RESUMEN
BACKGROUND: Blood pressure (BP) has a circadian rhythm, decreases at night and increases in the morning (dipper), have been observed in patients with impaired in this profile, increased at night and lower in the morning (no dipper) have increased cardiovascular risk. Preeclampsia-eclampsia complicates about 7% of pregnancies, preeclampsia is known to reverse the normal circadian cycle of the BP. OBJECTIVE: To determine the profile dipper/non-dipper in patients with severe preeclampsia, eclampsia and HELLP syndrome patients in Intensive Care and Obstetrics Hospital Juárez of México. MATERIAL AND METHODS: 15 patients were reviewed, 10 with severe preeclampsia, 4 with HELLP syndrome and 1 eclampsia, systolic, diastolic, mean and pulse PA were analyzed during the day/night and pregnancy/postpartum. Using ratios pregnancy day/night pregnancy, puerperium day/night postpartum dipper/non-dipper profile is determined RESULTS: Maternal age 30 ± 6.34 years, 7 primiparous (46%) 8 multiparous (54%), pregnancy was 31.67 ± 4.59 weeks. In all but two results in the ratio of pulse pressure during pregnancy was not the result dipper raiser and did not change during the postpartum period. CONCLUSION: in all patients during pregnancy profile was observed no dipper no change during the postpartum period. The established treatment did not modify this result. So it is appropriate to establish strategies to change this behavior and try to get the patient to regain normal circadian BP rhythm.
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Presión Sanguínea , Eclampsia/fisiopatología , Síndrome HELLP/fisiopatología , Periodo Posparto/fisiología , Preeclampsia/fisiopatología , Adulto , Ritmo Circadiano , Femenino , Humanos , Estudios Longitudinales , Embarazo , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: The molar pregnancy is complicated with hypertension before 20 weeks, divided into complete mole and partial mole, and in diploid and triploid hydatidiform mola depending on the fetal chromosomes. OBJECTIVE: To determine clinical and laboratory characteristics of patients with hydatidiform mole with and without hypertension, and choriocarcinoma, correlate serum chorionic gonadotropin (hCG) and hypertension. MATERIAL AND METHODS: We reviewed 55 cases with histopathologically proven mole, separately analyzed clinical, laboratory and hCG. RESULTS: The prevalence of mole with hypertension was 1:7; with the choriocarcinoma is 1:11. The age and sexual initiation of mole with hypertension was higher (p = .004 and .002 respectively), liver transaminase AST (p =. 004) and lactate dehydrogenase are higher in the group with hypertension (p =. 000). Positive correlation was obtained r = .246 p =. 044 statistically significant between mean arterial pressure and hCG. We reviewed 31 cases of 28 national and international articles, in patients with diploid hydatidiform the product is allowed to live normal and high blood pressure is showing mild preeclampsia, while partial moles are triploid, malformed products, incompatible with life and with hypertension severe like severe pre-eclampsia. CONCLUSIONS: The molar pregnancy is partially diagnosed with hypertension in our environment, is not properly analyzed and that most of the products of curettage were not performed genetic testing. The hCG probably participate in the hypertensive disorders of pregnancy.
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Coriocarcinoma/patología , Mola Hidatiforme/patología , Hipertensión/complicaciones , Neoplasias Uterinas/patología , Adolescente , Adulto , Factores de Edad , Aspartato Aminotransferasas/metabolismo , Presión Sanguínea , Gonadotropina Coriónica/sangre , Femenino , Humanos , Hipertensión/epidemiología , Hipertensión Inducida en el Embarazo/epidemiología , L-Lactato Deshidrogenasa/metabolismo , Preeclampsia/epidemiología , Embarazo , Complicaciones Cardiovasculares del Embarazo/epidemiología , Prevalencia , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Neoplasias Uterinas/complicaciones , Adulto JovenRESUMEN
Cervical cancer remains a serious public health problem in the world; that is why the Mexican Federation of Schools of Obstetrics and Gynecology convened the elaboration of a consensus that is devoted this number of Ginecologia y Obstetricia de Mexico. In recent years has strengthened perceptions (public and private) in the need for preventive strategies in the medium and long terms. The development of effective vaccines against the human papilloma virus and the application of new methods of detection from viral DNA (completely automated for personal application) allow some degree of optimism. It is proposed a consensus with general recommendations in two consecutive stages: (a) primary prevention consisting of education for the prevention of cervical cancer and universal immunization and (b) secondary prevention by early detection of infections or injuries that could favor carcinogenesis. The consensus reviewed characteristics of available vaccines in detail and proposes strategies for implementation in Mexican population. Also, check out main methods of early detection of infection (or predisposing lesions) and suggests public and private strategies for implementation. Consensus places particular emphasis on early immunization for female population and correct use of methods for detection of infections or injuries that might cause cervical cancer.
