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A Yuste

Publications and source records attributed to A Yuste.

11 recordsLinked to original sources
PubMed2003

Hodgkin's disease. Prognostic value of Gallium-67 scintigraphy.

AIM: The aim of this study is to assess the clinical impact of gallium-67 scintigraphy, before and after treatment, in patients with Hodgkin's disease, and to compare the overall survival between the patients whose gallium studies after treatment were negative and those whose studies remained positive. METHODS: We have studied 75 patients (40 women, 35 men) with Hodgkin's disease. All the patients underwent (67)Ga scintigraphy at the moment of the diagnosis (basal study) and in the case that basal study was positive (abnormal hyper-uptake focus) we performed follow-up studies after the treatment. We have calculated the overall survival among patients whose studies after treatment were negative (1(st) group) and those whose studies remained positive (2(nd) group) and between patients whose studies were negative at diagnosis (3(rd) group). RESULTS: Gallium scintigraphy was positive at diagnosis in 47 patients (62.6%). In 39 of them we were able to perform the follow-up study after treatment. The follow-up study was negative in 31 patients while in 8 patients the gallium scintigraphy remained positive. The overall survival was significantly higher (p<0.001) in the 1(st) group compared with the 2(nd) group. The overall survival was higher in the 1(st) group compared with the 3(rd) but statistic significance level was not reached. CONCLUSION: Our data suggest that: 1) in Hodgkin's disease (67)Ga scintigraphy is useful to establish the diagnosis of complete remission; 2) if the gallium scan remains positive after treatment, the prognosis of patients is worse than the prognosis of patients with a negative scan.

Adolescent↗
PubMed1999

Long-term results after combined modality treatment for non-metastatic osteosarcoma.

Since the introduction of multimodality treatment, the prognosis of patients with high-grade non-metastatic osteosarcoma has significantly improved. A retrospective review was performed to assess the long-term results of this approach in a single centre setting, and to investigate the impact of potential clinical prognostic factors. Between 1985 and 1993, 35 patients with stage II-A and II-B osteosarcoma underwent preoperative chemotherapy (high-dose methotrexate), wide surgery, and adjuvant chemotherapy (cisplatin-doxorubicin/bleo-mycin-cyclophosphamide-dactinomycin) (modified T-10A protocol). There were 19 males and 16 females. Median patient age was 17 y (range 12-42). Primary tumour sites were the extremities (83%) and axial bones (17%). In spite of an unfavourable grade 3-4 histologic response rate to high-dose methotrexate of 12%, 31 (88%) patients were able to undergo limb-sparing surgery and 28 (80%) were rendered disease free after the planned therapy. Median follow-up was 8 y. The actuarial overall survival and disease-free survival rates were 64% and 49% at 5 y, and 59% and 49% at 10 y, respectively. Tumour size and primary site were significant prognostic factors for survival in univariate analyses. In conclusion, long-term survival after combined modality treatment can be achieved in more than 60% of patients with localised osteosarcoma, including non-appendicular lesions. Limb-sparing surgery is a realistic goal for most cases. The prognostic value of tumour necrosis and the efficacy of neoadjuvant chemotherapy should be interpreted according to individual high-dose methotrexate scheduling.

Adolescent↗
PubMed1999

Isoterracinolides A and B, novel bishomoditerpene lactones from euphorbia terracina

An extract of Euphorbia terracina L. has yielded six acylated polyhydroxy terpenoid lactones (1-6), which all display the C22 17-ethyljatrophane carbon framework. Four of these (1-4) are delta lactones belonging to the previously described terracinolide type, and two of them (2, 3) are new. Two further new compounds have been named isoterracinolides A (5) and B (6) and exhibit an eight-membered lactone ring. Another isolated new compound is the jolkinolide-type, ent-abietane gamma lactone (7).

Journal Article↗
PubMed1999

ESHAP is an active regimen for relapsing Hodgkin's disease.

