The epileptogenic effect of tranexamic acid.
Explore the source record for details and available documents.
Aged↗
Biomedical subjects
F Bosch
Publications and source records attributed to F Bosch.
Translocation (11;14)(q13;q32) and preferential involvement of chromosomes 1, 2, 9, 13, and 17 in mantle cell lymphoma.
We have studied 13 cases of histologically confirmed mantle cell lymphomas (MCL) combining cytological-immunological features with conventional cytogenetics and in situ hybridization (ISH) techniques. Peripheral blood smears and lymph node biopsies expressed the typical mantle zone pattern with alpha B-cell phenotype. Most of the cases (11 of 13) had lymphomatous cells in the peripheral blood. Chromosome analysis was carried out on lymphoid cells from peripheral blood and/or lymph node biopsies. Phytohemagglutinin (PHA) and phorbol 12-myristate 13 acetate (TPA) were used as mitogens. Biotin-labeled libraries of whole chromosomes implicated in complex karyotypes were used to improve their interpretation. Clonal chromosome abnormalities were found in 10 of 13 patients (77%); 7 of these had a complex abnormality. The most frequent recurrent structural abnormalities were: t(11;14)(q13;q32), involvement of chromosome 1 (der[1], del[1], dup[1]), chromosome 2 (del[2], der[2]), chromosome 9 (der[9], -9), chromosome 13 (add[13], t[13q]), and chromosome 17 (add[17], der[17], t[17q]). The most frequent numerical abnormalities were monosomy 21 and loss of the Y chromosome.
Adult↗
An epidemiological comparison of pain complaints in the general population of Catalonia (Spain).
Epidemiological studies help to establish the health status in a country and allow a better allocation of economic resources. This survey estimated pain prevalence in Catalonia (Spain), analysed its relationship with demographic variables and evaluated pain-associated disabilities. The study was carried out in 1964 adults via phone interviews asking about any pain complaint they experienced in the last 6 months, regardless of its intensity and duration. Overall pain prevalence was 78.6%, significantly lower in men, with a trend to decrease with age. Back (50.9%), head (42%) and legs (36.8%) were the most affected locations. Less educated people reported, in general, higher prevalences. Pain described to be most annoying was related to musculoskeletal disease (26.2%) and migraines (16.5%). Pain was either very severe or unbearable in 33% of the sample, with women and older people reporting higher intensities. Personal and social activities were affected in 25.4% of cases and in 10.4% they became virtually impossible. Both the limitation of activity and the need for bed rest, which occurred in 19.6% of those who suffered pain, were more common amongst unemployed people, whereas 10.2% of workers had to take days off work due to pain, and 3.3% were fully incapacitated by it. In conclusion, the prevalence of pain was clearly higher among women, with an inverse relationship to age. Back pain and headaches were most prevalent and pain was rated as very severe to unbearable in one third of the patients. Pain-associated disabilities were a frequent finding. The present survey reports that pain is a substantial problem in the Catalonian population and generally reflects the characteristics of data previously reported in Anglo-saxon and Scandinavian countries.
Adult↗
c-myc mRNA expression and genomic alterations in mantle cell lymphomas and other nodal non-Hodgkin's lymphomas.
Cyclin D1 is a weak oncogene that cooperates with c-myc activation in the development of B cell lymphomas in transgenic animals. Cyclin D1 is constantly overexpressed in human mantle cell lymphomas (MCL). However, the status of c-myc gene in these tumors is not known. We have examined the c-myc mRNA expression and genomic alterations, including mutational analysis of exon 1, intron 1, and exon 2 regulatory elements, in a series of 33 MCL, 22 typical and 11 blastoid variants. In addition, c-myc alterations were also examined in 56 nodal non-Hodgkin's lymphomas (NHL). c-myc mRNA overexpression was found in 38% (11/29) of MCL with a slightly higher frequency in blastoid variants (5/10, 50%) than in typical cases (6/19, 31%). Genetic alterations were only found in one blastoid MCL showing a three-fold c-myc gene amplification. In other nodal NHL, c-myc overexpression was found in 24% (7/29) of indolent tumors but in 70% (19/27) of aggressive variants. c-myc Genetic alterations detected in these cases were gene rearrangement and hypermutations in one Burkitt's lymphoma, and individual point mutations in intron 1 or exon 2 in 1/19 (5%) indolent and 7/16 (44%) aggressive variants. These results indicate that c-myc is overexpressed in a subset of MCL, but structural gene alterations are less frequent than in other nodal NHL.
