Hepatic granulomas in brucellosis.
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Biomedical subjects
Publications and source records attributed to F Cervantes.
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Forty-eight patients with de novo non-Hodgkin's lymphoma (NHL) of unfavourable biology received CHOP as first-line chemotherapy. A complete remission (CR) was achieved in 64.5 per cent patients. Overall 4-year projected survival was 48 per cent with a median follow-up of 40.5 months. Two pretreatment characteristics, high LDH serum levels and bulky abdominal disease, were negatively associated with survival at the proportional hazards regression model and were used to calculate each patient's relative-risk. Such analysis allowed to identify two prognostic subgroups according to their outcome to CHOP. Firstly, a high-risk subgroup that showed an 8 per cent CR rate, most patients dying within the first year after diagnosis. Secondly, a low-risk subgroup that showed an 83.5 per cent CR rate and a 4-year project survival of 66 per cent. From the above results two major conclusions can be drawn: (1) the CHOP combination is an effective treatment for unfavourable NHL patients with a low relative-risk and (2) new therapeutic approaches should be explored for NHL patients with a high relative-risk at diagnosis.
A total of 1,030 diabetic patients were studied in order to identify factors associated with various complications. A higher proportion of women was found (64.1%). Using regression analysis of prevalence versus the logarithm of the duration of diabetes, a half-life of 5.14 years was calculated. In the study of complications, peripheral neuropathy, amputations, renal impairment, albuminuria, myocardial infarction, cataract and amaurosis were strongly associated with duration of diabetes rather than with the age of the patient or the age at diagnosis; in contrast, blood pressure and impotence correlated better with the age of the patient. A discriminant function analysis permitted to identify several factors as predictors of diverse complication mainly: the duration of the disease, and previous use of insulin (negative correlation). Other predictors were glycemia, alcoholism, smoking habit and intake of legumes (beans). Albuminuria was assessed with a radioimmunoassay procedure and found to be associated with: duration of diabetes, urinary tract infection, systolic blood pressure and amaurosis. Some alimentary habits were also included as predictors of complications.
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It is described the surgical interruption of Patent Ductus Arteriosus in ten premature newborn patients with cardiac insufficiency and/or respiratory distress syndrome. The authors mention the technical factors that they consider important to have good results with these fragile infants, as the use of local anesthesia; to perform the procedure in the neonatal intensive care unit, the extrapleural dissection of the ductus, etc. The post-operative care problems are analyzed and this experience is compared with reports from other authors.
The coexistence of chronic myeloid leukemia (CML) and B-cell chronic lymphocytic leukemia (CLL) in the same patient is rare. A 71-year-old woman developed a B-lineage lymphoid blast crisis at 18 months after diagnosis of Ph-positive CML. At this time, a lymphoid cell population with morphologic and immunophenotypic features of CLL was demonstrated. The retrospective review of the tests performed at diagnosis and thereafter disclosed the presence of lymphoid nodules in the initial bone marrow biopsy in the absence of lymphocytosis. Subsequently, there was an appearance of moderate lymphocytosis in the following months. Therefore, diagnosis of CML and coexistent CLL was established. Although a transient remission of blast crisis was achieved, blast cells reappeared two months later and the patient died shortly afterwards. Molecular studies of the immunoglobulin heavy chain gene (IH) rearrangement pattern point to the origin of the diseases in two different cell clones. In addition, previously published cases of simultaneous CLL and CML are reviewed.