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Biomedical subjects

J Ramon

Publications and source records attributed to J Ramon.

At least 37 records · Page 2Linked to original sources

Bicalutamide (Casodex) 150 mg as immediate therapy in patients with localized or locally advanced prostate cancer significantly reduces the risk of disease progression.

OBJECTIVES: To investigate the efficacy and tolerability of bicalutamide (Casodex) as immediate therapy, either alone or as adjuvant to treatment of curative intent, in patients with localized or locally advanced (T1b-T4, any nodal status, M0) prostate cancer. METHODS: This was a multicenter, prospective, randomized, double-blind, placebo-controlled trial in Europe, South Africa, Australia, and Mexico and is part of the Casodex Early Prostate Cancer program. RESULTS: A total of 3603 men were randomized to receive bicalutamide (n = 1798) or placebo (n = 1805). The patient demographics were well balanced between the two groups. Prior therapy of curative intent had been given to 64% of the patients (prostatectomy [44%], radiotherapy [18%], and prostatectomy and radiotherapy [2%]) and 36% had been monitored with watchful waiting. After a median follow-up of 2.6 years and a median exposure to the study drug of 2.2 years, a significant 43% reduction in the risk of objective progression was observed for the bicalutamide group compared with the placebo group (hazard ratio 0.57, 95% confidence interval 0.48 to 0.69, P << 0.0001). The time to prostate-specific antigen doubling was significantly delayed for the bicalutamide group compared with the placebo group (hazard ratio 0.37, 95% confidence interval 0.32 to 0.43, P << 0.001). The survival data were immature, with 7.2% overall mortality. The most frequently reported adverse events with bicalutamide were gynecomastia alone (17.4%), breast pain alone (17.6%), and gynecomastia with breast pain (47.5%). CONCLUSIONS: Bicalutamide 150 mg daily as immediate therapy, alone or as adjuvant to treatment of curative intent, significantly reduced the risk of disease progression in patients with localized or locally advanced prostate cancer. Longer follow-up is underway to assess any benefit in overall survival.

Adult↗

The effect of Escherichia coli heat-stable toxin on the trans-epithelial intestinal elimination of ciprofloxacin in the rabbit.

The effect of Escherichia coli heat-stable toxin (ST) on the intestinal trans-epithelial elimination of ciprofloxacin was studied in the rabbit model. Following a systemic 27 mg/kg dose, excreted amounts of ciprofloxacin during the 2 h experiment were: 9.3 (+/- 4.8); 12.5 (+/- 5.2) and 0.3 (+/- 0.1) microg/cm(2) surface of intestinal wall in ST-challenged jejunal, ileal and caecal loops, respectively. In control loops the corresponding amounts were: 5.0 (+/- 2.8), 6.5 (+/- 3.4) and 0.3 (+/- 0.1) microg/cm(2), respectively. The trans-epithelial elimination of ciprofloxacin was significantly higher in ST-challenged small bowel loops than in controls while caecal elimination was negligible.

Animals↗

[Nephrogenic adenoma--benign lesion of urinary tract system].

Nephrogenic adenoma is a rare metaplastic benign lesion of the urinary tract caused by chronic irritation to the urinary epithelium. The appearance of this lesion is usually characterized by hematuria and irritative symptoms. Nephrogenic adenoma may be found most commonly in the bladder and the urethra and less frequently in the renal pelvis and ureters. We present 5 patients who underwent surgery due to bladder or urethral nephrogenic adenoma. Despite the fact that nephrogenic adenoma is a benign lesion, long term follow-up is needed due to the high recurrence rate and the potential, though rare, malignant transformation.

Adenoma↗

Extensive necrosis in renal cell carcinoma specimens: potential clinical and prognostic implications.

