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Biomedical subjects

J Pastor

Publications and source records attributed to J Pastor.

At least 37 records · Page 2Linked to original sources
PubMed2003

[Emergency lung transplantation].

INTRODUCTION: Lung donors are scarce and lung transplantation resources limited, leading to a need to look at transplants in terms of efficiency. Because emergency transplants (C-0) are assumed to yield poor results, most countries do not perform them on a regular basis. Spain, however does accept the concept of emergency lung transplantation for patients who are on waiting lists. We assess outcome for our patients who have received scheduled and emergency transplants. MATERIAL AND METHOD: The survival of patients receiving lung transplants in our service from 1992 through 2001 was studied using, Kaplan-Meier, Cox regression and chi-squared statistical analyses. We compared outcome and perioperative mortality (over 30 days) for scheduled versus C-0 procedures, analyzing the influence of certain variables (age, sex, emergency status, type of transplant, mechanical ventilation and use of extracorporeal membrane oxygenation). RESULTS: Eleven of 183 lung transplants were C-0 and 172 were scheduled. Forty-one were single-lung and 142 were double-lung transplants. Perioperative mortality was 36.4% for emergency procedures and 8.7% for scheduled procedures (p = 0.0035). Survival was significantly better for scheduled patients than for C-0 patients (p = 0.0032), although outcome was similar when perioperative mortality was not taken into account (58.16% vs. 57.14% at 5 years for scheduled and C-0 patients, respectively). CONCLUSIONS: Long-term survival after lung transplantation shows that the procedure is effective and efficient in C-0 patients, in spite of perioperative risk, provided the patient has been adequately monitored.

Adolescent↗
PubMed2002

Survival and risk model for stage IB non-small cell lung cancer.

BACKGROUND: The aim of this work is to estimate the prognostic value of a set of clinical-pathological factors in patients resected for non-small cell lung cancer (NSCLC) and classified as stage IB, in order to create a prognostic model for establishing risk groups, and to validate that model. METHODS: Among 637 patients resected and classified as stage IB, we analyzed sex, age, symptoms, location, type of resection, cell type, histology, and tumor size. The Kaplan-Meier method was used to estimate the survival. The results were compared using the log-rank test. All the significant variables from this univariable method were then included in a multivariable method of estimation of the proportional risk for survival data developed by Cox, using the variables selected, a regression model was developed for accurately predicting survival. To validate the predictive capability of the regression model, we randomly divided our patients into training and test subsets, containing 322 and 315 cases, respectively. RESULTS: The overall 5-year survival rate of the series was 60%. The cell type, the squamous or non-squamous and the tumor size showed a significant influence on survival in the univariable analysis, while, according to the Cox model, only the tumor size and the squamous or non-squamous type entered into regression. Hazard rates were calculated for each patient. The mean risk was 0.87 +/- 0.25 (range 30-1.94). The series was divided into three risk groups (low, intermediate, and high risk) according to the fitted hazard rates, using cut-off points (one standard deviation from the mean). The 5-year survival rates were 85, 59, and 44%, respectively. To validate the model, we repeated the analysis for training and test subsets. Only the tumor size had a significant influence on survival in the univariable analysis. Using the Cox model, also the tumor size entered into regression. The mean risk was 0.79 +/- 0.29 (range 0.09-2.12). Cut-off points were 0.50 and 1.08 for the low, intermediate, and high-risk groups. The 5-year survival rates were 83, 58, and 40%, respectively. We validated the regression model obtained in the training subset by demonstrating its capacity in identifying risk groups in the test subset. The 5-year survival rates were 83, 61, and 49.5% for the low, intermediate, and high-risk groups, respectively (P = 0.0104). CONCLUSIONS: Stage IB does not succeed in configuring a group of patients with a homogeneous prognosis, as there is a wide variability in a 5-year survival. The estimation of prognosis derived from a multivariable analysis can obviate the limitations of the actual staging system for NSCLC.

Adenocarcinoma↗
PubMed2002

[Single-lung transplant and primary graft failure].

