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Biomedical subjects

A Espinosa

Publications and source records attributed to A Espinosa.

At least 55 records · Page 3Linked to original sources
PubMed1998

Hemangiopericytoma ischiorectal. Report of a case.

Hemangiopericytoma (HP) is a rare tumoral neoplasm of the soft tissues. Here, we report a case of HP that appeared in a young woman in a very uncommon location (perianal). Initially it was considered as a perianal abscess: arteriography, CT-scan and, eventually, histological studies, confirmed the diagnosis of HP. The tumoral mass was first embolized and thereafter was resected through a double approach (abdominal and perineal). One and a half years after surgery, the patient remains asymptomatic.

Adult↗
PubMed1997

Choline kinase inhibitors as a novel approach for antiproliferative drug design.

Recent progress in deciphering the molecular basis of carcinogenesis is of utmost importance to the development of new anticancer strategies. To this end, it is essential to understand the regulation of both normal cell proliferation and its alterations in cancer cells. We have previously demonstrated that in ras-transformed cells there is an increased level of phosphorylcholine (PCho) resulting from a constitutive activation on choiline kinase (ChoK). The importance of ChoK for the regulation of cell proliferation has also been proposed since an inhibitor for this enzyme, hemicholinium-3 (HC-3), drastically reduces entry into the S phase after stimulation with growth factors. Here we report the synthesis of several new compounds which are highly specific inhibitors for ChoK, with up to 1000-fold or 600-fold increased inhibitory activity, compared to HC-3 under ex vivo or in vitro conditions respectively. These novel compounds also drastically reduce entry into the S phase after stimulation with specific growth factors. A more profound inhibition of cell proliferation was observed in ras-, src- and mos-transformed cells in the presence of ChoK inhibitors, compared to their parental, untransformed NIH3T3 cells. By contrast, this effect was not observed in fos-transformed cells. While ras, src and mos transformation is associated with elevated levels of ChoK activity, fos-induced transformation does not affect ChoK activity. The inhibitory effect on proliferation of the new compounds correlates with their ability to inhibit the production of phosphorylcholine in whole cells, a proposed novel second messenger for cell proliferation. These results strongly support a critical role of choline kinase in the regulation of cell growth and makes this enzyme a novel target for the design of new antiproliferative and anticancer drugs.

3T3 Cells↗
PubMed1997

Peritoneal transport kinetics correlate with serum albumin but not with the overall nutritional status in CAPD patients.

The present study evaluates the influence of the peritoneal transport rate (PTR) on the nutritional status of continuous ambulatory peritoneal dialysis (CAPD) patients. Additionally, protein intake, dialysis adequacy, and other clinical variables were analyzed. Forty-two CAPD patients were concurrently subjected to the peritoneal equilibration test, a nutritional evaluation that included 24-hour dietary recall, and nutritional scoring system that included anthropometric, biochemical, and subjective parameters. Eight patients were high, 14 were high-average, 16 were low-average, and four were low transporters. Nine patients had normal nutritional status; six had mild, nine had moderate, and 18 had severe malnutrition. Malnutrition was inversely correlated (P < 0.05) with body surface, hemoglobin, and residual renal function, but not with PTR (r = 0.14; P = 0.38). In the multivariate analysis, the nutritional status was not predicted by the PTR, protein intake, or dialysis adequacy variables. When serum albumin (SA) level was evaluated as an isolated nutritional indicator, the most significant predictors were dialysate to plasma creatinine ratio at 4 hours (D/P4), body surface area, age, and diabetes mellitus. High transporters receiving a high dose of dialysis displayed a trend of having lower SA levels, whereas low-average transporters receiving a high dose of dialysis showed a trend of have higher SA levels. In conclusion, there was no correlation between PTR and nutritional status. In the multivariate analysis, no association was found between nutritional status and PTR, dialysis adequacy, and protein intake. The best predictors for SA are PTR, body surface area, age, and diabetes mellitus.

Analysis of Variance↗
PubMed1997

The arterialized antebrachial skin flap for hand reconstruction.