BACKGROUND: Extensive necrosis is rare in primary renal cell carcinoma. This finding may reflect the biological characteristics of the carcinoma and therefore could be of prognostic and clinical value. OBJECTIVES: To assess the incidence of necrosis in renal cell carcinoma and its potential prognostic value. METHODS: We conducted a consecutive retrospective study of 173 patients after radical nephrectomy for renal cell carcinoma. Clinical and pathological data were collected from hospital medical records and compiled into a computerized database. RESULTS: Extensive necrosis was found in 31 tumor specimens (17.9%). Univariate analysis showed that the specimens with extensive necrosis were significantly larger and manifested more perirenal and venous extension than the tumors without necrosis. The size of the renal tumor was the only parameter that remained significant in multivariate analysis (P = 0.0001). Overall disease-free survival did not differ significantly between patients with necrotic tumors and those without (68% and 66% respectively). CONCLUSIONS: The finding of extensive necrosis in renal cell carcinoma specimens does not seem to be related to tumor biology but rather may reflect the relation between size and vascularity of the tumor.

Adult↗

WISH-PC2: a unique xenograft model of human prostatic small cell carcinoma.

Prostatic small cell carcinoma is an aggressive subtype of prostate cancer that usually appears as a progression of the original adenocarcinoma. We describe here the WISH-PC2, a novel neuroendocrine xenograft of small cell carcinoma of the prostate. This xenograft was established from a poorly differentiated prostate adenocarcinoma and is serially transplanted in immune-compromised mice where it grows within the prostate, liver, and bone, inducing osteolytic lesions with foci of osteoblastic activity. It secretes to the mouse Chromogranin A and expresses prostate plasma carcinoma tumor antigen-1, six-transmembrane epithelial antigen of the prostate, and members of the Erb-B receptor family. It does not express prostate-specific antigen, prostate stem cell antigen, prostate-specific membrane antigen, and androgen receptor, and it grows independently of androgen. Altogether, WISH-PC2 provides an unlimited source in which to study the involvement of neuroendocrine cells in the progression of prostatic adenocarcinoma and can serve as a novel model for the testing of new therapeutic strategies for prostatic small cell carcinoma.

Adenocarcinoma↗

Is only meatoplasty a legitimate surgical solution for extreme distal hypospadias? A long-term follow-up after adolescence.

OBJECTIVE: To review the long-term outcome of glanular hypospadias repair for extreme distal hypospadias based on simple dorsal Browne meatoplasty and circumcision, with particular attention to patient satisfaction. PATIENTS AND METHODS: A review of medical records identified 124 patients who underwent surgery for hypospadias between 1970 and 1979. Their age at operation ranged from 3 months to 13 years. The operation, performed as a day-case, included dorsal Browne meatoplasty for meatal advancement, based upon the Heineke-Mikulicz principle, using three absorbable sutures and often circumcision. There were no immediate complications. A questionnaire was sent to 111 patients whose present address was available. Two patients had died since the operation and of the 109 remaining patients, 43 (39%) replied. RESULTS: The patients were aged 16-31 years at the time of assessment, giving a follow-up of 18 (13-23) years. Seven of the 43 patients were married. Seven patients had complained of some difficulties with urination, four reporting a poor urinary flow. The stream was directed forward in 32 patients and to some degree downwards in 11, still enabling all the patients to urinate while standing with a single stream. Thirty-two patients had had sexual experience, with no functional problems. Twenty-three defined their penile appearance as normal and 20 as abnormal. Overall, 24 (56%) reported complete satisfaction, 11 (25%) partial satisfaction and eight (19%) were dissatisfied with the surgical result. CONCLUSION: As there are few published reports about the long-term outcome and patient satisfaction after hypospadias repair, it is difficult to draw clear conclusions. However, this simple procedure is a legitimate surgical option for extremely distal glanular hypospadias.

Adolescent↗

Trans-epithelial intestinal elimination of moxifloxacin in rabbits.

The intestinal trans-epithelial elimination of moxifloxacin was measured in the jejunum, ileum, caecum and in the bile in a rabbit model. Over a 120 min period following a single parenteral administration of moxifloxacin 15 mg/kg, peak serum concentration was 3.1 (+/- 1.1) mg/L. The elimination constants were: 0.019 (+/- 0. 017) microg/cm(2)/min, 0.011 (+/- 0.014) microg/cm(2)/min and 0.002 (+/- 0.002) microg/cm(2)/min in the jejunum, ileum and caecum, respectively. Per loop, over 120 min, the respective eliminated quantities were: 9.59 (+/- 9.37) microg, 8.26 (+/- 6.74) microg and 1.92 (+/- 1.86) microg. Biliary moxifloxacin concentrations varied between 1.30 and 5.16 mg/L and exceeded serum levels from 45 min onwards. Intestinal concentrations paralleled serum moxifloxacin levels. Altogether, approximately 4.5% of the moxifloxacin dose was eliminated trans-epithelially in the digestive tract over the 120 min experimental period.

