Search PubMed⌕ Search

Biomedical subjects

A Antsaklis

Publications and source records attributed to A Antsaklis.

At least 55 records · Page 3Linked to original sources
PubMed1997

Percutaneous management of lymphocoeles following pelvic lymphadenectomy for cervical carcinoma.

Eighteen patients with 26 pelvic lymphocoeles following radical hysterectomy underwent percutaneous therapeutic intervention with either needle aspiration, or catheter drainage. In eight patients a percutaneous needle aspiration under sonographic control was performed. Five out of eight patients were successfully managed with needle aspiration, three of them requiring repetitive aspirations. Thirteen patients, with a total of 21 lymphocoeles underwent catheter drainage. Seventeen of the 21 lymphocoeles completely resolved. Redrainage was performed in four cases and it was successful in two of them. The duration of the catheter drainage was 8 to 34 days. Nine of the lymphocoeles were infected at initial drainage. Two patients underwent surgery because of increased volume of output. Percutaneous drainage is a safe and effective method and should be considered as the initial treatment for all patients with postoperative lymphocoeles.

Journal Article↗
PubMed1995

Comparison of intrapartum electronic fetal heart rate monitoring versus intermittent auscultation in detecting fetal acidemia at birth.

OBJECTIVE: Our purpose was to compare continuous intrapartum electronic fetal heart rate monitoring with intermittent auscultation for detecting fetal acidemia at birth. STUDY DESIGN: Data from a previously published randomized trial of electronic fetal heart rate monitoring versus intermittent auscultation were analyzed to identify any differences between the two methods in detecting fetal acidemia at birth. Fetal acidemia at birth was defined as the presence of cord blood arterial pH < 7.15. RESULTS: A total of 1419 patients with umbilical cord blood acid-base measurements were identified, 739 in the electronic FHR monitoring group and 680 in the auscultation group. Electronic FHR monitoring had significantly better sensitivity (97% vs 34%, p < 0.001), lower specificity (84% vs 91%, p < 0.001), higher positive predictive value (37% vs 22%, p < 0.05), and higher negative predictive value (99.5% vs 95%, p < 0.001) in detecting fetal acidemia at birth. In addition, electronic FHR monitoring was significantly better in detecting all types of acidemia: metabolic (95.5% vs 26.5%, p < 0.001), mixed (95% vs 37.5%, p < 0.001), and respiratory (100% vs 41.5%, p < 0.001). CONCLUSION: These data suggest that electronic FHR monitoring is superior to intermittent auscultation in detecting fetal acidemia at birth.

Acidosis↗
PubMed1995

Successful use of recombinant human erythropoietin in a pregnant woman with lupus nephritis.

Recombinant human erythropoietin (r-HuEPO) is broadly accepted as treatment for anemia in dialysis and nondialysis patients with chronic renal failure, but data regarding the safety and efficacy of this drug in pregnancy are limited. Maternal and fetal problems have been reported to be associated with anemia during pregnancy. On the other hand, anemia is a frequent feature of systemic lupus erythematosus. We report the successful use of r-HuEPO in a young woman with lupus nephritis complicated by severe anemia during pregnancy. Additional studies should be encouraged to confirm the safety of r-HuEPO therapy during pregnancy.

Adult↗
PubMed1995

Endothelin 1-21 plasma levels in fetuses at 18-24 weeks of gestation.

This study aimed to establish normal endothelin (ET) ranges in non malformed appropriate for gestational age fetuses of 18-24 weeks gestation and to investigate a possible correlation between maternal and fetal ET plasma levels. Twenty "mother-fetus" pairs were included in the study. The determination of ET 1-21 was performed by radioimmunoassay using 1 ml of fetal blood obtained by cordocentesis--indicated for various reasons--and in 2 ml of maternal venous blood. The statistical analysis involved the Wilcoxon test for pair differences and the Spearman rank correlation coefficient. Fetal and maternal ET 1-21 levels were respectively 11.39 +/- 2.22 pmol/L and 6.44 +/- 1.00 pmol/L. Fetal levels were significantly higher (p < 0.01) thus excluding passive ET transfer through the placenta, while no correlation between maternal and fetal levels was found. It is speculated that high fetal ET 1-21 levels result from increased ET production, which possess cell proliferative properties and/or decreased ET removal from the fetal circulation because of hypofunctioning lungs and kidneys. It can be assumed that the increased amounts of fetal ETs contribute to normal growth and development directly as well as by regulating vascular tonus and local blood flow.

