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Biomedical subjects

J Rodríguez

Publications and source records attributed to J Rodríguez.

At least 271 records · Page 15Linked to original sources
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Clinical significance of cathepsin D concentration in tumor cytosol of primary breast cancer.

BACKGROUND: Cathepsin D is the proteolytic enzyme most frequently implicated as a prognostic factor in primary breast cancer. In the present study we evaluated by means of an immunoradiometric assay the tumor content of this protease in primary breast cancer, its relationship with tumor-related clinical and pathological parameters, and its prognostic significance in a large series of breast cancer patients. METHOD: The study comprised 1033 women with histologically established invasive breast cancer. Cathepsin D was measured in cytosol samples by means of an immunoradiometric assay to determine the total amount of cathepsin D (52 kDa, 48 kDa and 34 kDa). Evaluation of relapse-free survival and cause-specific survival was performed in the group of 1003 patients without evidence of metastasis at the time of initial diagnosis. The median follow-up of the patients who were free of recurrence was 54 months. RESULTS: Cathepsin D levels showed a wide range among the studied tumors (n = 1033; median (range) 41 (0.9-2504) pmol/mg protein). Statistical analysis showed that the median cathepsin D levels were considerably higher in large tumors (T2-4) than in smaller ones (T1) (p = 0.017), as well as in node-positive than in node-negative tumors (p = 0.004). Cathepsin D levels were also higher in ductal tumors than in the other histological types (p = 0.001), as well as in moderately or poorly differentiated tumors (p < 0.001). Likewise, the median value of the protease was significantly higher in ER or PgR-positive tumors than in hormone receptor-negative ones (p = 0.011 and p = 0.004, respectively), as well as in aneuploid tumors than in diploid tumors (p = 0.029). Multivariate analysis demonstrated that elevated cathepsin D levels (> 59 pmol/mg protein) were notably associated with a shorter cause-specific survival in the whole group of patients with breast cancer, as well as in the subgroup of node-positive patients (p < 0.05). CONCLUSIONS: This study suggests that elevated intratumoral cathepsin D levels may identify a subset of node-positive breast cancer patients showing a high probability of earlier death.

Adult↗
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Focal pulmonary uptake of gallium-67 due to radiation pneumonitis: the case for a misdiagnosis of Hodgkin's disease progression.

Gallium-67 scan is usually performed in patients with Hodgkin's disease and high-grade non-Hodgkin lymphoma for evaluation of disease status after treatment. We present a case of an asymptomatic woman in complete remission of Hodgkin's disease after treatment with chemotherapy and radiotherapy where a focal uptake of Gallium-67 was discovered two months after finishing treatment. As classical radiation pneumonitis can appear one to three months after finishing radiotherapy and normally has an asymptomatic course, this possibility should be considered in these cases, especially when prior chemotherapy was administered.

Adult↗
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Effect of bacterial antigen lysate on IgG and IgA levels in children with recurrent infections and hypogammaglobulinemia.

To evaluate the effect of bacterial antigen lysate on serum immunoglobulin (Ig) levels, we studied 14 children with recurrent infections and hypogammaglobulinemia (IgG and IgA levels below 2 standard deviations for age). Patients were treated for a 60-90 day period with OM-85 BV and reevaluated both clinically and by measuring serum Ig levels at the end of follow-up. The control group consisted of 10 children with recurrent infections who received a placebo. Serum Ig levels were also compared with the reference values for age. The Wilcoxon and Mann-Whitney tests were used for statistical analysis. In the study group, IgG (pretreatment: 707 mg/dl; post-treatment: 1,022 mg/dl; p < 0.004) and IgA levels (pretreatment: 41 mg/dl; post-treatment: 83 mg/dl; p < 0.018) increased significantly. Furthermore, 13/14 children reached normal IgG levels, and 12/14 children reached normal age levels for serum IgA. Similarly, when comparing the pre- and post-treatment levels in the study group with the levels in the control group, they were significant for IgG (p < 0.002) as well as IgA levels (p < 0.04). The overall clinical response was favorable in all patients in the treated group. These results suggest an immunostimulant effect of OM-85 BV, both improving Ig levels and reducing recurrent infections.

Adjuvants, Immunologic↗
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[Serum pro-oxidant and antioxidant factors and risk of Parkinson's disease: population study].

