Anatomic dissections at the post-training level.
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Anatomy↗
Biomedical subjects
M Gamboa
Publications and source records attributed to M Gamboa.
Treatment of breast cancer by radical surgery: a personal experience of 653 patients with minimal follow-up of 10 years.
From June 1952 through December 1976, 695 radical operations were performed on 653 women suffering from invasive cancer of the breast. All operations were performed by a single surgeon (E.C.); the same principles in the selection of the patient techniques of surgery and overall treatment were practiced. Postoperative radiation therapy was used only in the beginning of the study, and 56 (15.9%) of the group with axillary metastases received such therapy. No patient with negative axillary lymph node received radiation therapy. No postoperative adjuvant chemotherapy or immunotherapy was administered. Complete follow-up data were obtained in 94.7% of all patients. In accord with the UICC clinical classification, 96 were classified as stage I (14.7%), 445 as stage II (68.1%), and 111 as stage III (17.%); 1 (0.1%) was not classified. From the 653 patients, 651 (two postoperative deaths) were observed for an average of 141.9 months. The longest period of follow-up evaluation for any patient was more than 35 years and the minimum, 10 years. Survival was calculated for the entire study group and for patients classified by nodal status and stage of disease. The 10-year overall survival rate for 651 patients is 60.4%; for those with positive nodes 46.4%, and for those with negative nodes, 76.7%. The overall survival, according to clinical stage, was as follows: the 5-year survival for patients in stage I was 89.5%, and the 10-year survival was 83.1%. In the stage II group, the 5-year survival was 76.1% and the 10-year survival, 58.5%. The patients in stage III had only a 62.1% 5-year survival and a 47.7% 10-year survival.
Adult↗
Two years of cyclophosphamide and 5-fluorouracil as adjuvant chemotherapy for stage II and III breast carcinoma.
The results after 6 years of a prospective clinical trial of adjuvant chemotherapy with a regimen of two drugs--cyclophosphamide and 5-fluorouracil (CF)-- for 2 years in 97 women with stage II or III breast cancer are reported. Eligible patients were free from distant metastases. All patients began adjuvant therapy within 4 weeks of surgery; therapy consisted of radical, modified, or extended radical mastectomy. No postoperative radiotherapy was given. The results are compared with a historical control group from previous consecutive patients treated by surgery alone. Patients were stratified by age (younger than 50 or older than or equal to 50) and nodal status (one to three positive axillary nodes vs. four or more positive nodes). The estimated 6-year survival was 60% for CF patients vs. 31% for control patients (P = 0.001). The estimated 6-year disease-free survival was 53.6 and 30.3% for CF and control, respectively (P = 0.007). There was a trend toward longer disease-free survival (DFS) and survival (S) in patients treated with CF, but this was not significant in all the subgroups. Disease-free survival was statistically significant in the subgroup of women greater than or equal to 50 years old with one to three positive nodes (P = 0.038); survival in the patients less than or equal to 49 years old with four or more positive nodes (P = 0.0036); and in patients greater than or equal to 50 years old with one to three lymph nodes involvement (P = 0.038).
Adult↗
Epidemiological aspects of Clostridium difficile in a pediatric hospital and its role in diarrheal disease.
The influence of antibiotics on the frequency of colonization by Clostridium difficile and the presence of its cytotoxin in infants and older children was examined to determine its role in diarrheal disease. Cytotoxin was more closely associated with cases of diarrhea, both in infants and in children than the microorganism, although not significantly. The isolates were typed by means of sensitivity to bacteriophages and bacteriocins and their cytotoxigenic potential was also determined. Less than 30% of the colonized patients had toxigenic strains. A study of strain variability over a four-year period in the same hospital showed that two bacteriophage-bacteriocin types and non-toxigenic strains predominated. The common presence of non-toxigenic strains could explain in part the lack of correlation between isolation of Clostridium difficile and diarrhea. Most of the non-toxigenic strains showed moderate resistance to tetracycline, a property which might explain their ability to persist for long periods in the hospital.
Adolescent↗