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Biomedical subjects

F Montoya

Publications and source records attributed to F Montoya.

At least 37 records · Page 2Linked to original sources
PubMed1993

Negative second-look laparotomy does not preclude recurrence in stage I ovarian carcinoma of any histological variety.

Between January 1980 and June 1991, 56 patients with Stage I ovarian carcinoma of different histological varieties were submitted to a second-look laparotomy (SLL) at the University Clinic (Hospital de Cruces) of Bilbao, Spain. The operation was performed upon all patients one year after initial surgery, after completion of adjuvant chemotherapy, or after one year of observation in those cases that were not treated postoperatively. The SLL was negative in 55 of cases and positive in one. The median follow-up after SLL was 59 months. Of the 55 negative cases, four (7.3%) have had a recurrence of their tumor during their long-term follow-up. Three had epithelial tumors and had received complete postoperative chemotherapy, and the fourth was a dysgerminoma. The three patients with epithelial tumors have died under second-line chemotherapy, whereas the dysgerminoma patient is responding well to rescue polychemotherapy. In view of these results, it is useless and probably unethical to perform second-look laparotomy in Stage I ovarian carcinoma if the initial staging was properly performed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Favourable outcome in 33 triplet pregnancies managed between 1985-1990.

In this paper, we describe the outcome of 33 triplet pregnancies referred to us between 1985 and 1990. They were managed as follows: management at home as soon as the diagnosis was made, then hospitalization at 28 weeks' gestation. Progesterone and beta-mimetics were administered daily, a cesarean section was always performed. One late abortion occurred at 21 weeks. The rate of prematurity was 90.6%, mean gestational age at delivery was 34.1 +/- 3 weeks, and 62.5% of deliveries occurred between 34 and 37 weeks. Ninety-four fetuses were delivered alive. Mean birth weight was 1880 +/- 410 g. Fetal growth retardation rate was 61.8%, including 28 infants under the third centile and 31 under the 10th centile. Perinatal death rate was 4.16% including 2 in utero deaths and 2 neonate deaths. All infants are healthy except for one child with severe mental retardation. These results show that triplet pregnancies can be safely managed, and that selective first-trimester reduction in triplet pregnancies does not appear to be necessary.

Adult↗
PubMed1992

Variations in estrogen and progesterone receptor levels after short-term tamoxifen treatment in breast carcinoma.

The modification of estrogen and progesterone receptor status was prospectively studied in mammary carcinoma after short-term (7 days) administration of tamoxifen citrate (30 mg/day). Seventeen patients fulfilled the stringent criteria required for final evaluation. Tamoxifen was administered to them immediately prior to surgery and receptor status was studied on the surgical specimen. Estrogen receptor levels were significantly (p < 0.05) decreased after treatment, whereas progesterone receptors remained statistically unaltered, although they showed a tendency towards significant increase (p = 0.12). Following these results, short-term tamoxifen treatment seems inadequate for the induction of significant levels of progesterone receptors in mammary carcinoma.

Adult↗
PubMed1991

Human immunodeficiency virus-induced immunosuppression: a risk factor for human papillomavirus infection.

In a group of 92 women with genital condylomata, 15 (16.3%) human immunodeficiency virus-positive patients were found, whereas no case was detected in a control group of 100 women. The relative risk was greater than 19.28. Human immunodeficiency-positive status was associated with other parameters: lower age and parity, major frequency of induced abortions, and sexually transmitted diseases. Thus although human immunodeficiency-positive status seems to be a true risk factor in relation to the altered immunologic state, an indirect association cannot be discarded. Such patients should be screened closely for human papillomavirus infection and cervical cancer. Among human immunodeficiency-positive women, a more resistant behavior of human papillomavirus-associated lesions was detected (recurrence-persistence of 41.7% versus 12%), a fact that might also be in relation to the immunodepressed status.

Biopsy↗
PubMed1991

Repeat pregnancy associated with cardiac pacemaker.

Two pregnancies in a patient with a fixed-rate pacemaker are reported. The first pregnancy was uneventful. The second had no maternal complications either. A moderate tachysystolia was detected during the second period. The newborn was delivered with forceps applied under spinal anesthesia. Newborn infant evolution presented no hazards, but umbilical cord analysis revealed a severe acidosis, in spite of a normal scalp analysis 45 min earlier. Epidural anesthesia is recommended for such patients.

Acidosis↗
PubMed1991

Pure FSH for ovulation induction in patients with polycystic ovary syndrome and resistant to clomiphene citrate therapy.

Twenty-nine infertile women with polycystic ovary disease which was resistant to therapy with clomiphene citrate underwent a combined treatment for follicle recruitment consisting of pure FSH during the first days of the cycle and HMG during the last days of the follicular phase. Sixty cycles were stimulated of which 83% were ovulatory. Eighteen pregnancies were achieved (36% of cycles, 62% of patients). The multiple pregnancy rate was 39%. Twelve cycles (20%) showed the ovarian hyperstimulation syndrome (OHS) although seven of these resulted in full term deliveries. There were no miscarriages among the patients studied.

Adult↗
PubMed1991

[Tumor recurrence following negative second-look laparotomy in ovarian carcinoma].

Between January 1980 and December 1990, 107 ovarian carcinoma patients in clinical complete remission were submitted to a second-look laparotomy at our department. Borderline carcinomas were excluded from the study. Second-look laparotomy was negative in 78.5% of the cases (84 patients). During the follow-up period after the second-look-laparotomy (mean 59 months, range 6 to 120), a recurrence of the tumour was diagnosed in 7 patients (8.4% false-negative rate). This took place after a mean time of 39 months following the previous negative second-look (range 8 to 108). Three of the recurrences were localized in the pelvis, two in the upper abdomen and two in the paraaortic and supraclavicular lymph nodes, respectively. All patients with a recurrence belonged to the group having received adjuvant chemotherapy for one year after initial surgery. At the present time we lack any means to anticipate which patients with a negative second-look will eventually show a recurrence of their tumour.