Blotting, Southern↗
A survey of postoperative pain treatment in children of 3-14 years.
There is a lack of information concerning the characteristics of pediatric postoperative pain in Southern European countries. The aim of this study was to document how postoperative pain in children was managed routinely at Spanish surgical wards.The study was carried out in three hospitals on the first postoperative day. Children were divided in four groups according to their age (years): Group I (3-5), II (6-8), III (9-11) and IV (12-14). The parameters evaluated were: analgesia characteristics (type of prescription, drug used and route of administration, prescribed dose and whether the drug was or was not administered, need of non-prescribed analgesics) and the postoperative pain intensity. The results were analysed using descriptive statistics. U-Mann Whitney, chi(2), ANOVA, Kruskall-Wallis and Student's t -test were also used.A total of 348 children ranging from 3 to 14 years were studied. The average age (+/- SD) was 8.2 +/- 3.3 and the majority were male (74%). Urologic surgery was the most frequent type of operation, with age (p<0.05) and hospital differences (p<0.001). The majority of the patients (52%) were prescribed an analgesic, but only 26% of them had an analgesia order at fixed dosage intervals. Differences among the hospitals were observed (p<0.001). The most commonly used analgesics were metamizol, propyphenazone, paracetamol and codeine. Differences in choice of drug in relation to age and hospital were significant (p< 0.001). Rectal was the preferred route of drug administration. Patient's age was unrelated with the prescribed analgesic dose. An average of 68% of prescriptions were given and half of the patients without scheduled analgesia needed to have analgesics administered. Around 20% of patients had high pain scores.Few paediatric patients are given analgesics at fixed dose intervals to treat postoperative pain. Pain relief therapy for children differs notably to that of adults, in respect to the drugs prescribed and the administered route. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.
Journal Article↗
Laparoscopic removal of accessory spleens after splenectomy for relapsing autoimmune thrombocytopenic purpura.
Explore the source record for details and available documents.
Choristoma↗
Expression of beta-integrin adhesion molecules in non-Hodgkin's lymphoma: correlation with clinical and evolutive features.
PURPOSE: To analyze beta-integrin expression in non-Hodgkin's lymphomas (NHLs) in order to assess its distribution among histologic subtypes and correlate with clinical features and outcome. PATIENTS AND METHODS: The expression of alpha2 through alpha6 and beta1 common chains of very late activation antigen (VLA ) molecules and alphaL (CD11a) and beta2 common (CD18) chains of leukocyte function-associated antigen 1 molecule were studied in 137 patients with NHL. Immunostaining was performed by a streptavidin-biotin alkaline phosphatase method, and integrin expression was semiquantitatively assessed. Correlation with clinical features was analyzed in 80 patients consecutively diagnosed as having immunocytoma (five cases), follicular lymphoma (19 cases), mantle-cell lymphoma (MCL; four cases), diffuse large-cell lymphoma (DLCL; 40 cases), lymphoblastic lymphoma (LL; six cases), anaplastic Ki-1-positive lymphoma (one case), and other peripheral T-cell lymphoma (five cases). RESULTS: MCL cells did not show alpha2 and alpha6 expression, whereas most expressed weak to moderate levels of alpha3, alpha4, and alpha5. LL mostly showed alpha2 to alpha5 expression, whereas alpha6 was observed in seven of 11 cases (higher proportion than that shown in other subgroups). Alpha chains of VLA molecules were present more frequently in T-cell than in B-cell lymphomas. Patients with moderate/strong alpha4, CD11a, and beta2 common chain expression presented more frequently with advanced stage and bone marrow infiltration. Moderate/strong alpha4, alpha5, and beta1 common chain expression correlated with extranodal involvement. In the subset of B-cell DLCL patients, negative/weak expression of alpha3 and alpha4 chains was related to a higher complete response rate. Moreover, negative or weak expression of alpha2, alpha3, alpha4, and beta1( )common chain had favorable significance for overall and failure-free survivals. CONCLUSION: In NHL, beta-integrin expression is related to histologic subtype. The expression pattern of these molecules probably influences disease dissemination and patients' prognoses.
