Search PubMed⌕ Search

Biomedical subjects

J Poch

Publications and source records attributed to J Poch.

16 recordsLinked to original sources
PubMed2006

[Assessment of the immigrant child].

In the last twenty years Spain has turned into one of the principal countries recipients of foreign population. As consequence of this massive entry of people, our country is among the first ones of Europe for interannual increase of population. The concept of immigrant child is very wide and includes minors of very diverse characteristics, as the proceeding from international adoptions, the children coming from developing countries or those that come from other developed countries. The immigrant children do not represent health risk for the autochthonous population, on the contrary, they are in situation of defenselessness for their scanty vaccination coverages, their situation of marginality and the precarious sanitary systems of the countries of origin. At the moment of offering medical paediatric attention to foreign children, we must individualize our actions in conformity with the characteristics of each patient. It is not possible to simplify in one unique protocol the best studies to resolve a problem of health in an immigrant child. The attention of these children implies an overstrain for the pediatrician and the sanitary personnel that receives them, because it is necessary to conquer idiomatic, cultural and social barriers to optimize the level of health of these patients. The syndromic initial description can help to prioritize the studies in each case (according to the most probable diagnoses). The children who return to the native land of their parents meet in a special situation of risk, for not being prepared to resist the attack of pathogen that do not exist or are rare in Spain.

Child↗
PubMed2003

3p21, 5q21, 9p21 and 17p13 allelic deletions accumulate in the dysplastic spectrum of laryngeal carcinogenesis and precede malignant transformation.

A tissue field of somatic genetic alterations precede the histopathological phenotypic changes of carcinoma. Loss of Heterozygosity (LOH) at the sites of known or putative tumor suppressor genes is a common genetic abnormality detected in precancerous conditions. These genomic changes could be of potential use in the diagnosis and prognosis of pre-malignant laryngeal lesions. Recently the concept of laryngeal intraepithelial neoplasia (LIN) was introduced. To evaluate patients with an increased risk of developing invasive laryngeal carcinoma via a dysplasia-carcinoma progression we investigated 102 microdissected cell populations. Cell populations were procured from 15 laryngectomy specimens with different peritumoral histological changes adjacent to the squamous cell carcinoma cells and 15 laryngeal endoscopic biopsies with no evidence of malignant transformation in a 6-10-year follow-up period. Histological diagnoses were subdivided into keratosis without dysplasia (KWD), with mild dysplasia (LIN 1), with moderate dysplasia (LIN 2), and with severe dysplasia or carcinoma in situ (LIN 3). Microsatellite analysis was performed with the aim of studying LOH of 5q21 (APC), 9p21 (p16), 3p21 and 17p13 (p53) chromosomal regions. Frequent allelic losses were found in carcinoma cells at p53 (54%), p16 (66%), 3p21(87%) and 5q21(58%). Identical LOH patterns were determined in 100% of the LIN3 peritumoral cells, 60% of LIN2, 50% of LIN 1 and 25% of KWD. In contrast, histologically normal mucosae, KWD and LIN1 lesions without malignant progression showed no allelic loss. These results show that dysplasia correlates with LOH at 3p21, 5q21, 9p21 and 17p13 in early laryngeal carcinogenesis. These genomic changes in pre-malignant laryngeal lesions could be of potential use as markers for cancer risk assessment.

Adult↗
PubMed2001

Functionally active duplications of the CYP2D6 gene are more prevalent among larynx and lung cancer patients.

The cytochrome P450 CYP2D6 is a polymorphic drug-metabolizing enzyme that is involved in the metabolism of several drugs and xenobiotics. Several independent studies indicate that the CYP2D6 metabolic status is a secondary factor in the risk of developing lung cancer, with individuals with high activity being at increased risk. The occurrence of functionally active duplications of the CYP2D6 gene is a phenomenon that affects 3-8% of Caucasians and up to 30% in some ethnic groups. These duplications cause ultrarapid metabolism of CYP2D6 substrates. In order to establish whether the highest CYP2D6 enzyme activity is associated with an increased risk of cancer, we analyzed the frequency of CYP2D6 gene duplications and enzyme-inactivating mutations in 199 Caucasian patients with lung or larynx cancer and in 335 healthy controls. A significantly increased frequency of carriers of the CYP2D6 gene duplication were found among lung and larynx cancer patients (13%), as compared with healthy controls (6.9%; p < 0.02). The frequency of the mutated active CYP2D6*9 allele was increased in lung cancer patients (p < 0.01) but not in larynx cancer patients. Global findings indicate that over 20% patients with lung or larynx cancer show CYP2D6 genotypes leading to ultrarapid metabolism or to the expression of an enzyme with altered kinetics (p < 0.01 vs. healthy controls). This may influence the metabolism of CYP2D6 substrates, including antineoplastic drugs and opioid derivatives used for pain relief in cancer patients. These patients would require higher doses than those considered as standard. We conclude that dosages for CYP2D6 substrates should be adapted to lung and larynx cancer patients.

Adult↗
PubMed1990

[Problems with indications for extracorporeal lithotripsy in urolithiasis].

