Biomedical subjects

Javier Gallego

Publications and source records attributed to Javier Gallego.

12 recordsLinked to original sources

PubMed2026

Prognostic modeling of overall survival in metastatic pancreatic cancer: an inflammation-based tool validated in PANTHEIA-SEOM cohort.

PURPOSE: To develop and internally validate the PANTHEIA-SIRI prognostic model, which integrates log-transformed systemic inflammation response index (SIRI) with clinical predictors, to estimate overall survival (OS) in metastatic pancreatic ductal adenocarcinoma (mPDAC) treated with first-line chemotherapy. METHODS: We used data from the multicenter PANTHEIA-SEOM registry. OS was defined from chemotherapy start. The model was fitted as a Weibull accelerated failure time model in the survival-analysis population with multiple imputation. Predictors were log-transformed baseline SIRI, modeled with restricted cubic splines, ECOG, tumor burden, chemotherapy regimen, and anorexia-cachexia syndrome. Internal validation used a separate, non-overlapping cohort from the same registry; the centers contributing to each cohort are listed in a supplementary annex. TRIPOD was followed. Discrimination was assessed with Harrell´s C-index and calibration with IPCW Brier scores and IPA. RESULTS: The derivation cohort comprised 672 patients with SIRI data (593 analyzed for survival) across 22 Spanish hospitals (2015-2025); 80.1% had died after a median OS of 9.9 months. The imputation-pooled derivation C-index was 0.654 (95% CI, 0.627-0.681); optimism-corrected, 0.629. Internal validation used 62 separate patients from the same registry; 96.8% had died after a median OS of 9.2 months. The validation C-index was 0.603 (95% CI, 0.518-0.687). Calibration was adequate at 6 and 12 months. CONCLUSIONS: The PANTHEIA-SIRI model provides individualized OS estimates in mPDAC with routine clinical predictors. Its open-access calculator ( https://pantheia-siri.shinyapps.io/calc/ ) may support prognostic communication, treatment-intensity selection, and supportive-care planning. Routine clinical implementation will require further validation in larger, fully independent cohorts.

Cachexia↗

PubMed2006

UFT in combination with oxaliplatin: clinical phase I study in patients with advanced or metastatic solid tumors.

This phase I trial evaluated the combination of oxaliplatin plus UFT in patients with advanced solid tumors to determine the maximum tolerated dose (MTD) and the dose limiting-toxicity for future phase II trials. Eligible patients (N = 27) were treated in sequential cohorts of three to six patients. The starting doses for oxaliplatin and UFT were 70 mg/m2 and 250 mg/m2/day respectively, and five dose levels were designed up to 85 mg/m2 and 400 mg/m2/day. Oxaliplatin was administered i.v. on day 1 and 15, and oral UFT was given daily in three divided doses on days 1-21 followed by 1 week rest of a 28-day cycle. At the recommended dose, six additional patients were entered. In total, 79 courses were administered with a median of 3 (range 1-6). MTD was not reached; oxaliplatin 85 mg/m2 on day 1 and 15 plus UFT 400 mg/m2/day for 21 days was considered the optimum combination for phase II trials. Gastrointestinal toxicity and asthenia were the most common adverse events. Eight out of 13 patients (61.5%) with metastatic colorectal cancer achieved stable disease. UFT plus oxaliplatin is a feasible and safe combination. A phase II trial in first-line advanced colorectal cancer is ongoing.

Administration, Oral↗

PubMed2004

Phase I study of the combination of oxaliplatin, irinotecan and continuous infusion 5-fluorouracil in digestive tumors.

Oxaliplatin (L-OHP), irinotecan (CPT-11) and 5-fluorouracil (5-FU) have shown their efficacy in metastatic colorectal cancer. The synergism of these drugs has been demonstrated in vivo and in vitro. The aim of this study was to determine the recommended dose of the triple combination of L-OHP, CPT-11 and CI 5-FU for a further phase II study. Eighteen patients received the study treatment in four dose levels. The male:female ratio was 15:3 and the median age was 51.6 years (range 30-71). The type of tumor was colon in eight patients, rectum in four and other locations in six patients. The treatment was repeated every 2 weeks, at the fixed dose of L-OHP, 85 mg/m, and escalated doses of CPT-11 and 48-h infusion 5-FU of 100/2000, 100/2250, 125/2250 and 150/2250 mg/m. Only one previous treatment for the advanced disease was permitted. Patients received a median of 8 cycles (range 1-26) and a total of 152 cycles were administered. Dose intensity administered at dose level L-OHP 85 mg/m, CPT-11 150 mg/m and 5-FU 2250 mg/m was 95, 92 and 95% for L-OHP, CPT-11 and 5-FU, respectively. One patient in level 2 and one patient in level 4 presented dose-limiting toxicity that was not confirmed in the three required additional patients by level. The anti-tumor activity was assessed in nine patients: seven partial responses, one stable disease and one progressive disease. The maximum-tolerated dose was not reached, and thus the recommended dose for this combination schedule is L-OHP, 85 mg/m, CPT-11, 150 mg/m and 5-FU, 2250 mg/m 48-h continuous infusion, the same doses that were recommended for the drugs when administered in combination therapy of L-OHP + 5-FU or CPT-11 + 5-FU. A phase II study in first-line treatment of patients with metastatic colorectal cancer with this dose regimen is ongoing.

