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Biomedical subjects

S García

Publications and source records attributed to S García.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

[Somatostatin receptor scintigraphy. When would a SPECT study be performed?].

UNLABELLED: Somatostatin receptor scintigraphy has become an essential tool in the treatment planning of patients with carcinoid tumor (CaT) and pancreatic neuroendocrine tumors (PNET). However, the contribution of SPECT images in the diagnosis and staging of these tumors has not been well established. OBJECTIVE: 1) To find out if SPECT improves the sensitivity of planar imaging and adds any value to tumor diagnosis, and 2) To determine under which circumstances SPECT images must be obtained. MATERIAL AND METHODS: We have evaluated 49 patients, 26 females and 23 males, using both planar and SPECT 111In-DTPAOC images. The patients were classified into three groups according to their clinical indication: Group A: Indolent symptoms of CaT or PNET (n = 9); Group B: Known or functioning CaT or PNET tumors (n = 22); Group C: Post-surgical follow-up (n = 18). The total number of SPECT studies were 51 (37 abdomen, 13 thorax and 1 brain). In all cases SPECT was performed 24 hours after 111In-DTPAOC injection. Scintigraphic images were compared with surgical findings in 17 patients and with a synthesis of biochemical, clinical and CT findings in the other patients. RESULTS: 16 primary lesions were detected with planar images whereas SPECT detected 18. The two tumors detected only by SPECT were a bronchial CaT and an insulinoma located in the pancreatic tail. Planar and SPECT image sensitivities were 66.6% and 75% respectively. Twenty one patients developed metastatic disease. Sensitivities of planar and SPECT images for metastases were 76.1% and 90.4% respectively. Furthermore, SPECT helps planar images in the evaluation of six patients with uncertain images (lesions with low receptor density or with an uncertain scintigraphic localization). Therefore, in 15.6% of patients with primary or metastatic tumors, planar images were normal whereas SPECT was abnormal and SPECT provided an added value in 21.8% of the studies with abnormal planar images. CONCLUSIONS: We recommend the use of SPECT images in: 1) Patients with specific functional clinical syndrome or with a known CaT or PNET and normal planar images. 2) When planar images are abnormal only in primary tumor. 3) In order to confirm the absence of other metastases in patients with known liver metastases. 4) In order to enhance the detection of lesions with low receptor density and uncertain planar images and 5) In order to determine exactly the anatomic location of some lesions

Adult↗
PubMedDate not supplied

[Usefulness of the sentinel node in the treatment and staging of initial cervix cancer].

OBJECTIVE: The aim of this study was to evaluate the usefulness of intraoperative sentinel node (SN) detection in patients with initial cervix cancer. PATIENTS AND METHODS: Lymphoscintigraphy and intraoperative SN detection was performed in 17 patients with initial cervix cancer who we going to have a radical laparoscopic hysterectomy and pelvic lymphadenectomy. Conization was performed in 4/17. The day before surgery, an injection of 111 MBq 99mtechnetium nanocolloid around the primary tumour and a subsequent lymphoscintigraphy were carried out. Blue dye was injected at the same location intraoperatively. A laparoscopic gamma probe was used to identify SNs. RESULTS: SNs were successfully localized using a combination of radiocolloid and blue dye in 16/17 patients (detection rate 94 %). The detection rate only using blue dye technique decreases to 71 % (12/17) and it reaches an 82 % (14/17) if we avoid the blue dye injection. In 3 cases, there was no migration in lymphoscintigraphy and in one of the three SN could not be detected. Thirty-three SNs were identified (1.9 nodes/patient). The most frequent location was left external iliac nodal group (13 nodes: 39 %). SNs were identified in regions that are not included in usual lymphadenectomy: right parametrium (2 sentinel nodes, one of them in the retrouterine region), and interiliac (2 SNs). In all four patients with previous conization SNs were identified (detection rate 100 %). CONCLUSIONS: The rate of SN detection combining lymphoscintigraphy with gamma probe and blue dye is 82 %. The use of blue dye allows increasing this rate to 94 % in those cases which migration was not seen or when the SN is placed near the injection site. The SN technique offers the possibility to find SNs in regions not included in usual lymphadenectomy.

Adult↗
PubMedDate not supplied

[Carcinoid tumor and bone metastases: diagnosis by somatostatin receptor scintigraphy].