Adolescent↗
PubMed1993

A randomized trial of intrapartum electronic fetal heart rate monitoring versus intermittent auscultation.

OBJECTIVE: To determine whether continuous intrapartum electronic fetal heart rate monitoring (EFM) is associated with decreased perinatal mortality and morbidity compared with intermittent auscultation. METHODS: The study was conducted simultaneously at two university hospitals in Athens, Greece (Alexandra and Marika Iliadi Hospitals) from October 1, 1990 to June 30, 1991. All patients with singleton living fetuses and gestational ages of 26 weeks or greater were eligible for inclusion. The participants were assigned to continuous EFM or intermittent auscultation based on the flip of a coin. Both groups were followed during labor according to the most recent ACOG guidelines. However, fetal scalp blood pH and crossover from one group to the other were not used. RESULTS: A total of 1428 patients were included, 746 in the EFM group and 682 in the auscultation group. There were no differences between the groups in terms of maternal age, gravidity, parity, gestational age, and number of antepartum high-risk factors. More patients monitored electronically received oxytocin for either augmentation (52.4 versus 38.1%; P = .0001) or induction (15.6 versus 7%; P = .0001). The length of labor was longer in the EFM group (first stage 6.1 +/- 4.3 versus 5.5 +/- 3.7 hours; P = .006; second stage 29.4 +/- 18.6 versus 26.9 +/- 16.9 minutes; P = .01). There was a higher incidence of nonreassuring fetal heart rate patterns in the EFM group (23.4 versus 10.7%; P = .0001) and a higher rate of surgical intervention (11.2 versus 4.8%; P = .0001). This difference pertained to both vacuum extraction (5.8 versus 2.4%; P = .002) and cesarean delivery for suspected fetal distress (5.3 versus 2.3%; P = .005). There were no differences in 1- and 5-minute Apgar scores, fetal acidosis at birth, need for neonatal resuscitation, neonatal intensive care unit admission, use of assisted ventilation, neonatal hospital stay, or any other neonatal complications. Two neonatal deaths occurred in the EFM group and nine perinatal deaths in the auscultation group (two intrapartum and seven neonatal deaths). The perinatal mortality rates were 2.6 per 1000 and 13 per 1000 total births, respectively (P = .04). The two deaths in the EFM group and three of the neonatal deaths in the auscultation group may not have been prevented by intrapartum monitoring; however, four neonatal deaths from the auscultation group occurred in depressed (5-minute Apgar scores less than 7), acidotic (cord artery pH at or below 7.13) infants. The perinatal death rate related to fetal hypoxia was significantly less in the EFM group (zero of 746 versus six of 682; P = .03). CONCLUSION: In this controlled trial, intrapartum EFM, as the primary and only method of intrapartum fetal surveillance, was associated with decreased perinatal mortality due to fetal hypoxia but also with higher rates of surgical intervention for suspected fetal distress.

Adult↗
PubMed1992

Diet, pregnancy estrogens and their possible relevance to cancer risk in the offspring.

Total estrogens, estradiol and estriol were determined by radioimmunoassay in the blood of 141 pregnant women during their 26th and 31st weeks of pregnancy, and the results were correlated with dietary patterns and nutrient intakes during pregnancy, assessed through a semiquantitative food frequency questionnaire. No food group or nutrient showed a significant (p less than 0.05) association with any of the examined hormones at both the 26th and the 31st week of pregnancy. Relatively more consistent were a positive association between consumption of starchy roots (potatoes) and all the indicated hormones, and a negative association between vitamin A and estradiol and total estrogens; however, the multitude of comparisons hinders a biologic interpretation at this time. There was suggestive evidence that weight gain up to the 31st week of pregnancy was positively associated with both total estrogens (p = 0.09) and estradiol (p = 0.11). The present study has limitations reflecting the relatively small sample size and the problems inherent in epidemiologic methods assessing nutritional intakes. However, the findings suggest that quantitative aspects of diet, as reflected in pregnancy weight gain, may be more important than dietary composition in influencing levels of pregnancy estrogens and in affecting the occurrence of gonadal germ cell tumors and other conditions that may be associated with them.

Body Weight↗
PubMed1991

Invasive techniques for fetal diagnosis in multiple pregnancy.

During a 12-year period, a variety of fetal diagnostic techniques were performed in 112 twin, 3 triplet and 1 quintuplet pregnancies, respectively. Tissues sampled included amniotic fluid, fetal blood and chorionic villi. Two spontaneous abortions occurred and one case of twins was stillborn. Four selective feticides were performed in twins for specific indications and four healthy surviving infants were delivered. It is concluded that fetal diagnosis in multiple pregnancy is safe and accurate without significant perinatal morbidity and mortality.

