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J Otero

Publications and source records attributed to J Otero.

At least 37 records · Page 2Linked to original sources
PubMed1998

Elderly patients with aggressive non-Hodgkin's lymphoma treated with CHOP chemotherapy plus granulocyte-macrophage colony-stimulating factor: identification of two age subgroups with differing hematologic toxicity.

PURPOSE: Standard cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy repeated at 3-week intervals is difficult to deliver in elderly patients with non-Hodgkin's lymphoma (NHL). The use of hemopoietic growth factors may decrease the hematologic toxicity of chemotherapy and allow the delivery of full-dose CHOP. PATIENTS AND METHODS: We conducted a phase II trial with the addition of granulocyte-macrophage colony-stimulating factor (GM-CSF) to CHOP chemotherapy in NHL patients older than 60 years of age. Twenty-six previously untreated patients were assessable; median age was 67 years (range, 61 to 84 years). CHOP included cyclophosphamide 750 mg/m2 intravenously day 1; doxorubicin 50 mg/m2 intravenously day 1; vincristine 1.4 mg/m2 (2 mg total dose) intravenously day 1; and prednisone 100 mg orally days 1 through 5. GM-CSF 5 microg/kg was administered subcutaneously on days 4 through 13. Cycles were repeated every 21 days for six cycles. Results were analyzed for the total group and for two age subgroups: 61 to 69 years (n = 15) and 70 years or older (n = 11). RESULTS: Sixteen patients (62%) achieved a complete response (CR), four patients (15%) achieved a partial response (PR), and six patients (23%) did not respond to therapy. After a median follow-up of 41 months, the median progression-free and overall survival were 19 and 30 months, respectively. Twenty patients completed six cycles. One hundred thirty-eight of the 156 planned cycles were delivered (88%). The relative dose-intensity was 95%. The chemotherapy-induced toxicity was important. Absolute neutrophil count was less than 500/mL in 43% of the cycles, platelet nadir was less than 20,000/mL in 19%, and febrile neutropenia occurred in 21%. There were no grades 3 to 4 mucositis. Treatment-related death occurred in two patients, and was associated with neutropenic septic shock. The toxicity related to GM-CSF was mild hypotension after the cytokine was administered in 7% of cycles. When the results of the study were analyzed by age subgroups, we observed that whereas response and median survival were similar in patients aged 61 to 69 years or 70 years or older, there were significant differences in dose delivery and toxicity. Chemotherapy was delivered in 86 of 90 planned cycles in patients aged 61 to 69 years, but in only 52 of 72 planned cycles in patients aged 70 to 84 years (P = .00008). Absolute neutrophil count was less than 500/mL in 24% of cycles in patients aged 61 to 69 years and 73% of cycles in patients aged 70 years or older (P = .00001). The platelet nadir of less than 20,000/mL occurred in 5% of patients aged 61 to 69 years and in 42% of patients aged 70 years or older (P < .0001). Fever and neutropenia occurred in 8% of patients aged 61 to 69 years and in 42% of patients aged 70 years or older (P < .0001). Mucositis (grades 1 to 2) occurred in 21% of patients aged 61 to 69 years and in 42% of patients aged 70 years or older (P = .006). CONCLUSION: CHOP chemotherapy plus GM-CSF is an active regimen in elderly patients with NHL. Despite cytokine support, the toxicity of the regimen is elevated. We have identified two age subgroups (61 to 69 and > or = 70 years) that do not differ in treatment efficacy but show large differences in treatment-related toxicity.

Age Factors↗
PubMed1998

Telomerase activity in thymomas and mammary gland adenocarcinomas induced by polyoma virus in AKR mice.

Telomerase is an enzyme that stabilizes telomere length in transformed cells and tumors. Its role in tumor development is far from clear. In this paper, a new experimental model to study telomerase activity during tumorigenesis is presented. After infection with Polyoma virus, AKR mice developed thymomas and mammary gland adenocarcinomas. Polyoma antigens were observed by the peroxidase-antiperoxidase technique on tissue sections, and by Western blot on tumor extracts. The TRAP assay was performed to detect telomerase activity. It was not present in normal mammary gland, but it was positive in mammary gland adenocarcinomas. A different pattern was seen in thymic tissues: normal thymus had higher telomerase activity than thymomas. The incubation of thymoma extracts with normal thymus extracts decreased telomerase activity in the latter. These results demonstrate two different patterns of telomerase activity in tumors induced by Polyoma virus, and suggest the presence of telomerase inhibitory factors in thymomas.

