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Biomedical subjects

E Espinosa

Publications and source records attributed to E Espinosa.

At least 109 records · Page 6Linked to original sources
PubMed1993

[Bearable truth as the crux of information for the cancer patient].

The communication with the patient suffering cancer is attracting an increasing attention. The change of attitudes towards death in our society, the poor training of physicians in this field and other factors have raised this new problem. In addition to the patient and the physician, the relatives and the nursing staff are also involved in the communication process. From the studies already performed, it can be derived that the "bearable truth" has to be supplied to the patient. The application of this concept needs time and dedication to the patient.

Attitude to Death↗
PubMed1992

Comparison of two antibiotic regimens (piperacillin plus amikacin versus ceftazidime plus amikacin) as empiric therapy for febrile neutropenic patients with cancer.

A total of 170 febrile episodes in neutropenic patients with cancer were randomly assigned to be treated with piperacillin-amikacin or ceftazidime-amikacin. The overall response rates were similar in both groups (68 and 65%, respectively). Response rates for clinically or microbiologically documented episodes were 54.5% for piperacillin-amikacin and 58.8% for ceftazidime-amikacin. Response rates for gram-negative bacillary infections were 65 and 73%, respectively. There was also no difference for gram-positive infections (31 and 50%, respectively). The toxicities were also comparable and consisted of skin rashes, hypokalemia, and diarrhea. Vancomycin was added if the fever persisted 72 h after the beginning of therapy; it increased the response rates to 94% when used with piperacillin-amikacin and 92% when used with ceftazidime plus amikacin. Our results suggest that the combinations show similar global efficacies in the treatment of febrile episodes in cancer patients.

Adult↗
PubMed1991

Bone metastases as the first manifestation of a tumour.

We have reviewed 29 patients whose first sign of a tumour was a bone metastasis. Two primaries were identified, lung adenocarcinoma and uterine adenocarcinoma and in 2 cases a presumptive diagnosis of tumours of the breast and prostate was made. The mean survival time was 3 months. When bone metastases are found in the absence of a primary tumour, investigation must include a clinical history, physical examination, routine laboratory tests and chest radiographs. Mammography should be done in women, particularly when there are palpable axillary nodes. Abdominal CT scanning and bronchoscopy should only be undertaken when there is a clinical indication.

Adult↗
PubMed1991

Further evidence for the molecular heterogeneity of chronic myeloid leukemia.

Cytogenetic and molecular techniques were performed on samples obtained from 29 patients with chronic myelocytic leukemia (CML); 27 were in the chronic phase and two were in blast crisis. A further five cases were also analyzed, two with atypical CML (aCML), one with chronic neutrophilic leukemia (CNL), and two with juvenile CML (JCML). Most of the cases with typical CML were Philadelphia chromosome (Ph) positive and had a rearrangement within the major breakpoint cluster region (M-bcr). One of these cases was shown to be Ph positive but showed no rearrangement within the M-bcr. Two cases with clinical features typical of CML were Ph negative. One of these showed a rearrangement within the M-bcr, but no rearrangement was demonstrated in the other. Both patients in blast crisis were Ph positive and M-bcr positive. One showed a second Ph. Patients with aCML were Ph negative and had no M-bcr rearrangement. A polymorphism within the M-bcr was found with BglII in one case. No Ph chromosome or M-bcr rearrangement was found in CNL or JCML. These data support the molecular heterogeneity reported in CML.

Blast Crisis↗
PubMed1991

Lead and zinc protoporphyrin in the blood of a rural child population in Asturias, Spain.

Lead and zinc protoporphyrin were determined in the blood of 54 children aged from 2 to 14 years living in a rural area of west Asturias (Spain). Mean values found were 14.4 and 27.7 micrograms dl-1, respectively. Blood lead levels are considerably lower than those of children living in central Asturias, which is more highly industrialised, showing the large part played by industry and road traffic in increasing both parameters.

Adolescent↗
PubMed1991

The effects of antihypertensive therapy on renal function.