INTRODUCTION: Several studies suggested a role of 'oxidative stress' (increased production of prooxidants, antioxidants deficiencies or both) in the pathogenesis of Parkinson's disease. In this study we have measured the serum levels of a number of prooxidant and antioxidant substances to evaluate their possible relation with the risk for Parkinson's disease. PATIENTS AND METHODS: We assessed the serum levels of iron, ferritin, ansferrin, ceruloplasmine, vitamin A, alpha-carotene, beta-carotene, and alpha-tocopherol, in 28 patients with Parkinson's disease and 85 matched controls. All of them were recruited from a population study. RESULTS: None of the values studied differed significantly between the two study groups, and none of them were correlated with age at onset, duration of the disease, scores of the Unified Parkinson Disease Rating Scale or the Hoehn and Yahr staging in the Parkinson's disease group. CONCLUSIONS: These results confirm the previous findings of classic case-control studies, suggesting the absence of relationship of the studied values with the risk for Parkinson's disease.

Age of Onset↗
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Suicide, adolescents and Puerto Rico.

Suicide is a multifactoral phenomena. This article reviews the recent literature and attempts to identify those factors which have particular relevance for Puerto Rican adolescents. Risk factors that correlate highly with the Puerto Rican experience include homosexuality, due to the hostility that the person may experience, depression, gender, prevalence of psychiatric disorders, lack of social integration and social skills, military experience, cultural and religious factors, alcoholism, substance abuse and unemployment/poverty. The literature reviewed indicates that the Puerto Rican adolescent male is in a high risk group for suicide and that the risk increases with age, sexual preference, dysfunction in the family and substance abuse.

Adaptation, Psychological↗
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Adolescent suicide: a review of the literature.

This article reviews the literature on the risk factors related to teen suicide in the United States and Puerto Rico. Findings indicate the interplay of multifactors including depression, homosexuality--due to the hostility that is often experienced by the person--, sexual abuse, lack of coping, social and problem-solving skills stemming from family dysfunction, feelings of isolation and helplessness, contagion, gender differences, alcohol and drug abuse, psychiatric disorders, biological factors, as well as natural disasters. Included in this report are some statistics on the prevalence of suicide among teens and in the military.

Adaptation, Psychological↗
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[Use of procholinergics in the prevention of postoperative delirium in hip fracture surgery in the elderly. A randomized controlled trial].

INTRODUCTION: 40 to 50% of elderly with hip fracture present delirium. The morbimortality increase in patients whose presented delirium. OBJECTIVE: To study the use of citicoline (CDP choline) in the prevention of delirium in elderly under hip fracture surgery. PATIENTS AND METHODS: A randomized control trial. The patients with hip fracture without dementia or an other organic brain illness. The medication were administered 24 hours before and during 4 days after surgery. The doses was 1.2 g/day. The primary outcome measure was percentage of patients with delirium measured with Abbreviated Mental Test (AMT) and Confusion Assessment Method (CAM). The Mini Mental State (MMS) was used before and 4 days after surgery. All treatment comparation was considered statistically significant at p< 0.05 calculating chi square and Wilcoxon test. RESULTS: The sample size was 81 patients (46 placebo and 35 citicoline). The mean age was 79.45 for tested group and 79.97 for placebo. There was no statistically significant difference between groups with respect to ASA class of anesthesia. The incidence of delirium was 17.39% in placebo and 11.76% in citicoline group (p= 0.6). CAM and AMT at 1, 2, 3, 4 days post surgery was not significant in placebo and citicoline group (p= 0.8 and p= 0.34). CONCLUSION: In the present study the citicoline did not prevent or reduce the incidence of delirium in hip fracture surgery in elderly.

Aged↗
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[Acute pancreatitis. The classification of its severity by dynamic pancreatography and the results of surgical treatment].

In acute pancreatitis determination of glandular necrosis has been difficult because of the lack of an objective method; with dynamic enhanced tomography (bolus injection of contrast media) we have reasonably classify 28 patients with acute pancreatitis. With this technique 5 grades of sequelae of acute pancreatitis are identified: I. Non complicated acute pancreatitis; II. pancreatic abscess: III. peripancreatic necrosis; IV. less than 50% pancreatic necrosis and V. more than 50% pancreatic necrosis. A 100% correlation was found between tomography and surgical findings. This is the first report in Mexico of this method to identify pancreatic or peripancreatic necrosis; we also present the surgical results with a programmed pancreatic debridation; mortality has decreased form 80 to 31.9% in our hospital in recent years.

