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Biomedical subjects

N Vitoratos

Publications and source records attributed to N Vitoratos.

At least 37 records · Page 2Linked to original sources
PubMed2000

A randomized trial of pulsatile vs continuous oxytocin infusion for labor induction.

In a prospective randomized study, 560 pregnant women were subjected to labor induction with continuous or pulsed intravenous oxytocin infusion. There were no significant differences with respect to maternal history, Bishop score and perinatal morbidity. The mean induction to delivery interval was shorter in the pulsed infusion group than in the continuous infusion group (325 +/- 63 vs 433 +/- 67 min in primiparous, p < 0.001 and 204 +/- 52 vs 236 +/- 87 min in multiparous women, p < 0.01). The mean amount of oxytocin administered in the pulsed infusion group was also significantly lower than in the continuous infusion group (4.7 +/- 0.6 mU/min versus 9.6 +/- 3.4 mU/min in primiparous, p < 0.001 and 2.1 +/- 0.4 mU/min versus 5.2 +/- 2.3 mU/min in multiparous women, p < 0.001). Our study demonstrates that pulsatile administration of oxytocin is as safe as continuous intravenous infusion, requires less oxytocin and is more effective as it reduces labor duration.

Female↗
PubMed2000

Changes of glucose tolerance after delivery in women with gestational diabetes.

We investigated glucose tolerance after cesarean section in 24 women with gestational-onset diabetes (group A), in 18 women with an adverse pregnancy outcome (group B), and in 19 healthy pregnant women (group C). Glucose tolerance was performed within six days as well as six weeks after delivery. Eleven (45.8%) women in group A, five (27.8%) in group B and one (5.2%) in group C showed glucose intolerance immediately after delivery. Six weeks after delivery, 18 (75%) women in group. A showed normal glucose tolerance (NGT), four (16.6%) impaired glucose tolerance (IGT) and two (8.3%) diabetes according to WHO criteria. NGT showed 16 (88.8%) women in group B, and 19 (100%) in group C, while two (11.1%) women in group B presented with IGT. We conclude that a glucose tolerance test both immediately and six weeks after delivery is useful not only in women who have gestational diabetes but also in women with an adverse pregnancy outcome.

Adult↗
PubMed1999

Defective antioxidant mechanisms via changes in serum ceruloplasmin and total iron binding capacity of serum in women with pre-eclampsia.

OBJECTIVES: The aim of this study was to investigate the role of serum ceruloplasmin, its ferroxidase activity and total iron binding capacity in women with pre-eclampsia. METHODS: Thirty primigravidas between 32 and 36 weeks of gestation were studied. The subjects were divided into two groups: group A consisted of 15 normal pregnancies with a mean gestational age of 33.9 weeks, and group B consisted of 15 pre-eclamptics with a mean gestational age of 32.8 weeks. RESULTS: The pre-eclamptics presented significantly higher serum ceruloplasmin levels compared to those with normal pregnancies (P<0.01), while the mean ferroxidase activity levels of ceruloplasmin did not differ significantly between the two groups (450.13+/-110.88 and 467.26+/-135.35 micromol/l/min in groups A and B, respectively). The mean+/-S.D. serum iron level (104.48+/-39.81 microg/dl) was greater whereas the total iron binding capacity (55.59+/-8.47 micromol/l) was lower in women with preeclampsia when compared to normal pregnancies (P<0.01 and P<0.0001 respectively). CONCLUSIONS: Our results indicate that the plasma of pre-eclamptic women shows a loss of ferroxidase activity of ceruloplasmin as well as a reduction of total iron binding capacity. Thus, it seems that the plasma of pre-eclamptic women lacks the protective anti-oxidative action of these substances.

Adult↗
PubMed1999

Umbilical cord blood gas analysis in augmented labour.

