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Biomedical subjects

V Moreno

Publications and source records attributed to V Moreno.

At least 73 records · Page 4Linked to original sources
PubMed1998

Efficacy of radiotherapy for malignant gliomas in elderly patients.

PURPOSE: Age above 65 years is a strong negative prognostic factor for survival in patients with malignant gliomas (MG) treated with radiotherapy (RT) and its value has been questioned. We analyzed the effect of RT on the survival of elderly patients with malignant gliomas. METHODS AND MATERIALS: We examined 85 consecutive elderly patients with a histological diagnosis of MG. Age ranged from 65 to 81 years (median 70 years). Glioblastoma multiforme (GBM) was diagnosed in 64 patients (75.3%). Surgical treatment included needle biopsy in 32 patients (37.6%). Median postoperative Karnofsky Performance Status (KPS) was 60 (range: 30-100). Survival probability was estimated using Kaplan-Meier method and compared with the log-rank test. Crude and adjusted hazard ratios (HR) were calculated using Cox's regression models. RESULTS: Median survival time for all patients was 18.1 weeks. In multivariate analysis, RT was the only independent prognostic variable for survival (HR: 9.1 [95% CI: 4.5-18.7]). Forty-two patients did not start RT mostly due to low KPS (<50). The median survival of the 43 patients who started RT was 45 weeks. In these patients, Cox multivariate analysis indicated that age was independently associated with prolonged survival (HR: 2.85 [95% CI 1.31-6.19]). Median survival of patients age 70 years and younger was 55 weeks compared with 34 weeks for patients older than 70 years. CONCLUSIONS: The overall survival for elderly patients with MG is poor. RT seems to improve survival in patients up to 70 years, but in older patients treated with RT the survival is significantly shorter.

Aged↗
PubMed1998

Study of the interaction of DNA with cisplatin and other Pd(II) and Pt(II) complexes by atomic force microscopy.

Modifications in the structure of a 260 bp DNA (hlyM) fragment from Escherichia coli caused by interaction with Pd(II) and Pt(II) complexes were studied. Cisplatin and transplatin [cis- and trans-PtCl2(NH3)2 respectively], Pt2Cl2(Spym)4 (Spym = 2-mercaptopyrimidine anion), Pd-famotidine and Pt-famotidine were incubated with DNA for 24 h at 37 degrees C and then observed with an atomic force microscope. Atomic force microscopy (AFM) provides the opportunity for nanometer resolution in research on the interaction between nucleic acids and metal complexes. The complexes induced noticeable changes in DNA topography according to their different characteristics and structure. In the case of cisplatin a shortening in DNA strands was observed. Transplatin and Pt2Cl2(Spym)4 caused shortening and compaction, whilst an aggregation of two strands was observed for the Pt-famotidine compound but not for the Pd-famotidine compound or the metal-free famotidine.

Antineoplastic Agents↗
PubMed1998

International trends in the incidence of cervical cancer: I. Adenocarcinoma and adenosquamous cell carcinomas.

Time trends in the incidence of cervical adenocarcinoma and adenosquamous cell carcinomas during the period 1973-1991 were examined using data provided by 60 population-based cancer registries from 32 defined populations in 25 countries. Three components of the incidence trend were studied: age, calendar period of diagnosis and birth cohort. Cumulative incidence rates per 1,000 for 2 groups with age ranges 25-49 and 50-74 years were calculated from the model that best described the incidence data. There was a significant increase in the cumulative incidence of cervical adenocarcinomas in women born in the mid-1930s and in successive cohorts thereafter in some populations in the United States (whites and Hispanic women), Australia, New Zealand (non-Maori), England, Scotland, Denmark, Slovenia, Slovakia and Japan (Osaka) and among Chinese women in Singapore, with a general decline in the incidence in women born in earlier periods. In Sweden and Slovenia there is a suggestion of an increasing trend in both age groups. A decrease in incidence in both age groups was apparent in Finland, France and Italy. There were no changes in incidence in 24 registries covering other European, Asian and black populations in the United States. Part of the increase may be attributable to an increasing prevalence of human papillomavirus infection, and part to improvements in screening.

Adenocarcinoma↗
PubMed1998

[Risk of developing and dying from cancer in Catalonia, Spain].

