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Biomedical subjects

M Arenas

Publications and source records attributed to M Arenas.

At least 19 recordsLinked to original sources
PubMed2006

Cosmetic outcome of breast conservative treatment for early stage breast cancer.

PURPOSE: To evaluate the cosmetic outcome of breast conservative therapy and to examine the degree of agreement between the patients' and oncologists' ratings. We also analyze the influence of several factors on cosmesis. METHODS AND MATERIALS: We retrospectively evaluated 145 patients with primary breast cancer treated by local excision and radiotherapy between January 2000 and May 2001. Cosmetic outcome was evaluated by doctors and patients and was scored as excellent, good, fair or poor. RESULTS: 73% of patients rated cosmesis as excellent or good while the percentage was 71% when rated by radiation oncologists. The degree of cosmesis concordance evaluated by oncologists and patients was low (kappa = 0.3). In our study the variables which significantly influence on the cosmetic outcome were concomitant adjuvant chemotherapy (p = 0.04) and radiation therapy boost, either by electron beam or brachytherapy (p = 0.013). CONCLUSION: The cosmetic outcome of breast conserving therapy was good. There was a similar rating by the patient and radiation oncologist, but the level of concordance between patients and doctors was low. Factors that significantly influence the cosmesis appear to be concomitant adjuvant chemotherapy and radiation therapy boost.

Adult↗
PubMed2006

Multiple agenesis and anhidrotic ectodermal dysplasia: a comparative longitudinal study of dental similarities and genetic differences in two groups of children.

AIM: Dental anomalies in shape and number may be present isolated or associated with other manifestations. In anhidrotic ectodermal dysplasia they occur more frequently and severely. The authors examined a group of children with similar dental anomalies but no other ectodermal or extra-ectodermal signs. METHODS: This study makes a comparative evaluation of similarities and differences of dental anomalies between two groups: A anhidrotic ectodermal dysplasia and B similar dental finding but without extra- dental anomalies. RESULTS: In group A, the average number of agenesis in primary teeth was 3.5 (upper) and 5.33 (lower); in permanent teeth it was 5.4 and 5.8, respectively. In group B, the average was 1.62 (upper) and 0.25 (lower) in primary teeth, and 4.0 and 4.25 in permanent teeth respectively, with no constant pattern of occurrence. The study of tooth morphology of both groups revealed numerous anomalies in both dentitions. No differences were found in the average number of agenesis and morphological anomalies in the permanent teeth between both groups, but in the primary dentition group B presented a lower degree of incidence. CONCLUSION: The presence of almost normal primary dentition (regarding to number), but with morphological anomalies, should lead to suspect their exacerbation in the permanent dentition.

Anodontia↗
PubMed2004

Mutation in the ITPA gene predicts intolerance to azathioprine.

Inosine triphosphate pyrophosphatase (ITPase) deficiency occurs with polymorphic frequencies in Caucasians and results in the benign accumulation of the inosine nucleotide ITP. In 62 patients treated with azathioprine for inflammatory bowel disease, the ITPA 94C>A deficiency-associated allele was significantly associated with adverse drug reactions (OR 4.2, 95% CI 1.6-11.5, p = 0.0034). Significant associations were found for flu-like symptoms (OR 4.7, 95% CI 1.2-18.1, p = 0.0308), rash (OR 10.3, 95% CI 4.7-62.9, p = 0.0213) and pancreatitis (OR 6.2, CI 1.1-32.6, p = 0.0485). Polymorphism in the ITPA gene thus predicts AZA intolerance. Alternative immunosuppressive drugs, particularly 6-thioguanine, should be considered for AZA-intolerant patients with ITPase deficiency.

Alleles↗
PubMed2004

Allele frequency of inosine triphosphate pyrophosphatase gene polymorphisms in a Japanese population.

The enzyme inosine triphosphate pyrophosphatase (ITPase) catalyses the pyrophosphohydrolysis of ITP to IMP. ITPase deficiency is a clinically benign autosomal recessive condition characterised by the abnormal accumulation of ITP in erythrocytes. A deficiency of ITPase may predict adverse reactions to therapy with the thiopurine drug 6-mercaptopurine and its prodrug azathioprine. In this study, we examine the frequencies of ITPA polymorphisms in 100 healthy Japanese individuals. The allele frequency of the 94C > A variant in the Japanese sample was 0.135 (Caucasian allele frequency 0.06). The IV2 + 21A > C polymorphism was not found in Japanese (Caucasian allele frequency 0.130). Allele frequencies of the 138G > A, 561G > A and 708G > A polymorphisms were 0.57, 0.18 and 0.06 respectively in the Japanese population, and with the exception of the 138G > A polymorphism, similar to allele frequencies in Caucasians.