Labour augmentation with oxytocin may produce an excessive increase in frequency, duration or strength in uterine contractions which may result in fetal stress. Umbilical cord acid-base assessment provides an objective parameter in evaluating the neonatal condition immediately after delivery. We evaluated the neonatal condition in 235 deliveries where oxytocin was used for labour augmentation. The umbilical cord blood acid-base status was correlated with intrapartum cardiotocographic findings and Apgar scores. In two cases we noted umbilical artery pH <7.05 but the BDecF was not higher than 11 mmol/l and the 5-minute Apgar score was 8 in all cases. Our results indicate that the use of oxytocin for labour augmentation had no adverse effects on neonatal condition.

Journal Article↗
PubMed1999

Evaluation of serum prolactin levels in patients with endometriosis and infertility.

The aim of this study was to clarify the significance of serum prolactin concentrations in patients with infertility and endometriosis. Forty patients with infertility and laparoscopically proven endometriosis were recruited into the study. Basal serum prolactin levels and prolactin levels after TRH administration were measured. The mean basal serum prolactin concentrations were 12.5, 16.5, 19.5, and 26.5 ng/ml and those after thyrotropin-releasing hormone (TRH) administration were 88.3, 114.2, 125.3 and 138.8 ng/ml in patients with stages I, II, III and IV endometriosis, respectively. A statistically significant relationship was found between the basal serum prolactin levels as well as those after TRH injection and the stage of the endometriosis. The patients were divided in two groups. Group I consisted of 20 patients who did not receive any treatment, while group II consisted of 20 patients who were initially treated with GnRH analogues for 24 week and subsequently with several therapeutic schemes in order to improve their fecundity. The pregnancy rate was not different between the two groups. The patients, however, who did not become pregnant had higher serum prolactin concentrations after TRH administration as compared to those who conceived. We conclude that occult hyperprolactinemia may be a cause of infertility in patients with endometriosis.

Adult↗
PubMed1999

Evaluation of fetal heart rate patterns during the second stage of labor through fetal oximetry.

The purpose of this study was to assess the feasibility and accuracy of fetal pulse oximetry during the second stage of labor in cases with abnormal fetal heart rate (FHR) patterns with reference to postpartum acid-base status and Apgar scores. Forty-eight parturients with normal and 20 parturients with abnormal FHR tracings during the second stage of labor were monitored by fetal pulse oximetry and postpartum umbilical artery pH, pO(2), pCO(2) values and 1- and 5-min Apgar scores. The mean SpO(2) value was 55. 47 +/- 9.95% in cases with normal and 52.55 +/- 16.42% in cases with abnormal FHR patterns. A significant correlation was noted between fetal SpO(2) and umbilical artery pH in cases with normal (r = 0.76, p < 0.05) as well as in cases with abnormal FHR patterns (r = 0.78, p < 0.05). No significant correlation was found between fetal SpO(2) and Apgar scores at 1 and 5 min in cases with normal FHR patterns. On the contrary a significant correlation was noted in cases with abnormal FHR patterns. A normal FHR pattern alone is reassuring. In cases with abnormal FHR, fetal pulse oximetry is an objective method for distinguishing a hypoxic fetus.

Apgar Score↗
PubMed1998

Role of serum ceruloplasmin and its ferroxidase activity on preterm labor.

The role of serum ceruloplasmin and its ferroxidase activity on preterm labor with or without rupture of the membranes was studied. Thirty-seven primigravid women between 31 and 35 weeks of gestation were investigated. Our material is divided into 3 groups. Group A consisted of 12 patients with premature rupture of the membranes; group B consisted of 10 patients with preterm labor but intact membranes, and group C consisted of 15 non-laboring patients. Patients with rupture of the membranes presented with statistically significantly higher serum ceruloplasmin levels compared to those with preterm labor but intact membranes (p < 0.05) as well as to non-laboring patients (p < 0.01). On the contrary, the mean ferroxidase activity level or ceruloplasmin was 518.2+/-183.42, 460.9+/-198.8 and 517.5+/-142.01 micromol/l/min in groups A, B and C, respectively. These values were not significantly different. Our results show a loss of ferroxidase activity of ceruloplasmin in patients with rupture of the membranes and probably suggest a defect in the maternal defense mechanisms.

