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Biomedical subjects

R Molina

Publications and source records attributed to R Molina.

At least 73 records · Page 4Linked to original sources
PubMed1997

Free and total PSA in the diagnosis of prostate cancer.

The use of PSA in the diagnosis of prostate cancer is controversial. This is due to false-positive results caused by benign prostatic hyperplasia (BPH). Different forms of circulating PSA have recently been described. Initial studies indicate that the fraction of free PSA is lower in prostate cancer than in BPH, therefore suggesting that its measurement could be of some diagnostic value. We have assessed the serum value of the percentage of free/total PSA in the differential diagnosis of BPH and prostate cancer. The levels of PSA and free PSA (DELFIA) were measured in 145 BPH patients and 56 prostate cancer patients. Free PSA is a small fraction of PSA, and significantly lower levels are being found in prostate cancer. In those patients with a PSA level between 2 and 25 micrograms/l, the determination of the percentage of free PSA increased the diagnostic efficiency of PSA, while reducing the number of negative biopsies. We conclude that free PSA may be a useful marker for the diagnosis of prostate cancer.

Aged↗
PubMed1997

Efficacy and safety of two new methods of rapid intravenous detoxification in heroin addicts previously treated without success.

BACKGROUND: New methods of rapid opiate detoxification, under intravenous sedation, can detoxify heroin-addicted patients in 24 hours. Their clinical application has been limited by the lack of studies establishing both efficacy and safety. METHOD: In a randomised, controlled study, 300 treatment-refractory, heroin-addicted patients received rapid intravenous detoxification treatment (naloxone infusion, 0.06-0.08 mg/kg, then oral naltrexone 50 mg/day) under either monitored light intravenous sedation or unmonitored deep intravenous sedation. RESULTS: All patients were successfully detoxified and 93% remained abstinent one month later. Severity of withdrawal, according to the Wang Scale modified by Loimer, was 4.9 (s.d. 3.0) points in the light sedation group and 4.8 (s.d. 2.9) in the deep sedation group (P = 0.26). Two patients (1.3%) in the light sedation group and four (2.6%) in the deep sedation group required tracheal intubation (P = 0.31). There was only one severe complication, a case of nosocomial aspirative pneumonia which improved with antibiotic treatment. CONCLUSIONS: Successful rapid intravenous detoxification can be achieved using relatively light levels of sedation.

Adult↗
PubMed1997

Phase III placebo-controlled trial of capsaicin cream in the management of surgical neuropathic pain in cancer patients.

PURPOSE: A minority of cancer survivors develops long-term postsurgical neuropathic pain. Based on evidence that capsaicin, the pungent ingredient in hot chili peppers, might be useful for treating neuropathic pain, we developed the present clinical trial. PATIENTS AND METHODS: Ninety-nine assessable patients with postsurgical neuropathic pain were entered onto this study. After stratification, patients were to receive 8 weeks of a 0.075% capsaicin cream followed by 8 weeks of an identical-appearing placebo cream, or vice versa. A capsaicin/placebo cream was to be applied to the painful site four times daily. Treatment evaluation was performed by patient-completed weekly questionnaires. RESULTS: During the first 8-week study period, the capsaicin-cream arm was associated with substantially more skin burning, skin redness, and coughing (P < .0001 for each). Nonetheless, treatment was stopped for patient refusal or toxicity just as often while patients were receiving the placebo as compared with the capsaicin. The capsaicin cream arm had substantially more pain relief (P = .01) after the first 8 weeks, with an average pain reduction of 53% versus 17%. On completion of the 16-week study period, patients were asked which treatment period was most beneficial. Of the responding patients, 60% chose the capsaicin arm, 18% chose the placebo arm, and 22% chose neither (P = .001). CONCLUSION: A topical capsaicin cream decreases postsurgical neuropathic pain and, despite some toxicities, is preferred by patients over a placebo by a three-to-one margin among those expressing a preference.

Administration, Topical↗
PubMed1997

Immunohistochemical study of alpha, mu and pi class glutathione S transferase expression in malignant melanoma. MMM Group. Multidisciplinary Malignant Melanoma Group.

