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Biomedical subjects

M Roca

Publications and source records attributed to M Roca.

At least 73 records · Page 4Linked to original sources
PubMed1992

Intracavitary oxytetracycline in malignant pericardial tamponade.

We started a treatment trial for malignant pericardial tamponade with intracavitary oxytetracycline, 500-1,000 mg/day, administered via an indwelling pericardial cannula after extraction of as much pericardial fluid as possible. This procedure was repeated every 24 h for 6 consecutive days or until no more fluid could be drained. Eleven consecutive patients were entered in the study. The responses were obtained by clinical examination, chest roentgenogram and echocardiogram, prior to and after treatment. The primary cancer was located in the breast in 7 patients, in the stomach in 2 patients, and in the lung in 2 patients. In all cases, systemic chemotherapy or hormonal therapy was started after the pericardial tamponade was cured. The mean tetracycline dose per patient was 3,000 mg (range 1,500-6,000). All patients responded to the treatment with rapidly improving symptoms. Response persisted during a median of 9 months coinciding roughly with the median survival because all patients died because of progression of the neoplasm at sites other than the pericardium with no evidence of pericardial relapse. The main concomitant effects were mild local pain during tetracycline instillation in 4 patients, and transient fever (less than 39 degrees C) in 3. These data suggest that intracavitary oxytetracycline is perhaps less toxic and similar by successful as tetracycline hydrochloride in malignant pericardial tamponade.

Adult↗
PubMed1992

[Endoscopic cytology in the diagnosis of carcinoma of Vater's ampulla].

An endoscopic cytology procedure was performed in 25 patients with a final diagnosis of carcinoma of the ampulla of Vater. A diagnosis of malignancy was made cytologically in 22 instances, and in 9 patients cytology was the only positive finding before operation. In two cases endoscopic biopsy was positive while the cytologic examination did not confirm the histological diagnosis.

Aged↗
PubMed1992

[Pernicious anemias with subtle or atypical presentation].

PURPOSE: To assess the prevalence and clinico-biologic characteristics of pernicious anaemia (PA) showing subtle or atypical onset. MATERIAL AND METHODS: One-hundred and twenty-four patients were found to fulfill criteria for PA (serum vitamin B12 deficiency due to absence of intrinsic factor secretion because of severe gastric atrophy). Of them were disclosed those lacking macrocytosis (MCV less than 98 fL), with or without anaemia (Hb less than 120 g/L in women and less than 14 f/L in men), but showing decreased serum B12 rates (less than 150 pmol/L). RESULTS: Macrocytosis was absent in 15 out of the 124 cases (12.1%); either they had anaemia or not, serum B12 rates were decreased in all cases. Eight patients had concurrent iron deficiency, one had secondary anaemia, two had polycythaemia and four were normal from a haematological standpoint. Serum B12 assays were performed because of neuropsychiatric impairment (2 cases), polycythaemia study (3 cases), or positive anti-parietal cell antibodies found in an immunologic study (4 cases). The remaining patients were studied for chronic atrophy of the gastric mucosa (2 cases), and Plummer-Vinson syndrome, leucopenia and nutritional assessment (1 case of each condition). CONCLUSIONS: Atypical presentation of pernicious anaemia, whose frequency is probably underestimated, was confirmed in our environment. This condition must be suspected and ruled out in patients with characteristics similar to those described above.

Anemia, Hypochromic↗
PubMed1991

Granulocyte-specific monoclonal antibody technetium-99m-BW 250/183 and indium-111 oxine-labelled leucocyte scintigraphy in inflammatory bowel disease.

Thirty-three patients suspected of suffering from inflammatory bowel disease were studied. Autologous leucocytes were labelled with indium 111 oxine and re-injected simultaneously with 0.3-0.5 mg of technetium 99m granulocyte-specific monoclonal antibody BW 250/183. Two scans were obtained, the early scan 3-4 h postinjection (p.i.) and the late scan 18-24 h p.i. Using the endoscopy study as standard, the diagnostic accuracy of both agents was determined. Sensitivity, specificity and accuracy of 111In scans was 88.8%, 100.0% and 93.7% at 4 h and 94.7%, 100.0% and 96.9% at 24 h, respectively. Concerning the results using antibodies, the values were 61.1%, 100.0% and 78.1% at 4 h and 78.9%, 92.8% and 84.8% at 24 h, respectively. Segmental analysis showed concordance in 89.3% and 93.3% of the cases at 4 and 24 h, respectively. Though less sensitive and less accurate than scanning employing indium 111 leucocytes, BW 250/183 granulocyte-specific scintigraphy can be used for inflammatory bowel disease diagnosis and localization.

Adult↗
PubMed1991

Gastric emptying of two radiolabelled antacids.

