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Biomedical subjects

J Martinez

Publications and source records attributed to J Martinez.

At least 577 records · Page 32Linked to original sources
PubMedDate not supplied

Hospice and palliative care: attitudes and practices of the physician faculty of an academic hospital.

It has been suggested that physicians, particularly in academic hospitals, are resistant to the hospice approach to palliative care for terminally ill patients. It is of interest, therefore, to assess the attitudes and practices of the physician faculty of an academic hospital where a hospice program has been in existence for more than 10 years. This was assessed with two faculty surveys. All 966 physician faculty that were on staff at Northwestern Memorial Hospital in the fall of 1993 were sent a survey about their opinion of hospice care (Survey A). Then, all physicians who had referred patients to the hospice program between September 1993 and September 1994 at Northwestern Memorial Hospital received a survey letter after the death of their patient (Survey B). Seventy-seven percent of faculty physician respondents to Survey A had either referred patients, or knew of colleagues who had referred patients to a hospice program. Ninety-four percent of those who answered "yes" to the question about referrals reported satisfaction with their care. Ninety-four percent would refer patients in the future and 96 percent thought the hospice program was a valuable resource to the medical center. Of the respondents to Survey B, nearly 100 percent thought the referral had been handled in an "excellent" or "good" fashion, that communication with hospice staff was "excellent" or "good," that symptom control was "excellent" or "good," that their patients and families had received "excellent" or "good" psychosocial support, and that their patients and families were satisfied with the hospice care they received.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
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Dominant macular colobomata.

Hereditary bilateral macular colobomata are not a consequence of an anomalous closure of the fetal fissure. Their extreme rarity, their lack of embryological explanation, and their morphologic similarity to postinflammatory congenital macular scars called the hereditary-malformative etiology of this entity in question. The authors describe a four generation family with seven affected members with isolated autosomal dominant bilateral macular colobomata.

Adult↗
PubMedDate not supplied

JMV1155: a novel inhibitor of glycine-extended progastrin-mediated growth of a human colon cancer in vivo.

BACKGROUND: Glycine-extended progastrin (G-17-Gly), the immediate biosynthetic precursor to gastrin (G-17), stimulates growth of some gastrointestinal cancers in vitro. The purpose of this study was twofold: to evaluate the effects of G-17-Gly on a human colon cancer (DLD-1) in vivo and to determine whether the novel gastrin-receptor antagonist, JMV1155, inhibits G-17-Gly-mediated growth. METHODS: DLD-1 cells (2 x 10(6)) were injected subcutaneously (s.c.) at a single site in athymic nude mice. Mice were randomized to four groups (n = 6/group) to receive injections, s.c., tid of either saline (control), G-17-Gly, JMV1155, or G-17-Gly + JMV1155 for 28 days. Tumors were measured biweekly until sacrifice at which time tumors were weighed and analyzed for DNA and protein content. RESULTS: JMV1155 significantly inhibited G-17-Gly-stimulated growth of DLD-1 tumors by 14 days of treatment, producing a 56% decrease in tumor size by 28 days. JMV1155 also significantly decreased G-17-Gly-mediated increases in tumor weight (by 64%), DNA content (by 61%), and protein content (by 65%). CONCLUSIONS: We have demonstrated, for the first time, that the novel gastrin-receptor antagonist, JMV1155, blocks G-17-Gly-induced growth of a transplanted human colon cancer in vivo. Hormonally based therapy with JMV1155 potentially could be employed for some patients with colon carcinoma.

Animals↗
PubMedDate not supplied

Adult liver transplantation: UCL experience.

