Biomedical subjects

H Romero

Publications and source records attributed to H Romero.

60 records · Page 4Linked to original sources

PubMedDate not supplied

nm23 expression in advanced and borderline ovarian carcinoma.

Twenty-four advanced (surgical stage III and IV) ovarian carcinomas and 15 borderline ovarian tumours were studied for the overexpression of nm23 and HER-2/neu (c-erb-B2) by means of immunohistochemistry on sections from routinely processed, paraffin-embedded, archival tumour blocks, using the NCL-nm23 and the NCL-CB11 monoclonal antibodies and the streptavidin-biotin-peroxidase technique. Significantly more advanced ovarian carcinomas (p = 0.034) expressed high levels of nm23 when compared to borderline tumours. HER-2/neu (c-erb-B2) expression, as could be expected, was also significantly more frequent in advanced ovarian carcinomas (p = 0.006). We were not able to find the previously reported association between nm23 and HER-2/neu overexpression in our tumours. Our results on nm23 overexpression in ovarian cancer are coincident with those previously reported using nm23-mRNA measurements on fresh ovarian tissues. Thus, ovarian carcinoma seems to belong to the group of tumours, like colon carcinoma and neuroblastoma, in which nm23 overexpression is associated with a more malignant phenotype. Immunohistochemistry performed on archival samples from ovarian carcinomas seems adequate for the demonstration of nm23 overexpression in ovarian cancer. This opens the possibility for larger studies on series of patients with a closed follow-up, which could help to establish the role of this gene in this kind of tumour.

Female↗

PubMedDate not supplied

[Decrease of the incidence of sepsis syndrome after early enteral nutrition of patients with severe burns].

The objective of this study was to evaluate the effect of early enteral nutrition on the incidence of the septic syndrome as well as its tolerance, in patients with severe burns. We retrospectively studied 64 patients older than 15 years of age, with a greater than 20% burned body surface area. They were divided into 2 groups as a function of the time elapsed between the beginning of Enteral Nutrition and the time of the burning: 23 patients were given Enteral Nutrition within 24 hours after the burn, and in 41 patients the enteral nutrition was started later than 24 hours after sustaining the thermal injury. Both groups were similar with respect to age, sex, percentage of 2nd and 3rd degree burns, incidence of inhalation, and deaths. All patients received the Enteral Nutrition through a nasogastric tube, with administration of a polymeric, hyperprotein and hypocaloric formula through a continuous infusion pump. In our study we saw a reduction of the incidence of the septic syndrome in the patients who received early enteral Nutrition (26%; 6 patients of a total of 23), with respect to those who did non receive early Enteral Nutrition (54%; 22 patients of a total of 41), with a statistical significance of p > 0.05. There were no differences between both groups with respect to the digestive tolerance to Enteral Nutrition. From our study we can deduce that early Enteral Nutrition reduces the incidence of septic complications, without this increasing the digestive intolerance to the same.

Adolescent↗

PubMedDate not supplied

Correlation of MDR1 expression and oncogenic activation in human epithelial ovarian carcinoma.

The expression of the MDR1 gene has been shown to correlate with tumor aggressiveness and oncogenic activation both in experimental tumor models and in human clinical specimens In order to verify whether this association also takes place in ovarian carcinoma, we studied tumor samples from 39 patients by means of immunohistochemistry for the overexpression of P-glycoprotein (MDR1), nm23, c-erb-B2 and p53. MDR1 (p = 0.023), nm 23 (p = 0.037) and c-erb-B2 (p = 0.015) were expressed significantly more in specimens from patients with advanced stage of disease. There were no differences in p53 expression between both groups of patients. Furthermore, we found a significant coexpression of MDR1 and nm23 (p = 0.028), and of MDR1 and c-erb-B2 (p = 0.0077). There was no association between the expression of the MDR1 gene and p53. These results parallel those previously reported by us for mammary carcinoma, and seem to indicate that expression of the multidrug resistance gene (MDR1) is inherent to the development of the malignant phenotype in several human tumors.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMedDate not supplied

[Percutaneous endoscopic gastrostomy and gastrojejunostomy. Experience and its role in domiciliary enteral nutrition].

