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Biomedical subjects

A Mohar

Publications and source records attributed to A Mohar.

51 records · Page 3Linked to original sources
PubMedDate not supplied

Osteosarcoma of the jaw.

BACKGROUND: Osteogenic sarcoma of the jaw has clinical and prognostic differences from that of long bones. METHODS: We reviewed 23 confirmed cases of osteosarcoma of the jaw seen at the Instituto Nacional de Cancerologia of Mexico between 1972 and 1990. RESULTS: Fifty-seven percent of the patients were women. Median age for all patients was 28 years. In 52% of cases, the neoplasm involved the maxilla. Tumor size ranged from 5 to 24 cm (median 10 x 7 cm) and 87% of the neoplasms were grade III or IV (Broder's). Twenty one (91%) patients were treated with surgery (s); radiotherapy (Rt) was administered to 14 (61%) and chemotherapy (Ct) to 11 (48%) patients. Clear (negative) surgical margins were obtained in 43% of surgically treated patients. Median follow-up for 20 patients eligible for evaluation was 16.5 months. Survival at 5 years was 10%. CONCLUSIONS: We found that tumor size and surgical margins were significant prognostic factors. Early diagnosis of these tumors is mandatory to improve survival; the role of Ct and Rt is still unknown.

Adolescent↗
PubMedDate not supplied

Type III radical hysterectomy after induction chemotherapy for patients with locally advanced cervical carcinoma.

Neoadjuvant chemotherapy followed by surgery is a promising approach in locally advanced cervical carcinoma. The aim of this study was to evaluate the feasibility, technical aspects, and clinical results of surgery after induction chemotherapy in this patient population. Forty-one untreated cervical carcinoma patients staged as IB2 to IIIB received three 21-day courses of cisplatin 100mg/m2 on day 1 and gemcitabine 1000 mg/m2 on days 1 and 8 followed by surgery or concomitant chemoradiation. The response to chemotherapy, operability, surgical/pathological findings, disease-free period, and survival of the surgically treated patients were evaluated. All 41 patients were evaluated for toxicity and 40 were evaluated for response. The overall objective response rate was 95% (95% confidence interval 88%-100%), and was complete in three patients (7.5%) and partial in 35 (87.5%). Granulocytopenia grades 3/4 occurred in 13.8% and 3.4% of the courses, respectively, whereas nonhematological toxicity was mild. Twenty-three patients underwent type III radical hysterectomy. Mean duration of surgery was 3.8 h (range 2:30-5:20), median estimated blood loss was 670 ml and median hospital stay was 5.2 days. Intraoperative complications occurred in one case (venous injury). In all but one case the resection margins were negative. Four patients (17%) had positive nodes (one node each); six (26%) had complete pathologic response, three (13%) had microscopic; and 14 (60%) macroscopic residual disease. At 24 months of maximum follow-up (median 20), the disease-free and overall survival rates were 59% and 91%, respectively. Induction chemotherapy with cisplatin/gemcitabine produced a high response rate and did not increase the difficulty of surgery. Operating time, blood loss, intraoperative complications, and hospital stay were all within the range observed for type III hysterectomy in early stage patients. We therefore conclude that type III radical hysterectomy is feasible in locally advanced cervical cancer patients who respond to chemotherapy.

Adolescent↗
PubMedDate not supplied

[The association between Helicobacter pylori and gastric neoplasia. Epidemiologic evidence].

Helicobacter pylori (HP) causes chronic gastritis and, together with non-steroidal anti-inflammatory drugs, is considered the most frequent etiologic agent of peptic ulcer. Since there are numerous epidemiologic and pathogenesis studies that demonstrate an association between infection by HP and gastric neoplasias, the World Health Organization declared, in 1994, HP infection a Group 1 carcinogen (a definitive cause of human neoplasias, similar to tobacco). This article reviews the epidemiological evidence supporting the association between HP infection and two gastric neoplasias: adenocarcinoma and B cell lymphoma associated to mucosas (MALT). This article also presents preliminary results of a project performed in the mountainous region of Chiapas, Mexico, in which the decrease of precancerous gastric lesions were studied one year after treatment for HP infection.

Adenocarcinoma↗
PubMedDate not supplied

Transfusion associated AIDS in Mexico. Clinical spectrum, conditional latency distribution, and survival.