OBJECTIVE: To evaluate the impact of standardized operative and peri-operative care on the outcome of liver transplantation in a single center series of 395 adult patients. METHOD AND MATERIAL: Between February 1984 and December 31, 1998, 451 orthotopic liver transplantations were performed in 395 adult patients (> or = 15 years) at the University Hospitals St-Luc in Brussels. Morbidity and mortality of the periods 1984-1990 (Gr I--174 pat.) and 1991-1998 were compared (Gr II--221 pat.). During the second period anti-infectious chemotherapy and perioperative care were standardized and surgical technique changed from classical orthotopic liver transplantation with recipients' vena cava resection (and use of veno-venous bypass) towards liver implantation with preservation of the vena cava (without use of bypass). Immunosuppression was cyclosporine based from 1984 up to 1996 and tacrolimus based during the years 1997 and 1998. Immunosuppression was alleviated during the second period due to change from quadruple to triple and even double therapy and due to the introduction of low steroid dosing and of steroid withdrawal, once stable graft function was obtained. Indications for liver grafting were chronic liver disease (284 pat--71.9%), hepatobiliary tumor (52 pat--13.2%), acute liver failure (40 pat--10.1%) and metabolic disease (19 pat--4.8%). Regrafting was necessary because of graft dysfunction (21 pat), technical failure (12 pat), immunological failure (18 pat) and recurrent viral allograft disease (5 pat); three of these patients were regrafted at another institution. Follow-up was complete for all patients with a minimum of 9 months. RESULTS: Actuarial 1, 5 and 10 years survival rates for the whole group were 77.9%, 65.7% and 58.3%. These survival rates were respectively 77.3%, 69.7%, 62.5% and 73.2%, 59.6% 51.4% for benign chronic liver disease and acute liver failure; those for malignant liver disease were 80.6%, 44.3% and 36.7%. Early (< 3 months) and late (> 3 months) posttransplant mortalities were. 14.4% (57 pat) and 21.2% (84 pat). Early mortality lowered from 20% in Gr I to 9.4% in Gr II (p < 0.02); this was due to a significant reduction during the second period of bacterial (99/174 pat.--56.9% vs 82/221 pat.--37.1%), fungal (14 pat.--8% vs 7 pat.--3.2%) and viral (87 pat.--50% vs 49 pat.--22.2%) infections (p < 0.05) as well as of perioperative bleeding (92 pat.--52.9% vs 39 pat.--17.6%--p < 0.001). Late mortality remained almost identical throughout the two periods as lethal outcome was mainly caused by recurrent allograft diseases, cardiovascular and tumor problems. Morbidity in these series was important considering that almost, half of the patients had a technical complication, mostly related to bleeding (131 pat--33.2%) and biliary problems (66 pat--16.7%). Retransplantation index was 1.1 (54 pat.--14%). Early retransplantation mortality was 24%; it lowered, although not yet significantly, during the second period (8/25 pat.--32% vs. 5/29 pat.--17.2%). CONCLUSION: Despite a marked improvement of results, liver transplantation remains a major medical and surgical undertaking. Standardization of operative and perioperative care, less haemorraghic surgery and less aggressive immunosuppression are the keys for further improvement.

Adolescent↗
PubMedDate not supplied

Self-expandable endovascular stent for treatment of venous stenoses.

The increase in survival among patients undergoing haemodialysis, the non-limitation of patient age regarding the start of renal substitution treatment, and the high incidence of vascular problems--particularly in diabetics--have caused the positioning of percutaneous catheters in central vessels to become a common practice in haemodialysis.

Aged↗
PubMedDate not supplied

Intensive care during prolonged anhepatic state after total hepatectomy and porto-caval shunt (two-stage procedure) in surgical complications of liver transplantation.

BACKGROUND/AIMS: Recently, total hepatectomy and temporary porto-caval shunt has been indicated in surgical complications of liver transplantation. Four cases of liver transplantation which presented liver hemorrhage at the time of implant, and a 5th case with surgical trauma of hepatic hilum are presented. METHODOLOGY: The graft was removed and a porto-caval shunt was performed in all patients. Retransplantation was possible in all recipients, after an anhepatic period of 16-24 hours. RESULTS: Early persistent ionic hypocalcemia and late olyguric renal failure were the most constant and prominent complications during the anhepatic period. Two patients died of renal failure and respiratory distress syndrome at 6 and 28 days, respectively, after liver transplantation. The other 3 patients are alive and without complications at 48, 33 and 11 months of follow-up. CONCLUSIONS: Total hepatectomy with a temporary porto-caval shunt and later retransplantation must be considered as a useful procedure for surgical complications of liver transplantation which may not be treated using other techniques. Special attention should be paid to preserve renal function in the anhepatic state in order to improve survival in similar cases of two-stage liver transplantation.

Adolescent↗
PubMedDate not supplied

Adult liver transplantation at UCL: update 2002.

The authors present the results of a single centre study of 587 liver transplants performed in 522 adults during the period 1984-2002. Results have improved significantly over time due to better pre-, peri- and post-transplant care. One, five, ten and fifteen year actuarial survivals for the whole patient group are 81.2; 69.8; 58.9 and 51.2%. The high incidence of de novo tumors (12.3%), of cardiovascular diseases (7.5%) and of end-stage renal function (3.6%) should be further incentives to tailor the immunosuppression to the individual patient and to direct the attention of the transplant physician to the long-term quality of life of the liver recipient.

Adult↗
PubMedDate not supplied

Reduced peptide bond pseudopeptide analogues of neurotensin.

Pseudopeptide analogues of the C-terminal hexapeptide of neurotensin (H-Arg-Arg-Pro-Tyr-Ile-Leu-OH) were obtained by replacing each peptide bond by the reduced peptide bond CH2NH. The resulting analogues were then examined for their ability to inhibit binding of labeled neurotensin to new-born mouse brain membranes and for stimulation of guinea pig ileum contraction. Replacement of the Ile12-Leu13, Tyr11-Ile12, Pro10-Tyr11 and Lys9-Pro10 peptide bonds resulted in about 2000-, 3400-, 200- and 3400-fold losses, respectively, in binding affinity and 400-, 750-, 250- and 300-fold losses, respectively, in biological activity. Replacement of both Arg8 and Arg9 by lysine led to an analogue exhibiting the same pharmacological profile as the C-terminal hexapeptide of neurotensin. Interestingly, replacement of the Lys8-Lys9 peptide bond by the CH2NH bond produced an analogue exhibiting the same affinity for neurotensin receptors, but 10 times more potent in stimulating guinea pig ileum contraction. N-terminal protected analogues (by the Boc group) showed decreased potency as compared with their amino-free corresponding compounds.

