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Biomedical subjects

J Maestre

Publications and source records attributed to J Maestre.

30 records · Page 2Linked to original sources
PubMed1991

Pulmonary mass and air meniscus sign in a 19-year-old man.

Sacrococcygeal teratoma is rarely diagnosed in adults. Pulmonary mass as the presenting clinical form of the malignant variety of this germ-cell tumor is exceptional. We report herein such a case with the noticeable peculiarity of showing the air meniscus sign on chest roentgenographic examination.

Adult↗
PubMed1990

Cyclophosphamide and ifosfamide combination as neoadjuvant chemotherapy for locally advanced nonsmall-cell lung cancer: a meta-analytic review.

Twenty-three patients with marginally resectable and unresectable non-small-cell lung cancer (stages IIIA and IIIB) were treated by neoadjuvant chemotherapy. All patients received three cycles of preoperative chemotherapy with two alkylating agents, cyclophosphamide 2.5 g/m2 intravenously (i.v.) and ifosfamide 3.5 g/m2 i.v., mesna 12 g/m2 was given additionally to prevent drug hematuria. Six of 23 patients (26%) had partial response. Of the seven patients who underwent thoracotomy, two were completely resected, but with macroscopic residual disease. Mean time to progression for the whole group was 7 months. Fifteen patients had progression of disease, with local metastases only in six, and distant metastases in eight. After administering 52 chemotherapy cycles, cyclophosphamide-ifosfamide doses were cut down, as eight of 16 patients required hospitalization for fever during neutropenia nadirs. This two-alkylating (non-cisplatin) regimen, unlike cisplatin-based regimens, was ineffective, and further trials are not recommended.

Aged↗
PubMedDate not supplied

[Semantic verbal fluency in neurological patients without dementia with a low educational level].

INTRODUCTION AND OBJECTIVE: The Semantic Verbal Fluency Test (sVFT) is very sensitive to cognitive deterioration. Standard values are usually those found in normal persons with an average or high cultural level. We analyze the results of a sVFT in a broad sample of persons assessed in a Neurology Clinic so as to find the standard values in this particular population. PATIENTS AND METHODS: A sVFT (animals in one minute) was given to 138 patients without dementia, aged over 55 years, assessed in the Neurology Clinic. Variables recorded were sex, age, years of schooling, studies completed, diagnosis and place of origin. A bivariate descriptive study and multivariate lineal regression analysis was done following a 'step by step' strategy. RESULTS: This group had a low educational level (72% had been to school for less than 10 years), with an average +/- standard error of 16.02 +/- 0.45 animals in one minute. The variables: years of schooling, sex, age and diagnosis showed a significant association with semantic verbal fluency in the adjusted regression model. CONCLUSIONS: Our values are lower than those of other standard groups. This may be related to the low educational level of our group and to the inclusion of persons with neurological disorders. The lineal regression model proposed permits prediction of the values of semantic verbal fluency in specific persons depending on their personal characteristics.

Aged↗
PubMedDate not supplied

[Chronic obstructive pulmonary disease and lung transplants: results in Spain].

OBJECTIVE: To determine the outcome of lung transplantation in patients with chronic obstructive pulmonary disease (COPD) in Spain. METHODS: In all COPD patients transplanted at four Spanish hospitals over a period of seven years, we studied actuarial survival rates retrospectively using the Kaplan Meier test in relation to demographic characteristics, type of transplant, underlying disease, lung function evolution in terms of forced vital capacity (FVC), maximum expiratory flow in 1 second (FEV1) and gasometric evolution (PaO2 and PaCO2). RESULTS: Seventy-four transplants were performed in COPD patients over a five-year period. Mean age was 47 +/- 7 years (26-61) and 77% of the patients were men. A diagnosis of emphysema was made in 58%, alpha-1 antitrypsin deficiency emphysema in 14% and chronic bronchitis in 28%. The likelihood of survival was 75% for the first year, 63% for two years and 41% for the third year. Lung function and blood gases improved significantly by the third month after transplantation: FVC was 1677 +/- 637 ml before transplantation and 2631 +/- 670 ml afterwards; FEV1 was 585 +/- 189 ml before transplantation and 2118 +/- 673 ml afterwards (p < 0.001). Double lung transplants achieved significantly greater improvement in function variables than did single-lung transplants (FVC 2843 +/- 681 ml and FEV1 2543 +/- 620 ml by the third month in DLT patients versus FVC 2402 +/- 587 ml and FEV1 1659 +/- 350 ml for SLT), with no significant differences in blood gases after the two types of transplant. Half the sing-lung transplant patients developed hyperinflation of the native lung and reached maximum lung function values, which tended to be lower than those for patients who did not experience this complication (FEV1 1638 +/- 349 ml versus 1930 +/- 307 ml, p = 0.051). CONCLUSIONS: First-year mortality in patients with COPD undergoing lung transplantation in Spain is similar to that described in the International Transplant Registry. We found no differences between double- and single-lung transplant patients. Functional change is good for both types of transplantation, although this aspect of outcome is significantly better when two lungs are transplanted.

Adult↗
PubMedDate not supplied

[Genotype-phenotype correlation in myotonic dystrophy and prediction of clinical seriousness].

INTRODUCTION: Since description of the expansion of the number of CTG trinucleotides on the long arm of chromosome 19 in the 19 q 13.2-13.3 interval as being responsible for myotonic dystrophy (DM), many studies have established a direct relationship between the size of the expansion and the severity of the manifestations. OBJECTIVES: To evaluate the clinico-genetic correlation in a population with DM in Eastern Andalucia and to establish the predictive value of the increase in number of CTG repetitions with regard to clinical gravity. PATIENTS AND METHODS: A transverse study of persons from families known to have members with DM, classified with regard to the clinical gravity of their illness. Diagnosis was by means of clinical neurological, ophthalmological and neurophysiological examination and subsequently by genetico-molecular study, Southern blot, PCR, oligonucleotide CTC hybridization and Northern blot. RESULTS: Genetic studies confirmed the previous clinical diagnosis of DM in 78 persons, of the 145 studied, who came from 32 families. The average size of the mutation was 1-5 kb. There was close correlation between the size of the expansion and the clinical condition. Logistic repression studies permitted adequate classification in function of the size of the expansion in 87.23% of the cases of clinically relevant illness and in 90% of the cases in which the condition was not clinically relevant. CONCLUSIONS: There is a strong association between the clinical features of DM and the magnitude of the mutation. The size of the expansion has considerable predictive value in prognosis of the disorder. This may be useful when making decisions during prenatal diagnosis.

Adolescent↗
PubMedDate not supplied

[Validation of a model for the prediction of verbal semantic fluency].

INTRODUCTION: The diagnosis of dementia requires documentation of cognitive loss with respect to the patient's previous level. It would therefore be very useful to have models available which would predict the result expected in the tests normally used in the diagnosis of dementia. OBJECTIVE: To validate a model for prediction of the results of a test of semantic verbal fluency in persons with no dementia. PATIENTS AND METHODS: A model for the prediction of semantic verbal fluency deduced from a sample of 138 persons was applied to two other independent samples: the first of 86 persons from the same environment as the original sample and a second multicentric sample of 92 persons. The validity of the model was evaluated by residual analysis. RESULTS: No sex differences were seen between the samples, but there were differences regarding the other variables, including the observed and predicted verbal fluency. The residuals of the samples did not differ from each other nor vary from zero, but were normally distributed. CONCLUSION: The model proposed based on sociodemographic and clinical variables is valid and satisfactorily predicts the verbal fluency to be expected in each case.

Aged↗