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Biomedical subjects

R Giner

Publications and source records attributed to R Giner.

11 recordsLinked to original sources
PubMed2003

Incidence and epidemiological factors of hepatocellular carcinoma in Valencia during the year 2000.

AIM: to ascertain the incidence and epidemiological factors of hepatocellular carcinoma in the Province of Valencia, Spain. DESIGN: a prospective study was made of hepatocellular carcinoma during the year 2000 collecting all diagnosed cases from four hospitals during that year. RESULTS: a total of 64 cases of hepatocellular carcinoma with a male predominance (42/22) and a mean age of 73.4 years (range of 42-90) were diagnosed. Incidence rate was 8.2 per 100,000, and cirrhosis was known to pre-exist in most cases, half of which were Child-Pugh A. Anti-VHC positive, alone or alcohol or virus B related was detected in 3 of every 4 cases. In the majority of the cases the tumours were located in the right hepatic lobe and the size at first diagnosis was less than 3 cm in 37.3% of the cases. Alpha-fetoprotein levels only exceeded 200 mg/ml in 37.3% of the patients and bore a good size relation to the tumour (R=0.245, p=0.003. No relation vis-à-vis aetiology with age, sex, tumour location or Child-Pugh stage was found. CONCLUSIONS: the incident rate of hepatocellular carcinoma in Valencia province during 2000 was 8.2 per 100,000 individuals. This lesion appeared more frequently in men between the ages of 60-80. Hepatitis C virus was the main etiologic agent found. Key words: Hepatocellular carcinoma. Incidence. Hepatitis C virus. Epidemiology. Child-Pugh grade. Alpha-fetoprotein.

Adult↗
PubMed2001

[Preoperative embolization in meningioma of the ponto-cerebellar angle. Indications and advantages].

Preoperative embolization of meningiomas has been performed in order to reduce surgical hemorrhage during the removal of these vascularized tumors. In this paper we emphasize the fact that occlusion of the tumoral vessels by artificial emboli produces an ischemic necrosis that greatly helps tumor exeresis. This is especially useful in meningiomas of certain localizations requiring complex surgical approaches. In our case, a giant ponto-cerebellar meningioma was dried up totally and then removed with relative ease through a conventional suboccipítal lateral craniectomy. The technique, indications and control of preoperative embolization are reviewed.

Adult↗
PubMed2001

Cardiological monitoring of sailors via offshore Internet connection.

BACKGROUND: Sailing is becoming increasingly popular as a form of holiday recreation. The purpose of the present study was to profile the heart rate characteristics of non-professional crew members on a Mediterranean sailboat trip. Additionally, the practicability of transferring electronic data via the Internet while sailing offshore was also studied. METHODS: Seven healthy male non-professional crew members responsible for steering and navigating the boat during the observation period were studied using continuous electrocardiographic recording (Holter). Manually measured blood pressure, side effects and sailing data were taped half-hourly. RESULTS: While sailing we observed that the heart rate increased typically into the 120-170 beats/min range, mean arterial pressure remained stable between 80-90 mmHg. Heart rate changes and the incidence of supraventricular arrhythmias correlated with activity on board, boat speed and wind velocity. No subject showed ventricular arrhythmias during sailing. The minimal blood pressure changes correlated only with activity on board. CONCLUSIONS: All these results indicate that sailboating on vacation, even in a non-professional status, does not promote disease-relevant changes in heart rhythm on trips in mild to moderate seas. Additionally, we were able to demonstrate that the online transfer of electronic data via the Internet from a sailboat offshore is possible, easy and inexpensive.

Adult↗
PubMed2000

Effect of triterpenoids on the inflammation induced by protein kinase C activators, neuronally acting irritants and other agents.

In order to establish the mode of the anti-inflammatory activity of triterpenoids, 11 naturally occurring compounds were assayed on mouse ear oedema induced by the protein kinase C activators, mezerein, 12-O-tetradecanoylphorbol-13-acetate (TPA), two 12-deoxyphorbol-13-monoesters (13-tetradecanoate (DPT) and 13-phenylacetate (DPP)) and bryostatin 1, and by resiniferatoxin, xylene and arachidonic acid. The effects on bradykinin-induced paw oedema and on the rat skin inflammation caused by hydrogen peroxide were also examined. The oedema induced by mezerein and DPT was reduced to different extents by the triterpenoids administered epicutaneously (0.5 mg per ear). Against DPT-induced oedema, lupane and oleanane derivatives were the most effective compounds. Oleananes and lupanes possessing a carboxyl group were active against bryostatin 1-induced oedema. Most of the triterpenoids were ineffective against the neurogenic inflammation caused by resiniferatoxin and xylene. Many triterpenoids, especially oleanane and lupane alcoholic derivatives, were active against the plantar oedema induced by bradykinin and on the intradermal inflammation induced by hydrogen peroxide. In conclusion, the anti-inflammatory activity of triterpenoids may depend on inhibition of protein kinase C, without any involvement of neurogenic inflammatory mechanisms.

Animals↗
PubMed1998

Urea reduction ratio considering urea rebound.