Human pi, mu and alpha class glutathione S transferases (GST) have been localized immunohistologically in normal skin, naevi and melanoma. Pi GSTs were found principally in the stratum basalis and, to a lesser extent, in the superficial layers. Normal melanocytes showed strong nuclear and cytoplasmatic staining. Distribution of GST mu in the epidermis showed that only the stratum basale, where melanocytes are located, stained well but with weak nuclear staining. Normal melanocytes were also well stained. The alpha GSTs were relatively abundant in the upper strata and to a lesser extent, in the basal layers. The absence of nuclear staining gives these cells a target appearance. Normal melanocytes showed strong cytoplasmatic staining. The pi GSTs seem to be most persistently and strongly expressed in malignant melanoma (MM), but mu GSTs are also found, whereas the alpha GSTs were only occasionally present. The finding of the GST mu in the melanocytes of the basal layer raises new questions regarding the role of GST mu in these cells because of the inherent risk of MM in individuals with a congenital deficiency of this isoenzyme. The role of GSTs in the resistance of cells to chemotherapy is also discussed.

Cell Nucleus↗
PubMed1997

Social, familial and medical aspects of Usher syndrome in Colombia.

A psycho-social study was performed in 19 Colombian families with 40 affected individuals with Usher syndrome, identified through our national screening program for this disease in Colombia. The study was aimed to understand their needs, kind of familial inter-relationships, and social and familial implications of the patients' double sensorial limitation, in order to provide enough information to support the importance of early diagnosis, appropriate genetic counseling, and the establishment of adequate educational and rehabilitation programs in Colombia.

Adolescent↗
PubMed1996

Detection of nonprostatic PSA in serum and nonserum samples from women.

Prostate-specific antigen (PSA) has been characterized as a specific prostate marker, although recent studies have suggested the existence of PSA of nonprostatic sources. We have assessed the presence of PSA by an ultrasensitive assay in 276 serum and nonserum samples from women. Our data show the presence of PSA in 90% of nonserum samples, including milk secretions, breast cysts, amniotic fluids and broncho-alveolar washings. We have also detected its presence in 58% of the sera tested, although it only exceeded 0.1 microg/l in 6 of the cases. We conclude that PSA can no longer be considered a specific prostate tissue marker; since the concentrations detected in women's serum are ultralow, this finding appears to interfere minimally with its value as a tumoral marker.

Biomarkers, Tumor↗
PubMed1996

Prostate-specific antigen detection by ultrasensitive assay in samples from women.

BACKGROUND: The Prostate Specific Antigen (PSA) has been characterized as a specific prostate marker. Recent studies have indicated the existence of a PSA of nonprostatic origin detected in lactating women and breast tumors. METHODS: We have evaluated the presence of PSA by an ultrasensitive assay (COBAS CORE) in 252 serum and non serum samples from women. RESULTS: The results demonstrate the presence of PSA in 100% of the breast secretions, 81% of the breast cysts, 80% of the bronchoalveolar lavage fluids and 71% of the cytosols of breast cancer. Likewise, PSA was detected in 14% of the sera evaluated, although the concentrations were always lower than 0.5 ng/ml. CONCLUSIONS: We conclude that PSA should not continue being considered as the specific prostate tissue marker although, given that the serum concentrations detected are very low, they do appear to interfere to a minimum extent in the usefulness of PSA as a tumor marker.

Breast↗
PubMed1996

Value of PSA (prostate-specific antigen) in the detection of prostate cancer in patients with urological symptoms. Results of a multicentre study.

The aim of this multicentre study was to assess the usefulness of prostate-specific antigen (PSA) as a diagnostic procedure for prostate cancer in patients with urological symptoms, and compare it with digital rectal examination (DRE). The study included 2054 urological patients, aged over 50 years, and PSA levels were measured using an automated enzyme immunoassay. In the 680 cases with PSA levels > 3 micrograms/l and/or suspect DRE, transrectal ultrasound and prostate biopsy were also performed, leading to a diagnosis of cancer in 131 cases. The sensitivity of PSA was higher (95% and 73% for the cut-off values of 3 and 10 micrograms/l, respectively) than DRE (69%), both parameters being complementary. When DRE and PSA (> 10 micrograms/l) were combined, 118 cancers were diagnosed, with a PPV of 37%. We recommend using PSA and DRE in combination as a diagnostic procedure for prostate cancer in urological patients, since both methods are complementary.

