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Biomedical subjects

J T Parente

Publications and source records attributed to J T Parente.

11 recordsLinked to original sources
PubMed1995

Uterine rupture in association with alkaloidal ("crack") cocaine abuse.

The use of alkaloidal ("crack") cocaine in pregnancy can result in systemic and focal vasoconstriction and abnormal uterine contractions forceful enough to cause the complete rupture of a gravid uterus along a previous vertical cesarean section scar. A 43-year-old woman was admitted to the emergency department with acute abdominal pain at 34 weeks' gestation. She had had a low vertical cesarean section 3 years previously for breech presentation with acute fetal distress at 28 weeks' gestation. The patient had a history of heavy "crack" abuse and admitted to inhaling "crack" throughout the day until 4 hours before admission. Within 15 minutes after presentation a laparotomy was performed, revealing an infant floating in the abdominal cavity. A live baby was promptly delivered, and the ruptured uterus was repaired. The patient was discharged 4 days post partum. "Crack" cocaine, through its known effects on the vasculature and contractility of the myometrium, likely facilitated the uterine rupture in this patient. The edges of the rupture wound were surprisingly clean, with little bleeding, perhaps owing to the drug's vasoconstrictive effects. It was therefore feasible to repair the uterus as an alternative approach to hysterectomy.

Adult↗
PubMed1995

Adjuvant surgical and hormonal treatment of leiomyomatosis peritonealis disseminata. A case report.

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition that usually presents during pregnancy or in women during the reproductive years and who are taking oral contraceptives. An unusual case of extensive LPD occurred in a 39-year-old woman who was not pregnant and had never taken oral contraceptives. The condition was treated successfully with total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, limited debulking and adjuvant hormonal therapy with megestrol acetate. Complete, rapid remission of residual tumor occurred in two months, as substantiated by clinical examination and serial sonography and laparoscopy. This is the first time that adjuvant hormonal therapy has been used successfully in the treatment of LPD. Radical surgery in patients with LPD is probably not indicated, and the use of adjuvant hormonal therapy may accelerate regression of residual tumor. Further evaluation of this form of therapy is recommended.

Adult↗
PubMed1988

Breast cancer associated with pregnancy.

Detection of breast tumors during pregnancy is difficult because of hormone-influenced tissue engorgement and the tendency to limit attention to the pregnancy itself. Eight cases of breast cancer during pregnancy were seen among 12,500 pregnancies in a five-year period. All diagnoses were confirmed by surgical biopsy. Five of the eight patients detected their own tumors. Two requested abortion, but prophylactic abortion did not appear to improve outcome in the one patient with advanced disease. Seven of eight patients were between 35-40 years of age. Although based on limited experience, a plan for managing breast cancer during pregnancy is suggested. It appears that a more favorable prognosis for cure and longer periods of remission can be achieved with better breast examinations, responsible screening techniques, early diagnosis, and prompt therapy.

Adult↗
PubMed1985

Testicular feminization syndrome. An unusual case with high estrogen levels.

In an unusual case of testicular feminization, the patient had a high estrogen and low testosterone level. The source of this female hormone excess may have been functioning gonadal stroma of either female or male derivation. All other aspects of the case were consistent with classic examples of the syndrome.

Adult↗
PubMed1983

Cervical pregnancy analysis: a review and report of five cases.

Five cases of cervical pregnancy are presented, with an incidence of 1:2400. Four of the cases, proved after hysterectomy and histopathologic confirmation, occurred in 1981. One was clinically most probable and was treated conservatively by curettage and packing. The distinction between proved and clinically probable cases of cervical pregnancy is defined. A review and analysis of the literature reveals an increasing incidence of cervical pregnancy. This may be due largely to increased numbers of induced abortions and sharp curetting. The maternal mortality rate has decreased from approximately 40 to 45% to zero in the past 30 years. Approximately 70% are treated necessarily by total hysterectomy. The remaining 30% are treated conservatively; however, ensuing pregnancies are rare in such women. Only three cases of pregnancy following probable cervical pregnancy have been reported. The last reported case was in 1953.

Abortion, Induced↗
PubMed1981

Carcinoembryonic antigen levels in the diagnosis of malignant lesions of the abdominopelvic region.

The differential diagnosis of tumors of the abdominopelvic region can be difficult. The inability to differentiate carcinoma of the colon and rectum from carcinoma of the ovary, in particular, may result in inadequate surgical procedures and unnecessary complications. In this study, elevated pretreatment levels of carcinoembryonic antigen were used as an aid in distinguishing between extragenital and gynecologic tumors in 76 women. Levels below 10 nanograms per milliliter suggested a malignant tumor of the female reproductive tract or benign disease; levels above 20 nanograms per milliliter indicated carcinoma of an extragenital organ. In addition to other diagnostic studies, pretreatment values of carcinoembryonic antigen may enable the physical to anticipate the specificity of the tumor and the scope of the surgical problem more precisely and, thus, be better able to prepare the patient for optimum treatment.

Adult↗