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Biomedical subjects

E Prats

Publications and source records attributed to E Prats.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Treatment with (131)I of toxic multinodular goiter. Assessment of a fixed dose protocol].

OBJECTIVE: Present the results of treatment with 131I in a cohort of 119 patients diagnosed of toxic multinodular goiter (TMG) from a specific geographic area who had been treated with fixed doses of isotopes (555 MBq). The indication for the administration of the 131I was hyperthyroidism correction in all of the cases. MATERIAL AND METHODS: 111 of the 119 patients treated were women (93%) and 8 were men (7%) and their ages ranged from 38 to 88 years. The follow-up periods were always greater than one year (1.78 +/- 1.05 years). Treatment with thyroid medication was discontinued in all of the patients at least 7 days prior to the administration of the isotope. RESULTS: 93 (78.1%) of the 119 patients remained euthyroidic, 10 (8.4%) presented hypothyroidism, 11 (9.2%) hyperthyroidism and 5 (4.2%) had sub-clinical levels of hyperthyroidism at the end of the follow-up period. No statistically significant relationship were found between hypothyroidism, gender and previous administration of thyroid medication. CONCLUSIONS: The use of 131I is an alternative to the treatment of TMG produced hyperthyroidism. The fixed doses of 555 Mbq that we propose are comfortable, make it unnecessary for the patients to travel in extensive geographic areas and produce a low rate of hypothyroidism. In our opinion, the differences in the iodine content of the diets that continue to exist are one of the factors that could influence in the differences in results observed in the different series, although other factors, such as the size of the goiter and the heterogeneity of the radioisotope uptake can contribute to the variations found in our patients.

Adult↗
PubMed2000

[The effects of enalapril on exercise capacity and right ventricular function in patients with chronic cor pulmonale].

BACKGROUND: Chronic cor pulmonale (CPC) in patients with chronic obstructive pulmonary disease (COPD) is a predictor of mortality. ACE inhibitors (ACEIs) improve the symptoms and reduce mortality of left ventricular or congestive failure, however their long term use in patients with CPC has not been tested. The aim of this study is to assess the effect on exercise tolerance and cardiorespiratory function of long term administration of enalapril in patients with CPC. METHODS: Placebo-controlled, double blind, randomized study. 28 patients (24 men and 4 women, mean age of 68.11 +/- 7.78, range 51-79) with CPC and without exacerbation of their respiratory symptoms at baseline were double blind randomised to receive enalapril or placebo for 6 months, added to their previous therapy. Respiratory function test, exercise tolerance ("six minutes walking test") and isotopic ventriculography were performed at baseline and at the end of the study. RESULTS: At baseline there were no differences in FEV1, FVC, FEV1/FVC and exercise tolerance. Both placebo and enalapril were well tolerated. At the end of the study, patients taking enalapril increased their exercise tolerance an 8.9% (19 m) vs 4.7% (33 m) in the placebo group (p 0.44; 95 percent confidence interval, -41.10 to 91.99). RVEF improved a 6.4% with enalapril but worsened a 7.09% in placebo group (p 0.15; 95 percent confidence interval, -12.87 to 2.10). CONCLUSIONS: Long term administration of enalapril do not improve neither exercise tolerance, nor right ventricular (RV) function, although given in increasingly doses is well tolerated and might prevent further worsening in RV systolic function.

Aged↗
PubMed1999

Mytilus edulis histone gene clusters containing only H1 genes.

We isolated five different phage clones containing histone gene clusters with up to five H1 genes per phage clone from a Mytilus edulis genomic library. Among these H1 genes, nine gene types coding for five different H1 proteins have been identified. All H1 histone genes were located on repetitive restriction fragments with only slightly different sizes. The H1 coding regions show highly related sequences, suggesting that the multitude of H1 genes has evolved by gene duplication events. Core histone genes could not be found on these five Mytilus edulis genome fragments.

Amino Acid Sequence↗
PubMed1999

Mammography and 99mTc-MIBI scintimammography in suspected breast cancer.