Age Distribution↗
PubMed1996

Utility of C-erbB-2 in tissue and in serum in the early diagnosis of recurrence in breast cancer patients: comparison with carcinoembryonic antigen and CA 15.3.

To evaluate the utility of c-erbB-2, carcinoembryonic antigen (CEA) and CA 15.3 in the early diagnosis of recurrence, serial serum determinations of these antigens were performed in 200 patients (follow-up 1-4 years, mean 2.2 years) with primary breast cancer and no evidence of residual disease (NED) after radical treatment (radical mastectomy or simple mastectomy and radiotherapy). Eighty-nine patients developed metastases during follow-up. C-erbB-2, CEA and CA 15.3 were elevated (> 20 U ml-1, > 10 ng ml-1 or > 60 U ml-1 respectively) before diagnosis in 28%, 30% and 47% of the 89 patients with recurrence, with a lead time of 4.5 +/- 2.4, 4.9 +/- 2.4 and 4.8 +/- 2.4 months respectively. Tumour marker sensitivity was clearly related to the site of recurrence, with the lowest sensitivity found in locoregional relapse and the highest in patients with liver metastases. When patients with locoregional recurrences were excluded, sensitivity improved: 31% (c-erbB-2), 33% (CEA) and 56% (CA 15.3), with 76% having at least one of the three tumour markers. C-erbB-2 sensitivity in early diagnosis was significantly higher in patients with c-erbB-2 overexpression in tissue (8/10, 80%) than in those without overexpression (1/30, 3.3%) (P = 0.0001). Likewise, higher levels of both, c-erbB-2 and CA 15.3 at diagnosis of recurrence, higher sensitivity in early diagnosis of relapse and a higher lead time were found in PR+ patients (CA 15.3, P < 0.0001) or in PR- patients (c-erbB-2, P = 0.009). Specificity of the tumour markers was 100% for all three markers (111 NED patients). In conclusion, c-erbB-2 is a useful tool for early diagnosis of metastases, mainly in those patients with c-erbB-2 overexpression in tissue. Using all three markers simultaneously it is possible to increase the sensitivity in the early diagnosis of recurrence by 11.2%.

Bone Neoplasms↗
PubMed1996

Usefulness of prostate-specific antigen density as a diagnostic test of prostate cancer.

To evaluate the diagnostic usefulness of prostate-specific antigen density (PSAD) in prostate cancer (PC) prostate-specific antigen (PSA) concentrations were measured in 175 patients with benign prostatic hypertrophy (BPH) and 50 patients with PC. Patients with BPH were classified according to the presence of complications of the disease: urinary infection or the presence of a bladder catheter. PSAD levels were observed to be greater than 0.15 in 3% of the patients with uncomplicated BPH and in 40% of the patients with complicated BPH. PSA levels were higher than 10 micrograms/l in 3 and 27% of these patients, respectively. High levels of PSAD were observed in 80% of the patients with cancer. Sixty-four percent of the patients with cancer presented PSA levels greater than 10 micrograms/l. These results indicate that PSAD is a useful parameter in the differential diagnosis of PC and BPH with the diagnostic efficacy of PSAD being greater than that of the serum determination of PSA.

Biomarkers, Tumor↗
PubMed1996

Prognostic significance of SCC antigen in the serum of patients with head and neck cancer.

SCC antigen (Ag) is a tumor-associated Ag (TAA) obtained from squamous cell carcinoma of the uterine cervix. This study reports the evaluation of this TAA in patients with head and neck malignant diseases and its possible prognostic value. Serum samples from 28 patients with benign head and neck diseases from 399 patients with cancer were obtained prior to treatment. SCC Ag serum levels were determined by radioimmunoassay using 2.5 ng/ml as the upper limit of normality. Elevated SCC Ag serum levels were found in 14% of 28 patients with benign diseases, in 29% of 217 patients with primary tumors, in 48% of 46 patients with recurrence (43% in locoregional, 64% in metastases) and in 4% of 136 patients with no evidence of disease. In patients with primary tumors, SCC Ag serum levels were related to nodal involvement and tumor location with significantly higher levels in node-positive patients (p = 0.001) and in tumors located in the nasopharynx and piriform sinus (p = 0.02). Presurgical SCC Ag serum levels in patients with primary tumors had prognostic value with shorter disease-free survival in those patients with abnormal values of this TAA (p < 0.001), in both, node-negative and node-positive patients (p < 0.01). Multivariate analyses showed that SCC Ag is a significant independent predictor of disease-free survival even when other prognostic factors are considered. In conclusion, pretreatment SCC Ag serum levels are an independent prognostic indicator in patients with head and neck malignancies.

