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Biomedical subjects

O Abulafia

Publications and source records attributed to O Abulafia.

At least 55 records · Page 3Linked to original sources
PubMed1999

The impact of pretreatment staging laparotomy on survival in locally advanced cervical carcinoma.

The purpose of this retrospective study was to determine the effect of pretreatment surgical staging on survival of patients with locally advanced cervical carcinoma. Two hundred and seventy-four women with cervical cancer stages IIB-IVA treated with primary radiotherapy comprised the study group. Eighty-nine patients underwent pretreatment staging laparotomy (group 1) and 172 patients underwent clinical staging (group 2). Thirteen patients underwent CT guided biopsy of paraaortic adenopathy. Paraaortic metastases were detected in 12.3% and intraabdominal metastases were found in 4.5% of patients in group 1. Extended field radiotherapy and/or systemic chemotherapy were given in these cases. The median survival of patients in group 1 was statistically longer than that of patients in group 2, 29 months vs 19 months, respectively (p=.01). Multivariate analysis controlling for both stage and age showed pretreatment staging laparotomy is a significant predictor of survival (p=.03). Our data suggest that surgical staging may be beneficial in patients with locally advanced cervical carcinoma.

Carcinoma↗
PubMed1998

Rapid marked response of severe hyperemesis gravidarum to oral erythromycin.

A recent report has noted an association between Helicobacter pylori and hyperemesis gravidarum. We present two cases in which first-trimester patients with severe hyperemesis gravidarum requiring intravenous fluid replacement were placed on oral erythromycin therapy for other nonrelated conditions. Surprisingly, marked rapid improvement of the hyperemesis gravidarum was observed with complete resolution of all symptomatology. Both these patients tested seropositive for Helicobacter pylori. These unexpected, marked therapeutic responses are consistent with the recently reported association between hyperemesis gravidarum and Helicobacter pylori and possibly suggest a new therapeutic modality for similar patients.

Administration, Oral↗
PubMed1998

Intra- and early postpartum ultrasonography: a review. Part I.

The objective of this article is to review current literature pertaining to intra- and early postpartum sonography. All the manuscripts published in the English language regarding this topic were selected from a MEDLINE search from 1966 through August 1997. Additional sources were identified through cross-referencing. Currently, intra- and early postpartum sonography may be performed for either maternal or fetal indications. Maternal indications include cervical assessment in preterm labor/rupture of membranes, assessment of the lower uterine segment, size and position of uterine fibroids, guided-placement of central venous or pulmonary artery catheters, detection of intraoperative venous air embolism, deep venous thrombosis, assist management of the third-stage of labor, postpartum hemorrhage or febrile morbidity. Fetal indications include an anatomical survey in patients presenting without prenatal care, verification of fetal presentation, estimated fetal weight, assessment of the breech-presenting fetus, external cephalic version, management of delivery of the second-twin, and internal podalic version. Doppler flow velocimetry is a useful tool in depicting both maternal and fetal intrapartum physiologic changes. We conclude that intra- and early postpartum sonography is an established versatile diagnostic and interventional-guiding modality for many obstetric conditions and should be readily available on labor and delivery suites.

Cesarean Section↗
PubMed1998

Intra- and early postpartum ultrasonography: a review. Part II.

Part II is a continuation of the preceding segment, which appeared in the previous issue (Survey 1998;53:000-000). This part presents data pertaining to ultrasound-guided procedures (invasive and noninvasive), physiology (fetal behavior), intrapartum hemorrhage, the third stage of labor, post-partum hemorrhage, and postcaesarean ultrasonography. In addition, this article includes data regarding nonobstetric ultrasound including anesthesiology, catheter placement, venous air embolism, effect of epidural anesthesia on uterine blood flow, and urinary retention. Finally, this part presents ultrasonographic data of the maternal cerebral circulation in preeclampsia/eclampsia and of the maternal deep venous system.

Amniotic Fluid↗
PubMed1997

Angiogenesis in primary and metastatic epithelial ovarian carcinoma.