Female↗
PubMed1990

The validity of gynecological ultrasonography.

The present study was undertaken to examine the reliability of the sonographic diagnosis in 705 gynecological patients. The determination of the lesions was defined according to the operative diagnosis. The sensitivity, specificity and positive predictive value of the ultrasound technique were evaluated using the surgical findings as 'gold standard'. In 631 patients (89.5%) the ultrasound examination established a correct diagnosis. The sensitivity and specificity of the ultrasound examination varied between 75-95.3% and 93.3-100%, respectively. The positive predictive value was found between 89.7 and 100%, while the false sonographic results were 10.4%, which included those of ectopic pregnancies. It is thus concluded that ultrasonography as compared to the surgical findings has proved to be of great value in establishing a gynecological diagnosis.

Adnexal Diseases↗
PubMed1987

Prenatal diagnosis of chromosomal abnormalities from chorionic biopsy samples: improved success rate using a modified direct method.

Several methods for fetal chromosome analysis using chorionic biopsy samples were compared. A modified direct method for culturing villi was considered to be the method of choice and details are presented of 186 pregnancies tested prenatally. The success rate in obtaining a fetal karyotype with the direct method was 93 per cent. The fetal loss rate in the prenatal series was 4.3 per cent and congenital abnormalities in the babies already born did not differ from the expected incidence.

Adult↗
PubMed1983

A study of cefoxitin, moxalactam, and ceftazidime kinetics in pregnancy.

In 27 women with fetuses affected by beta-thalassemia major, termination of gestation between 19 and 21 weeks was induced by amniocentesis and intrauterine instillation of prostaglandin F2 alpha. Pharmacokinetics in maternal blood and amniotic fluid were studied after at least three doses of one of the following antibiotics and before prostaglandin F2 alpha infusion: (1) cefoxitin, 2 gm, intravenously, 1/2-hour infusion, three times per day; (2) moxalactam, 2 gm, intravenously, 1/2-hour infusion, three times per day; and (3) ceftazidime, 1 gm, intramuscularly, three times per day. Successful amniotic fluid levels effective against various pathogens implicated in maternal-fetal infections appeared at least 3 hours beyond administration of the drug and ranged between 2.3 and 6.7 micrograms/ml, 1.56 and 15 micrograms/ml, and 1.5 and 5 micrograms/ml for cefoxitin, moxalactam, and ceftazidime, respectively. Beyond the third-hour after infusion a percentage ratio of amniotic fluid to simultaneous maternal serum level of almost greater than or equal to 50 was constantly observed for all studied antibiotics. Cefoxitin serum levels were about the same as those in nonpregnant women, while moxalactam and ceftazidime serum levels were 50% lower than the expected level in normal individuals.

Adult↗
PubMed1983

Prenatal diagnosis of hemoglobinopathies in twin pregnancies by double simultaneous fetoscopy.

A new technique for sampling fetal blood in twin pregnancies using two fetoscopes simultaneously is described. Two fetoscopes were inserted, one after the other, into both amniotic cavities and fetal blood samples were obtained from either the chorionic plate vessels or the umbilical cord insertion area. The observation of the bright tip of the second fetoscope behind the septum using the first fetoscope assured the successful entry of the two fetoscopes into the two different amniotic sacs. This technique was performed on 15 out of 17 patients. In all patients the fetuses were at risk of beta-thalassemia major. Sampling was successful in all cases. Double simultaneous fetoscopy seems to be a safe and accurate technique without technical problems or complications. The simultaneous use of two fetoscopes opens new possibilities in intrauterine fetal surgery and research.

Diseases in Twins↗
PubMed1982

Evaluation of diagnostic fetoscopy.

The authors evaluate the efficacy and safety of fetoscopy on a series of 510 patients in which the procedure was carried out between the 18th and 20th week of gestation in order to obtain a suitable fetal blood sample for prenatal genetic diagnosis; the whole pregnancy could be completely followed up in them. The complication rate was low (1.7%) when the first attempt of fetoscopy was successful, but rose dramatically up to 17.9% on repeated attempts: however, they only amounted to 7.8% of all cases. The results of their study lead the authors to propose fetoscopy as a powerful, accurate and safe addition to the presently available diagnostic methods, provided it is performed by well trained fetoscopists, under aseptic conditions and local anaesthesia.

Abortion, Therapeutic↗