Alleles↗
PubMed2004

Genetic determinants of the pre- and post-azathioprine therapy thiopurine methyltransferase activity phenotype.

Thiopurine drug therapy has been reported to lead to a variable increase in red cell TPMT activity that may alter effective dose and therapeutic outcome. The aim of this study was to correlate Variable Number Tandem Repeat (VNTR) in the promoter region of the TPMT gene with induction of red cell TPMT activity in patients treated with azathioprine (AZA). In 58 patients, TPMT activity measured at 3 months was not significantly induced on average above pre-therapy levels. Individual patients showed variation in TPMT activity pre- and post-AZA therapy, however changes in TPMT activity were not predicted by VNTR configuration. In conclusion, TPMT promoter VNTRs are unlikely to play a significant role in changes in TPMT activity in response to AZA therapy.

Alleles↗
PubMed2001

Ehrlich ascites tumor cells expressing anti-sense glutaminase mRNA lose their capacity to evade the mouse immune system.

Glutaminase (EC 3.5.1.2) is a key enzyme in rapidly proliferating cells. Using anti-sense technology, an Ehrlich ascites tumor cell line (0.28AS-2) with reduced glutaminase activity has been obtained. We investigated the in vivo growth characteristics of the 0.28AS-2 cells. When injected i.p. into normal Swiss albino mice, the 0.28AS-2 cells were unable to grow. On the contrary, when injected into nude mice, they developed into solid tumors. Mice inoculated with 0.28AS-2 cells kept immunologic memory and rejected a second inoculation with parental Ehrlich ascites tumor cells. Expression of both polymorphic epithelial mucin-1 (MUC-1) and the enzyme N-acetyl-alpha-D-galactosaminidase, proteins implicated in host immune system escape, were markedly diminished in 0.28AS-2 cells. Study of the immune system response in mice inoculated with 0.28AS-2 cells revealed an increase in splenic CD18 cells and the presence of a large number of activated F4/80+ macrophages in the ascites cavity. These features, not observed in mice inoculated with parental Ehrlich ascites tumor cells, indicate that a distinctive, strong immune response occurred in animals inoculated with 0.28AS-2 cells. Our results suggest that inhibition of glutaminase expression using anti-sense technology induces phenotypic changes in Ehrlich ascites tumor cells that allow the development of an effective anti-tumor immune response, which makes the cells unable to develop in vivo tumors.

Animals↗
PubMed2001

Radiotherapy for genital extramammary Paget's disease in situ.

BACKGROUND: Radiotherapy as a first-choice treatment for extramammary Paget's (EMP) disease in situ has been seldom used. OBJECTIVE: To review the most relevant aspects of radiotherapy as first-choice treatment in selected cases of anogenital EMP disease in situ. METHODS: Two men with an age range of 71-79 years (mean age 75 +/- 5.6 years) with EMP disease in situ localized in the genital region were treated by means of X-rays of 100 kV, 440 cGy/day, 3 days a week over 3 weeks until a total dose of 3960 cGy was completed. RESULTS: Complete regression of EMP disease in situ was observed in both patients after radical radiation therapy and neither local recurrences nor internal malignancies have been documented. CONCLUSION: Radiotherapy is a curative treatment in selected cases of EMP disease in situ affecting large areas of the anogenital region.

Aged↗
PubMed2000

Acoustic analysis after radiotherapy in T1 vocal cord carcinoma: a new approach to the analysis of voice quality.

PURPOSE: The study of acoustic voice parameters (fundamental frequency, jitter, shimmer, and harmonics-to-noise ratio) in extended vowel production, oral reading of a standard paragraph, spontaneous speech and a song in irradiated patients for Tis-T1 vocal cord carcinoma. METHODS AND MATERIALS: Eighteen male patients irradiated for Tis-T1 vocal cord carcinoma and a control group of 31 nonirradiated subjects of the same age were included in a study of acoustic voice analysis. The control group had been rigorously selected for voice quality and the irradiated group had previous history of smoking in two-thirds of the cases and a vocal cord biopsy. Radiotherapy patients were treated with a 6MV Linac receiving a total dose of 66 Gy, 2 Gy/day, with median treatment areas of 28 cm(2). Acoustic voice analysis was performed 1 year after radiotherapy, the voice of patients in extended vowel production, oral reading of a standard paragraph, spontaneous speech, and in a song was tape registered and analyzed by a Kay Elemetric's Computerized Speech Lab (model CSL# 4300). Fundamental frequency, jitter, shimmer, and harmonics-to-noise ratio were obtained in each case. Mann Whitney analysis was used for statistical tests. RESULTS: The irradiated group presented higher values of fundamental frequency, jitter, shimmer, and harmonics-to-noise ratio. Mann-Whitney analysis showed significant differences for fundamental frequency and jitter in vowel production, oral reading, spontaneous speech, and song. Shimmer only showed differences in vowel production and harmonics-to-noise ratio in oral reading and song. CONCLUSIONS: In our study only fundamental frequency and jitter showed significant increased values to the control group in all the acoustic situations. Sustained vowel production showed the worst values of the acoustic parameters in comparison with the other acoustic situations. This study seems to suggest that more work should be done in this field.