OBJECTIVE: To quantify primary graft failure (PGF) and its impact on perioperative and early mortality in single-lung transplant (SLT). METHOD: We analyzed 35 SLT procedures performed using similar techniques. PGF was defined as a PaO2/FiO2 coefficient lower than 200 mmHg during the first 72 hours or ventilation assistance lasting longer than 5 days attributable to primary lung dysfunction. We defined perioperative mortality as occurring within 30 days of surgery and early mortality within 90 days. RESULTS: Twenty-five men and 10 women received lungs, 22 for pulmonary fibrosis and 13 for emphysema; the mean age was 53.26 10.77 years. Twenty right SLTs were performed and 15 left SLTs. Twenty-nine donors were men and 6 were women, with a mean age of 29.31 12.33 years. Twenty-six died from cranial trauma, 8 from stroke and 1 from a brain tumor. The mean time of intubation was 1.69 1.35 days. The mean PaO2 was 470.71 70.82 mmHg. The mean time of ischemia was 201.77 62.64 minutes. Four patients (11.42%) developed PGF and 3 died during the perioperative period. Two additional patients died within the early postoperative period. Survival was 91.4% at one month and 85.5% at three months. The cause of donor death was the only variable that influenced the development of PGF. CONCLUSION: We observed a low incidence of PGF and of perioperative and early mortality, with one and three month survival rates similar to those reported internationally.

Adolescent↗
PubMed2002

Isolated primary Langerhans' cell histiocytosis of central nervous system.

Solitary eosinophilic granuloma that involves the CNS is an uncommon lesion and most frequently affects the hypothalamus. We report a new and rare case of solitary eosinophilic granuloma of the left temporal lobe in a patient without systemic disease. The diagnosis was confirmed by electron microscopy and immuohistochemical techniques. The treatment of choice is surgical resection. There is a better prognosis in comparison with cases accompanied by systemic disease.

Adult↗
PubMed2001

Changes in peripheral blood leukocyte populations in pigs with natural postweaning multisystemic wasting syndrome (PMWS).

The objective of the present study was to analyze, by flow cytometry, changes in PBMC subsets in pigs having postweaning multisystemic wasting syndrome (PMWS), a new condition associated to porcine circovirus type 2 (PCV2) infection. Thirteen acutely PMWS affected pigs were selected from a farm seronegative to porcine reproductive and respiratory syndrome virus (PRRSV) and to Aujeszky's disease virus (ADV); 11 clinically healthy pigs were selected from a high health farm with no history of PMWS and free of the major swine pathogens, and used as a control group. All pigs were necropsied, and tissue samples were fixed in formalin; blood with EDTA anticoagulant was used to perform the flow cytometric analysis. PBMC were incubated with mAb against porcine CD3, CD4, CD8, CD25, CD45, IgM, SWC3, and SLA-Class II. Flow cytometric analysis showed substantial changes in leukocyte subsets in the peripheral blood of PMWS-affected pigs, which were characterized by an increase of monocytes, a reduction of T (mainly CD4(+)) and B-lymphocytes, and the presence of low-density immature granulocytes. Altogether, these changes would suggest an inability of acutely PMWS-affected pigs to mount an effective immune response.

Animals↗
PubMed2001

Magnetic resonance imaging in the diagnosis of Fournier's gangrene.

Magnetic resonance imaging and ultrasound are the imaging modalities recommended in the early diagnosis of Fournier's gangrene. Because of the high mortality of this inflammatory disease early diagnosis is essential to initiate adequate surgical and medical treatment. In the clinical literature only a handful of cases, in which diagnosis of Fournier's gangrene is based on MRI findings, have been reported; therefore, we report another case which shows the ability of MRI especially to determine the point of origin and extension of disease.

Adult↗
PubMed2001

[Model of mortality risk in stage I non-small cell bronchogenic carcinoma].

