M García Manero

Universidad de Navarra, Iruña, Navarre, Spain

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Publications (39)38.59 Total impact

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    Manuel García Manero · Pedro Royo · Begoña Olartecoechea · Juan Luis Alcázar
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    ABSTRACT: The prevalence of pelvic endometriosis is high, affecting approximately 6% to 10% of women of reproductive age. Although endometriosis has been associated with the occurrence of menstrual cycles, it can affect between 2% to 5% of postmenopausal women. We present a case of ovarian endometriosis in a 62-year-old Spanish Caucasian woman with no previous use of hormonal therapy and no history of endometriosis or infertility. ALTHOUGH THE REPORTED SITUATION IS RARE, IT IS IMPORTANT TO BE AWARE OF ENDOMETRIOSIS AFTER THE MENOPAUSE: post-menopausal endometriosis confers a risk of recurrence and malignant transformation.
    Full-text · Article · Nov 2009 · Journal of Medical Case Reports
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    Manuel García Manero · Begoña Olartecoechea · Pedro Royo · Juan Luis Alcázar
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    ABSTRACT: Thrombospondin-1 serum levels is correlate with pelvic pain in patients with ovarian endometriosis. Thrombospondin-1 serum levels were prospectively analysed in 51 patients (group A asymptomatic patients or patients presenting mild dysmenorrhea and women comprised group B severe dysmenorrhea and/or chronic pelvic pain and/or dyspareunia) who underwent surgery for cystic ovarian endometriosis to asses whether a correlation exists among thrombospondin-1 serum levels and pelvic pain. From 56 patients, five cases were ultimately excluded, because the histological diagnosis was other than cystic ovarian endometriosis (2 teratomas and 3 haemorrhagic cysts). The mean thrombospondin-1 serum levels in group A was 256,69 pg/ml_+37,07 and in group B was 291,41 pg/ml + 35,59. Pain symptoms in ovarian endometriosis is not correlated with thrombospondin-1 serum levels.
    Full-text · Article · Nov 2009 · Journal of Ovarian Research
  • M García Manero
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    ABSTRACT: Endometriosis is a common gynaecological syndrome of unknown aetiology. The most widely accepted hypothesis for the development of endometriosis is retrograde menstruation. However, some other factor renders certain women susceptible to the implantation and growth of ectopic endometrium. Angiogenesis appears to be one of the process involved in the pathogenesis of endometriosis. Angiogenic factors are increased in the peritoneal fluid of patients with endometriosis in peritoneal implants and in ovarian endometriomas. We believe that the optimal serum marker should be used to monitor the response of new antiangiogenic agents in endometriosis treatment.
    No preview · Article · Jul 2009 · Revista de medicina de la Universidad de Navarra
  • B Olartecoechea · M García Manero · P Royo · M Aubà
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    ABSTRACT: Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induced a chronic inflammatory reaction. Endometriosis is associated with severe dysmenorrhea, deep dyspareunia, chronic pelvic pain, ovulation pain, cyclical, or perimenstrual symptoms, with or without abnormal bleeding, infertility, and chronic fatigue. Therapies can be useful to relieve and sometimes solve the symptoms, encourage fertility, eliminate endometrial lesions, and restore the anatomy of the pelvis. For medical therapy, several different preparations (oral contraceptives, progestogenics, gestrinone, danazol, and GnRHa) and new options (GnRH antagonists, aromatase inhibitors, estrogen receptor beta agoinist, progesterone receptor modulators, angiogenesis inhibitors, and COX-2 selective inhibitors) are available.
    No preview · Article · Jul 2009 · Revista de medicina de la Universidad de Navarra
  • M García Manero