OBJECTIVE: The aim of this study has been to retrospectively assess the usefulness of 111In-DTPAOC scintigraphy in the detection of bone metastases (BM) in patients diagnosed of carcinoid tumour (CaT). MATERIALS AND METHODS: Between June 1995 and April 2003 78 111In-DTPAOC studies were consecutively performed in 58 patients, 31 females and 27 males, 28 to 73 years old, with a histological diagnosis of CaT. Moreover, whole body bone scans (BS) using 99mTc-MDP were performed in 13 of these patients. The patients were classified into three groups: Group A: Initial CaT staging (n = 23); Group B: CaT staging after surgery (n = 14); and Group C: Post-treatment CaT re-staging (n = 29). In this last group, 6 patients of group A and 2 patients of group B were included. In only 2 patients the diagnoses of bone metastases were established before the 111In-DTPAOC scan. RESULTS: Twenty six (44.8 %9 of the 58 patients with CaT had metastatic disease: 15 patients with hepatic metastases, associated with BM in 4 of them, 10 patients with hepatic and extra-hepatic metastases, abdominal and/or thoracic, associated with BM in 4 and in one patient, the BMs were the only metastases detected. The global incidence of BM in patients diagnosed with CaT was 15.5 % (9/58), whereas the incidence of BM in patients with metastasic disease was 34.6 % (9/26). Significant differences (p = 0.0035) were found on the incidence of BM in patients with or without hepatic metastases. In 4 patients, BMs were detected during the initial staging (group A), whereas in 5 patients, BMs were detected during the post-treatment re-staging (group C). During diagnosis, 4 of the 9 patients with BM had bone pain. BM were multiples in 8 patients, affecting axial skeleton in 4 and axial and appendicular skeleton in 4. One patient had a diffuse infiltration of bone marrow. BS was positive in 8 of the 9 patients with BM. In these 8 patients with abnormal BS, 111In-DTPAOC scintigraphy provides similar information to the BS in one patient, shows a greater number of bone lesions in 3, whereas BS was superior in 5 patients. Four of the patients with BM died between 6 and 47 months after diagnosis (mean: 29.7 months). CONCLUSIONS: BMs are preferably located on axial skeleton, can be asymptomatic and are associated with hepatic metastases. Although the 111In-DTPAOC scintigraphy is able to detect some BM earlier than BS, the information provided by both studies is complementary. In patients with CaT, any invasive therapy on the hepatic metastases make it necessary to exclude extrahepatic metastases, including bone ones, and the somatostatin receptor scintigraphy is the diagnostic method of choice.

Adult↗
PubMedDate not supplied

[HIV seroprevalence and exposure categories among adolescents tested at a sexually transmitted clinic diseases. Madrid, 1986-2000].

OBJECTIVE: To describe the time-trend in exposure categories and HIV seroprevalence among adolescents who underwent to voluntary testing in the period 1986-2000. METHODS: This study covered all adolescents, aged 13 to 19 years, at their first test for HIV in a sexually transmitted disease clinic in Madrid. Gender, age and HIV risk behaviours were collected. HIV diagnosis relies on ELISA test and Western blot confirmation. Time trends in HIV seroprevalence and exposure categories were analysed. RESULTS: A total of 1327 adolescents, 52% women and 22% under 18 years, were studied. The annual number of adolescents remained through the time, but injecting drug users (IDU) and IDU partners declined and female sex workers rose. 108 adolescents were diagnosed with HIV infection -71% were IDU-. HIV seroprevalence was 8.1% -31.3% in IDU-. It declined from 18.2% in 1986 to 1.5% in 1995, and after then it held steady under 4%. This decline involved several risk categories and was statistically significant in homo/bisexual men and female sex workers. The logistic regression analysis, adjusting for changes in exposure categories, showed an annual reduction in HIV seroprevalence (OR = 0.87; 95% CI, 0.81-0.94). CONCLUSIONS: HIV seroprevalence has decreased due to the fall of new young IDU and the decrease of seroprevalence within several exposure categories. HIV infections and risk behaviours continue happened among adolescents.

Adolescent↗
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[Current and suitable organization of the Basque Health System. Opinion of the managing level].

Osasuna Zainduz (caring our health), a planned change tor the public health care services, is being implemented in the Basque Country. A questionnaire discriminant terms passed to all the managers of the Basque Health Service is analysed to assess its actual and optimum organizational culture. We looked at significant differences between means, comparing actual and optimum profiles. All the differences of means were highly significant (P < 0.00001); performance based salaries (6.19) and identification with the organization (5.82) were the highest. New management styles based on information and communication, tolerance with conflicts and risks, as well as support from managers were identified through regression analysis as key success criteria for such our organization.

Health Services↗
PubMedDate not supplied

[Program for the early detection of hyperphenylalaninemia: 11 years on].

In 1980 the Neonatal Screening Program was set in motion in Navarra. One of its aims is the early detection of hyperphenylalaninemias. In 1987 the quantification of phenylalanine came to be carried out in the Clinical Chemistry Department of the Hospital of Navarra. From then until December 1997, 51,815 newborn babies have been studied, which represents 99.24% of the infants born in Navarra. The quantification of phenylalanine in dried blood spots during 1989 enabled us to obtain the reference interval for this amino acid that is contained between 69.5 +/- 0.01 micromol/L and 139.9 +/- 0.03 micromol/L. During these 11 years we detected 2 cases of phenylketonuric hyperphenylalaninemia and one case of transitory hyperphenylalaninemia. From the clinical point of view, the children are well at present, following prescription of adequate treatment, which is based on a diet with a low phenylalanine content.

