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Biomedical subjects

A Moreno

Publications and source records attributed to A Moreno.

At least 559 records · Page 31Linked to original sources
PubMedDate not supplied

[Sentinel lymph node (SN) detection in patients with breast cancer. Influence of tumor size and age of the patient].

OBJECTIVE: The objective of this study is to analyze the influence of tumor size and age of the patient in the detection of the SN in breast neoplasms. MATERIAL AND METHODS: A total of 190 patients affected of breast cancer with a mean age of 57 years (range from 28 to 87 years) were studied. According to age, the following were distinguished: under 40 years, 23 patients; between 40 and 60 years, 102 patients and over 60 years, 65 patients. The lesions were classified based on size (in mm) into: less than 10 in 27 patients, between 10 and 20 in 61 patients, between 20 and 30 in 64 patients, and greater than 30 in 38 patients. In all the cases, a scintigraphy was performed at 2 hr. post-injection of 3 mCi of 99mTc-nanocoloide, in the peritumoral area. After lymphoscintigraphy detection of the SN, cutaneous labeling was performed and it was detected surgically by a gamma detector probe. A complete lymphadenectomy was performed in all the patients. The histopathology was performed with hematoxylin-eosin and immunohistochemistry techniques and the state of the SN was compared with the remaining lymph nodes of the lymphadenectomy. RESULTS: The SN was located in 169 of the 190 cases (89%). In 164 cases, it was found in the axilla. The greatest percentage of those not detected was observed in tumors over 30 mm (32%) and patients older than 60 years (30%). No false negative were observed in tumors under 10 mm or in patients under 40 years, but the false negative rate increased with the patient's age and the tumor size. CONCLUSIONS: The patient's age and tumor size seem to influence SN detection rates. The FN rates seem to be superior in patients over 60 years. Patients under 40 years with tumors less than 10 mm are those who benefit most from this technique.

Adult↗
PubMedDate not supplied

[Cost-effectiveness analysis of the use of celecoxib for the treatment of osteoarthritis].

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs), used for the treatment of osteoarthritis, can produce serious gastrointestinal (GI) adverse reactions.Celecoxib, a specific COX-2 inhibitor, has a proven efficacy equivalent to that of traditional NSAIDs with an improved tolerance and safety profile. OBJECTIVE: The objective of this study was to perform a cost-effectiveness analysis on the use of celecoxib versus traditional NSAIDs in the treatment of osteoarthritis. MATERIAL AND METHODS: This cost-effectiveness analysis was designed through a pharmacoeconomic model; each effectiveness unit was defined as each year of life gained after the ingestion of celecoxib or NSAIDs. The probability of different clinical results appearing was obtained from published articles and incorporated assumptions. Only direct medical costs were evaluated (medication, hospitalization, additional tests, analyses, extra visits, etc.) and other costs were excluded. The study perspective was the national health system and the time horizon chosen was 6 months. RESULTS: The additional cost for each year of life gained through the use of celecoxib compared with that of traditional NSAIDs amounted to 8017; (1,333,834 ptas). Sensitivity analysis demonstrated how these values were sensitive to changes in the costs of NSAIDs and gastroprotective agents as well as to the inclusion of younger population groups. CONCLUSION: Celecoxib can be considered as a cost-effective option in the treatment of osteoarthritis because its use prevents deaths and increases survival rate and the additional cost is reasonable and moderate compared with that of NSAIDs. Its efficiency increases in proportion to its use in younger patients and probably in those at high risk for developing GI complications.

Aged↗
PubMedDate not supplied

From complexity to simplicity: nature and symbols.

This paper reviews Pattee's ideas about the symbolic domain as a phenomenon related to the self-simplifying processes of certain hierarchical systems, such as the living. We distinguish the concepts of constraint, record, and symbol to explain how the Semantic Closure Principle, that is to say, the view that symbols are self-interpreted by the cell, emerges. Related to this, the notion of complementarity is discussed both as an epistemological and as an ontological principle. In the final discussion we consider whether autonomous systems can exist in which constraints are not symbolically preserved, and if biological symbols can be considered to have a descriptive nature.

