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Biomedical subjects

R Torres

Publications and source records attributed to R Torres.

160 records · Page 9Linked to original sources
PubMedDate not supplied

Phase III randomized pilot study comparing interferon alpha-2b in combination with radiation therapy versus radiation therapy alone in patients with stage III-B carcinoma of the cervix.

This randomized pilot study was designed to determine whether the addition of interferon alpha-2b to standard radiation therapy offered an advantage in loco-regional control and survival over radiation therapy alone in a homogeneous group of patients with stage IIIB carcinoma of the cervix. Thirty-six patients were treated with a combination of interferon alpha-2b plus radiation therapy, and 38 patients were treated with radiation therapy alone. Patients with evidence of ureteral obstruction were excluded from the study. Evaluation of loco-regional response was determined by pelvic examination, cervical cytology, biopsies and CT scans when indicated. Survival time was measured from initiation of treatment to date of death or last follow-up. Patient characteristics were comparable between both study arms. The objective complete response rate was 67% in the combined therapy group and 55% in the radiation alone group (P = 0.454). With a median follow-up of 17 months for all patients and 31 months for live patients, 50% of the combined group survived vs. 39.5% of the radiation alone group (P = 0.424). We conclude that the addition of interferon alpha-2b to standard radiation therapy did not significantly improve loco-regional response or survival, although such a trend was noted. We encourage the design of a larger randomized study with sufficient power to detect meaningful differences to prove whether the tendency observed in the present investigation holds any promise to improve the outcome of these patients.

Adult↗
PubMedDate not supplied

Recurrent ovarian dysgerminoma after laparoscopy.

To our knowledge, recurrent dysgerminoma at the site of tumor removal by laparoscopy in a patient with stage IA disease has not been previously reported. A woman with ovarian dysgerminoma treated by laparoscopy and tumor removed through the cul-de-sac recurred the 17 months later at the site of tumor removal. She was successfully treated with etoposide, bleomycin, and cisplatin chemotherapy with complete response. This case illustrates the potential for surgical site implant of an ovarian dysgerminoma; surgeons should follow strict guidelines when performing laparoscopic procedures for ovarian malignancies in order to prevent this type of incident.

Adult↗
PubMedDate not supplied

Osseous and intestinal compartments in the humoral hypercalcemia of malignancy associated to Walker 256 tumor in rats.

The objective of the present work has been to study some aspects of bone and intestinal compartments in rats with Walker 256 carcinosarcoma, an experimental model of humoral hypercalcemia of malignancy (HHM). The results have been compared to those obtained in control animals and, also, to those obtained in Yoshida sarcoma-bearing rats, which were used as tumoral controls without hypercalcemia. Urinary hydroxyproline/creatinine ratio (OHProl/creat) is increased, in both Walker 256 and Yoshida tumor-bearing animals, showing the nonspecifity of this bone marker. However, serum tartrate-resistant acid phosphatase (TRAP) levels are increased in Walker 256 tumor-bearing animals, but they are normal in Yoshida tumor-bearing animals, indicating that TRAP is a better index of bone resorption than OHProl/creat in the HHM syndrome. The decrease of bone calcium content in Walker 256 tumor-bearing rats, not shown by Yoshida-bearing rats, also reflects an increased bone resorption due to HHM. Serum and bone osteocalcin levels are similar in control, Walker 256 and Yoshida tumor-bearing rats, but we observed a decrease in serum alkaline phosphatase levels in Walker 256 and Yoshida tumor-bearing animals, which could also be a nonspecific tumor effect, due to the presence of the neoplasia. Our results support the convenience of the employment of a nonhypercalcemic tumor group as control in the HHM study, in addition to the healthy controls. We have also observed higher 1,25-dihydroxyvitamin D serum levels in Walker 256 tumor-bearing rats than in control and Yoshida tumor-bearing rats. On the other hand, we have found normal levels in the fractional rate of intestinal calcium absorption in Walker-256 tumor-bearing rats, in spite of their high calcium levels, and a significant decrease of this parameter in Yoshida sarcoma-bearing animals. These results support the concomitant contribution of intestinal compartment to hypercalcemia, in the experimental model of HHM studied.

