Papers by Francisco Garcia
Journal of Gynecologic Surgery, 2007
The aim of this study was to investigate the effects of preoperative massage on intra-and postope... more The aim of this study was to investigate the effects of preoperative massage on intra-and postoperative outcomes in 105 female subjects who had a laparoscopic gynecologic surgery procedure done. The subjects received a 30-minute massage (massage group) or 30 minutes of passive touch (control group). There was no difference between the groups in the average dose of inhaled anesthetics received. Patients in the massage group received significantly less intraoperative narcotics (2.2 ؎ 1.1 versus 2.8 ؎ 2.0 mcg of fentanyl/kg/hour). Patients in the massage group had significantly less postoperative anxiety (massage group, 9.83 ؎ 2.9 vs. control group 11.24 ؎ 3.6). The findings suggest that preoperative massage decreased intraoperative narcotic requirements and postoperative anxiety levels. (J GYNOL SURG 23:97) 97
Nutrition journal, 2005
Cancer chemoprevention is a new approach in cancer prevention, in which chemical agents are used ... more Cancer chemoprevention is a new approach in cancer prevention, in which chemical agents are used to prevent cancer in normal and/or high-risk populations. Although chemoprevention has shown promise in some epithelial cancers, currently available preventive agents are limited and the agents are costly, generally with side effects. Natural products, such as grape seed, green tea, and certain herbs have demonstrated anti-cancer effects. To find a natural product that can be used in chemoprevention of cancer, we tested Arizona cactus fruit solution, the aqueous extracts of cactus pear, for its anti-cancer effects in cultured cells and in an animal model. Aqueous extracts of cactus pear were used to treat immortalized ovarian and cervical epithelial cells, as well as ovarian, cervical, and bladder cancer cells. Aqueous extracts of cactus pear were used at six concentrations (0, 0.5, 1, 5, 10 or 25%) to treat cells for 1, 3, or 5 days. Growth inhibition, apoptosis induction, and cell cycl...
Gynecologic oncology, 2015
In 2011, the American Cancer Society, the American Society for Colposcopy and Cervical Pathology,... more In 2011, the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology updated screening guidelines for the early detection of cervical cancer and its precursors. Recommended screening strategies were cytology and cotesting (cytology in combination with hrHPV testing). These guidelines also addressed the use of hrHPV testing alone as a primary screening approach, which was not recommended for use at that time. There is now a growing body of evidence for screening with primary hrHPV testing, including a prospective US-based registration study. Thirteen experts including representatives from the Society of Gynecologic Oncology, American Society for Colposcopy and Cervical Pathology, American College of Obstetricians and Gynecologists, American Cancer Society, American Society of Cytopathology, College of American Pathologists, and the American Society for Clinical Pathology, convened to provide interim guidance...
Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology, 2002
To characterize nuclei from adenocarcinoma of the endometrium of different grades in order to est... more To characterize nuclei from adenocarcinoma of the endometrium of different grades in order to establish whether significantly different nuclear subpopulations exist. A total of 1,400 nuclei from 14 cases of adenocarcinoma of the endometrium of grades 1, 2 and 3 were recorded, and 600 nucleifrom normal, secretory phase glandular endometrial epithelium were used as a reference data set. Karyometric features were computed and a discriminant function derived to define a trend in feature values for nuclei from lesions of different grades. The nuclei from lesions of different grades were processed by a nonsupervised learning algorithm in an effort to detect and define subpopulations. Nuclei from grade 1 lesions represented a near-diploid stemline, whereas nuclei from grade 3 lesions formed an aneuploid set with a mode around 3N. The existence of three subpopulations with statistically different nuclear chromatin patterns could be shown for nuclei from each grade. In each grade these three...
Work (Reading, Mass.), 2013
The development and evaluation of Un Abrazo Para La Familia, [A Hug for the Family] is described.... more The development and evaluation of Un Abrazo Para La Familia, [A Hug for the Family] is described. Un Abrazo is discussed as an effective model of education, information-sharing, and skill-building for use with low-income co-survivors of cancer. Sixty co-survivors participated. The majority were women and all reported being Hispanic. Using quantitative data (N=60), the needs, concerns, and characteristics of the co-survivor population served through Un Abrazo are presented. Further, we offer three qualitative case studies (with one co-survivor, one survivor, and one non-participant) to illustrate the model and its impact. The median level of education level of co-survivors was 12 years. The majority were unemployed and/or identified as homemakers, and indicated receipt of services indicating low-income status. Half reported not having health insurance. The top four cancer-related needs or concerns were: Information, Concern for another person, Cost/health insurance, and Fears. Recogn...
