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Biomedical subjects

G Delgado

Publications and source records attributed to G Delgado.

At least 55 records · Page 3Linked to original sources
PubMed1995

Retroperitoneal radical hysterectomy.

A surgical technique is presented which combines both the abdominal and vaginal approaches to radical hysterectomy with significant modifications to allow it to be named "retroperitoneal" radical hysterectomy. Small oblique skin incisions are made 1 cm superior to the inguinal ligament exposing the retroperitoneal structures. The round ligament, uterine artery, ovarian vessels, and cardinal ligament are divided without entering the peritoneal cavity. The remainder of the procedure is completed by a modified Schauta technique. Eight patients with Stage I cancer of the cervix underwent this operation. The expected surgery time should be 3 1/2-4 hr once the surgical team becomes familiar with the procedure, with a blood loss similar to that of the Meigs procedure. Patients tolerated the procedure with minimal discomfort. Total hospital days was limited to 4 days or less in all but the first patient. One patient was discharged on the evening of surgery. No significant complications were reported except some degree of bladder atony that required self-catheterization for a short period of time. We believe that this surgical procedure fulfills the principles of a radical abdominal hysterectomy with less operative time and shorter hospital stay, and employs conventional surgical skills.

Adult↗
PubMed1995

Bilateral pallidostriatal necrosis caused by a wasp sting: a clinical and pathological study.

A previously healthy man developed an acute encephalopathy with coma after a single wasp sting on his chin. Brain CT showed bilateral pallidostriatal radio-lucencies. He died 72 hours after the sting with no evidence of primary cardiorespiratory failure or allergic reaction. Pathological findings were bilateral pallidostriatal necrosis and diffuse neuronal damage in the frontal, temporal, and parietal cortex. The neurotoxic effect of the poison, together with a hypersensitivity are the most likely explanations for this unusual encephalopathy.

Aged↗
PubMed1995

Diurnal variations in the fatty acid composition of milk fat from marginally nourished women.

This investigation was designed to test whether the composition of free fatty acids varied in the milk of a group of marginally nourished women, throughout the day in response to their habitual pattern of eating. Ten fully lactating women, aged 19 - 29 years, weighing 53.3 +/- 7.7 kg, with a mean height of 145.5 +/- 4.5 cm volunteered for the study. They ate two standardized meals a day at 8 and 16 h. Milk samples were pumped out every 4 h, for a period of 24 h, starting at 8:00 A.M. Milk fat was extracted with hexane and the fatty acid content was determined in a gas chromatograph. No changes were noted in the mean diurnal pattern of individual fatty acids throughout the day. Saturated medium-chain (MCFA), and long-chain fatty acids (C16:0, C18:0) were significantly lower and unsaturated long-chain fatty acids (C16:1, C18:1, C18:2) (UFA) were higher than that of reference well nourished women. Analyzed by individual cases, the changes in the sum of UFA were followed by mirror changes in MCFA. Diurnal peaks of total fat were associated with the peak of UFA, whereas troughs of total fat were associated with troughs of UFA but peaks of MCFA. It is suggested that the low total milk fat reported in these women might be the combined result of a limited intake of dietary fat and a limited ability of the mammary tissue to synthesize de novo fatty acid.

Adult↗
PubMed1994

Vulvar reconstruction using a mons pubis pedicle flap.

The treatment of early vulvar carcinoma has moved toward less radical surgery with reconstruction. This report describes our preliminary experience with a mons pubis flap that is simple and appears safe, reliable, and gives excellent cosmetic and functional results following radical hemivulvectomy. Four patients have undergone this procedure with excellent results. The flap brings pliable, hair-bearing skin which authentically mimics the normal side, thus providing good sexual function. The mons pubis pedicle flap should be considered in patients undergoing radical hemivulvectomy where an excellent cosmetic result is desirable.

Adult↗
PubMed1994

Thrombocytosis in surgically treated stage IB squamous cell cervical carcinoma (A Gynecologic Oncology Group study).

Thrombocytosis has previously been shown to be an unfavorable prognostic factor in cervical cancer patients treated with irradiation. We evaluated the significance of thrombocytosis (platelet count > 400 x 10(9)/liter in 623 surgically treated patients with stage IB squamous cell carcinoma of the cervix. These patients had no gross evidence of extrauterine disease at the time of exploration, and none had metastasis to the para-aortic nodes. Fifty-nine (9.5%) of these 623 patients had thrombocytosis. The 5-year survival for patients with thrombocytosis was 82% compared to 83.5% for patients with normal platelet count (P = 0.4). Pelvic node metastasis was present in 13 (22%) of 59 patients with thrombocytosis, and 77 (13.7%) of 564 patients with normal platelet count (P = 0.1). There was a significant correlation between tumor size and platelet count. Patients with thrombocytosis had a mean tumor size of 27.9 mm, while it was 20.4 mm in patients without thrombocytosis (P = 0.002). Other factors found to be associated with thrombocytosis in this population were elevated white blood cell (WBC) count (P = 0.009) and history of chronic obstructive pulmonary disease (COPD) (P = 0.02). In a multivariate analysis for thrombocytosis adjusted for COPD, WBC count, and tumor size, tumor size continued to be statistically significant (P = 0.01). These data suggest that thrombocytosis is a marker of tumor burden and not an independent prognostic factor for progression-free interval or survival.