CD18 Antigens↗
Central nervous system involvement in acute promyelocytic leukemia. A description of two cases and review of the literature.
Explore the source record for details and available documents.
Central Nervous System Diseases↗
Renal failure in multiple myeloma: presenting features and predictors of outcome in 94 patients from a single institution.
BACKGROUND: Twenty percent of patients with multiple myeloma (MM) have renal failure. OBJECTIVE: To analyze the presenting features, the response to therapy, and the factors associated with renal function recovery and survival in 94 patients with MM and renal failure. PATIENTS AND METHODS: Medical records of patients from our institution with MM and renal failure diagnosed between January 1969 and December 1994 were reviewed. The statistical methods consisted of Kaplan-Meier survival curves, the log-rank test, logistic regression analysis, and the Cox proportional hazards model for survival analysis. RESULTS: Renal failure was observed in 94 (22.2%) of 423 patients. Patients with renal failure had more advanced disease than the others. Patients with renal failure had a lower response rate to chemotherapy than those with normal renal function (39% vs 56%; P<.001). However, when patients dying within the first 2 months of treatment were excluded, no significant differences in the response rate were found between patients with renal failure and those with normal renal function. Renal function recovery was observed in 26% of patients. Serum creatinine level (<354 micromol/L [<4 mg/dL]), serum calcium level (> or =2.88 mmol/L [> or = 11.5 mg/dL]), and amount of proteinuria (< 1 g/24 h) were associated with renal function recovery. Patients who recovered renal function had a median survival of 28 months vs 4 months for those with nonreversible renal failure (P<.001). In the multivariate analysis, only serum creatinine level (P=.003) and response to chemotherapy (P<.001) were correlated with survival. CONCLUSIONS: Renal failure was present in almost one fourth of patients with MM. Patients with reversible renal failure had longer survival than those not recovering renal function. When patients dying within the first 2 months of treatment were excluded, the response rate was not affected by renal function. Factors associated with renal function recovery were degree of renal failure, presence of hypercalcemia, and amount of proteinuria. Response to chemotherapy and severity of renal failure were the only independent factors associated with survival.
Adult↗
Evidence from transgenic mice that interferon-beta may be involved in the onset of diabetes mellitus.
A number of cytokines have been shown to alter the function of pancreatic beta-cells and thus might be involved in the development of type 1 diabetes. Interferon-beta (IFN-beta) expression is induced in epithelial cells by several viruses, and it has been detected in islets of type 1 diabetic patients. Here we show that treatment of isolated mouse islets with this cytokine was able to alter insulin secretion in vitro. To study whether IFN-beta alters beta-cell function in vivo and leads to diabetes, we have developed transgenic mice (C57BL6/SJL) expressing IFN-beta in beta-cells. These mice showed functional alterations in islets and impaired glucose-stimulated insulin secretion. Transgenic animals presented mild hyperglycemia, hypoinsulinemia, hypertriglyceridemia, and altered glucose tolerance test, all features of a prediabetic state. However, they developed overt diabetes, with lymphocytic infiltration of the islets, when treated with low doses of streptozotocin, which did not induce diabetes in control mice. In addition, about 9% of the transgenic mice obtained from the N3 back-cross to outbred albino CD-1 mice spontaneously developed severe hyperglycemia and hypoinsulinemia and showed mononuclear infiltration of the islets. These results suggest that IFN-beta may be involved in the onset of type 1 diabetes when combined with either an additional factor or a susceptible genetic background.
Animals↗
Mantle cell lymphoma: presenting features, response to therapy, and prognostic factors.
