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Biomedical subjects

J Salvador

Publications and source records attributed to J Salvador.

At least 19 recordsLinked to original sources
PubMed1996

Hypergastrinaemia in Cushing's syndrome: pituitary origin or glucocorticoid-induced?

OBJECTIVES: Several reports have shown an increase in serum gastrin levels in patients with Cushing's syndrome (CS). However, the actual origin of this hypergastrinaemia is not known. Two hypotheses have been proposed: concomitant ACTH and gastrin secretion by corticotrophic pituitary adenomas or hypergastrinaemia induced by hypercortisolism. DESIGN AND PATIENTS: We performed simultaneous, bilateral inferior petrosal sinus (IPS) sampling in nine patients with Cushing's disease (CD), proven by histological studies. In all of them, blood samples were taken from both IPS and a peripheral vein to measure plasma ACTH and serum gastrin. In addition, we measured peripheral serum gastrin levels after an overnight fast in 10 patients with CS (seven with pituitary tumours and three with adrenal tumours) before and after surgical treatment. RESULTS: Petrosal-peripheral and interpetrosal gradients of ACTH were higher than 2.0 and 1.4, respectively, confirming the pituitary origin of ACTH. Mean serum gastrin levels were 149.1 +/- 53.6 ng/l in peripheral vein, 183.4 +/- 71.7 ng/l in dominant IPS and 181.4 +/- 68.9 ng/l in non-dominant IPS. No significant differences in gastrin concentrations in these locations were found. Mean preoperative gastrin level in patients with CD was 194.6 +/- 47.9 ng/l, whereas in patients with adrenal tumours it was 247.3 +/- 125.9 ng/l. After surgical treatment, the gastrin levels decreased to 62.1 +/- 13.2 ng/l (P < 0.05) and 90.3 +/- 50.3 ng/l (NS), respectively. CONCLUSIONS: These results suggest that hypergastrinaemia is a common finding in patients with Cushing's syndrome. The lack of significant petrosal-peripheral gradient in individuals with Cushing's disease and the reduction in gastrin level following adrenal tumour resection argues against the hypothesis of a predominantly pituitary source of gastrin, suggesting a glucocorticoid related mechanism as an explanation for the hypergastrinaemia.

Adenoma↗
PubMed1996

Effect of paclitaxel alone or in combination on the intracellular penetration and activity of quinolones in human neutrophils.

We evaluated the effect of paclitaxel alone or in combination with cisplatin or doxorubicin, on the intracellular penetration and activity of ciprofloxacin, ofloxacin, levofloxacin and sparfloxacin in human polymorphonuclear leukocytes (PMN). In general, paclitaxel either alone or in combination did not affect the intracellular concentrations of the quinolones evaluated (intracellular to extracellular concentration ratio (C/E > 4). However, at high concentrations (20 mg/L) paclitaxel decreased the penetration of ofloxacin and levofloxacin although the C/E ratios remained higher than 3. Paclitaxel alone or in combination affected neither the production of oxygen radicals by PMN nor the intracellular activity of the quinolones against Staphylococcus aureus.

Anti-Infective Agents↗
PubMed1996

Follow-up of the remaining bladder after supravesical urinary diversion.

OBJECTIVES: To review our experience in 14 patients who underwent supravesical urinary diversion maintaining their defunctionalized bladder in situ. METHODS: A variety of pathological entities indicated surgery, including neurogenic bladder, urinary tuberculosis (with severely contracted bladder), interstitial cystitis, and retroperitoneal fibrosis. RESULTS: Global analysis revealed a total of 11 patients (78.5%) who presented complications, the most frequent being mucopurulent and bloody secretions (28.5%), and painful bladder spasms (14.2%), followed by hemorrhage, pyocystis, hypogastric or urethral pain, and sepsis. CONCLUSION: Two patients (14.2%) required hospitalization for treatment of complications. The majority of complications were treated successfully with bladder irrigations and antibiotics. One patient required total cystectomy secondary to pyocystis.

Adult↗
PubMed1996

Cholinergic modulation of spontaneous hypothalamic-pituitary-adrenal activity and its circadian variation in man.