Adenocarcinoma↗
PubMed1997

Ifosfamide plus cisplatin as primary chemotherapy of advanced ovarian cancer.

We have performed a phase II study to evaluate the activity and toxicity of ifosfamide and cisplatin as first-line treatment for advanced ovarian cancer. Patients were treated with cisplatin 100 mg/m2 on day 1 and ifosfamide 5 g/m2 in 18-hr continuous infusion on day 1 or 1.5 g/m2 bolus on days 1-5. Between August 1988 and March 1990, 30 women were entered in the trial, 26 of them with measurable disease. The overall clinical response rate was 69% (95% CI: 48-85%), including 34.6% complete responses (95% CI:17-55%). Reassessment laparotomy was performed in 12 cases, and 4 (33%) exhibited a pathologic complete response. For all patients, the median duration of progression-free survival was 14 months, and the median overall survival was 25 months. There were no major differences in the response rate or survival between the two ifosfamide administration modalities. Relevant toxicities were grade IV hematologic toxicity in 11/30 patients and grade IV renal toxicity in 2/30 patients. A patient with grade IV encephalopathy developed a trauma-related cerebral hemorrhage and died 2 months later. The combination of ifosfamide and cisplatin is active in first-line therapy in advanced ovarian cancer, although it does not seem to improve the efficacy or toxicity profile of conventional combinations.

Adult↗
PubMed1997

Treatment of experimental pneumonia due to penicillin-resistant Streptococcus pneumoniae in immunocompetent rats.

A model of pneumonia due to Streptococcus pneumoniae resistant to penicillin was developed in immunocompetent Wistar rats and was used to evaluate the efficacies of different doses of penicillin, cefotaxime, cefpirome, and vancomycin. Adult Wistar rats were challenged by intratracheal inoculation with 3 x 10(9) CFU of one strain of S. pneumoniae resistant to penicillin (MICs of penicillin, cefotaxime, cefpirome, and vancomycin, 2, 1, 0.5, and 0.5 microg/ml, respectively) suspended in brain heart broth supplemented with 0.7% agar. The rats experienced a fatal pneumonia, dying within 5 days and with peak mortality (70 to 80%) occurring 48 to 72 h after infection, and the bacterial counts in the lungs persisted from 8.87 +/- 0.3 log10 CFU/g of lung at 24 h of the infection to 9.1 +/- 0.3 log10 CFU/g at 72 h. Four hours after infection the animals were randomized into the following treatment groups: (i) control without treatment, (ii) penicillin G at 100,000 IU/kg of body weight every 2 h, (iii) penicillin G at 250,000 IU/kg every 2 h, (iv) cefotaxime at 100 mg/kg every 2 h, (v) cefpirome at 200 mg/kg every 2 h, and (vi) vancomycin at 50 mg/kg every 8 h. Two different protocols were used for the therapeutic efficacy studies: four doses of beta-lactams and one dose of vancomycin or eight doses of beta-lactams and two doses of vancomycin. Results of the therapy for experimental pneumonia caused by penicillin-resistant S. pneumoniae showed that initially, all the antimicrobial agents tested had similar efficacies, but when we prolonged the treatment, higher doses of penicillin, cefotaxime, and cefpirome were more effective than penicillin at lower doses in decreasing the residual bacterial titers in the lungs. Also, when we extended the treatment, vancomycin was more efficacious than penicillin at lower doses but was less efficacious than higher doses of penicillin or cefpirome. The model that we have developed is simple and amenable for inducing pneumonia in immunocompetent rats and could be used to explore the pathophysiology and to evaluate optimal therapy of this infection in the immunocompetent host.

Animals↗
PubMed1996

Dopamine and serotonin in the trout (Oncorhynchus mykiss) pituitary: main metabolites and changes during gonadal recrudescence.

Monoamine neurotransmitters and their metabolites in the trout pituitary have been studied. Dopamine (DA), serotonin (5HT), dihydroxyphenylacetic acid (DOPAC), and 5-hydroxyindoleacetic acid (5HIAA) were separated as pure peaks by HPLC. Peak purity and identity were confirmed by electrochemical behavior. However, measurable amounts of the O-methylated DA metabolites 3-methoxytyramine and homovanillic acid were not detected in pituitary glands of different-aged trout or during the reproductive cycle. Treatment with L-DOPA or DA increased DOPAC levels, whereas O-methylated DA metabolites remained undetectable. Thus, MAO may be the major, if not the only, enzyme involved in DA catabolism in trout pituitary. A pronounced decline in dopaminergic turnover, measured as the DOPAC/DA ratio, was seen as gonadal recrudescence developed. 5HT or 5HIAA levels were not associated with reproductive status.