BACKGROUND: The goal of this study was to analyze the presenting features, natural history, and prognostic factors in 59 patients with well characterized mantle cell lymphoma (MCL). METHODS: Cases were classified as nodular or diffuse and as typical or blastic variants. Age, performance status (PS), histologic variants, mitotic index (MI), hematologic parameters, tumor extension data, and International Prognostic Index (IPI) were recorded and evaluated for prognosis. RESULTS: The median age of the patients was 63 years (range, 39-83 years), and the male to female ratio was 3:1. Fifty-three patients had typical histology (3 nodular and 50 diffuse), and 6 had the blastic variant. Approximately 95% of patients presented with advanced stage disease (Ann Arbor Stage III-IV). Leukemic expression was observed in 58%. Complete and partial response rates were 19% and 46%, respectively. Parameters associated with lower response rate were Stage IV, high/intermediate or high risk IPI, and increased lactate dehydrogenase (LDH) level. In the logistic regression analysis, high LDH level and Stage IV disease were associated independently with lower response rate. Median survival was 49 months. Parameters associated with a short survival were: poor PS, splenomegaly, B-symptoms, MI > 2.5, leukocyte count > 10 x 10(9)/L, high LDH level, blastic variant, and high/intermediate or high risk IPI. In the Cox proportional hazards regression model, only poor PS (relative risk [RR] = 3.3; P = 0.002), splenomegaly (RR = 2.8; P = 0.007), and MI > 2.5 (RR = 2.4; P = 0.012) were associated with short survival. CONCLUSIONS: In this series, patients with MCL presented with advanced stage and extranodal involvement. Only a minority of patients achieved a complete response. The median survival was 4 years, with PS, splenomegaly, and MI being the most important factors predicting survival. These results show clearly that more effective therapies for MCL are needed.
Adult↗
Residual splenic function after laparoscopic splenectomy: a clinical concern.
OBJECTIVE: To document the existence of residual splenic function after laparoscopic splenectomy in a series of 48 patients. DESIGN: A noncomparative descriptive case series. SETTING: A tertiary care center. PATIENTS: A series of 9 patients without clinical improvement after laparoscopic splenectomy of 48 consecutive patients undergoing laparoscopic splenectomy for several hematologic disorders after a mean follow-up of 16 months (range, 1-40 months). INTERVENTIONS: A computed tomographic scan and technetium Tc 99m sodium pertechnetate heat-damaged red blood cell scintigraphy were performed for patients with partial (platelet count <100x10(9)/L) or total (platelet count <50x10(9)/L) failure of improvement. MAIN OUTCOME MEASURE: Evidence of residual splenic tissue by image diagnosis. RESULTS: The condition of 9 of the 48 patients failed to improve after laparoscopic splenectomy. Six patients experienced a total failure of improvement and 3 experienced a partial failure of improvement (1 patient had human immunodeficiency virus-related thrombocytopenia and 8 had idiopathic thrombocytopenic purpura). Three patients had residual splenic function, which was revealed by scintigraphy. The results of a computed tomographic scan showed an accessory spleen in one patient and splenic implants in splenic fossa in another patient. CONCLUSION: Laparoscopic splenectomy has a promising role in the management of hematologic diseases requiring splenectomy, but it requires exquisite care to avoid parenchymal rupture and cell spillage and to avoid leaving accessory spleens, which can lead to the failure of surgical treatment.
Adolescent↗
Patterns of regular drug use in Spanish childbearing women: changes elicited by pregnancy.
