PubMed Health⌕ Search

Biomedical subjects

R Rojas

Publications and source records attributed to R Rojas.

At least 19 recordsLinked to original sources
PubMed1994

Cavernous hemangiomas of the dura mater at the convexity. Report of a case and therapeutical considerations.

A rare case of cavernous angioma of the dura mater at the convexity is presented. In comparison with the more common cavernous hemangiomas that arise from dural sinuses, the ones on the convexity have a much better prognosis. They do not seem to be associated with spontaneous hemorrhage, their removal is simpler and, transoperatory bleeding, if it occurs, is scanty. Computerized tomography detects the presence of cavernous angiomas of the convexity in only 70% of the cases, magnetic resonance imaging in 100%.

Aged↗
PubMed1994

Strict glycemic control in women with pregestational insulin-dependent diabetes mellitus.

OBJECTIVE: To determine the efficacy of strict glycemic control in women with pregestational insulin-dependent diabetes mellitus (IDDM). METHODS: The records of 62 pregnant women with pregestational IDDM who had attended the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Virgen de las Nieves General Hospital, Granada, Spain, between 1982 and 1992, were reviewed. The women had received several daily doses of a mixture of rapid action (regular) and intermediate action insulin with the aim of keeping preprandial glucose levels lower than 95 mg/dl and postprandial glucose levels lower than 120 mg/dl. Perinatal outcomes were compared with those of a control group consisting of 96 randomly selected, normal, pregnant women who gave birth at approximately the same time. RESULTS: Mean glycemic profile in the first assay at an insulin dose of 33.1 +/- 15.9 IU/day was 153.7 +/- 52.3 mg/dl and the HbA1c was 7.7 +/- 2.3%. In the last assay before delivery patients received an insulin dose of 68.2 +/- 30.7 IU/day and had a mean glycemic profile of 94.4 +/- 18.1 mg/dl and an HbA1c of 5.9 +/- 1.4% (P < 0.001 for all parameters). The perinatal mortality of newborn infants of the diabetic mothers was 48 per 1000, and 11.3 per 1000 had some congenital malformations. CONCLUSIONS: Our results verify that strict glycemic control decreases the elevated perinatal mortality normally suffered by IDDM patients. However, if it is to reduce the number of congenital malformations, it must be initiated before the early gestational stages.

Adult↗
PubMed1992

Increase in the D-dimer levels during treatment in patients with acute myelogenous leukemia.

Plasma concentration of thrombin-antithrombin III complex (TAT), tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), PAI-2, D-dimer complex and urokinase-plasminogen activator (u-PA) activity were studied in 30 patients with acute nonlymphoblastic leukemia (ANLL), before and during antileukemic therapy. Fifteen patients showed signs of disseminated intravascular coagulation (DIC), 10 of them classified as M3, 2 as M2 and 3 as M5 subtypes. The initial levels of TAT complex were elevated in all ANLL patients. This increase was more pronounced in patients with DIC (p less than 0.05). TAT increased significantly during the treatment period in all cases. u-PA and PAI-1 levels were elevated but there were no statistically significant differences between patients with and without DIC. PAI-2 levels were below the limit of detection in controls and in patients. However, the initially elevated D-dimer complex levels were significantly higher in DIC cases (p less than 0.01) and they increased during the treatment period. A significant and positive correlation between D-dimer and TAT complex values was found in DIC patients (r = 0.68, p less than 0.001). The high TAT complex and D-dimer levels further increased during chemotherapy treatment strongly suggest a hypercoagulable state with secondary activation of fibrinolysis not severe enough to manifest itself as clinically evident DIC in the majority of cases.

Adolescent↗
PubMed1991

[Survey about smoking among third-year medical students at the National University of Cordoba].

A survey about smoking was done at the Second Department of Pathology at the National University of Córdoba. The results of a questionnaire answered by 70% of 520 students were as follows: 23% of the students smoke (29% of the males and 17% of the females). The generation of these students smoke much less than that of their parents (70% of the male parents and 25% of the female parents smoke). The family groups are fairly well informed about cigarette danger for health. Nevertheless, in a significant number of cases children and pregnant women are subjected to passive smoking and to a lesser extent pregnant women smoke themselves. It is difficult to quit smoking. Many tried it without results. 80% of students are against smoking in closed places. The majority of students claim to respect the right of non smokers. Few of the Departments of Basic Sciences teach about smoking and several members of the teaching staff smoke during academic activities and/or permit students to smoke. This meets the disapproval of the great majority of the students which view this as a bad example and something in contradiction with the expected role of teachers. We hope smokers will respect the right of non smokers and also respect the rules about smoking of our University.