OBJECTIVE: Our goal was to evaluate angiogenesis in the ovaries and omental metastases as a prognostic indicator in patients with epithelial ovarian carcinoma. STUDY DESIGN: Ovarian specimens of 42 consecutive patients with primary epithelial ovarian carcinoma (stages I to IV) and omental metastases of 19 of these patients with stage IIIB or stage IIIC disease were stained immunohistochemically for factor VIII-related antigen. Microvessel counts were tested for correlation with patient age, stage of disease, type of tumor, preoperative serum CA 125 level, tumor size, tumor resectability, patient survival, and omental microvessel counts. Statistical analysis included parametric (factorial analysis of variance) and nonparametric (Mann-Whitney and Kruskal-Wallis) group comparison tests, parametric (Pearson) and nonparametric (Spearman) correlation tests, and parametric (Cox proportional hazards) and nonparametric (Kaplan-Meier) survival analysis with p < 0.05 considered significant throughout. RESULTS: Microvessel counts of omental metastases in patients with stage IIIB or stage IIIC ovarian carcinoma were significantly correlated with preoperative serum CA 125 level (p = 0.028) and patient survival (p = 0.019). Microvessel counts of the ovaries examined were not correlated with patient age, stage of disease, type of tumor, preoperative serum CA 125 level, tumor size, tumor resectability, patient survival, or microvessel count of the corresponding omental metastases. CONCLUSION: Microvessel count of omental metastases is an independent prognostic indicator of survival in patients with advanced epithelial ovarian carcinoma and correlates with preoperative serum CA 125 level.

Adult↗
PubMed1997

Postoperative color Doppler flow ultrasonographic assessment of ureteral patency in gynecologic oncology patients.

Our objective was to assess postoperative ureteral patency in gynecologic oncology patients with color Doppler flow ultrasonographic assessment of ureteral jets. Forty-five consecutive gynecologic oncology patients meeting inclusion criteria prospectively underwent postoperative transabdominal color Doppler flow ultrasonographic assessment of ureteral jets to establish patency; 48 consecutive women undergoing transabdominal ultrasonographic studies for benign gynecologic conditions served as a control group. Statistical analysis included two-tailed t-test, with P < 0.05 considered significant. Bilateral ureteral jets were successfully demonstrated by color Doppler flow ultrasonography in all study patients and control patients. The mean time required to visualize bilateral ureteral jets was significantly different between the study group and control group (mean, 5.8 min +/- 0.6 min versus 2.6 min +/- 0.2 min, respectively) (P < 0.05). We conclude that postoperative ureteral patency in gynecologic oncology patients can be easily demonstrated by transabdominal color Doppler flow ultrasonographic assessment of ureteric jets.

Feasibility Studies↗
PubMed1996

Angiogenesis in squamous cell carcinoma in situ and microinvasive carcinoma of the uterine cervix.

OBJECTIVE: To evaluate angiogenesis in squamous cell carcinoma in situ (CIS) and microinvasive squamous cell carcinoma of the uterine cervix and to investigate the relations among angiogenesis, stromal inflammation, and depth of invasion. METHODS: Three groups of women were studied: 22 controls who had undergone hysterectomy for benign conditions; 18 with squamous cell CIS of the cervix who underwent cone biopsy, hysterectomy, or both; and 14 with microinvasive squamous cell carcinoma who underwent conization of the cervix and subsequent surgical management according to depth of invasion. All specimens were stained immunohistochemically for factor VIII-related antigen. Areas below the basement membrane with the highest angiogenic density were selected. The degree of stromal inflammatory reaction was assessed. Statistical analyses included Kruskal-Wallis, analyses of variance and covariance, Scheffe and Bonferroni-Dunn post hoc procedures, and Pearson correlation analysis. P < .05 was considered statistically significant. RESULTS: Microvessel counts per high-power field (x 400) of microinvasive squamous cell carcinoma of the cervix differed significantly from those of controls and squamous cell CIS (median 34.5 per high-power field, range 9-76 versus median 17, range 7-47, and median 19, range 8-39, respectively; P < .005). Microvessel counts per high-power field in squamous cell CIS did not differ significantly from those of controls (P = .91). Among patients with microinvasive squamous cell carcinoma of the cervix, no significant correlation was found between microvessel counts per high-power field and the depth of invasion (r = 0.19, P = .51). Stromal inflammatory reaction (graded 0-3) differed significantly among controls, squamous cell CIS, and microinvasive carcinoma (mean 0.40, 0.83, and 1.64, respectively; P < .005). CONCLUSIONS: Microinvasive squamous cell carcinoma of the uterine cervix is angiogenic, but depth of invasion is not associated with increased angiogenicity. Squamous cell CIS is not angiogenic.

Adult↗
PubMed1995

Recurrent transient superior vena cava-like syndrome possibly associated with megestrol acetate.