Adult↗
PubMed1994

Magnetic resonance angiography in meningovascular syphilis.

Meningovascular neurosyphilis (MN) is an unusual cause of stroke in young adults. The clinical manifestations include prodromal symptoms weeks or months before definitive stroke. The diagnosis is based on clinical findings and examination of the serum and cerebrospinal fluid. We report a case of MN with basilar artery irregularities demonstrated by magnetic resonance angiography.

Adult↗
PubMed1994

Detection of human herpesvirus-6 in paraffin-embedded tissue of cervical cancer by polymerase chain reaction.

The polymerase chain reaction (PCR) was used to detect human herpesvirus-6 (HHV-6) DNA sequences from paraffin-embedded tissue from cervical cancer patients. Two of eight cases were positive for HHV-6 using two sets of HHV-6 primers. Hybridization of PCR products with specific radioisotope-labeled oligonucleotide probes confirmed the results. Furthermore, HHV-6 typing was possible by adapting restriction endonuclease digestion of PCR product. This method is useful for retrospective studies in investigating the etiologic role of HHV-6 in the development of human diseases.

Base Sequence↗
PubMed1994

Cytotoxic and antimicrobial screening of selected terpenoids from Asteraceae species.

Twelve pure compounds originally obtained through a systematic chemotaxonomical study with Mexican plants of the Asteraceae, were subjected to a cytotoxic and in vitro antimicrobial screening. Three different cell lines in culture (KB, KB-VI and P388) were used in the cytotoxicity assay, while antimicrobial activity was tested against Gram-positive and Gram-negative bacteria, as well as Candida albicans. Of the twelve terpenoids tested, only taraxasterol showed antimicrobial activity against Staphylococcus aureus. The significant cytotoxic activity exhibited by five sesquiterpene lactones, and the moderate cytotoxicity of an eudesmane, is discussed.

Animals↗
PubMed1994

Detection of human herpesvirus 6 and human papillomavirus 16 in cervical carcinoma.

A subset of human papillomaviruses (HPVs) is associated with the majority of cervical cancers; however, cofactors appear to be required for carcinogenic progression of HPV-induced neoplasia. As human herpesvirus-6 (HHV-6) was recently shown to infect cervical epithelial cells in vitro and activate transcription of HPV-transforming genes, human cervical dysplasia and cancers were analyzed for the presence of HHV-6 by multiple methods, including polymerase chain reaction, slot blot, Southern blot, and in situ hybridization. HHV-6 DNA sequences were detected in 6 of 72 cases of squamous cervical carcinoma and cervical intraepithelial neoplasia. HPV-16 was found in four of the HHV-6-positive cases (two squamous cervical carcinomas and two cervical intraepithelial neoplasias). None of the 30 normal cervices and biopsies of patients with cervicitis was positive for HHV-6 DNA. These results are the first suggestion of an in vivo association between HHV-6 and some cervical neoplasia.

Carcinoma, Squamous Cell↗
PubMed1994

[Outbreaks of hepatitis A in the City of Havana in the year 1991].

Fifty-six outbreaks of hepatitis A infection were studied in City of Havana between January and September, 1991. In 34 of these, the presence of the hepatitis A virus (HAV) was confirmed, either by the detection of specific serum IGM antibodies to the HAV or by the detection of the antigen in the feces of the subjects under study. Diagnosis was not made in some of the outbreaks due to the insufficient number of samples sent to the laboratory. Of the 453 blood serum samples under study, 126 were positive for IGM antibodies to HAV (27.8%): a there was a good correlation between the presence of this immunoglobulin and the levels attained by the alanyl aminotransferase enzyme (ALT). Only in 19 feces samples, of the 263 under study, was the HAV antigen detected, which accounted to 7.2%; it was demonstrated that this marker is not useful for the diagnosis of an outbreak of hepatitis A infection.

Alanine Transaminase↗
PubMed1994

[Development and evaluation of an ELISA for the detection of IgM antibodies against the hepatitis A virus].

We present the results of the normalization of an IgM capture ELISA method for the diagnosis of type A viral hepatitis with reagents produced in the laboratory and its comparison with the "Diag-A-Hep" commercial ELISA. The results attained were: sensibility by 91%; specificity by 100%; and coincidence of the two systems by 97%. Results are discussed and their relationship with clinical symptoms and epidemiological characteristics is established. The results attained in 13 serum samples taken from patients seen during 2 acute viral hepatitis outbreaks agreed with clinical findings.

Enzyme-Linked Immunosorbent Assay↗
PubMed1993

Colonic surgery in gynecologic oncology. Risk factor analysis.