Diagnostic and Therapeutic Endoscopy, 1997
Bowel injury is an uncommon but recognized risk of operative laparoscopy. Because of the signific... more Bowel injury is an uncommon but recognized risk of operative laparoscopy. Because of the significant morbidity that can occur with this complication, it is important that clinicians be aware of its incidence, presentation, and management. This manuscript outlines the common causes of bowel injury, including herniation and traumatic bowel perforation. Management of laparoscopic bowel injuries is discussed and recommendations are made for avoidance of such complications.
Journal of Maternal-Fetal and Neonatal Medicine, 1997
The purpose of our study was to determine if women with polycystic ovary syndrome are more likely... more The purpose of our study was to determine if women with polycystic ovary syndrome are more likely than other women with infertility to develop gestational diabetes. All women who were successfully treated for infertility in the reproductive endocrinology clinic at , were identified. A retrospective cohort study was performed comparing the incidence of gestational diabetes and abnormal diabetic screening tests among subjects with polycystic ovary syndrome (N ϭ 24) and a general infertility control group (N ϭ 44). The incidence of gestational diabetes diagnosed in subjects with a history of polycystic ovary disease was similar to the incidence of gestational diabetes in subjects with infertility not ascribed to polycystic ovary disease (four subjects, 16.7% v. three subjects, 6.7%; relative risk [RR] 2.05, 95% confidence interval [CI] 0.31-13.57). A greater number of subjects with polycystic ovary syndrome had a positive diabetic screening test compared to the control group (13 subjects, 54% v. 10 subjects, 23%; RR 2.44, 95% CI 1.26-4.71). Our study suggests that women with polycystic ovary syndrome are more likely to have a positive diabetic screening test, but no more likely to have gestational diabetes than other women with infertility.
Salud Pública de México, 2005
Dadas las ya conocidas dificultades para el funcionamiento efectivo del programa de detección med... more Dadas las ya conocidas dificultades para el funcionamiento efectivo del programa de detección mediante el Pap, tanto en México como en otros países, 11-13 en 1998 el Instituto Mexicano del Seguro Social (IMSS) puso en marcha un programa de detección usando la ...
Obstetrics and Gynecology Clinics of North America, 2007
Nearly all cervical cancers require human papillomavirus infection (HPV) for subsequent carcinoge... more Nearly all cervical cancers require human papillomavirus infection (HPV) for subsequent carcinogenesis. The identification of this obligate viral etiology, in addition to a vast knowledge about the HPV viral life cycle and resultant host response, has led to a vaccine approach to cervical cancer prevention. The use of prophylactic cancer vaccine as primary prevention holds the most promise for long-term cancer prevention but raises some important and as yet unanswered questions that are addressed in this article.
Obstetrics & Gynecology, 2001
To determine whether the academic affiliation and obstetric volume of the delivering hospital has... more To determine whether the academic affiliation and obstetric volume of the delivering hospital has an impact on clinical and economic outcomes. We performed a cross-sectional analysis of data for all births in the State of Maryland during 1996. Acute hospital discharge data were obtained from the publicly available Maryland Health Services Cost Review Commission database. Institutions were classified as community hospitals, community teaching hospitals, and academic medical centers. Principal outcome variables included cesarean birth and complication rates, total hospital charges, and length of stay. A total of 63,143 cases were identified for analysis. The cesarean delivery rate was lower among academic medical centers, compared with community teaching hospitals and community hospitals (18.4% compared with 24.3% and 21.2%, respectively). After adjustment for patient case-mix, the adjusted odds ratio (OR) for cesarean birth was 0.66 at academic medical centers and 1.23 at community teaching hospitals compared with community hospitals (P <.01). Rates of episiotomy and serious complications were lower at academic medical centers compared with community hospitals. Adjusted total hospital charges were lower and length of stay was shorter for community hospitals compared with academic medical centers ($2937 compared with $3564 and 2.2 days compared with 2.5 days, respectively). Hospital academic affiliation was an important predictor of clinical outcomes. Better clinical outcomes were found primarily among patients at academic medical centers, although these institutions demonstrated moderately higher resource utilization, compared with community hospitals.
