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Biomedical subjects

Eduardo Lara-Torre

Publications and source records attributed to Eduardo Lara-Torre.

17 recordsLinked to original sources
PubMed2005

Massive edema of the ovary: a case report and review of the pertinent literature.

BACKGROUND: Massive edema of the ovary is a rare entity affecting mainly young women. It is often misdiagnosed for a malignancy, posing the young patient at risk for over-treatment with resultant loss of hormonal function and fertility. CASE: A 13-year-old premenarchal girl presented with a large solid pelvic mass after recurrent episodes of self-limited abdominal pain. With a working diagnosis of malignant ovarian tumor, an exploratory laparotomy was done in which a twisted ovarian mass was found and excised completely. Pathological examination of the mass revealed massive edema of the ovary with hemorrhagic necrosis. CONCLUSION: After extensive review of the literature, it seems most cases were over-treated, as was ours. This entity should be suspected in women at the fertile age range with solid enlargement of the ovary and definite treatment should be undertaken only after confirmed pathological diagnosis. Conservative treatment is feasible and should be the rule in these cases, where fertility preservation is mandatory.

Abdominal Pain↗
PubMed2005

Müllerian agenesis and ovarian torsion. A case report and review of literature.

A case report of a premenarcheal patient with an ovarian torsion and müllerian agenesis is presented. An 11-year-old prepubertal girl presented with severe left lower quadrant abdominal pain and mild rebound. A computed tomography showed a normal appendix; an ultrasound showed a left ovary measuring 3 x 2 cm with multiple 0.5-mm simple cysts. A diagnostic laparoscopy showed the left ovary tube to be twisted, but the uterus was absent, and the right ovary and tube were not visualized in the appropriate location; instead, a right adnexal structure was buried in the right sidewall. The ovary was untwisted and fixed to the pelvic sidewall. Chromosomes were 46,XX, and her hormonal evaluation was normal. Ovarian torsion and müllerian agenesis are rarely reported. An association between the lax attachment of the adnexa and torsion may be a contributing factor in this condition.

Abdominal Pain↗
PubMed2004

Vulvar intraepithelial neoplasia in adolescents with abnormal Pap smear results: a series report.

OBJECTIVE: The objective of this study was to determine the prevalence of vulvar intraepithelial neoplasia (VIN) in adolescents presenting for cervical colposcopy in an adolescent gynecology office. MATERIALS AND METHODS: We conducted a retrospective chart review from 1999 to 2002 of the concomitant diagnosis of cervical intraepithelial neoplasia and VIN in our private general pediatric and adolescent practice in patients younger than 22 years of age who underwent cervical colposcopy as well as evaluation of the vulva secondary to gross and microscopic visualized lesions. RESULTS: Sixty-one patients underwent colposcopy for abnormal Pap smears; we found a 10% overall prevalence of vulvar intraepithelial neoplasia. Forty-four percent (n=27) underwent concomitant evaluation of the vulva; from these, 22% (n=6) fulfilled the characteristics of vulvar and cervical intraepithelial neoplasia. CONCLUSION: In the presence of cervical cytology abnormalities, VIN may be more common than recognized and careful screening is definitely warranted.

Adolescent↗
PubMed2004

Bone mineral density in adolescent females using depot medroxyprogesterone acetate.

STUDY OBJECTIVE: To examine bone mineral density (BMD) on a semi-annual basis among control subjects and adolescent females receiving depot medroxyprogesterone acetate (DMPA) injection or oral contraceptives. DESIGN: Non-randomized prospective study. SETTING: Teenage pregnancy prevention intervention clinic. PARTICIPANTS: Adolescent females who were new users of DMPA injection (N=58, age 12-21) or the oral contraceptive pill (N=71, age 11-19) and normal menstruating girls (N=19, age 15-18). INTERVENTIONS: Baseline and 6-monthly measures of lumbar vertebral BMD using dual-energy X-ray absorptiometry over a 2-year period. MAIN OUTCOME MEASURES: comparison of percent change on BMD over time between DMPA users, pill users, and normal menstruating girls. RESULTS: There was no difference on group characteristics at baseline except for the ethnicity between the controls and the DMPA group. There was a statistically significant decrease in BMD between DMPA users and controls at 6 months (-3.02% change, P=0.014) 12 months (-3.38% change, P=0.001) 18 months (-4.81% change, P<0.001) and 24 months (-6.81% change, P=0.010). There was no statistical difference between pill users and controls. CONCLUSION: There is a relationship between DMPA use and a decrease in BMD compared to normal menstruating controls that seems to persist up to 24 months.

