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J Mora

Publications and source records attributed to J Mora.

167 records · Page 10Linked to original sources
PubMedDate not supplied

[Lymphoscintigraphy and sentinel node biopsy in non-palpable breast cancer].

OBJECTIVE: The aim of the study was to evaluate the efficacy of lymphatic mapping and sentinel node biopsy in non-palpable breast cancer (NPBC) patients in comparison with palpable breast cancer (PBC) patients. MATERIAL AND METHODS: 199 breast cancer patients were studied. Patients were classified into two groups: NPBC and PBC. Following sentinel node biopsy all patients underwent axillary lymphadenectomy. Surgery was performed at 4-24 h after peritumoral injection of 111MBq 99mTc-nanocolloid. Histological sentinel node analysis was performed by cytological imprinting and delayed study. The following parameters were analyzed in both groups: scintigraphic and surgical detection rates, true positives (TP), true negatives (TN), sensitivity (S), predictive negative value (PNV), false negative rate (FNR) and global precision (GP) of the technique. RESULTS: No significant differences were observed (p > 0.05) in either the lymphoscintigraphy or surgical sentinel node detection, or drainage to internal mammary chain (p = 0.211) in both groups. Metastatic axillary prevalence was lower in NPBC group (p = 0.019). Similar S, NPV and GP values (>90 %) and FNR (< or = 6 %) were found in both groups. CONCLUSIONS: The reliability of the technique is similar in both groups. Drainage is predominantly axilar. Drainage to internal mammary chain was more frequently seen in medial tumours and in NPBC. Metastatic axillary prevalence was lower in the NPBC group.

Adult↗
PubMedDate not supplied

[Prognostic utility of scintigraphy with 99mTc-HMPAO labelled leukocytes in inflammatory bowel disease].

OBJECTIVE: The inflammatory bowel disease (EII) has a chronic evolution with a frequent relapses. There is no specific diagnosis method to detect the patients with a high risk to relapse. The aim of the work was to analyse the prognostic value of 99mTc-HMPAO leukocyte scintigraphy (LS) performed during an acute attack of EII. MATERIAL AND METHODS: 18 patients (mean age 32 +/- 10 years) admitted for an acute attack of EII has been prospectively studied (5 ulcerative colitis [UC] and 13 Cronh's disease [CD]), excluding patient with prior steroids or immunosuppressive therapy during the last year. LS were obtained in basal conditions and following 3 weeks of steroid treatment and the scintigraphic activity index (SAI) has been calculated. Colonoscopy has been done in all patients, and CDAI in CD and Truelove index in UC have been calculated. Patients were followed up for 1 year. In the evolution the therapy requirements as well as the good response to initial treatment have been evaluated. RESULTS: All patients with UC and 4 patients with CD showed a SAI decrease > 50 % and all had a good clinical evolution. Only 2 out of the 9 patients with CD showing a IAG decrease < 50 % and had a good clinical evolution, the 7 remaining required additional medical treatment (immunosuppressors or surgery). CONCLUSION: LS may be of prognostic value in the management of EII. A SAI decrease > 50 % at 3 weeks of steroid treatment indicates a good clinical evolution.

Adult↗
PubMedDate not supplied

Employer coverage of experimental medical procedures.

Should an employer's medical plan pay for organ transplants, in vitro fertilization or other "experimental" or "high-risk" procedures? Most employers have looked to insurance companies to decide, but the rising frequency and cost of such procedures, coupled with the litigation potential they pose, raise policy making issues that employers themselves must face. A Hewitt Associates Consultant describes some problems and some solutions for insured and self-funded medical plans.

Diffusion of Innovation↗
PubMedDate not supplied

[Accuracy of imaging techniques and tumor markers in the diagnosis of pancreatic cancer].

OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of: a) three imaging techniques: ultrasonography (US), computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP), and b) the serum tumor markers CEA, CA 19-9 and CA 125, in the diagnosis of pancreatic cancer. PATIENTS AND METHODS: A total of 137 patients were prospectively evaluated. Pancreatic cancer was diagnosed in 25 patients; chronic pancreatitis in 24; acute pancreatitis in 22; extrapancreatic malignancies in 24, and benign digestive disease in 42. The reference interval for each marker was determined in 36 healthy volunteers. Diagnostic accuracy was determined using receiver operating characteristic (ROC) curves. Each diagnostic test was used in order: a) to diagnose pancreatic cancer when the disease was clinically suspected, and b) to differentiate between pancreatic cancer and chronic pancreatitis. RESULTS: CT (0.976-0.888) and US (0.857) diagnostic accuracy resulted greater than the best serum tumor marker CA 19-9 (0.755-0.786) (p = NS), in both diagnostic conditions. To obtain a diagnostic specificity of 90% in pancreatic cancer, the CA 19-9 cutoff level should increase up to 3 and 7.5 folds being in this case better than CEA and CA 125 (p < 0.05). CONCLUSIONS: CT scan offers the greatest accuracy in the diagnosis of PC. Among the tumor markers, CA 19-9 offers the best accuracy in the diagnosis of pancreatic cancer.

Acute Disease↗