Acid Phosphatase↗
PubMedDate not supplied

Comparative study of vitrectomy with and without vein decompression for branch retinal vein occlusion: a pilot study.

PURPOSE: To report the clinical outcomes in patients undergoing pars plana vitrectomy with and without vein decompression for treatment of branch retinal vein occlusion (BRVO). METHODS: Thirty-five eyes with macular edema and visual acuity worse than 20/100 secondary to BRVO were prospectively evaluated. Vitrectomy with posterior hyaloid removal and vein decompression at the arteriovenous crossing was performed on 15 eyes (Group 1); consecutively, the same technique without vein decompression was performed on 20 eyes (Group 2). Primary outcome was visual acuity and secondary outcomes were resolution of macular edema and development of neovascularization. RESULTS: No differences were found between groups in either patient age (p = 0.566) or preoperative visual acuity (p = 0.505). No differences were found in visual acuity at 3 (p = 0.651), 6 (p = 0.697), 9 (p = 0.763), 12 (p = 0.881), or 18 (p = 0.748) months. Mean time for macular edema resolution and visual acuity improvement was 9 months in both groups, with a mean improvement of 3.5 +/- 2.35 lines in Group 1 and 3.2 +/- 2.97 lines in Group 2. No eyes in either group developed new vessels. CONCLUSIONS: Results suggest that vitrectomy with posterior hyaloid removal without vein decompression can resolve macular edema, improve vision, and prevent development of new vessels in BRVO.

Aged↗
PubMedDate not supplied

[The endoscopic treatment of pancreatic pseudocyst].

We define in this paper different modalities of endoscopic treatment as well as the criteria for this procedure. Endoscopic drainage were done through cystoenterostomy and nasocystic drainage and enterocystic prosthesis plus sphincterostomy of the principal pancreatic and biliary duct, in all patients, but only in eleven of them we implanted the prosthesis in both ducts. The complication was bleeding, in two patients (16.7%) and they were treated with endoscopic inyectotherapy.

Acute Disease↗
PubMedDate not supplied

[Laparoscopic cholecystectomy. Report of the first 1300 cases carried out by a multidisciplinary team].

Nowadays, the laparoscopic cholecystectomy has been accepted as the more effective and safe procedure for the treatment of symptomatic gallstones. The present issue shows the initial result in the management of 1300 patients undergoing laparoscopic cholecystectomy, by a surgical team integrated by experienced endoscopist and surgeons. The diagnosis and treatment of common duct stones were performed preoperatively in 35 patients (2.7%). The ERCP, with endoscopic sphincterotomy and stone extraction was performed in all cases. The overall conversion rate to open cholecystectomy was 0.8%. The technical difficulty to identify the structures was the more frequent cause of conversion. On the other hand, the complication rate was 2.5%, there were no bile duct injuries, and the mortality associated was 0.15%. The 92.8% of our patients was discharged within 24 hours of surgery. We conclude that the medical team, integrated by endoscopist and surgeons, offer to patient an organic and sequential management of their illness; moreover, this was decisive to obtain lower rate of complications, mortality and conversion.

Adolescent↗
PubMedDate not supplied

[Current indications for reimplantation of the upper extremity].

In the last decades there has been a great development in microsurgery that has enabled successful replantation of totally severed parts. Nowadays, the important issue is to decide which segments should be replanted, in order to achieve a good functional result. In this paper we study the indications and contraindications of replantation, based in our experience and we present a review of the recent literature. We consider the following aspects: general condition and age of the patient, mechanism of lesion, amputation level, ischemic time and also economic aspects. We conclude that replantation should be attempted in thumb and multiple digits amputations, in amputations at the palm, wrist and forearm, in single digit amputations distal to the flexor superficialis insertion and in any case in children.

Adult↗