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Search Results: 1 - 10 of 779824 matches for " María Teresa Milanés Roldán "
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Fósforo 32: Experiencia de 30 a?os en la policitemia vera
Fernández Delgado,Norma; Fundora Sarraff,Teresa; Milanés Roldán,María Teresa;
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2003,
Abstract: a retrospective study of 279 patients suffering from polycytemia vera (pv) was made. seventy-two of these patients (25%) were treated with 32 phosphorus and followed-up for 4 to 28 years. the average age was 61 years on the first treatment. the hematological control was obtained in 95.8% of cases (n=69). the mean duration of the hematological control was 27.8 months. the total dose mean used per patient was 9.2±8.9 mci. thirty-four patients (54.1%) required the administration of more than one dose of the radioactive pharmaceutical during the evolution of the disease. of all the treated patients, five (6.9%) developed acute leukemia 9 to 25 years after the first administration of the radiopharmaceutical and 3 (4.1%) developed other malignancies after 15 years of having been diagnosed or more. the post-treatment survival median was 10.1 years and the fundamental cause of death was vascular problems. 32 phosphorus treatment is undoubtedly a desirable effective therapeutical method for over 60 years-old patients since it assures excellent quality of life and extends the survival period, with minimum adverse reactions at a moderate cost
Fósforo 32: Experiencia de 30 a os en la policitemia vera Thirty years of experience in the use of 32 phosphorus for Polycythemia Vera
Norma Fernández Delgado,Teresa Fundora Sarraff,María Teresa Milanés Roldán
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2003,
Abstract: Se realizó un estudio retrospectivo de 279 pacientes con policitemia vera (PV) de los cuales 72 (25,8 %) fueron tratados con 32P con un tiempo de seguimiento entre 4 y 28 a os. La edad promedio fue de 61 a os al recibir el primer tratamiento. El control hematológico se obtuvo en el 95,8 % de los casos (n=69). La media de duración del control hematológico fue de 27,8 meses. La media de la dosis total utilizada por paciente fue de 9.2 ± 8,9 mCi. En 34 pacientes (54,1 %) fue necesaria la administración de más de una dosis del radiofármaco durante el tiempo de evolución de la enfermedad. Del total de pacientes tratados, 5 (6,9 %) desarrollaron una leucemia aguda entre los 9 y 25 a os posteriores a la primera administración y 3 (4,1 %) desarrollaron otras malignidades después de más de 15 a os del diagnóstico. La mediana de supervivencia postratamiento fue de 10,1 a os y la causa fundamental de muerte fueron los accidentes vasculares. No hay dudas de que el 32P constituye un método terapéutico conveniente y eficaz, fundamentalmente en pacientes mayores de 60 a os, que logra una excelente calidad de vida y prolonga la supervivencia con un mínimo de reacciones adversas y un costo moderado A retrospective study of 279 patients suffering from Polycytemia Vera (PV) was made. Seventy-two of these patients (25%) were treated with 32 Phosphorus and followed-up for 4 to 28 years. The average age was 61 years on the first treatment. The hematological control was obtained in 95.8% of cases (n=69). The mean duration of the hematological control was 27.8 months. The total dose mean used per patient was 9.2±8.9 mCi. Thirty-four patients (54.1%) required the administration of more than one dose of the radioactive pharmaceutical during the evolution of the disease. Of all the treated patients, five (6.9%) developed acute leukemia 9 to 25 years after the first administration of the radiopharmaceutical and 3 (4.1%) developed other malignancies after 15 years of having been diagnosed or more. The post-treatment survival median was 10.1 years and the fundamental cause of death was vascular problems. 32 phosphorus treatment is undoubtedly a desirable effective therapeutical method for over 60 years-old patients since it assures excellent quality of life and extends the survival period, with minimum adverse reactions at a moderate cost
Hemoglobinuria paroxística nocturna: Actualización Paroxysmal nocturnal haemoglobinuria
María Teresa Milanés Roldán,Norma Fernández Delgado,Teresa Fundora Sarraff,Juan Carlos Jaime Facundo
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2003,