An American National Study shows that survival benefits from higher dialysis doses appear to be present up to a Kt/V level of 1.3 or a urea reduction ratio (URR) of 70%. The effect of increasing dialysis efficiency magnified urea rebound and the error in URR determinations. Several formulas have been developed to calculate URR considering the urea rebound (URRr). Smye and coworkers have proposed a method whereby the equilibrated blood urea nitrogen is predicted by additional intradialytic urea sample. Maduell and colleagues, based on analysis of postdialysis urea rebound, have proposed a method whereby the urea rebound is predicted. To compare measured URRr to estimated by Smye and Maduell formulas, 384 patients were studied, 211 males and 173 females, who received a dialysis session with their habitual parameters. Measurements of plasma urea concentration were obtained at the beginning, 90-100 min following the start of dialysis, at the end, and 45 min after dialysis. The postdialysis urea rebound was 22.4+/-9.7%. The urea kinetic model Kt/V was 1.365+/-0.26, and Kt/Vr was 1.14+/-0.23. URR was 68.7+/-6.6%, and when it was calculated with urea rebound, it decreased to 61.9+/-7.4%. The URRr correlated with calculations by Smye and Maduell formulas: 60.7+/-8.4 (r = 0.722, p < 0.001) and 61.8+/-6.6 (r = 0.933, p < 0.001), respectively. The precision of estimated limits of agreement and percentage of error by Bland and Altman analysis show that URRr estimated Maduell formula could be used in place of the URRr. Otherwise, the degree of agreement of the Smye method was not clinically acceptable. In conclusion, our results led us to suggest that in actual dialysis, the use of URR is not adequate for delivered hemodialysis dose, and URRr should be used. URRr estimated by Maduell formula could be a simple and accurate method for use in clinical practice. The recommended dialysis dose by the American National Study of URR of 70% could correspond, considering urea rebound, to Kt/Vr 1.18 or URRr of 64%.

Adult↗
PubMed1997

Validation of different methods to calculate Kt/V considering postdialysis rebound.

BACKGROUND: The effect of increasing dialysis efficiency magnifies rebound urea and the error in Kt/V determinations from single pool urea kinetics. Several formulae have been developed to calculate Kt/V taking into account the rebound urea (Kt/Vr). Smye et al. proposed a method whereby the equilibrated BUN is predicted by an additional intradialytic urea sample (Kt/VrSmye). Daugirdas et al. proposed a method where a single pool Kt/V is modified according to the speed of dialysis to obtain a double pool Kt/V (Kt/VrDaug). Maduell et al. developed a method based on analysis of post-dialysis urea rebound whereby the Kt/Vr is predicted according to the single pool Kt/V and K/V (Kt/VrMad). DESIGN OF THE STUDY: We compared Kt/Vr estimated by these three formulae (Smye, Daugirdas, and Maduell) in 384 patients consisting of 211 males and 173 females, who received dialysis according to their regular protocols. Plasma urea was measured at the beginning, 90-100 min following the start of dialysis, the end, and 45 min post-dialysis. RESULTS: Post-dialysis rebound urea was 22.4 +/- 9.7%. Kt/V and Kt/Vr obtained with rea kinetic model Kt/V 1.184 +/- 0.22 and 0.984 +/- 0.20, respectively. These was a good correlation between Kt/Vr and the Smye formula (Kt/VrSmye = 0.956 +/- 0.21, r = 0.729, P < 0.001), and a better one for Daugirdas (Kt/VrDaug = 0.984 +/- 0.18, r = 0.931, P < 0.001), and Maduell formulae (Kt/VrMad = 0.980 +/- 0.18, r = 0.946, P < 0.001). Limits of agreement and percentage of error estimated according to Bland and Altman show that Kt/Vr estimated by Daugirdas and Maduell formulae could be used in place of the Kt/Vr. The degree of agreement with the Smye method is not clinically acceptable. CONCLUSION: Our results suggest that the use of a single pool Kt/V is not adequate to estimate the haemodialysis dose delivered and Kt/V taking rebound urea in consideration. Kt/Vr estimated by Daugirdas or Maduell formulae are a simple and accurate method for use in clinical practice.

Adult↗
PubMedDate not supplied

[Association between cerebral infarction and malignant glioma].

INTRODUCTION: It is very rare for cerebral infarction to be the first symptom of an intracranial tumour. Only three cases have been reported in which cerebral infarction is thought to have been caused by the arterial compromise triggered by incipient high grade gliomas that are not yet visible in radiological tests. CASE REPORT: A 46-year-old male with no relevant medical history or cardiovascular risk factors who presented with acute hemiplegia on the right-hand side of the body and a significantly impaired level of consciousness. Computerised axial tomography of the brain showed a left frontal malignant ischemic infarct that exerted an important mass effect. The patient was submitted to a left-side frontoparietal decompressive craniectomy. Post-operative progress was good and the patient even recovered his normal level of consciousness, although he was left with right hemiparesis and conduction dysphasia. Seven months after the craniectomy the patient experienced a progressive deterioration with symptoms of endocranial hypertension. Magnetic resonance imaging of the brain revealed the presence of a highly malignant tumour in the previously infarcted territory. A histological study of the excised lesion showed it to be a glioblastoma multiforme. CONCLUSIONS: The proximity in time, as well as the identical location of the two lesions, led us to think that the glioblastoma, although not yet visible in radiological explorations, affected a branch of the middle cerebral artery and gave rise to the infarct. Therefore, in the presence of a cerebral infarct in patients with no risk factors for suffering a brain vascular pathology, it is advisable to carry out a radiological follow-up so as to be able to diagnose a possible lesion due to a tumour.

Cerebral Infarction↗