Adult↗
PubMed1998

Clinical value of creatinine kinase in the diagnosis of ectopic pregnancy.

The role of creatinine kinase (CK) in the diagnosis of ectopic pregnancy was studied. We selected 56 patients divided into 4 groups. Group A consisted of 10 patients with asymptomatic tubal pregnancy, group B consisted of 11 patients with symptomatic tubal pregnancy whereas groups C and D consisted of 20 and 15 patients with normal and threatened intrauterine pregnancy, respectively. Serum samples of CK were taken from all patients on admission. No significant difference was observed in the median CK value of cases with normal pregnancy (58.5 +/- 7.24 U/1, mean +/- SE) as well as threatened abortion (73 +/- 11.43 U/1) compared to that of cases with asymptomatic 58.5 +/- 12.42 U/1) or symptomatic tubal pregnancy (59 +/- 10.08 U/1). We conclude that serum CK is not a useful biochemical marker in the diagnosis of ectopic pregnancy.

Abortion, Threatened↗
PubMed1998

Evaluation of ovarian cysts following GnRH-a treatment in patients with polycystic ovarian syndrome.

The aim of this study was to evaluate the ovarian cysts appearing during GnRH-a/hMG treatment in patients with polycystic ovarian syndrome (PCOS). A total of 35 women with PCOS were included in the study. All women received 3.75 mg IM of long-acting leuprolide acetate on the first day of the menstrual cycle. On the 15th day of the menstrual cycle, transvaginal ultrasound examination (US) and determination of serum E2 were done. A total of 90 cycles were studied in this way and during these cycles, 14 (15.5%) ovarian cysts with a diameter of >/= 20 mm developed. According to the serum E2 levels, 11 cases (group A) had E2 concentrations > 35 pg/ml and 3 (group B) had serum E2 levels < 35 pg/ml. Group A patients attained a significantly larger mean size of ovarian cyst than group B patients (42 +/- 7.3 vs. 24.2 +/- 3.2 mm, p < 0.001). When the serum E2 concentrations were < 35 pg/ml, the ovarian cysts were disregarded and ovarian stimulation with gonadotropins was initiated. In case that serum E2 levels were > 35 pg/ml, the initiation of the ovarian stimulation with hMG was postponed until serum E2 levels indicated down-regulation, which was achieved after 5.8 +/- 2.9 days. In both groups the ovarian stimulation resulted in ovulatory cycles, while four pregnancies in group A and one in group B were achieved. In conclusion, our results indicate that in patients with PCOS the GnRH-a administration may cause follicular cysts at an incidence of 15.5%. These cysts do not constitute a contraindication for ovarian stimulation provided that serum E2 levels are low.

Adult↗
PubMed1998

Intrapartum vibratory acoustic stimulation after maternal meperidine administration.

OBJECTIVE: To examine the effectiveness of the acoustic stimulation test in the interpretation of suspicious cardiotocograms obtained after meperidine administration to the mother during the first stage of labor. SUBJECTS AND METHODS: We studied 45 unselected parturients who received 50 mg meperidine i.m. when cervical dilatation was 5 cm. In all cases a decreased beat-to-beat variability of the fetal heart rate and fetal movements was noted after the injection of meperidine. A vibratory acoustic stimulation was performed in 25 patients (group A) while the remaining 20 (group B) had no stimulation. RESULTS: After the meperidine injection, the acoustic-induced reactivity returned immediately in group A, while the spontaneous reactivity returned 30 minutes later. The mean number of fetal movements in all parturients was 8.71 +/- 2.18 before meperidine administration. Sixty minutes after the meperidine injection the mean number was 8.52 +/- 2.48 in group A and 1.65 +/- 1.81 in group B (p < 0.0001). CONCLUSION: The acoustic stimulation test is an effective method of interpreting suspicions CTG's obtained after meperidine administration to the mother during the first stage of labour.

Acoustic Stimulation↗
PubMed1997

Effects of nasal administration of calcitonin in oophorectomized women: 2-year controlled double-blind study.