Colonic surgery is a critical part of gynecologic oncology care. A 12-year review of colonic surgery on a gynecologic oncology service was performed evaluating risk factors and their impact on postoperative morbidity. There were 124 procedures performed on 92 patients; 9 patients had no prior surgery, chemotherapy or radiation. Fifty-six percent of the patients were considered malnourished on the basis of a serum albumin level < 3.5 g/dL. The 124 procedures consisted of 57 colon resections with primary reanastomosis, 10 small bowel-colon bypass procedures and 57 colostomies. Of the 57 (67%) colostomy operations, 38 also had concomitant abdominal-pelvic procedures. There were 15 major bowel complications and 17 major systemic postoperative complications. Prior surgery and poor nutritional status significantly correlated with postoperative morbidity; however, prior radiation did not reveal an increased risk for postoperative complications.

Adult↗
PubMed1992

Histopathologic predictors of the behavior of surgically treated stage IB squamous cell carcinoma of the cervix. A Gynecologic Oncology Group study.

Disagreement persists about the superiority of Reagan and Ng's method over that of Broders' for the histologic grading of squamous carcinoma of the cervix. Uncertainty about the predictive value and reproducibility of any of the grading methods prompted a comparison of factors previously suggested as indicating the biologic behavior for cervical squamous carcinoma. One hundred ninety-five women, who were enrolled in a Gynecologic Oncology Group treatment protocol of Stage IB squamous carcinoma of the cervix and underwent radical hysterectomy with pelvic and paraaortic node sampling, formed the study population. The tumors were graded first by participating institutional pathologists, with submitted slides subjected to an independent review by two pathologists (R.J.Z. and S.W.). The histologic parameters examined included the presence and amount of keratinization, nuclear pleomorphism, mitotic rate, gestalt grading, pattern of invasion at the stromal interface, and inflammatory cell infiltrate. The depth of invasion and presence or absence of vascular invasion also were assessed. The probability of pelvic lymph node metastasis and the progression-free interval were determined for each parameter. Surprisingly, none of the grading methods was effective in predicting nodal spread or progression-free interval. However, an increasing depth of invasion strongly correlated with nodal spread and a diminished progression-free interval (P less than 0.0001). Vascular invasion was less effective in these predictions (0.05 less than P less than 0.10). Both measurements were reasonable reproducible. It was concluded that histologic grading of surgically treated cervical carcinoma is not useful but that the depth of invasion and vascular invasion are important predictors of behavior that should be reported routinely.

Carcinoma, Squamous Cell↗
PubMed1992

Ovarian metastases in stage IB carcinoma of the cervix: a Gynecologic Oncology Group study.

Surgical and pathologic findings at laparotomy for radical hysterectomy in 990 patients with clinical stage IB carcinoma of the cervix were analyzed to determine the frequency of metastases to the ovary. Ovarian spread was identified in 4 of 770 (0.5%) patients with squamous carcinoma and 2 of 121 (1.7%) with adenocarcinoma. No patients with adenosquamous carcinoma (n = 82) or other histologic types (n = 17) had ovarian metastases. Although the frequency of metastases was greater among patients with adenocarcinoma, this was not statistically significant (p = 0.19, Fisher's exact test). All 6 patients with ovarian metastases had other evidence of extracervical disease. Three underwent radical hysterectomy and bilateral salpingo-oophorectomy. Of these, one patient received extended field radiotherapy and died of disease 18 months after diagnosis. Two patients, one treated with combination chemotherapy and one with no adjunctive therapy, are alive without evidence of disease at 59 and 62 months, respectively. Three patients underwent exploratory laparotomy with salpingo-oophorectomy and lymphadenectomy without hysterectomy. All three patients died of disease at 2, 3, and 30 months; the first and last patient received adjunctive radiotherapy. Not all patients underwent oophorectomy. Of 347 patients with at least unilateral ovarian preservation, no postoperative pelvic radiotherapy, and no gross extracervical disease or metastasis to the paraaortic nodes, pelvic recurrence developed in 16. There was no excess of pelvic recurrences in patients with adenocarcinoma (0/41) or adenosquamous carcinoma (1/29, 3.4%) when compared with those with squamous carcinoma (15/270, 5.6%). This suggests no excess of occult ovarian metastases in nonsquamous tumors of the cervix. There is no evidence in these data of an increased risk of ovarian preservation in patients with stage IB carcinoma of the cervix with no gross extracervical disease.

Adenocarcinoma↗
PubMed1992

Radiotherapy of malignant subdiaphragmatic implants in advanced ovarian carcinoma: a new technique.

We report the development of a new technique using remote afterloading intraoperative radiation therapy to deliver a tumoricidal dose to diaphragmatic tumor implants. A multi-positional lucite applicator was designed based on anatomic studies of the diaphragmatic surface to accommodate a high dose rate iridium source in a series of needles placed 1.5 cm apart. The applicator curvature can vary from planar to full accommodation of the diaphragmatic surface with a constant source to surface distance of 0.5 cm. The applicator has been piloted in three patients with ovarian carcinoma with residual subdiaphragmatic disease found at second look laparotomy, to deliver a dose of 1,500 to 2,000 cGy at 0.5 cm. Tolerance of the diaphragm and hepatic surface has been excellent. There were no postoperative complications and no deterioration in liver function studies. The additional postoperative external beam irradiation directed with the aid of surgically placed clips and gated to respiratory movements permits achievement of a tumoricidal dose while limiting the treated volume and related toxicities.

Brachytherapy↗