OBJECTIVE: To develop and validate a mortality risk model for patients with resected stage I non-small cell bronchogenic carcinoma (NSCBC). PATIENTS AND METHOD: Tumors from 798 patients with diagnoses of NSCBC were resected and classified in stage I. The Kaplan-Meier method and Cox's proportional hazard model were used to analyze the influence of clinical and pathologic variables on survival. RESULTS: Univariate analysis revealed that age (p = 0.0461), symptoms (p = 0.0383), histology (p = 0.0489) and tumor size (p = 0.0002) and invasion (p = 0.0010) affected survival. Size (p = 0.0000) and age (p = 0.0269) were entered into multivariate analysis. Each patient's risk was estimated by applying the regression equation derived from multivariate analysis; the mean was 1.47 +/- 0.31 (range 0.68 to 2.92). The series was divided into three groups by degree of risk (low, intermediate and high), establishing the cutoff points at 1.16 and 1.78 (standard deviation of the mean). Five-year survival rates were 85%, 62% and 46%, respectively (p = 0.0000). To validate the model's predictive capacity, the series was divided randomly into two groups: the study group with 403 patients and the validation group with 395. Age (p = 0.0295), symptoms (p = 0.0396), tumor size (p = 0.0010) and invasion (p = 0.0010) affected survival in the univariate analysis. Size (p = 0.0000) and age (p = 0.0358) were entered into Cox's model. Mean risk was 1.94 +/- 0.36 (range 0.98 to 3.32). The series was divided into three risk groups, with cut-off points established at 1.58 and 2.30. Five year survival rates were 90%, 62% and 46% for the low, intermediate and high risk groups, respectively (p = 0.0000). The same model proved able to identify risk when applied to the validation group, in which five-year survival rates were 78%, 61% and 48%, respectively (p = 0.0000). CONCLUSIONS: Risk models can identify patient subgroups, potentially influenced by co-adjuvant treatment, as well as facilitate comparison of patient series.

Adult↗
PubMed2000

Biotic indices based on soil nematode communities for assessing soil quality in terrestrial ecosystems.

Nematode communities offer several advantages for assessing the quality of soils. Diversity and maturity indices as well as trophic structure defining parameters based on the composition of soil nematode communities have been used to detect various kinds of man-induced disturbances and monitor ecological recovery. In the present paper we examined the response of these indices in herbaceous Mediterranean ecosystems. Incipient soils, which were developed on the top of waste dumping sites were compared with agricultural soils under fallow. Grasslands and old-fields were considered as reference systems. Either diversity or maturity indices were shown to be very sensitive to changes in soil system caused by waste dumping. However, they were less useful for the categorisation of perturbation in agroecosystems. Trophic composition related parameters were more meaningful for this aim. Plant parasite index (PPI) may be a good generic indicator of recovery processes after perturbation in these annual herbaceous ecosystems.

Animals↗
PubMed2000

Effects of sarcoptic mange on serum proteins and immunoglobulin G levels in chamois (Rupicapra pyrenaica) and Spanish ibex (Capra pyrenaica).

Three groups of chamois (Rupicapra pyrenaica) and three groups of Spanish ibex (Capra pyrenaica) were established to study the effects of sarcoptic mange on serum proteins and immunoglobulin G (IgG) levels. The first group of chamois consisted of 22 healthy Pyrenean chamois (R. pyrenaica pyrenaica) from a non-infested area, the second group consisted of 20 healthy Cantabrian chamois (R. p. parva) from an area where sarcoptic mange has been reported since 1994 and the third group consisted of 16 Cantabrian chamois from the same area but naturally infested by Sarcoptes scabiei. The first group of Spanish ibex was 39 healthy animals from a sarcoptic mange non-infested area, the second group was 23 healthy animals from a sarcoptic mange infested area and the third group consisted of 20 animals from the same area but naturally infested with the parasite. Blood samples were taken after killing the animals as part of hunting programmes. Values for total proteins, gamma-globulin and IgG were higher in infested and healthy chamois from the infested area compared to healthy chamois from the non-infested area, and IgG levels were higher in infested chamois compared to healthy-exposed chamois. Values for alpha2-globulin were higher in healthy Cantabrian chamois. In Spanish ibex, albumin, alpha2-globulin and IgG levels were lower in the healthy Spanish ibex from the non-infested area than in healthy animals from an infested area. The differences found in the chamois were indicative of the establishment of a humoral antibody response in the animals in contact with the disease. As the IgG levels were not significantly different between healthy and infested Spanish ibex from the same area, a different pattern of chronic infection with humoral response to the disease was suggested.