BACKGROUND: Cumulative risk reflects the lifetime probability that a person will develop a disease or will die from a disease. In this paper we estimate the cumulative risk of developing cancer and dying from cancer during the period 1988-1992 in Catalonia (Spain). MATERIAL AND METHODS: Data from the Tarragona Cancer Registry and Catalonia Mortality Registry are used. Cancer incidence from Tarragona is extrapolated to the total Catalan population. Cumulative risk is estimated from cumulative rate and with a life table method, which takes into account competing risks. The change in risk with age is also studied. RESULTS: Lifetime risk of developing cancer in Catalonia is 38.9% for men and 28.0% for women. Risk of dying from cancer is 26.3% for men and 17.2% for women, that is, a 67.6% and a 61.5% of incident cases, respectively. One in 14 men will develop lung cancer and nearly all of them will die from the disease. One in 14 women will develop breast cancer and 45% of them will die from the disease. CONCLUSION: Cancer is an important health problem in Catalonia because its high impact at the individual level shown by the cumulative risk. More than one in 3 men and one in 4 women are diagnosed of cancer during their lives and, among them, two thirds die because the disease.

Adolescent↗
PubMed1998

Cardiac surgical mortality: comparison among different additive risk-scoring models in a multicenter sample.

OBJECTIVE: To compare the performance of several risk-scoring models to predict surgical mortality following open heart surgery. DESIGN: A prospective observational study. SETTING: Seven tertiary cardiac centers (3 private and 4 public and teaching hospitals) in Catalonia (Spain). PATIENTS: A consecutive sample of 1287 patients submitted to open heart surgery during a 6 1/2-month period (February 14, 1994, to August 31, 1994). INTERVENTION: None. MAIN OUTCOME MEASURE: Model discrimination capability was assessed with the c-statistic. A chi(2) test to compare observed and predicted mortality rates was used as a measure of model calibration. Performance of centers was evaluated through the standardized mortality ratio and using the center as an indicator variable in a logistic regression model. The agreement among models for individual predictions was tested using weighted K statistics. RESULTS: Models developed in other health care contexts showed, as expected, lower c-statistics and an inappropriate calibration. There were no statistically significant differences among hospitals after adjusting for baseline patients' risk factors with the use of any of the different models. Models also agree in the standardized rank of centers. Weighted K statistics indicated poor agreement among models for individual patient risk prediction. CONCLUSIONS: Models can be a useful tool to compare providers' performance and to give a more in-depth look at the process of care when appropriately customized to the context. Severity-adjusted models can also play a role in supporting the informed and subjective surgeon's assessment, but it is inappropriate to use them for individual predictions.

Cardiac Surgical Procedures↗
PubMed1998

Recurrent in vitro fertilization failure evaluated by fluorescence in situ hybridization: a case report.

OBJECTIVE: To present a case of IVF failure evaluated by fluorescence in situ hybridization (FISH). DESIGN: Case report. SETTING: Research university laboratory and clinical IVF laboratory. PATIENT(S): An infertile couple with recurrent IVF failure. INTERVENTION(S): Fluorescence in situ hybridization study of the complete cohort of "zygotes" obtained at the third IVF attempt. MAIN OUTCOME MEASURE(S): Fluorescence in situ hybridization studies of chromosomes X, Y, 13, 18, and 21. RESULT(S): All the recovered putative zygotes were abnormal for the expected ploidy, presumably as a result of abnormal oocytes. CONCLUSION(S): Fluorescence in situ hybridization techniques represent a promising approach to analyze zygotes that fail to divide normally in vitro and eggs that fail to become fertilized. In cases of recurrent IVF failure, the results of FISH could be used to counsel couples and thus to help them choose among methods other than IVF for assisted reproduction.

Adult↗
PubMed1998

Palladium and platinum famotidine complexes.

The molecule of the well-known ulceration inhibitor, famotidine, is an excellent coordinator of transition metal ions. The guanidine, amine group and thiazole nitrogen, and the thioether sulphur are preferential sites to bind metal ions. Pd(II) and Pt(II) derivatives of famotidine have been synthesized and studied structurally. There is evidence that the palladium complex is a monomer while the platinum complex forms a dimer. Due to the interesting structure of the platinum complex several assays have examined the possible antitumour activity. Changes in DNA conformation induced by both complexes have been detected by CD, interstrand crosslinking interactions and electrophoretic mobility, but studies of the cytotoxicity of the platinum compound with U937 human leukemia cells and HeLA human womb carcinoma cells show only a small antiproliferative potential.

Animals↗
PubMed1998

Ecstasy: a common cause of severe acute hepatotoxicity.

BACKGROUND/AIMS: Ecstasy is a synthetic amphetamine recently identified as a possible cause of acute liver injury. This drug is consumed by young people and has a marked effect on improving sociability. The extent of ecstasy-associated severe hepatic damage is unknown to date. METHODS: The clinical histories of 62 patients with acute liver failure admitted to the Intensive Care Liver Unit between January 1994 and December 1996 were reviewed to assess the frequency, the epidemiological, clinical and histological characteristics and the outcome of ecstasy-induced severe hepatitis. RESULTS: Over this period of time, five patients (8%) were admitted because of ecstasy-induced acute liver failure, representing 31% of the cases with drug hepatotoxicity. Ecstasy was the second most common cause of liver injury in patients under the age of 25 years, being 20% in this subset of patients and 36% after ruling out the cases of viral etiology. All the patients had severe liver disease of acute onset, with jaundice, high peak of serum transaminases activity, hypoglycemia and low prothrombin activity, but no hepatic encephalopathy. Full recovery was observed in all cases from 3 to 12 months. CONCLUSIONS: Ecstasy is responsible for a relatively high number of cases of acute liver failure in young people. Therefore, the use of this drug should be investigated in all patients with severe hepatitis of unclear origin. Efforts must be made to advise young people of the risks of ecstasy consumption.

Adolescent↗
PubMed1998

Randomised double-blind study comparing tropisetron alone and in combination with dexamethasone in the prevention of acute and delayed cisplatin-induced emesis.

In a randomised, double-blind and parallel-design multicentre study, 282 chemotherapy-naive cancer patients received tropisetron 5 mg intravenously (i.v.) before high-dose cisplatin on day 1, and oral tropisetron 5 mg daily on days 2-6, in combination with either placebo (n = 143) or dexamethasone (n = 135), given i.v. on day 1 and orally on days 2-6. Complete protection from acute vomiting/nausea was achieved in 76.3%/79.3% of patients receiving the combination and in 55.2%/61.5% of those receiving tropisetron alone. Complete protection on days 2-6 from delayed vomiting/nausea was obtained in 60%/60% and 39.2%/40.6%, respectively. Tropisetron in combination with dexamethasone is safe and more effective than tropisetron alone in the prevention of both acute and delayed cisplatin-induced emesis.

Administration, Oral↗
PubMed1998

Helical CT versus CT arterial portography in the detection of hepatic metastasis of colorectal carcinoma.

OBJECTIVE: The study is a prospective comparison of helical CT with nonhelical CT arterial portography (CTAP) in the detection of liver metastases from colorectal carcinoma, using surgical and histologic findings as the gold standard. SUBJECTS AND METHODS: Thirty-five patients with colorectal carcinoma and suspected liver metastases were prospectively examined with helical CT and CTAP before surgery. In nine cases, surgery was not performed. In the remaining 26 patients, imaging results were correlated with surgical and pathologic findings. Three radiologists prospectively assessed metastatic involvement with both techniques. The results were compared with pathologic and surgical findings on a lesion-by-lesion basis. In a second phase, three radiologists not directly concerned in the design of the study independently assessed metastatic involvement of the liver as revealed on helical CT and CTAP on a segment-by-segment basis with a five-level scale of confidence. Results were analyzed by receiver operating characteristic methods. RESULTS: The results of the histologic study disclosed 50 metastatic lesions. Helical CT had a sensitivity of 76% (38/50) and a positive predictive value of 90%. CTAP had a sensitivity of 74% (37/50) and positive predictive value of 69%. Receiver operating characteristic analysis revealed a greater area under the curve (Az index), 0.96, for helical CT than for CTAP (0.86). Differences were statistically significant (p < .001). CONCLUSION: Helical CT is superior to nonhelical CTAP in the detection of hepatic metastases from colorectal carcinoma.

Adult↗
PubMed1998

Oestrosis in red deer from Spain.

A survey of naso-pharyngeal myiasis affecting red deer (Cervus elaphus) in southern Spain was conducted. The parasites involved were the larvae of Pharyngomyia picta and Cephenemyia auribarbis (Diptera:Oestridae), which coexist sympatrically within this host. Males and older animals had higher prevalences and intensities of fly larvae. Differences in behaviour and habitat use by male and female deer, and the increase of head size in older males are possibly responsible for this. There were low densities of C. auribarbis while P. picta was the species most frequently observed, although both oestrids were located in the same host cavities. The earlier larviposition by C. auribarbis, and its faster larval development may reflect asynchronous life-cycles of both oestrids; this may decrease inter-specific competition between these sympatric species.

Age Factors↗
PubMed1997

[Nosocomial infection with methicillin resistant Staphylococcus aureus in 14 human immunodeficiency virus infected patients].

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) frequently occurs with nosocomial infections. Although human immunodeficiency virus (HIV) infected subjects spend a long time in hospital, the transmission of MRSA nosocomial infections in this group of patients has not been previously reported previously. PATIENTS AND METHODS: A clinical sample of 14 HIV infected patients from an Infectious Diseases Unit, in whom MRSA had been isolated, were evaluated as part of a 6 months prospective study. The measures employed in assessing infectivity were the prospective surveillance of all those isolated and the search for carriers in associated health-workers. RESULTS: The potential index case was a patient with an isolated MRSA pneumonia. From him, it was transmitted to his cohabitors and to the rest of the Unit. All the patients had AIDS and 13 presented with MRSA-associated symptoms. Five were admitted 30 days previously and 12 had intravenous catheters. The mean time for the appearance of the infection was 16 days. In the antibiotic investigations multiresistance was confirmed and in the 13 symptomatic cases systemic treatment with vancomycin was indicated requiring replacement by teicoplanin in 50% due to adverse reactions. Two years later, the 14 patients had died but only one in relation to MRSA. Of the health-workers, one carrier was detected. The line of decolonization with mupirocin was efficatious. CONCLUSIONS: The MRSA nosocomial infection in HIV infected patients took place in subjects who were immunodepressed and had a prolonged mean time of hospitalization. The treatment with vancomycin and/or teicoplanin was effective in the majority of the cases.

AIDS-Related Opportunistic Infections↗
PubMed1997

Visceral leishmaniasis in patients infected with the human immunodeficiency virus.

The experience with 52 episodes of visceral leishmaniasis diagnosed in 43 patients is reported. The most common symptoms were fever (81%), splenomegaly (65%), hepatomegaly (63%), and pancytopenia (73%). In 79% of the patients, CD4+ cell counts were < 100 cells/mm3. Prior or simultaneous diagnosis of AIDS was made in 29 (67%) patients. Diagnosis was considered fortuitous in 19% of the episodes. In 27% of the episodes, the diagnosis was made on the basis of demonstration of parasites outside the reticuloendothelial system, chiefly blood (7 cases) and gastrointestinal mucosa (5 cases). Parasites were frequently observed or cultured from blood (22/37 episodes) or the digestive tract (8/9 episodes). High antimony doses were more effective than low doses in achieving clinical or parasitological cure (rate of cure, 80% vs. 40%, p = 0.11). Severe toxicity was observed in six (11.7%) of the 51 treated episodes. Severe AIDS-related diseases [odds ratio (OR) 10, p < 0.05] and CD4+ counts (OR 12, p < 0.05) were independent factors for early death. Prophylaxis with monthly pentamidine was not useful in reducing relapses of visceral leishmaniasis.

AIDS-Related Opportunistic Infections↗
PubMed1997

Assessing open heart surgery mortality in Catalonia (Spain) through a predictive risk model.

OBJECTIVE: To develop a risk stratification model to assess open heart surgery mortality in Catalonia (Spain) in order to use risk-adjusted hospital mortality rates as an approach to analyze quality of care. METHODS: Data were prospectively collected through a specific data-sheet during 6 1/2 months in consecutive adult patients subjected to open heart surgery. The dependent variable was surgical mortality, and independent variables included were presurgical (sociodemographic data, clinical antecedents, morphological and functional studies) and surgical. The model was built on a subsample (70% of study population) through univariate and logistic regression analysis and validated in the rest of the sample. RESULTS: The total sample was of 1309 procedures in seven hospitals; 47% of them were valve procedures. The overall crude mortality rate was 10.9% and varied among centers (range, 2.8-14.8%). Risk factors included in the model received a weight based on the logistic regression coefficient and a score was generated for each patient. The factors with the highest weight were patient older than 80 and second reoperation. Score was stratified in five categories of increasing risk. There was a good agreement between observed and predicted mortality rates in the validation group. Overall patient distribution was as follows: 52% low risk level, 16% fair, 13% high, 12% very high, and 6% extremely high risk level. Mortality rate increased from 4.2% in the low risk to 54.4% in the highest risk group. Case mix adjustment was performed through the risk score level. There were statistically significant differences in the risk profiles of patients admitted among centers. After adjustment by risk profiles, there were no differences in mortality by hospital. CONCLUSION: A risk stratification model through a multicentric, prospective and exhaustive collection of data in all types of open heart procedures was developed. In spite of wide differences on crude rates and in the risk profiles of patients admitted, we did not find statistically significant differences in adjusted mortality rates among centers. Timely and accurate information about surgical outcomes can lead to improvements in clinical practice and quality of care.

Adolescent↗
PubMed1997

Transfer of the yeast salt tolerance gene HAL1 to Cucumis melo L. cultivars and in vitro evaluation of salt tolerance.

An Agrobacterium-mediated gene transfer method for production of transgenic melon plants has been optimized. The HAL1 gene, an halotolerance gene isolated from yeast, was inserted in a chimaeric construct and joined to two marker genes: a selectable-neomycin phosphotransferase-II (nptII)-, and a reporter-beta-glucuronidase (gus)-. The entire construct was introduced into commercial cultivars of melon. Transformants were selected for their ability to grow on media containing kanamycin. Transformation was confirmed by GUS assays, PCR analysis and Southern hybridization. Transformation efficiency depended on the cultivar, selection scheme used and the induction of vir-genes by the addition of acetosyringone during the cocultivation period. The highest transformation frequency, 3% of the total number of explants cocultivated, was obtained with cotyledonary explants of cv. 'Pharo'. Although at a lower frequency (1.3%), we have also succeeded in the transformation of leaf explants. A loss of genetic material was detected in some plants, and results are in accordance with the directional model of T-DNA transfer. In vitro cultured shoots from transgenic populations carrying the HAL1 gene were evaluated for salt tolerance on shoot growth medium containing 10 gl-1 NaCl. Although root and vegetative growth were reduced, transgenic HAL1-positive plants consistently showed a higher level of tolerance than control HAL1-negative plants.

Acetophenones↗
PubMed1997

Ki-ras mutation modifies the protective effect of dietary monounsaturated fat and calcium on sporadic colorectal cancer.

The geographic differences in the incidence of colorectal cancer have been mostly attributed to variations in diet. The diversity of the Mediterranean diet and the heterogeneity of acquired genetic alterations in colorectal cancer sets the stage for investigating the possible association between dietary factors and mutations in tumor genes known to play a role in the pathogenesis of these neoplasms. With this purpose, we have studied the Ki-ras gene in 108 colorectal cancers using archival tissue and epidemiological data from our previous case-control study. Mutations in exon 1 of the Ki-ras gene were detected by a PCR-single strand conformation polymorphism approach. A polychotomous logistic regression model was used to assess the significance of observed differences between wild-type and mutated tumors with respect to population controls in the different categories of nutrient consumption. Multivariate density models were used to adjust the correlation between nutrients and total energy. Our studies show that high consumption of monounsaturated fats, mostly derived from olive oil, is associated with a statistically significant decrease in the risk of cancer with wild-type Ki-ras genotype but not of Ki-ras mutated cancers. Conversely, we find that high calcium intake is associated with a decreased risk of Ki-ras mutated tumors but not of wild-type tumors. Tumor genotyping can reveal epidemiological associations that are weak or unapparent when cases-control studies are not stratified by tumor genotype.

Aged↗