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Biomedical subjects

D Prados

Publications and source records attributed to D Prados.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Kikuchi-Fujimoto disease associated with acute infection by herpesvirus 6].

The histiocytic necrotizing lymphadenitis or Kikuchi-Fujimoto disease is a very rare entity in Spain. We present a 34-year-old arabic male admitted to hospital because one-month story of asthenia, anorexia, weight loss, fever and lymphadenopathies in all palpable sites. Analytic studies were all within normal limits except LDH levels and globular sedimentation rate, both raised. After cervical lymph node biopsy performance high grade Non-Hodgkin lymphoma was initially diagnosed. During admission he complained from pain in both shoulders and an erythematous desquamative eruption in trunk appeared. Some days later, a second lymph node biopsy was performed and Kikuchi-Fujimoto disease was diagnosed. Serologic tests for human herpes virus 6 were positive demonstrating active associated infection. He begun treatment with indomethicin, fever and general symptoms disappeared one week later discontinuing treatment. Two months after discharge, all lymphadenopathies had disappeared. A review on epidemiological, clinical, pathological and differential diagnosis issues is made.

Adult↗
PubMed1995

[Primary testicular lymphoma. Report of two cases].

Primary testicular lymphoma (PTL) is the most frequently diagnosed testicular tumor in men over 60 years, in spite of this circumstance it is a rare process. Two cases of PTL are reported, the first one in a child and the second in an adult. Both cases were intermediate grade lymphoma and had low stage (IEA), presenting initially as an enlargement of the testicle as the only symptom, the second case presented involvement by contiguity of the abdominal muscles. Immunohistological markers showed T nature in the first case, and B in the second. The treatment applied in both cases was orchiectomy and systemic chemotherapy using COP-BLAM/IMVP-16, in the child prophylaxis of the central nervous system using methotrexate was made. Response to treatment was good, the first patient achieved complete remission and his survival at present is 24 months, the second patient died 5 month after diagnosis due to stroke without having completed chemotherapy but with an important reduction of the tumoral mass. A review of the literature on clinical, diagnostic and therapeutic issues is made.

Aged↗
PubMed1994

[Lymphoma of the ocular adnexa].

Ocular adnexa are rarely involved in lymphomas. Four cases are reported of lymphoma involving the ocular adnexa. In two cases a previous systemic involvement existed or simultaneous to the ocular involvement; another patient had systemically a different histological pattern to that observed in the ocular region, and the fourth patient only had ocular region, and the fourth patient only had ocular symptoms; we therefore recorded two cases of primary ocular lymphoma. The lymphoma was located at the orbit in two cases and at the conjunctiva in the other two cases; the condition was bilateral in three cases. The most common symptom was exophtalmus; other major symptoms were diplopia and disturbances in ocular motility. The histological examination revealed three low grade lymphomas and one case of intermediate grade. Management of patients included radiotherapy and different chemotherapeutic regimens with a good response in all cases. A higher ocular relapse rate was observed in those patients with systemic involvement; in one primary case the condition resolved spontaneously. A review of the literature on clinical, diagnostic and therapeutic issues is made.

Adult↗
PubMed1994

[Treatment with oral anticoagulants (acenocoumarol): influence of the initial doses in the incidence of hemorrhagic and thromboembolic episodes].