There is very little information on the clinical spectrum and the incubation period among AIDS patients in Latin America. This study reports the clinical spectrum, survival, and the incubation period for a group of Mexican patients infected with HIV-1 as a result of contaminated blood transfusion. We analyzed data from 39 patients of whom date of transfusion and diagnosis were known. The clinical spectrum of the disease was compared with a group of AIDS Mexican patients infected by sexual route. The prevalence distribution of opportunistic infections was similar in both groups. However, there was a significant difference in the distribution of opportunistic malignancies, i.e., Kaposi's sarcoma was observed only in the homosexual group. AIDS developed within 48 months after infection (3% within 12 months after transfusion, 50% within 29 months, 75% within 36 months, and the remaining within four years). The mean survival was of nine months after AIDS is made, the survival in this group of AIDS Mexican patients was similar to that observed in other HIV-1 exposed risk groups in Mexico. These findings suggest that the route of exposure to HIV-1 may have prognostic implications in the natural history of this infection in the Mexican population.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[AIDS and neoplasms in Mexico].

OBJECTIVE: To describe the epidemiological profile of AIDS and malignancies in Mexico. MATERIAL AND METHODS: The study population included a group of AIDS patients seen at four National Institutes of Health and one at a general hospital in Mexico City, from 1983 to 1992. Demographic, clinical and laboratory information was obtained. RESULTS: A total of 202 patients were studied; 199 men and three women. The mean age was of 34.5 years (range 18-67 years). Kaposi's sarcoma was the most frequent malignancy, with 166 cases, followed by non-Hodgkin's lymphoma, with 33 cases. The three women had non-Hodgkin's lymphoma, one of them associated with cervical carcinoma. Rectal cancer was present in three cases. DISCUSSION: The spectrum of AIDS-associated malignancies in Mexico is similar to that described in other populations. The early diagnosis of this complication is necessary, as well as the search for therapeutic actions to prevent severe immunosuppression and the consequent appearance of malignancies.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Simplified CD4+ T-lymphocyte count in patients with HIV/AIDS in Mexico].

OBJECTIVE: To study the correlation between ALC and CD4 cell counts and to find alternative ways of counting CD4+ T-lymphocytes. MATERIAL AND METHODS: The double positivity for CD3/CD4 antibodies was measured in 175 consecutive HIV-positive patients using flow cytometry; in these cases a difference was made between counting cells that were positive for both antibodies vs those that were positive only to CD4. ALC and CD4 counts were also compared among 500 subjects infected with HIV, using linear regression analysis and comparing the number of dissimilar cases for counts below 200 cells/microliters and ALC counts lower than 1 500 and 2000 cells/microliters. RESULTS: In the 175 cases measured by the CD3/CD4 antibody combination the mean percent was 13.8% and for total CD4 cells 14.2% (p = NS); the mean difference was 0.4% and the median 0.2%. For the 500 patients the mean ALC was 1 700 cells/microliters and the mean CD4 count was 219 cells/microliters; the correlation coefficient was 0.59. CONCLUSIONS: These data suggest a poor correlation of ALC and CD4 cell counts, thus it is impossible to predict CD4 on the basis of ALC. This is the reason why it is necessary to measure CD4 cells separately. The difference between measuring double positive CD3/CD4 cells vs only CD4 positive cells was not significant. Our data suggest that the use of a single CD4 antibody may cut costs and still produce clinically useful information.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[A surveillance program for surgical wound infections at the National Institute of Cancerology of Mexico].

OBJECTIVES: To evaluate the results of a prospective wound infection surveillance program during its first semester of operation, and to analyse the risk factors associated to wound infection. METHODS AND DESIGN: From January 01 to June 30 1993, 1103 surgeries were prospectively followed. The incidence rates of infection were calculated and a case control analysis was done to evaluate the associated risk factors to POWI (postoperative wound infection). SETTING: An oncological tertiary-care center. RESULTS: The POWI rate was 9.0 per 100 surgeries. By univariate analysis the associated risk factors were: obesity (OR = 2.07 CI95% = 1.19-3.64), one drainage (OR = 2.10 CI = 1.33-3.31), two drainages (OR = 3.14 CI = 1.85-5.26), length of stay of the drainage (patients with wound infection: 15.2 +/- 6.7 days vs. patients without wound infection: 8.2 +/- 6.6 days), duration of operation (patients with wound infection: 188 +/- 163 minutes vs. patients without wound infection: 122 +/- 127 minutes) and duration of preoperative hospitalization (patients with wound infection: 2.9 +/- 6.4 days vs. patients without wound infection 1.5 +/- 3.0 days). The associated risk factors by regression analysis were: obesity (OR = 1.93 CI = 1.08-3.43), two drainages (OR = 2.09 CI = 1.03-4.05) duration of operation > = 120 minutes (OR = 1.96 CI = 1.00-3.86) and duration of preoperative hospitalization (OR = 1.03 CI = 1.00-1.09). CONCLUSIONS: The program showed a previous under-reporting of POWI from 4.2-4.8 per 100 surgeries in the previous seven years to 9.0 in the first semester of operation. It also identified the associated risk factors to POWI in our institution.

Cross Infection↗
PubMedDate not supplied

[About death. A review and a proposal].

The experience of the human being towards death is reviewed in this essay. Some historical, medical and psychological points of view are analyzed. It is disquieting to note that the death theme, as well as the experience of patients who confront their own death, are forgotten topics and occasionally even vetoed by patients and physicians. We consider that is timely and important to reflect about death. The advancement of medical technology must walk in parallel with physician-patient relationship. Who, if not the doctor, is to help his patient to die in comfort?

Adolescent↗
PubMedDate not supplied

[Descriptive epidemiology cancer in the National Cancer Institute of Mexico].

OBJECTIVE: To analyze the descriptive epidemiology of cancer at the Instituto Nacional de Cancerología of Mexico, and describe the characteristics of the growing demand for medical care. MATERIAL AND METHODS: A review of the 10 year experience of the Hospital Cancer Registry from 1985 to 1994 was done. RESULTS: During the study period a total of 28591 patients was registered with the histological confirmation of cancer. There were 8984 (31.4%) men, being the testicle (8.3%), the lung (7.4%), non-Hodgkin's lymphoma (7.1%) and the prostate (5.5%) the more frequent malignancies. In women a total of 19597 (68.6%) cases were seen; together, invasive cervical cancer (30.6%) and breast cancers (20.6%) represent more than 50% of all patients. In 1996, 108876 outpatient services were given, 6492 hospitalizations, 36388 sessions of radiotherapy and 9116 of chemotherapy. Only 30% of this population comes from Mexico City, the remaining lives in the 31 different states of Mexico. CONCLUSIONS: Supporting the development of the Centros Estatales de Cancerología for the referral of patients is necessary, this will avoid the rapid saturation of medical care at the institute. Also, stimulate the development of hospital registries and collaborate with the Ministry of Health to improve the early cancer detection programmes in Mexico.

Adolescent↗
PubMedDate not supplied

The role of commercial plasmapheresis banks on the AIDS epidemic in Mexico.

OBJECTIVE: To characterize the circumstances underlying the epidemic of AIDS associated with blood transfusion in Mexico and to explore the possible mechanisms for its dissemination. METHODS: A retrospective analysis comparing the total number of AIDS cases and transfusion-associated AIDS cases and the male:female ratio reported in Mexico and the U.S. from 1981 to 1996 was done. We analyzed the relationship between the location of plasmapheresis banks and the geographic distribution of transfusion-associated AIDS cases and AIDS cases among paid donors in order to assess the possible role of plasmapheresis banks in its dissemination. RESULTS: The proportion of transfusion-associated AIDS in the total number of cases was significantly higher in Mexico than in the U.S. from 1987 through 1996 (p < .0001). A rapid drop in the male:female ratio of AIDS was observed in Mexico but not in the U.S. coinciding with a growing number of transfusion associated cases; transfusion has been the main risk factor for AIDS in women in our country. In 1986, seven States and Mexico City had plasmapheresis banks: they reported 90% of the cases associated to paid donation and 75% of those associated to transfusion, despite the fact that commercial blood banks without plasmapheresis facilities existed in 23 of the other 24 States. CONCLUSION: There was a difference on the frequency of transfusion associated AIDS between Mexico and the U.S. which reached epidemic proportions in Mexico. We believe that plasmapheresis banks played a major role in the dissemination of the infection in Mexico as paid donors provided a third of the blood used in Mexico in 1986. These findings highlight important implications for the prevention of AIDS in developing countries where commercial plasmapheresis practices are still in operation.

Acquired Immunodeficiency Syndrome↗