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Dimitrios Lolis

Publications and source records attributed to Dimitrios Lolis.

8 recordsLinked to original sources

Prolonged use of gonadotropin-releasing hormone agonist and tibolone as add-back therapy for the treatment of endometrial hyperplasia.

OBJECTIVES: To investigate the response of the various hyperplastic disorders of the endometrium to a prolonged treatment with leuprolide acetate, a gonadotropin-releasing hormone agonist (GnRH-a), plus tibolone, as add-back therapy, and further to study if the tibolone addition reduces the hypoestrogenic actions of the GnRH-analogue. METHODS: We treated 26 women with histologically confirmed simple (n = 9), complex (n = 15) or atypical (n = 2) endometrial hyperplasia (EH) for 12 months with monthly injections of 1Ampulle/3.75 mg of leuprolide acetate, followed by tibolone, 2.5mg per day per os. Every woman underwent a hysteroscopic evaluation and biopsy of the endometrium after 3 (in cases with atypical EH), 6 and 12 months of treatment, as well as after 12 and 24 months of follow-up. The clinical, paraclinical and laboratory course of the disease was followed-up by using of a climacteric scoring system and by testing of various parameters. RESULTS: The histopathologic evaluation of the endometria revealed regression of EH in all women after 12 months of treatment, however, during the first 2 years of follow-up EH reappeared in four women (4/21, 19%). Bone mineral density and serum parameters did not show significant changes during treatment, whereas only a mild suffering from hypoestrogenic side-effects was noted. CONCLUSIONS: It seems that the combined GnRH-a/tibolone treatment in women with EH is a potent alternative, so far as the endometrial status and the clinical course of the disease are concerned, whereas tibolone appears to act sufficiently as add-back therapy to prolonged GnRH-a treatment. The probability of relapse of the disease during the follow-up period makes the close monitoring of the endometrium after cessation of the treatment absolutely necessary.

Adult↗

Intramural pregnancy with negative maternal serum b-HCG.

We report an extremely rare case of intramural pregnancy with negative maternal b-HCG value. The patient underwent a "myomectomy" but the pathology examination revealed chorionic villi consistent with ectopic pregnancy. Diagnosis is very difficult in cases with menorrhagia and especially when pregnancy is not suspected.

Chorionic Gonadotropin, beta Subunit, Human↗

Umbilical cord length and parity--the Greek experience.

OBJECTIVES: To investigate the relationship between parity and cord length, with respect to peripartum characteristics. STUDY DESIGN: Parity, cord length, placental and birth weight were the studied variables in a sample of 534 parturients with singleton fetuses. Parturients were divided into four groups: primiparous (para-1), secundiparous (para-2), tetriparous (para-3) and multiparous (para >3). Oneway ANOVA and post-hoc tests were applied for the comparison of mean cord length between the four groups of parity. General Linear Model was applied for the detection of covariates. RESULTS: ANOVA yielded significant differences between the four groups. Mean cord length was significantly higher in women of parity >or=3 than in women with lower parity. Although both placental and birth weight were correlated with cord length, application of GLM showed that only birth weight could act as a covariate for the length differences between parity groups. CONCLUSIONS: Cord length appears to increase with advancing parity, the cut-off point being between the second and the third labor. We suggest that intrapartum monitoring should be performed in all multiparous parturients, because of their propensity for longer cords, and thus for related complications.

Birth Weight↗

Amniotic fluid glucose at the time of genetic amniocentesis: correlation with duration of pregnancy and birthweight.

OBJECTIVE: To test whether amniotic fluid (AF) glucose levels in 15-18 weeks of pregnancy can predict birthweight and duration of pregnancy. STUDY DESIGN: In this prospective study, 66 non-diabetic pregnant women underwent amniocentesis between 15 and 18 weeks of pregnancy and glucose levels were measured immediately by using the enzymatic method of hexocinase. They were all followed up and delivered in our department and neognological parameters were recorded. RESULTS: AF glucose values ranged from 12 to 69mg/dl (mean 44.2mg/dl, S.D. 11.6mg/dl). No linear relationship was found between AF glucose and either birthweight or duration of pregnancy. CONCLUSION: AF glucose values between 15 and 18 weeks of pregnancy did not correlate with either birthweight or duration of pregnancy. A single measurement of this value cannot be used for the prediction of the factors studied.

Adolescent↗

Upper limb abnormalities as an isolated ultrasonographic finding in early detection of trisomy 18. A case report.

Trisomy 18 is the second most common multisystem malformation syndrome. We present here a case of a fetus with trisomy 18, in which upper limb reduction was detected prenatally, as an isolated defect, at 17 weeks of gestation. The pregnancy was terminated by vaginal administration of misoprostol, and postmortem examination confirmed the ultrasound findings, including bilateral upper limb reduction with radial aplasia, absent first metacarpal and thumb and ventrally hyperflexed hands. This case demonstrates the need for thorough ultrasound evaluation of the fetal hands, as early as possible, because upper limb deformities can be the only abnormality of trisomy 18.

Adult↗

Prenatal paternity testing using DNA extracted from coelomic cells.

OBJECTIVE: Prenatal paternity testing can be performed following invasive prenatal diagnosis with amniocentesis or CVS. Coelocentesis is a new technique that could be used as an alternative method early in the first trimester of pregnancy. The aim of this study is to investigate the potential use of the DNA extracted from coelomic cells in the prenatal paternity testing. METHODS: Coelocentesis was performed in 20 singleton pregnancies at 7-9 weeks of gestation immediately before surgical termination of pregnancy. Chorionic cells from the placenta and blood cells from the parents were processed by the standard salt extraction method. Two loci, TPO and Apo B, were used for paternity testing in the DNA of coelomic cells, chorionic cells and blood cells. RESULTS: There was concordance in the results obtained from the coelomic cells and chorionic villi. In two cases only the polymorphisms used were not conclusively informative for paternity exclusion. CONCLUSIONS: Coelomic cells are potentially useful for early paternity testing.

Apolipoproteins B↗

Fetal akinesia deformation sequence presenting with increased nuchal translucency in the first trimester of pregnancy.

Prenatal sonographic diagnosis of fetal akinesia deformation sequence (FADS) is usually achieved during the second and third trimester of pregnancy and relies on the demonstration of contractures of multiple joints, paucity of fetal movements and nuchal edema or generalized hydrops. We present the early diagnosis of FADS in a 13-week fetus presenting with nuchal translucency thickness (NT) of 5.1 mm, bilateral talipes and fixed flexion deformity of the fingers and wrists. We also review cases of this condition diagnosed during the first trimester and discuss the role of increased NT in the early diagnosis of FADS even in cases without previous history of an affected child.

Adult↗