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Biomedical subjects

E Espinosa

Publications and source records attributed to E Espinosa.

At least 91 records · Page 5Linked to original sources
PubMed1994

Comparison of two chemotherapeutic regimens--mitomycin + vindesine + cisplatin (MVP) vs. mitomycin + ifosfamide + cisplatin (MIP)--in advanced non-small-cell lung cancer. ONCOPAZ Cooperative Group.

BACKGROUND: A prospectively randomized trial was performed to compare the efficacy and toxicity of two chemotherapeutic regimens widely used in advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: From January 1989 to March 1992, 196 patients with measurable disease were included in the trial. Ninety-three patients received mitomycin-vindesine-cisplatin (MVP) and 94 mitomycin-ifosfamide-cisplatin (MIP). RESULTS: The objective response rate (complete plus partial remissions) was 28% (26/93 patients, 95% confidence interval 20%-40%) in the MVP arm and 30% (28/94 patients, 95% confidence interval 20.5%-40%) in the MIP arm. The median survival was 8.5 and 9 months, respectively. Neither the response rates nor the median survivals were significantly different. Grade III-IV leukopenia was more frequent with MVP (13% vs. 2% of the courses, p < 0.001), as well as grade I-II neurologic toxicity (30% vs. 6%, p < 0.001). In contrast, grade I-II anemia and grade I-II urologic toxicity were more frequent with MIP (7% vs. 25%, p < 0.001 and 1% vs. 11%, respectively). CONCLUSION: Given the low efficacy of both schemes in the treatment of advanced NSCLC, their use cannot be recommended outside of clinical trials.

Adult↗
PubMed1994

[Treatment of promyelocytic leukemia with retinoic acid: results in Cuba].

PURPOSE: To assess the results attained with all-trans-retinoic acid (ATRA) in a group of Cuban patients with acute promyelocytic leukaemia (PML). PATIENTS AND METHODS: Twenty-one patients with PML were studied. Their cytogenetic study was performed with G-band techniques. ATRA was given orally as a single dosis of 50 mg/m2 a day, or divided in two doses. After attaining complete remission (CR), ATRA was maintained for 1-3 months in association with minimal doses of Ara-C or alpha-interferon. A rotation of three therapeutic regimes (TRAP, POMP and DOAP) was subsequently administered. RESULTS: Twelve of the patients were women and 9 men; 15 were adults and 6 were children, the median age being 19 years (range: 6-60 years). Only two patients had leucocytosis, all others presented with leucopenia. Platelet count below 30 x 10(10)/L was found in 67% of the cases, while some sort of bleeding was present in 81% of them. Laboratory evidence of disseminated intravascular coagulation was seen in 52% of the cases, and t (15; 17) appeared in 67% of the evaluable cytogenetic studies. CR was attained in 17 patients (81%) within a mean of 40 days. Headache was the commonest untoward effect of the treatment. Eight patients developed leucocytosis during treatment, white-cell count being over 20 x 10(9)/L in six of them. Fever without infectious signs was present in 5 patients, and in 3 of them the temperature recovered with steroid therapy. Two patients had retinoic acid syndrome prior to achieving CR. Four patients relapsed and 13 (76%) have maintained CR after 1 to 24 months. CONCLUSIONS: The incidence of CR in this series is within the limits reported in the literature. The secondary effects of the treatment are the same than those reported by others, and they were transient and well tolerated. The response to steroids of those patients with fever secondary to ATRA is noteworthy. The efficacy of ATRA, in general terms, in the induction of CR in PML seems confirmed by these results.

Adolescent↗
PubMed1993

p53 gene rearrangements in chronic myelocytic leukemia.

We performed Southern-blot analysis of the p53 gene in 41 consecutive patients with typical chronic myelocytic leukemia (CML). In two of them, we were able to study cells during both the chronic and the accelerated phases. Only one of the 29 chronic-phase samples had rearrangement of the p53 gene, whereas three of the nine accelerated-phase samples and one of the five patients in blast crisis exhibited rearrangements. Gene deletion was observed in two patients, one in accelerated phase and the other in blast crisis. One patient with a nonrearranged p53 gene in chronic phase showed rearrangement after progression to the accelerated phase. On the other hand, one patient in accelerated phase exhibited rearrangements which disappeared after reversion to chronic phase with successful treatment. Our findings support the opinion that alterations of the p53 gene may play an important role in CML evolution.

