Anabolic agents to treat osteoporosis in older people: is there still place for fluoride? Fluoride for treating postmenopausal osteoporosis.
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Aged↗
Biomedical subjects
G Duque
Publications and source records attributed to G Duque.
Total Laparoscopic Hysterectomy
We analyzed our experience with laparoscopic hysterectomy and determined the most important factors that made it safe and reproducible. From January 1, 1994, to March 30, 1996, 68 laparoscopic hysterectomies were performed. The most frequent indication was uterine myomas. Average operating time decreased over the years from 6 hours in 1994 to 1.5 hours in 1996. The most important reasons for the long surgery time were surgeons' skills, uterine size, posterior wall leiomyomata, presence of adhesions, history of cesarean section, presence of deep infiltrating endometriosis with obliteration of the cul-de-sac, and equipment failure. We had no major intraoperative complications, except for a bladder injury in a woman who had had two cesarean sections, which was diagnosed and immediately repaired laparoscopically. Continuous training in endoscopic surgery, especially learning how to dissect the pelvic organs, the development of a trained team, adequate equipment, and appropriate patient selection were among the most important factors that allowed us to reach a safe level in performing this procedure.
Journal Article↗
Interferon alpha 2b as maintenance therapy in low grade malignant lymphoma improves duration of remission and survival.
We assessed the efficacy and toxicity of interferon alpha 2b (IFN) as maintenance therapy in patients with low grade malignant lymphoma. Between March 1986 and December 1989, 98 patients with low-grade malignant lymphoma in complete remission after conventional chemotherapy were randomly assigned to received IFN, 5.0 MU three times a week for one year, as maintenance therapy (n = 48), or to receive no treatment (control group, n = 50). In March 1994, the median duration of response had not yet been reached in the patients treated with IFN compared to 46 months in the control group. At 9-years 62% of the patients in the IFN arm remain in first complete remission compared to only 25% in the control group (p <.001). In addition, the median duration of survival has not yet been reached in either the IFN arm compared to 74 months in the control group (p <.001). Quality of life was excellent in both groups and severe side effects secondary to IFN treatment were not observed. All patients completed the planned dose of IFN. We conclude that IFN as maintenance therapy in low-grade malignant lymphoma is an excellent therapeutic option because it improves the duration of remission and survival without producing severe side effects or reducing the quality of life.
Adult↗
[Endoscopic surgery in ectopic pregnancy. Analysis of 105 cases].
A report on 105 cases of ectopic pregnancy resolved via endoscopy is presented. Surgical techniques for total salpingectomy (82), salpingotomy (11), tubal expression (6), partial salpingectomy (3), partial ooforectomy (2) and anexectomy (1) is described. The excellent postsurgical recovery and low incidence of complications are depicted, as well as the growing percentage of ectopic pregnancies resolved endoscopically in our Department.
Adult↗
[Danazol and its effect on bone and lipid metabolism in patients with endometriosis].
Danazol is a synthetic steroid, derived from 17-alpha ethinyltestosterone and it is used primarily in the treatment of endometriosis. It effectiveness is due to a reversible hypoestrogenic and hyperandrogenic state, which lead to atrophy of the ectopic endometrial tissue. A prospective study was undertaken in 14 women of child-bearing age with laparoscopically confirmed pelvic endometriosis to evaluate the alterations produced in bone and lipid metabolism after a six month treatment with Danazol. Laboratory evaluation included: bone mineral density, urine hydroxiproline/creatinine and calcium/creatinine ratios, lipid profile, bone isoenzyme of alkaline phosphatases and plasma estradiol. A significant decrease in plasma estradiol levels was observed (p < 0.001). Decrease in HDL cholesterol and increase in LDL cholesterol levels were statistically significant after 3 and 6 months of medication (p < 0.001), but the lipoproteins returned to normal levels three months after discontinuing Danazol. The bone isoenzyme of alkaline phosphatases showed a progressive increase (p < 0.001) and there were no significant variations in the hydroxyproline/creatinine and calcium/creatinine ratios. The osteodensitometry remained unchanged at 6 months of therapy. We conclude that, even though Danazol produces hypoestrogenism and hyperandrogenism, the markers of bone loss did not change, it has no negative effect on bone mineral density, and the transient worsening of the lipid profile that it causes is reversible on discontinuation of medication.
Adolescent↗
[Endoscopic surgery in gynecology. Our experience in total hysterectomy].
