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J H Ravina

Publications and source records attributed to J H Ravina.

12 recordsLinked to original sources

[Intraperitoneal chemotherapy for ovarian adenocarcinoma: pharmacokinetics of cisplatin].

Chemotherapy using cis dichlorodiamine platinum (CDDP) in doses of 30 and 60 mg/m2 was carried out in 6 patients who had adenocarcinoma of the ovary, that had not been treated before, 15 to 120 minutes before surgery was carried out. The results of doses of platin given on the blood levels are demonstrated. A slight and progressive increase in the plasma levels of CDDP with peaks between 0.6 and 1.95 of total platinum and 0.22 mcg/ml of free platin were found. The tissue levels in the region of the ovaries were found to be between 0.16 and 0.94 mcg/mg. There was a stepwise increase in the levels found in the pathological peritoneal cover of between 0.42 and 31.2 mcg/mg. This dropped as time went by; and then led to change in accordance with the intra-peritoneal concentrations. This study shows that it is possible when giving drugs intraperitoneally to avoid high plasma peaks and to obtain good levels of concentration of cisplatin in the peritoneum.

Adenocarcinoma

[Complications of intraperitoneal chemotherapy by the needle technique. Evaluation after ten years].

A hundred and twenty three patients with intraperitoneal cancer (mostly ovarian) were treated between 1980 and 1990 with intraperitoneal chemotherapy administered through a "needle". Local complications were infinitely fewer and less serious than those observed with materials implanted for months. General complications depended on which protocols were being used. But tolerance on the whole was better when the drugs were administered intraperitoneally. This is particularly clear with cisplatin, although the dose is doubled intraperitoneally over a period of 10 months instead of 6. In this ways there was hardly any neurotoxicity and there was a noteworthy prolongation of survival time in cases of ovarian carcinoma.

Antineoplastic Combined Chemotherapy Protocols

[Ovarian carcinomas. Intraperitoneal chemotherapy by needle].

Between January 1980 and February 1988, 61 women with ordinary ovarian carcinoma (OC) were treated with combined intraperitoneal and intravenous first-line therapy. For intraperitoneal infusions we did not use implanted systems which are often poorly tolerated and sometimes create non-negligible complications. We simply used a lumbar puncture needle left in situ for less than 2 hours. In second regard laparotomies, the 7 patients with stage I OC and the 3 patients with stage II OC were in histologically and cytologically proven complete remission, as were 34 of the 43 patients with stage III OC (79 percent) and 1 of the 8 patients with stage IV OC. After a mean follow-up of 56 months, the overall actuarial survival rate was 66 percent and the survival rate without recurrence was 54 percent. During the same period, 26 patients with recurrent OC were treated with second-line intraperitoneal chemotherapy. After a mean follow-up of 30 months, 10 were in apparently complete remission, and after a 27 to 61 months period 7 of these 10 patients had no recurrence. These results must be compared with those obtained with other salvage methods.

Abdominal Pain

[Von Recklinghausen's disease and pregnancy].

On the basis of six cases and a review of the literature, the authors identify the special features associated with the combination of von Recklinghausen's disease and pregnancy. Fertility is unaffected and pregnancy possible. Careful monitoring is required because of severe complications. In certain probably minor forms of the disease, the outcome of pregnancy is favourable with no complications.

Adult

Chemotherapy by the intravenous and intraperitoneal routes combined in ovarian cancer.

Intraperitoneal (ip) administration allows delivery of concentrations of cytotoxic drugs to the site of tumor development that could not be attained by the intravenous (iv) route. Rather than leaving ip delivery systems (Tenckhoff catheter, Port à Cath, etc.) in position for several months, with the attendant risk of complications, we prefer to use a simple needle for lumbar puncture and leave it in place between 1 and 2 hr at each infusion of chemotherapy. Results observed at second-look laparotomy in 31 patients with stage III (FIGO) common epithelial carcinoma, treated from January 1980 to December 1986, are reported after six to ten courses of ip and iv chemotherapy combined. In five patients in whom complete surgical excision had been possible, there was still complete remission (CR). In 26 patients in whom initial surgical excision had been incomplete, there was complete remission in 20 (76%). In the other 6 cases, there were small residual masses (incomplete remission), which could readily be excised by the surgeon. Following second-look laparotomy, these 6 patients received ip maintenance chemotherapy for a further 6 months. During follow-up periods of 22 to 105 months (average 45 months), 8 recurrences were observed (4 of them died); 23 of 31 patients are disease free. At 4 years, actuarial survival was 81.5% and actuarial disease-free survival was 66.2%.

Adult

[Diagnostic and prognostic elements of non-immunologic feto-placental anasarca. Review of the literature apropos of 7 new cases].

Non immunologic hydrops fetalis (NIHF) is relatively more frequent now since prevention and treatment of blood incompatibilities are common. Seven cases of NIHF were observed between November 1984 and April 1987; antenatal diagnosis by ultrasound scanning was possible in six of these seven cases. Fetal prognosis is usually poor. Only one of the seven children survived, four infants died shortly after birth; two women chose an elective termination of pregnancy at 18 and 23 weeks of gestation, respectively. The review of the literature shows that more than 150 etiologies are associated with this condition. An etiology was found in five of our seven cases, these were all different; renal vein thrombosis, cardiac malformation, cystic hygroma, osteogenesis imperfecta and one case of recurrent NIHF (four affected siblings). Two cases remained idiopathic. Diagnosis of NIHF is best oriented by three investigations: obstetrical ultrasound scanning, fetal echocardiography and any kind of amniocentesis, either for karyotype alone, or to evacuate pleural, pericardial of peritoneal effusions. Ultrasound scanning can evaluate the importance of these effusions and help to choose other etiological investigations. Fetal echocardiography is mandatory because out of the 150 etiologies described in association with NIHF, 25% are cardiac (malformation or dysrhythmias). As already mentioned, fetal prognosis in our series was poor, but perhaps more aggressive in utero treatment could have improve it.

Adult

[Initial immunochemotherapy in inflammatory carcinomas of the breast. Preliminary results of a trials in 9 patients (author's transl)].

Traditional treatments have proved to be of little effect on inflammatory carcinomas of the breast. The later show a tendency to early metastases and the mean survival is less than 19 months. The preliminary results of the therapeutic protocol reported here and whose originality lies in the primary use of non-specific immunotherapy and of high-dosage chemotherapy appear to be very favourable. The protocol was used in 9 patients. "Thermographic cooling" was taken as the criterion of operability. Initial chemotherapy was restarted after surgery up to a total of 10 courses, and followed by maintenance chemotherapy for one year. Immunotherapy using BCG was routinely associated with the antimitotic agents. After 41 months, the results were as follows: -- local recurrence after tumorectomy in 2 patients (18th and 31st months); these recurrences were controlled by cobalt. -- the other 7 patients show no sign of recurrence. These 9 patients are presently in complete remission.

Adult

[Amniofetography].

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Amniocentesis

[Thermography of the testicle. Preliminary study].

The preliminary study is concerned with 25 cases that have been examined using thermography in planes to check the conditions of temperature of the testes in normal and pathological states. Normal testicular thermography is characterised by a symmetrical and constant thermographic picture, the temperature staying between 32.5 and 34.5 degrees. In the pathological states of oligoasthenospermia plate thermography shows up a particular thermic picture associated with a varicocoele whether this is clinical or subclinical. The picture is one of hyperthermia and lack of symmetry in the case of a unilateral lesion. In these cases tyeing off the spermatic vein shows a rapid return to a normal thermographic picture. These positive results have led to a more extensive and deep study which is at present in progress.

Body Temperature