    No preview · Article · Jul 2009 · Revista de medicina de la Universidad de Navarra
  • Manuel García Manero · Juan Luis Alcazar
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    ABSTRACT: To determine whether interleukin-8 (IL-8) serum levels are correlated with pelvic pain in patients with ovarian endometriomas. Prospective study. Tertiary-care university hospital. Interleukin-8 serum levels were prospectively analyzed in 51 patients (group A, asymptomatic patients or patients with mild dysmenorrhea; group B, severe dysmenorrhea and/or chronic pelvic pain and/or dyspareunia) who underwent surgery for cystic ovarian endometriosis to asses whether a correlation exists between IL-8 serum levels and pelvic pain. Interleukin-8 serum levels determination. Interleukin-8 serum levels and pelvic pain. From 56 patients, five cases were ultimately excluded because the histologic diagnosis was not cystic ovarian endometriosis (2 teratomas and 3 haemorragic cysts). The mean (+/-SD) IL-8 serum levels in group A were 6.41 +/- 12.17 pg/mL and in group B were 6.52 +/- 8.73 pg/mL. Pain symptoms in ovarian endometriosis is not correlated with IL-8 serum levels.
    No preview · Article · Jun 2009 · Fertility and sterility
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    ABSTRACT: The current knowledge status on the patogenesis of endometriosis as well as devastating consequences of disease evolution in women's reproductive health, have promoted researchers advances in a great manner during last years. The immunologic and neangiogenesis systems implication have opened new ways of knowledge over classic theories from the beginning of the xx century. The experimental resesearch, using animal induction models. Below we explain the first steps a new induction model ("PGR1-HotDog"), based on Wistar rats using a new disease autogeneration system, created for te study of the early stages of the endometriosis.
    Full-text · Article · Apr 2009 · Revista de medicina de la Universidad de Navarra
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    M García Manero · B Olartecoechea · P Royo Manero · M Aubá · G López
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    ABSTRACT: Endometriosis is a common gynaecological disease of unknown aetiology which affects an estimated 10% to 15% of all premenopausal women. It is defined as the presence of endometrial tissue, consisting of both glandular epithelium and stroma, outside the uterine cavity. Three different clinical entities of endometriosis can be distinguished: peritoneal endometriosis, ovarian endometriosis and deep invasive endometriosis. There are several theories to explain their pathogenesis: metaplasia of the mesothelium, in situ development of Müllerian remnants in the rectovaginal area (deep-invasive lesions) or retrograde transplantation of shed menstrual effluent (peritoneal implants). The most widely accepted hypothesis for the development of endometriosis is retrograde menstruation. However, some other factor renders certain women susceptible to the implantation and growth of this ectopic endometrium.
    Full-text · Article · Apr 2009 · Revista de medicina de la Universidad de Navarra
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    M García Manero · B Olartecoechea · M Aubá · J L Alcázar · G López
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    ABSTRACT: Endometriosis is a common gynaecological disease of unknown aetiology. Angiogenesis appears to be one of the processes involved in its pathogenesis. Angiogenic factors are increased in the peritoneal fluid of patients with endometriosis (McLaren 1996 et al; Taylor et al, 2002), in peritoneal implants (Ferriani et al, 1993) and in ovarian endometriomas. On the other hand, some researchers have found that angiogenesis is related to pelvic pain. We speculated that ovarian endometriomas in patients presenting with pelvic pain would be more angiogenic than those in asymptomatic women and that their vascular features would therefore be different.
    Preview · Article · Apr 2009 · Revista de medicina de la Universidad de Navarra
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    Pedro Royo · Manuel García Manero · Begoña Olartecoechea · Juan Luis Alcázar
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    ABSTRACT: An imaging diagnosis after an iterative cesarean delivery is reviewed demonstrating a fine ultrasound-pathologic correlation. A 33-year-old woman (G3, P3) presented referring intense dysmenorrhea and intermenstrual spotting since her third cesarean delivery, 1 year before. A cesarean section dehiscence with utero-peritoneal fistula was diagnosed by transvaginal ultrasound. We can conclude that transvaginal two-dimensional power Doppler and three-dimensional ultrasound are highly accurate in detecting cesarean section dehiscence and uterine fistula.
    Full-text · Article · Feb 2009 · Journal of Medical Case Reports
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    Full-text · Article · Jan 2009 · Donald School Journal of Ultrasound in Obstetrics and Gynecology
  • M García Manero · M Rodriguez Fraile · M Valero · J A Richter · G López
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    ABSTRACT: Although needle-wire localization is the most commonly used localization technique for nonpalpable breast lesion biopsy, the technique of radioguided occult lesion localization (ROLL), is becoming increasingly used for open-surgery diagnosis in such cases. Sentinel lymph node biopsy(SLNB) is based on the hypothesis that lymphatic drainage from a tumor reaches the sentinel node(SLN) first and that it can be identified accurately and removed. If SLN exactly reflects the lymph-node status, a negative SLN for metastasis might allow complete axillary lymph node dissection (ALDN) to be avoided.
    No preview · Article · Jan 2008 · Revista de medicina de la Universidad de Navarra
  • Manuel García Manero · Fernando Martínez Regueira