OBJECTIVE: To determine drug use in Spanish women before pregnancy and from conception to the awareness of pregnancy (early period of pregnancy, EPP), as well as to analyse attitudinal changes when pregnancy was planned or known. METHODS: Trained gynaecologists used a structured questionnaire to collect demographic and obstetric characteristics, histories of regular drug taking before pregnancy, attitudes towards drug taking during pregnancy and current drug use in the EPP. Women were interviewed at their first antenatal visit during the first trimester. RESULTS: Two hundred and seventy-two women were included (mean age 29.3 years and 66.3 days of gestation). Before pregnancy, 24% regularly took drugs, 70% of them more than twice a week; a significantly higher frequency was found in those receiving public antenatal care and in those who had had less education. In 39% of women, awareness of pregnancy did not change their attitudes towards regular drug use. Among those who decided to suppress their regular drug intake, 58% did so when their pregnancy was confirmed and 42% when they planned it. In women who planned their pregnancy, 30.1% stopped when they tried to become pregnant. However, 62% of all women took drugs during the EPP. In private antenatal care significantly more drugs were taken per patient. By the 168 women 278 compounds were consumed during the EPP: 40% were analgesics (mainly paracetamol and acetylsalicylic acid) and 25% were digestive and metabolic drugs (mainly antacids and laxatives). Drugs were often used more than twice a week, particularly in women receiving public antenatal care and in those who had had less education. CONCLUSION: Drug taking is common in Spanish women of childbearing age, and many of those in our study did not decide to stop during the EPP. Few women avoid drugs when planning a pregnancy. Therefore, gynaecologists must advise against drug taking in patients who wish to become pregnant and suggest that unnecessary drug use be avoided when the pregnancy is already diagnosed.
Adult↗
Hematopoietic stem cell transplantation in chronic lymphocytic leukemia: a report of 12 patients from a single institution.
BACKGROUND: Stem-cell transplantation is a reasonable therapeutic approach for younger patients with high-risk CLL. PATIENTS AND METHODS: Twelve patients (seven males; median age 47 years, range 29-51) with high-risk CLL underwent transplantation (allo, n = 7; auto, n = 5). The conditioning regimen consisted of cyclophosphamide and total body irradiation in 11 patients, and BEAC in the remaining one. Minimal residual disease (MRD) was assessed by cytofluorometry and PCR. RESULTS: All 11 evaluable patients engrafted. Of the seven allografted patients, two died of treatment-related causes; three patients developed acute GVHD. No transplant-related mortality was observed in autografted patients. After transplantation, 10 of 11 patients evaluable for response achieved CR (91%; 95% CI 59%-100%) which was molecular in nine patients (82%; 95% CI 48%-98%). One patient in CR but MRD+ relapsed nine months after transplantation and died. Seven patients remain in molecular CR for a median of 16 months (range 1-58). Estimated actuarial survival and disease-free survival at two years is 81% (95% CI 43%-100%) and 71% (95% CI 43%-99%), respectively. Relapse risk at two years is 12.5% (95% CI 0%-35.5%). CONCLUSIONS: Patients with high-risk CLL can achieve long-lasting molecular CR after SCT. The role of transplants in CLL management deserves investigation in controlled trials.
Adult↗
Peripheral T-cell lymphomas: initial features, natural history, and prognostic factors in a series of 174 patients diagnosed according to the R.E.A.L. Classification.
BACKGROUND: Peripheral T-cell lymphomas (PTCL) account for about 10% of all lymphomas in Western countries. The aim of the present study is to analyze the initial characteristics and prognostic factors in a large series of PTCL patients. PATIENTS AND METHODS: 174 patients (105 male/69 female; median age 61 years) were diagnosed with PTCL according to the R.E.A.L. Classification in nine Spanish institutions between 1985 and 1996. Cutaneous lymphomas and T-cell chronic lymphocytic/prolymphocytic leukemia were excluded from the study. Univariate and multivariate analyses were used to assess the prognostic value of the main initial variables. RESULTS: The distribution according to histology subgroup was: PTCL unspecified, 95 cases (54.4%); anaplastic large-cell Ki-l-positive (ALCL), 30 cases (17%); angioimmunoblastic T cell, 22 cases (13%); angiocentric, 14 cases (8%); intestinal T cell, 12 cases (7%), and hepatosplenic gamma delta T cell, one case (0.6%). As compared to the other types, ALCL presented more frequently in ambulatory performance status, without extranodal involvement, in early stage, normal serum beta 2-microglobulin (B2M) level and low-risk international prognostic index (IPI). Most patients were treated with adriamycin-containing regimens. The overall CR rate was 49% (69% for ALCL vs. 45% for other PTCL; P < 0.02). The risk of relapse was 48% at four years. Median survival of the series was 22 months (65 months for ALCL vs. 20 months for other PTCL; P = 0.03), with a four-year probability of survival of 38% (95% confidence intervals (95% CI): 28-48). In the univariate analysis, in addition to the histology, older age, poor performance status, presence of B-symptoms, extranodal involvement, bone marrow infiltration, advanced Ann Arbor stage, high serum LDH, high serum B2M, and intermediate- or high-risk IPI were related to poor survival. In the multivariate analysis the histologic subgroup (ALCL vs. other PTCL) (P = 0.02; response rate (RR): 4.3), the presence of B-symptoms (P = 0.02, RR: 2.2), and the IPI (low vs. high) (P = 0.04, RR: 2) maintained independent predictive value. When the analysis was restricted to the unspecified subtype, only IPI had independent prognostic value (P = 0.003; RR: 3.5). CONCLUSIONS: PTCL have adverse prognostic features at diagnosis, respond poorly to therapy and have short survival, with no sustained remission. ALCL constitutes a subgroup which responds better to therapy and has a longer survival.
