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1.
Rev. méd. Chile ; 150(5): 643-649, mayo 2022.
Article in Spanish | LILACS | ID: biblio-1409843

ABSTRACT

BACKGROUND: Acute myeloid leukemia (AML) is the most common leukemia in adults. Aim: To Describe our population of patients with AML and report the outcomes of our treatments. MATERIAL AND METHODS: Review of electronic clinical records of 114 patients with AML with a median age of 57 years (59% men). Results: Seventeen percent of patients were classified as low risk, 38% as intermediate risk and 33% as high risk. Seventy-six percent of patients were treated with intensive chemotherapy. Five years overall survival according to cytogenetic risk was 59, 41, and 12% in low, intermediate, and high-risk patients, respectively. The outcomes were better in patients under 60 years. The median survival of patients treated with intensive chemotherapy aged less than 60 years and 60 years and above was 3.4 and 1 year, respectively. CONCLUSIONS: Our results are comparable to those reported in developed countries. Improving the survival of patients 60 years and older is our main challenge.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Leukemia, Myelomonocytic, Acute/genetics , Leukemia, Myelomonocytic, Acute/drug therapy , Retrospective Studies , Treatment Outcome
2.
Rev Med Chil ; 150(5): 643-649, 2022 May.
Article in Spanish | MEDLINE | ID: mdl-37906765

ABSTRACT

BACKGROUND: Acute myeloid leukemia (AML) is the most common leukemia in adults. AIM: To Describe our population of patients with AML and report the outcomes of our treatments. MATERIAL AND METHODS: Review of electronic clinical records of 114 patients with AML with a median age of 57 years (59% men). RESULTS: Seventeen percent of patients were classified as low risk, 38% as intermediate risk and 33% as high risk. Seventy-six percent of patients were treated with intensive chemotherapy. Five years overall survival according to cytogenetic risk was 59, 41, and 12% in low, intermediate, and high-risk patients, respectively. The outcomes were better in patients under 60 years. The median survival of patients treated with intensive chemotherapy aged less than 60 years and 60 years and above was 3.4 and 1 year, respectively. CONCLUSIONS: Our results are comparable to those reported in developed countries. Improving the survival of patients 60 years and older is our main challenge.


Subject(s)
Leukemia, Myeloid, Acute , Male , Adult , Humans , Middle Aged , Female , Retrospective Studies , Leukemia, Myeloid, Acute/drug therapy , Leukemia, Myeloid, Acute/genetics , Treatment Outcome
3.
Behav Brain Res ; 416: 113523, 2022 01 07.
Article in English | MEDLINE | ID: mdl-34390801

ABSTRACT

Previous studies have shown that the anxiogenic effects of chronic stress do not correlate with dendritic remodeling in the central nucleus of the amygdala (CeA). We analyzed the effect of chronic restraint stress (CRS; 20 min/day for 14 days), relative to control (CTRL) conditions on anxiety-like behavior in the elevated plus maze (EPM) and the open field tests, and dendritic morphology, dendritic spine density and spine type numbers in pyramidal neurons of the CeA. Reversal of CRS-induced effects was explored in animals allowed a 14-day stress-free recovery after treatments. CRS decreased the frequency and time in the open arms and increased the anxiety index in the EPM, and reduced visits and time in the center of the open field. Morphological assays in these animals revealed no effect of CRS on dendritic complexity in CeA neurons; however, a decrease in dendritic spine density together with decreased and increased amounts of mushroom and thin spines, respectively, was detected. Subsequent to a stress-free recovery, a significant reduction in open arm entries together with an increased anxiety index was detected in CRS-exposed animals; open field parameters did not change significantly. A decreased density of total dendritic spines, in parallel with higher and lower numbers of thin and stubby spines, respectively, was observed in CeA neurons. Results suggest that CRS-induced anxiety-like behavior might be accounted for by a reduction in synaptic connectivity of the CeA. This effect, which is long lasting, could mediate the persisting anxiogenic effects of chronic stress after exposure to it has ended.


Subject(s)
Anxiety , Central Amygdaloid Nucleus/physiology , Dendritic Spines/physiology , Restraint, Physical/adverse effects , Stress, Psychological , Animals , Central Amygdaloid Nucleus/metabolism , Dendritic Spines/metabolism , Male , Maze Learning , Pyramidal Cells/metabolism , Rats
4.
Rev Med Chil ; 149(1): 22-29, 2021 Jan.
Article in Spanish | MEDLINE | ID: mdl-34106132

ABSTRACT

BACKGROUND: In our country, transplantation centers differ in the age limit for allogeneic hematopoietic transplantation (ALOHT). In our program, transplants with age- adjusted conditioning are performed in patients until 70 years old. Currently more than 60% of ALOHT reported to the Center for International Bone Marrow Transplantation Research (CIBMTR) are performed in patients older than 40 years. AIM: To report our experience with ALOHT in acute myelogenous leukemia (AML), analyzing patient age at transplantation in different periods and transplant results in different age groups. MATERIAL AND METHODS: A retrospective analysis of the database of adult hematopoietic transplants in AML patients was performed. Demographic data, disease characteristics, transplant data, survival and relapse times, and mortality were collected. RESULTS: In our program, 1030 transplants were performed in adults and 119 ALOHT were performed in AML patients, between 1990 and 2020. The median age of patients in all periods was 41 years, (range 16-69). The median age was 33 and 45 years, in the periods 1990-2000 and 2000-2020 respectively (p < 0.01). Seventy-eight patients received myeloablative conditioning (median age 44 years) and 41 reduced intensity conditioning (median age 53 years). Five-year overall survival was 44.6% (confidence intervals (CI) 41-48). Non relapse mortality of all periods was 19% (CI 17 - 40%) and relapse rate was 17 % (CI 16-22). No difference in five years overall survival among patients younger than 40, 41 to 50 and over 51 years was observed. CONCLUSIONS: Overall Survival, non-relapse mortality and relapse rate were similar in younger and older patients in our program and similar to those previously reported in other centers.