Biological Evolution↗
PubMedDate not supplied

Induction of protective immunity against experimental infection with malaria using synthetic peptides.

Synthetic peptides are potential vaccine candidates because they may be able to induce high antibody titres and specific cellular immune responses against native proteins and thus the whole invading organism. In a previous study we showed that immunization with molecules of relative molecular mass (Mr) 155,000 (155K) 83K, 55K and 35K, specific for the late schizont and merozoite stages of Plasmodium falciparum, could elicit either partial or total protection in Aotus trivirgatus monkeys experimentally infected with P. falciparum. Here we have chemically synthesized 18 peptides corresponding to different fragments of these proteins to immunize Aotus trivirgatus monkeys. Some peptides gave partial protection from challenge with P. falciparum parasites, but none provided complete protection individually. A combination of three partially protective peptides gave complete or almost complete protection, however, suggesting that this particular combination of peptides is a good candidate for a malaria vaccine.

Animals↗
PubMedDate not supplied

Apoptosis in ductal carcinoma in situ of the breast.

Programmed cell death (apoptosis) may play a role in tumor development and progression. The importance of apoptosis dysregulations in ductal carcinoma in situ (DCIS) and its relationships with p53 mutations and expression of bcl-2 has received little attention in the literature. In a series of 58 DCIS patients, we evaluated the number of apoptotic cells by the TUNEL technique in subgroups of DCIS and correlated it with immunohistochemical expression of hormone receptors, c-erbB-2, p53, bcl-2, and Ki-67 (MIB-1) and DNA content measured by image cytometry. High apoptotic index (greater than 3%) was related to high tumor grade, negative hormone receptors, c-erbB-2 overexpression, aneuploidy and lack of bcl-2 immunohistochemical stain. Apoptosis was not related to p53 or proliferative index. The findings are similar to those found in infiltrating breast cancer.

Adult↗
PubMedDate not supplied

Nosocomial bacteremia in a large Spanish teaching hospital: analysis of factors influencing prognosis.

Five hundred forty-three episodes of nosocomial bacteremia were prospectively followed in a large Spanish university hospital. The commonest isolates were Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Candida species. The most frequent sources of infection were intravenous lines, urinary tract, and lower respiratory tract. Overall mortality was 18%. A step-forward logistic regression analysis defined eight variables independently influencing the outcome: shock, underlying rapidly fatal disease, high-risk source of bacteremia (intraabdominal, lower respiratory tract, or not identified), age more than 70 years, hospitalization in intensive care or medical units, inappropriate antibiotic treatment, infection due to a high-risk microorganism (P. aeruginosa, Serratia marcescens, Klebsiella, Bacteroides, or Candida), and development of septic metastasis. The identification of those factors independently influencing the outcome and their possible modification may represent a further step in the control of nosocomial bacteremia by improving its prognosis.

Adult↗
PubMedDate not supplied

Neonatal lupus erythematosus in an infant with Turner syndrome.

Neonatal lupus erythematosus (NLE) is characterized by transient, annular cutaneous lesions, congenital heart block, and a variety of systemic or hematologic abnormalities. We describe a white infant girl with onset of skin lesions on the face and scalp at 4 days of age. At age 4 weeks she had generalized, erythematous, scaly, annular skin lesions that underwent spontaneous regression at age 5 months. Her mother had no cutaneous or other lesions, but complement examinations revealed the presence of anti-Ro(SSA) and anti-La(SSB) antibodies, and absence of anti-Sm and anti-RNP antibodies. Karyotyping revealed Turner syndrome (TS) with 45,XO sex chromosome constitution. Ro(SSA) and La(SSB) antibodies were found, and direct immunofluorescence testing on healthy skin was positive. At age 5 months, follow-up immunologic examination of the infant had normal results but the mother still had anti-Ro(SSA) and anti-La(SSB) antibodies. We believe that this is the first reported case of NLE in association with TS.

