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Biomedical subjects

S Michalas

Publications and source records attributed to S Michalas.

133 records · Page 8Linked to original sources
PubMedDate not supplied

Successful management of severe idiopathic thrombocytopenia in the second trimester of pregnancy.

This paper describes a case of severe idiopathic thrombocytopenia in a primigravida. The disorder became symptomatic at 22 weeks gestation with a platelet count of 20,000/microliter. The existence of chronic idiopathic thrombocytopenia under remission was strongly suspected, but could not be documented. The patient was treated with oral corticosteroids over a period of 7 weeks. During this period, she also had three cycles of high-dose intravenous globulin. This treatment produced a transient improvement, but the platelet count fell to 4,000/ microl by the 29th gestational week. Caesarean section was carried out for maternal indication a week later, following a fourth intensified course of gamma-globulin, coupled with platelet transfusions and low-dose vinblastine. Splenectomy was not performed. Potentially life-threatening thrombocytopenia persisted for 6 weeks post partum. Despite the presence of circulating antiplatelet globulin in the maternal blood and the antenatal use of vinblastine, the infant was entirely unaffected and thrived.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Absence of transplacental passage of the low molecular weight heparin enoxaparin.

BACKGROUND: Venous thromboembolism (VTE) during pregnancy and puerperium remains a major cause of maternal morbidity and mortality. The use of low molecular weight heparin (LMWH) constitutes a promising alternative for the prevention of VTE instead of unfractionated heparin as it can be administered subcutaneously once daily and without coagulation measurement. Unfortunately, the safety of LMWHs administration for the mother and fetus has not been well established. STUDY DESIGN: In order to examine the safety of enoxaparin to the fetus, 24 women were recruited and 40 mg of enoxaparin was administered in 14 of them. All 24 women were going to have an early termination of pregnancy due to major fetal malformations. Maternal blood samples were drawn before and after the injection of enoxaparin, while fetal blood samples were taken only after the drug administration. Anti-IIa and anti-Xa activities were measured. RESULTS: A statistically significant increase of anti-Xa activity in the mothers studied was pointed out, while there was no detection of anti-IIa and anti-Xa activities in the fetuses. CONCLUSIONS: Since no anti-IIa and anti-Xa activities were detected in the fetuses' blood samples, it is concluded that enoxaparin does not cross the placenta and therefore appears safe for the fetus.

Adolescent↗
PubMedDate not supplied

Arm morbidity following treatment of breast cancer with total axillary dissection: a multivariated approach.

In order to clarify the factors that mainly influence arm morbidity following treatment of breast cancer with the full axillary dissection protocol, we evaluated, in a model of multiple regression analysis, parameters such as the type of breast surgery, adjuvant radiotherapy, time of irradiation, age, number of dissected nodes and axillary nodal status. A total of 104 women were studied. Late arm edema was observed in 17% of the patients and was more frequent when (1) irradiation was given immediately after the operation than if it was given 6 months later (p = 0.009) and (2) the number of removed nodes exceeded 40 (p = 0.037). Upper limb pain was reported by 16% of the patients and was reported more frequently from patients over 60 years of age (p = 0.036), as well as from patients who underwent modified radical mastectomy (p = 0.044) and those in whom 30-40 nodes were dissected (p = 0.025). Shoulder joint mobility was impaired in 17% of the patients, and it was not affected by any of the examined factors. It seems that conservative breast surgery or adjuvant breast radiotherapy 6 months after the operation might reduce independently the likelihood of arm morbidity by 25%.

Age Factors↗
PubMedDate not supplied

Immunocytochemical determination of EGFR, OV 632 and OC 125 in primary ovarian cancer patients.

An immunocytochemistry study was performed to compare the immunoreactivity of the monoclonal antibodies OC 125, EGFR and OV 632 with smear imprints from 60 ovarian tumours (21 serous cystadenocarcinomas, 12 mucinous cystadenocarcinomas, 9 endometrioid carcinomas, 5 clear cell carcinomas and 5 mixed tumours). Twenty-six patients were premenopausal and 34 postmenopausal. The results showed that 75% of mucinous cystadenocarcinomas were negative for all 3 antigens as were 2 of the 5 (40%) clear cell carcinomas. All other tumours were positive for at least one of the three antigens. OV 632 had an overall sensitivity of 73.3%, EGFR 55% and OC 125 46.6%. Four tumours were OC 125-positive and OV 632-negative. There was no significant difference in positivity of OV 632, OC 125 and EGFR, between pre- and post-menopausal patients (chi 2 = 0.03) or between tumours of stage I and stage III [chi 2 = 0.075 (EGFR) 0.95 (OV 632) and 10.49 (OC 125)]. OV 632 was conducted to be the most sensitive antibody in all types of tumours but OC 125, while less sensitive by itself, increased the overall sensitivity in combination with OV 632 from 73.3 to 80% (not statistically significant).

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

ras gene mutations in human endometrial carcinoma.

The purpose of this study was to assess the extent of involvement of the ras oncogene activation by point mutations in endometrial carcinoma in the Greek population. The PCR technique was employed, followed by RFLP analysis to identify the point mutations in codon 12 of the K-ras, H-ras and N-ras genes. K-ras gene point mutations were detected in 8 of the 55 cases (15%) of primary endometrial carcinoma, H-ras in 4 (7.3%), while no mutations were found for the N-ras gene. No correlation was found between the presence of ras gene mutations and the clinicopathological parameters, or patient survival. The only association found was between H-ras mutations and the FIGO stage of the tumor (Fisher's exact test, p = 0.011). These results indicate a possible role of ras gene activation in a small subset of endometrial carcinomas.

Carcinoma↗
PubMedDate not supplied

Erythromycin treatment for subclinical Ureaplasma urealyticum infection in preterm labor.

This study was undertaken to test the effects of erythromycin as an adjunct to tocolysis for preterm labor in women with vaginal cultures positive for Ureaplasma urealyticum. The study group consisted of 18 women in active preterm labor with pregnancies between 26 and 34 weeks of gestation and intact membranes who received 500 mg erythromycin orally every 8 h for 10 days. Seventeen women with similar characteristics served as controls and received no antibiotics. In all women contractions were suppressed with ritodrine. Erythromycin treatment resulted in a statistically significant greater mean delay of delivery (36.4 days) than among the control group (23.1 days). Higher proportion of term pregnancies (7 versus 3 pregnancies), higher mean birth weight (2,745 versus 2,474 g), lower neonatal morbidity (22.2 versus 42.2%) and shorter mean neonatal hospitalization time (9.6 versus 12.1 days) were observed, although these differences were not statistically significant. Adjunctive erythromycin treatment given to women treated for preterm labor with intact membranes and positive vaginal cultures for U. urealyticum appears to prolong gestation and to improve perinatal outcome.

Administration, Oral↗