Animals↗
PubMed2000

Information processing in large-scale cerebral networks: the causal connectivity approach.

Today, cognitive functions are considered to be the offspring of the activity of large-scale networks of functionally interconnected cerebral regions. The interpretation of cerebral activation data provided by functional imaging has therefore recently moved to the search for the effective connectivity of activated regions, which aims at understanding the role of anatomical links in the activation propagation. Our assumption is that only causal connectivity can offer a real understanding of the links between brain and mind. Causal connectivity is based on the anatomical connection pattern, the information processing within cerebral regions and the causal influences that connected regions exert on each other. In our approach, the information processing within a region is implemented by a causal network of functional primitives, which are the interpretation of integrated biological properties. Our choice of a qualitative representation of information reflects the fact that cerebral activation data are only the approximate view, provided by imaging techniques, of the real cerebral activity. This explicit modeling approach allows the formulation and the simulation of functional and physiological assumptions about activation data. Two alternative models explaining results of the striate cortex activation described by Fox and Raichle (Fox PT, Raichle ME (1984) J. Neurophysiol 51:1109-1120; Fox PT, Raichle ME (1985) Ann Neurol 17:303-305) are provided as an example of our approach.

Animals↗
PubMed2000

[Small-cell nonanaplastic bronchogenic carcinoma. The new stage I].

OBJECTIVE: To validate updated guidelines for stage I classification of patients with differentiated small-cell bronchogenic carcinoma. METHODS: Seven hundred seventeen tumors of differentiated small-cell bronchogenic carcinoma were resected in our hospital and given a TNM classification of stage I based on guidelines recently issued by the Spanish Society of Pneumology and Chest Surgery (SEPAR). Survival was calculated using the Kaplan-Meier method and curves were compared with a log-rank test. The Cox proportional hazards model was used to analyze multiple variables. RESULTS: One hundred forty-two cases were classified as stage IA and 575 as stage IB. Survival was significantly longer for stage IA than for stage IB (p = 0.0021). The prognosis was significantly better for stage IA patients who were asymptomatic (p = 0.0380) or who had tumors < or = 2 cm in diameter (p = 0.0431). In stage IB, histologic grade (p = 0.0104) and tumor diameter (p = 0.0002) significantly affected survival. A noteworthy finding was the 82% survival at five years in a group of 66 patients with a maximum tumor diameter of 3 cm classified as T2N0M0 due to invasion of the visceral pleura or to proximal involvement of a lobar bronchus at a site > 2 cm from the carina; that survival rate was not significantly different from survival for stage IA (p = 0.1573). Multivariate analysis showed that tumor diameter (p = 0.0272) was of prognostic importance in stage IA, while tumor diameter (p = 0.0005) and histologic grade (p = 0.0092) were relevant in stage IB. CONCLUSION: The new staging guidelines for differentiated small-cell bronchogenic carcinoma are nearer to prognostic reality given that survival for stage IA patients is significantly longer than for stage IB patients. However, the method continues to have shortcomings in that it fails to achieve one of its main objectives, namely prognostic homogeneity for each subgroup, as indicated by problems related to variables of tumor extension such as diameter, involvement of the visceral pleura or bronchial location, apart from other factors that affect survival.

Carcinoma, Bronchogenic↗
PubMed2000

Immunoglobulin G class identification from wild ungulates by cross-reactivity with antisera to domestic animals.

Seven species of Spanish ungulates were tested for the presence of homologous immunoglobulin G (IgG) with a gel-diffusion test using bovine, ovine, caprine and porcine IgG antisera. Homologous ovine and caprine IgG were detected in sera from chamois (Rupicapra pyrenaica), Spanish ibex (Capra pyrenaica hispanica), mouflon (Ovis orientalis musimon), red deer (Cervus elaphus), fallow deer (Dama dama) and roe deer (Capreolus capreolus). Homologous porcine IgG was detected in wild boar (Sus scrofa) serum. Immunoelectrophoretic assays were performed to compare the electrophoretic mobility of IgG from domestic and wild species.