Antibodies, Antinuclear↗
PubMedDate not supplied

Menkes' kinky hair syndrome: ultrastructural cutaneous alterations of the elastic fibers.

Menkes' kinky hair syndrome is associated with the defective functioning of several copper-dependent enzymes due to impaired copper absorption, transport, or metabolism. Lysyl oxidase is a copper-requiring enzyme that catalyzes the oxidative deamination of lysyl residues linking two adjacent chains of tropoelastin polypeptides into an insoluble network. Elastin of the connective tissue is the responsible protein for the elastic properties of the skin. We report transmission electron microscopy findings concerning elastic fiber alterations of the skin in three patients with Menkes' syndrome. The reticular dermis showed marked changes in the elastic fibers with a paucity of the central amorphous component while retaining normal microfibrillary material. These ultrastructural observations, to the best of our knowledge, are reported for the first time in skin from these patients and may be readily interpreted in terms of a specific biochemical defect in elastogenesis.

Child, Preschool↗
PubMedDate not supplied

The normal and pathologic ischiorectal fossa at CT and MR imaging.

A wide spectrum of disease processes involve the ischiorectal fossa, including congenital and developmental lesions; inflammatory, traumatic, and hemorrhagic conditions; primary tumors; and pathologic processes outside the ischiorectal fossa with secondary involvement. Both computed tomography (CT) and magnetic resonance (MR) imaging are useful in the definitive diagnosis of these pathologic conditions, with MR imaging being the modality of choice because of its superior contrast resolution and multiplanar capability. In Gartner duct cyst, both CT and MR imaging demonstrate a well-defined, round mass; in tailgut cyst, CT demonstrates a well-defined retrorectal mass with a solid or cystic appearance. MR imaging in particular plays a major role in the assessment of fistula in ano, infection, and hematoma. Lipoma and pelvic plexiform neurofibroma typically have low attenuation and high signal intensity at CT and MR imaging, respectively. Recurrent rectal tumor appears at both modalities as an irregular soft-tissue mass with or without central necrosis in the presacral space, perineum, or pelvic sidewall. Familiarity with the imaging features and differential diagnoses of various ischiorectal pathologic processes will facilitate prompt, accurate diagnosis and treatment.

Adult↗
PubMedDate not supplied

[Simultaneous location of non-palpable breast neoplasms and sentinel node (SN) study by radioisotopic techniques].

OBJECTIVE: To obtain correct location of non-palpable breast lesions, with high suspicion of malignancy and detection of SN by radiosotopic techniques. MATERIAL AND METHODS: Thirty-one patients whose ages ranged from 35 to 79 years, with non-palpable breast lesions detected by mammography and/or ultrasonography were studied. All the patients were diagnosed of breast cancer and treated with primary chemotherapy. All the patients underwent total axillary dissection. At 24 hours of the intervention, all patients received one dose of 37 MBq (1 mCi) of 99mTc labeled macroaggregated albumin (MAA) in the center of the lesion by ultrasonographic guide. Scintigraphic images were performed in anterior and lateral projections (in prone decubitus with hanging breast) to verify the correct location of the radiopharmaceutical. After, a study of the SN was performed by subdermal administration of an 18 MBq (0.5 mCi) dose of 99mTc labeled nanocolloid. The SN site was labeled on the skin with indelible ink. The intrasurgical site of the breast lesion and SN was performed using a gamma detector probe. Correct placement of the intralesional radiopharmaceutical, existence of disease free borders and histological study of SN were performed by the pathologist in the surgical act. The differed pathology study was performed with hematoxilin-eosin and immunohistochemistry. RESULT: In 29 of the 31 lesion sites, there was good placement of the radiotracer (93.5 %). There was 1 case of contamination of the needle pathway and another that did not coincide with the lesion, due to poor placement. Location of the SN was 96 % in the axilla and 4 % in axilla and internal mammary chain. The SN was located in surgery in 28/31 patients (90 %). CONCLUSION: Simultaneous radioguided location of the hidden breast lesions and sentinel node is a simple method, which is well tolerated by the patients and can be done in a single operation act.