PURPOSE: To compare two initial doses of oral anticoagulant (acenocoumarin) studying the haemorrhagic and thromboembolic episodes occurred during the first month of treatment, the mean time and necessary controls until achievement of the desired level of anticoagulation. PATIENTS AND METHODS: From january 1992 to december 1993; a comparative study of two groups of patients was performed: group 1, compiling 129 patients chosen at random and retrospectively, who begun oral anticoagulant treatment with 4 daily mg of acenocoumarin; and group 2, compiling 129 patients chosen prospectively, who begun with 2 mg daily. In both groups the mean time and the number of controls performed until achieving the desired level of anticoagulation were analyzed, as well as the haemorrhagic episodes occurred during the first month of treatment, their severity (classified into major and minor ones), the level of anticoagulation when they occurred and their possible causes. In the same way the thromboembolic processes occurred during that period in both groups were studied. RESULTS: The mean time necessary to achieve the desired level of anticoagulation was 3.8 days in group 1 and 6.3 in group 2; the mean number of controls performed in group 1 was 1.2 and in group 2 it was 1.8. We have observed 19 haemorrhagic episodes, 15 in group 1 (4 minor and 11 major); and 4 in group 2 (2 minor and 2 major). We have found significant differences with respect to the mean time (p < 0.01), number of controls (p < 0.01) and incidence of hemorrhages (p = 0.017) between groups 1 and 2. One thromboembolic episode was registered in each group: in group 1 a deep venous thrombosis and in group 2 a stroke. CONCLUSION: The initial daily doses of acenocoumarin of 2 mg is as effective as the 4 mg one in the prevention of thromboembolic episodes, with a significant reduction in the number of haemorrhages observed during the first month of treatment. However this produces a prolongation in the necessary mean time and more number of controls performed until the achievement of the desired level of anticoagulation.

Acenocoumarol↗
PubMed1994

[Human recombinant erythropoietin in the treatment of myelodysplastic syndromes anemia. Meta-analytic study].

PURPOSE: To study the usefulness of different published epidemiological and analytic parameters to decide the treatment with human recombinant erythropoietin (rHuEPO) of anaemic patients with myelodysplastic syndromes (MDS). PATIENTS AND METHODS: We have revised 10 published series compiling 115 patients, studying age, sex, initial diagnosis, route of administration and posology, criteria of response, duration of the study, dosis with the response was obtained, response according to initial diagnosis, duration of responses, and effect of the treatment on other hematopoietic series. We have made a comparison between responders and non-responders based on epidemiological and analytical parameters. RESULTS: We have compiled 115 patients with a rate of global response of 23.5%. We have not found significative differences between the route (s.c. or i.v.) or frequency of administration, however the number of responses was higher when rHuEPO was administered three times weekly. A great variability in the criteria of response was observed among the different studies. Most of studies have a duration of three months but we have observed significative differences in the number of responses when the study is longer. We have not found significative differences between responders and non-responders with respect to age, sex, used dosis, transfusional dependency and degree of transfusional dependency, basal serum erythropoietin, time since diagnosis, transfusional period, haemoglobin level among non-transfusion dependent patients and haemoglobin level among transfusion dependent patients. We have found significative differences with respect to initial diagnosis, a higher rate of responses was observed in the refractory anaemia with excess of blasts (RAEB) group. We have not found a higher rate of transformations into acute myeloid leukaemia (AML) among these patients. The effects of the treatment on other haematopoietic series can be considered as anecdotical. CONCLUSION: The different epidemiological and analytic parameters published up to now are not useful in the decision of including an anaemic patient with MDS in the treatment with rHuEPO. Those patients with RAEB can be benefited with the treatment with rHuEPO. The concomitant use of other cytokines could improve these results.

Anemia↗
PubMed1994

[Hodgkin's disease and HIV: relations between CD4/CD8 rate, histology and stage].

Hodgkin's disease (HD) is not currently accepted as an AIDS diagnostic criterion by the Centers for Disease Control (Atlanta), although there are reports on a higher incidence of the disease in HIV infected patients, with the special feature of a marked clinical and histological aggressiveness. A review of the literature was made and a total of 54 cases of HD compiled of patients with HIV infection. The relationships between the absolute counts of CD4 and the CD4/CD8 ratio with histopathology and with the stage at diagnosis was investigated. No significant differences were found between the absolute counts of CD4 and CD4/CD8 ratio with the clinical stage of disease, histopathologic subgroup or presence of B symptoms in HD. Nevertheless, lower CD4 counts were observed in more advanced clinical stages and in patients with B symptoms; the highest CD4/CD8 ratios were observed in patients with more advanced disease. It is hypothesized that immunological disturbances caused by HIV would lead to more aggressive histological lesions and more advanced stages of HD in HIV-positive patients. Thus, the inclusion of HD as a diagnostic criterion of AIDS would be warranted.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Hemorrhagic complications in patients treated with oral anticoagulants].