Blast Crisis↗
PubMed1993

Urinary kallikrein excretion and blood pressure response to angiotensin converting enzyme inhibitors and calcium antagonists in hypertensive patients.

OBJECTIVE: To investigate whether the hypotensive effects of angiotensin converting enzyme (ACE) inhibitors in comparison with those of calcium antagonist might be predicted by urinary kallikrein activity, a marker of the activity of the renal kallikrein-kinin system. DESIGN: Seventy-five essential hypertensive patients were randomly assigned to treatment with ACE inhibitors (enalapril or lisinopril 20 mg once a day) or with calcium antagonists (nifedipine 20 mg twice a day or lacidipine 4 mg once a day). Fifty-four had normal (NK) and 21 low (LK) kallikrein activity. Blood pressure was measured after 2 weeks, and 3 and 6 months. Patients whose diagnostic blood pressure, 2 weeks after the first dose, decreased by at least 15 mmHg or was < or = 90 mmHg were defined as responders. The others were defined as non-responders. In non-responders a second drug was added and the patients were not considered for further analysis. METHODS: Urinary kallikrein activity was determined by a spectrophotometric assay using a synthetic chromogenic substrate. RESULTS: After 2 weeks therapy with ACE inhibitors 88% of NK patients were responders, whereas in the LK subgroup 40% were responders, a significant difference between subgroups. For the patients treated with calcium antagonists, conversely, 59% of NK patients were responders in comparison with 82% of the LK subgroup, a significant difference between drug groups. After 3 and 6 months of treatment blood pressure was significantly lower in NK patients treated with ACE inhibitors and in LK patients treated with calcium antagonists. In the NK group on ACE inhibitors the mean arterial pressure after the first dose was significantly related to that observed after 6 months (n = 0.71, P < 0.01). CONCLUSIONS: Our data indicate that urinary kallikrein activity may represent an index to predict the chronic antihypertensive effect not only of ACE inhibition but also of calcium antagonism, and support the concept that the renal kallikrein-kinin system might play some contributory role in modulating the hypotensive action of ACE inhibitors.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1993

Ursodeoxycholic acid in the Ursidae: biliary bile acids of bears, pandas, and related carnivores.

The biliary bile acid composition of gallbladder bile obtained from six species of bears (Ursidae), the Giant panda, the Red panda, and 11 related carnivores were determined by reversed phase liquid chromatography and gas chromatography-mass spectrometry. Bile acids were conjugated solely with taurine (in N-acyl linkage) in all species. Ursodeoxycholic acid (3 alpha, 7 beta-dihydroxy-5 beta-cholan-24-oic acid) was present in all Ursidae, averaging 1-39% of biliary bile acids depending on the species; it was not detected or present as a trace constituent (< 0.5%) in all other species, including the Giant panda. Ursodeoxycholic acid was present in 73 of 75 American Black bears, and its proportion averaged 34% (range 0-62%). Ursodeoxycholic acid averaged 17% of biliary bile acids in the Polar bear (n = 4) and 18% in the Brown bear (n = 6). Lower proportions (1-8%) were present in the Sun bear (n = 2), Ceylon Sloth bear (n = 1), and the Spectacled bear (n = 1). Bile of all species contained taurine-conjugated chenodeoxycholic acid and cholic acid. In some related carnivores, deoxycholic acid, the 7-dehydroxylation product of cholic acid, was also present. To determine whether the 7 beta hydroxy group of ursodeoxycholic acid was formed by hepatic or bacterial enzymes, bile acids were determined in hepatic bile obtained from bears with chronic biliary fistulae. Fistula bile samples contained ursodeoxycholic acid, chenodeoxycholic acid, and a trace amount of cholic acid, all as taurine conjugates, indicating that ursodeoxycholic acid is a primary bile acid formed in the liver in Ursidae.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Soft tissue sarcomas: thirteen years experience in the service of medical oncology of a general hospital.

Thirty-seven patients with soft tissue sarcomas were treated between 1981 and 1990. All of them were operated. Thirteen patients with marginal resection received adjuvant radiotherapy. Radiotherapy decreased the rate of local relapses. Sixteen patients received adjuvant chemotherapy with ifosfamide-epirubicin and four of them had a recurrence. Twenty-one patients did not receive chemotherapy and 13 of them relapsed. Adjuvant chemotherapy improved the disease-free survival during the first year, but not benefit appeared in long-term disease-free survival and overall survival.

Adult↗