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Biomedical subjects

J Salinas

Publications and source records attributed to J Salinas.

108 records · Page 6Linked to original sources

Preoperative values of CA 15-3 and CEA as prognostic factors in breast cancer: a multivariate analysis.

The role of circulating tumor markers in providing prognostic information has not been widely studied. In the current study, serum levels of the carbohydrate antigen 15-3 (CA 15-3) and carcinoembryonic antigen (CEA) were determined preoperatively in 364 breast cancer patients with no clinical signs of metastasis. The prognostic relevance of these markers for recurrence (175/364) and death of disease (104/175) was determined by Cox multivariate analysis, including the comparison with classical prognostic factors. High levels of both tumor markers were associated with aneuploid tumors with high S-phase fraction and high ornithine decarboxylase activity. CA 15-3 was highly associated with the number of positive lymph nodes and peritumoral lymphatic or blood vessel invasion. No significant associations were found between CEA or CA 15-3 levels and histologic grade, necrosis and steroid receptor status. In univariate analysis, preoperative values, using optimum cutoff values of CA 15-3 (40 U/ml) and CEA (6 ng/ml), were statistically significant for relapse-free survival and overall survival. In multivariate analysis, only node status, DNA ploidy and ornithine decarboxylase activity were independent predictors for relapse-free survival; the estrogen receptor status was a predictor of overall survival. In node-negative patients, ornithine decarboxylase activity was the only factor selected for relapse-free survival. In node-positive patients, the number of lymph nodes and DNA ploidy were the only variables selected for relapse-free survival or overall survival. Estrogen receptor and ornithine decarboxylase activity were excluded for relapse-free survival, but were significant prognostic factors for overall survival.

Adult↗

Differences in the immune response against ruminant chlamydial strains in a murine model.

CBA/J mice were used in the present study to establish differences between the immune response to three chlamydial strains: AB7 (Chlamydia psittaci wild-type strain), 1B (C. psittaci vaccinal strain) and iB1 (C. pecorum). The evolution of chlamydial infection was evaluated in each strain by studying the clinical signs, the number of bacteria isolated from the spleen and the pathology of the liver. Three aspects of the immune response were then studied: the characterization of the infiltrate of leukocytes in the liver, the percentages of T- and B-cells, macrophages and neutrophils in the spleen, and the presence of cytokines in the serum. Infection followed a different course in the C. psittaci-infected mice; 1B-infected mice showed milder levels in all the parameters analysed than their AB7-infected counterparts. The resolution of infection was earlier in 1B-infected mice and, although the immune response to both strains was Th1-like, a more intense CD8+ T-cell response and an earlier presence of TNF-alpha in serum were observed in this group. C. pecorum infection was controlled mainly by a non-specific immune response, since these mice showed no signs of a systemic specific immune response. Neutrophil depletion experiments showed that these cells play a very limited role in the non-specific response against C. pecorum.

Animals↗

[Genitourinary changes in multiple sclerosis: the need for a urodynamic study].

OBJECTIVE: In this study we have evaluated the urinary and sexual alterations of patients with multiple sclerosis (MS) by means of neurourological and neuroandrological studies. PATIENTS AND METHODS: In 41 patients with MS we took a clinical history and made a neurourological physical examination. We also did a full urodynamic study including measurement of flow and postmictional residue, cystomanometry and test of the detrusor pressure/mictional flow. Selective electromyography of the periurethral sphincter and a cystourethrographic study were also done. In patients complaining of erection dysfunction this was also studied by means of an erection test with intracavernosal vasoactive drugs and special neurophysiological techniques including the obtention of S2-S4 evoked potentials in the bulbo-cavernosal muscle and the somatosensorial potentials of the pudendal nerve. RESULTS: In patients with MS there is a predominance of mixed and irritative urinary symptoms rather than obstructive symptoms. The vesico-urethral dysfunction of upper motor neurone type was the most frequent urodynamic diagnosis. There were no statistically significant differences between the urinary symptoms of the different urodynamic diagnoses. Ninety percent of the patients with erectile dysfunction had associated vesico-urethral dysfunction of upper motor neurone type and 100% of the patient with erectile dysfunction had dysfunction of the sphincter of the urinary bladder. CONCLUSIONS: In patients with MS there is no correlation between the clinical symptoms and urodynamic diagnosis. Therefore urodynamic diagnosis is essential not only for diagnosis but also for development of suitable treatment. The urodynamic diagnosis of dysfunction of the bladder sphincter is a risk factor in patients with MS. In our series 100% of the cases with erectile dysfunction also had dysfunction of the bladder sphincter.

Adult↗

[Results of prostatectomy in the treatment of obstructive benign prostatic hypertrophy].

Aimed to evaluate the results of surgery in patients with obstructive prostatic hypertrophy, we studied the clinical and flow measure results from 51 patients undergoing prostatectomy (31 TUR, and 20 retropubic prostatectomies). It was shown that prostatectomy significantly improved the irritation (63% of patients), and most importantly, the obstructive (89%) symptoms. Peak flow increased in 100% of patients while maximum flow percentile in 92% of patients. Post-operative results showed no correlation to the patients' age, duration of evolution or severity of urinary symptoms, weight of prostate removed or histology of the prostate. Our results were compared with those obtained with other therapeutical options, and it was demonstrated that prostatectomy (both retropubic and RUT) are, clinically and urodynamically, the most effective procedure in the treatment of obstructive prostate hypertrophy.