Subject(s)
Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Leukemia, Myeloid, Acute , Adolescent , Adult , Aged , Humans , Leukemia, Myeloid, Acute/therapy , Middle Aged , Retrospective Studies , Transplantation Conditioning , Transplantation, Homologous , Treatment Outcome , Young Adult
5.
Rev. méd. Chile ; 149(1): 22-29, ene. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1389344

ABSTRACT

BACKGROUND: In our country, transplantation centers differ in the age limit for allogeneic hematopoietic transplantation (ALOHT). In our program, transplants with age- adjusted conditioning are performed in patients until 70 years old. Currently more than 60% of ALOHT reported to the Center for International Bone Marrow Transplantation Research (CIBMTR) are performed in patients older than 40 years. AIM: To report our experience with ALOHT in acute myelogenous leukemia (AML), analyzing patient age at transplantation in different periods and transplant results in different age groups. MATERIAL AND METHODS: A retrospective analysis of the database of adult hematopoietic transplants in AML patients was performed. Demographic data, disease characteristics, transplant data, survival and relapse times, and mortality were collected. RESULTS: In our program, 1030 transplants were performed in adults and 119 ALOHT were performed in AML patients, between 1990 and 2020. The median age of patients in all periods was 41 years, (range 16-69). The median age was 33 and 45 years, in the periods 1990-2000 and 2000-2020 respectively (p < 0.01). Seventy-eight patients received myeloablative conditioning (median age 44 years) and 41 reduced intensity conditioning (median age 53 years). Five-year overall survival was 44.6% (confidence intervals (CI) 41-48). Non relapse mortality of all periods was 19% (CI 17 - 40%) and relapse rate was 17 % (CI 16-22). No difference in five years overall survival among patients younger than 40, 41 to 50 and over 51 years was observed. Conclusions: Overall Survival, non-relapse mortality and relapse rate were similar in younger and older patients in our program and similar to those previously reported in other centers.


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Aged , Young Adult , Leukemia, Myeloid, Acute/therapy , Hematopoietic Stem Cell Transplantation , Graft vs Host Disease , Transplantation, Homologous , Retrospective Studies , Treatment Outcome , Transplantation Conditioning
6.
Chest ; 155(5): e149-e154, 2019 05.
Article in English | MEDLINE | ID: mdl-31060713

ABSTRACT

CASE PRESENTATION: A previously healthy 45-year-old man was admitted to our ED with a 3-week history of progressive dyspnea on exertion. He also presented with orthopnea, paroxysmal nocturnal dyspnea, and mild ankle swelling, but he showed no fever, wheezing, coughing, or sputum production. Outpatient laboratory studies, performed 1 week after symptom onset, revealed hypereosinophilia (4.100/µL). He was diagnosed with asthma and prescribed inhaled corticosteroids and low-dose prednisone, but he showed no symptomatic improvement. Over the last 48 h, he experienced rapid progression of dyspnea that made it difficult to speak with accompanying resting, substernal, nonradiating chest pain that became worse on inspiration. He had no allergies and reported no recent travels. Before symptom onset, he had not been taking any medication. He denied eating raw fish or meat and had not been exposed to mildew. His only exposure to animals was from his two indoor cats.


Subject(s)
Albendazole/therapeutic use , Asthma/diagnosis , Hypereosinophilic Syndrome/diagnosis , Toxocariasis/diagnosis , Adrenal Cortex Hormones/therapeutic use , Animals , Asthma/drug therapy , Cats , Chest Pain/diagnosis , Chest Pain/etiology , Diagnosis, Differential , Disease Progression , Dyspnea/diagnosis , Dyspnea/etiology , Echocardiography/methods , Electrocardiography/methods , Emergency Service, Hospital , Eosinophilia/diagnosis , Eosinophilia/etiology , Follow-Up Studies , Humans , Male , Middle Aged , Radiography, Thoracic/methods , Risk Assessment , Treatment Outcome
7.
Arch. Inst. Cardiol. Méx ; 56(3): 237-42, mayo-jun. 1986. ilus, tab
Article in Spanish | LILACS | ID: lil-47219

ABSTRACT

Los tumores de tejido cromafín, hormonalmente activos y capaces de producir daño a varios órganos e incluso la muerte, con frecuencia permanecen insospechados ejerciendo por períodos prolongados su efecto deletéreo. Con frecuencia son múltiples y al problema de su diagnóstico se agrega el de su localización. Describimos el caso de una mujer joven, con historia de episodios paroxísticos de palpitaciones, disnea, opresión precordial e hipertensión arterial de ocho años de evolución. El diagnóstico de tumor cromafín fue realizado a través de determinación de catecolaminas séricas y urinarias. Fué intervenida quirúrgicamente en tres ocasiones después de efectuar ultrasonografía de abdomen y pelvis, tomografía axial computada de torax, abdomen y pelvis, muestreo hormonal a través de cavografía; arteriografía selectiva y empleo de metaiodo-benzyl-guanidina 131. Enfatizamos la incapacidad de los métodos empleados, cruentos e incruentos y la ausencia del procedimiento ideal cuando se emplean aisladamente. Recomendamos también el estudio de la respuesta presora al ejercicio en banda sinfín para evaluar el comportamiento de las resistencias periféricas en sí, una vez conseguida la curación quirúrgica


Subject(s)
Adult , Humans , Female , Catecholamines/urine , Chromaffin System , Iodobenzenes , Kidney Neoplasms , Multiple Endocrine Neoplasia/surgery , Paraganglioma/diagnosis , Kidney
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