Adult↗

PubMed2004

Comparative population genetics of the panicoid grasses: sequence polymorphism, linkage disequilibrium and selection in a diverse sample of sorghum bicolor.

Levels of genetic variation and linkage disequilibrium (LD) are critical factors in association mapping methods as well as in identification of loci that have been targets of selection. Maize, an outcrosser, has a high level of sequence variation and a limited extent of LD. Sorghum, a closely related but largely self-pollinating panicoid grass, is expected to have higher levels of LD. As a first step in estimation of population genetic parameters in sorghum, we surveyed 27 diverse S. bicolor accessions for sequence variation at a total of 29,186 bp in 95 short regions derived from genetically mapped RFLPs located throughout the genome. Consistent with its higher level of inbreeding, the extent of LD is at least severalfold greater in sorghum than in maize. Total sequence variation in sorghum is about fourfold lower than that in maize, while synonymous variation is fivefold lower, suggesting a smaller effective population size in sorghum. Because we surveyed a species-wide sample, the mating system, which primarily affects population-level diversity, may not be primarily responsible for this difference. Comparisons of polymorphism and divergence suggest that both directional and diversifying selection have played important roles in shaping variation in the sorghum genome.

Genes, Plant↗

PubMed2002

Determination of deforestation rates of the world's humid tropical forests.

A recently completed research program (TREES) employing the global imaging capabilities of Earth-observing satellites provides updated information on the status of the world's humid tropical forest cover. Between 1990 and 1997, 5.8 +/- 1.4 million hectares of humid tropical forest were lost each year, with a further 2.3 +/- 0.7 million hectares of forest visibly degraded. These figures indicate that the global net rate of change in forest cover for the humid tropics is 23% lower than the generally accepted rate. This result affects the calculation of carbon fluxes in the global budget and means that the terrestrial sink is smaller than previously inferred.

Africa↗

PubMed2002

Oxaliplatin: results in colorectal carcinoma.

Oxaliplatin, a platinum compound characterized by a diaminocyclohexane (DACH) platinum carrier ligand, has proven its efficacy in first- and second-line advanced colorectal cancer (CRC) treatment. Acute reversible and cumulative peripheral sensory neuropathy has been observed frequently with oxaliplatin treatment and limits its use. Its synergism with other drugs, as well as its different mechanism of action and toxicity profile make it an attractive candidate for combination studies in CRC. It can be combined safely with 5-fluorouracil (5-FU)+/-folinic acid (LV), irinotecan, raltitrexed, multitarget antifolate LY231514 (MTA), and oral 5-FU prodrugs. These combinations confer both an increased response rate compared to that of any single agent and an increased secondary surgical resection of initially unresectable metastases, possibly leading to prolonged survival. In three prospective randomized phase III studies in advanced CRC, oxaliplatin plus 5-FU/LV improved significantly progression-free survival without a significant increase in median survival time and without affecting quality of life, compared to treatment with 5-FU/LV. Ongoing clinical trials will define its role in the adjuvant setting.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

[Reoperation in mitral valve reconstructive surgery].

UNLABELLED: In the past few years reconstructive surgery of the mitral valve has experienced a growing popularity. It is now clearly established that restoration of a normal function valve is preferable to valve replacement. The authors report the results of the mitral valve reconstructive surgery in a population of 701 patients with high incidence of restrictive lesions of rheumatic fever. This represents an experience of 14 years. 5.1% of patients who underwent mitral valvuloplasty required late reoperation for recurrent mitral valve dysfunction. Repeat mitral valve repair resulted in successful treatment for 40% of these patients. CONCLUSION: The mitral valve repair failure are: 1--Procedure related: (58.1%); a--surgical technical related--35.8%; b--no ring implantation (in restrictive lesions)--15%; c-rupture of previously chordae shortened--7.4%. 2--Valve related: (41.9%); a--progressive primary valve disease--(25.4%); b--wrong surgical indication--(15%); c--endocarditis--(1.5%).