The rate of gastric emptying of two antacids, magaldrate and Maalox, was investigated using scintigraphy. Successful labelling of the antacids was carried out with 99mTc. The stability of the 99mTc-labelled antacids was satisfactory and there was no difference in antacid capacity between the labelled and unlabelled antacids. The studies were carried out on 15 healthy male volunteers. After an eight hour fast each subject ingested a standardised meal of 95.7 MJ (400 kcal). One hour later 10 ml of one of the two antacids previously labelled with 99mTc was administered. Serial detection by anterior and posterior projection of the amount of antacid retained in the stomach was performed to determine gastric emptying of antacid. One week later the study was repeated under the same conditions with the other antacid also labelled with 99mTc. The mean (SD) percentages of antacid retained in the stomach fit a linear model with a t1/2 of 86.6 (15.3) minutes for magaldrate and 52.3 (5.2) minutes for Maalox (p less than 0.01). When the mean percentages of retention at six time intervals were compared for both antacids, it was found that Maalox emptied much faster (p less than 0.01 at 15 and 30 minutes, p less than 0.02 at 45, 60, 75, and 90 minutes).

Adult↗
PubMed1991

Acute effects of abdominopelvic irradiation on the orocecal transit time: its relation to clinical symptoms, and bile salt and lactose malabsorption.

Twenty-five patients with abdominopelvic malignant tumors receiving irradiation were studied. The following items were assessed before, during, and at the end of the radiation period: 1) clinical symptoms, scored on the basis of their severity; 2) orocecal transit time (lactulose-H2 breath test); and 3) absorption of lactose and bile salts. Ninety-two percent of the patients showed clinical symptoms suggestive of acute radiation enteropathy, mainly diarrhea. A significant acceleration of the orocecal transit was observed during the study: 70 +/- 6.9 min vs 63.3 +/- 6.3 min vs 44.3 +/- 5.1 min (F = 5.49, p = 0.008), being faster in patients with severe diarrhea (F = 3.25, p = 0.05). Forty-four percent and 57% of the patients developed lactose and bile salt malabsorption, respectively. A decrease in the transit time was observed, independent of the absorption or malabsorption of such substances. However, the orocecal transit was faster in those lactose malabsorbers with severe diarrhea, than in those with mild diarrhea (F = 4.2, p = 0.03). The results suggest that acceleration of orocecal transit may be a major factor in the pathophysiology of radiation-induced diarrhea, whereas lactose malabsorption may contribute to the severity of the diarrhea.

Abdominal Neoplasms↗
PubMed1989

[Gammagraphy with 111In-labelled leukocytes in an acute outbreak of inflammatory intestinal disease. Evaluation of the localization, extension and degree of activity].

We have studied 59 patients suspected of presenting an acute bout of inflammatory bowel disease: 23 had Crohn's disease and 36 had ulcerative colitis. All them underwent scintigraphic examination using 111In labelled leukocytes during the first 72 hours after their admittance and in a period no longer than 30 days, they also underwent barium enema and/or endoscopic study. Scintigraphic examination was more sensitive (100%), specific (100%) and accurate (100%) than endoscopy (72%, 100% and 78%) and barium enema (69%, 80% and 71%) in Crohn's disease. In ulcerative colitis, although endoscopy (100%) was slightly more sensitive than scintigraphy (100% and 94% against 78% and 93%). Reliability of barium enema was always lower to that of scintigraphy. In both conditions, scintigraphic examination detected a higher number of affected segments than barium enema did (40/16 in Crohn's disease and 65/31 in ulcerative colitis). Correlation between the index of scintigraphic activity and Harvey's index of clinical and biologic activity was highly significant (p less than 0.001) in both diseases. We conclude that scintigraphic examination using 111In labelled leukocytes is a reliable examination method for evaluation of localization, extension, and degree of activity of inflammatory bowel disease and that it must be a part of the examination protocol.

Acute Disease↗
PubMed1989

[Study of thyroid function parameters and thyrotropin in general non-thyroid diseases].

The changes in the parameters of thyroid function and thyrotropin (TSH) have been evaluated in 5 groups of patients with general non-thyroid disease (GNTD): acute severe bacterial infection (16 patients), acute myocardial infarction (22 patients), diabetic ketoacidosis (24 patients), non-ketotic hyperosmolar decompensation (8 patients), protein-calorie undernutrition (12 patients), without associated conditions or drug therapies that might have modified the thyroid hormones. These patients were evaluated at the beginning of their GNTD and after recovery. Thyroxine (T4), triiodothyronine (T3) and reverse T3 (rT3) were measured by radioimmunoassay (RIA), the TBC index by competitive analysis, the free T4 by a labeled T4 analogue and T4 by immunoradiometric analysis (IRMA). In all patients similar changes in thyroid hormones and in IRMA were found, and they returned to normal after recovery; the changes were most marked in diabetic ketoacidosis, followed by hyperosmolar decompensation and by undernutrition. When the 5 groups were evaluated together, T3 was the most commonly low value (57.3%), followed by T4 and TBC index (26.8%), free T4 (20.7%) and the free T4 index (10.9%). The level of rT3 was increased in 39% of cases. Baseline TSH was, initially, 1.05 +/- 1.05 microU/ml, and 1.36 +/- 0.85 microU/ml after recovery (p less than 0.001). It was only found to be suppressed in one patient (a female with diabetes mellitus and Graves disease); in 17 cases it had borderline values between 0.1 and 0.4 microU/ml, and in the remaining patients it was normal. GNTD induces profound changes in the thyroid functional parameters, with reductions below their normal range, including the analogue measured T4 and low TSH.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