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Neoplasias del Cuello Uterino/prevención & control , Femenino , Humanos , MéxicoRESUMEN
High-grade serous ovarian cancer (HGSOC) is hallmarked by early onset of peritoneal dissemination, which distinguishes it from low-grade serous ovarian cancer (LGSOC). Here, we describe the aggressive nature of HGSOC ascitic tumor cells (ATCs) characterized by integrin α5high (ITGA5high) ATCs, which are prone to forming heterotypic spheroids with fibroblasts. We term these aggregates as metastatic units (MUs) in HGSOC for their advantageous metastatic capacity and active involvement in early peritoneal dissemination. Intriguingly, fibroblasts inside MUs support ATC survival and guide their peritoneal invasion before becoming essential components of the tumor stroma in newly formed metastases. Cancer-associated fibroblasts (CAFs) recruit ITGA5high ATCs to form MUs, which further sustain ATC ITGA5 expression by EGF secretion. Notably, LGSOC is largely devoid of CAFs and the resultant MUs, which might explain its metastatic delay. These findings identify a specialized MU architecture that amplifies the tumor-stroma interaction and promotes transcoelomic metastasis in HGSOC, providing the basis for stromal fibroblast-oriented interventions in hampering OC peritoneal propagation.
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Fibroblastos/patología , Integrinas/metabolismo , Neoplasias Ováricas/patología , Neoplasias Peritoneales/secundario , Animales , Línea Celular Tumoral , Receptores ErbB/genética , Femenino , Fibroblastos/metabolismo , Regulación Neoplásica de la Expresión Génica , Humanos , Integrinas/genética , Ratones Endogámicos NOD , Ratones Transgénicos , Neoplasias Ováricas/genética , Neoplasias Ováricas/metabolismo , Neoplasias Ováricas/mortalidad , Neoplasias Peritoneales/patología , Esferoides Celulares/patología , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
Males are affected from primary extragonadal germ cell tumors with a frequency of 2 to 5%. There is a high incidence of infertility of more than 60% and most of the cases have azoospermia due to testicular damage. The hormonal profile of these patients shows normal luteinizing hormone, normal follicle stimulating hormone and normal testosterone and estradiol. We communicate the case of a male who had a primary retroperitoneal germ cell tumor with a low title of chorionic gonadotropin, elevated estradiol and normal testosterone, prolactin and seminogram. Before beginning treatment with chemotherapy, his wife became pregnant delivering twins, both males. The patient was treated with chemo and radiotherapy after which he became azoospermic with an increase in both luteinizing hormone and follicle stimulating, decreased levels of estradiol and without alteration in prolactin and testosterone. The pituitary testicle axis was affected by the tumor, but the microenvironment of the testicles did not seem to be damaged only after initiating treatment.