OBJECTIVE: The aim of this study was to assess the effects of nasal salmon calcitonin (SCT) administration on bone turnover in ovariectomized women. METHODS: Patients who had undergone bilateral ovariectomy 7 days previously, received either calcium supplementation (1000 mg/day, together with nasal SCT (100 IU/day) (n = 19) or the same calcium supplementation together with a placebo intranasal spray daily (n = 19), for 2 years. RESULTS: In the calcium-only-treated subjects, lumbar bone mineral density (BMD) was found to have decreased significantly (P < 0.001), 6 months after surgery and remained at this level until the end of the study. In the SCT-treated group, BMD remained stable during the 1st year and then decreased gradually, reaching a statistically significant level in the 2nd year. Mean serum osteocalcin concentration was unchanged during the 1st year of SCT treatment but was significantly elevated during the 2nd year (P < 0.01). The observed rise in serum osteocalcin concentration and urinary hydroxyproline excretion during the 2nd year of treatment with SCT was accompanied by a significant rise in serum calcitonin levels (P < 0.001 after 18 months and P < 0.01 after 24 months). CONCLUSION: This study shows that continuous treatment with intranasal SCT is able to prevent the bone loss that follows ovariectomy.

Administration, Intranasal↗
PubMed1997

The effect of early second stage bradycardia on newborn status.

In the present study 45 patients with intrapartum cardiotocograms showing prolonged fetal bradycardia during the early second stage of labor were included. Bradycardia persisted for 180 s or more with either rapid or prolonged return to baseline, without loss of variability and rise of baseline fetal heart rate (FHR). The mean duration of bradycardia was 5.0 +/- 1.3 min. In the group with normal FHR tracings the rate of normal delivery (73.3%) was significantly higher than that of the group with fetal bradycardia (26.7%, P < 0.0001). We also noted a significantly higher rate of cesarean section (44.4%) in patients with abnormal FHR tracings, compared to that (11.1%) of parturients with normal FHR tracings (P < 0.001). In all cases blood samples were obtained from the umbilical cord artery, immediately after delivery. Only in two cases with abnormal FHR tracing umbilical cord artery was the pH less than 7.20. We conclude that in most cases, prolonged fetal bradycardia in the early second stage with the characteristics described above is well tolerated by a mature fetus.

Adult↗
PubMed1997

Vaginal ultrasound of the endometrium in postmenopausal women with symptoms of urogenital atrophy on low-dose estrogen or tibolone treatment: a comparison.

OBJECTIVE: The objective of this study was to compare the efficacy of locally administered low-dose estrogens (0.625 mg of conjugated estrogens) and orally administered tibolone in postmenopausal women with symptoms and signs of atrophic vaginitis. Vaginal ultrasound was performed for the evaluation of endometrial or ovarian abnormalities. METHODS: A 6-month comparative randomised prospective study of women taking tibolone and locally administered low-dose estrogens. Seventy two postmenopausal women with symptoms of atrophic vaginitis were examined with vaginal ultrasound. The endometrial thickness, the endometrial volume, the uterus and the ovaries were measured before and after 6 months of treatment with low-dose estrogens or tibolone. RESULTS: In group A (low-dose estrogens treatment) the mean endometrial thickness, before and after treatment, was 3.0 +/- 0.1 mm and 2.9 +/- 0.8 mm, respectively. The mean ovarian volume was 3.9 ml. There were no changes in uterine volume during the treatment period. In group B (treated with tibolone) endometrial thickness was 3.2 +/- 0.3 mm and 3.2 +/- 0.7 mm, respectively. One women experienced vaginal bleeding. The volume of corpus uteri was unchanged after treatment. The volume of both ovaries was 4.2 ml and 3.9 ml, respectively. The overall acceptability of both types of administration was good. CONCLUSIONS: This study, using vaginal ultrasound, has shown that either hormone replacement therapy with tibolone or symptomatic treatment with low-dose estrogens, gives no sign of endometrial proliferation measured as endometrial thickness.