UNLABELLED: The aim of this work has been to evaluate whether a diagnostic protocol based on the joint use of mammography and 99mTc-methoxyisobutyl isonitrile (MIBI) scintimammography is capable of reducing the number of biopsies required in patients with suspected breast cancer. METHODS: We performed prone scintimammography in 90 patients with suspected breast cancer, involving 97 lesions. In all patients, the diagnosis was established by way of biopsy. On mammography, we evaluated the degree of suspicion of malignancy and the size of the lesion (smaller or larger than 1 cm in diameter). RESULTS: The results of only 41 of the biopsies indicated malignancy. On mammography, 20 lesions (of which 1 was breast cancer) were considered to be of low suspicion of malignancy, 31 (of which 4 were breast cancer) as indeterminate and 46 (of which 36 were breast cancer) as high. Fourteen lesions (2 low probability, 2 indeterminate and 10 high) were smaller than 1 cm, whereas 83 (18 low probability, 29 indeterminate and 36 high) were larger. The sensitivity, specificity, positive predictive value and negative predictive value of scintimammography were 85%, 79%, 74% and 88%, respectively. Scintimammography was positive in all cases of breast cancer that initially had a low or indeterminate suspicion of malignancy according to mammography, as well as in 30 cases of breast cancer that initially were highly suspicious. Six false-negative scintimammography studies were obtained in lesions with a high suspicion of malignancy. CONCLUSION: We propose a diagnostic protocol with a biopsy performed on lesions that have a high suspicion of malignancy as well as those with low or indeterminate suspicion that are smaller than 1 cm or with positive scintimammography results. This would have reduced the total number of biopsies performed by 34%. More importantly, there would have been a 65% reduction in number of biopsies performed in the low and indeterminate mammographic suspicion groups. All 41 cases of breast cancer would have been detected.

Adult↗
PubMed1999

Clinical applications of radiolabeled blood elements in inflammatory bowel disease.

This work discusses the main clinical features of inflammatory bowel disease (IBD) and the methods to obtain an accurate diagnostic. Nuclear medicine procedures are deeply analyzed, with special emphasis in those where clinical experience is larger and that are available for clinical practice in most countries. In the opinion of the authors 99mTc-HMPAO is the first choice agent, while 111In-oxine could be considered as the gold standard for evaluation of new agents. In the context of IBD, the WBC scintigraphy is useful for its diagnosis (early and accurate) and the evaluation of disease extension (whole bowel examination, without patient preparation and negligible risk). The evaluation of disease severity deserves further experiences.

Antibodies, Monoclonal↗
PubMed1999

[Scintigraphy with 99MTc-HMPAO labeled leukocytes and computed tomography in the diagnosis of vascular graft infection. A comparative study].

The purpose of this work was to compare the results obtained with a scitigraphy using 99mTc-HMPAO labeled leukocyte and a computed tomography (CT) in the diagnosis of vascular graft infection (VGI). We carried out 22 studies with both scintigraphy and CT in 20 patients with vascular grafts with VGI suspicion. One patient had two grafts, thus a total of 23 grafts were analyzed. In addition, 6 control studies were performed. The persistent increase in leukocyte uptake in the graft area was considered as evidence of VGI and the scintigraphy with HMPAO-99mTc labeled leukocytes. For the CT, the presence of perigraft fluid and/or gas collection in the graft bed was also considered to be evidence of VGI. The total number of VGI was 12. The VGI diagnosis was confirmed by culture in all cases. The sensitivity and specificity of the scintigraphy in the diagnosis of VGI was 100%, while the CT has a sensitivity of 58% and specificity of 91%. Five grafts presented pseudoaneurysm in distal aorto-bifemoral graft anastomosis. All theses cases were detected with CT and only one patient with pseudoaneurysms showed scintigraphic evidence of VGI. In addition, both techniques detected two soft tissue infections associated with cutaneous fistulae, one case of abdominal abscess and another of acute diverticulitis. The scintigraphy was also pathologic in one infection of the surgical wound while that the CT was negative. In conclusion, although both techniques are useful to evaluate patients with suspicion of VGI, the scintigraphy with 99m-Tc-HMPAO labeled leukocytes has been shown to be more sensitive than the CT in the assessment of patients with VGI suspicion.