PURPOSE: We have studied the haemorrhagic episodes occurred in patients treated with oral anticoagulants, with special reference to their type, frequency and severity and analyzing the risk factors that could influence in their production. PATIENTS AND METHODS: We carried out a retrospective study in 435 patients of the haemorrhagic episodes occurred since January 1989 to December 1991, determining in each one the prothrombin time expressed as INR, the time from the beginning of treatment, the patient's age and the known or underlying pathologies that could predispose to haemorrhage; depending on their severity these episodes were classified as moderate and major. RESULTS: We observed 50 haemorrhagic episodes in 50 patients (11.5%) which represents 7 x 100 patient/years, 30 (6.8% of the total patients or 4.2 x 100 patient-years) were moderate and 20 (4.5% of the total patients or 2.8 x 100 patient/years) were major. The mean age in patients with haemorrhage was 50.5 years. The incidence of hemorrhages in the first month of treatment was 60.8 x 100 patient/years; 9.4 x 100 patient/years in the period from the first month to the first year of treatment; and 3.6 x 100 patient/years in the period from the first year of treatment. The most frequent type of haemorrhage among the moderate ones was haematuria (46%) and among major ones digestive haemorrhages (26%). Depending on the coagulation level, 37 patients (66%) were within therapeutical range. Depending on patients' sex, the incidence was 23 (46%) males and 27 (54%) females. We observed at risk predisposing factors hypertension (18%), stroke (12%), hepatic disease (8%) and myocardial infarction (8%). CONCLUSION: We have found no relationship between haemorrhagic episodes and patients' age or sex. The risk of haemorrhage is higher at the beginning of the treatment and increases with the level of anticoagulation, which makes the beginning of treatment with lower doses more desirable, increasing them progressively until the desired level is achieved. Previous hypertension, stroke, hepatic disease and myocardial infarction are factors predisposing to haemorrhage.

Administration, Oral↗
PubMed1992

[Chronic neutrophilic leukemia associated with myeloma. Simultaneous presentation].

A case of chronic neutrophilic leukaemia associated with multiple myeloma is reported. The patient had a 6 months history of bruising and weight loss, and showed mature neutrophilic leukocytosis, hepatosplenomegaly, high neutrophil alkaline phosphatase score, hyperuricaemia, neutrophils with pseudotoxic granulation and scarce Döhle bodies; moreover, a monoclonal IgG lambda was detected amounting 57.3 g/L. The bone marrow was grossly hypercellular with marked myeloid hyperplasia and aggregates of immature plasma cells. After treatment during 1 year with melphalan and prednisone she is well, although persisting with neutrophilic leukocytosis, slight splenomegaly, and the monoclonal IgG decreased to 25.8 g/L.

Bone Marrow↗
PubMed1984

Bone marrow histologic pattern--the best single prognostic parameter in chronic lymphocytic leukemia: a multivariate survival analysis of 329 cases.

In previous studies, the prognostic value of bone marrow (BM) histologic patterns in chronic lymphocytic leukemia (CLL) has been demonstrated. In order to investigate whether such a value is independent of other prognostic parameters, a multivariate survival analysis (Cox's regression model) was undertaken in a series of 329 CLL patients in whom a BM had been performed. The following binary variables were included in the analysis: age (more than 60 years), lymphadenopathy (more than two areas involved), splenomegaly, hepatomegaly, absolute lymphocyte count (more than 30,000 microL), anemia (hemoglobin less than 10 g/dL), thrombocytopenia (less than 100,000 microL), and BM pattern (diffuse v nondiffuse). Three variables entered the regression at significant level: BM pattern (P less than .001), anemia (P less than .001), and hepatomegaly (P = .03). The model was also tested by expressing the variables in a continuous way when possible. Again, BM pattern entered first in the regression (P less than .001), followed by the hepatomegaly (P = .002), hemoglobin level (P = .02), and lymphadenopathy (P = .04). When both the binary and the continuous models were tested separately in 227 patients with BM as initial staging procedure and in 102 patients in whom this was performed later during the course of the disease, in all instances, BM pattern entered first in the regression at a highly significant level. BM histologic pattern appears to be a better single prognostic parameter than any one of the variables employed in current clinical staging systems. A combined clinicopathologic system incorporating the BM pattern, together with the usual clinical variables, is presented.

Actuarial Analysis↗