Aged↗

[Uncoordinated urination syndrome].

Fourteen male and female patients aged 8 to 21 (mean 12.57 years) underwent clinical and urodynamic evaluation. These patients had different lower urinary tract symptoms, and flow changes and increased perineal muscle activity during voiding were demonstrated urodynamically. The urodynamic work up consisted of flowmetry, cystomanometry, detrusor pressure-flow test, videocystourethrography and electromyography of the periurethral sphincter. The urinary symptoms were nocturnal enuresis in 6 cases (42.85%), urinary infection in 6 (42.85%), difficulty in voiding in 4 (28.57%), urgency incontinence in 4 (28.57%), voiding urgency in 2 (14.28%) and diurnal urgency and frequency in 1 case (7.18%). The following 3 voiding bladder behaviour patterns were observed; 1) involuntary micturition from bladder instability (7 cases, 50%), 2) micturition from voluntary bladder contraction (2 cases, 14.28%) and 3) absence of bladder contractile activity with voiding achieved using the abdominal muscles (5 cases, 35.71%). Decompensated voiding was observed in 21% of the overall group. Of these, 75% belonged to the group that used the abdominal muscles to void. Dilatation of the proximal or prostatic urethra was frequently accompanied by bladder instability (57%). The urodynamic data may be useful in determining the outcome of treatment.

Abdominal Muscles↗

[Some recent determinants of breast feeding in Chile].

Four factors that could explain in great part breast milk production difficulties in Chilean mothers are analyzed according to recent studies. Maternal nutritional status, positively influences breast milk volume and duration, thus adequate weight increment during pregnancy should be encouraged. Maternal work has been negatively correlated with breast-feeding duration in various local studies, by the contrary post-partum rest and direct care of infant show protective effects. Mothers that smoke during pregnancy and lactation have shorter breast-feeding periods than non smokers, meanwhile the latter have lower malnutrition rates. Elimination of health team practices that interfered with physiological lactation have increased breast-feeding time. New programs in this regard are encouraged. The presence at the national level of each of the four determinants is discussed according to available data.

Attitude of Health Personnel↗

[Clinical and urodynamic study of enuresis in a juvenile male population].

We carried out a clinical and urodynamic assay of 100 cases of enuresis of a male population of ages ranging from 17 to 25. 64% displayed urodynamic alterations and these were significantly greater (p less than 0.005) amongst those suffering from nocturnal enuresis with diurnal symptoms (90%) than amongst those suffering from nocturnal enuresis only (59%). 36% of the patients did not display any urodynamic alteration. The urodynamic dysfunction most commonly displayed was vesical instability (46%). The other urodynamic dysfunctions found were 18% of the total, and detrusor contraction alteration constituted 10% of these (2 of the cases corresponded to vesical-urethral neurogenic dysfunction). The presence of minimum latent rachichisis was accompanied by urodynamic alterations in a significantly larger proportion (p less than 0.005) than in individuals not displaying this. The three case of wide-scale rachischisis were accompanied by urodynamic alterations corresponding to vesico-urethral neurogenic dysfunction. The case of secondary enuresis displayed neither urodynamic nor radiological alterations. Juvenile age enuresis displayed similar characteristics to infantile enuresis, although the percentage of vesical instability was lower. However, detrusor contraction alterations increased and the presence of previously non diagnosed vesico-urethral neurogenic dysfunctions was displayed.

Adolescent↗

Antibody prevalence and isolation of Chlamydia psittaci from pigeons (Columba livia).

The isolation of Chlamydia psittaci and serological detection of Chlamydia-specific antibodies in racing pigeons and pigeons from public parks is described. Several serological methods (complement fixation test, indirect microimmunofluorescence test, and enzyme-linked immunosorbent assay) were compared with bacteriological techniques (isolation both in embryonated eggs and McCoy cell monolayers). Tests confirmed that 28.6%, 33.5%, and 35.9% of the pigeons, respectively, were seropositive by the tests mentioned above. Chlamydiae were isolated from 13% of the fecal specimens in ovocultures and from 18% of the fecal specimens in cell cultures. No significant differences between the two groups of pigeons were found (at a 95% confidence level, alpha = 0.05) using the hypothesis test of the difference between proportions of two populations. The serological and bacteriological techniques used are compared and discussed.

Animals↗

Recent advances on ovine chlamydial abortion.

This paper reviews new findings on ovine chlamydial abortion. Concerning chlamydial taxonomy, with the recent advances due to the analysis of the ribosomal genes, nine genotypic groups were identified separated into two lineages. It also describes the transmission of the disease, the site of entry of the organism and chlamydial shedding by underlying the role of latent infections. Recent results also concern the pathogenesis, with the kinetics of placental colonization and placental pathology leading to abortion in ruminants. Studies using experimental infection in a pregnant mouse model have allowed the identification of target placental cells and have shown the differential evolution of the infection according to the stage of pregnancy. Different diagnosis techniques are compared (ELISA, PCR and immunofluorescence for the direct diagnosis) but also the possibilities of distinction between antibodies against Chlamydia pecorum and Chlamydia psittaci (for serodiagnosis). The recent advances on prophylaxis are presented, as well as the research efforts needs for the next century.

Abortion, Veterinary↗