Adult↗
PubMed1990

Clinical results of TBI for bone marrow transplantation at Sevilla.

We report on a series on 81 patients affected with acute leukemia undergoing TBI prior to BMT. An analysis of the achieved results is given, emphasizing the limited incidence of interstitial pneumonitis in our patients (3.7%). A suitable patient selection and treatment technique is also needed.

Acute Disease↗
PubMed1989

[Familial deficiency of protein S associated with thrombophilia].

Protein S (SP) is a vitamin K-dependent plasma protein which acts as a cofactor of activated C protein in the inactivation of the factors Va and VIIIa; in addition, it enhances fibrinolysis by increasing the affinity of the enzyme for phospholipid surfaces. The congenital deficiency of SP is an autosomal dominant inherited trait, associated with a high risk of development of thrombotic phenomena at a relatively early age (young adults). We report a Spanish family which carried a congenital deficiency of SP associated with thrombotic complications; for its diagnosis we used the immunological quantification of the levels of free and total SP as well as the evaluation of the immunoelectrophoretic behavior of the inhibitor.

Adolescent↗
PubMed1989

Cyclosporin A versus methotrexate, followed by rescue with folinic acid as prophylaxis of acute graft-versus-host disease after bone marrow transplantation.

Fifty-seven patients undergoing bone marrow transplantation were randomly assigned to receive either cyclosporin A (CsA, n = 26) or methotrexate, followed by rescue with folinic acid (MTX + FA, n = 31) as prophylaxis for graft-versus-host disease (GVHD). All patients but one receiving CsA had evidence of sustained engraftment, and there was no difference between the two groups on the day in which marrow engraftment was documented. Oropharyngeal mucositis was of similar incidence and severity in the two groups. In contrast, patients receiving CsA showed higher renal and hepatic toxicity rates than those treated with MTX + FA. Severe-to-moderate acute GVHD (grades II-IV) was documented in 12 patients receiving CsA and in 12 treated with MTX + FA. The cumulative incidence of this complication was similar in both groups (46.1% and 38.7%). Similarly, there was no difference in the incidence of chronic GVHD. The leukemic relapse rates were also comparable, as well as the estimated probability of survival, which was 55% in patients treated with MTX + FA and 41% in those who were given CsA. We conclude that MTX + FA is as effective as CsA in the prevention of GVHD, with the additional advantage of reduced renal and hepatic toxicities.

Actuarial Analysis↗
PubMed1989

[Juvenile dermatomyositis. Clinical and epidemiologic experience].

27 cases with a diagnosis of Juvenile Dermatomyositis were studied from a total of 1307 patients who suffered from connective tissue diseases; 19 of which met the diagnosis criteria of Bohan and Peters. Females were the most frequently affected. 52.63% of the cases presented the first symptoms between 5 and 9 years of age. Skin lesions, debility in inferior extremities and fever were the most frequent motives of consultation. The Aldolase and LDH were the muscular enzymes whose values increased in the majority of the cases. The electromyography was more sensible than the muscular biopsy in the diagnosis of the disease. We suggest that the epidemiologic and clinical characteristics found in our study should be taken into account for further accurate diagnosis of Juvenile Dermatomyositis in Venezuela.

Adolescent↗
PubMed1989

[Bone marrow necrosis as a manifestation of leukemic relapse in a patient with bone marrow transplant].

A case of bone marrow necrosis (BMN) in transplanted acute lymphoblastic leukaemia (ALL) is presented. The propositus is a 16 year-old boy with L-2 type ALL on whom allogeneic bone marrow transplantation (BMT) had been performed after the second relapse. He was admitted to hospital at 415 after BMT with fever, malaise and hip pain. One week later he had aplasia without blast cells. Scanty cellularity with necrobiosis was found in bone marrow aspirates; bone marrow biopsy confirmed the suspicion of BMN. Osseus scintigraphy with 99-Tc-diphosphonate showed poor, irregular distribution. Steroid therapy was followed by a favourable response. Peripheral blast cells appeared two weeks later, and the relapse was confirmed by bone marrow aspiration. Chemotherapy was started, but the patient died on day 467 after BMT. BMN has been reported in ALL at onset, in relapses, after chemotherapy and as necropsy finding; however, it had not been found in patients subjected to BMT. The experience of these Service was revised, this being the only case of 140 patients subjected to BMT who presented such severe complication.

Adolescent↗
PubMed1989

Allogeneic bone marrow transplantation versus chemotherapy in the treatment of childhood acute lymphoblastic leukemia in second complete remission.

