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Biomedical subjects

M Rovira

Publications and source records attributed to M Rovira.

125 records · Page 7Linked to original sources
PubMed1975

Some aspects of the spinal cord circulation in cervical myelopathy.

Under usual technical conditions, it is possible, in a great percentage of cases, to visualize angiographically the afferent radiculospinal artery feeding the anterior cervical spinal axis, coming from the vertebral arteries. The level of its emergence is varied, predominating at C5--C6. This radiculospinal artery can be directly affected by a spondylotic lesion at the foraminal level and is one of the causes of the ischemic syndrome observed in the cerival myelopathies resulting from this process.

Angiography↗
PubMedDate not supplied

Mitoxantrone and intermediate-dose cytosine arabinoside for poor-risk acute leukemias: response to treatment and factors influencing outcome.

Mitoxantrone (MIT, 12 mg/m2, i.v. 5 days) and intermediate-dose cytosine arabinoside (IDAC 1 g/m2/12 h, i.v. 3 days) was given to 43 patients with poor-risk acute leukemias (AL). Moderate or severe toxicity was infrequent. The proportion of complete remissions (CR) in the main patient categories was as follows: 15/18 (85 per cent) in acute myeloid leukemia (AML) in the first relapse, 2/6 in ALL in the first relapse, 0/2 in AML in relapse after bone marrow transplantation (BMT), 2/7 in AML refractory to first-line treatment (REF-AL), and 1/6 in postmyelodysplastic (PMD-AL) plus secondary AL (S-AL). The mortality rate during induction was 23 per cent. Median duration of CR was 24 weeks. The multivariate prognostic factor analysis on CR obtention showed that data concerning treatment for the first relapse and platelet count higher than the median of the series were favourable. On the contrary, PMD-AL, S-AL and REF-AL were unfavourable situations. A percentage of marrow erythroblasts superior to the median was a favourable prognostic factor for survival. Finally, the duration of CR after MIT-IDAC was directly related to the duration of previous CR. In conclusion, MIT-IDAC was highly effective to attain CR in AML in the first relapse. However, due to the poor long-term results in these patients, additional measures are recommended after CR.

Adolescent↗
PubMedDate not supplied

Comparative bioavailability of two immediate release tablets of enalapril/hydrochlorothiazide in healthy volunteers.

A bioequivalence study of two oral formulations of 20/12.5 mg tablets of enalapril/hydrochlorothiazide was carried out in 20 healthy male volunteers according to a single dose, two-sequence, crossover randomized design. One washout period of nine days was observed between the two periods. Multiple samples were collected over 96 hours post-dosing. Bioavailability was evaluated on the basis of plasma concentrations of enalapril and its main active metabolite, enalaprilat and hydrochlorothiazide. Plasma samples were assayed for enalapril, enalaprilat and hydrochlorothiazide using a selective and sensitive high-performance liquid chromatography method with mass spectrometry detection (LC-MS). The pharmacokinetic parameter values of Cmax and tmax were obtained directly from plasma data, k(e) was estimated by log-linear regression, and AUC was calculated by trapezoidal rule. Different statistical tests were performed on the basis of untransformed and log-transformed data and the overall residual variance from ANOVA. Assuming the accepted tolerance intervals, a beta-error of 20% and 90% confidence intervals (alpha = 0.10), all the generally accepted tests (Schuirmann test and Wilcoxon-Tukey and Hauschke nonparametric tests) showed that the formulations can be considered as bioequivalent with respect to the extent of absorption, given by the AUC(0-infinity) and with respect to rate of absorption as assessed by Cmax and tmax.

Administration, Oral↗
PubMedDate not supplied

Computed tomography in supratentorial hemangioblastoma.

Supratentorial hemangioblastomas are rare. A 28-yr-old man with a solid tumor in the left temporal region is described. There was neither meningeal connection nor associated polycythemia or Von Hippel-Lindau disease. Contrast enhanced computerized tomography showed a hyperdense, homogeneous lesion and cerebral angiography demonstrated a nodular tumor blush. The microscopic appearance of the lesion is described with a review of previously reported cases.

Adult↗
PubMedDate not supplied

Post-radiation cranial malignant fibrous histiocytoma studied by CT.

A 37-year-old woman presented with a proven case of malignant fibrous histiocytoma of the skull. This is thought to be a rare complication of post-radiation to a chromophobe adenoma which was treated by radiotherapy nine years previously. The radiation dose given to the sella region after the removal of the chromophobe adenoma was 4500 cGy.

Adenoma, Chromophobe↗
PubMedDate not supplied

Anti-K1 of the IgA class associated with Morganella morganii infection.

An anti-K1 alloantibody developed in a patient infected with Morganella morganii. The serologic behavior and response to dithiothreitol initially suggested that the alloantibody was an IgM. However, flow cytometry and the separation of immunoglobulin classes by serum chromatography revealed that the anti-K1 was constituted solely of IgA. These data suggest that bacteria-induced red cell antibodies might be of the IgA class.

Aged↗
PubMedDate not supplied

Thyrotoxic periodic paralysis in caucasians. Report of 8 cases.