English Abstract↗
PubMedDate not supplied

Determination of six metals in galician red wines (in northwestern Spain) by capillary electrophoresis.

A simple technique is described for the routine simultaneous capillary electrophoretic determination of 6 cations in wine. Separation was achieved on a fused silica capillary column with a UV-Cat-1, alpha-hydroxysobutyric acid and 18-crown-6-ether buffer at pH 4.5 and indirect UV detection at 214 nm. The content of magnesium, sodium, potassium, calcium, manganese, and lithium was determined. The method is quantitative, with recoveries in the 92-102% range, and linear over more than one order of magnitude. The precision is better than 2.5-3.4%. The method is sensible, with detection limits between 0.01 and 0.06 mg/L. Twenty-five red wines with a Certified Brand of Origin from Galicia (north-western Spain) were analyzed by the proposed method. Various wines showed very similar electrophoretic profiles, but significant quantitative differences were observed.

Buffers↗
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[Meningoencephalitis caused by Herpesviridae family virus in Cuba. 1996-1998].

Herpesvirus isolation from cerebrospinal fluid (CSF) has proven not to be very useful because of its low sensitivity; that is the reason why PCR has considerably improved the diagnosis of several viral infections of the central nervous system. We studied, by means of PCR, 253 CSF received in our laboratory from 1996 to 1998, which had a suspected diagnosis of herpesviral-associated neurologic disease (encephalitits or meningoencephalitis). Of these, 182 were from HIV seropositive patients and the other 71 were from HIV seronegative. The percentage of all positive cases was 22.5% in AIDS patients and CMV was the virus most frequently detected (13.7%). We detected a percentage of 29.5 of positive cases in immunocompetent individuals, being HSV the virus most frequently found. Other herpesviruses (varicella-zoster virus, Epstein-Barr virus, human herpesvirus 6) were also detected in some cases in both groups. Finally, we obtained clinical data from all positive patients and established a relationship with PCR results.

Adult↗
PubMedDate not supplied

[Prevalence of antibodies against herpes simplex virus, Epstein-Barr virus and cytomegalovirus in a group of patients after hemodialysis].

Infections from herpes virus play a key role in post-transplantation pathology, so it is indispensable to characterize the group of would-be renal transplant recipients. IgG antibody titers were detected by indirect immunofluorescence to Herpes simplex virus, Epstein Barr virus (EBV) and cytomegalovirus (CMV) in 100 patients treated with hemodialysis in the Nephrology Institute. The prevalence of antibodies to cytomegalovirus and to Herpes simplex and Epstein Barr viruses was 100% and 95% respectively. Average geometric titers (AGT) of antibodies to CMV were significantly higher. There was no correlation between AGT and sex, age, time of disease remission, number of blood transfusions and number of transplants.

Adult↗
PubMedDate not supplied

[Subcellular distribution of soluble and membrane-bound aminopeptidase in the left and right hemispheres of young and adult rats].

The levels of soluble and membrane-bound aminopeptidase activities were assayed in subcellular fractions from young (1 month old) and adult (5 month old) left and right rat brains, using Leu-, Arg- and Asp-2-naphthylamide as substrates. Both soluble Leu- and Arg-aminopeptidase activities showed the highest levels in the synaptosomal fraction in the two groups of rats. The highest levels of membrane-bound Leu- and Arg-aminopeptidase activities were found in the microsomal fraction of the two ages studied. There were no differences between the two ages in soluble Leu- and Arg- aminopeptidase activities. However, a significant decrease in both membrane-bound activities was evidenced in the synaptosomal fraction of adult rats. The young rats showed the highest soluble and membrane-bound levels of Asp-aminopeptidase activity in the microsomal fraction but no differences among fractions were found at 5 months of age. The soluble Asp-aminopeptidase activity of the homogenate and the mitochondrial fraction was significantly increased in adult animals when compared to that of younger ones. Finally, no differences between left and right brains, in soluble or membrane-bound activities, were found neither in young animals nor in the adult ones.

Aging↗
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[Mallory-Weiss syndrome. Surgical treatment after sclerotherapy. Presentation of a case and review of the literature].

We herein report a case of a male patient aged 23, with acute upper gastrointestinal hemorrhage, secondary to ingestion of acetyl salicylic acid. Endoscopy showed a linear laceration in the esophagus-gastric union. Based on endoscopic findings the diagnosis of Mallory-Weiss Syndrome was established. Surgical treatment was required, after sclerotherapy; we reviewed the literature for presenting a general panorama of this pathology.

Adult↗