Aged↗
PubMed1999

[Gammagraphy of somatostatin receptors in an ACTH secreting thymic carcinoid].

Ectopic ACTH secretion represent 10 to 15% in the causes of Cushing's syndrome. Carcinoid tumor of the thymus is a rare neoplasm and is currently believed to arise from population of thymic cells of neural crest origin. We present the case of a 43-year-old man with a corticotropin hormone (ACTH) secreting thymus carcinoid. 111In-octreotide scintigraphy demonstrated an intense uptaken on the lesion. The surgical specimen measured 17 x 18 x 18 cm and weighed 1. 25 kg. Postoperatively the patient was treated by chemotherapy and radiotherapy. A follow-up 111In-octreotide scintigraphy was normal. Very few scintigraphic images of these lesions have been published in the literature. Somatostatin receptor scintigraphy can be successful in the detection and follow-up of ACTH-secreting neuroendocrine tumors.

Adrenocorticotropic Hormone↗
PubMed1999

[131I-treatment of the autonomous toxic nodule. Assessment of a fixed dose protocol].

Ninety six patients diagnosed of toxic thyroid adenomas received fixed doses of 131I (555MBq) for treatment of hyperthyroidism. The inclusion and exclusion criteria, the patient's characteristics and the advantages of the fixed doses are described. The hypothyroidism rate found at the end of the mean follow-up period (2.46 +/- 1.72 years) which was 27.08% significantly lower to that observed in patients treated for Graves-Basedow disease, is pointed out. No differences were found in the hypothyroidism rate when the patients were differentiated by sex or when this situation was related to pretreatment with the antithyroid drugs. The extensive differences in the hypothyroidism rates observed between the different series that have been published and the variability in the doses administered leads us to think that factors other than the dose of 131I may be responsible for this post-therapeutic hypothyroidism.

Adenoma↗
PubMed1998

[antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease].

BACKGROUND: The aim of the present study was to determine the prevalence and diagnostic usefulness of antineutrophil cytoplasmic antibodies (ANCA) in a Spanish population of patients with inflammatory bowel disease from the province of Tarragona. PATIENTS AND METHODS: One hundred and fifty-six sera obtained from 116 patients with inflammatory bowel disease (75 ulcerative colitis and 41 Crohn's disease) and 40 healthy controls were tested using an indirect immunofluorescence assay. RESULTS: ANCA were detected in 65% of patients with ulcerative colitis but in only 12% of patients with Crohn's disease (p < 0.01), and 2.5% of control subjects (p < 0.01). The overall sensitivity of the test for the diagnosis of ulcerative colitis was 65% with a specificity of 88% and a positive predictive value of 91%. Among patients with ulcerative colitis there was no relationship between the presence or titre of ANCA and the duration, the clinical course, the extent, the disease activity or the need for medical treatment. CONCLUSIONS: In the population studied, ANCA occur more commonly in ulcerative colitis than in Crohn's disease, as reported in other populations. Their determination in patients with inflammatory bowel disease may be useful to differentiate ulcerative colitis from Crohn's disease.

Adult↗
PubMed1998

Scintimammography with technetium-99m methoxyisobutylisonitrile: results of a prospective European multicentre trial.

The aim of the trial was to determine the diagnostic accuracy of scintimmammography with technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) in the detection of primary breast cancer and to verify its clinical usefulness. A total of 246 patients with a suspicious breast mass or positive mammogram were included in this prospective European multicentre trial. At 5 min and 60 min (optional) p.i. two lateral prone images were acquired for 10 min each; 30 min p.i. one anterior image was acquired for 10 min. There were 253 lesions (195 palpable and 58 non-palpable), in respect of which histology revealed 165 cancers and 88 benign lesions. Institutional and blinded read results were correlated to core laboratory histopathology results obtained during excisional biopsy. Diagnostic accuracy for the detection of breast cancer was calculated per lesion. The overall sensitivity and specificity of blinded read scintimammography were 71% and 69%, respectively. For palpable lesions, the sensitivity of blinded read and institutional read scintimammography was 83% and 91%, respectively. Sensitivity was not dependent on the density of the breast tissue. Invasive ductal and invasive lobular cancers showed similar sensitivity. The sensitivity and specificity of mammography were 91% and 42%, respectively, and did not depend on the tumour size. In 60% of false-negative mammograms, 99mTc-MIBI was able to diagnose malignancy (true-positive). High-quality imaging with 99mTc-MIBI has a high diagnostic accuracy for the detection of primary breast cancer. Used as a complementary method, scintimammography with 99mTc-MIBI can help to diagnose breast cancer at an earlier stage in patients with dense breasts.