Adolescent↗
Transgenic rabbits overexpressing growth hormone develop acromegaly and diabetes mellitus.
Transgenic rabbits expressing the bovine growth hormone (bGH) gene in liver and kidney were obtained to study the long-term effects of chronic exposure to GH in nonrodent animals. These rabbits presented high levels of bGH and insulin-like growth factor I in serum. In spite of chronic exposure to bGH, transgenic rabbits had similar body weight to controls. However, enlargement of the head and limbs and reduction of visceral fat were observed in these animals. They also showed marked hyperinsulinemia, hyperglycemia, and hypertriglyceridemia, indicating that they developed insulin resistance. Furthermore, serious histopathological alterations, including marked fibrosis, were observed in liver, kidney, and skeletal muscle. These anatomical, metabolic, and histological alterations closely resemble those found in patients with acromegaly. Thus, transgenic rabbits overexpressing GH may be a good model of the human disease.
Acromegaly↗
Risk of relapse and clinico-pathological features in 103 patients with diffuse large-cell lymphoma in complete response after first-line treatment.
Patients with diffuse large-cell lymphoma (DLCL) achieve a complete response (CR) in most cases, but at least one-third of them eventually relapse. Such an event occurs most frequently within 2 yr from CR achievement. The aim of the present study was to analyse the risk and pattern of relapse of patients with DLCL in CR. One hundred and three patients with DLCL (53 male/50 female; median age: 55 yr) in CR after doxorubicin-containing first-line treatments were included in the study. Main clinicobiological characteristics at diagnosis and at relapse were analysed. Uni- and multivariate studies were performed. Forty-one patients (40%) eventually relapsed, in 27 cases within 2 yr from CR and 14 thereafter. Histological subtype was the same at diagnosis and at relapse in all the early relapsing patients and in 8 of 10 late relapsing patients with available biopsy. The most important variables at diagnosis for predicting relapse were advanced stage (p<0.01) and bone marrow infiltration (p=0.05), with stage (I-II vs. III-IV) (p=0.009; relative risk=2.28) being the only predictive variable in the multivariate analysis. No differences were found according to the treatment given. The second CR rate obtained in the late relapsing patients after salvage therapies was higher that in early relapsing (50% vs. 37%). Median survival from relapse was 1.4 yr for patients early relapsing and it was not achieved for those with late relapses (p=0.09). Late relapse is a quite common event in DLCL lymphomas, with those patients achieving more frequently a second CR and having better survival than early relapsed patients.
Aged↗
Transgenic mice in the analysis of metabolic regulation.
In normal animals, the extracellular concentration of glucose is maintained within a very narrow range by the matching of glucose flux into and out of the extracellular space through the tightly coordinated secretion of insulin and glucagon. Functional alterations in beta-cells, liver, or skeletal muscle and adipose tissue may disrupt glucose homeostasis and lead to the development of non-insulin-dependent diabetes mellitus (type 2 diabetes). This review outlines the contribution of these organs and tissues to the control of glucose homeostasis. We discuss new insights obtained through studies of transgenic mice that overexpress or show decreased expression of putative key genes in the regulation of pancreatic beta-cell function, in the control of hepatic glucose uptake and output, and in the regulation of glucose uptake and utilization by skeletal muscle and adipose tissue.
Adipose Tissue↗