Administration, Intravaginal↗
PubMed1997

Effect of tibolone on postmenopausal women with myomas.

OBJECTIVE: The aim of this study is to assess the effect of Tibolone (Livial) on uterine fibroids in postmenopausal women. METHODS: This study included 40 naturally postmenopausal women with at least one uterine fibroid measuring > 20 mm. All of theme were scanned by transvaginal ultrasonography. Patients were randomized into two groups. Group A (n = 20) were treated with Tibolone 2.5 mg daily for 1 year and group B (n = 20) did not received therapy. The size of the uterine fibroids was reevaluated on the end of the treatment. RESULTS: No statistically significant difference was found in the mean volume of fibroids before and after treatment with Tibolone. The administration of Tibolone resulted in an increase of fibroid volume in three patients, whereas it remained constant in the majority of the patients (70%) and decreased in three patients. CONCLUSIONS: Our results suggest that treating menopausal symptoms with Tibolone does not affect preexisting asymptomatic uterine fibroids.

Anabolic Agents↗
PubMed1997

Receptor scintigraphy of non-neuroendocrine cancers with In-111 pentetreotide.

Somatostatin receptors (SR) are surface markers characterizing not only APUDomas associated with neuroendocrine identities but also malignancies without neuroendocrine expression. Recently, the somatostatin analog pentetreotide was labeled with In-111 (OctreoScan 111, Mallinckrodt Medical BV, Petten, Holland) and introduced for the in vivo visualization in man of SR-positive tissues. In the present report, SR-specific scintigraphy is evaluated as a clinical tool for tissue characterization in correlation with histological and radiological examinations. Scintigraphy was focused and performed in cancer types without neuroendocrine tissue expression such as brain (n = 6) and breast tumors (n = 9) and lymphomas (n = 5). Scintigraphy was performed for comparison at 6 and 22 h after i.v. application of 111 MBq (3 mCi) of In-111-Pentetreotide. In the breast cancer group, the primary tumor was visualized in all 9 women as well as in all 4 cases with palpable axillary lymph nodes. Three women with a negative axillary node scan and impalpable nodes had positive biopsy. In two cases, mediastinal lymph node involvement was observed. So far the role of SR-positive breast cancer (BC) scans remains unknown. It is tempting to speculate that in resected women who are histologically and scintigraphically SR positive, it might be of value in the early detection of symptom-free recurrences. High densities of SR were present within both meningiomas, the high-grade astrocytoma and the craniopharyngioma. Differentiation of low- and high-grade astrocytomas could not be successfully achieved because both grades showed intense radioactivity uptake, even though high-grade tumors lack SR. The latter might be due to the damaged blood-brain barrier and the poor radioactivity washout observed in high-grade astrocytomas. All five lymphomas could be detected due to the presence of activated lymphocytes and macrophages that express SR at a sufficient density. In conclusion, SR scintigraphy in non-neuroendocrine malignancies does not seem to be reliable for an initial tumor staging but rather more suitable for a tissue characterization and extremely useful for monitoring changes of SR expression after treatment.

Adolescent↗
PubMed1997

Hematological parameters of the mother and neonatal status during normal labor.

This study reviews the relationship between hematological parameters of the mother and the newborns status. Our material consisted of 180 pregnant women with singleton pregnancies who had an uncomplicated vaginal delivery. A negative relationship was noted between the pH and the maternal hemoglobin values both in the umbilical artery and vein (r = -0.27, p < 0.001, for the umbilical vein and r = -0.32, p < 0.0001, for the umbilical artery). A negative relationship was also noted between the umbilical vein pH and the maternal hematocrit, which was statistically significant (r = -0.28, p = 0.001). A similar negative correlation was observed between the umbilical artery pH and the maternal hematocrit (r = -0.32, p < 0.0001). In conclusion, maternal hematological parameters (hemoglobin, hematocrit) can affect the fetal acid-base balance.

Acid-Base Equilibrium↗