Abstract: La hemoglobinuria paroxística nocturna (HPN) es una enfermedad clonal y adquirida causada por una mutación somática en el gen PIG-A que se encuentra en el cromosoma X y codifica una proteina involucrada en la síntesis del glicosilfosfatidilinositol (GPI), el cual le sirve como anclaje a muchas proteínas de la membrana celular. La mutación ocurre en el stem cell hematopoyético y da lugar a una deficiencia parcial o total de la proteína PIG-A con la consecuente alteración en la síntesis del GPI de anclaje; como resultado, una parte de las células sanguíneas serán deficientes de todas las proteínas ligadas al GPI. La ausencia de estas proteinas en la HPN explica algunos de los síntomas clínicos de la enfermedad, como la hemólisis intravascular mediada por el complemento, la trombosis venosa, el déficit de la hematopoyesis, etc; pero no el mecanismo mediante el cual el clon HPN se expande en la médula ósea. Varios estudios han demostrado que la inactivación del gen PIG- A por sí sola, no confiere una ventaja proliferativa al stem cell mutado, uno o más factores ambientales externos son necesarios para la expansión de este clon mutado, los cuales ejercen una presión selectiva a favor del clon HPN. La causa por el cual el clon HPN se estimula a proliferar podría ser un da o selectivo a la hematopoyesis normal. En el tratamiento de esta enfermedad se han utilizado varios agentes terapéuticos, pero el único tratamiento curativo es el trasplante de progenitores hematopoyéticos The paroxysmal nocturnal haemoglobinuria (PNH) is a clonal acquired disease caused by a somatic mutation in the PIG-A gene that is located in the chromosome X and codifies a protein involved in the synthesis of glycosil phosphatidylinositol (GPI), which serves as an anchor for many proetins of the cellular membrane. The mutations occurs in the hematopoietic stem cell and gives rise to a partial or total deficiency of the protein PIG-A with the subsequent alteration in the synthesis of the anchored GPI. As a result, a part of the blood cells will be lacking all the proteins bound to the GPI. The absence of these proteins in the NPH explains some of the clinical symptoms of the disease, such as the intravascular hemolysis mediated by the complement, the venous thrombosis, the deficit of hematopoiesis, etc., but not the mechanism by which the NPH clone expands into the bone marrow. Some studies have proved that the inactivation of the GPI-A gene does not confer a proliferative advantage to the mutated stem cell. One or more external environmental factors are needed for the expansion of this m
Aspectos clínicos y epidemiológicos de la leucemia mieloide aguda en el anciano Clinical and epidemiological aspects of acute myeloid leukemia in the elderly
María Teresa Milanés Roldán,Rafael Losada Buchillón,Porfirio Hernández Ramírez,Olga M Agramonte Llanes
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2002,
Abstract: Se realizó una actualización sobre aspectos clínico-epidemiológicos de la leucemia mieloide aguda (LMA) en el anciano, donde se expusieron las características clínicas, morfológicas, citogenéticas y biológicas de la enfermedad. Se destaca que en los ancianos existen diferencias biológicas particulares con respecto al paciente joven, las cuales le confieren un peor pronóstico al estar relacionadas con una respuesta pobre a la quimioterapia. Del mismo modo, se relacionaron los principales factores pronósticos que afectan el éxito del tratamiento de la LMA en el anciano, entre los que se observan la edad, el estado funcional al inicio de la enfermedad, las anormalidades cromosómicas y la expresión de la P- glicoproteína. Se destaca que tanto la incidencia como la mortalidad tienen una tendencia ascendente en el individuo viejo con respecto al joven, y que los resultados generales del tratamiento de la LMA en estos pacientes, son cada vez menos alentadores, pues se observa un porcentaje de remisión completa y sobrevida libre de enfermedad mucho menor que en pacientes jóvenes. Por tal motivo, se sugiere que en este tipo de pacientes debe realizarse una diferenciación terapéutica encaminada a utilizar el esquema más adecuado para lograr mejores resultados que los alcanzados hasta el momento An updating study of the clinical-epidemiological aspects of acute myeloid anemia in the elderly was conducted. It set forth the clinical, morphological, cytogenetic and biological characteristics of the disease. It was underlined that the elderly have specific biological differences in relation to the young patient, which give them a worse prognosis since such differences are related to a poorer response to chemotherapy. Similarly, the study listed the main prognostic factors affecting the success of AML treatment in the elderly, such as age, functional state at the onset of disease, chromosomal abnormalities and P-glycoprotein expression. Both incidence and mortality are higher in older people than in young people and the general results of the AML treatment in these aged patients are increasingly discouraging because it is observed that complete remission and disease-free survival rates in the elderly are much lower than in young patients. Therefore, a therapeutical differentiation aimed at using the most suitable scheme to obtain better results is suggested in this type of patients
Frecuencia de la leucemia promielocítica en Cuba Frequency of promyelocytic leukemia in Cuba
María Teresa Milanés Roldán,Porfirio Hernández Ramírez,Eva Svarch Guerchicoff,Gisela Martínez Antu?a
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2001,