    No preview · Article · Jan 2008 · Revista de medicina de la Universidad de Navarra
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    ABSTRACT: La frecuencia de lesiones mamarias ha aumentado debido a los programas de screening poblacional con técnicas como la mamografía. Tradicionalmente, la localización de esas lesiones se ha realizado mediante la colocación de guías metálicas. En la actualidad, la cirugía radioguiada supone un avance en el tratamiento de dichas lesiones favoreciendo un mejor acceso a la lesión, disminuyendo la cantidad de tejido sano extirpado y en defi nitiva, logrando un resultado cosmético óptimo. La biopsia de ganglio centinela se encuadra dentro de las técnicas de cirugía radioguiada con exéresis del primer ganglio linfático que recibe el drenaje linfático de la glándula mamaria. El análisis intraoperatorio de dicho ganglio permite conocer la presencia o no de diseminación linfática y evita realizar linfadenectomías innecesarias.
    Preview · Article · Jan 2008
  • F M Regueira · N Rodríguez-Spiteri · M García Manero · G Zornoza
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    ABSTRACT: Adecuate surgical treatment is mandatory in order to achieve cure in patients with breast cancer. Breast surgeons have to choice the best surgical technique over the breast and over the axillary nodes. Two new surgical aproaches have been implemented in the last decade: oncoplastic conservative surgery and sentinel lymph node biopsy. Oncoplastic surgery provides oncologic safety results and good cosmetic outcome. In this paper the technical steps and indications of different oncoplastic techniques in conservative breast surgery are review. Concerning to axillary surgery sentinel lymph node biopsy is the gold standard. However there are several controversial points in sentinel node biopsy referring to indications, identification and histological findings.
    No preview · Article · Jan 2008 · Revista de medicina de la Universidad de Navarra
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    ABSTRACT: La asociación de cáncer de mama y embarazo se defi ne como la aparición de un tumor maligno mamario en la gestación o durante el primer año posparto. La frecuencia global oscila entre el 0.2 al 3.8% del total de los tumores malignos de la mama. El cáncer de mama se diagnostica, por término medio en 1 de cada 3000 gestaciones. Esta asociación plantea múltiples interrogantes y para su correcto tratamiento es necesario conocer una serie de aspectos generales, así como evaluar la repercusión que tienen los distintos esquemas de tratamiento oncológico sobre el embarazo y poder ofrecer secuencias terapéuticas aceptables y efi caces. A continuación se realiza una puesta al día de todos estos aspectos. As women in western countries delay childbearing, it has been hypothesized that the incidence of breast cancer diagnosed during pregnancy will increase. Breast carcinoma during pregnancy(BCP) put the health of the mother in confl ict with that of the fetus. The aim is to give optimal treatment to the mother to maximise the chances of survival, whilst minimising the risk of harm of the fetus. Few breast surgeons or oncologist develop expertise in this area owing the rarity of the association. We report the epidemiology, pathology, clinical picture, therapeutic management and fetal outcome of pregnant women with breast cancer treated in our institution.
    Preview · Article · Jan 2008
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    F M Regueira · N. Rodríguez-Spiteri · M. García Manero · G Zornoza
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    ABSTRACT: Adecuate surgical treatment is mandatory in order to achieve cure in patients with breast cancer. Breast surgeons have to choice the best surgical technique over the breast and over the axillary nodes. Two new surgical aproaches have been implemented in the last decade: oncoplastic conservative surgery and sentinel lymph node biopsy. Oncoplastic surgery provides oncologic safety results and good cosmetic outcome. In this paper the technical steps and indications of different oncoplastic techniques in conservative breast surgery are review. Concerning to axillary surgery sentinel lymph node biopsy is the gold standard. However there are several controversial points in sentinel node biopsy referring to indications, identifi cation and histological fi ndings. Un tratamiento quirúrgico correcto es imprescindible para conseguir la curación de las pacientes con cáncer de mama. El cirujano debe elegir la mejor cirugía tanto en la mama como en los ganglios axilares. En la última década se han incorporado dos nuevas técnicas quirúrgicas: la cirugía oncoplástica conservadora y la biopsia de ganglio centinela. La cirugía oncoplástica aporta seguridad oncológica y buen resultado estético. En este trabajo se revisan los pasos técnicos y las indicaciones de las diferentes técnicas oncoplásticas que se emplean en cirugía conservadora de mama. Respecto a la cirugía axilar, la biopsia de ganglio centinela es la técnica de elección actual. Sin embargo existen aspectos controvertidos en la biopsia del ganglio centinela respecto a indicaciones, técnicas de identifi cación y hallazgos histológicos.
    Full-text · Article · Jan 2008
  • M García Manero · G López García · L Pina Insausti · S Lizarraga
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    ABSTRACT: As women in western countries delay childbearing, it has been hypothesized that the incidence of breast cancer diagnosed during pregnancy will increase. Breast carcinoma during pregnancy(BCP) put the health of the mother in conflict with that of the fetus. The aim is to give optimal treatment to the mother to maximise the chances of survival, whilst minimising the risk of harm of the fetus. Few breast surgeons or oncologist develop expertise in this area owing the rarity of the association. We report the epidemiology, pathology, clinical picture, therapeutic management and fetal outcome of pregnant women with breast cancer treated in our institution.
    No preview · Article · Jan 2008 · Revista de medicina de la Universidad de Navarra
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    R. Galván · C. Laparte · M. García‐Manero · J. Mazaira · J. L. Alcazar

    Full-text · Article · Oct 2007 · Ultrasound in Obstetrics and Gynecology
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    ABSTRACT: Pheochromocytomas located outside the adrenal glands are called paragangliomas. Approximately 18% of pheochromocytomas are paragangliomas. A pelvic location is rare; the most common location is the retroperitoneal space, arising from neural crest cells. Paragangliomas are malignant in 29% to 40% of cases. There is a familial history in 30% of patients. The lesions are multiple in 30% of cases but in less than 5% of nonfamilial types. We present a case of pelvic paraganglioma and discuss its clinical presentation, its morphologic appearance (as seen on 3-dimensional [3D] power Doppler ultrasonography, magnetic resonance imaging [MRI], positron emission tomographic [PET] imaging, and [123I]metaiodobenzylguanidine [MIBG] scintigraphy), and its pathologic correlation. When a pheochromocytoma is suspected, one of these imaging techniques should be performed to localize the tumor and help plan surgical removal.
    Full-text · Article · Mar 2007 · Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine