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Biomedical subjects

V Pinto

Publications and source records attributed to V Pinto.

At least 55 records · Page 3Linked to original sources

Dexamethasone inhibits the expression of an inducible nitric oxide synthase in infarcted rabbit myocardium.

Infarcted areas of rabbit myocardium show relatively higher inducible nitric oxide synthase activity, measured by the conversion of L-[14C]arginine to L-[14C]citrulline. The principal finding in this study is that dexamethasone (2 mg/kg) prevents the induction of inducible nitric oxide synthase in heart muscle when given before, or even 3 hr after coronary artery ligation. Additionally cyclic GMP levels remain unchanged following treatment with dexamethasone. It is possible that the enhanced production of nitric oxide by inducible nitric oxide synthase accounts, at least in part, for the depression of myocardial contractility seen in myocardial infarction and in other clinical conditions.

Amino Acid Oxidoreductases↗

Effect of amphiphiles on nitric oxide synthase in endothelial cells.

Amphiphiles are known to modulate the activity of ATPase, phospholipase A2, adenylate and guanylate cyclase amongst others and relax vascular smooth muscle. The effect of two amphiphiles, lysophosphatidylcholine (LPC) and digitonin on the activity of nitric oxide synthase (NOS), as measured by conversion of radiolabeled L-arginine to L-citrulline, has been studied. Neither digitonin (0.01 mmol/l) nor LPC (0.01 mmol/l) influenced NOS activity in endothelial cell homogenates. Digitonin but not LPC stimulated NOS in intact endothelial cells. NOS activity was markedly inhibited by L- but not by D-omega-nitroarginine (D-NNA, 0.1 mmol/l). L-NNA or D-NNA data demonstrate no effect of amphiphiles on isolated NOS. NOS activation may occur as a result of detergent action on the membrane.

Amino Acid Oxidoreductases↗

[The estimation of LHRH receptors in the tissue of human leiomyoma, myometrium and endometrium].

Uterine leiomyoma is the most common female benign pelvic tumor, affecting 20-25% of women during their reproductive years. There is strong clinical evidence that these tumors are estrogen-dependent for their growth, as also supported by their clear regression after the menopause. Although large clinical trials have not yet been reported, according to the estrogen dependency of uterine fibroids, LHRH agonists have been shown to be effective in the treatment of these conditions because they produce a condition of temporary hypoestrogenism secondary to the specific hypogonadotrophinism. This study was designed to evaluate if specific binding sites for LHRH are present in human uterine leiomyomata, myometrium and endometrial tissue. These tissues were taken from the fresh operative specimens of 14 patients who had undergone total hysterectomy for uterine leiomyomata. The results of this study demonstrate the presence of a LHRH specific binding site in uterine leiomyomata in 26% of cases; this specific binding site is also present both in myometrium and in endometrial tissue in 71% of cases. Moreover our study shows, for the first time, the high specificity of binding between LHRH agonist (goserelin) and natural LHRH receptor. In accordance with our results, a direct effect of LHRH agonists on fibroid tissue can be stressed.

Adult↗

[Kerion of the vulva. Report of a case and review of the literature].

We report a case of a 43 year old woman who developed an extensive vulvar kerion caused by Trichophyton menthagrophytes that was initially mistaken for a bacterial infection. The peculiarity of this case lies in the fact that the kerion is rarely located in the vulva and it has not yet been described in the literature. On the contrary, cases have been found in the scalp, beard, eye-brow, etc. We discuss the etiopathogenetic aspects, criteria for differential diagnosis and therapy management of this rare clinical picture.

Administration, Oral↗

Simplified ondansetron regimens for antiemetic prophylaxis in cisplatin-based chemotherapy of ovarian cancer.

In past years prevention of emesis and nausea induced by antiblastics has been based on extremely heterogeneous protocols with little efficacy. However, by the use of selective antagonists of serotonin S3 receptors there has been a remarkable improvement in the control of side effects. Among these antagonists ondansetron has been till now the most studied. The dosage protocols with which it has usually been employed establish an i.v. administration of the drug of 1 mg/h for 24 hours or the repetition of ondansetron 0.15 mg/kg x 2 every 2-4 hours after the end of chemotherapy. In our study, carried out from September 1991 till September 1992, 21 patients affected by ovarian carcinoma and treated by cisplatin chemotherapy protocols were evaluated (for a total of 63 cycles). Ten patients were under first line adjuvant chemotherapy treatment, whereas 11 patients were in relapse and had already undergone previous antiblastic treatments with serious side effects. In 18 out of 21 patients cyclophosphamide which has a strong emetic factor was associated with cisplatin. According to the total quantity of cisplatin contained in each cycle (in all < or =/> 100 mg) we used ondansetron in two different dosages simplified and shortened in time. They have been illustrated with particular details in the text. The control of nausea and vomiting during the first 24 hours was similar to the controls obtained in other studies in which ondansetron was administered according to the "traditional schemes".(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗

11-Oxycorticosteroid-dependent antibody in the serum of a patient with bladder neoplasm.

An IgM 11-oxycorticosteroid-dependent antibody was identified in the serum of a patient with bladder malignancy, which at 4-37 degrees C reacted with all the 11-oxycorticosteroids tested but not with desoxycorticosterone, testosterone, nortestosterone and progesterone. The resulting drug-antidrug antibody complex combines nonspecifically with red blood cells causing agglutination. This reactivity is enhanced both by acid pH and by high drug solution concentrations as well as by ficin test. The antibody is complement-independent and has no blood group specificity. No in vivo or in vitro hemolysis was observed.

Adrenal Cortex Hormones↗

[Low-grade non-Hodgkin's lymphomas. Study of 73 cases].

PURPOSE: To analyse the clinico-biologic features at diagnosis and the response to therapy and survival of a group of patients with low-grade non-Hodgkin's lymphoma (NHL). MATERIAL AND METHODS: The study comprises 73 NHL patients diagnosed between 1974 and 1989 in the Covadonga Hospital and classified as low-grade in accordance with the international Working Formulation. The first-line treatment regimens used were cyclophosphamide-vincristine-prednisone (CVP), chlorambucil-prednisone (CBL-PRED), radiotherapy, and other combinations. The statistical study was performed by comparative statistics (Student's tests, chi-square), univariate analysis (Cox Mantel method) and multivariate analysis (Cox proportional risks); the BMDP pack was used for the study. RESULTS: The median age of the group was 63 years. Stages III and IV were seen at first in 75% of the patients, and 22% of the series had extranodal involvement. CVP was used in 69% of the cases, 7.6 received CBL-PRED, 11% were given radiotherapy, and other combinations were given to 11% of the patients. As a whole, responses were seen in 46 cases (73%), of whom complete remission (CR) was achieved in 49% and partial remission (PR) or minor responses (MR) were attained in 24% of instances. The factors influencing upon CR were: stage (p less than 0.0005), B-symptoms (p 0.004), splenomegaly (p less than 0.801), platelet count and haemoglobin rate (p less than 0.01). The total survival at 10 years was 53%, and the disease-free survival for those attaining CR was 48%, with disease-free median of 81 months. The univariate analysis was influenced in a negative fashion by the following: peripheral blood lymphocyte count below 2 x 10(9)/L, B-symptoms (p less than 0.002), bulky tumoural mass (p less than 0.007), advanced stage (p less than 0.003) and, chiefly, response to treatment (p less than 0.0001). The 10-year survival of the patients achieving CR was 86%, that of both types of response (PR and MR) was 20%, and it was 0% for the failures. CONCLUSIONS: 1) Patients in low stages have high possibilities of curation with radiotherapy. 2) CVP for advanced stages provides moderate percentage of response, with CR rate lower than 50%. It is necessary to select those patients with unfavourable prognostic factors in order to use aggressive treatment to achieve CR. 3) Patients attaining CR have better prognosis in spite of the frequent relapses (63% at 10 years).

Adult↗

[Uncomplicated pregnancy in patients with unrecognized primary biliary cirrhosis].

A 32 yr-old woman suffering from an unsuspected primary biliary cirrhosis (PBC), completed an uneventual pregnancy. She only experienced diffuse pruritus and subicterus, which misled to an antepartum diagnosis of intrahepatic cholestasis of pregnancy. The most remarkable points of the reported case are: (a) the younger age of onset of PBC; (b) the paucisymptomatic course of PBC; (c) the rarity of PBC-associated pregnancy (only 15 previous instances in 12 patients, from a review of the literature); (d) the uncomplicated course of pregnancy for both the mother and the fetus, which is the exception rather than the rule, in such a condition. The present observation calls our attention to the possible existence of an underlying latent liver cirrhosis in pregnant women with pruritus, jaundice and mild alterations of liver function indexes. This association, which is expected to increase in frequency in the near future, may have important implications in the management of pregnancy.

Adult↗

Relationship of transfusion and infectious complications after gastric carcinoma operations.

To determine the effect of transfusion on the incidence of postoperative infection, a retrospective cohort study of 196 patients who underwent surgery for gastric carcinoma in the period from 1985 through 1989 was carried out. Seventy-one patients (36.2%) developed postoperative septic complications; they had received an average of 4.2 blood units, as compared with 2.7 units received by patients not affected (p less than 0.0053). The hypothesis of dose-response relationship is supported by the Mantel-Haenszel test, as applied to the overall results (p less than 0.01) and the results grouped by duration of operation (p less than 0.02). Furthermore, logistic regression analysis shows transfusion to be an independent risk factor in the incidence of infection (p less than 0.01), as are antibiotic prophylaxis (p less than 0.015), urinary tract catheterization (p less than 0.002), and the duration of surgery (p less than 0.027). This significance is attained after adjustment for age, gender, period of evolution of symptoms; preoperative infection(s), number of white cells, hemoglobin level and total proteins on diagnosis, location of tumor, tumor, nodes, and metastasis staging, operative technique, drainage of the area of operation, enteral nutrition, and the histologic studies and macroscopic appearance of the tumor. This study is further evidence that transfusion may cause an increased incidence of postoperative infection.

Aged↗

[Transfusion evaluation measured by a retrospective audit].

From a sample of 759 transfusions requests (2123 Units) for 392 patients, evaluated by retrospective audits the incidence of inappropriate transfusion at our Hospital was found to be 25.8% of request, affecting 23.3% of units and 39.3% of patients. The most frequent causes were: non-surgical and surgical use of whole blood in patients without hypovolaemia, use of fresh frozen plasma in patients with normal coagulation study red blood cells transfusion in patients with chronic anaemia and haematocrit of 24-30% without risk factors, surgical overtransfusion and prophylactic platelet transfusion in patients with platelet count above 20 x 10(9)/L. 17.3% of units could have been saved, and 32.3% of patients were overexposed or unnecessarily exposed to the risks inherent in any transfusion.

Adolescent↗

[Blood transfusion and survival of patients with neoplasms of the colon and rectum].

The fate of 248 patients diagnosed of colorectal malignancies between 1973 and 1982 and subjected to radical surgery with curative purposes was analysed. The effect of peroperative whole blood and packed red cells transfusions, along with other co-variants, on the survival of the patients was studied. It was found, by means of the Cox analysis, that whole blood and the Duke's staging system had the most important correlation (p = 0.003 and p = 0.02, respectively) on the patients' prognosis and survival, no such relationship being found with packed red cells transfusion (p = 0.25). Dose-related association between the relapse index and the number of whole blood units transfused was shown by the Mantel's global trend test (p = 0.015). The different effect of the transfusion products would confirm the hypothesis that the relationship between transfusion and poorer prognosis, thought to be due to patient's immunosuppression and hence higher relapse index, could be determined by any ill-defined plasmatic factor.

Adult↗

Antiepileptic drugs and vitamin D supplementation.

The incidence of biochemical signs of vitamin D deficiency and the effects of vitamin D supplementation were investigated in 83 children and 95 adults on chronic antiepileptic therapy and 40 mentally retarded controls living under comparable conditions. Low 25-hydroxyvitamin D and serum calcium, and elevated immunoreactive parathyroid hormone and alkaline phosphatase was a common finding in all groups, but in patients on antiepileptic drugs, signs of vitamin D deficiency were recorded more frequently. Supplementation of 125 microgram or 250 microgram vitamin D3 per week for 9 months normalized the laboratory findings in most patients; the effect of 37.5 microgram/week only slightly exceeded the influences of season observed in the controls and in epileptic patients without vitamin D. It is suggested that a dose between 37.5 and 125 microgram vitamin D3/week might be most suitable to avoid biochemical signs of vitamin D deficiency in children and adults on antiepileptic drugs.