BACKGROUND: Periodic paralysis is a well known complication of thytotoxicosis in Chinese and Japanese patients, but has been considered extremely rare in caucasians. PATIENTS AND METHODS: Between 1991 and 1996, we admitted 8 caucasian patients to our Hospital due to thyrotoxic periodic paralysis. We retrospectively analysed their clinical manifestations. RESULTS: All the patients were males. Their attacks started at night or early after awakening, frequently triggered by a high carbohydrate diet and physical exertion. Myalgias and flaccid weakness predominated over proximal leg muscles, sparing bulbar and respiratory musculature. Reflexes were brisk at the onset of the attack and reduced or absent during the course of the episode. Prior to diagnosis patients presented 1-5 attacks of thyrotoxic periodic paralysis each lasting 1-96 hours. Hypokalemia was documented in 6 patients. The episodes of periodic paralysis led to the diagnosis of a previously unsuspected thyrotoxicosis in 6 patients. In the other 2 patients the diagnosis of the thyroid dysfunction preceded the periodic paralysis. Attacks resolved after treatment of the hyperthyroid state. CONCLUSIONS: Thyrotoxic periodic paralysis is an under-diagnosed but probably frequent complication of hyperthyroidism in caucasians. Early recognition of the attacks is essential to investigate and treat the underlying thyroid dysfucntion whose symptoms are usually mild. The episodes of periodic paralysis resolve with the correction of the hyperthyroidism.

Adult↗
PubMedDate not supplied

[Hyperviscosity syndrome and mental disorders].

The hyperviscosity syndrome has been described clinically as the triad of bleeding, visual signs and neurological manifestations associated with elevated serum viscosity. Several reports have recognised an association between hyperviscosity and altered mental status. Since to our knowledge only a case of hyperviscosity-induced delirium has been described (1), we raise the possibility of this diagnosis in the most of this reported cases, based on the nature of the symptoms, sudden onset and fluctuating course, and its resolution with plasmapheresis. In this paper we review the literature about hyperviscosity syndrome and altered mental status. In conclusion, serum hyperviscosity should be added to the large list of causes altered mental status, especially of delirium. Since plasmapheresis can reverse clinical symptoms, it early recognition and the measurement of serum viscosity is essential in patients suffering from diseases that may lead to this syndrome, and who develop psychiatric symptoms.

Blood Circulation↗
PubMedDate not supplied

Prolapsed lumbar disk: value of CT in diagnosis.

A group of 40 patients with symptoms of prolapsed lumbar disk, seven of which were recurrent after surgery, was studied by computed tomography. In all cases, the diagnosis was confirmed by myelography and posterior surgery. Computed tomography was performed after the disappearance of myelographic contrast medium. Positive herniated disk was shown by computed tomography in 88%. In postoperative cases, computed tomography after intravenous contrast enhancement favored the recognition of postoperative scar, rather than recurrent herniation. Computed tomography also facilitated the diagnosis of spondylotic lesions, which may accompany herniated disks. Computed tomography should reduce the need for myelography, which is reserved for cases with doubtful computed tomographic findings.

Diagnosis, Differential↗
PubMedDate not supplied

High incidence of chronic graft versus host disease after allogeneic peripheral blood progenitor cell transplantation. The Spanish Group of Allo-PBPCT.

BACKGROUND AND OBJECTIVE: The incidence of acute GVHD (aGVHD) in allogeneic peripheral blood progenitor cell transplantation (allo-PBPCT) seems to be similar to that seen in allogeneic bone marrow transplantation (allo-BMT). In contrast, some preliminary results suggest that the incidence of chronic GVHD (cGVHD) might be higher. The aim of the present study was to analyze the actuarial probability of developing cGVHD in allo-PBPCT, its clinical manifestations and response to treatment. METHODS: We have retrospectively analyzed clinical results from 21 allo-PBPCT recipients that had been transplanted at least 18 months before this study and that fulfilled the following criteria: HLA identical sibling donor, non T-cell depleted apheresis and more than 90 days of survival with sustained engraftment. The median follow-up was 12 months (range 4.5-22). RESULTS: Twelve out of the 21 (57%) patients presented cGVHD, 1 limited and 11 extensive. The actuarial probability of cGVHD was 72.7% (95% CI, 49-96%). The median interval from transplant to onset was 180 days (range 95-270). Nine of the 12 cases (75%) presented combined skin and liver involvement. Of the other three, the liver was involved in one case; skin, mouth, and nail cGVHD was observed in another case; and skin and mouth involvement together with an obstructive pulmonary disease was observed in the remaining case. Under therapy, a complete resolution of cGVHD manifestations was achieved in five cases, and a partial improvement was attained in three other cases. In two responsive patients, cGVHD reappeared after stopping treatment. Four patients were refractory to the treatment. INTERPRETATION AND CONCLUSIONS: It would appear from this retrospective and multicenter study that, after a median follow-up of 12 months, cGVHD after allo-PBPCT could be more frequent than after allo-BMT. A randomized trial with a large number of patients and a sufficient follow-up will be necessary to answer this question definitively.

Adolescent↗