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Biomedical subjects

R Lillo

Publications and source records attributed to R Lillo.

At least 19 recordsLinked to original sources
PubMed2000

[Thyroid cancer. Report of 85 cases].

BACKGROUND: Thyroid cancer is the most frequent endocrine cancer with important implications in terms of diagnosis and treatment. AIM: To report a population of patients with thyroid cancer diagnosed by pathological studies of the surgical piece. PATIENTS AND METHODS: Eighty five patients (68 female) with the definitive diagnosis of thyroid cancer were studied. Clinical, imaginological, cytological and pathological findings were analyzed. RESULTS: The age range of patients was 10 to 77 years old. Sixty nine patients had ultrasonographic studies which showed a solid nodule in 84%, mixed solid-cystic area in 14.5% and a purely cystic nodule in 1.5% of the cases. Nineteen patients had non specific calcifications. Fine needle aspiration cytology was negative for malignancy in eight patients (false negative rate of 9.9%). The average size of the nodules was of 2.8 +/- 1.6 cm). Six nodules measured less than one cm (microcarcinoma). In the initial surgical procedure, 13 patients had lymph node metastases, 2 of them had a primary tumor of 1 cm and 5 patients had Graves's Disease. Frozen biopsies during operation had 9 false negative results for cancer (10.6%). Pathology showed 64 cases of papillary cancer (75%), 14 of follicular (16.5%), two were Hurthle cell cancer (2.4%), three were medullary (3.5%), and two anaplastic (2.4%). CONCLUSIONS: In our experience, thyroid cancer is more common in women, solid lesions predominate in the ultrasonography and calcifications are frequently found. The tumor size is variable and the most frequent pathological type corresponds to differentiated cancers. Using the definitive pathological study as the standard, the diagnostic sensitivity of fine needle cytology was 90.1%, and of frozen section 89.4%.

Adolescent↗
PubMed2000

[Treatment of hyperthyroidism with radioiodine: effects of administered dose on complications and thyroid function].

BACKGROUND: Radio-iodine is a definite therapy for Graves disease hyperthyroidism. However, the optimal dosage is still debatable. AIM: To assess the effects of different radioiodine doses on thyroid function and complications in patients with hyperthyroidism. MATERIAL AND METHODS: A retrospective analysis of 139 patients with hyperthyroidism, treated with ratio-iodine between 1988 and 1998. Radio iodine dose used was classified as low (< 10 mCi), intermediate (10-14.9 mCi) or high (> or = 15 mCi). RESULTS: Thirty-five patients were treated with low doses, 33 with intermediate doses and 71 with high doses. There were no differences between these patients in age, disease severity, frequency of post treatment euthyroidism or complications. Patients treated with low doses had a higher frequency of persistent hyperthyroidism than patients treated with high doses (25.7 and 4.2% respectively, p < 0.001). Likewise, the frequency of subsequent hypothyroidism was 60% in patients treated with low doses and 84.5% of those with high doses, in whom it also appeared earlier. Associated complications were clinically irrelevant. In seven patients, Graves ophthalmopathy progressed after treatment, but this progression was not associated with the dose used. CONCLUSIONS: Radio iodine in high doses is useful, safe and effective for the treatment of Graves hyperthyroidism.

Adolescent↗
PubMed1999

Characterization of a new HLA-B*38 allele (B*3803) in a Spanish Caucasian individual which is closely related to the Oriental B*38021 and B*39021 alleles.

The broad HLA-B16 serologic specificity is divided into B38 and B39 splits associated to Bw4 and Bw6, respectively. Differential serologic variants have been defined for several molecular subtypes of B39 and for B38. We found a Spanish Caucasian individual carrying a B16 Bw4-associated antigen which was not recognized by reagents against B16 splits. Sequencing analysis showed a new B16 subtype termed B*3803. HLA class I sequence-based typing (SBT) analysis demonstrated that B*3803 co-segregates with A*2608 and Cw*1203, forming a common Caucasian haplotype. Sequence comparison with B*38 and B*39 subtypes evidences that although B*3803 is close related to B*3802, it only differs from B*39021 by six clustered nucleotide position in the Bw4/Bw6 motif, and strongly suggests that B*3803 could have evolved from, or be the ancestral gene of the Oriental-associated B*3802 and B*39021 alleles. However, more complex patterns of genetic events should be considered due to the Caucasian background of the B*3803 individual an its associated haplotype.

