleles↗
PubMed2003

Palpable breast lesions: utility of Doppler sonography for diagnosis of malignancy.

This study was designed to find whether there are any differences between benign and malignant palpable breast lesions as they are seen on grey-scale and colour-Doppler and on power-Doppler sonography; to determine which variables for each technique are most helpful in distinguishing any such differences; and to see whether the use of an echo-enhancing agent gives better results in the differential diagnosis. Forty-five palpable breast lesions (16 benign and 29 malignant) were evaluated in a preoperative study using grey-scale sonography, colour-Doppler sonography and power-Doppler sonography before and after administration of an echo-enhancing agent (Levovist). We reached the following conclusions: (1) In the grey-scale ultrasound study of palpable breast lesions the presence of microcalcifications, acoustic shadowing and non-well-defined margins are related to malignancy. (2) Colour- and power-Doppler sonography may help in the differential diagnosis. (3) The use of an echo enhancer (Levovist) accentuates these differences and enables them to be noted in other variables, such as pulsatility index, nodule-to-vascularity ratio and number of poles.

Adult↗
PubMed2002

Sequential treatment with bolus and continuous infusion of recombinant factor VIIa for hip arthroplasty in a patient with haemophilia A and inhibitor.

We describe a total arthroplasty of the hip in a 40-year-old male patient with haemophilia A and a high-titre inhibitor to factor VIII, treated with rFVIIa. The patient received sequential therapy first as bolus in the early postoperative phase in order to obtain appropriate haemostasis and then as continuous infusion with lower doses to avoid frequent episodes of bleeding without a higher consumption of product. After an initial dose of 150 micro g kg-1 for the first five days after surgery, we used bolus doses of 120-90 micro g kg-1 every 2.5-3 h, achieving plasma FVII:C levels above 40 U mL-1. We then continued with continuous infusion at decreasing doses 15-7 micro g kg-1 h-1 for 12 days (FVII:C 19-7 U mL-1). There were no bleeding complications nor signs of clotting activity. The rehabilitation programme was continued without prophylactic treatment. The total consumption of rFVIIa was 6.3 mg kg-1, implying a saving of at least 30% of the product with respect to previous publications.

Adult↗
PubMed2002

Surgical management and complications of Meckel's diverticulum in 90 patients.

OBJECTIVE: To review controversial aspects of the pathology, management, and complications of Meckel's diverticula. DESIGN: Retrospective study. SETTING: University hospital, Spain. SUBJECTS: 90 patients who had Meckel's diverticula during the 32 year period April 1968-May 2000. MAIN OUTCOME MEASURES: Epidemiological and histopathological findings (including a search for Helicobacter pylori); surgical management and morbidity. RESULTS: There were no differences in sex between patients with asymptomatic and symptomatic disease, although we did find differences in age. Signs of abnormalities on scintigraphy were associated with the presence of ectopic fundal mucosa, although not significantly so. No signs of Helicobacter pylori were found in any of our patients. Morbidity after intestinal resection was higher than after diverticulectomy. CONCLUSIONS: Meckel's diverticulum should be suspected particularly when there are symptoms of obstruction or gastrointestinal bleeding in children. The presence of both ectopic gastric mucosa and ulcers is related to the symptoms and we found no H. pylori in any of the cases.

Adult↗
PubMed2001

Does injection distance of the radiocolloid modify lymphatic mapping in melanoma?

BACKGROUND: An important factor to be considered when performing lymphogammagraphy in melanoma patients is the adequate distance of injection of the radiopharmaceutical from the biopsy excision site or the primary lesion. OBJECTIVE: To test the reproducibility of lymphatic mapping in patients with primary cutaneous melanoma who had undergone narrow excisional biopsy by injecting a technetium marker at different distances from the biopsy scar. METHODS: After informed consent, two lymphoscintigraphies were performed on each of 19 melanoma patients, following narrow excisional biopsy. Four aliquots of the radiocolloid were intradermally injected in each procedure, surrounding the biopsy excision site at 1.5 and 0.5 cm, respectively. RESULTS: Both lymphoscintigraphies showed similar lymph channels and sentinel node(s). CONCLUSION: In melanoma patients who have undergone narrow excisional biopsy, lymphoscintigraphy marks with accuracy the sentinel node, at least when the radiopharmaceutical is injected at a distance of less than 1.5 cm from the limits of the biopsy scar.