The first 44 cases of total hysterectomy by laparoscopy are presented. This experience was performed at the Catholic University Hospital and in the Las Condes Clinic. The authors describe the technique and the low rate of complications in the post-operative period.
Adult↗
[The ultrasonographic characteristics of the endometrium during the spontaneous ovulatory menstrual cycle].
Six hundred and four serial transvaginal sonograms were performed in 70 normal and healthy women throughout an ovulatory cycle. The endometrium was classified in 4 types (0, 1, 2 and 3) according to: the aspect of the myometria-endometrium and endometrium-endometrium interfaces, and the texture and thickness of the functional layer. Type 0 appears as a smooth, pencil line endometrium. Type 1 has a trilaminar structure with an iso or hypoechoic functional layer. Type 2 is also trilaminar, but myometria-endometrium interfaces are thicker than type 1. Type 3 appears as a thick and homogeneously echogenic image. The relative frequency of each type of endometrium was determined for every day of the menstrual cycle. Day 0 was defined sonographically as the day of follicle rupture. Type 0 was found during and immediately after menstruation. Type 1 was seen during mid-follicular phase and until day +2. Types 2 and 3 were observed post ovulatory in 100% of the cases. The endometrium increases in thickness more during preovulatory phase (mean: 5.5 mm), than in the luteal phase (mean: 2.6 mm). We conclude that this working classification of the endometrium is useful in clinical practice when associated to the ultrasonographic aspect of the ovaries and the moment of the menstrual cycle.
Adult↗
[Cervical and abdominal microbiology in infertile patients].
The microbiology of twenty-nine asymptomatic infertile women was evaluated prospectively. Samples were taken from the cervix and the endosalpinx during laparoscopy. Cultures for aerobes, anaerobes, Neisseria gonorrhoeae, Mycoplasma, Ureaplasma urealyticum and Chlamydia trachomatis were performed. No association was found between the presence of germs in the abdomen or cervix and tubal abnormalities. History of previous IUD use was associated with tubal disease.
Abdomen↗
[A laparoscopic approach to a paratyphoid ovarian abscess].
A case report of a 29-year-old nulligravid patient with a ovarian typhoid abscess managed endoscopically is presented. Puncture and drainage of the pelvic mass was performed laparoscopically. The infrequency of Salmonella paratyphi as an etiologic agent of pelvic inflammatory disease is discussed and a review of the literature regarding endoscopic management of purulent pelvic collections is presented.
Abscess↗
[Transabdominal cerclage in the treatment of cervical incompetence].
Six transabdominal cerclages in patients with cervical incompetence due to severe cervix damage or vaginal cerclage failure are presented. Results are discussed. In this series the salvage rate was 90%. For the first time in the literature a successful case of transabdominal cerclage in patient with a cervico-vaginal fistula is presented.
Adult↗
[Pregnancy in a patient with premature ovarian failure secondary to chemotherapy].
A 30 year old patient with idiopathic thrombocytosis received chemotherapy and developed amenorrhea and secondary ovarian failure. After discontinuation of chemotherapy, she became pregnant and recovered normal ovarian function 6 months after delivery.
Adult↗
[Gynecological endoscopic surgery. Surgical approach by laparoscopy].
We report the first 32 patients in whom surgical procedures were performed through laparoscopy. We practiced adhrenciolysis, biopsy and fenestration of cystic ovarian lesions, section of uterosacral ligaments as a treatment for pelvic pain, ovaric biopsies in cases of premature ovarian failure, fulguration of endometriotic implants, myomectomy, conservative management of an hemorrhagic corpus luteum, linear salpingostomy and total salpingectomy in ectopic pregnancy. The average operating time was 45 minutes, and the postoperative stay 28 hours. The only complication was active tubal bleeding in an ectopic pregnancy initially approached through linear salpingostomy, that required laparotomy. We describe the utilized technique, discussing the most frequent indications, and also, the basic elements necessary for performing laparoscopy surgery.
Adnexal Diseases↗
[Tubal pregnancy: surgical management by endoscopy].
We present the first 10 cases of ectopic pregnancy surgically resolved by laparoscopy. Tubal expression and aspiration was performed in 2 cases, linear salpingostomy in 2, and total salpingectomy in 6 cases. The procedure was successfully done in 9 cases, with an excellent postoperative evolution. The intrahospital permanence was brief (43 hours in average), and rejoining habitual activities was rapidly achieved. The only complication was a case of salpingostomy that required laparotomy due to active bleeding.
Adult↗