Alleles↗
PubMed1999

Large-volume leukapheresis in pediatric patients: pre-apheresis peripheral blood CD34+ cell count predicts progenitor cell yield.

BACKGROUND AND OBJECTIVE: In children it is very important to optimize PBPC harvesting and to reduce the number of leukaphereses per patient. The value of pre-apheresis peripheral blood CD34+ cell concentration as a predictor of PBPC yield was studied in 23 pediatric patients with hematologic and non-hematologic malignancies in order to optimize duration of PBPC collection. DESIGN AND METHODS: The patients underwent 25 stem-cell mobilization episodes with G-CSF alone and 40 large-volume leukapheresis procedures. Peripheral blood and harvested CD34+ cell concentrations were analyzed by means of flow cytometry. RESULTS: Using linear regression analysis, a highly significant correlation was found between the peripheral blood CD34+ cell count and the CD34+ cells/kg patient body weight collected on the apheresis day (r = 0.826, p = 0.0001). The results indicate that at least 1 x 10(6)/kg CD34+ cells can be harvested during one leukapheresis procedure in all patients if the pre-apheresis blood CD34+ cell count is > or = 30/microL and a CD34+ cell target of > or = 5 x 10(6)/kg is achieved in at least 80% of patients if this value is > or = 50 CD34+ cells/microL processing a median blood volume of 438.7 mL/kg (range, 207-560) over a median time of 232.5 minutes (range, 182-376). INTERPRETATION AND CONCLUSIONS: Our results suggest that the number of CD34+ cells harvested in a single large-volume leukapheresis can be predicted from the measurement of peripheral blood CD34+ cell concentration on the collection day.

Adolescent↗
PubMed1999

[Dual photon absorptiometry in full-term newborns].

BACKGROUND: There is scanty information about bone mineral density in newborns. Normal values are needed to assess the effects of diseases and drugs used during the neonatal period. AIM: To assess bone mineral density in normal newborns. PATIENTS AND METHODS: Total body bone mineral density was measured in 16 newborns with 39 +/- 1.2 weeks of gestational age, using a Norland dual photon densitometer. RESULTS: The mean weight of newborns was 3.366 +/- 325 g. Bone mineral content was 58.3 +/- 10.8 g and bone mineral density was 0.369 +/- 9.6 g/cm2. RESULTS: The availability of normal bone mineral content values in newborns will be useful for the assessment of conditions that affect bone mineralisation.

Absorptiometry, Photon↗
PubMed1998

Progenitor cell subsets and engraftment kinetics in children undergoing autologous peripheral blood stem cell transplantation.

The main objective of the present study was to determine the role of CD34+ cell subsets in the haemopoietic recovery of children undergoing peripheral blood stem cell transplantation. For this purpose, 38 leukaphereses from 33 children with malignancies mobilized with G-CSF were analysed. Using dual-colour flow cytometry, different subpopulations of CD34+ cells were quantified and the number of each reinfused subsets correlated with haemopoietic resurgence. Multivariate analysis showed that the number of CD34+CD38- cells and CD34+CD38+ cells correlated better with time to neutrophil and platelet recovery, respectively, than the total number of CD34+ cells. Threshold values for rapid haemopoietic recovery, determined by the receiver operating characteristic analysis, were found to be 0.5 X 10(6) CD34+CD38- cells for neutrophil engraftment, and 2.0x10(6) CD34+CD38+ cells for platelet recovery. It is suggested that the analysis of CD34+ cell subsets could increase understanding of the repopulation capacity of a given leukapheresis product in peripheral blood stem cell transplantation procedures in children. In particular, this procedure could be extremely useful when low numbers of CD34+ cells are collected.

Adolescent↗
PubMed1998

Characterization and distribution of HLA-B*5002 in a Spanish population sample.

