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Biomedical subjects

J M Rodriguez

Publications and source records attributed to J M Rodriguez.

At least 37 records · Page 2Linked to original sources
PubMed2000

Clinical and histological differences in anaplastic thyroid carcinoma.

OBJECTIVE: To report our experience in patients with anaplastic thyroid carcinoma and try to establish differences between cases in which the histological study showed that there was an associated thyroid carcinoma and those that were strictly anaplastic or pure. DESIGN: Retrospective study. SETTING: University hospital, Spain. SUBJECTS: 14 patients with anaplastic thyroid cancer treated over a period of 26 years; 7 presented with associated thyroid tumours and 7 were pure. MEAN OUTCOME MEASURES: Clinical data (age, sex, symptoms), treatment, histological study (associated thyroid disease, spread, involved lymph nodes) and follow-up. RESULTS: 13 of the 14 tumours had spread locally. 5 patients were treated by total thyroidectomy, 3 subtotal thyroidectomy, 5 excision of the tumour, and 1 patient had a biopsy alone. There were associated thyroid tumours in 7 cases: 2 follicular, 2 tall cell papillary, 1 solid papillary, 1 medullary and 1 Hurthle cell tumour. 12 patients died. Another 2 are still alive having survived 61 and 70 months respectively, both with associated anaplastic cancers (follicular and solid). The mean survival was 14 months (24 for associated anaplastic carcinoma and 4 for pure anaplastic carcinoma). CONCLUSION: There is a subgroup of anaplastic cancers in which a better differentiated thyroid carcinoma coexists with the anaplastic carcinoma. The prognosis in this subgroup is better than that for primary pure anaplastic carcinoma.

Adult↗
PubMed1999

Allogeneic bone marrow transplantation vs chemotherapy for the treatment of childhood acute lymphoblastic leukaemia in second complete remission (revisited 10 years on).

In 1989 we carried out a trial comparing allogeneic BMT to chemotherapy (CT) in 76 children with relapsed acute lymphoblastic leukaemia (ALL). Ten years on we have clinically revised outcome to firmly establish the role of each treatment, to analyse the importance of length of first remission and to provide long-term actuarial results for disease-free survival (DFS) and relapse rate in each group. For 21 patients within the transplantation group, probability of DFS and relapse are 42.8 +/- 10.8% and 40.2 +/- 11.7% (s.e.), respectively. In the chemotherapy group, probability of DFS is 10.0 +/- 4.74% (P = 0.001) and probability of relapse 87.5 +/- 5.2% (P = 0.0004). These results strongly reflect those at initial analysis, confirming a key role of BMT in the management of ALL in second remission. Moreover, on univariate analysis only two factors influenced DFS: treatment group and length of first complete remission (less or more than 30 months from first CR). Thus, it seems clear that the best therapeutic option in early relapse is BMT, whereas DFS in late relapse is at the limit of significance (P = 0.07), with a higher relapse rate in the CT group. Although encouraging results using intensified rotational combination chemotherapy have been published, prospective randomised studies are needed to assess with certainty the best therapeutic option in these patients.

Adolescent↗
PubMed1999

Substernal goiter: clinical experience of 72 cases.

The aim of this work was to study the clinical management and surgical approach of substernal goiters. We studied the clinical data, preoperative evaluation, surgical treatment, histopathologic data, complications, and follow-up of 72 patients found to have substernal goiter over a period of 15 years, from a total of 780 patients with goiter who underwent surgery. In this group, 83% were women, and the mean age was 61 years. The most common symptoms were the existence of a palpable cervical mass (93% of cases) and dyspnea (40%). The most successful study to diagnose substernal goiter was computed tomography (100%), followed by chest radiography (75%), gammagraphy (19%), and ultrasound (15%). All but 7 patients received a Kocher cervicotomy, and 49% of the cases underwent a total thyroidectomy. The histologic study revealed 3 carcinomas (4%). There was 1 permanent unilateral recurrent laryngeal nerve injury (1.4%) and 1 instance of permanent hypoparathyroidism (1.4%). We regard surgery as the most successful treatment for patients with substernal goiter, even in those without compressive symptoms. We base our choice on the low morbidity and zero mortality obtained.

Adult↗
PubMed1998

Design and implementation of the United States National Animal Health Monitoring System 1995 National Swine Study.