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Neoplasias Retroperitoneales/fisiopatología , Seminoma/fisiopatología , Testículo/fisiopatología , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Azoospermia/sangre , Azoospermia/etiología , Gonadotropina Coriónica/sangre , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Terapia Combinada , Ciclofosfamida/administración & dosificación , Ciclofosfamida/efectos adversos , Femenino , Fertilidad , Hormona Folículo Estimulante/sangre , Humanos , Sistema Hipotálamo-Hipofisario/fisiología , Recién Nacido , Hormona Luteinizante/sangre , Masculino , Embarazo , Embarazo Múltiple , Radioterapia Adyuvante/efectos adversos , Neoplasias Retroperitoneales/tratamiento farmacológico , Neoplasias Retroperitoneales/radioterapia , Seminoma/tratamiento farmacológico , Seminoma/radioterapia , Testosterona/sangre , GemelosRESUMEN
Colposcopy is nowadays a habitual tool applied to the routine gynecological exploration. The terminology for the normal and abnormal colposcopic findings has changed according with the time and the new knowledge about the low genital tract diseases. Gynecologists must be aware of this terminology for a correct application in diagnosis, therapeutics and papers on findings and results. It is necessary that the whole medical community around the world applies the same terminology in order to have a better communication.
Asunto(s)
Colposcopía , Enfermedades de los Genitales Femeninos/diagnóstico , Terminología como Asunto , Diagnóstico Diferencial , Femenino , Enfermedades de los Genitales Femeninos/terapia , HumanosRESUMEN
Cervico-uterine cancer screening with cytology decrease incidence by more than 50%. The cause of this cancer is the human papilloma virus high risk, and requires a sensitive test to provide sufficient sensitivity and specificity for early detection and greater interval period when the results are negative. The test of the human papilloma virus high risk, is effective and safe because of its excellent sensitivity, negative predictive value and optimal reproducibility, especially when combined with liquid-based cytology or biomarkers with viral load, with higher sensitivity and specificity, by reducing false positives for the detection of cervical intraepithelial neoplasia grade 2 or greater injury, with excellent clinical benefits to cervical cancer screening and related infection of human papilloma virus diseases, is currently the best test for early detection infection of human papillomavirus and the risk of carcinogenesis.
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Detección Precoz del Cáncer/métodos , Neoplasias del Cuello Uterino/prevención & control , Biomarcadores de Tumor , Sondas de ADN de HPV , Detección Precoz del Cáncer/tendencias , Femenino , Genes Virales , Genes p16 , Promoción de la Salud , Humanos , Incidencia , Recurrencia Local de Neoplasia/diagnóstico , Proteínas Oncogénicas Virales/genética , Prueba de Papanicolaou , Papillomaviridae/clasificación , Papillomaviridae/aislamiento & purificación , Papillomaviridae/patogenicidad , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/prevención & control , Infecciones por Papillomavirus/virología , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Infecciones Tumorales por Virus/diagnóstico , Infecciones Tumorales por Virus/epidemiología , Infecciones Tumorales por Virus/virología , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/virología , Frotis Vaginal , Carga Viral , Displasia del Cuello del Útero/diagnóstico , Displasia del Cuello del Útero/epidemiología , Displasia del Cuello del Útero/patología , Displasia del Cuello del Útero/virologíaRESUMEN
Epithelial ovarian cancer is the fifth most common cancer in women. It is usually diagnosed at an advanced stage and is the leading cause of death from gynecologic cancers in women. The overall survival rate at five years is 50% and its treatment is still poor. We need new treatments for patients with recurrent ovarian cancer who are incurable with current management. We review the effectiveness of new biological agents and morbidity and mortality of cytoreductive surgery. Since the hyperthermic increases the effectiveness of chemotherapy and the chance of survival, hyperthermic intraperitoneal chemotherapy has been proven to be a promising option, however it still requires further study to be the standard treatment.
RESUMEN
Cancer screening programs have been successful in reducing the incidence and mortality due to cervical cancer. For more than a decade, the human papillomavirus test has been recommended as part of these programs, however, Pap tests is not currently recommended for women 65 years of age who participated adequately in screening programs, continuing with these screening programs is not needed. Screening programs will be different in special populations at greatest risk where tests are frequently needed or use of alternative methods.