BACKGROUND: Refractory or relapsing Hodgkin's disease is associated with a poor prognosis. There is no widely accepted salvage chemotherapy regimen for these patients. However, the addition of high-dose chemotherapy followed by autologous hematopoietic transplantation (AHT) has proven of benefit to them. A prospective clinical trial was carried out to evaluate the efficacy and toxicity of ESHAP (etoposide, methylprednisolone, high-dose cytarabine, and cisplatin). PATIENTS AND METHODS: Twenty-two patients with refractory (5) or relapsing Hodgkin's disease (17) were entered and scheduled to receive three courses of ESHAP. Patients suitable for AHT were then given high-dose chemotherapy with CBV (cyclophosphamide, carmustine, and etoposide) plus AHT, whereas responding, non-AHT-suitable patients completed six ESHAP courses. RESULTS: Nine patients achieved complete responses and seven partial responses (overall response rate 73%) with ESHAP. Grade 3-4 myelotoxicity was seen in 13 patients (59%). Nine patients received CBV plus AHT. At a median follow-up time of 50 months (range 6-96), seven patients (32%) are alive and disease-free. Three patients died of toxic effects of ESHAP (1) or CBV (2). Actuarial overall survival and disease-free survival were 35% and 27% at three years. CONCLUSIONS: ESHAP is an active regimen for relapsing Hodgkin's disease, with myelosuppression as its dose-limiting toxicity. An increased risk of treatment-related mortality when it is combined with high-dose chemotherapy can not be ruled out.

Adolescent↗
PubMed1998

Comparative analysis of the vascular actions of diterpenes isolated from Euphorbia canariensis.

We have analysed the effects of 2,3-diepiingol 7,12-diacetate-8-isobutyrate (compound 1), ingenol-3-angelate-17-benzoate (compound 2), ingenol-3-angelate-17-benzoate-20-acetate (compound 3) and 3,5,7,8,9,15-hexahydroxyjatropha-6(17),11-dien-14-one-5,8-bi s(2-methylbutyrate)-7-(2-methylpropionate) (compound 4), four diterpenes isolated from E. canariensis, on the isometric tension developed by isolated rabbit basilar and carotid arteries. Concentration-response curves to these compounds were obtained cumulatively in both arteries at resting tension and active tone (KCl, 50 mM). At resting tension a concentration-dependent contraction was induced by the four compounds. In the basilar artery the order of potency was 3=1>2=4, without significant differences between Emax values. In the carotid artery the order of potency was 3>2=1=4 and there were no significant differences between the Emax (maximum effect) values of compounds 1-3, all of which were higher than that of compound 4. In pre-contracted basilar artery compounds 1-3 induced concentration-dependent relaxation and compound 4 was almost ineffective; the order of potency was 3>2=1 without significant differences between Emax values. In the carotid artery with active tone the four compounds tested induced further contractions; the order of potency was 3>2=4>1 without significant differences between Emax values. These results show that the four diterpenes are potent active substances in rabbit basilar and carotid arteries and that there are regional differences between their action. The four compounds tested contract basilar and carotid arteries at resting tension. Compounds 1-3 relax pre-contracted basilar artery but not carotid artery.

Animals↗
PubMed1997

Analysis of rabbit vascular responses to DBI, an ingol derivative isolated from Euphorbia canariensis.

We have analysed the effects of 7,12-O-diacetyl-8-O-benzoil-2,3-diepiingol (DBI), an ingol derivative isolated from E. canariensis, on isometric tension developed by isolated rabbit basilar and carotid arteries. Concentration-response curves to DBI (10(-8) - 3 x 10(-5) M) were obtained cumulatively in both arteries at resting tension and active tone (KCI, 50 mM). At resting tension, DBI induced a concentration-dependent contraction, which was not inhibited in Ca(2+)-free medium. H7 (1-(5-isoquinoline sulphonyl)-2-methylpiperazine dichloride) (10(-4) M) inhibited the DBI-induced contraction both in basilar and in carotid arteries. Calmidazolium (10(-4) M) inhibited the maximum contraction of the carotid artery to DBI, and completely abolished the response in the basilar artery. In pre-contracted basilar arteries DBI induced a concentration-dependent relaxation that was not modified by incubation with NG-nitro-L-arginine (L-NOARG; 10(-5) M) or indomethacin (10(-5) M). In the carotid artery with active tone DBI induced further contractions, which were not significantly modified by L-NOARG (10(-5) M) and were potentiated by indomethacin (10(-5) M). These results suggest that DBI contracts rabbit basilar and carotid arteries by a mechanism that is independent of extracellular Ca2+ and involves the participation both of protein kinase C and of calmodulin. DBI relaxes basilar but not carotid arteries by a mechanism independent of the liberation of nitric oxide and prostacyclin. In the carotid artery prostacyclin but not nitric oxide partially counteracts the contractile action of DBI.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗
PubMedDate not supplied

