Publications by authors named "María de Los Ángeles Rodríguez"

8 Publications

  • Page 1 of 1

[Prognostic value of interim PET/CT in non-hodgkin lymphoma].

Rev Med Chil 2020 Nov;148(11):1558-1567

Departamento de Hemato-oncología y Jefe de Banco de Sangre, Clínica Las Condes, Santiago, Chile.

Background: The prognosis of Non-Hodgkin Lymphoma (NHL) depends on the type of lymphoma, the extension of the disease and the response to therapy.

Aim: To evaluate the prognostic value of pretreatment and interim PET/CT compared to classic prognosis factors and body composition measurement (sarcopenia, adipopenia) in patients with recently diagnosed NHL.

Material And Methods: Patients with recently diagnosed NHL who had staging 18F-FDG PET/CT performed between December 2008 and August 2018 were selected. Age, gender, weight, height, B symptoms, laboratory tests, pathology, staging PET/CT findings (Ann Arbor, number of nodal groups and extranodal sites involved, Bulky, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis), Computed Tomography findings (psoas muscle mass index, psoas area, psoas density, subcutaneous fat index (all of them at L3 level), and Deauville score (Lugano Criteria) were recorded. The prognostic value of each of these factors was assessed using Cox multivariable regressions.

Results: Of 138 NHL studied patients (median 61 y, 15-87 y, 60.4% men), 31 of them died due to the disease. The median follow-up was 39 months (1-115 months). The strongest prognostic factors were: B symptoms (p < 0.01), anemia (p < 0.01), hypoalbuminemia (p: 0.01), sarcopenia (p < 0.01), adipopenia (p < 0.01), number of node groups involved (p < 0.01), MTV (p < 0.01), and a bad response in interim PET/CT (p < 0.01). In a comparative Cox multivariable analysis, interim PET/CT was the independent variable with the highest significance (p < 0.01).

Conclusions: Early treatment response assessed by interim PET/CT is the strongest prognostic factor in NHL patients.
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http://dx.doi.org/10.4067/S0034-98872020001101558DOI Listing
November 2020

[Lung infection by lophomonas spp. in a female patient with acute myeloid leukemia].

Rev Peru Med Exp Salud Publica 2018 Jul-Sep;35(3):527-530

Servicio de Medicina Interna, Hospital Naval Almirante Nef. Viña del Mar, Región de Valparaíso, Chile.

Protozoic infections are prevalent worldwide, particularly in immunosuppressed patients. We reported the case of a patient from the city of Viña del Mar, Chile, a carrier of acute myeloid leukemia in whom an infection by Lophomonas sp. was confirmed by bronchoalveolar lavage. She was treated with antibiotics but died of complications of the underlying disease. There is little literature available on this microorganism. We conclude that Lophomonas sp. should be considered as a diagnostic possibility if protozoa are found in bronchoalveolar lavage of immunosuppressed patients.
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http://dx.doi.org/10.17843/rpmesp.2018.353.3683DOI Listing
June 2019

The activity of discrete sets of neurons in the posterior insula correlates with the behavioral expression and extinction of conditioned fear.

J Neurophysiol 2018 10 22;120(4):1906-1913. Epub 2018 Aug 22.

Departamento de Ciencias Fisiológicas, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile , Santiago , Chile.

The interoceptive insular cortex is known to be involved in the perception of bodily states and emotions. Increasing evidence points to an additional role for the insula in the storage of fear memories. However, the activity of the insula during fear expression has not been studied. We addressed this issue by recording single units from the posterior insular cortex (pIC) of awake behaving rats expressing conditioned fear during its extinction. We found a set of pIC units showing either significant increase or decrease in activity during high fear expression to the auditory cue ("freezing units"). Firing rate of freezing units showed high correlation with freezing and outlasted the duration of the auditory cue. In turn, a different set of units showed either significant increase or decrease in activity during low fear state ("extinction units"). These findings show that expression of conditioned freezing is accompanied with changes in pIC neural activity and suggest that the pIC is important to regulate the behavioral expression of fear memory. NEW & NOTEWORTHY Here, we show novel single-unit data from the interoceptive insula underlying the behavioral expression of fear. We show that different populations of neurons in the insula codify expression and extinction of conditioned fear. Our data add further support for the insula as an important player in the regulation of emotions.
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http://dx.doi.org/10.1152/jn.00318.2018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230801PMC
October 2018

[Hemophagocytic syndrome after kidney transplant in a patient with hereditary nephritis. Report of one case].

Rev Med Chil 2013 Apr;141(4):519-24

Sección Nefrología, Servicio de Medicina, Hospital Naval Almirante Nef, Viña del Mar, Chile.

We report a 28-year-old mole with a hereditary nephritis (Alport Syndrome) on hemodialysis for 5 years, who received a kidney graft from a deceased donor. Cyclosporine (CsA), mycophenolate mofetil (MMF) and steroids were prescribed. In the postoperative period the patient had thrombophlebitis and diarrhea. A CT sean showed splenomegaly, ascites, bilateral pleural effusion and bowel edema. Laboratory showed hypoalbuminemia, increased C reactive protein (CRP) and panhypogammaglobulinemia. At day 32 after transplantation, an acute rejection (Banff II b) was diagnosed and treated with methylprednisolone, replacing CsA by tacrolimus. The acute rejection was controlled but six days later, high fever, pancytopenia and hyperferritinemia appeared. A bone marrow smear showed numerous histiocytes and hemophagocytosis. Hemophagocytic syndrome was diagnosed. MMF and tacrolimus were withdrawn and CsA was reinstituted. Fever fell quickly, CPR normalized at 24 hours and white blood cell count at 72 hours. Days later, the concentrations of albumin, immunoglobulins and hematological parameters normalized. The patient was discharged on day 57 after admission in good condition.
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http://dx.doi.org/10.4067/S0034-98872013000400014DOI Listing
April 2013

[Type B lactic acidosis associated with marginal lymphoma of the spleen: report of one case].