Los programas de detección oportuna del cáncer han logrado disminuir, con éxito, la incidencia y la tasa de mortalidad por cáncer cervicouterino. Desde hace más de una década se ha recomendado la prueba del virus del papiloma humano como parte de estos programas; sin embargo, actualmente no se recomienda la prueba de Papanicolaou a las mujeres menores de 21 años, ni a las que se efectuó histerectomía total por enfermedad benigna, no relacionada con lesiones precursoras de cáncer cervicouterino o problemas oncológicos. Esto debido a que la mayor parte de las anomalías observadas en adolescentes remiten espontáneamente, y las pruebas de tamizaje citológico para este grupo de edad provocan ansiedad innecesaria, pruebas adicionales y, por lo tanto, mayor costo. Además, existe poca evidencia que demuestre que la citología es útil en mujeres después de la histerectomía, pues no se ha comprobado que ésta mejore los RESULTADOS. Al igual que en mujeres mayores de 65 años que participan adecuadamente en programas de detección, que no es necesario continuarlos, y una vez suspendidos no se vuelven a iniciar por ninguna causa. Los programas de tamizaje sólo serán diferentes en poblaciones especiales con mayor riesgo, donde son necesarias pruebas o métodos alternativos más frecuentes.
Asunto(s)
Detección Precoz del Cáncer/métodos , Prueba de Papanicolaou , Guías de Práctica Clínica como Asunto , Neoplasias del Cuello Uterino/diagnóstico , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Pruebas Diagnósticas de Rutina , Detección Precoz del Cáncer/normas , Femenino , Promoción de la Salud , Humanos , Histerectomía , Persona de Mediana Edad , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/epidemiología , Sociedades Médicas , Estados Unidos , Procedimientos Innecesarios , Displasia del Cuello del Útero/diagnóstico , Displasia del Cuello del Útero/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Adulto JovenRESUMEN
BACKGROUND: Lymphangiomas are congenital malformations or acquired (secondary to trauma, infection or neoplasia) in the mammary gland, are extremely rare. These lesions tend to infiltrate surrounding tissues and malignant degeneration is extremely rare. Clinically manifests as benign masses, slow growing; diagnosed clinically and by imaging studies. Suegery with removal of the mass is performed for aesthetic reasons and to make differential diagnosis with other common injuries. CLINICAL CASE: Women 45 years of age with progressive increase in size of the left breast, breast trauma concerns and has no other symptoms.The histologic diagnosis was cystic lymphangioma giant left mammary gland. DISCUSSION: Lymphangiomas are uncommon lesions and extremely rare in the mammary gland, locally aggresive behavior and are benign, where abnormal lymphatic tissue has some ability to proliferate and accumulate large amounts of liquid, representing cystic appearance, as presented in our case. Local surgical excision is the treatment. CONCLUSION: In this first case of giant breast cystic lymphangioma reported in Mexico, which corroborates the benignity of the lesion.
Antecedentes: los linfangiomas son malformaciones congénitas o adquiridas (secundarias a traumatismos, infecciones o neoplasias) de la glándula mamaria sumamente raras. Estas lesiones tienden a infiltrar los tejidos circundantes y la degeneración maligna es excepcional. Su manifestación clínica es en tumores benignos y de crecimiento lento. Se diagnostica clínicamente y por estudios de imagen. El tumor se extirpa por razones estéticas y para establecer el diagnóstico diferencial con otras lesiones más comunes. Caso clínico: paciente femenina de 45 años de edad, con incremento progresivo del tamaño de la mama izquierda, quizá originado por un traumatismo y no tiene otros sintomas. El diagnóstico histológico definitivo fue: linfangioma quístico gigante de la glándula mamaria izquierda. Discusión: los linfangiomas son lesiones extremadamente raras en la glándula mamaria, de comportamiento agresivo local y benignas. El tejido linfático anormal posee cierta capacidad de proliferar y de acumular grandes cantidades de líquido, lo que representa su apariencia quística, como sucedió en el caso aquí reportado. La extirpación quirúrgica local es el tratamiento indicado. Conclusión: este primer caso de linfangioma quístico gigante de mama reportado en México permite corroborar la benignidad de la lesión.