Abstract: Se realizó el análisis de 1 112 pacientes con LA (leucemias agudas) de todo el país (714 adultos y 398 ni os menores de 15 a os de edad), 637 (554 adultos y 83 ni os) presentaron LMA (leucemia mieloide aguda), y se diagnosticaron 98 casos (72 adultos y 26 ni os) con LPM (leucemia promielocítica aguda). La LPM representó el 8,9 % de todos los casos de LA en adultos y el 6,5 % de todos los casos de LA en ni os. Su frecuencia en relación con el total de casos de LMA sin límite de edad representó el 15,3 %. Sin embargo, cuando esta frecuencia se analizó por grupos de edades se apreció que en los ni os era de 31,3 % mientras que en los adultos fue solo del 13 %. En nuestro estudio se pudo comprobar que de forma similar a lo que ocurre en ciertas regiones geográficas y grupos poblacionales, existe un incremento de la frecuencia de LPM en ni os en relación con los datos de la literatura previa. Nuestros resultados destacan la necesidad de considerar por separado este tipo de leucemia en ni os y adultos, pues su análisis en un solo grupo podría ocultar variaciones en su frecuencia 1 112 patients with AL (acute leukemias) from all over the country (714 adults and 398 children under 15) were analyzed. 637 (554 adults and 83 children) had AML (acute myeloid leukemia) and 98 cases (72 adults and 26 children) were diagnosed APL (acute promyelocytic leukemia). The APL accounted for 8.9 % of all the cases of AL in adults and 6.5 % of all the cases of AL in children. Its frequency in relation to the total of cases of AML with no age limit represented 15.3 %. However, when this frequency was analyzed by age group, it was observed that it was 31.3 % in children, whereas in adults it was just 13 %. In our study, it was possible to prove that similarly to what happens in certain geographic regions and population groups, there is an increase of the frequency of APL in children compared with the data found in the previous literature. Our results stress the need to consider by separate this type of leukemia in children and adults, since its analysis in only one group may occult variations in its frequency
Hemoglobinuria paroxística nocturna: Actualización
Milanés Roldán,María Teresa; Fernández Delgado,Norma; Fundora Sarraff,Teresa; Jaime Facundo,Juan Carlos; Hernández Ramírez,Porfirio;
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2003,
Abstract: the paroxysmal nocturnal haemoglobinuria (pnh) is a clonal acquired disease caused by a somatic mutation in the pig-a gene that is located in the chromosome x and codifies a protein involved in the synthesis of glycosil phosphatidylinositol (gpi), which serves as an anchor for many proetins of the cellular membrane. the mutations occurs in the hematopoietic stem cell and gives rise to a partial or total deficiency of the protein pig-a with the subsequent alteration in the synthesis of the anchored gpi. as a result, a part of the blood cells will be lacking all the proteins bound to the gpi. the absence of these proteins in the nph explains some of the clinical symptoms of the disease, such as the intravascular hemolysis mediated by the complement, the venous thrombosis, the deficit of hematopoiesis, etc., but not the mechanism by which the nph clone expands into the bone marrow. some studies have proved that the inactivation of the gpi-a gene does not confer a proliferative advantage to the mutated stem cell. one or more external environmental factors are needed for the expansion of this mutated clone. these factors exert a selective pressure in favor of the nph clone. the cause for which the nph clone is estimulated to proliferate may be a selective damage to the normal hematopoiesis. several therapeutic agents have been used in the treatment of this disease, but the only curative treatment is the transplantation of hematopoietic progenitors
Aspectos clínicos y epidemiológicos de la leucemia mieloide aguda en el anciano
Milanés Roldán,María Teresa; Losada Buchillón,Rafael; Hernández Ramírez,Porfirio; Agramonte Llanes,Olga M; Rosell Monzón,Edelis;
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2002,
Abstract: an updating study of the clinical-epidemiological aspects of acute myeloid anemia in the elderly was conducted. it set forth the clinical, morphological, cytogenetic and biological characteristics of the disease. it was underlined that the elderly have specific biological differences in relation to the young patient, which give them a worse prognosis since such differences are related to a poorer response to chemotherapy. similarly, the study listed the main prognostic factors affecting the success of aml treatment in the elderly, such as age, functional state at the onset of disease, chromosomal abnormalities and p-glycoprotein expression. both incidence and mortality are higher in older people than in young people and the general results of the aml treatment in these aged patients are increasingly discouraging because it is observed that complete remission and disease-free survival rates in the elderly are much lower than in young patients. therefore, a therapeutical differentiation aimed at using the most suitable scheme to obtain better results is suggested in this type of patients
Frecuencia de la leucemia promielocítica en Cuba
Milanés Roldán,María Teresa; Hernández Ramírez,Porfirio; Svarch Guerchicoff,Eva; Martínez Antu?a,Gisela; Ballester Santovenia,José M;
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2001,