Animals↗
PubMed1996

Strategies for Helicobacter pylori eradication in 1995: a review of international and Belgian experience.

After a decade of research, Helicobacter pylori eradication is still a problem because of the steady increase of bacterial resistance (imidazole, macrolides), pH-dependent efficiency of antibiotics, poor compliance of patients and frequent side effects of the therapies. After the failure of various monotherapies and the unefficiency of Amoxicillin-Imidazole combination for Imidazole-resistant strains, the two weeks ¿Oral Triple Therapy' with a 85% mean eradication rate, was abandoned because of a mean 35% side effects rate. The current goal is to obtain 90% eradication rate and the excellent results of german studies with a 2 weeks regimen combining a Proton Pump Inhibitor (PPI) with Amoxicillin have not been confirmed elsewhere in Europe. PPI plus Clarithromycin (two weeks) gave a mean 72% eradication rate on an ITT basis. The short, low-dose combination PPI-Clarithromycin-Imidazole for one week proposed by Bazzoli is very efficient in a population where Imidazole resistant strains are rare. The recent result of one week with (Omeprazole 20-Clarithromycin 250-Tinidazole 500) BID or (Omeprazole 20-Clarithromycin 500-Amoxi 1000) BID reached a 95% eradication rate but these very promising results are not confirmed in Belgium in an on-going study including 147 patients.

Amoxicillin↗
PubMed1996

Kidney ATPase response in seawater-transferred rainbow trout (Oncorhynchus mykiss). Effect of salinity and fish size.

Two sizes of domesticated rainbow trout (Oncorhynchus mykiss, 40 +/- 0.67 and 180 +/- 3.9 g) were directly transferred to brackish water (9 ppt) and seawater (28 ppt). Kidney Na(+)-K(+)-ATPase and Mg(2+)-ATPase activities were measured in fresh water, and after long-term seawater adaptation (up to 21 days). Renal Na(+)-K(+)-ATPase activity increased after saltwater loading in small trout, while large trout displayed an unmodified ATPase activity. The smallest trout showed a low but progressive increase in renal Mg(2+)-ATPase activity after the transfer to both salinities. However, ATPase activity remained unchanged or significantly decreased in large trout after the transfer to seawater or brackish water, respectively.

Adaptation, Physiological↗
PubMed1995

Phase II trial of weekly i.v. vinorelbine as a single agent in first-line advanced breast cancer chemotherapy. The Latin-American experience.

This study investigated the therapeutic effect of single-agent i.v. weekly Navelbine (vinorelbine), a semisynthetic vinca alkaloid, in women who had received no prior treatment for locally advanced or metastatic breast cancer. Of 68 patients entered into the study, 63 were adequate inclusions, assessable for toxicity and response by WHO criteria; the 5 patients who were not evaluated were excluded from analysis because they were found not to meet the eligibility criteria of the study. Navelbine was given as a weekly 30 mg/m2 short i.v. (20 minutes) infusion; treatment was continued until disease progression. The overall response rate was 44% (complete response 8%, partial response 36%). The response rate according to target was lymph nodes, 62.9%; liver, 50.0%; lung, 50.0%; skin, 37.5%; and primary tumor, 30.8%. The median duration of response was 17.9 weeks (range: 7-52 weeks). The median time to treatment failure was 12.9 weeks, and the median survival was 50.3 weeks. The 63 eligible patients received 501 cycles. The mean dose intensity was 76%. At least one episode of WHO grade 3/4 granulocytopenia was seen in 46% of the patients (13.6% of cycles). Significant nausea/vomiting was seen in only 5% of patients corresponding to 1% of cycles. Only 5% of patients developed WHO grade 3-4 constipation and grade 3 peripheral neuropathy was observed in 1.6% of patients. Alopecia was rare (6.3% of patients), and other side effects were uncommon. This study confirms that Navelbine has major single-agent antitumor activity as frontline therapy in advanced breast cancer. Given its excellent tolerance profile and low morbidity, it should be recommended for inclusion in first-line combination chemotherapy regimens.

Adult↗
PubMed1995

[The efficacy of iodine prophylaxis in the prevention of endemic goiter in the southwestern area of Asturias].