Acute Disease↗
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[Primary adenocarcinoma of the duodenum: a report of 2 cases and a review of the world literature].

We presented two cases of adenocarcinoma of the duodenum diagnosed at the Gastroenterology Unit of the General Hospital of Lidice Dr. Jesús Yerena and reviewed retrospectively the pathology cases from 1980-1990. We review the world literature and found that the most common clinical presentation was as obstructive type. In our cases perforation and jaundice were the presentation.

Adenocarcinoma↗
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[Topiramate therapy in patients with refractory epilepsy].

AIMS: The purpose of this study was to examine the result of administrating topiramate (TPM) to patients with epilepsy that is refractory to treatment with two or more antiepileptic agents. PATIENTS AND METHODS: A total of 50 patients were evaluated, 90% of which had partial seizures (simple partial, complex partial and partial with secondary generalisation) and the remaining 10% suffered from generalised seizures. The most frequent aetiology was that which corresponded to the symptoms (52% of the cases). 98% of the patients were treated with two or three drugs. TPM was added with a dosage interval between 75 and 550 mg and follow-up visits were carried out throughout a period of nine months. RESULTS: 12 patients remained seizure-free for at least the first three months of the study; in 20 patients the number of seizures decreased by 50% or more; in 14 patients no changes were observed, and in the other four there was an increase in the number of seizures. The best results were obtained in cases of seizures with an idiopathic aetiology, while complex partial seizures offered the worst results. We also analysed the factors that might exert an influence on the different degrees of response. CONCLUSIONS: TPM was effective in all kinds of seizures. 24% of the patients became seizure free, and the total percentage of respondents rose to 64%. No patients dropped out of the study because of intolerance to the drugs.

Adolescent↗
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[Sciatic nerve block by the lateral route at the level of the popliteal fossa with 0.75% ropivacine: advantages of a more proximal approach].

OBJECTIVES: To assess the efficacy of a sciatic nerve block using a lateral approach 11 cm cephalad to the lateral femoral epicondyle for providing surgical anesthesia and postoperative analgesia in scheduled foot surgery (hallux valgus) after a single injection of 30 mL of 0.75% ropivacaine. METHODS: A block was performed in 30 patients using a point of puncture 11 cm cephalad to the most prominent point of the lateral femoral epicondyle in the groove between the biceps femoris and vastus lateralis muscles. Once the nerve had been located with a stimulator (2 Hz, 0.5 mA), 30 mL of 0.75% ropivacaine was injected. Data recorded were time until block, number of attempts, depth at which the nerve was found, sciatic nerve response obtained, and time until the sensory block was complete. We evaluated quality of anesthesia during surgery, duration of postoperative analgesia, and patient discomfort during performance of the block. RESULTS: Time required to perform the block was 4.3 +/- 1.2 minutes and only one puncture attempt was needed in 27 patients. The nerve was located at 5.5 +/- 0.4 cm, with response located in the common peroneal nerve in 18 patients and in the posterior tibial nerve in 12. The time needed to achieve a full sensory block was 19.3 +/- 5.1 minutes. Twenty-six patients (86%) were very satisfied with the anesthetic quality of the block, 2 were moderately satisfied, and 2 were dissatisfied. Postoperative analgesia lasted 19 +/- 3.4 hours. Four patients reported minimal discomfort during performance of the block. No complications were observed. CONCLUSIONS: The sciatic nerve block from a lateral approach 11 cm cephalad to the lateral femoral epidondyle is an appropriate anesthetic technique for foot surgery. It is safe, effective and easy to perform. Infusion of 30 mL of 0.75% ropivacaine provided adequate anesthesia and long-lasting postoperative analgesia for our patients.

Adult↗
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[Hemodynamic effects of levosimendan following cardiac surgery].