HLA-B45, in contrast to B44, does not show molecular polymorphism. We have found a group of Caucasian Spanish individuals, serologically typed as B45, showing an unexpected HLA-B12 PCR-SSO subtyping pattern. Complete coding region sequencing and B45 subtyping by PCR-SSO demonstrated that the B45 serologic specificity is constituted by two molecular alleles: B*4501 and B*5002. B*5002 is recognized by polyclonal and monoclonal allosera against B12 and B45, whereas it is not detected by B21, B49, or B50 reagents, providing a new example of poor correlation between serology and structure. B*5002 explains an important subset (18%) of the B45-positive individuals of the Spanish population studied, and almost half are included in a very infrequent haplotypic association, Cw6-B*5002-DRB1*0406-DQA1*03-DQB1*0402.

Amino Acid Sequence↗
PubMed1998

Complete coding sequence of HLA-B*2712: a serologic B27-negative antigen associated to Bw6.

We report the complete coding sequence of a new HLA-B27 subtype, B*2712, which was found in a Caucasian Spanish family within the chromosome A2-Cw2-B*2712-DR15-DQ6. B*2712 was first detected as a segregating B blank Bw6-associated antigen. Extensive serologic analysis demonstrated that this new B27 subtype was not recognised by any of the B27-monospecific antibodies, giving positive reactions only with some monoclonal reagents against B40 or B27,40. Sequencing analysis showed a high similarity with B*2708, only differing in three clustered amino acid residues at positions 69 to 71 located in the alpha helix of the alpha1 domain. Residues 69 and 71 point towards the T-cell receptor, while amino acid 70 points to the antigen binding site. Loss of the conserved structure of pocket B as well as the differentiated pocket F configuration suggests that B*2712 does not confer ankylosing spondylitis susceptibility. Misleading serologic definition supports the usefulness of DNA-typing methods to complement HLA class I typing.

Amino Acid Sequence↗
PubMed1998

Characterization of a new HLA-B18 allele, B*1806, which lacks expression of the Bw6 epitope.

HLA-B18 is a well defined Bw6-associated serologic specificity. Up to now, four different sequences have been characterised in Caucasian populations (B*1801,3,4,5), and one in Orientals (B*1802). We report a new HLA-B18 subtype (B*1806) which was serologically detected in a Spanish Caucasian individual as a B18 Bw4-associated antigen. Complete coding region sequencing showed that B*1806 differs from B*1801 in a unique nucleotide at position 299 (A to T), giving rise to an amino acid replacement in residue 76 (glutamic acid to valine) placed at the alpha1 domain. Therefore, in contrast to the serologic results, B*1806 possesses the canonical Bw6 motif at position 77-83. Subsequent flow cytometric assays proved that B*1806 evidences neither Bw4 nor Bw6 epitopes. Only three additional HLA-B alleles encode valine at codon 76, B*4601, B*7301 and B*5503, and like B*1806, all of them would include a Bw6 motif associated to the negative recognition by Bw6 antibodies. These findings support that valine at position 76 will modify the Bw6 epitope drastically, and suggest that this group of HLA-B alleles would define a third, Bw4 and Bw6-negative, lineage of molecules. Furthermore, valine 76 will also prevent the binding of Bw6 antibodies to those HLA-C antigens with the canonical Bw6 epitope (Cw*1,3,7,8,12,13,14,16).

Alleles↗
PubMed1997

HLA-B14 subtyping by semi-nested PCR-SSP and haplotype distribution in a Spanish population.

HLA-B14 serological subtyping is very limited probably due to the internal position of the unique amino acid residue that differentiates B64 and B65 molecules. In order to carry out an accurate B14 subtyping we have designed a semi-nested PCR-SSP procedure that can differentiate B*1401 and B*1402 in any HLA-A, -B or -C antigen combination. A panel of 133 B14-positive and 31 B14-negative healthy and unrelated Spanish individuals were studied. Additionally, 45 B14-bearing haplotypes (-A,-B,-C,-DRB1,-DRB3/DRB4/DRB5,-DQA1,- DQB1) were available through family studies. The relative frequencies of HLA-B14 subtypes were 74% for B*1402 and 26% for B*1401, in agreement with those found in other Central European populations, but differing from those in Wales, where the relative presence of B64 goes to 41%. A total of 11/17 and 18/28 different haplotypes for B*1401 and B*1402, respectively, were identified. Both alleles showed the strongest association to Cw8 (43/45), indicating a primary ancestral B14-Cw8 association. However, B14 subtypes evidenced very distinguishable haplotype distributions. B*1401 is strongly associated with the common HLA class II haplotype DRB1*0701-DQA1*0201-DQB1*02 (13/17), while B*1402 is mainly associated to DRB1*0102 (16/28). Three major haplotypes were identified: A32-Cw8-B*1401-DR7-DQ2 (5/17), A33-Cw8-B*1402-DRB1*0102-DQ5 (5/28) and A2-Cw8-B*1402-DRB1*0102-DQ5 (5/28).