Carcinoma↗
PubMed1990

Serum CA 125, CA 15.3 and CA 19.9 levels and surgical findings in patients undergoing second look operations for ovarian carcinomas.

Sera from 52 ovarian cancer patients undergoing chemotherapy and second look operation were studied. CA 125, CA 15.3 and CA 19.9 assays were performed during chemotherapy and prior to relaparotomy. Twenty-six patients (50%) had no evidence of disease whereas 2 (3.8%) and 24 (46.1%) had microscopic and macroscopic disease. In general although the predictive value of an elevated CA 125 or CA 15.3 level is excellent, a normal value (less than 35 U/ml) has limited significance. Moreover, we found no improvement in negative predictive and positive predictive value by adding the determination of CA 19.9.

Antibodies, Monoclonal↗
PubMed1990

[Male pseudo-hermaphroditism. Prenatal factors].

The authors report on nine cases of male pseudo-hermaphroditism (MPH) diagnosed at birth. They had a karyotype 46 XY and their external genital organs were ambiguous. Analysing the conditions under which the pregnancies occurred we found that there was primary infertility before the pregnancy in 4 out of 9 cases. There was raised maternal blood pressure in 3 out of 9 cases and one of them led to eclampsia. Three babies were preterm and 7 showed intra-uterine growth retardation (below the 10th centile). In 3 cases there were other birth defects and difficulties in the neonatal stage in 6 (2 with respiratory distress, 1 with birth asphyxia, 1 with infection and 2 with jaundice). The diagnosis was based on cytogenetic analysis, x-ray of the urinary tract, x-ray of the genital organs, plasma testosterone levels and the binding capacity of dihydrotestosterone receptors on fibroblasts of the sexual skin areas (fentomoles/mg DNA). The partial androgen insensitivity syndrome was proven in two cases. These mothers had taken drugs that could potentially cause external genital ambiguity (demegestone and chlorpromazine). In 7 cases the diagnosis could not be arrived at. It is known to be very difficult to find an aetiology for MPH but the abnormalities of pregnancy and the frequent occurrence of intra-uterine growth retardation suggest that there are metabolic and endocrine upsets so that fetal malnutrition could play a role in poor external genitalia development. It should be possible to set up a large multicentric study in order to acquire more data and work out the factors that lead to MPH and their relationship to one another.

Adult↗
PubMed1989

[The CHARGE association].

The CHARGE association includes a group of several malformations, and always a coloboma and/or choanal atresia. We present 8 cases of this syndrome, 5 complete and 3 incomplete forms. Prognosis at term seems severe, considering the visceral malformations (namely cardiac) and the cerebral handicap often associated. In most cases the CHARGE association is a sporadic event; however, one cannot exclude the possibility that certain forms follow a Mendelian pattern of inheritance. The mechanisms leading to this association have not yet been elucidated: it is probably due to migration abnormalities of the neural crests as in the VATER association of Di George syndrome.

Abnormalities, Multiple↗
PubMed1989

Simultaneous appearance of ovarian and endometrial carcinoma: a therapeutic challenge.

We have analyzed 37 cases of simultaneous appearance of carcinoma in the ovary and endometrium. This paper deals with the question of whether they should be considered stage III endometrial carcinomas, stage II ovarian carcinomas or independent primary tumors. The cases were grouped according to their histology as endometrioid ovarian carcinomas with endometrial carcinoma (group A), same carcinoma, but not of endometrial origin in both organs (group B) and histologically different concomitant carcinomas of ovary and endometrium (group C). Although our series was small, the survival was better than could have been expected either for stage III endometrial carcinoma, or stage II ovarian carcinoma. This supports the view that many of those tumors should be considered independent stage I carcinomas. Another fact in favour of this hypothesis is the strong correlation between myometrial invasion and prognosis in these cases, which is comparable to that found in endometrial carcinoma alone.

Adenocarcinoma↗
PubMed1988

Induction of dead fetus labor with 15-(S)-methyl prostaglandin F2 alpha.

This study examines whether labor can be induced with the intramuscular administration of 15-(S)-methyl prostaglandin F2 alpha in cases of intrauterine fetal death. The success rate of labor induction in the studied group was 93.75%, and was the same for primigravid and multigravid patients. The authors conclude that the prophylactic administration of an analgesic potentiator, an anti-emetic and an anti-diarrheal is advantageous to a woman's tolerance of the prostaglandin. PGF2 alpha is a quick and effective drug for use in the induction of labor to terminate pregnancies with intrauterine fetal death and offers tolerable side-effects when used with adjuvant medication.

Adult↗
PubMed1988

[Hereditary congenital lymphedema with pseudosexual ambiguity].

A case of uncommon genital lymphedema in a newborn girl like a pseudo sexual ambiguity is reported. The karyotype was 46, XX. Lymphedema of the lower limbs in the patient and in the mother's family confirmed a None-Milroy disease. Different considerations about genetic counseling in hereditary lymphedema, isolated or associated with others anomalies, are developed.

Disorders of Sex Development↗
PubMed1987

[Intraventricular hemorrhage in the newborn infant at term: thalamic origin].

Four observations of intraventricular hemorrhage in full term neonates without perinatal asphyxia are reported. The clinical pictures were remarkably similar in the four infants: neurological symptoms developed several days after birth with sunsetting and eye deviation and symptoms of cranial hypertension. Ultrasonography and CT scan showed a thalamic hemorrhage.

Cerebral Hemorrhage↗