Animals↗
PubMed2000

Back-scattered electron imaging of a non-vertebral case of hypervitaminosis A in a cat.

We describe a clinical case of hypervitaminosis A in a cat. The main lesions were bony fusions of both the hip and stifle joints, without spinal involvement. A post-mortem study using back-scattered scanning electron microscopy (BEI-SEM) revealed that exostoses had formed around the joints without articular surface involvement. The more recently formed areas of bony proliferation were composed mainly of chondroid tissue surrounded by different degrees of woven bone. As the bony reaction occurred, remodelling of the trabeculae was observed which lead to progressive substitution of chondroid tissue by woven bone surrounded by apposition of lamellar bone. No traces of calcified cartilage were observed in any of the bone sections evaluated.

Animals↗
PubMed2000

Finite resolution effects in the analysis of the scaling behavior of rough surfaces

We investigate the influence of finite spatial resolution in the analysis of the scaling behavior of rough surfaces. We analyze such an effect for two usual measurement methods: the local width and the height-height correlation function. We show that while the correlation function is insensitive to finite resolution effects for practical purposes, the local width presents correction terms to the scaling law, leading to an effective value of the local roughness exponent smaller than the theoretically expected. We also show that a functional scaling relation can only be properly formulated in terms of the height-height correlation function.

Journal Article↗
PubMed2000

Hematologic and serum chemistry values of the captive European wildcat.

Hematologic and serum chemistry values were determined for 20 adult captive European wildcats (Felis silvestris) in Lleida (Catalonia, Spain). Seven wildcats (4 females and 3 males) were captured in the wild and 13 (4 females and 9 males) were born and raised in captivity. Samples were collected between September and December from 1993 to 1998. Blood was obtained by jugular venipuncture after administration of either ketamine and xylazine or ketamine and medetomidine. Females had significantly higher mean eosinophil counts, albumin concentration, (and A/G ratio) and lower mature neutrophil counts, although these differences were not clinically relevant. Results for many of the blood parameters fall within the reference range for domestic cats. Mean values for alanine aminotransferase, aspartate aminotransferase, creatine phosphokinase, and lactate dehydrogenase activities as well as blood urea nitrogen, glucose, and sodium concentrations were higher than the upper limit of the reference range for domestic cats.

Animals↗
PubMed2000

Preliminary evaluation of medical outcomes (including quality of life) and costs in incident RA cases receiving hospital-based multidisciplinary management.

A six-month, prospective descriptive study of medical outcomes (including quality of life) and costs was conducted in 20 incident cases of rheumatoid arthritis (RA). Multidisciplinary management was started during an inpatient stay at the beginning of the study. Patients were evaluated on a day-hospital basis three and six months later. The following parameters were studied: quality-of-life scores on a generic scale (the Nottingham Health Profile [NHP]) and two specific scales (Health Assessment Questionnaire [HAQ] and the short-form Arthritis Impact Measurement Scale [AIMS]), pain severity, disease activity assessed by the patient and physician, painful and swollen joint counts, erythrocyte sedimentation rate, and C-reactive protein level. The following costs were evaluated: laboratory tests, plain radiographs, other investigations, physician care (by rheumatologists or other specialists), second-line drug therapy and monitoring for its side effects, care by nurses, physical therapy, and occupational therapy. All patients showed significant improvement three months after initiation of multidisciplinary management. This effect was sustained through the sixth month. Quality-of-life scores improved, with the exceptions of the social isolation subscore on the NHP and the psychological impact, social activity, and occupational activity subscores on the short-form AIMS. Mean total cost for the six-month period was 3429 +/- 880 euros (1 euro = 6.6 FF). Laboratory tests contributed the largest portion of the total cost (39%), followed by rheumatologist care (16%); the other costs accounted for 7.6 to 9.2% of the total cost. This prospective medical and economic study is preliminary. Comparative studies are needed.

Arthritis, Rheumatoid↗