Animals↗

Modification in the inherent mode of allelic replication in lymphocytes of patients suffering from renal cell carcinoma: a novel genetic alteration associated with malignancy.

Using fluorescence in situ hybridization (FISH) to interphase nuclei, we examined the replication timing of 1 allele relative to its counterpart in PHA-stimulated peripheral blood lymphocytes of normal subjects and patients suffering from a solid tumor (renal cell carcinoma). In the FISH assay, an unreplicated DNA sequence is identified by a single dot-like hybridization signal, whereas a replicated region gives rise to a duplicated, bipartite signal. Accordingly, lymphocytes of normal individuals show 2 patterns of allelic replication: (i) synchronized replication of allelic counterparts, as exemplified by the biallelically expressed loci TP53 and D21S55; and (ii) non-synchronized replication of allelic partners, as exemplified by the early and late replicating alleles of GABRB3, an imprinted locus subjected to monoallelic expression. However, when present in lymphocytes of the cancer patients, all 3 loci change their replication mode: alleles of TP53 and D21S55 become asynchronous, whereas the early replicating allele of GABRB3 delays replication, leading to relaxation in the imprinted mode of replication. Based on the tight relationship between temporal order of allelic replication and allelic mode of expression, the modified order of allelic replication observed in nonmalignant cells of individuals diagnosed with cancer represents a novel genetic alteration associated with malignancy. This alteration detected by simple cytogenetic means, applied to peripheral blood lymphocytes, offers a potential test for cancer identification. Genes Chromosomes Cancer 27:270-277, 2000.

Aged↗

Assessment of drug addiction. The experience of the Medico Legal Institute of Oporto.

Since 1993 in Portugal, it is possible, by legal enforcement, to request forensic examination to study possible conditions of drug addiction. On the basis of examinations carried out in the Medico Legal Institute of Oporto, we present a study of 494 cases involving the relation to the demographic data of the examined individuals, their family background, legal situation, age at which drug consumption began, consumption profile at the beginning and at time of forensic examination and our conclusions.

Academies and Institutes↗

[Malignant lymphoma of the bladder].

Urinary tract lymphoma is usually reported when the secondarily stem is affected by widespread non-Hodgkin lymphoma. We describe an 83-year-old woman who presented with secondary lymphoma of the bladder 3 years after diagnosis when it initially infiltrated her breast. Treatment included local transurethral excision followed by chemotherapy, during which she died of disseminated disease.

Aged↗

Traumatic testicular dislocation: a case report and review of published reports.

Testicular dislocation after blunt scrotal trauma is a rare event. Its diagnosis depends on the awareness of the physician of its possible occurrence. It is usually a late finding during treatment of a motorcyclist brought to the emergency room because of multitrauma injury and is sometimes demonstrated in an abdominal computed tomography scan. We describe a typical case and discuss the chain of events leading toward the correct diagnosis and treatment based on a review of published reports.

Adult↗

[Can preoperative urodynamic examination allow us to predict the risk of incontinence after radical prostatectomy?].

OBJECTIVES: To verify whether bladder dysfunction detected by urodynamic studies prior to radical prostatectomy can predict postoperative continence status. MATERIAL AND METHODS: Twenty patients diagnosed with prostate cancer had multichannel subtracted filling and voiding videocystometry before undergoing radical retropubic prostatectomy. Postoperatively, all patients had periodic clinical assessment of continence status. RESULTS: On preoperative filling cystometry, detrusor instability with a maximal detrusor pressure greater than 15 cm H2O was demonstrated in 12/20 patients (60%). Postoperatively, 11/20 patients (55%) were continent, 4 (20%) had mild stress incontinence and 5 (25%) complained of episodic urge incontinence. However, only 5 of the 12 patients with preoperatively diagnosed detrusor instability manifested clinical urge incontinence after surgery (positive predictive value = 41.6%). CONCLUSION: The incidence of preoperative detrusor instability in our series was high, but little correlation was found between this finding and postoperative incontinence.

Aged↗