Abstract: 1 112 patients with al (acute leukemias) from all over the country (714 adults and 398 children under 15) were analyzed. 637 (554 adults and 83 children) had aml (acute myeloid leukemia) and 98 cases (72 adults and 26 children) were diagnosed apl (acute promyelocytic leukemia). the apl accounted for 8.9 % of all the cases of al in adults and 6.5 % of all the cases of al in children. its frequency in relation to the total of cases of aml with no age limit represented 15.3 %. however, when this frequency was analyzed by age group, it was observed that it was 31.3 % in children, whereas in adults it was just 13 %. in our study, it was possible to prove that similarly to what happens in certain geographic regions and population groups, there is an increase of the frequency of apl in children compared with the data found in the previous literature. our results stress the need to consider by separate this type of leukemia in children and adults, since its analysis in only one group may occult variations in its frequency
Medicina basada en la evidencia
Lam Díaz,Rosa M; Oliva Pérez,Maritza; Hernández Ramírez,Porfirio; Milanés Roldán,María Teresa;
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2002,
Abstract: at present, the health professional faces some knowledge gaps in their daily contact with his/her patients; and at the same time he/she avails of a great flow of information but has neither the capability nor the time to update those pieces of knowledge. in this context, evidence-based medicine emerged, which refers to the conscious, wise and explicit updating of best scientific evidence available in decision-taking about the individual health care of the patients. evidence-based medicine suggests a structured method to solve clinical practice-derived doubts and put valid and relevant scientific information at the disposal of the busy physician. it requires four steps to put it into practice as well as it combines the individual clinical competence with the best available external evidence on the basis of systematic research. evidence quality levels have been set, which are related to the study design. these levels go from randomized clinical assays to clinical experience- and descriptive studies-based opinions. likewise, the evidence quality is linked to the strong recommendation of a certain practice or intervention to be applied in the patients
Medicina basada en la evidencia Evidence-based anemia
Rosa M Lam Díaz,Maritza Oliva Pérez,Porfirio Hernández Ramírez,María Teresa Milanés Roldán
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2002,
Abstract: En la época actual, el profesional de la salud en su contacto diario con los pacientes, presenta, por una parte, lagunas del conocimiento a las cuales debe dar respuesta, y por otra, cuenta con un abrumador caudal de información, pero no dispone de la habilidad ni del tiempo para poder actualizarse. En este contexto surge la medicina basada en la evidencia (MBE), que se refiere a la actualización consciente, juiciosa y explícita de las mejores evidencias científicas disponibles en la toma de decisiones sobre el cuidado sanitario individual de los pacientes. Propone un método estructurado para resolver las dudas derivadas de la práctica clínica, y pone a disposición del médico atareado información científica válida y relevante. Requiere 4 pasos para su práctica, así como integrar la competencia clínica individual con la mejor evidencia externa disponible a partir de la investigación sistemática. Se han establecido niveles de calidad de la evidencia, relacionados con el tipo de dise o de estudio. Estos niveles van desde los ensayos clínicos aleatorizados hasta las opiniones basadas en experiencias clínicas y estudios descriptivos. Igualmente la calidad de la evidencia está relacionada con la fuerza de la recomendación de una determinada práctica o intervención en los pacientes At present, the health professional faces some knowledge gaps in their daily contact with his/her patients; and at the same time he/she avails of a great flow of information but has neither the capability nor the time to update those pieces of knowledge. In this context, evidence-based medicine emerged, which refers to the conscious, wise and explicit updating of best scientific evidence available in decision-taking about the individual health care of the patients. Evidence-based medicine suggests a structured method to solve clinical practice-derived doubts and put valid and relevant scientific information at the disposal of the busy physician. It requires four steps to put it into practice as well as it combines the individual clinical competence with the best available external evidence on the basis of systematic research. Evidence quality levels have been set, which are related to the study design. These levels go from randomized clinical assays to clinical experience- and descriptive studies-based opinions. Likewise, the evidence quality is linked to the strong recommendation of a certain practice or intervention to be applied in the patients
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