Controversy still exists regarding the role of cholinergic pathways in the regulation of the hypothalamic-pituitary-adrenal axis in man. We studied the effects of the administration of placebo, pyridostigmine (PD); 120 mg, orally), and the combination of PD and pirenzepine (PZP; 100 mg, orally) on ACTH, cortisol, and GH secretion at 0730 and 2230 h in seven normal males. PD induced a clear decrease in ACTH levels at both times of the day compared to treatment with placebo, producing higher suppression in the nocturnal period (34.4 +/- 5.8% vs. 21.8 +/- 10.7%). The combination PD and PZP prevented the inhibitory action of PD on ACTH secretion in the morning, but not in the evening, when ACTH values showed a decrease similar to that seen after giving PD alone (38.1 +/- 5.6% vs. 34.4 +/- 5.8%, respectively). Cortisol values declined only when the association PD plus PZP was given in the evening. GH levels had a significant increase after PD administration in the morning (4.1 +/- 1.2 ng/mL) and in the evening (10.2 +/- 1.6 ng/mL), confirming that cholinergic stimulation was taking place, whereas the addition of PZP to PD induced a significant attenuation of these responses. It is concluded that cholinergic pathways have a inhibitory role in ACTH secretion in man. M1 muscarinic receptors seem to be involved in the diurnal inhibition of PD, whereas our observations are consistent with the mediation of another type of cholinergic receptors as an explanation for the nocturnal effect of PD on ACTH secretion. PD did not alter the circadian variation in the hypothalamic-pituitary-adrenal axis, whereas the association of PD and PZP increased the differences between diurnal and nocturnal ACTH values, suggesting a modulatory effect of the cholinergic system on the circadian rhythm of ACTH secretion.

Adrenocorticotropic Hormone↗
PubMed1996

[Treatment of prostate benign hyperplasia (BPH) with visually controlled laser, assessment at 2 years, and anatomopathologic findings].

The endoscopically-guided lateral discharge laser (VLAP) has been considered an alternative in the management of benign prostate hyperplasia (BPH). The purpose of this paper is to describe the technique, results obtained in 20 treated patients, and pathoanatomical findings in those later treated with prostate transurethral resection. Four patients were carriers of an indwelling catheter, while IPSS/QL mean values in the other 16 patients were 23/4. Mean maximum flow was 7.01 mL/s. Assessment after one and two years shows a fall of mean IPSS/QL to 5/1 and mean maximum flow to 15.2 mL/s and 21 mL/s, respectively, but the difference is not significant. This paper also describes the morbidity affecting 65% patients, which is comparable to the retreatment rate (15%) obtained in other series published. The results are similar to those described in the literature although, in our view, the high rate of complications undermines this choice as an alternative in BPH management.

Aged↗
PubMed1995

Cytogenetic characterization of a familial papillary renal cell carcinoma.

We describe the first case of a familial renal cell carcinoma cytogenetically characterized as a papillary renal cell carcinoma. Cytogenetic and molecular studies were performed on primary renal cell carcinomas and normal kidney tissue from two members of the same family. Both patients showed a normal constitutional karyotype. The two tumors analyzed from the first patient showed the numerical chromosome alterations characteristic of papillary renal cell carcinomas. From the four tumors analyzed in the second patient, three of them presented the cytogenetic pattern of papillary renal cell tumors, and the fourth showed only structural chromosome abnormalities with the presence of a del(7)t(7;7) or dup(7) in all metaphases analyzed. Chromosome 3 was cytogenetically unaffected in all tumors from both patients, and restriction fragment length polymorphism analysis performed with probe pEFD145 (3p21.1-p23) did not detect any loss of heterozygosity.

Adult↗
PubMed1995

Chemotherapy-induced growth hormone deficiency in children with cancer.