HLA-B Antigens↗
PubMed1996

[Assessment of bone status in intermittent and continuous alcoholics, without evidence of liver damage].

The effect of chronic alcoholism on bone mass and density has been a subject of considerable controversy. The goal of the present study was to evaluate bone mineral content and density in 2 groups of alcoholic men without evidence of liver damage and determine if the modality of alcohol consumption could cause an alcohol-mediated bone loss. We studied 70 alcoholic non cirrhotic men divided into intermittent (n = 38) and continuous (n = 32) drinkers. They were compared to 109 normal men. Dual photon densitometry technique using a Gd 153 source was utilized and bone mineral density (BMD) of lumbar spine, femoral neck, Ward's triangle, trochanter, total body bone density (TBBD) and mineral (TBBM) were measured. Hematologic, serum and urinary tests of mineral metabolism were also carried out. No significant differences were found in lumbar spine BMD between normals and alcoholics regardless of the type of alcohol consumption and duration of alcoholism. In the femoral neck a significant decrease in BMD was found in alcoholics when plotted as regression curves (r = 25; p = 0.02). In this site duration of alcoholism was significantly correlated to decreased BMD in the total group of alcoholics (r = 0.27; p = 0.02) and also in the continuous drinker group (r = 0.39; p = 0.02) but not in the intermittent drinker group. At the whole body level, BMD did not significantly differ between alcoholics and normals (p = 0.08) except in continuous (r = 0.40; p = 0.02) when considered duration of alcohol abuse. Total bone mineral was significantly lower in alcoholics (p < 0.001) and the subgroups compared to normals, and correlated with duration of alcohol abuse (p = 0.01). Chemical values revealed normal calcium, phosphorus, alkaline phosphatases, PTH and Ca/Cr concentration. Only serum magnesium was found diminished in 16.6% of studied subjects. We conclude, that pure alcoholism may affect femoral neck density and total body mineral content, being proportional to the duration of alcohol abuse. Spine density appears unaffected. The type of alcoholic abuse was less important than its duration to cause bone mass abnormalities.

Adult↗
PubMed1996

[Osteoporosis in men under 65 years old presenting as vertebral crushing: idiopathic or secondary? Study of 9 cases].

BACKGROUND: Osteoporosis in young or middle age men is unusual and requires an extensive diagnostic work-up. AIM: To report a retrospective review of nine men with osteoporosis. PATIENTS AND METHODS: The charts of nine men aged 27 to 61 years old (mean 39), that presented with a primary diagnosis of osteoporosis, were reviewed. RESULTS: Subjects were subjected to a diagnostic work up five years after the onset of symptoms. Their body mass index ranged from 21.7 to 26.3 kg/m2, all had vertebral fractures (crush fractures in 8 and a biconcave deformity in one) between T4 and L4 and all had normal serum calcium, phosphate, alkaline phosphatase and creatinine. Four patients had a history of nephrolithiasis and three had hypercalciuria. Bone density, measured in seven patients with a dual photon densitometer, showed a mean Z score of -2.0 in the spine and of -2.2 in the femoral neck. The final diagnoses of these patients were Cushing's disease in two, malabsorption syndrome in one, use of phenobarbital and hydantoin in one, overt renal hypercalciuria with low calcium intake in one and alcoholic liver disease in one. In three patients, osteoporosis was considered idiopathic. Of these, two had moderate absorptive hypercalciuria as a presumable risk factor. CONCLUSIONS: Six of the nine studied male patients with osteoporosis had an underlying cause and in three, this condition was considered idiopathic.