Adult↗
PubMedDate not supplied

[Sentinel lymph node biopsy in cutaneous non-melanoma malignancies].

PURPOSE: To assess the feasibility of the Sentinel lymph node biopsy (SLNB) technique in cutaneous non-melanoma malignancies. MATERIALS AND METHODS: Nine patients were retrospectively evaluated performing a scintigraphy with 99mTc-nanocolloid. On the day of the surgery, an initial dynamic study and static images were obtained. The first drainage station visualized was considered the sentinel node (SLN). The SLN position was marked on the skin and after a correct localization in the surgical field with a gamma probe the SLN was obtained. Patients of this study have been followed up for 8 to 48 months. RESULTS: Lymphoscintigraphy detected the sentinel node in 88,8 % of our studies (the SLN was not observed in a patient with a Merkel's tumour on the back). The SLN was identified intraoperatively in those patients with positive imaging. Those cases without scintigraphic demonstrated migration were also not found intraoperatively. Histopathological analysis of the SLN showed non metastatic disease and none patient developed metastases or local recurrence in the monitoring period. CONCLUSIONS: Sentinel node biopsy can be applied to certain cutaneous non-melanoma malignancies. In patients with unclear drainage and to avoid unnecessary lymphadenectomy, the technique offers clear advantages. In our study the SLN analysis was related to the clinical progress. A large number of patients should be examined to truly assess the benefit of this technique in this kind of malignancies and to determinate when the technique must be performed.

Adult↗
PubMedDate not supplied

Silver nitrate: antimicrobial activity related to cytotoxicity in cultured human fibroblasts.

The aims of this study were to ascertain whether silver nitrate (AgNO3) concentrations below those used in clinical practice inhibit bacterial growth, and in parallel study the cytotoxic effects on human fibroblasts. The cytoprotective effects of fetal calf serum (FCS) were also evaluated. The cytotoxic effects of eight different silver nitrate concentrations were determined by assessing mitochondrial activity of viable cells capable of cleaving tetrazolium salts. Antimicrobial activity of AgNO3, range: 7-550 x 10(-5)%, was tested against Staphylococcus aureus, Citrobacter freundii, and Pseudomonas aeruginosa. Silver nitrate concentrations exerting antimicrobial effects were: S. aureus, >70 x 10(-5)%; P. aeruginosa, >/=270 x 10(-5)%, and C. freundii, >/=550 x 10(-5)%. With 2% FCS, the lowest AgNO3 concentration studied (7 x 10(-5)%) showed cytotoxic effects (cell survival 71 +/- 19%) at only 2 h of incubation. Under these conditions AgNO3 cytotoxicity was time- and concentration-dependent in all exposure periods. Cytotoxicity was greatly enhanced causing 76% fibroblast growth inhibition at concentrations of 14 x 10(-5)% and contact time of 2 h. The AgNO3 concentration of 7 x 10(-5)% was also cytotoxic with 5% FCS in the media compared with controls, although cell survival was higher than with 2% FCS. The cytoprotective action of FCS was clearly shown at the concentration of 10% at which AgNO3 cytotoxicity of 7 x 10(-5)% to 28 x 10(-5)% was partially or completely inhibited. Our results show that AgNO3 at concentrations 100-700 times more diluted than that normally used in clinical practice retained effective inhibitory activity against some of the above-mentioned microorganisms. However, even these concentrations are cytotoxic for cultured fibroblasts. Thus, silver nitrate concentrations up to 100 times more diluted can be used, since they possess bacterial growth-inhibiting power, are less cytotoxic and therefore favour wound healing.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Nitric oxide-cGMP and prostacyclin-cAMP pathways in patients with type II diabetes and different types of retinopathy.

