Search PubMed⌕ Search

Biomedical subjects

J F Magrina

Publications and source records attributed to J F Magrina.

At least 37 records · Page 2Linked to original sources
PubMed1996

Primary surgery for stage IB-IIA cervical cancer, including short-term and long-term morbidity and treatment in pregnancy.

Radical hysterectomy and pelvic lymphadenectomy are indicated for the treatment of cervical carcinoma that is localized clinically to the cervix and upper vagina. Intraoperative complications have been reported in 1.1%-7.4% of patients. Long-term complications include bladder dysfunction (2% at 3 years), urinary fistula (vesical, 0.8%; ureteral, 1.2%), stress urinary incontinence (29%), ureteral stricture (1%), rectal dysfunction (80%), severe constipation (5.3%), lymphocysts (20% by ultrasonography; 2% clinically), and lymphedema (10%). The operative mortality is 0.7%. The 5-year survival rate for patients with stage IB disease is 85.7% and for stage IIA is 69.6%. The recurrence rate is 27.2%. Recurrences are distributed equally between the pelvis and extrapelvic sites. Radical hysterectomy is the treatment of choice for pregnant patients with early cervical cancer. It affords termination or delivery of the pregnancy at the same time that the treatment is provided. For patients with stage I disease treated with radical hysterectomy, the survival rate is 92.1%.

Female↗
PubMed1995

Modified radical hysterectomy: morbidity and mortality.

Among 375 patients who underwent a modified radical hysterectomy at the Mayo Clinic, the complication rate was 24%, and the operative mortality was 0.5%. When compared with radical hysterectomy, this procedure is associated with a lower overall incidence of complications, particularly those related to the urinary tract.

Adolescent↗
PubMed1993

Complications of irradiation and radical surgery for gynecologic malignancies.

Radical hysterectomy after full-dose pelvic irradiation is associated with a high fistula rate, high operative mortality, and decreased survival rate compared with primary radical hysterectomy. Radical hysterectomy is not recommended after full-dose pelvic irradiation. Extended radical hysterectomy after full-dose pelvic irradiation is associated with a higher complication rate than radical hysterectomy or exenteration and it should be abandoned. Preoperative reduced-dose pelvic irradiation followed by radical hysterectomy for early cervical cancer provides similar survival rates but increased complication rates compared with radical hysterectomy alone and it is not recommended. Intracavitary radium or cesium alone has not resulted in a higher complication rate, but in our experience the benefits are doubtful because the local control provided by radical hysterectomy alone was 97.4 per cent (24). The addition of pelvic irradiation after radical hysterectomy does not seem to result in significant deleterious effects on bladder function compared with either treatment modality alone. However, it is associated with increased overall, urinary, and gastrointestinal morbidity and a higher reoperation rate. In radical hysterectomy patients with positive pelvic nodes, postoperative pelvic irradiation provides improved local control but not increased survival rate. Other forms of therapy must be investigated. External irradiation to the aortic area after aortic lymphadenectomy is associated with a decreased complication rate when the external beam dose is limited to 45 Gy and lymphadenectomy is performed extraperitoneally. However, the survival benefit for patients with positive aortic nodes is minimal.

Combined Modality Therapy↗
PubMed1993

Therapy for urologic complications secondary to irradiation of gynecologic malignancies.

Hemorrhagic cystitis, ureteral stenosis or obstruction, and bladder fistulas are the most serious urologic complications secondary to pelvic irradiation for gynecologic malignancies. Hemorrhagic cystitis is usually controlled by formalin instillation. In instances of ureteral stenosis or obstruction or bladder fistulas, the possibility of tumor recurrence must be eliminated. Most patients with ureteral stenosis or obstruction will require surgical correction. Most patients with bladder fistulas will be best served by creation of an ileal conduit. In selected patients, closure of the fistula with pedicle flaps will be possible.

Cystitis↗
PubMed1991

Self-retaining retractor for vaginal operations.

A self-retaining retractor designed for the performance of vaginal operations reduces the physical effort by the assistant, improves the assistant's efficiency, and provides adequate, continuous exposure. In most instances, it eliminates the need for a second assistant. The retractor is composed of a vaginal ring, five retractor blades, four ratchets, and two accompanying bars to secure it in position. The mechanism of self-retraction is achieved by the pushing tension of the retracted tissues on the blades. It is most adequate for educational purposes, since the teaching surgeon, acting as assistant, is not obligated to hold retracting blades and can participate more freely in directing the procedure. The surgeon is provided with continuous adequate exposure regardless of the degree of expertise of the assistants.

Equipment Design↗
PubMed1990

Types of pelvic exenterations: a reappraisal.

Subgrouping of pelvic exenterations as supralevator (type I), infralevator (type II), with vulvectomy (type III), and, an added category, extended can be helpful to facilitate communication when referring to these patients. It also can facilitate a more detailed analysis of operative risk factors, complications, and results and can increase our knowledge of the indications and limitations of the different exenterative procedures.

Evaluation Studies as Topic↗
PubMed1987

Methylprednisolone in cis-platinum induced nausea and emesis: a placebo-controlled trial.

In a double-blind, placebo-controlled trial, the antiemetic efficacy of a total of 1-2 g methylprednisolone sodium succinate (MPSS) alone versus placebo was evaluated over the first three courses of chemotherapy in a group of 27 women receiving moderate to high-dose cis-platinum (50-118 mg/m2) for ovarian or cervical carcinomas. Antiemetic protection was classified as total (no emesis), major (one or two bouts), minor (three to five bouts), or minimal (six or more bouts). Total or major protection occurred in 10/26 (38.5%) of the MPSS cycles and in 6/24 (25%) of the placebo cycles (NS). A significant number of placebo patients (7/14 placebo versus 1/13 MPSS, P = 0.02) dropped out of the study due to lack of efficacy. Patient evaluations completed 24 hr before and after each course of chemotherapy indicated no treatment effect on pain, appetite, nausea, drowsiness, anxiety, sense of well-being, or sleep. Physician and patient global evaluations of antiemetic efficacy favored treatment with MPSS. Evidence of the efficacy of single-drug MPSS antiemetic therapy during non-cis-platinum or low-dose cis-platinum (less than 50 mg/m2) chemotherapy can be found in the literature. The results of this study, however, do not support the use of MPSS alone with high-dose cis-platinum chemotherapy.

Adult↗
PubMed1985

Cyclophosphamide and cisplatinum combination chemotherapy for the treatment of epithelial ovarian carcinoma.

A review of 18 patients with Stage III epithelial ovarian carcinoma treated by surgery and followed by cyclophosphamide and cisplatinum combination chemotherapy is presented. At the end of 12 months from the initiation of chemotherapy, 88.9% of the patients were alive and 77.8% remained free of tumor progression. At the end of 2 years 77.8% of the patients were alive and 44.4% of the patients were free of tumor progression. The combination of cyclophosphamide and cisplatinum has low toxicity, a simple pattern of administration, and has provided satisfactory results.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Comparison of clinical and surgical-staging in patients with endometrial carcinoma.

The preoperative clinical and radiologic findings and staging were compared with the operative and pathological findings and surgical staging in 62 consecutive patients with endometrial carcinoma. Overall, the tumor grade was changed in 33.8% of the patients, and the histologic type of tumor was changed in 27.4% of the patients. The preoperative clinical staging was changed in 51% of the patients after surgery. The change for the stage was as follows: stage I, 30.4%; stage II, 62.5%, stage III, 60%; and stage IV, 0%. The endocervical curettage was found to have a 50% false-positive rate and a 13% false-negative rate.

Dilatation and Curettage↗