Antigens, Neoplasm↗
PubMed1996

Cytokines (IL-6, TNF-alpha, IL-1alpha) and soluble interleukin-2 receptor as serum tumor markers in multiple myeloma.

The serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), soluble interleukin-2 receptor (sIL-2r), and interleukin-1alpha (IL-1alpha) were measured in 30 healthy subjects, 22 patients with monoclonal gammopathy of undetermined significance (MGUS), five patients with smoldering multiple myeloma (SMM), and 46 with multiple myeloma (MM). Serum levels of IL-6, TNF-alpha, and sIL-2r were significantly increased in patients with active MM when compared with normal controls. Furthermore, MM patients with advanced aggressive disease had significantly higher levels of IL-6, TNF-alpha, and sIL-2r than those with MM in plateau phase. In conclusion, our data support the involvement of IL-6, TNF-alpha, and sIL-2r in MM. This confirms recent in vitro studies suggesting that these cytokines may play a central role in the pathogenesis of MM. Our data also show that serum levels of TNF-alpha, sIL-2r, and, particularly, IL-6 could be useful in the clinical management of patients with MM.

Biomarkers, Tumor↗
PubMed1996

[Seroprevalence of hepatitis A in hemophiliacs].

PURPOSE: To study the seroprevalence of hepatitis A virus (HAV) infection in haemophiliacs treated with factor VIII/IX concentrates. PATIENTS AND METHODS: Anti-HAV IgG antibodies were tested in 133 haemophiliacs previously treated (20 of them only infused with virus-inactivated factor concentrates), 11 previously untreated haemophiliacs and 60 healthy individuals (> 25 yr. old). RESULTS: The overall anti-HAV prevalence was 43%. Anti-HAV was found in 2 (10%) of the patients treated only with virus-inactivated concentrates and in 55 (49%) of those who had received non-inactivated concentrates. The seroprevalence in the untreated haemophiliacs was 27% and 90% in the healthy control group. The anti-HAV seroprevalence showed a significant (p < 0.001) dependence on patient age, it being higher in patients aged > 25 (77%) than in those aged 10-25 (31%) and < 10 (4%). The seroprevalence of anti-HAV was lower in the treated haemophiliacs aged 25 or more than in the healthy individuals, although the difference did not reach statistical significance (p = 0.06). CONCLUSION: These results show that the seroprevalence of HAV infection in haemophiliacs is similar to that in the general population, and that there is not a significant excess of HAV infections amongst haemophiliacs with high exposure to coagulation factor concentrates.

Adolescent↗
PubMed1996

[Cholera in a district of Peru].

Taking to consideration the low report of cholera patients and with the main knowing the reality about the introduction of Vibrio cholerae (V. cholerae) in Peru, a sample of 101 cases with acute diarrheal disease (ADD) was taken at the Distrito Villa El Salvador. They were selected by a systematic randomized sampling defined for each health care unit in the District, according to the daily average occurrence of ADD cases attended a week before the beginning of the study. All of them took part in a epidemiological survey. A sample was taken by rectal swab in order to isolate V. cholerae. 53 positive cases were found (52.2% and a confidence interval from 42.29 to 62.5%) with significant differences (p < 0.01) between the frequency in adults (67.3%) and children (34.8%). V. cholerae was isolated only in 13 (61.9%) of the 21 cases who had contact with cholera patients, for a relative risk of 1.24 (0.83 < RR < 1.85). A high positivity was also found, 21 cases (72.4%) among those who had raw food. A significant difference (p < 0.01) was observed in connection with those who had cooked food. In the multivariate logistic regression analysis it was only found a significant relationship with age and with the ingestion of raw food as regards the occurrence of cholera.

Acute Disease↗