Adult↗
PubMed2001

Extrathyroid spread in papillary carcinoma of the thyroid: clinicopathological and prognostic study.

INTRODUCTION: The extrathyroid spread (ETS) is one of the risk factors that influence mortality and recurrence in patients with papillary carcinoma of the thyroid (PCT). The aim of this study is to analyze the clinical and histologic features and follow-up of a series of patients with ETS undergoing surgery for PCT and to identify patients with a greater risk of presenting with ETS. MATERIAL AND METHODS: Retrospective study of a series of 200 patients undergoing surgery for PCT, of whom 47 (23.5%) presented with ETS. The clinical and histologic features and follow-up of the patients with ETS were compared with those without ETS using the Pearson chi(2) test. We used a logistics regression model to perform a multivariant analysis for ETS. The survival and disease-free interval rates were calculated using the Kaplan-Meier method. RESULTS: ETS is most associated with patients over 50 years of age, with tumors over 4 cm that are not encapsulated, with lymph node metastasis, and with certain PCT histologic subtypes after the multivariant analysis. The overall rate of recurrence and mortality in patients with ETS was much higher than in patients without ETS. CONCLUSIONS: PCT patients with ETS have a greater risk of tumor-related recurrence and mortality than patients without ETS. There are patients with certain clinical and histologic features who have a greater risk of presenting with ETS.

Adolescent↗
PubMed2001

Has the incidence of perforated peptic ulcer decreased over the last decade?

BACKGROUND: The therapeutic use of new drugs for inhibiting gastric secretion together with Helicobacter pylori antimicrobe therapy has given rise to controversy over the current incidence of perforated peptic ulcer (gastroduodenal peptic ulcer, GDPU). The aim of this study is to analyze the incidence of ulcer perforation over the last 12 years in our health area and the influence of new medical treatments. MATERIAL AND METHODS: Our series includes 246 patients operated on for perforated peptic ulcer during a 12-year period (January 1987 to December 1998) in our health area. The mean patient age was 55.2 +/- 18.1 (16-93) years, and there was a predominance of males (199/246; 80.9%). The ulcer was located fundamentally in the pylorus (48.3%) and duodenal bulb (39.1%), and the most frequent surgical technique was bilateral truncal vagotomy associated with pyloroplasty (85.3%). RESULTS: During the 1987-1992 period, 152 patients underwent surgery, whereas 94 patients were operated on between 1993 and 1998, which reveals a statistically significant difference (p < 0.001). Furthermore, if we divide the study into four 3-year periods (1987-1989, 1990-1992, 1993-1995 and 1996-1998), we see that there were 74 and 78 GDPUs in the first two periods, with no statistical differences between each other, and 48 and 46 cases in the last two periods, also with no statistical differences between each other, but statistically significant when compared to the first two periods. CONCLUSION: The incidence of perforated GDPU has dropped by half over the last 6 years due fundamentally to the use of proton pump inhibitors.

Adolescent↗
PubMed2000

Relation of biochemical, cytologic, and morphologic parameters to the result of gammagraphy with technetium 99m sestamibi in primary hyperparathyroidism.

The aim of this study was to analyze the possible relation of biochemical, cytologic, and morphologic parameters to the results of parathyroid gammagraphy with Tc 99m sestamibi in primary hyperparathyroidism. We studied 46 consecutive patients with primary hyperparathyroidism who were undergoing surgery. All the patients were given a preoperative parathyroid gammagraphy with Tc 99m sestamibi and a complete preoperative biochemical study. During the surgical intervention we recorded the weight and size of the pathologic glands to calculate the volume of each. We also determined the percentage of the chief and oxyphil cells in the pathologic glands. Tc 99m sestamibi sensitivity is higher in adenomas (91%) than in hyperplasia (67%) or double adenomas (50%). No relation was found between biochemical or cytologic parameters and gammagraphic results. Weight and gland volume were significantly greater for adenomas than for hyperplasia (P < 0.0014 and P < 0.0004, respectively), and statistically significant differences in both of them were observed between the glands with positive and negative sestamibi.

Adenoma↗