Adult↗
PubMed1996

[Bone mass in celiac patients].

Bone mineral content was measured in the whole body, the spine (L2-L4) and hip by Dual Photonic Absorpciometry (densitometer Norland 2600 Gd-153), in seventeen celiac patients, aged 6 to 12 years, with good adherence to the gluten free diet. The diagnosed was made before 30 months of age in 50% of cases. Average treatment duration was 69.8 +/- 36 months. The randomly selected control group was composed of 48 school age children, of the same age and sex of patients. Total bone mass (TBM) and bone mineral density (BMD) were expressed as Z scores on the basis of normal values established by the authors in Chilean children. Celiac patients had lower TBM and BMD of whole body, than controls (-1.11 +/- 0.94 vs 0.00 +/- 0.85 and -0.59 +/- 0.76 vs 0.06 +/- 0.84, respectively) and at the spine (-0.79 +/- 1.04 vs 0.003 +/- 0.92 and -1.49 +/- 0.99 vs 0.06 +/- 0.87 respectively). A lower TBM was founded at the hip (-0.62 +/- 1.28 vs -0.08 +/- 0.82) without differences in BMD. Celiac patients had a lower bone mass than controls despite early diagnosis and good compliance with the gluten-free diet. These differences could not be atributed entirely to the lower height of celiac patients. These results suggest that celiac patients constitute a risk group for development of osteoporosis later in life. This fact should be taken into consideration in the treatment of this condition.

Bone Density↗
PubMed1995

[Evaluation of bone mass in hip fractures measuring lumbar spine and contralateral hip with bone densitometry].

Hip fracture is frequent in postmenopausal women with osteoporosis. The aim of this work was to assess bone mass in women with hip fracture and compare it with that of normal women. Bone densities of lumbar spine (considering areas with and without spondylosis), femoral neck, greater trochanter, and unfractured hip Ward's triangle were measured with a double beam isotopic densitometer. Thirty-one women aged 58-95 years old were studied and compared with normal women studied at the same laboratory. Bone densities in fractured and normal women were 0.82 +/- 0.16 and 0.85 +/- 0.05 g/cm2 in lumbar spine respectively (NS), 0.74 +/- 0.15 and 0.85 +/- 0.05 g/cm2 in lumbar spine without spondylosis respectively (p < 0.001), 0.60 +/- 0.11 and 0.65 +/- 0.08 g/cm2 in femoral neck respectively (NS), 0.49 +/- 0.09 and 0.57 +/- 0.05 g/cm2 in greater trochanter respectively (p < 0.001) and 0.48 +/- 0.12 and 0.52 +/- 0.09 g/cm2 in Ward's triangle respectively (NS). It is concluded that the larger differences in bone density between women with and without hip fracture are observed in the greater trochanter.

Absorptiometry, Photon↗
PubMed1995

[Bone mineralization and calcium intake in Chilean school children].

Bone mineralization was evaluated in 36 school age children with calcium intake below 50% of Recommended Dietary Allowances (RDA), and compared with 28 school age children with calcium intake higher than 100% of the RDA. The total group was aged between 86 and 178 months. The calcium intake was evaluated by 24 hours recordatory survey. Height for age and weight for height were evaluated according to WHO tables. Puberal development was evaluated according to Tanner stages. Bone mineral density (BMD) and total bone mass (TBM) of whole body, spine and femoral neck were measured with Norland 2600 densitometer. School age children with intakes below 50% of RDA had lower height for age adequation (97.7 +/- 4.0%), whole body TBM adequation (98.9 +/- 17.9%) and BMD adequation (97.8 +/- 7.9%) than those ingesting more than 100% of the RDA (115.9 +/- 17.4%), (109.7 +/- 18.0%) and (104.7 +/- 11.1%) respectively. In spine, however, there was a clear tendency to be lower, there were no significant differences between both groups. There were no differences in femoral necks BMD adequation, or TBM adequation between both groups. These results show that children with calcium intake below 50% of the recommendation has lower adequation of statural growth and bone mineralization. The role of calcium in the differences found in this study is discussed.

Adolescent↗