The authors present 20 microvascular flaps based on arteriovenous perfusion, harvested from the distal anterior forearm, and configured in three different designs. Indications were small palmar, dorsal, and commissural defects, when other conventional procedures were not available; problematic cases of open reduction internal fixation with skin defect; and when aggressive rehabilitation was needed. The follow-up varied between 6 and 28 months. Some degree of vascular congestion was observed in 100 percent of the flaps, and those changes were classified in a progressive form. Coverage was judged as stable, thin, and pliable in 75 percent of the cases in the series; aggressive rehabilitation was started promptly in all cases where this was possible. On average, an additional 2.4 hr were required for the original procedure. This flap demands little technical expertise for any microsurgical surgeon, and does not sacrifice any important donor vessel. The flap should not be followed-up by conventional monitoring methods instead, simple palpation of the pulse, Doppler auscultation, or PPG are required.

Adult↗
PubMed1997

Treatment of human brucellosis with doxycycline and gentamicin.

The objective of the present prospective, noncomparative, multicenter study was assess the safety and efficacy of gentamicin and doxycycline therapy for human brucellosis. In the first part of the study, a cohort of 17 patients received 100 mg of doxycycline (or 50 mg/kg of body weight per day if the body weight was < 40 kg) orally every 12 h for 45 days (cohort 1). In the second part of the study a subsequent cohort of 35 patients was treated with doxycycline at the same dosage for 30 days (cohort 2). All patients were treated intramuscularly with gentamicin at 240 mg (or 5 mg/kg per day if the body weight was < 50 kg) once daily for the first 7 days. Both cohorts showed a favorable response during therapy, and there were no therapeutic failures. Relapse was noted in 1 (5.9%; 95% confidence interval [95% CI], 0.15 to 28.7%) of the 17 patients in cohort 1 and in 8 (22.9%; 95% CI, 10.4 to 40.1%) of the 35 patients in cohort 2. Nineteen patients (36.5%; 95% CI, 23.6 to 51.0%) had adverse effects, with no differences between cohorts, and no patients had a treatment-limiting adverse effect. The study indicates that the combination of doxycycline for 45 days and gentamicin for 7 days is an effective and well-tolerated therapy for human brucellosis. The relapse rates obtained with doxycycline treatment for 30 days appear to be higher than those obtained with doxycycline treatment for 45 days.

Adolescent↗
PubMed1997

Recognition and optimum treatment of brucellosis.

Brucellosis (infection with Brucella spp.) is a common zoonosis in many parts of the world. Human brucellosis is a multisystem disease that may present with a broad spectrum of clinical manifestations. Treatment of brucellosis must effectively control acute illness and prevent complications and relapse. The choice of regimen and duration of antimicrobial therapy should be based on the presence of focal disease and underlying conditions which contraindicate certain specific antibiotics. The regimen of first choice is combination therapy with doxycycline for 45 days and streptomycin for 14 days. Gentamicin or netilmicin for the first 7 days may be substituted for streptomycin. Second-choice regimens consist of combinations of doxycycline and rifampicin (rifampin) for 45 days, or monotherapy with doxycycline for 45 days. Surgery should be considered for patients with endocarditis, cerebral or epidural abscess, spleen abscess or other abscesses which are antibiotic-resistant. Tetracyclines are generally contraindicated for pregnant patients and children < 8 years old. Rifampicin 900 mg once daily for 6 weeks is considered the drug of choice for treating brucellosis in pregnant women. In children < 8 years old the preferred regimen is rifampicin with cotrimoxazole (trimethoprim-sulfamethoxazole) for 45 days. An alternative regimen consists of a combination of rifampicin for 45 days with gentamicin 5 to 6 mg/kg/day for the first 5 days.

Adult↗
PubMed1997

Diheterocyclanes as synthons for the preparation of novel series of nucleoside and acyclonucleoside analogues.

Convenient synthesis of 1-[[3-(2-hydroxyethylhetero)-1-alkoxy]alkyl]-5-fluorouracils 3-8 was accomplished via the use of tin (IV) chloride, capable of a 1,4-chelation on alkoxy-1,4-diheteroepanes. Increasing the reaction time led to 5-FU seven-membered nucleoside analogues which could be considered as upper isosteres of the effective antitumour agent Ftorafur. Using 1-[[3-(2-hydroxyethoxy)-1-alkoxy]propyl]-5-fluorouracil as a parent drug, several chemical modifications on the acyclic moiety were made with the aim of obtaining new compounds showing significant antiproliferative activity in rhabdomyosarcoma (RD) cells. 14 treatment in vitro caused time- and dose-dependent growth inhibition on RD cells. Interestingly, when they were treated with doses of 35 microM and 140 microM of 14 for 6 days, they showed morphological and phetotypic differentiation with increased expression of desmin, alpha-actinin and tropomyosin. We suggest a potential role for differentiation therapy as a therapeutic approach to the treatment of rhabdomyosarcoma.

Antineoplastic Agents↗
PubMed1996

Treatment of human brucellosis with netilmicin and doxycycline.

We conducted a prospective, noncomparative, multicenter study to assess the safety and efficacy of doxycycline and netilmicin in the treatment of human brucellosis. The study included 64 patients who had acute brucellosis without endocarditis or neurobrucellosis. The treatment schedule consisted of the administration of 100 mg of doxycycline (or 5 mg/[kg.d] if body weight < or = 40 kg) twice a day orally for 45 days, plus 300 mg of netilmicin (6 mg/[kg.d] if body weight < or = 50 kg) intramuscularly once daily for 7 days. Therapeutic failure was noted in 5 patients (7.7%; 95% confidence interval [CI], 2.5%-17.1%), of whom 2 had spondylitis, 1 had sacroiliitis, and 1 had a splenic abscess that required splenectomy. Relapse was noted in eight patients (12.5%; 95% CI, 5.6%-23.2%). When relapse was considered in combination with initial lack of efficacy, 13 patients (21.9%; 95% CI, 12.3%-33.9%) failed to respond to therapy. Fifteen patients (23%; 95% CI, 13.5%-35.2%) had adverse effects, and one patient (1.5%) had a treatment-limiting adverse effect. Combination therapy with netilmicin/doxycycline may be effective in treating acute brucellosis. However, prospective controlled trials must confirm these results.

Acute Disease↗
PubMed1996

Prevalence of malnutrition in Mexican CAPD diabetic and nondiabetic patients.

Malnutrition is often present on continuous ambulatory peritoneal dialysis (CAPD), and contributes to morbidity and mortality. Diabetics (DM) have an increased risk for developing malnutrition. Our purpose was to assess the nutritional status (NS) of our CAPD population, to define NS differences between DM and nondiabetics (NoDM), and to identify NS-related factors. Patients were subjected to a nutritional assessment, which included a 24-hour dietary recall and a nutritional scoring system including anthropometric, biochemical, and subjective evaluation, and that classifies patients as: normal, and mildly, moderately, and severely malnourished. We studied 90 patients: 35 DM and 55 NoDM. In our whole population we observed a high frequency of malnutrition: NS was normal in 18%, and 20% had mild, 24% had moderate, and 38% had severe malnutrition. Ninety-one percent of DM and 76% of NoDM showed some degree of malnutrition. DM patients had significantly higher levels of malnutrition (p = 0.02), were significantly older, had more body fat, and spent less time on dialysis. There were 37 males and 53 females. Sex distribution was similar between DM and NoDM. Seventy-six percent of males and 86% of females had malnutrition. Moderate and severe malnourishment were more frequent in females. DM and female sex were the strongest predictors for moderate and severe malnutrition.

Adult↗
PubMed1995

Anticancer pyrimidine acyclonucleosides.

Several acyclonucleosides have been synthesized. Series 8 could liberate 5-FU and acrolein selectively in the tumour tissue whilst 9 only discharge 5-FU. The conformational analysis of 8 and 9 has been carried out by means of Molecular Mechanics, using the MM2 force field. It was observed that the open chain linked to the N-1 of the 5-FU moiety mimics the conformational structure of the sugar of desoxyuridine. Biological assays have been carried out in vitro on tumour growth in Ehrlich ascitic cells with the consequent decrease of 35% in the cellular mitosis. IC50 showed values between 3-45 microM for series 8 whilst series 9 were less active than 5-FU. Compared with that of 5-FU the acute and chronic toxicity is considerably decreased.

Animals↗
PubMed1994

[Health council: conclusions after 3-year experience].