BACKGROUND: Superior vena cava syndrome is a rare, life-threatening clinical entity associated with occlusion of venous outflow from the head, neck, and upper extremities; this syndrome produces facial edema, cyanosis, dyspnea, and prominent neck veins, and is usually caused by intrathoracic neoplasms. CASE: In this unusual case, a patient receiving megestrol acetate for stage IV endometrial carcinoma developed recurrent transient superior vena cava-like syndrome in the absence of venous obstruction. CONCLUSION: Superior vena cava-like syndrome may occur with megestrol acetate. This unusual complication should be considered in patients receiving this medication who present with symptomatology similar to that of superior vena cava syndrome.

Adenocarcinoma↗
PubMed1995

Angiogenesis in endometrial hyperplasia and stage I endometrial carcinoma.

OBJECTIVE: To evaluate angiogenesis in endometrial hyperplasia and stage I endometrial carcinoma, and to investigate the relationship between angiogenesis and tumor grade and depth of invasion. METHODS: Three groups of patients were analyzed: control patients who underwent hysterectomy for benign conditions (n = 19), patients with endometrial hyperplasia (n = 24), and patients with stage I endometrial carcinoma (n = 34). All hysterectomy specimens were stained immunohistochemically for factor VIII-related antigen as a sensitive and specific marker for vascular endothelium. Areas close to the deepest myometrial invasion or those with the highest grade of endometrial hyperplasia and the highest angiogenic intensity were selected. Three fields (x 400) were selected for each slide, and the mean microvessel count was calculated. Statistical analysis included Mann-Whitney U test or Kruskal-Wallis analysis of variance and Dunn post hoc procedure. P < .05 was considered significant. RESULTS: A significant difference was found between the microvessel count of controls versus the group with complex endometrial hyperplasia (median 21, range 16-80, versus median 38, range 20-130; P < .05). Microvessel counts of complex endometrial hyperplasia were significantly higher than those of simple hyperplasia (median 25, range 16-42; P < .05) and significantly lower than counts of endometrial carcinoma (median 77.5, range 19-189; P < .05). Microvessel counts in complex hyperplasia were not significantly different than those of noninvasive stage I endometrial carcinoma (median 38, range 20-130, versus median 44, range 19-119; P = .5). In cases of stage I endometrial carcinoma, a higher number of microvessels was noted in specimens with myometrial invasion than in those without myometrial invasion (median 44, range 19-119, versus median 83, range 19-189; P < .01). A higher number of microvessels was noted in cases with grade 2 than in those with grade 1, stage I endometrial carcinoma (median 44, range 19-98, versus median 96, range 63-189; P < .001). CONCLUSION: Complex endometrial hyperplasia and endometrial carcinoma are angiogenic. Furthermore, in stage I endometrial carcinoma, greater depth of invasion and higher tumor grade are directly correlated with angiogenic intensity.

Endometrial Hyperplasia↗
PubMed1995

Adjuvant chemotherapy in stage IB neuroendocrine small cell carcinoma of the cervix.

BACKGROUND: Neuroendocrine small cell carcinoma of the cervix is a very rare and aggressive tumor which tends to metastasize early. This tumor is similar histologically to small cell carcinoma of the lung. Conventional treatment with surgery and/or radiation therapy has not been successful and has prompted the use of adjuvant chemotherapy regimens similar to those used for small cell carcinoma of the lung. METHODS: Three patients with Stage IB neuroendocrine small cell carcinoma of the cervix treated with postoperative adjuvant chemotherapy consisting of cisplatinum and VP-16, were identified. Analysis of the outcome of these three patients and a review of the current literature were performed. RESULTS: Median survival was 28 months. Two patients received pelvic radiation therapy, one due to positive surgical margins and the other due to recurrent disease. Currently two patients are alive and free of disease at 17 and 61 months. The third patient developed hepatic and pelvic recurrence and died 30 months after her presentation and 18 months after recurrence. CONCLUSION: The outcome of our three patients and eight similar cases in the literature suggest an improved survival rate with adjuvant chemotherapy compared to conventional treatment with surgery and or radiation therapy.

Adult↗
PubMed1995

An additional imaging sign preceding spontaneous fragmentation and embolization of an implanted subclavian vein catheter.

Analysis of chest roentgenograms performed before spontaneous fragmentation and distal embolization of an implanted subclavian vein catheter revealed discontinuity of the catheter's radiopaque marker in addition to kinking of the area proximal to the breakage point. To the authors' knowledge the case presented in this article is the first report of this imaging sign before catheter fragmentation. Lateral catheter placement and early recognition of subtle imaging signs may assist in decreasing the incidence of this significant complication.

Catheterization, Central Venous↗