Asunto(s)
Neoplasias de la Mama/patología , Linfangioma Quístico/patología , Biopsia , Mama/lesiones , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/etiología , Neoplasias de la Mama/cirugía , Líquido Quístico , Diagnóstico Diferencial , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Lipoma , Linfangiectasia/diagnóstico , Linfangioleiomiomatosis/diagnóstico , Linfangioma Quístico/diagnóstico , Linfangioma Quístico/etiología , Linfangioma Quístico/cirugía , Persona de Mediana Edad , Neoplasias Primarias Secundarias , Neoplasias Ováricas , Neoplasias de los Tejidos BlandosRESUMEN
BACKGROUND: Epidemiological studies treat testicular germ cancer as a single disease, the behavior of the two histological types of cancer; seminoma and nonseminoma have differences in reproductive hormone secretion and impair fertility differently. OBJECTIVE: To demonstrate that the serum concentration of pituitary hormones involved in fertility and spermatogenesis in the affected male is different in the two histological types. METHODS: Were determined by radioimmunoassay or inmunoradiometric assay, luteinizing hormone, follicle stimulating hormone, total testosterone, prolactin, estradiol, human chorionic gonadotropin and alpha fetoprotein in 37 patients with germ cell cancer (15 seminoma and 22 nonseminoma) and 35 controls. We analyzed the semen of patients, and were questioned about paternity before the cancer diagnosis. RESULTS: Age was higher in patients with seminoma cancer, showed decreased luteinizing hormone, follicle stimulating hormone, and testosterone and increased estradiol and prolactin in nonseminoma compared with seminoma. In patients with nonseminoma they had 9 children, 5 were oligozoospermic, 3 azoospermic and 6 normal concentration, 8 did not provide sample, seminoma group they had eight children, only one azoospermic, nine normal concentration, and 5 did not provide sample . CONCLUSIONS: The hormonal behavior is different in men with nonseminoma compared with seminoma, so that the negative impact on the reproductive axis and fertility is higher in cases of non-seminoma.
Antecedentes: los estudios epidemiológicos tratan al cáncer germinal de testículo como una sola patología, el comportamiento de los dos tipos histológicos: el seminoma y no seminoma tienen diferencias en la secreción de hormonas reproductivas y alteran la fertilidad de forma diferente. Objetivo: demostrar que la concentración sérica de las hormonas hipofisarias que intervienen en la fertilidad y espermatogénesis en el varón afectado es diferente en los dos tipos histológicos. Material y métodos: estudio clínico, prospectivo, transversal, comparativo de tres grupos de pacientes. Por medio de radioinmunoensayo o ensayo inmunorradiométrico se determinaron las concentraciones de: hormona luteinizante, hormona folículo estimulante, testosterona total, prolactina, estradiol, gonadotropina coriónica humana y alfa feto proteína en suero de 37 pacientes (15 seminoma, y 22 no seminoma) y 35 controles. Se analizó el semen de los pacientes y se les interrogó acerca de su satisfacción de paternidad antes del diagnóstico de cáncer. Resultados: los pacientes con cáncer tipo seminoma fueron de mayor edad, se encontró disminución de: hormona luteinizante, hormona folículo estimulante y testosterona; aumento de: estradiol y prolactina en cáncer no seminoma, en comparación con seminoma. En los pacientes con no seminoma 9 ya tenían hijos, 5 eran oligozoospérmicos, 3 azoospérmicos y 6 con concentración normal 8 no proporcionaron muestra; en el grupo de seminona, 8 ya tenían hijos, sólo 1 azoospérmico; 9 concentración normal, y 5 no proporcionaron muestra. Conclusiones: el comportamiento hormonal es diferente en los hombres con cáncer no seminoma en comparación con los de seminoma, por lo que la repercusión negativa en el eje reproductor y fertilidad es mayor en los casos de no seminoma.
Asunto(s)
Hormonas Esteroides Gonadales/sangre , Gonadotropinas Hipofisarias/sangre , Infertilidad Masculina/etiología , Neoplasias de Células Germinales y Embrionarias/sangre , Neoplasias Testiculares/sangre , alfa-Fetoproteínas/análisis , Adulto , Azoospermia/sangre , Azoospermia/etiología , Estudios Transversales , Humanos , Infertilidad Masculina/sangre , Masculino , Neoplasias de Células Germinales y Embrionarias/complicaciones , Estudios Prospectivos , Seminoma/sangre , Seminoma/complicaciones , Espermatogénesis , Neoplasias Testiculares/complicaciones , Adulto JovenRESUMEN
Resumen OBJETIVO: Estimar la morbilidad obstétrica grave y mortalidad materna en el Hospital Juárez de México. MATERIALES Y MÉTODOS: Estudio retrospectivo y transversal efectuado para evaluar los registros de pacientes con morbilidad obstétrica grave y la mortalidad materna, de acuerdo con los criterios de la OMS, atendidas en el Hospital Juárez de México de 2010-2016. Se analizaron las variables relacionadas con el diagnóstico, insuficiencia o disfunción orgánica y las intervenciones asociadas con el tratamiento. Se calculó la tasa de morbilidad materna extrema y obstétrica grave (Near Miss/total de embarazadas). Se utilizaron medidas de tendencia central y de dispersión. RESULTADOS: Se registraron 137 casos de morbilidad obstétrica grave y 26 de muerte materna. La mortalidad promedio fue de 5.78% y el índice de mortalidad de 0.415. Las principales causas de morbilidad materna grave y mortalidad fueron: hemorragia obstétrica, hipertensión asociada con el embarazo y sepsis. Se observó un incremento en los casos de morbilidad materna grave y disminución de la mortalidad materna en el periodo estudiado. CONCLUSIÓN: Se sugiere establecer un comité de evaluación y análisis de pacientes con morbilidad obstétrica grave para mejorar la calidad de atención y tratamiento, y disminuir la tasa de mortalidad materna.
Abstract OBJECTIVE: To determine how many cases of severe obstetric morbidity and maternal mortality were presented in 2010-2016, at the Hospital Juárez de México. MATERIALS AND METHODS: A retrospective, cross-sectional, observational study was carried out in cases of severe obstetric morbidity and maternal death were included according, to WHO criteria, attended in the Hospital Juárez de México from 2010-2016,. We included variables related to the diagnosis, with the organic failure or dysfunction and the interventions related to the management. The extreme maternal morbidity rate was calculated; obstetric (Near miss / Total pregnant). Measures of central tendency and dispersion were used. RESULTS: A total of 137 cases of severe obstetric morbidity and 26 of maternal deaths were registered. The mortality rate on average was 5.78% and death rate .415. The main causes of severe maternal morbidity and mortality were obstetric haemorrhage, hypertension associated with pregnancy and sepsis. There was an increase in cases of severe maternal morbidity and decrease in maternal death in the period studied. CONCLUSION: We suggest the establishment of a committee to evaluate and analyze cases of severe obstetric morbidity to improve the quality of care and treatment for this group of pregnant women, to reduce maternal death.
RESUMEN
A history of endometriosis is a risk factor for some subtypes of epithelial ovarian cancer. Endometriosis is associated with increased risk of ovarian clear cell, serous low-grade endometrioid cancer, but it is unclear what the role of endometriosis is in the development of other histopathological subtypes of ovarian cancer, such as high-grade serous borderline tumors subtypes or borderline serous and mucinous cancers. An understanding of the mechanisms leading to malignant transformation of endometriosis will be needed to identify subgroups of women at increased risk of ovarian cancer. This is important because of their high prevalence and cause of infertility in Mexico and the world. All factors must be considered during the decision-making process for the treatment of endometriosis, including the rare malignant transformation.