BACKGROUND: Chemotherapy (CT) may produce growth impairment, however, the pathogenesis is still unclear. METHODS: A series of 25 patients mean age 13.3 years (6.3-19.8), previously treated for malignant solid tumours with only CT and surgery were studied. Growth hormone (GH) reserve was assessed by two different provocative stimuli (Clonidine and L-Dopa). Mean time between completion of treatment and GH evaluation was 18.5 months (2-74 months). At that time, all patients were in complete remission. RESULTS: GH deficiency (GHD), defined by an impaired GH response to both provocative tests was observed in 11 out of 25 patients (44%). At diagnosis, mean standing height was +0.23 +/- 1.42 SDS in the GHD group (GHD-g) and +0.18 +/- 1.23 SDS in the non-GHD group (n-GHD-g). At the end of therapy, the mean standing height in the GHD-g was -0.31 +/- 1.22 SDS and -0.17 +/- 1.41 in the n-GHD-g, differing from the former group (P = 0.05). For a mean follow-up of 30 months from the end of treatment, the mean standing height was -0.48 +/- 1.23 SDS in the GHD-g and -0.24 +/- 1.51 SDS for the n-GHD-g (P = 0.03). Growth rate at the end of treatment was +0.13 +/- 1.54 in the GHD-g and +0.21 +/- 1.75 in the n-GHD-g. For a mean follow-up of 30 months from the end of treatment, the growth rate was different between GHD-g and n-GHD-g (-0.31 +/- 2.72 vs. -0.21 +/- 1.93, P < 0.05). CONCLUSIONS: 1) Growth impairment in children treated because of malignant diseases has a multifactorial etiology, but CT-induced GH deficiency is one potential adverse factor. 2) An endocrine follow-up should be introduced in order to detect and treat hormonal deficiencies as early as possible.

Adolescent↗
PubMed1993

Effect of antimicrobial and antineoplastic drugs on the uptake of fluconazole by human neutrophils and tissue culture cells.

The effect of eight antimicrobial and three antineoplastic drugs on the uptake of fluconazole by human neutrophils and culture epithelial cells was evaluated. Fluconazole reached higher concentrations intracellularly than extracellularly (cellular to extracellular concentration ratio C/E > or = 1.3) in the presence of therapeutical concentrations of the antimicrobial and antineoplastic agents evaluated.

Anti-Infective Agents↗
PubMed1993

[Intraprostatic prostheses].

Intraprostatic stents appeared as an alternative to surgery in high surgical risk obstructed patients. A critical review of the different types of endoprostatic prostheses is made. Finally we tried to establish the true cost/effectiveness ratio in our country, comparing the temporary prostheses with the indwelling catheter and the permanent prostheses with prostatic surgery.

Humans↗
PubMed1993

[Acute colonic pseudo-obstruction (Ogilvie syndrome) after nephrectomy for renal carcinoma: persistence after decompressive colonoscopy and spontaneous remission].

A 65-year-old male patient presented acute dilatation in the ascendant colon on the third post-operative day following nephrectomy due to renal adenocarcinoma. No changes in colonic diameter were seen after decompressive colonoscopy and, while the patient was asymptomatic, conservative therapy was instituted and the picture was resolved in just a few days. The case is used to review the issue of acute colonic pseudo-obstruction and its relationship to urological operations.

Acute Disease↗
PubMed1993

[Gastrocystoplasty for renal insufficiency in adults].

Vesical substitution or augmentation with various segments from the gut is a frequent occurrence in urology. In the presence of normal renal function there are few or no metabolic disorders. In the presence of renal failure the most suitable gut segment is the stomach due to its characteristics of Cl- and ammonium excretion, smaller mucus formation, acid pH provided to the urine and because it allows easy ureteral regrafting. This article contributes one case of gastrocystoplastia in a patient with trigonal bladder and chronic renal failure, presenting reno-vesical TB.

Humans↗
PubMed1992

Prostatic abscess: diagnosis and treatment.

We present a series of 25 men with prostatic abscesses studied during an 11-year interval in whom prostatic fluctuation upon digital rectal examination was the most characteristic sign. Transrectal ultrasound was the most reliable method for diagnosis and transurethral drainage under antibiotic coverage was the ideal treatment for this disease.

Abscess↗