OBJECTIVE: To evaluate the Health Council from 1990 to 1993. To find out what is the knowledge and opinion of the Community about Health Council. DESIGN: Observational, descriptive and crossover study. SITE. Health Council in El Higuerón Health Center. Rural population. Córdoba. PARTICIPANTS: Social agents and professionals who had participated in the Health Council's meetings during the three last years. Community of our suburb. MEASUREMENTS AND MAIN RESULTS: The records from three years ago have been analysed. A questionnaire was developed and answered in the community. Three focal groups, which had been done with social agents and health professional, have been analysed as well. Two groups of activities have been discussed: in relation to health problem of the community and in relation to Health Center's working. The 70% of them were carried out. Social agents took the initiative in 36%. Questionnaire: 92% of community think they must participate in the health's problems; 40% of community know the Health Council. Focal groups: Health Council is useful for improving the relation between Health Center and Community or for getting the Community to participate in this subject. CONCLUSIONS: It is important to remain and increase its utilization. It is necessary to divulge the Health Council and its function.

Attitude of Health Personnel↗
PubMed1994

5-Fluorouracil-interferon-alpha 2b adjuvant treatment of Dukes C colorectal cancer.

PURPOSE: To determine whether interferon: alpha 2b can improve results of 5-fluorouracil adjuvant treatment of Dukes C colorectal cancer patients, we compared the outcome of patients receiving a fluorouracil-interferon combination to that of historic controls treated with fluorouracil alone. METHODS: Fifty-seven Dukes C colorectal cancer patients were given 5-fluorouracil-interferon-alpha 2b adjuvant treatment from October 1986 to September 1990. The results were compared with those obtained in 51 consecutive patients treated at the same institutions with 5-fluorouracil (5-FU) alone (used at the same doses and schedule) between 1983 and 1986. The main prognostic variables were similar in the two groups. RESULTS: No life-threatening toxicity occurred in either group. The addition of interferon (IFN) slightly impaired tolerance to the treatment; however, the dose of IFN had to be reduced only in five patients and discontinued in one patient. Grade 3 and 4 myelotoxicity was rare and not substantially different in the two groups. Interferon-related side effects (fever, flu-like syndrome, malaise, etc.) were frequent, but, in general, mild or moderate. At the time of this analysis (July 1992), median follow-up was 49 (range, 20-70) months in the group of patients treated with 5-FU+IFN, and 86 (range, 68-103) months in the group receiving 5-FU alone. There were 17 recurrences and 15 cancer-related deaths among patients receiving combined treatment, and 27 deaths in the group treated with 5-FU alone. Both five-year relapse-free survival (65 percent vs. 47 percent; P = 0.043) and cause-specific survival (64 percent vs. 46 percent; P = 0.038) were significantly better in the patients receiving combined treatment. After correction for the influence of prognostic pretreatment variables, 5-FU+IFN again afforded a significant advantage in terms of both relapse-free (P < 0.01) and overall survival (P < 0.001). CONCLUSION: 5-FU-IFN-alpha 2b treatment seems to improve the prognosis in Dukes C colorectal cancer patients.

Aged↗
PubMed1993

Adenosine receptor antagonists potentiate dopamine receptor agonist-induced rotational behavior in 6-hydroxydopamine-lesioned rats.

Adenosine receptor antagonists, DMPX, PACPX and theophylline, produce contralateral rotations in unilateral 6-hydroxydopamine-lesioned rats. DMPX and theophylline markedly increase rotations produced by bromocriptine (a dopamine D2 receptor agonist) and/or SKF38393A (a dopamine D1 receptor agonist). All of these effects are inhibited by CGS21680C (an adenosine A2 receptor agonist). These findings suggest synergistic interactions among D1, D2 and A2 receptors that may be relevant to the treatment of Parkinson's disease.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗
PubMed1992

McArdle's disease and gout.

We report the first case of McArdle's disease (muscle phosphorylase deficiency) and tophaceous gout. To examine the contribution of adenine nucleotide degradation to the disturbance of uric acid metabolism, we labeled the adenine nucleotide pool with [8-14C]adenine, and measured plasma and urine purines following vigorous exercise tests. Plasma and urinary hypoxanthine and xanthine concentrations and the specific radioactivity of urinary purines increased markedly, but plasma urate levels and uric acid excretion were not substantially modified. We suggest that, in this patient, the association of McArcle's disease with gout is coincidental.

Adenine Nucleotides↗