Asunto(s)
Endometriosis/epidemiología , Neoplasias Ováricas/epidemiología , Adenocarcinoma de Células Claras/epidemiología , Adenocarcinoma Mucinoso/epidemiología , Carcinoma Endometrioide/epidemiología , Comorbilidad , Cistadenocarcinoma Seroso/epidemiología , Cistadenocarcinoma Seroso/patología , Femenino , Genes Relacionados con las Neoplasias , Predisposición Genética a la Enfermedad , Humanos , Infertilidad Femenina/epidemiología , México/epidemiología , Mutación , Clasificación del Tumor , Oportunidad Relativa , Neoplasias Ováricas/genética , Neoplasias Ováricas/patología , Prevalencia , Factores de Riesgo , Factores de TiempoRESUMEN
Breast Cancer is a heterogeneous disease, progressive, currently, are classified according to in pattern of gene expression luminal A, luminal B, basal and HER-2neu + and Triple-negative, 75% to 80% have receptors positive hormonal and 15% to 20% are positive for hER-2neu and 10% to 20% are triple negative, with hormone receptor negative and HER2-neu and their diagnostic is made by exclusion, the Metabolic Syndrome is related to a higher incidence of these cancers where the insulin-leptin axis-adiponectin are implicated in carcinogenesis.
RESUMEN
INTRODUCTION: Breast cancer is diagnosed in pregnant women during pregnancy or the first year after childbirth, and is the second leading cause of death among women of reproductive age. We don't know the frequency of this disease or the characteristics of the women affected at the Juarez Hospital of Mexico. This paper analyzed the cases of pregnant women diagnosed with breast cancer treated in the Oncology Department over a period of 10 years (1990-2000). METHODS: We performed a retrospective descriptive study of pregnant women diagnosed with breast cancer, treated at the hospital. Of the cases found, the following indicators were studied: maternal age, type of cancer, weeks of gestation at the time of diagnosis, resolution of pregnancy and perinatal outcome, and treatment monitoring. Descriptive statistics were performed using measures of central tendency and dispersion. RESULTS: There were 14 cases of pregnant women with breast cancer. The mean age of patients was 28 years, with a mean of 23 weeks gestation at diagnosis. The resolution of pregnancy was favorable in 73% of cases. 78.6% of the patients were treated, 72.7% had follow-up for 2 years that found 62.5% of patients without tumor activity. CONCLUSIONS: The frequency of pregnant women with breast cancer is low, affecting young people. The choice of treatment allowed the resolution of pregnancy and survival of women without tumor activity.
Asunto(s)
Neoplasias de la Mama/epidemiología , Carcinoma Ductal de Mama/epidemiología , Complicaciones Neoplásicas del Embarazo/epidemiología , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/terapia , Autoexamen de Mamas , Carcinoma Ductal de Mama/diagnóstico por imagen , Carcinoma Ductal de Mama/terapia , Terapia Combinada , Femenino , Estudios de Seguimiento , Edad Gestacional , Humanos , Recién Nacido , Mamografía , Mastectomía , Edad Materna , México/epidemiología , Embarazo , Complicaciones Neoplásicas del Embarazo/diagnóstico por imagen , Complicaciones Neoplásicas del Embarazo/terapia , Resultado del Embarazo , Trastornos Puerperales/epidemiología , Trastornos Puerperales/terapia , Radioterapia Adyuvante , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
Robotic surgery is a surgical technique recently introduced, with major expansion and acceptance among the medical community is currently performed in over 1,000 hospitals around the world and in the management of gynecological cancer are being developed comprehensive programs for implementation. The objectives of this paper are to review the scientific literature on robotic surgery and its application in gynecological cancer to verify its safety, feasibility and efficacy when compared with laparoscopic surgery or surgery classical major surgical complications, infections are more common in traditional radical surgery compared with laparoscopic or robotic surgery and with these new techniques surgical and staying hospital are lesser than the former however, the disadvantages are the limited number of robot systems, their high cost and applies only in specialized centers that have with equipment and skilled surgeons. In conclusion robotic surgery represents a major scientific breakthrough and surgical management of gynecological cancer with better results to other types of conventional surgery and is likely in the coming years is become its worldwide.