Seventy-six patients between the ages of 2 and 17 years with acute lymphoblastic leukemia (ALL) achieved a second complete remission induced by polychemotherapy. Twenty-one had an HLA-identical donor and underwent allogeneic bone marrow transplantation (BMT) after conditioning with total body irradiation and cyclophosphamide. The remaining 55 patients lacked a suitable donor and received intensive chemotherapy as treatment. Fifteen patients were excluded from the analysis because they relapsed within 3 months after achieving a second complete remission. Three of the 21 BMT patients died of transplant-related complications and seven relapsed between 90 and 480 days after transplantation. Eleven patients are alive and disease free at 5.5-71 months with an actuarial survival of 47.1%; eight patients are on a plateau extending from 22 to 71 months. Thirty-three patients treated with chemotherapy died from relapse and seven are alive and disease free 7.5-99 months from the second remission, with an actuarial survival of 9%. The probability of survival was significantly higher in the BMT group (p less than 0.025). The probability of remaining in complete remission in the BMT group was 58.5% versus 10.9% in the chemotherapy group (p less than 0.005). Our results show that BMT is the best alternative therapy for children affected by ALL who have had a relapse in the marrow.

Adolescent↗
PubMed1985

Release of granulocyte-macrophage colony-inhibiting activity by normal human postthymic precursor cells.

Seven normal human peripheral blood cell fractions (buffy coat, mononuclear cells, non-T, T, Fc-IgM receptor-depleted T-lymphocyte, Fc-IgG receptor-depleted T-lymphocyte, and autologous rosette-forming T-cell-depleted T-lymphocyte subpopulations) treated with phytohemagglutinin (PHA) were examined for the production of granulocyte-macrophage colony-stimulating activity (CSA). It was found that medium conditioned by a T-lymphocyte subpopulation depleted of autologous rosette-forming T-cells (Tar cells, a postthymic precursor subpopulation that inhibits Ig synthesis) stimulated colony-forming units of granulocyte and macrophages (CFU-GM) to a greater extent than did the other conditioned media (CM) analyzed. Based on this finding, CM from an enriched Tar subpopulation was prepared and thus showed that PHA-treated Tar cells release a factor capable of inhibiting CFU-GM growth. The inhibitory activity of this factor persisted-after heat inactivation, suggesting that cause of the colony-inhibiting activity (CIA) is other than interferon. Further studies revealed that Tar-derived inhibitory factor acts either directly upon CFU-GM or via monocytes/macrophages (M phi/Ma), enhancing CIA, and not the level of CSA production by M phi/Ma. The overall data are interpreted as demonstrating the presence of CIA in a specific T-lymphocyte subpopulation that may represent a new relationship between lymphocytic and myelocytic systems in the human.

Colony-Forming Units Assay↗
PubMed1984

Bifonazole cream in the treatment of superficial candidosis. A double-blind comparative study.

This is the summary of a prospective, randomized, double-blind study comparing four therapeutic regimens: bifonazole cream applied once or twice daily, clotrimazole and placebo twice daily during 4 weeks for the treatment of cutaneous candidosis. The study is multicentric and was accomplished in four centres of different climate: Costa Rica, Dominican Republic, Sweden and Yugoslavia. The trial was carried out with approximately identical numbers of patients: 275 in total. The duration of treatment was 4 weeks and the check-ups were done before, during and 2 weeks after the end of the therapy. The results have shown the great efficacy of bifonazole cream (65-75%) in comparison to placebo (19.4%). There was no significant difference in applying bifonazole cream once or twice daily. So the reasonable therapy with bifonazole as to apply it only once a day, is confirmed. The excellent tolerance and absence of side-effects in such an extended study have once more proved the value of this antimycotic in topical treatment of cutaneous candidosis.

Adolescent↗
PubMed1984

Effect of phorbol ester TPA on macrophage metabolic activity.

Metabolically active macrophages are known to play a role in tumor immune surveillance, not only as effector cells but also as collaborators in T cell mediated immune response. The present work reports that non-toxic concentrations of the tumor promoter TPA, stimulate the adherence of murine peritoneal macrophages after short time incubation, while TPA pretreatment for periods longer than 4 hrs suppresses phagocytosis, RNA and protein synthesis by these cells. Although inhibition of macrophage metabolic activity could play an additional role in tumor promotion, the enhancing and depressing effects of TPA on the immune system must be weighed before it can be assumed that TPA acts in vivo primarily to depress the immune system.

Animals↗