Adolescent↗

Dose-response study with a new LH-RH analogue, D-Ser (TBU)6 LH-RH 1-9 (EA)10 during the follicular phase of the menstrual cycle.

D-Ser (TBU)6 LH-RH 1-9 (EA)10 (HOE 766) a highly active LH-RH analogue, was studied with regard to its effects on the release of follicle stimulating hormone (FSH), luteinizing hormone (LH) and oestradiol-17beta (Oe2) during the follicular phase of the menstrual cycle. Forty-two regularly menstruating women were allowed to five different treatment groups with different doses (1.25 microgram; 2.5 microgram; 5.0 microgram; 10.0 microgram; 20.0 microgram) of HOE 766 given as intravenous bolus injections and the plasma concentrations of FSH, LH and Oe2 were measured up to 24 h after injection using specific radioimmunoassays. In the majority of cases, peak values of both FSH and LH occurred 4 h after injection being significantly different from pre-injection levels (P less than 0.02 in the 1.25 microgram treatment group, P less than 0.005 for the other treatment groups). Statistical analysis of maximum values as well as the absolute and relative increase in the different treatment groups revealed a dose-dependent effect of HOE 766. Maximum values of Oe2 occurred 8 h after injection and were found to be significantly different from pre-injection levels (P less than 0.005). However, no dose dependent effect was observed. It was concluded that HOE 766 is a potent and long-acting stimulator of FSH, LH and OE2 release in women. The effect of HOE 766 is dose dependent for FSH and LH but not for Oe2.

Adult↗

Prenatal sonographic imaging of an immature intracranial teratoma.

This article describes the prenatal sonographic diagnosis of a rare case of intracranial immature teratoma in a fetus at the 35th week of gestation which looked normal at previous examinations. At sonography a markedly enlarged fetal head containing a complex irregular mass and hydrocephalus was detected. Color Doppler examination of the mass showed intense vascularization with low resistance flows.

Adult↗

Preoperative evaluation of ferritinemia in primary epithelial ovarian cancer.

AIMS AND BACKGROUND: High ferritin serum levels have been reported in patients suffering from various malignancies. The aim of this study was to evaluate the role of ferritinemia in the preoperative diagnosis of ovarian carcinoma. METHODS: Between March 1993 and September 1996, 60 patients suffering from ovarian carcinoma were surgically treated at our Department. Their ferritin serum levels were measured preoperatively by a solid-phase, two-site chemiluminescent immunometric assay and compared with those of a group of 60 healthy, age-matched, non pregnant controls. RESULTS: The mean serum concentration of ferritin was 54.7 +/- 7.8 ng/ml (range, 14-135) in healthy controls and 112.3 +/- 21.2 ng/ml (range, 9-947) in patients with ovarian carcinoma. The difference was statistically significant (P = 0.005, X2 test = 7.951). Serum ferritin was elevated preoperatively (cutoff > or = 120 ng/ml) in 18/60 patients with malignancy (sensitivity 30%), whereas the CA 125 levels were above the cutoff in 53/60 patients (sensitivity 88.3%). Only 2/60 women of the control group had ferritin titers > 120 ng/ml (specificity 96.7%). The ferritin levels increased with advancing disease stage; no significant correlation was found between ferritin concentration and neoplastic histology and grading. The mean serum iron levels were also measured preoperatively in patients with ovarian carcinoma and healthy controls. They were 57.2 +/- 3.8 and 66.3 +/- 2.61 micrograms/dl, respectively, and the difference was not significant (P = 0.655, X2 test = 0.200). CONCLUSIONS: The present study underlines that although ferritin shows an elevated specificity, its low sensitivity does not suggest any true usefulness as a tumor marker in epithelial ovarian cancer.

Adult↗

[Colonic polyps. Experience at a clinical center in Caracas].

After six years experience in the anatomopathological study and having checked 33.452 histological cases 772 corresponded to colon tumoral pathology. It was then decided to proceed with the epidemiological analysis of the polyps, it's anatomical distribution according to sex and age, it's histolopathological characteristics and the possible relationship with malignant transformation. We found a clear predominance mainly of adenomatosic neoplasic polyps, followed by hyperplasic polyps. 65% of the patients were male and more than half of the cases were between the ages of 50 and 70. Coincitentally, 86% of the atypical polyps were found within this age group.

Adenoma, Villous↗