The hemodynamic effect of levosimendan was compared to that of dobutamine in a trial enrolling 30 adults undergoing scheduled cardiac surgery with cardiopulmonary bypass. Fifteen patients were randomly assigned to receive levosimendan in a single dose of 18 microg x kg(-1) followed in 15 to 20 minutes by start of infusion at a rate of 0.2 microg x kg(-1) min(-1) for 24 hours (levosimendan group). Another 15 randomized patients received dobutamine infused at a rate of 7.5 microg x kg(-1) min(-1). Hemodynamic parameters were measured before starting infusion of the drug and after 24 hours of treatment. Changes in the main hemodynamic parameters were as follows. In the levosimendan group heart rate (beats/min) was 87.15 (SD 10.22) at baseline and 87.91 (6.00) at 24 hours; mean arterial pressure (mm Hg) was 83.96 (10.57) at baseline and 86.41 (13.29) after 24 hours; cardiac index (L/min/m2) was 2.21 (0.23) at baseline and 2.53 (0.35) at 24 hours; systemic vascular resistance (dyn/sec(-1)/cm(-5)) was 1436.74 (311.48) at baseline and 1378.35 (320.68) at 24 hours. In the dobutamine group heart rate (beats/min) was 84.28 (2.18) at baseline and 96.02 (9.10) after 24 hours; mean arterial pressure (mm Hg) was 83.59 (9.05) at baseline and 74.29 (6.33) at 24 hours; cardiac index (L/min/m2) was 2.16 (0.28) at baseline and) 3.02 (0.34) at 24 hours; systemic vascular resistance (dyn/sec(-1)/cm(-5)) was 1578.93 (334.88) at baseline and 1136.68 (158.60) at 24 hours. We found that mean arterial pressure and both systemic and pulmonary vascular resistance decreased significantly in the levosimendan group (P < 0.05), but not in the dobutamine group. On the other hand, both heart rate and cardiac index increased in the levosimendan group only (P < 0.05). We conclude that levosimendan improves hemodynamic stability in patients who have undergone cardiac surgery and that it is a good alternative for treating postoperative low cardiac output syndrome.

Adult↗
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[Deferred repair of surgical ureteral lesions].

Our experience in surgical injuries of the ureter, as well as the therapeutic approach followed to repair them as expounded in this paper. Immediate nephrostomy following diagnosis, and restoration deferred a minimum of three weeks have provided good results, as well as it has allowed us to detect and achieve spontaneous restoration in one case. These reasons, together with the absence of technical difficulties during the second intervention, invite us to consider the reevaluation and deferred restoration--if appropriate--of the surgical ureteral injuries as a therapeutic approach from which a number of patients can profit.

Female↗
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[The clinical features of myocardial infarct via "normal" coronary angiography. The experience of the Instituto Nacional de Cardiología].

The end-point of our study was to find clinical differences between patients with myocardial infarction and evident obstructions in coronary angiography, and patients without coronary obstructions. In a 10 years follow-up period, 48 patients with diagnosis of myocardial infarction and normal coronary arteries by angiography (group A) where admitted al hospital. We compared this group with 80 patients (group B), randomly selected from all patients with myocardial infarction and evident obstructions in coronarography. Patient age at the ischemic event, familiar history of ischemic heart disease or sudden death, obesity, drug habits, contraception drugs use, and history of migraine and Raynaud's phenomenon were pointed out. Thirty patients from group A were admitted with acute myocardial infarction, and we also analysed in these patients prodromal symptoms, precipitating factors, AMI localisation, serum enzymatic levels, rhythm and/or conduction disturbances, clinical condition, treatment and new ischemic events. Group A patients showed lower age-average, smoking habit, prodromal symptoms and serum CPK levels. They have better ventricular performance parameters and a greater incidence of women. The only different risk factor for ischemic heart disease between both groups was smoking.

Age Factors↗
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[Pubo-vaginal percutaneous suspension by the Gittes technique for stress incontinence. Initial experience].

The paper presents our initial experience with endoscopic suspension of the vesical neck, as per the modification introduced by Gittes and based on incorporation through the vaginal mucosa of non-absorbable single-filament sutures. In this way it is feasible to use a simple non-incisive vaginal surgery with minimum morbidity. Good results have been obtained so far in six of the seven patients operated on. No complications have presented following tube retrieval on the second day. It is our belief that these initial results can be a reasonable basis to a wider use of this technique and to know its long-term results in treating stress incontinency through urethral hypermobility.

Endoscopy↗