The aim of the present work was to assess the prevalence of the endemic goiter in Asturias southwestern area (46,000 inhabitants; 6,638 in school age), after 10 years of iodized salt introduction in diet. 317 schooling children were randomly chosen (stratified by age, sex and geographic area). We evaluated thyroid gland size and urinary iodine excretion (microgram of iodine per gram of creatinine = I/C). Previously, studies of infantile population suggested a 63% of prevalence. Our results indicate a decrease to 16.4% of endemic goiter prevalence. Nevertheless, the success of iodine prophylaxis was heterogeneous and not good in some case: point out Ibias population with a prevalence of 48.5% (2,000 inhabitants and 353 in schooling). Remainder population was prevalences between 6.9% and 19.8%. The mean of urinary iodine excretion increased to I/C = 106 (previously I/C = 53). The smallest index I/C become to Ibias population = 78. (p < 0.01 and p < 0.05 with regard to Cangas del Narcea and Tineo population respectively). Only 2 of the 52 cases of goiter were hypothyroidism (but because of autoimmune thyroiditis). We conclude that iodine prophylaxis with salt was effective generally, in order to diminish the endemic goiter in the area.

Adolescent↗
PubMed1995

Omeprazole-based antimicrobial therapies: results in 198 Helicobacter pylori-positive patients.

AIM: To compare the efficacies of omeprazole-based antimicrobial therapies in Helicobacter pylori-positive patients. PATIENTS AND METHODS: We report the results of seven therapeutic trials combining omeprazole, clarithromycin, amoxycillin, colloidal bismuth subcitrate and tinidazole in 198 patients (peptic ulcer disease/non-ulcerative dyspepsia, 137/61) to eradicate H. pylori infection. The diagnosis of infection was performed by Sydney system biopsies, compliance was checked after a pill count at the end of the treatment and eradication was assessed at least 4 weeks after the end of the treatment either by the Sydney system for peptic ulcer disease or the urease breath test for non-ulcerative dyspepsia. RESULTS: When results were analysed on a protocol basis, the only significant difference in eradication (P = 0.006) was found between the total population of patients treated with amoxycillin-based combinations (27 eradications out of 48 patients) and those given a treatment that included clarithromycin (84 eradications out of 108). Forty-two patients (21%) dropped out either because of side effects (10 among patients taking clarithromycin and two taking amoxycillin) or because they were lost to follow-up (27 patients). Out of 64 patients with active ulcers, 43 (67%) were both H. pylori-negative and ulcer-free 4-8 weeks after the end of therapy, 12 out of 64 (19%) were ulcer-free but remained H. pylori-positive and nine out of 64 (14%) were H. pylori-positive and had active ulceration.

Amoxicillin↗
PubMed1994

Irregular discharges from a dual diagnosis unit.

Irregular discharges, previously studied on psychiatric or substance abuse treatment units, are a particular problem for dual diagnosis units. We examined demographic and clinical variables for their association with irregular discharge from an acute dual diagnosis inpatient unit, retrospectively reviewing 316 consecutive admissions. One hundred and nineteen patients (37.7%) were irregularly discharged (61 AMA, 31 administrative, 27 elopements), staying an average of 18.8 days compared with 51.4 days for those regularly discharged (p < .001). Younger age (p = .007) and discharge diagnosis of antisocial personality disorder (p < .001) were associated with irregular discharge; the attending psychiatrist was also significant (p = .016). Demographic variables (sex, ethnicity, marital status, religion, employment, education, living circumstances), Axis I diagnosis, and type and number of substances abused were not predictive of discharge type. Patients irregularly discharged within the first week (40% of irregular discharges) were significantly less likely to have known legal involvement (p = .006). No significant temporal clustering of irregular discharges was found on a daily, weekly, or monthly basis, nor was a seasonal pattern detected. These findings are generally consistent with several pre-DSM-III studies on nondual diagnosis units, but more specifically highlight the diagnosis of antisocial personality. Regarding program completion, they suggest that risk factors for irregular discharge (substance abuse, antisocial personality, characteristics of the doctor-patient relationship, problems of younger patients) have not been adequately addressed simply by creating dual diagnosis units. Further programming study appears warranted to address the problem of patient retention on dual diagnosis units.

Adult↗
PubMed1993

[Thyroid nodule disease in a previously endemic goiter area].