Absorptiometry, Photon↗
PubMed2004

Premenarchal recurrent periclitoral abscess: a case report.

BACKGROUND: Periclitoral abscesses in premenarchal girls is a serious condition and can have negative implications for future reproductive health. Recurrent periclitoral abscess in premenarchal girls is rare. CASE: An 11-year-old, premenarchal girl presented complaining of dysuria, vulvar swelling, pain and erythema of the clitoral hood and a similar episode 12 months previously. Intravenous antibiotics and local measures resulted in spontaneous drainage of the abscess. On day 3 the area was healing, and the patient was discharged on oral antibiotics and sitz baths. At her 6-month follow-up, she had a normal clitoral hood without tenderness or erythema. CONCLUSION: Broad-spectrum antibiotics and local measures may prevent surgical treatment and potential associated reproductive morbidity.

Abscess↗
PubMed2003

Accuracy of detection of trichomonas vaginalis organisms on a liquid-based papanicolaou smear.

OBJECTIVE: The study was undertaken to determine the accuracy of the liquid-based Papanicolaou (Pap) smear in the detection of Trichomonas vaginalis organisms in women. STUDY DESIGN: Two hundred three consecutive patients who had the liquid-based Pap smear also underwent a culture for T vaginalis. A wet mount was performed if symptomatic. Results were analyzed for sensitivity, specificity, and positive and negative predictive values. RESULTS: Forty-four patients (21.6%) had a positive culture. On the liquid-based Pap smear, 28 patients (13.8%) were positive for T vaginalis, showing a sensitivity of 61.4%, a specificity of 99.4%, a positive predictive value of 96.4%, and a negative predictive value of 90.8%. When wet mount and culture were compared, a sensitivity of 50%, a specificity of 93%, a positive predictive value of 77%, and a negative predictive value of 80% were obtained. CONCLUSION: The presence of T vaginalis organisms, as stated by the liquid-based Pap smear pathology report, is accurate and warrants treatment without further testing.

Adult↗
PubMed2002

Adolescent compliance and side effects with Quick Start initiation of oral contraceptive pills.

Adolescents' compliance with use of oral contraceptive pills has been described in the literature. The purpose of this study was to compare traditional Sunday Start to a same day (Quick Start) approach. A retrospective study of patients 22 years of age and younger was performed comparing compliance at 3 months and 12 months and side effects. The groups were divided into Quick Start (N = 77, 40%) and Sunday Start (N = 116, 60%). One hundred twenty-five (65%) patients were compliant at 3 months; 68 patients (35%) were compliant at 12 months. Quick Start users were more likely to comply at 3 months (72% vs. 56%, p = 0.059), especially if they were Caucasian (80% vs. 65%, p = 0.007), with dysmenorrhea (86% vs. 62%, p = 0.006), nulligravid (77% vs. 58%, p = 0.008), or nulliparous (73% vs. 59%, p = 0.038). There was no difference in side effects. There was no significant difference at 1 year in compliance or side effects. Findings suggest better compliance in adolescents at 3 months with the Quick Start approach while maintaining side effect profile.

Adolescent↗
PubMed2002

Bilateral retinal occlusion progressing to long-lasting blindness in severe preeclampsia.

BACKGROUND: Temporary blindness in pregnancy associated with preeclampsia has been reported. Most cases have been attributed to cortical cerebral edema with transient vision impairment. We present a patient with bilateral retinal arteriole occlusions causing permanent blindness. CASE: A teenage primigravida at term presented with uterine contractions and preeclampsia. Twenty-four hours after delivery she developed sudden visual loss that progressed to total bilateral blindness. Imaging studies ruled out cerebral edema and an ophthalmologic examination found retinal hemorrhages and infarcts consistent with bilateral central retinal arteriole occlusions. At 2- and 6-month follow-up there was marked persistent visual impairment. CONCLUSION: The combination of blindness and preeclampsia is rare. Evaluation for ophthalmologic findings should be part of the initial patient assessment with preeclampsia.

Adolescent↗
PubMed2002

Viable intrauterine pregnancy with acute salpingitis progressing to septic abortion. A case report.

BACKGROUND: A viable intrauterine pregnancy with salpingitis has been reported rarely. CASE: A 27-year-old woman at 10 weeks' gestation developed abdominal pain, fever, leukocytosis, peritoneal signs, closed cervix and a viable pregnancy. Progression from acute salpingitis to septic abortion was documented. CONCLUSION: Acute salpingitis in the presence of a viable pregnancy warrants aggressive intervention.

Abdominal Pain↗