Aged↗
PubMed1997

[Clinical assessment systems in the diagnosis of pulmonary thromboembolism].

We proposed developing two symptom-based systems for assessing the presence of pulmonary thromboembolism (TEP) in our practice, using a standardized questionnaire and multivariate models. Data were collected from September 1993 through November 1994 (case reports, physical examination findings and complementary test results) of patients admitted to our ward with a suspicion of TEP. The calculated odds ratio for each of the variables recorded were used as weights to determine their relevance or not for the group at risk for TEP. The yield of the two systems developed (a weights system and a logistical model) were studied by plotting ROC curves. Eighty-two patients (40 women and 42 men, mean age 60.94 +/- 14.39 years) were admitted. The questionnaire had a sensitivity of 88% and a specificity of 75%, a positive predictive value of 94% and a negative predictive value of 60%. The logistical regression model had a sensitivity of 96.3% for a diagnosis of TEP with inclusion of the following variables: female sex, disease-related immobility, presence of deep venous thrombosis (DVT) in the lower extremities and the appearance of unexplained dyspnea. Neither system was clearly superior to the other for arriving at a clinical diagnosis of TEP.

Aged↗
PubMed1997

[Evolution of pulmonary scintigraphy in the follow-up of pulmonary embolism. Effect of anticoagulant treatment and other associated factors].

We performed a prospective study to determine the evolution of perfusion defects 6 months after pulmonary thromboembolism (PTE), to identify associated factors and to evaluate the incidence of subclinical recurrence. Seventy patients diagnosed of PTE were enrolled. Perfusion pulmonary scintiscans were performed 6 months after the acute PTE episode and the results were compared with initial defects. We looked for significant relations between several course profiles and factors such as age, sex, anticoagulation therapy and patient history. Defects revealed by the initial scintiscan remained the same 6 months later in 15 (21%), decreased in 35 (53%) and disappeared in 16 (23%) of the 70 patients. New defects were identified in 2 patients. A significant relation was found between a favorable outcome as shown by follow-up scintiscans and compliance with anticoagulation therapy (p = 0.0024). Other statistically significant relations were observed between favorable outcome and a history of surgical intervention during the acute episode (p = 0.004) and between unfavorable outcome and a history of venous thromboembolic disease (p = 0.004).

Adult↗
PubMed1994

[An opinion/satisfaction survey on 2 models of clinical histories used in primary care].

OBJECTIVE: We aimed to discover the opinion of primary care doctors regarding the structure, usefulness and problems when using two models of clinical records employed consecutively in the same health centres. DESIGN: A double crossover study. An opinion poll (with 22 closed questions and one open), filled out in 1988 (evaluating the type A clinical record) and then in 1992 (for type B), was used. Chi squared statistical analysis with Yates corrections and Fisher test. SETTING AND PARTICIPANTS: Staff doctors and third-year family and community medicine interns at their teaching centres in Alicante province. In 1988, 49 doctors took part, and in 1992, 68: 70 and 75% respectively of the target group. RESULTS: The new record was an improvement over the earlier one. It was broader and corresponded more closely to the actual case. But problems of completion and legibility persisted, as did the difficulties in filling out socio-economic data and work/school history. Model B favoured use by all the team members. It was better for new patients and when doing later checks, although it did not avoid the accumulation of inactive documentation. The need for specific documents for preventive activities was detected. Computerisation would improve manageability. For both models lack of time was the main reason for under-recording. CONCLUSIONS: The new model is better than the earlier one but is lacking in the areas of manageability and difficulty in retrieving information. The methodology employed shows its use for evaluating health-care innovations and detecting insufficiencies, as well as allowing user-satisfaction to be more easily identified.

Attitude of Health Personnel↗