Asunto(s)
Neoplasias de los Genitales Femeninos/cirugía , Procedimientos Quirúrgicos Ginecológicos/métodos , Laparoscopía/métodos , Robótica/métodos , Neoplasias Endometriales/cirugía , Femenino , Procedimientos Quirúrgicos Ginecológicos/economía , Procedimientos Quirúrgicos Ginecológicos/educación , Procedimientos Quirúrgicos Ginecológicos/instrumentación , Procedimientos Quirúrgicos Ginecológicos/tendencias , Accesibilidad a los Servicios de Salud , Humanos , Laparoscopía/economía , Laparoscopía/educación , Laparoscopía/instrumentación , Laparotomía , Tiempo de Internación , Procedimientos Quirúrgicos Mínimamente Invasivos , Neoplasias Ováricas/cirugía , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Robótica/economía , Robótica/educación , Robótica/instrumentación , Robótica/estadística & datos numéricos , Neoplasias del Cuello Uterino/cirugíaRESUMEN
Cervical cancer is a global public health problem related to infection by human papilloma virus. Countries with organized programs for detection and treatment of precancerous lesions and cervical cancer prevent 80% of cases; however, prevention-based cytology, colposcopy and treatment of injuries is effective but still expensive, invasive and nonspecific, especially in developing countries. The goal of primary prevention through immunization against human papillomavirus is with the use of quadrivalent vaccine genotypes 6, 11, 16 and 18 and bivalent genotypes 16 and 18, which are produced using recombinant technology. These are effective in patients without prior exposure to viral genotypes, mainly when they have not initiated sexual activity. Recommended ages are 9 to 13 years and vaccine is administered through school health centers or community centers who promote informational campaigns and dissemination aimed at parents who request this. Screening programs for cervical cancer are limited and only oncogenic virus immunization will reduce their frequency, saving the lives of hundreds of women worldwide.
Asunto(s)
Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus , Prevención Primaria , Neoplasias del Cuello Uterino/prevención & control , Neoplasias del Cuello Uterino/virología , Femenino , HumanosRESUMEN
ANECEDENTES El embarazo ectópico abdominal es raro; con baja incidencia y ausencia de sintomatología especifica que dificulta el diagnóstico y no existan criterios para el diagnóstico y tratamiento. OBJETIVO se presenta un caso de embarazo intra-ligamentario de 16 semanas de gestación y se hacer una revisión de la literatura sobre el manejo y comparación de los resultados. CASO CLÍNICO Mujer de 32 años de edad, gestas 3 partos 2; desconoce fecha de ultima menstruación; y control de la fertilidad con condón; acude por presentar dolor abdominal, sin datos de irritación peritoneal; se le realiza ultrasonido y se diagnostica embarazo de 16 semanas con muerte fetal; con sospecha embarazo abdominal; se realiza laparotomía exploradora para extracción fetal, dejando la placenta in situ, y manejo con metotrexate dejando la placenta in situ y egresado al tercer día sin complicaciones. CONCLUSIÓN el embarazo abdominal es raro, de difícil diagnostico; que requiere la extracción quirúrgica y dejar la placenta in situ y manejo adyuvante con metrotexate; reportándose buenos resultados; pero, existe escasa información sobre la fertilidad futura.
BACKGROUND The abdominal ectopic pregnancy is rare; with low incidence and absence of specific symptomatology diagnosis difficult and there are no criteria for the diagnosis and treatment. OBJECTIVE a case of intra-ligament 16 weeks of gestation pregnancy occurs and a review of literature on the handling and comparison of results is done. CASE REPORT Female 32 years old, deeds 3 births 2; known last menstrual period; and fertility control with a condom; comes because of abdominal pain without peritoneal irritation; Ultrasound was performed 16 weeks pregnant and diagnosed with fetal death; abdominal suspected pregnancy; laparotomy for fetal extraction is performed, leaving the placenta in situ, and leaving management methotrexate placental site and discharged on the third day uncomplicated. CONCLUSION abdominal pregnancy is rare, difficult to diagnose; requiring surgical removal and leave the spot and adjuvant use with methotrexate placenta; good results being reported; but there is little information on future fertility.