Extracorporeal lithotripsy is a modern noninvasive method for the treatment of urolithiasis. The morphological and functional state of the urinary pathways, the localization of concrement and their size and number call in 35% of the patients for additive and auxiliary operations. Such comprehensive treatment can be provided by departments where all methods for the treatment of lithiasis are readily available. Repeated lithotripsy and combined therapeutic methods of more complicated conditions protract hospitalization and reduce the number of patients. The authors tested in more than 2500 lithotripsies the possibility to apply this treatment in the great majority of lithiases. However, because of the limited capacity they had to reduce the spectrum of indications to a minimum. Retardation of treatment by a protracted waiting period could damage the patient and it is then better to indicate another therapeutic approach; or to provide adequate treatment. We hope that patients who will need treatment after a year's time, will have the opportunity to be treated sooner by lithotriptors which should be installed before long in other departments.

Humans↗
PubMed1989

[Percutaneous extraction of concretions from the kidney].

The authors submit a report on 225 patients operated by the percutaneous approach on the kidney during the period between March 1985 and February 1987. From 231 operations on account of lithiasis concrements were removed in 94.8%. No major complications were observed. The mean period which elapsed from operation to discharge was 8 days in one-stage operations and 19 days in multiple-stage operations. The authors discuss the indications and some technical conditions of the method.

Adolescent↗
PubMed1989

[Extracorporeal shock-wave lithotripsy].

Concrement lithotripsy in the kidney and ureter using extracorporeal shock waves (ESWL) was performed with the aid of a 2nd-generation lithotriptor--Lithostar Siemens. Over a period of 11 months ESWL was applied in 526 patients aged 7 to 80 years, 10 of these were children. 19 patients had bilateral lithiasis so that the treatment was applied to a total of 545 renoureteral units and 698 concrements were disintegrated. In the ureter 34 concrements were disintegrated, the remainder being in the kidney. 12 patients had solitary kidney lithiasis; 62 subjects prior to ESWL, had been operated on the same kidney for lithiasis or on the ipsilateral ureter. Most patients had only local infiltration anaesthesia of the relevant intercostal nerves sometimes supplemented with mild opioid analgesia. Children were operated on in general anaesthesia. More than one ESWL application was needed in 33% cases, 54 disintegrated concrements measured more than 30 mm. Cystine concrements in 2 patients remained unaffected, in 1 woman with apatite lithiasis the disintegration was unsatisfactory. Auxiliary interventions had to be performed in 22% cases, prior to ESWL, and in 13% patients after ESWL, in 1 case following ESWL, open ureteromy was performed. The patient's exposure to radiation is negligibly low, the paramedical personnel is exposed to none. The noise level both for the patient and personnel is within the hygienic limits and is lower than in the case of 1st--generation lithotriptors. The average hospitalization period in patients with unilateral lithiasis lasted 7 days, 8 patients were treated in out-patient departments. When released from the clinic, 39.5% patients had no concrements, the remainder had only minute residual concrements. Three months upon the release, 77.6% patients were found with no demonstrable signs of concrements.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1980

[Farmer's lung. Report of a case (author's transl)].

Asthenia, anorexia, fever, weight loss, dyspnea and cough developed insidiously over 3 months in a patient working in a farm and exposed to moldy organic dusts (hay and alfalfa). Complete recovery occurred when exposure was stopped, but symptoms reappeared when the patient took the same job again. Pulmonary function tests showed reduced compliance and diffusion of gases. The demonstration of precipitating antibodies to moldy hay extracts confirmed the diagnosis of farmer's lung. Eight months after discontinuance of exposure and on steroid therapy the patient was asymptomatic with spirometric values within normal limits. Chest roentgenogram showed a residual finely reticular pattern in the superior lobules. The importance of an early diagnosis and subsequent change of job in order to avoid irreversible pulmonary fibrosis is stressed.

Farmer's Lung↗
PubMedDate not supplied

[First results of a study for the standardization of the electroglottogram of the normal subject].

"Primary results of a study for the standardization of the electroglottogram in normal subjects". Using one sample of waveforms from 151 normal subjects, 79 females form 17 to 80 years of age and 72 males from 12 to 85, the waves were normalized in accordance with frequency and amplitude. Two Kinds of parameters were measured, a) morphological, consisting in the three temporal phases determined by the three main inflexions of the waveform, and b) global, obtained when the glottal cycle is divide through the horizontal line of the electrical "O" into a negative and a positive semi-wave. Statistical analysis shows significant variations in the morphological parameters according to sex, age and fundamental frequency of voice Fo, confirming their close correlation with the vibratory events in the glottis. No significant relations have been found between global parameters and sex, age and Fo, indicating a lack of correlation between the electrical "O" line of the electroglottogram and the vibratory events of the glottal cycle.

Adolescent↗
PubMedDate not supplied

[Multiple carcinoma of the upper aerodigestive tract of metachronic onset].

One of the most important concepts in the understanding of the biology of squamous cell carcinoma of the head and neck is "multicentric cancer" as proposed by Slaughter et al. in 1953. With prolonged survival as a result of improved cancer therapy, the possibility of a second primary lesion should always be kept in mind during patient follow-up. A late or unusual metastasis in a patient with upper aerodigestive malignancy should be suspected of having a new primary carcinoma. In the last 12 months, we have treated 72 patients with upper aerodigestive malignancy. 5 of them had a history of previous squamous cell carcinoma of head and neck treated 6-13 years before. Probable etiopathogenic factors are discussed.

Adult↗