Examinando por Autor "Salazar, Anibal"

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    Ítem
    Increasing immune dysfunction is associated with increasing matrix-metalloproteinase-2 expression and predicts biochemical failure in men with bone marrow micro-metastasis positive localized prostate cancer
    (Asian Pacific Organization for Cancer Prevention (APOCP), 2022-07) Murray, Nigel P.; Aedo, Socrates; Fuentealba, Cynthia; Reyes, Eduardo; Salazar, Anibal
    Introduction: To determine if there was an association of the ALC (absolute lymphocyte count) and LCP (lymphocytopenia) with the expression of MMP-2 in bone marrow micro-metastasis, the changes occurring during follow-up and association with biochemical failure. Methods and patients: One month after surgery blood and bone marrow samples were taken to determine the presence of micro-metastasis, the presence of circulating prostate cells (CPCs) and ALC. CPCs and micro-metastasis were detected using immunocytochemistry and MMP-2 expression determined in micrometastasis. Only men positive for micro-metastasis participated in the study. At end follow blood was taken for serum PSA, ALC and CPCs, if the ALC decreased by more than 10% bone marrow sampling was repeated and MMP-2 expression determined, similarly for men with BF. Men who had stable ALCs had an end of study evaluation of the bone marrow. Results: 402 men underwent radical prostatectomy, one month post surgery 79 men were positive for only bone marrow micro-metastasis and formed the study group; of whom 36/79 (45%) underwent BF. Clinical pathological findings were not significantly different between men with or without BF. In men with BF the ALC was significantly lower one-month post surgery. The 5 and 10 year Kaplan-Meier survival was 100% at 5-years and 65% at 10-years for the whole cohort. Men without BF had stable ALCs. A decrease of >10% in the ALC was associated with increasing MMP-2 expression in the micro-metastasis and surrounding stromal tissue, the appearance of CPCs 6-12 months later and BF. Conclusions: the immune host-tumour cell interaction in the microenvironment is dynamic and changes with time. A decreasing ALC may be a valuable marker in identifying men with high risk of BF and changes in immune mediated dormancy before the PSA rises.
  • Miniatura
    Ítem
    Renal infarction assicated wit hastmpto,atic covid-19 infection
    (Elsevier, 2021-07) Murray, Nigel P.; Fuentealba, Cynthia; Reyes, Eduardo; Salazar, Anibal
    Renal infarction is an infrequent condition resulting from obstruction of a renal artery. The symptoms it causes are non-specific and as a result the diagnosis may be missed, resulting in loss of renal parenchyma, or the risk of other thrombotic phenomenon. The estimated incidence of renal infarction, based on emergency service admissions, is between 0.004 and 0.007%.1 Four risk groups for renal infarction have been suggested: renal infarction of cardiac origin, the most common of which is atrial fibrillation; renal infarction associated with renal artery injury; renal infarction associated with thrombophilia, and; finally, idiopathic. The SARS-CoV-2 infection (Covid-19) has been associated with an increased risk of both arterial and venous thrombosis. A meta-analysis reported an incidence of venous thrombosis in 22.7% of Intensive care unit (ICU) patients and 7.9% in non-ICU patients2 and reports of an increased risk of arterial thrombosis in severely ill patients, even in those patients receiving antithrombotic prophylaxis with low molecular weight heparin.3,4 Arterial thrombosis has involved the cerebral, coronary, the aorta and peripheral arteries.3,4 In a report on 241 patients with severe COVID-19, 5.7% suffered from acute ischaemic cerebrovascular disease.3 However, there is limited evidence of the risk of both arterial and venous thrombosis in patients with asymptomatic COVID-19. In this context of asymptomatic patients, we present the case of a previously healthy 25-year-old man with no known risk factors for thrombosis who presented to the emergency services with severe loin pain and had a positive polymerase chain reaction (PCR) test for SARS-CoV-2 infection. The angio-computed tomography (CT) of the abdomen and pelvis showed images consistent with thrombosis in one of the two left renal arteries, associated with renal infarction. We present the clinical and laboratory findings, along with the patient's management.