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M Mariscal

Publications and source records attributed to M Mariscal.

5 recordsLinked to original sources

Determinants of the interval between the onset of symptoms and diagnosis in patients with digestive tract cancers.

The main objective of this cohort study was to analyze the influence of social factors on the interval from the onset of symptoms to diagnosis in the 217 patients with digestive tract cancer. From the clinical charts, the following information was extracted: date of the beginning of illness, dates of medical attendance, type and date of diagnostic tests, characteristics of the disease (symptoms, stage), and date of treatment. From personal interviews we gathered the data not present in the clinical chart: sociodemographic data, information about other underlying diseases, and variables related to lifestyle. The time periods considered were from onset of symptoms to initial consultation (S-C); from initial consultation to hospital admission (C-H); and from hospital admission to diagnosis (H-D). The information on hospital admission, diagnosis, and treatment was prospectively gathered, whereas data before hospitalization were assessed retrospectively. For statistical analysis, we used Kruskal-Wallis test and Cox regression. Pain was the only predictor associated with a shorter S-C period. Hemorrhage, number of symptoms, and hospital consultation significantly shortened the interval C-H. Both hemorrhage and pain, and an initial visit at private primary care were the independent predictors that decreased the period H-D. In conclusion, sociodemographic factors did not influence healthcare attendance.

Aged↗

Improved dose distribution with customized I-125 source loading in temporary interstitial implants.

I-125 sources are being used in temporary interstitial implants of various sites. Radiation safety considerations favor its use over other available radioisotopes. Cost containment is achieved by using the same sources for a number of patients. Loading I-125 seeds into implant catheters at our institutions permit customized source arrangement to optimize the implant dose patterns. Clinical examples are given for which the dose distributions achieved with customized source loading are superior to those achievable with standard Ir-192 ribbons.

Brachytherapy↗

Determinants of the interval between diagnosis and treatment in patients with digestive tract cancer.

The main objective was to analyze the influence of social factors on the interval from diagnosis to treatment in a cohort of 217 patients with digestive tract cancer. From the clinical charts data were obtained for: date of the beginning of illness, dates of medical attendance, type and date of diagnostic tests, characteristics of the disease (symptoms, stage), and date of treatment. From the personal interview we gathered information lacking in the clinical charts such as socio-demographic factors, other underlying diseases, and variables related to life style. The information on hospital admission, diagnosis, and treatment was prospectively gathered, whereas data before hospitalization were retrospectively assessed. In statistical analysis the Kruskal-Wallis test and Cox regression were used. The predictors associated with a shorter diagnosis-treatment period were: low social class, lymphatic involvement at diagnosis, first visit at secondary/tertiary level of health care, no car availability, two or more symptoms at the beginning of disease, sex (male), age (less than 74 years), and diagnosis out of vacation periods. In conclusion, several socio-demographic variables (age, gender, social class, and car availability) influence the interval diagnosis-treatment.

Aged↗

[Intraoperative blood replacement in aortic surgery. Autotransfusion technics].

INTRODUCTION: The performance of increasingly invasive surgical techniques involves higher consumption of blood products, along with associated immunological problems and infections. Measures intended to reduce the use of homologous blood products include autologous transfusion and the application of transfusion criteria. We describe our experience with a group of patients scheduled for aortic surgery. PATIENT AND METHODS: Three hundred fifty- eight patients were studied prospectively over a period of 60 months, during which various techniques for conserving blood were applied. Up to 2 units were donated before surgery by patients who had baseline hemoglobin (Hb) counts equal to or greater than 13 g/dl. The donated blood was stored in the form of packed red cells (PRC) and fresh frozen plasma (FFP). Plasmapheresis was performed before surgery whenever a loss of 1,200 ml was expected to occur. Intraoperative salvage of lost blood, with the "Cell- Saver" system, was also used in such cases. No patient was given PRC if Hb was equal to or greater than 10 g/dl; nor was plasma given unless analytical levels indicated need. RESULT: Between 25 and 33% of the patients, depending on age, required no blood products. In up to 55%, self- donated blood was used. Salvage during surgery conserved around 50% of estimated blood lost. The percentage of autologous blood replaced during surgery increase from 21% in 1989 to 38% in 1993. The amount of autologous plasma used also increased with time, reaching nearly 80% of total plasma infused thanks to the introduction of preoperative plasmapheresis. CONCLUSION: The establishment of strict protocols regarding use of blood products and the application of self-donation techniques provided a savings of homologous blood products during the period this study lasted. Preoperative donation of blood was accepted in all cases in which it was indicated and there were no adverse reactions when the autologous blood was replaced.

Aged↗