The aim of this study was to investigate two factors of endothelial dysfunction and their platelet second messengers in patients with type II diabetes and different types of retinopathy. We compared 20 healthy volunteers and 117 patients with type II diabetes (34 with no signs of diabetic retinopathy, 26 with background diabetic retinopathy, 29 with ischemic-proliferative diabetic retinopathy and 28 with edematous diabetic retinopathy). The following parameters were recorded: platelet aggregometry, nitrites, 6-keto-prostaglandin-F(1alpha) and intraplatelet cAMP and cGMP. Platelet aggregation was greater in patients with diabetic retinopathy. The concentration of ADP that produced 50% maximum intensity of aggregation was 1.81 microM in patients without diabetic retinopathy, 0.92 microM in patients with background diabetic retinopathy, 0.85 microM in patients with ischemic-proliferative diabetic retinopathy and 0.44 microM in patients with edematous diabetic retinopathy. The platelets in these patients were more resistant to inhibition by SIN-1 (concentrations of SIN-1 that produced 50% inhibition of maximum intensity of collagen-induced aggregation in the four patient groups: 18.1, 13.6, 16.2 and 33.2 microM, respectively). Nitrite concentration in patients with ischemic-proliferative diabetic retinopathy was one sixth of the value in healthy controls, but there was no significant difference between the control group and patients with edematous diabetic retinopathy. In the latter group, neutrophils increased nitrite production by 68.7 +/- 3%, whereas in patients with ischemic-proliferative diabetic retinopathy, this increase was 18.7 +/- 2.0%. We conclude that nitric oxide production is higher in patients with type II diabetes and edematous retinopathy than in those with ischemic-proliferative retinopathy. This finding, together with the possibly greater production of free radicals, may explain the greater impairment of platelet function in the former patients.

6-Ketoprostaglandin F1 alpha↗
PubMedDate not supplied

Effects of ditazol on the vascular retinal pattern in experimental diabetes in rats.

Platelets from diabetic patients are hypersensitive to aggregating agents. An imbalance in thromboxane/prostacyclin synthesis has been postulated as an antecedent to the development of diabetic retinopathy. We studied 3-month streptozotocin-diabetic rats (SDR) treated with 200 mg/kg/day p.o. of ditazol, an antiplatelet drug that inhibits thromoboxane formation. Thromboxane B2 (TxB2) production was higher and 6-keto-PGF1 alpha synthesis lower in SDR than nondiabetic rats (NDR). In treated animals, ditazol inhibited platelet aggregation by 66%, and TxB2 production by 58%, and increased vascular 6-keto-PGF 1 alpha by 45%. Furthermore, 13% of the retinal surface was covered by peroxidase-labelled vessels in NDR, 2.1% in nontreated SDR, and 8.9% in SDR treated with ditazol. We postulate that ditazol may prevent or reduce diabetic retinopathy.

Animals↗
PubMedDate not supplied

Study of the ability of proton nuclear magnetic resonance spectroscopy of human plasma to differentiate between controls and breast cancer patients.

Water-suppressed proton nuclear magnetic resonance spectroscopy of plasma had been proposed as a technique for detecting malignant tumors although its general diagnostic value is widely contested. To assess its diagnostic value in screening for breast cancer, we collected and analyzed 108 plasma samples from healthy women and women with breast disorders, mainly adenocarcinomas. No significant differences were found between controls and patients when average methylene-methyl linewidths were compared. Significant differences, however, were observed when methylene linewidths were compared. Unfortunately, the marked overlapping of both groups greatly reduced the possible diagnostic value of the technique. Among the various biochemical parameters analyzed for each plasma sample--triglyceride, total cholesterol and HDL cholesterol concentration, altered levels of carcinoembryonic antigen, phosphohexose isomerase, 5'-nucleotidase and phosphatase alkaline in patient samples, and estrogen and progesterone receptors of tumors--only triglyceride concentrations presented a clear inverse linear correlation with methylene linewidths.

Adenocarcinoma↗