The United States Department of Agriculture's National Animal Health Monitoring System 1995 National Swine Study was designed to estimate management, health and productivity parameters on pig operations in the United States. Sixteen major swine-producing states that accounted for nearly 91% of June 1, 1995 swine inventory and nearly three-fourths of United States swine producers were included in the study. In the initial phase of the study, National Agricultural Statistics Service enumerators collected information from 1477 producers involved in all phases of swine production (farrowing, nursery, and grower/finisher). Of these, 405 operations with > or = 300 finisher pigs (with at least one finisher pig > or = 54 kg) participated in the subsequent component of the study, which involved on-farm visits by state and federal veterinary medical officers and animal health technicians, and which concentrated on the grower/finisher phase of production. Of those eligible to take part in the second phase of the study, participation was higher among independent producers (48.3%) than among contract producers (15.3%). Participation was also higher among operations that used advanced record-keeping systems (such as record cards for individual breeding hogs or a computer-based record-keeping system). Thus, study results could have been influenced by response biases. As a biosecurity measure, 40.5 +/- 2.1% of operations restricted entry to employees only. For operations that permitted non-employees to enter the premises, relatively few enforced other biosecurity measures on visitors (0.4 +/- 0.1% required feed-delivery personnel and livestock handlers to shower before entering the premises; 3.3+/- 0.9% required a footbath; and 7.0 +/- 1.5% required feed-delivery personnel and livestock handlers not to have visited another operation with pigs on that day). The most common method of waste storage (used by 49.9 +/- 3.8% of operations with > or = 300 finisher pigs) was below-floor slurry or deep pit.

Animal Husbandry↗
PubMed1998

Value of repeated fine-needle aspiration cytology and cytologic experience on the management of thyroid nodules.

Although fine-needle aspiration is being currently accepted as the most reliable method to select patients with thyroid nodules for surgery, controversy remains about the accuracy in distinguishing benign nodules. We present our results from 636 fine-needle aspirations performed from 1984 to 1989. Our article focuses on the value of cytologic expertise and repeated punctures for follow-up of benign nodules. We found annual figures for specificity and positive predictive value to increase steadily from 1984 to 1989, thus suggesting that the power of the test is proportional to the experience of the cytologist. We also state that the value of performing repeated punctures for the follow-up of unselected benign nodules is low.

Adolescent↗
PubMed1998

Insular carcinoma: an infrequent subtype of thyroid cancer.

BACKGROUND: Insular carcinoma is a little-known thyroid cancer, characterized by the presence of well-defined nidi of small uniform cells with frequent areas of tumor necrosis and microfollicles with thyroglobulin. It was described by Carcangiu in 1984, but its prognosis is not yet clear. STUDY DESIGN: Six of 335 patients undergoing surgery for thyroid carcinoma had the insular type. We studied age, gender, treatment, histology (tumor size, coexistence of another tumor, extrathyroid spread, vascular invasion, multicentricity, and metastatic adenopathies), TNM, and followup (recurrences, mortality, and survival). These results were compared with those published in the literature. RESULTS: Insular carcinoma was more common in women (4 of 6), and mean patient age was 32 years. Three patients had metastatic adenopathies. Four patients presented with other thyroid tumors (2 papillary, 1 follicular, and 1 anaplastic) and 2 were simple. Two patients had vascular invasion, and another 2 were extrathyroid. Only 1 case was multicentric. Three recurrences were detected in 2 patients over 50 years old: 1 lymph node at 60 months, 1 pulmonary at 132 months, and the other a bone recurrence at 8 months. Two patients died at 12 and 140 months. CONCLUSIONS: Insular carcinoma is a special type of thyroid cancer, and the prognosis is poorer than for the classic differentiated thyroid carcinoma.

Adenocarcinoma, Follicular↗
PubMed1998

Differences between sporadic and multiple endocrine neoplasia type 2A phaeochromocytoma.

OBJECTIVES: Phaeochromocytoma may be either sporadic or part of a familial cancer syndrome. We have investigated whether there are differences between sporadic and MEN 2A phaeochromocytomas. DESIGN: A retrospective study. We analysed age at presentation, sex, mode of presentation, clinical data, laboratory and imaging techniques, treatment, pathology and follow-up. PATIENTS: Forty-six patients diagnosed with phaeochromocytoma between 1979 and 1995 (23 sporadic and 23 familial) at the Hospital Universitario Virgen de la Arrixaca (Murcia, Spain), a tertiary referral centre. RESULTS: Mean age at presentation was 47 +/- 16 years for sporadic and 38 +/- 11 years for familial phaeochromocytoma (P < 0.05). The most common clinical feature and the presenting feature in cases of isolated phaeochromocytoma was hypertension. Of the MEN 2A patients, 52% were asymptomatic at diagnosis and only 35% presented with hypertension. Levels of adrenaline, noradrenaline, dopamine and metanephrines in a 24-hour urine connection confirmed the diagnosis in 95% of the isolated and 91% of the familial phaeochromocytomas. Computed tomography located 100% of the sporadic and 76% of the familial phaeochromocytomas (P < 0.02). All the MEN 2A phaeochromocytomas were bilateral compared with none of the sporadic phaeochromocytomas (P < 0.001). All the patients with familial phaeochromocytoma underwent bilateral adrenalectomy. The patients with sporadic phaeochromocytoma had the affected gland or the tumour, if extraadrenal, removed. CONCLUSIONS: In comparing sporadic and MEN 2A phaeochromocytoma we found differences in age at presentation, mode of presentation, clinical data, duration of clinical features, imaging findings bilaterality and type of surgical treatment required.