Obstetrics & Gynecology, 1999
Obstetrics & Gynecology, 2000
Obstetrics & Gynecology, 2003
To compare the performance of patient- and physician-obtained cytology and human papillomavirus (... more To compare the performance of patient- and physician-obtained cytology and human papillomavirus (HPV) testing for the detection of high-grade cervical intraepithelial neoplasia. A cross-sectional study was performed involving 334 women seen at three colposcopy clinics (Tucson, Arizona; Hermosillo, Mexico; and Lima, Peru). All women used a cytobrush to self-collect specimens for cervical cytology and HPV testing. Subjects subsequently underwent physician collection for cytology and HPV, followed by a complete colposcopic evaluation with directed biopsy. Cytology was processed using thin-layer technology, and HPV was determined using the polymerase chain reaction technique. Test performance characteristics were determined using the histopathologic diagnosis as the reference standard and designating high-grade cervical intraepithelial neoplasia as clinically significant disease for the purpose of the analysis. The sensitivity of patient-collected cytology was significantly lower (55.0%) and specificity was significantly better (84.1%) than those of physician-directed sampling (85.2% and 73.4%, respectively). Patient-collected HPV had significantly lower sensitivity (49.0%) than physician sampling (82.2%), although specificity did not significantly differ. Patient collection is a feasible although inferior alternative to physician-collected cervical cytology and HPV testing.
Obstetrics & Gynecology, 2003
The Journal of the American Association of Gynecologic Laparoscopists, 1996
A 10-year-old girl was diagnosed with an 8-cm mature cystic teratoma. An outpatient ovary-conserv... more A 10-year-old girl was diagnosed with an 8-cm mature cystic teratoma. An outpatient ovary-conserving cystectomy was performed, and the girl recovered fully in 24 hours. We suggest that laparoscopy can be effective in the conservative management of some gynecologic disorders in properly selected children.
Journal of Lower Genital Tract Disease, 2007
The purpose of this study is to describe the expression of cyclooxygenase (COX) 2 cervical intrae... more The purpose of this study is to describe the expression of cyclooxygenase (COX) 2 cervical intraepithelial neoplasia (CIN) and vulvar cancer specimens. Archived tissues from 21 cases including 6 cases negative for CIN (no CIN), 71 low-grade (CIN 1) diseases, 8 high-grade (CIN 2, 3) diseases, and 14 vulvar cancer cases were examined. Immunohistochemistry was evaluated in COX-2 expression in tissue using an isoform-specific COX-2 polyclonal antibody. Specimens were assigned an immunohistochemical score for intensity of staining and the percent of cells stained. The slides were scored by 2 independent pathologists and compared across histological categories. A greater proportion of cells were stained in specimens with high-grade CIN (p = 0.01). Staining intensity was not statistically different among the 3 groups. Higher scores were found for vulvar cancer as compared with normal vulva (p = 0.01). The increase in COX-2 in cervical cancer precursors may provide a potential target for prevention studies.
Journal of Family Nursing, 2011
Although recent work has recognized that the influence and consequences of cancer extend beyond t... more Although recent work has recognized that the influence and consequences of cancer extend beyond the individual receiving the diagnosis, no studies have focused on the specific psychosocial intervention needs of female co-survivors in low-income populations. In this qualitative study, the cosurvivors, 16 women, representing 10 low-income families and predominately Hispanic, were interviewed about their experience of having someone in their family diagnosed with cancer. Several themes emerged from
Journal of Clinical Microbiology, 2006
We evaluated a commercialized PCR assay, Linear Array, that detects 37 human papillomavirus (HPV)... more We evaluated a commercialized PCR assay, Linear Array, that detects 37 human papillomavirus (HPV) genotypes, using a sample of liquid cytology specimens (n ؍ 534). We found a strong association of an increasing level of HPV risk (HPV type 16 [HPV16] > HPV18 > other carcinogenic types > noncarcinogenic types > negative specimens) with increasing severities of cytologic interpretations (P Trend < 0.0005) and histologic diagnoses (P Trend < 0.0005).
Journal of Clinical Microbiology, 2009
Results from a prototype real-time PCR assay that separately detected human papillomavirus genoty... more Results from a prototype real-time PCR assay that separately detected human papillomavirus genotype 16 (HPV16), HPV18, and 12 other carcinogenic HPV genotypes in aggregate (cobas 4800 HPV test) and results from a PCR assay that detects 37 HPV genotypes individually (Linear Array) were compared using a convenience sample of cervical specimens (n = 531). The percentage of total agreement between the two assays was 94.7% (95% confidence interval, 92.5 to 96.5%). The Linear Array test was more likely than cobas 4800 HPV test to test positive for the 12 other carcinogenic HPV genotypes among women without evidence of cervical disease (P = 0.004).
Journal of Adolescent Health, 2010
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Papers by Francisco Garcia