Biomedical subjects

R Santolaya

Publications and source records attributed to R Santolaya.

10 recordsLinked to original sources

PubMed2004

[Evaluation of a pharmaceutical care program to improve adherence to antiretroviral therapy].

OBJECTIVE: To establish the impact of a pharmaceutical care program on the improvement of adherence to antiretroviral therapy, and on patient immunologic and virologic outcome. MATERIALS AND METHODS: A multicenter, observational, prospective study in a HIV-infected patient cohort under treatment with antiretrovirals selected by random sampling in 19 Spanish hospitals. The study lasted 12 months, in which the program was applied through a baseline preprocedural visit and 4 quarterly visits. Adherence estimation was based on pill counting. An adherence > or = 90, or > or = 95% was considered adequate (in two time points). RESULTS: 541 patients were included, most of them were males (68.8%) between 20 and 78 years of age. Major risk groups included injecting drug users (43.4%) and heterosexuals (29.4%). Sixty percent had already received treatment for more than 3 years. Mean baseline viral load and CD4 count values were 32,866 copies/ml and 485 cells/mm3, respectively. Throughout the study a slight increase in the percentage of adherent patients was seen; however, statistical significance was not reached (64.3 and 79.2% of patients showed an adherence > 95 and > 90%, respectively, during the fourth quarter, versus 59.8 and 75.5% at baseline). A statistically significant decrease in viral load and increase in CD4 cells was seen following program application. The percentage of patients with a viral load < 200 copies/ml was 72.2, 76.7, and 75.0% at the 2nd, 3rd, and 4th quarters, respectively, versus 64.2% at baseline. CD4 cell counts increased by 50 cells/mm3 on average from the start to the end of follow-up. CONCLUSIONS: Patients included in the program had a good immunologic and virologic outcome, and a trend towards an increased percentage of patients with good adherence was also seen. These results confirm the need to implement follow-up programs for patients receiving antiretrovirals in order to ensure maximum therapeutic benefits.

Adult↗

PubMed1999

Treatment of malignant melanoma.

OBJECTIVE: To review the current treatments for cutaneous melanoma and discuss treatment approaches for each patient population. DATA SOURCES: MEDLINE and IOWA database search from January 1990 to December 1998. DATA EXTRACTION: Clinical trials and review articles were selected and classified to answer questions considered of clinical relevance. RESULTS: Patients with stage I, II, and III melanoma should undergo excision after biopsy. In patients with stage IV melanoma, surgical excision of metastatic melanoma is not considered curative but can provide palliation and improve quality of life. Therapeutic lymph node dissection should be performed in patients with melanoma in stages III and IV once pathologic confirmation is obtained. Patients at high risk for recurrence or metastasis may also be considered for elective node dissection. Adjuvant therapy after surgery excision is not a standard of care in patients with stage I and IIa melanoma. In patients with stage IIb and III melanoma, the best results have been obtained with high doses of interferon alfa-2b, although toxicity is of concern. Isolated limb perfusion with melphalan adjuvant to surgery has demonstrated clinically significant benefit in patients with locally recurrent melanoma and in-transit metastases. Studies comparing efficacy and quality of life with this technique or with high doses of interferon alfa-2b are needed. The technique cannot be recommended for high-risk primary melanoma of an extremity with no clinical evidence of metastatic disease. CONCLUSIONS: To date, dacarbazine still appears to be the treatment of first choice in metastatic melanoma, outside of a clinical trial. The combination of chemotherapy with interferon alfa-2b or interferon alfa-2a enhances toxicity without a significant survival advantage. Aldesleukin may be an alternative in selected patients when other treatments have failed, but the higher toxicity and cost must be considered.

Animals↗

PubMed1995

[Mammary phyllodes tumor. A clinico-pathological review of 14 cases].

We report a retrospective analysis of 14 female patients, aged 20 to 62 years old, with phyllodes tumors of the breast. The tumors were located in the right breast in nine patients and their diameter ranged from 2.5 to 28 cm. Six mammographies and six needle cytological examinations were performed and aided very little to the diagnosis. The preoperative diagnosis was correct in five patients and the principal differential diagnosis was fibroadenoma. Eight patients were subjected to tumorectomy, three to simple mastectomy, one to a cleaning mastectomy, one to a modified radical mastectomy and one to a subcutaneous mastectomy. The anatomopathologic study disclosed an increased stromal growth in two patients and increased stromal cellularity in six cases. Only one case had more than five mitoses per microscopic field. Phyllodes tumors are infrequent, their diagnosis requires a high degree of clinical suspicion and they have a benign biologic behaviour.

Adult↗

PubMed1989

Different hematologic responses to hypoxia in Sherpas and Quechua Indians.

Previous studies of the erythropoietic response to hypoxia in high-altitude natives suggest that the hematocrit and hemoglobin values in Himalayan natives (Sherpas) are lower than expected for the altitude, perhaps because of a genetic adaptation. However, differences in sampling techniques and experimental methods make comparisons difficult. Our studies were carried out to compare the erythropoietic response with the same altitude in age-matched natives of the Himalayas and Andes by the same experimental techniques. Healthy male subjects were selected in Ollagüe, Chile (n = 29, 27.3 +/- 5.9 yr) and in Khunde, Nepal (n = 30, 24.7 +/- 3.8 yr). Both of these villages are located at 3,700 m above sea level. Hematologic measurements confirmed lower hematocrit values in Nepal (48.4 +/- 4.5%) than in Chile (52.2 +/- 4.6%) (P less than 0.003). When subjects were matched for hematocrit, erythropoietin concentrations in Chile were higher than in Nepal (P less than 0.01). Detailed measurements of blood O2 affinity in Nepal showed no differences in shape or position of the O2 equilibrium curve between Sherpas and Western sojourners. Our results indicate that although Quechua Indians have higher hematocrits than Sherpas living at the same altitude, nevertheless they may be functionally anemic.

Adult↗

PubMed1980

Localization of adenylate cyclase in the neurointermediate lobe of the rat pituitary. Ultrastructural cytochemistry.

The ultrastructural localization of adenylate cyclase was accomplished cytochemically in the neurointermediate lobe of Sprague-Dawley rats. The main concentration of the reaction product was found on the plasmalemma of neurosecretory nerve fibers, their terminals and plasma membranes of pituicytes. Positive reaction for adenylate cyclase was found less regularly in endothelial cells, pericapillary spaces and processes of the basal lamin. The septum between the pars nervosa and the pars intermedia showed heavy deposits of the reaction product, especially around the neurosecretory nerve fibers but also around other types of nerve fibers. Reaction for adenylate cyclase was not seen in the cells of the pars intermedia. When the substrate (ATP) was omitted, no reaction product was found. These findings support the suggestion of an involvement of cyclic AMP in the release mechanism of neurohypophysial of an involvement of cyclic AMP in the release mechanism of neurohypophysial hormones from the neurosecretory nerve terminals, and possibly also their transfer into blood vessels and perivascular channels.

Adenylyl Cyclases↗

PubMed1978