Breast Neoplasms↗
PubMed1998

[Usefulness of home visits in the control and evaluation of the appropriate use of home continuous oxygen therapy].

The aim of this study was to determine the usefulness of home visits to monitor and evaluate the appropriate use of domiciliary oxygen therapy (DOT). Appropriateness was based on the coincidence of circumstances needed to predict benefit from DOT: appropriate indications correct hypoxemia and patient compliance. All patients receiving DOT residing in the town of L'Hospitalet (Barcelona) in June 1994 were enrolled. During a home visit to each patient a questionnaire was administered and spirometric variables, CO in exhaled air and pulse oximetry were recorded. If DOT was not considered appropriate, the patient was referred to the hospital clinic for reevaluation of the prescription. One hundred twenty-eight patients (74% men) were visited. Mean age was 68 years. Use of DOT was seen to be appropriate in only 26% of patients. The prescription of DOT was considered strictly correct in 73 patients (49%); 13 of them were seen to have continued smoking. Of the 60 remaining patients, hypoxemia was correct with oxygen therapy in 46, and of these only 33 complied with DOT. The home visit combined with hospital monitoring allowed us to withdraw DOT from 20 patients, for whom the indications had been incorrect, and to introduce changes in oxygen supply sources for 16 patients who carried pumps. Fourteen started using a concentrator and 2 began using liquid oxygen. Periodic review is necessary for optimal treatment of DOT. The home visit is a good tool for improving DOT follow-up, as it allows the patient to be assessed in the setting where DOT is really applied. It is a monitoring method that is well accepted by the patient.

Aged↗
PubMed1998

[Thoracic SPECT using (111 In-DTPA-D-Phe1)-octreotide in bronchial carcinoid syndrome].

We describe two cases of bronchial carcinoid tumour detected by (111In-DTPA-D-Phe1)-octreotide scintigraphy. The SPECT of the thoratic region provided a better images of the primary tumour than the planar images. In one of the patients, the bronchial carcinoid tumour was associated with sarcoidosis, which led to an erroneous evaluation of the extension of the tumour.

Adult↗
PubMed1998

[Gammography using Tc 99m MIBI in patients with suspected breast cancer. Proposed diagnostic protocol].

The aim of this work has been to determine whether the joint use of mammography and scintimammography is capable of reducing the number of biopsies required in patients with suspected breast cancer. We have performed scintimammography in 90 patients, 97 lesions, with breast cancer suspicion. In the mammography was evaluated the degree of malignancy suspicion and the size of the lesion. Only 41 of the biopsies revealed the presence of cancer. The sensitivity, specificity, PPV and NPV of scintimammography were 85%, 79%, 74% and 88%. According to the mammography findings 20 lesions (1 breast cancer) were included as low, 31 lesions (4 breast cancer) as indeterminate and 46 lesions (36 breast cancer) as high malignancy suspicion. 14 lesions (2 low, 2 indeterminate and 10 high suspicion) were smaller than 1 cm. The scintimammography was positive in all breast cancer of low and indeterminate suspicion of malignancy and in 30 of high probability. On the basis of this results we propose that a biopsy must be carried out to those lesions with a high suspicion of malignancy, and to lesions with low or indeterminate suspicion that are smaller than 1 cm or that present a positive scintimammography. Following this protocol, only 64 of the 97 biopsies would have been necessary, with a reduction of the 34% in the total number of biopsies and, more important, a 65% of reduction in the number of biopsies carried out in the groups of low and indeterminate suspicion of malignancy. At the same time we would indicate biopsy in all cases of breast cancer.

Adult↗