Renal vascular resistance is increased in essential hypertension, with a consequent reduction in renal plasma flow together with a normal or slightly reduced glomerular filtration rate. Non-specific vasodilators may exacerbate this effect while loop diuretics, beta-blockers, angiotensin converting enzyme inhibitors and calcium antagonists may increase these renal hemodynamic parameters. We studied the effect of lacidipine, a new long-lasting calcium antagonist, on renal hemodynamics in 11 essential hypertensives. Lacidipine (4 mg once a day) acutely increased renal plasma flow without affecting the glomerular filtration rate. A transient, but non-significant, diuresis and natriuresis occurred. After 4 weeks of lacidipine treatment, all the parameters of renal function returned to basal levels. These results suggest that the well known renal effects of calcium antagonists are, at least in part, related to the onset of the antihypertensive effect being more pronounced with compounds such as nifedipine which have a rapid-onset, blood pressure-lowering effect.

Adrenergic beta-Antagonists↗
PubMed1991

[Descriptive study of the care of oncologic patients at the emergency service of a general hospital].

Clinical records of 352 patients seen in the Emergency Room of Hospital La Paz between January and April 89 and previously diagnosed of a malignancy were retrospectively reviewed. From the present study we concluded: 85.5% of them had not been seen by a physician before admission; most common tumors were lung, breast and gastrointestinal; anxiety and respiratory diseases were the most frequent diagnoses. This group of patients rarely need sophisticated complementary tests or therapy, but they spend more time at the hospital than other patients.

Adolescent↗
PubMed1991

[Immunologic changes in sickle-cell anemia].

In order to assess the status of their immunologic system, a study was carried out in 38 adults with sickle-cell anaemia. Fifty healthy blood donors were used as control group. Significant decrease of serum albumin (p less than 0.02) and increase of alpha-globulins (p less than 0.01) and gamma-globulins (p less than 0.001) were present in the patients. They showed also significantly decreased percentage of spontaneous rosette-forming lymphocytes (p less than 0.01) and of lymphocytes responding to anti-CD3 monoclonal antibody (p less than 0.05) with respect to the control group. Such relative T-cell decrease in peripheral blood seemingly took place by means of decreasing CD4-positive subpopulations, whose percentage was significantly lower (p less than 0.001) in the patients than in the control subjects. Functional studies showed a significant decrease (p less than 0.001) of the activity of natural cytotoxic cells. None of the patients had antibodies against human immunodeficiency viruses type 1 and type 2, and 60% of them were positive to cytomegalovirus test. No statistical correlation was found between the immunological findings and the presence of antibodies against such virus, neither such alterations correlated with the number of blood units received by the patients.

Adolescent↗
PubMed1989

Clinical features of hepatic sequestration in sickle cell anaemia.

Episodes of hepatic sequestration were seen in four patients with sickle cell anaemia (SCA). One case presented a severe and fatal sequestration crisis whereas the others showed mild episodes associated with less striking haematological and clinical changes. These clinical pictures are similar to those seen in the splenic sequestration crises of children with SCA. Different causes of liver enlargement in SCA suggest that the clinical spectrum representing intrahepatic trapping of blood could range from the acute sequestration crisis to chronic sequestration events which very probably should play any role in the pathogenesis of the hepatomegaly frequently found in these patients.

Adolescent↗
PubMed1986

Circulating immune complexes in sickle cell anaemia.

Circulating immune complexes were investigated in sera of 100 patients with sickle cell anaemia (SCA) in different clinical stages, using inhibition of complement-dependent rosette formation (EAC rosette inhibition), anticomplementary activity, polyethylene glycol 6000 precipitation, immunoconglutinin titre, total haemolytic complement, C4 and C3d. A high positivity was observed in patients with hepatic crisis (75%) and cases with leg ulcers (43%) compared with painful crisis (12%) and asymptomatic (7%) patients. These results provide evidence for the presence of circulating immune complexes during leg ulcers and hepatic crisis in SCA.

Adolescent↗
PubMed1981

Evidence for endothelial cell origin of vinyl chloride-induced hepatic angiosarcoma.

Previous reports of hepatic angiosarcoma have not clearly defined the cellular type from which this tumor arises, as evidenced by the terminology of endothelioma, Kupffer cell sarcoma, endothelial cell sarcoma, and hemangioendothelial sarcoma, etc., which have been used interchangeably. In addition, there has been no consensus on the separate entity of Kupffer and sinusoidal endothelial cells. In the work presented here, evidence for the endothelial cell origin of this tumor is provided by the demonstration of factor VIII, a known endothelial cell marker, in the tumor cells. Fluorescence due to the presence of factor VIII appeared intense in the tumor sinusoidal cells of all four vinyl chloride-associated angiosarcomas studied, whereas normal liver sinusoidal lining cells showed negligible fluorescence.

Endothelium↗