Adolescent↗

PubMedDate not supplied

["Off pump" coronary surgery and simultaneous carotid endarterectomy].

The occurrence of significant carotid artery disease in patients requiring coronary artery bypass grafting (CABG), results in a dilemma regarding the best surgical management. Our philosophy has been to perform simultaneous carotid endarterectomy and CABG off-pump. We reviewed the efficacy of this therapy in six patients treated in our hospital between January 2001 and December 2002. The result was satisfactory and there was no hospital mortality.

Aged↗

PubMedDate not supplied

[Surgery of mediastinal tumors: 11-years experience].

Between 1993 and 2004, 70 operations on patients with the diagnosis of mediastinal tumors were performed in the Cardiothoracic Surgery Department of Santa Maria Hospital. In this study we did not include diagnostic surgery of mediastinal tumors. In 70 patients treated, 63 p (90%) had the tumor located in the anterior mediastinum, 21 p with thymoma, 6 p with lymphoma, 4 p with carcinoid tumors, 1 p with sarcoma and 1 p with adenocarcinoma. 3 patients had tumors located in the medium and 4 patients in the posterior mediastinum. We analysed the results of the mediastinal tumors surgery during the 11-years period. Also, we evaluated the clinical effects of the thymectomy in myasthenia gravis.

Carcinoid Tumor↗

PubMedDate not supplied

[Surgical diagnosis of mediastinal pathology: eleven-years experience].

Between January 1993 and December 2004, 68 patients with mediastinal pathology were submitted to diagnosis surgery. All the pathological process were located in the anterior mediastinum, and most of them were malignant (64.1%). The most common pathology was limphoma (26.5%), sarcoidosis (23.5%) and thymomas (23.5%). Seven cases consisted in ganglionar tuberculosis (10.3%), six cases were ganglionar metastases of lung adenocarcinoma (8.8%), and three cases were thymic carcinoma (4.4%). One patient had no definite diagnosis (1.5%). In this experience high diagnosis accuracy (98.5%), and low morbidity were demonstrated. Although the present video assisted thoracic surgery progress and development, mediastinoscopy still remains as a reliable, safe and efficient surgical approach for the diagnosis of mediastinal pathology.

Adolescent↗

PubMedDate not supplied

[Results of Dor's endoventricular repair in the management of left ventricular aneurysms].

INTRODUCTION: Left ventricular aneurysms are serious long-term complications from acute myocardial infarction that produce hemodynamic alterations in the cardiac function. OBJECTIVE: The aim of this study is to evaluate the chirurgical and clinic results of the endoventricular patch repair of the akinetic or dyskinetic portions of the left ventricle. METHODS: From August 2002 to October 2005, 20 consecutive patients underwent surgical repair of left ventricular aneurysm using the endoventricular patch repair technique. The mean age was 63,6 years, and 80% where male. Every patient have had only one episode of acute myocardial infarction, which resulted in a akinetic or dyskinetic alteration in the motility of the left ventricle. The preoperative functional class of most of the patients was class III or IV and 45% where on angina class II. In 90% of the patients the ventricular aneurysm where antero-septal. Left ventricular dysfunction was present in 65%. RESULTS: All patients underwent the Dor procedure associated with coronary artery bypass grafting. There was no perioperative mortality. One patient died in the immediate postoperative period. Four patients needed inotropic support for more than 24h and intra-aortic balloon pumping was used postoperatively in two cases. Mean hospital stay was 8,6 days. At late follow-up the functional class was I in 20%, class II in 55% and class III in 10%. The angina class was I in 65% of the cases. CONCLUSIONS: The surgical repair of left ventricular aneurysm using the endoventricular patch repair technique proved to be safe, causing significant clinical improvement and an increase in the ejection fraction.

Cardiac Surgical Procedures↗

PubMedDate not supplied

[Cardiac papillary fibroelastoma].

Cardiac papillary fibroelastoma is a rare and histologically benign tumor. It is the most common valvular tumor and preferentially is found in the aortic valve (44% of the cases). They are typically smaller than 1 cm in diameter, and are characterized by having a fibrous core with elastic fibers, connective tissue and an endothelial lining. Papillary fibroelastoma are typically diagnosed incidentally during TEE. Tumor or thrombus embolizations may lead to severe complications such as stroke, myocardial infarction or even sudden death. In patients with the preoperative diagnosis of papillary fibroelastoma in addition to histories of cardiovascular and cerebrovascular injury require surgical resection to reduce the risk of future embolizations. The authors present two clinical cases of cardiac papillary fibroelastoma who were operated on in the Cardiothoracic Department from 2005 to 2006.

Heart Neoplasms↗