Rev Med Chil 2012 Feb;140(2):236-42

Sección de Nefrología, Servicio de Medicina Interna, Hospital Naval A. Nef, Viña del Mar, Chile.

Lactic acidosis in the absence of hypoxia or tissue hypoperfusion (type B) is very rare and is associated with the use of some drugs or malignancy. We report a 79-year-old woman, with a marginal non-Hodgkin's lymphoma of the spleen that was subjected to a splenectomy one year ago. She presented with unexplained tachypnea associated with pancytopenia and elevation of IgM to 10 times over the higher normal limit. Laboratory tests showed the presence of metabolic acidosis and high lactic acid levels in the absence of infection, tissue hypoxia or hypoperfusion. She was treated with sodium bicarbonate and steroids without obtaining a reduction in lactate levels. Twelve days after admission, a single dose of Rituximab quickly normalized lactate concentrations and platelet count. After the fourth dose of Rituximab, pancytopenia disappeared and IgM fell to 25% of its baseline concentration.
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http://dx.doi.org/10.4067/S0034-98872012000200014DOI Listing
February 2012

Near-peer teaching in an anatomy course with a low faculty-to-student ratio.

Anat Sci Educ 2012 May-Jun;5(3):171-6. Epub 2012 Mar 1.

Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico.

Near-peer teaching is an educational format which utilizes tutors who are more advanced in a curriculum's content to supervise students' activities and to act as instructors in laboratory settings. This format is often used in anatomy laboratory courses. The goal of the present study is to describe the design and implementation of near-peer teaching in an anatomy course and to evaluate students' perceptions of the program. A total of 700 students were registered for this anatomy course which employed near-peer instructors. Of enrolled students, 558 (79.7%) agreed to participate in this study. In general, the practical section (e.g., the clinical hour, image-based anatomy session, and gross anatomy laboratory) of the course was viewed more favorably compared to the theory section (54.8%, n = 306), with dissection and prosection in the laboratory rated as the most valued experiences (34.9%, n = 195). Near-peer teaching is a viable option that satisfies the demands of modern curricula using small groups. This format stimulates learning within courses that have large numbers of students and low faculty-to-student ratios.
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http://dx.doi.org/10.1002/ase.1269DOI Listing
August 2012

Rituximab in the treatment of acute cellular rejection of renal allograft with CD20-positive clusters in the infiltrate.

Clin Exp Nephrol 2011 Apr 10;15(2):308-11. Epub 2010 Dec 10.

Departamento de Medicina, Escuela de Medicina, Universidad de Valparaíso, Valparaiso, Chile.

A 31-year-old woman with nephronophthisis received a cadaveric kidney transplant, and was immunosuppressed with cyclosporine, azathioprine and steroids. Twelve days after transplant a biopsy showed acute rejection with vascular damage. She was treated with 3 pulses of methylprednisolone and change of immunosuppression to mycophenolate mofetil and tacrolimus, without improving graft function. At day 21, a second biopsy showed accentuation of interstitial and vascular rejection. Antibody-mediated rejection was suspected and plasmapheresis and rituximab were prescribed. Graft function improved rapidly. Staining for C4d was negative and there were no circulating antibodies against the donor. In the interstitial infiltrate there were clusters of B lymphocytes that accounted for 40% of cells, which was thought to be an ominous sign, as it has been associated with poor graft outcome. Acute T-cell-mediated rejection grade III (Banff 07) was diagnosed. Thirty-nine months after transplant her kidney function is stable with no other complication. This clinical case generates the hypothesis that rituximab may have a beneficial role in the therapy of acute cellular rejection when there are clusters of B lymphocytes in the infiltrate and a good response has not been obtained to conventional anti-rejection therapy.
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http://dx.doi.org/10.1007/s10157-010-0387-8DOI Listing
April 2011

[Bone marrow aplasia during hemodialysis successfully treated with cyclosporine. Report of one case].

Rev Med Chil 2004 Aug;132(8):989-94

Servicio de Medicina Interna, Secciones de Nefrología, Hospital Naval Almirante Nef, Viña del Mar.

A 28 years old male on chronic hemodialysis for 40 months due to a IgA crescentic glomerulonephritis developed pancytopenia (hematocrit 16%, white blood cell count 3,800 mm3 and platelets 11,000 mm3. The bone marrow aspirate showed erythropoietic hyperplasia. Hemolytic anemia, folate or vitamin B12 deficiency and paroxysmal nocturnal hemoglobinuria were ruled out. Steroids were given with a transient elevation of red cells and platelets, which lasted only for some weeks. Afterwards, intravenous immunoglobulin was given without benefit. Two months after, a bone marrow biopsy and a bone marrow magnetic resonance imaging showed severe aplasia. Cyclosporine was started with a rapid increase in blood cells count. Eight months later, he received a renal transplant from a cadaveric donor. Immunosupression was achieved with cyclosporine, prednisone and mycofenolate mofetil. The patient required hemodialysis for the first three weeks and a mild acute cellular rejection was treated with methylprednisolone. At discharge, 6 weeks later, serum creatinine was 2.4 mg/dl and creatinine clearance 37.6 ml/min. During the first months after transplant, platelet count and hemoglobin decreased and a bone marrow biopsy showed only mild hypoplasia. Four months after renal transplant the hematocrit was 43%, white blood cell count 6,600 mm3 and platelets, 150,000 mm3 and did not change during the first year of follow up.
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http://dx.doi.org/10.4067/s0034-98872004000800012DOI Listing
August 2004