Pulmonary fibrosis induced by cyclophosphamide.

OBJECTIVE: To report a case of pulmonary fibrosis resulting from use of cyclophosphamide as chemotherapy to treat a patient with breast cancer. CASE SUMMARY: We describe the case of a 52-year-old woman with breast cancer who developed pulmonary fibrosis after four cycles of chemotherapy that included cyclophosphamide. Pulmonary function tests revealed the presence of a severe ventilatory restriction. The open lung biopsy revealed pulmonary fibrosis with vascular sclerosis and signs of pulmonary hypertension. DISCUSSION: Cyclophosphamide is an alkylating agent that has been associated with interstitial pneumonia and pulmonary fibrosis. The frequency of these unwanted effects is <1%. The clinical picture consists of the progressive appearance of dyspnea and a non-productive cough that progresses to severe pulmonary insufficiency. The risk factors described for these complications have been the use of chemotherapy regimens that include other drugs with known pulmonary toxicities, the cumulative total dose, the addition of radiotherapy, and the use of high doses of cyclophosphamide. CONCLUSIONS: Even though the frequency of pulmonary fibrosis in patients treated with cyclophosphamide-based chemotherapy regimens is low, the presence of dyspnea and an interstitial pattern in a patient makes it necessary to consider that possible drug toxicity. The open lung biopsy is the most accurate diagnostic technique for these cases. The discontinuation of cyclophosphamide and treatment with corticosteroids is usually followed by clinical recovery in approximately 50% of patients and, in some cases, reversal of the lung injury.

Antineoplastic Agents, Alkylating↗
PubMedDate not supplied

[Acute pain in "Don Quixote"].

OBJECTIVE: A descriptive analysis of references to pain symptoms in Don Quixote based on linguistic, literary, clinical, and mannerist features. METHODS AND MATERIAL: Don Quixote was read and an entry was created for each description of an injury or illness (group I/I). A second group of entries was created for each medical commentary (group C). This information was complemented using a computer search for the roots of words referring to pain symptoms, with an asterisk placed after each root to locate all word forms used. Data entries with pain references were analyzed in group I/I by examining patient, location, characteristics, causes, associated disorders, remedies, caregivers, and recovery times and in group C by examining the full text. RESULTS: Ninety-one entries were made (64 in group I/I, 27 in group c). References to pain were found in 37 entries (29 in group I/I, 8 in group C). The most commonly used words came from the roots dol (the Spanish root for dolor, or pain, among other related words) (52) and moli (for forms related to Spanish idiomatic uses of molido, suggesting severe injury) (19). All pains were due to injuries. Forty-two occasions of injury (Don Quixote 14, Sancho 9, others 19) and 51 lesions (ribs 5, back 5, other 15, unspecified 26) were mentioned. Known remedies and caregivers of the period were described, but other invented ones were also present. Associated disorders were insomnia, anxiety, rage, melancholy, functional impotence and other sexual dysfunctions. Recovery times ranged from 0 to 8 days. CONCLUSION: Pain references are subject to literary considerations. The style is simple and the descriptions are credible for the period depicted but do not meet clinical standards. Issues of current interest are treated: pain threshold and sensitivity, social influences, the placebo effect, and affective disorders.

Acute Disease↗