We conducted a 6-year study of 110 patients with thyroid nodular disease in a previously goitrogenic area. The aim of the present work was to establish its incidence, to determine if multinodular goiter and autonomous thyroid nodule have the same analytical and clinical behaviour and to verify if the iodation campaign had resulted in the development of thyrotoxicosis induced by iodine. The results demonstrated an incidence of 0.4 per 1,000 population and per year. The two modalities of thyroid nodular disease did not present any clinical and analytical differences. 58.2% of the patients had hyperthyroidism, 53.1% of which were T-4 thyrotoxicosis, 12.5% T-3 thyrotoxicosis and 34.4%, subclinical hyperthyroidism. 8.2% of the patients under study had hyperthyroidism induced by iodine (Jod Basedow), with iodide excretion values higher that 3 standard deviations with respect to the population average (> 220 micrograms/g creatinine).

Adult↗
PubMed1993

[Lymphomas of the gastrointestinal tract: a neoplastic disease of underdevelopment].

458/3,495 malignant lymphomas seen at the Instituto de Enfermedades Neoplásicas between 1965-1992, had primary extranodal disease in the GI tract. This is one of the largest institutional series reported, which would suggest that this is a relatively frequent malignancy in Peruvian population. Fifty per cent of cases had a primary in the small bowel and 38.9 per cent in the stomach. The age at presentation, the clinical picture and the location at the intestine show similarities with the so called Mediterranean lymphoma. Cases were classified according to the TNM system, and patients in stages I-II were surgically resected; 80 per cent of them were alive and free of disease at 5 years. Gastric lymphomas with inoperable disease were treated with chemotherapy with a 5-year survival of 50 per cent.

Adolescent↗
PubMed1992

Prognostic factors for survival and tumor control in cervical lymph node metastases from head and neck cancer. A multivariate study of 492 cases.

A multivariate analysis was carried out in 492 patients with metastatic neck disease from squamous cell carcinoma to determine the influence of clinical and therapeutic factors on survival, local and regional control, and distant metastases. After radiation treatment with radical intent, recurrence at the primary site was the most frequent site of treatment failure (20% of cases), followed by distant metastases (14% of the cases), whereas isolated neck recurrences occurred in only 7% of the patients. The most significant factors influencing survival were primary tumor site, node fixation, N-stage, T-stage, and number of lymphatic chains. The most significant factors influencing local control were primary site, T-stage, and node fixation. Significant factors influencing regional control were radiation therapy volume, primary tumor site, node fixation, and node location (upper and lower neck). Significant factors influencing distant control were N-stage, number of nodes, and number of involved lymphatic chains.

Adolescent↗
PubMed1992

Longitudinal study of bone metabolism after ethanol withdrawal in alcoholic patients.

The pathogenesis of osteopenia in chronic alcoholism remains unclear, and many ethanol-related abnormalities have been advocated to explain bone loss. A direct inhibitory effect of ethanol on osteoblast function was suggested by in vivo and in vitro studies. We measured biochemical markers of bone turnover in 12 alcoholic men before and during a 2 week period of alcohol withdrawal, and we compared the results with those obtained in 15 nonalcoholic men. Our alcoholic patients presented with (1) decreased serum concentrations of bone gla protein (BGP), suggesting decreased bone formation; (2) increased urinary excretion of hydroxyproline, suggesting increased bone resorption; (3) increased renal threshold of phosphate excretion without modification of serum PTH concentration, suggesting a direct effect of ethanol on the renal handling of phosphate. The rapid increase in serum BGP concentrations following ethanol withdrawal suggests that low serum BGP concentrations in alcoholics may result from a direct toxic effect of ethanol on osteoblast function and/or numbers.

Adult↗
PubMed1992

[Adenovirus infections in an emergency department].

We have reviewed 108 emergency ward reports of patients with adenoviral positive cultures in "Doce de Octubre" Hospital in Madrid. Our aim was to know the most frequent symptoms of the infection so that identification and treatment could be managed more efficiently in our department. Cellular cultures were negative for other viruses such as CMV, enterovirus and herpesvirus. No bacteria were found in the throat cultures. Of the children who were evaluated, 78% were younger than 3 years old. The most frequent symptom was high fever with an otherwise good state of health. During the physical examination, a reddened throat with an exudate was found in half of the patients. A white blood cell count of over 15,000 was found in 33% of the patients with a left shift in 20%. The clinical findings overlapped with throat bacterial infections in 66%, lower respiratory infections in 14%, and more unusual, gastroenteritis, hematuria, intestinal invagination or exanthemas. Only 15% were not given antibiotic therapy.

Adenoviridae Infections↗