Amino Acid Sequence↗
PubMedDate not supplied

[Structure-activity relationship of cystokinins: analogs exhibiting selective activity].

Structure-activity relationship on cholecystokinin is presented. C-terminal heptapeptide analogues of cholecystokinin exhibiting selective agonist or antagonist activities were synthesized and their biological and pharmacological properties studied. We showed that: 1) Suppression of the C-terminal phenylalanine residue leads to peripheral as well as central cholecystokinin receptor antagonists; 2) Suppression of the C-terminal amide function produces "partial agonists" exhibiting interesting biological and pharmacological activities; 3) Replacement of L-tryptophan residue by D-tryptophan in such "partial agonist analogues" resulted in potent CCK receptor antagonists; 4) The peptide bond between methionine28 and glycine29, as well as the glycine residue are quite significant for the central biological activity; 5) It is possible to obtain highly potent and selective CCK analogues for the central receptor (CCK-B) by cyclization including the C-terminal tetrapeptide. Synthesis and pharmacological studies with these analogues have allowed to precise the significance of some amino acid residues as well as of some peptide bonds. They are significant pharmacological tools for the study of CCK-A (peripheral) and CCK-B (central) receptors, their biological actions and their associated intracellular messengers.

Amino Acid Sequence↗
PubMedDate not supplied

[Design of a vaccination campaign against hepatitis b virus].

Plans for a vaccination campaign among the health care personnel at the "Valle del Nalón" Hospital are discussed. For this purpose, first of all, the serological testing to determine the markers as compared to the VHB was done using the ELISA technique, and in following, the vaccine based on genetic engineering, ENGERIX BR was provided, initially according to the criteria established to this effect by law, and then from a less restricted view, according to the principles which are given in the text. We have observed that 14.74% of the workers in our town have some positive marker priori to the vaccination and that 1.81% are carriers. The level of tolerance was that of 45.79%, said level being related to the professional group in question and the service in which they work, differences obtained in both cases being statistically quite significant (p less than 0.0001).

Hepatitis B↗
PubMedDate not supplied

Monitoring of morphonuclear characteristics of hormone-sensitive and insensitive HCT-15 and LOVO human colorectal cells by means of digital cell image analysis.

We recently set up in vitro several human colorectal neoplastic cell lines that we labelled hormone-sensitive (HS) in comparison with the original cell lines which appeared to be rather "hormone-insensitive" (HI). We describe here the cell proliferation rate and the morphonuclear characteristics of the HS and HI variants of the HCT-15 and LOVO human neoplastic colorectal cell lines which were cultured either in serum-supplemented or chemically-defined media. Morphonuclear characteristics were monitored by means of the digital cell image analyses of Feulgen-stained nuclei, while the proliferation activity of the various cell types was assessed by means of the tetrazolium-based compound (MTT) assay. The results show that it is possible to culture human LOVO and HCT-15 colorectal cells in chemically defined media. This said, growth in a chemically defined medium is difficult for these cells and is markedly less sustained than when they are cultured in serum-supplemented media. The transition of the culture from a serum-supplemented medium to a chemically defined one is accompanied by a very marked drop in cell proliferation and a number of profound changes in terms of morphonuclear characteristics. These changes basically involve chromatin decondensation, which occurs as the result of the drop in the number of large chromatin clumps in the nucleus.

Cell Differentiation↗
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Port site metastasis. An unresolved problem in laparoscopic surgery. A review.

After the explosive success of laparoscopic cholecystectomy, great interest has been shown in the laparoscopic treatment of digestive malignancies. Laparoscopy has been proposed for diagnosis and staging, and as a technical option aiming to cure or palliate. But this optimism has been tempered by the doubt about the potential disseminatory role of laparoscopy after the observation of a large number of port site seeding tumors. Since the first laparoscopic cholecystectomy, more than 100 port site metastases have been reported, without a clear explanation for these findings. Port site recurrences have been observed after gynaecologic procedures, laparoscopic cholecystectomy in which an unsuspected gallbladder cancer was found and after laparoscopic operations indicated for oncological treatment of digestive tumors, mainly colorectal cancer. Other cases have been reported after thoracoscopic resection of oesophageal cancer or urologic cancer, even after staging laparoscopy associated with sampling. Possible mechanisms for port site cell implantation are direct implantation in the wound during unprotected and forced tissue retrieval or by contaminated instruments during tumor dissection, the effect of gas turbulence in long laparoscopic procedures and embolization of exfoliated cells during tumor dissection or hematogenous dissemination. Probably, a multifactorial mechanism may be responsible, in which the key factors could be a long operative procedure, the high pressure pneumoperitoneum, tumoral manipulation during dissection and forced extraction of unprotected specimens. Prophylactic measures proposed to avoid this disastrous complication are the use of protective bags for tissue retrieval, peritoneal lavage with heparin in order to avoid adhesion of free cells, or lavage with cytocidal solutions.

Cholecystectomy, Laparoscopic↗