Adolescent↗
PubMed1998

Use of bile cytology for early diagnosis of complications in orthotopic liver transplantation.

We conducted a daily analysis of bile cellularity in 25 patients undergoing 29 orthotopic liver transplants (OLT) and correlated the cytological parameters with the clinical outcome of each patient. The 16 patients without complications only showed slides with cells during the first 4-5 postoperative days. The four patients with primary non-function (PNF) of the graft had a high cell density up to the time of the retransplant, with a preponderance of polymorphonuclear (PMN) leucocytes (59.2%) and epithelial cells (29.2%). During the episodes of sepsis (n = 3) and rejection (n = 7) we noted the sudden appearance of high cellularity, almost exclusively PMN leucocytes (96.5%), and a preponderance of PMN leucocytes (84.2%) with appreciable percentages of mononuclear cells and macrophages as well as the early appearance of lymphoblasts in the rejection episodes. Our results show that bile cytology can be a useful method for diagnosing graft complications in liver transplantation.

Adult↗
PubMed1997

The influence of coffee with milk and tea with milk on the bioavailability of tetracycline.

The effect of milk added to coffee or black tea on the bioavailability of tetracycline was evaluated in 12 healthy volunteers according to a crossover design. Results showed that even a small volume of milk containing extremely small amounts of calcium severely impair the absorption of the drug, so that the presence of this metal ion should be carefully controlled in order to avoid decreasing the available tetracycline.

Adult↗
PubMed1997

Design and implementation of the United States National Animal Health Monitoring System 1994-95 Cattle on Feed Evaluation, and an evaluation of the impact of response biases.

The 1994-95 Cattle on Feed Evaluation was a cooperative project (sponsored by the United States Department of Agriculture) involving Washington State University, state agricultural departments, and several agencies of the United States Department of Agriculture). The project focused on cattle-on-feed operations in 13 states that accounted for over 85% of the United States cattle on feed inventory. Participants were selected from National Agricultural Statistics Service list frames. Questionnaires were administered by telephone to operations with a one-time capacity of fewer than 1000 cattle; larger operations were visited twice to administer questionnaires. The participation rate for the first phase of the study was 56.7%. Ninety-one percent of eligible operations completed the second phase of the study. Data summarized from this national study can be used to profile management practices on cattle-feeding operations in the United States. Differences between participants and non-participants did not appear to be great. However, one does need to be mindful of the fact that a small percentage of the producers accounted for the vast majority of feedlot cattle marketed when interpreting the results.

Animal Feed↗
PubMed1997

High-resolution ultrasound associated with aspiration biopsy in the follow-up of patients with differentiated thyroid cancer.

OBJECTIVE: To assess the value of ultrasound in the follow-up of patients undergoing surgery for differentiated thyroid carcinoma. SUBJECTS: The study included 89 patients (70 women and 19 men) with differentiated thyroid carcinoma (76 papillary and 13 follicular cancer). METHODS: High-frequency ultrasound (US) was used in the evaluation of 89 subjects who underwent surgery for thyroid carcinoma. Fine-needle aspiration was performed in cases with positive US. In addition, determinations of thyroglobulin (Tgb) in serum, scintigraphy with (131)I, and cervical palpation were evaluated. We determined sensitivity, specificity, and overall accuracy for each of these diagnostic methods. RESULTS: Ultrasonography was positive in 22 subjects, 16 in the nodal area and 6 in the thyroid bed. Twenty-two subjects received fine-needle aspiration with US control; 13 (59%) of 22 were positive for cancer. The results of the US for detecting neoplastic disease showed a sensitivity of 65%, specificity of 86%, and overall accuracy of 82%. The overall accuracy for scintigraphy was 88% and for Tgb, 91%. CONCLUSION: We concluded that US can be included in the follow-up protocol for patients undergoing surgery for differentiated cancer of thyroid, as a valuable tool to localize the recurrence. This technique is particularly useful in the evaluation of patients who are found to have elevated Tgb levels.

Adenocarcinoma, Follicular↗
PubMed1997

Detection of animal pathogens by using the polymerase chain reaction (PCR).

The polymerase chain reaction (PCR) is a nucleic acid-based technique that enables the rapid and sensitive detection of specific micro-organisms. Although this technique is widely used in veterinary research, it has not yet found applications in routine microbiological analysis of veterinary clinical samples. However, advances in sample preparation together with the increasing availability of specific gene sequences will probably lead to the more widespread diagnostic use of PCR in the future. PCR is likely to have a strong impact in the epidemiology, treatment and prevention of animal infectious diseases.

Animal Diseases↗