UNLABELLED: Percutaneous Endoscopic Gastrostomy (PEG) and its variation Percutaneous Endoscopic Gastrojejunostomy (PEGJ), has become the method of choice to achieve an enteral access route in patients who require long term enteral nutrition, especially in the area of the At Home Enteral Nutrition (AHEN). We present our experience on the first PEG's and PEGJ's carried out in our hospital. MATERIAL: We studied 48 patients (14 women and 34 men) in whom a PEG/Percutaneous Endoscopic Gastrojejunostomy (PEGJ) was indicated, as they required enteral nutrition for prolonged periods of time (> 4 weeks) and/or they presented obstructive dysphagia, neuromotor dysphagia, or incorrigible vomiting in the two cases in whom PEGJ was carried out. 34 patients underwent the Ponsky-Gauderer technique, 6 patients underwent the Sacks-Vine technique, and 2 patients underwent a PEGJ. 24 hours after the PEGJ enteral nutrition (EN) was begun in a progressive manner. During the hospitalization period there was a daily follow up of the patient. In those cases in which At Home Enteral Nutrition was programmed, the patients/families were trained in the techniques and the care of the PEG and the EN, and the control was carried out through the Nutrition out patient department. RESULTS: PEG was successfully carried out in 42 patients (88%). 35 patients had previously been given EN through a naso-gastric tube (NGT), while in 7 cases the PEG was the first enteral access route. The average duration of the PEG was 212 days, and 27 patients (64%) needed the PEG for more than 3 months. The mean caloric supply was 1921 +/- 200 kcal/day. The mode of administration was by means of an intermittent infusion by gravity in 31 cases, and by continuous infusion using a volumetric pump in 11 patients. Two patients with pregnancy induced hyperemesis underwent a PEGJ in the 3rd and the 4th month of pregnancy, with the pregnancy being successfully brought to term and ending in vaginal deliveries. Carrying out a PEG permitted release from hospital and the programming of At Home Enteral Nutrition in 30 patients. With respect to the evolution of the patients, 22 patients have died during the course of the study. 18 patients remain in follow up in an ambulatory Enteral Nutrition program, and in the two patients with pregnancy induced hyperemesis, the PEGJ was removed after the pregnancy was successfully ended. There were no complications of any kind in 21 patients. The most common complication was the infection of the gastrostomy, which occurred in 13 patients. There was an accidental removal of the gastrostomy tube in 3 patients. In 3 cases there was an eversion of the gastric mucosa through the ostomy within the first 24-hours, and 20 days after the PEG respectively. In 2 cases there was an incarceration of the gastrostomy tube in the abdominal wall. Only two patients showed an important reflux of the gastric contents. There were no deaths as a result of PEG complications. CONCLUSION: From our experience we can conclude the advantages of PEG as a long term nutritional support, showing a low incidence of complications, and the endoscopic technique has a zero mortality.

Adult↗

PubMedDate not supplied

[Evaluation of energy metabolism in burn patients: indirect calorimetry predictive equations].

INTRODUCTION: Knowing the most reliable method for measuring the metabolic energy use (MEU), is of great importance in patients with severe burns. For the calculation of the energetic requirements of large burn patients, several predictive equations (PE's) are used, based on weight, size, age, body surface area (BSA), and burned body surface (BBS). Previous studies note the tendency for over-or underestimating the MEU, depending on whether one or another PE is used, which is why it is considered necessary to calculate the energy requirements in the most exact manner possible, which can be done by means of indirect calorimetry (IC). MATERIAL AND METHODS: 18 patients (14 men and 4 women) who were admitted to the Burn Unit between 1994 and 1995, were included in the study, with the following inclusion criteria; age > 18 years and < 65 years, and who presented deep burns on are than 15% of the body surface. The MEU of the patients was evaluated by means of IC, using a Deltatrac il unit. The MEU calculated by means of IC was compared with that calculated by means of the four most commonly used PE's in literature: Long Formula: MEU = Basal energy use (BEU) x activity factor x aggression factor which is variable according to the BBS; Curreri Formula: MEU = (Weight x 25) + (total BBS x 40); MEU = 2000 x BSA. As statistical methods, one looked for the existence of correlation, by means of the Pearson method, and the "r" were compared by means of the Fischer conversion. The regression coefficient was found among the values obtained through the PE's and those measured by IC, as well as among those of IC and the percentage of deep burn and the total burned body surface. RESULTS: All the formulate included overestimated the MEU measured between 30.6% and 43.8% with the 2 x MEU formula being the one which did so least (30.6%). In any of them, there is an important variation of the percentage of overestimation with respect to the average MEU in this group. All are correlated in an important way with the MEU. The reliability of these PE's is variable, as is shown by the slopes of the regression lines, with the most reliable PE being that of 2000 x BSA, and that of 2 x MEU, by Harris-Benedict. There is also correlation between the average MEU by IC and the deeply burned body surface. CONCLUSION: This study proves the usefulness of the IC for knowing the EME in burn patients, to prevent their hypernutrition, as well as the relative value of the formulae usually used clinically to estimate this parameter.

Adolescent↗

PubMedDate not supplied

[A case of Parkinson syndrome secondary to combined amineptine and bromazepam abuse].

A case report of parkinsonism secondary to chronic abuse of amineptine (3 gr/day) and bromazepam (35 mg/day) in a patient diagnosed of borderline personality disorder is presented. The patient did not take any other drugs and he was not recently on neuroleptic treatment; he recognized the abuse of amineptine, as a stimulant, and the bromazepam abuse, looking for a relief to the excessive anxiety secondary to amineptine. The parkinsonism improved after removing both drugs and taking biperiden and diazepam; lastly the patient was discharged without any medication. The patient did not suffer from other complications associated with amineptine or bromazepam abuse. There are some cases reported of parkinsonism secondary to benzodiazepines but there is none secondary to amineptine. We present a short review of the possible responsible mechanisms, thinking on a complex interaction of both drugs on dopamine and its modulatory systems.

Adult↗