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Biomedical subjects

S Karpathios

Publications and source records attributed to S Karpathios.

7 recordsLinked to original sources

A phase II study of paclitaxel in platinum pretreated ovarian cancer. A Hellenic Cooperative Oncology Group study.

Paclitaxel was administered at a dose of 175 mg/m2 in a 3-hour infusion every 3 weeks in platinum pretreated patients with ovarian cancer. 51 patients with a median age of 57 years entered the study. 33 (65%) presented with stage III and 18 (35%) with stage IV disease. 39 patients (76%) were previously treated with only one and 12 (24%) with two regimens. The median interval from the last previous chemotherapy was 4 months (range, 1-65). Ninety-eight per cent of the planned dose of paclitaxel was actually delivered. Overall and complete response rate was 26% (13/51) and 16% (8/51), respectively. All complete responses were observed among patients previously treated with only one regimen. Median time to progression was 10.26 months (range, 4.9-25.2+) and median survival 15.6 months (range, 1.3-27.1+). Factors influencing survival were performance status and the number of previous regimens.

Adult

Carboplatin alone compared with its combination with epirubicin and cyclophosphamide in untreated advanced epithelial ovarian cancer: a Hellenic co-operative oncology group study.

We compared, in a multicentric randomised prospective study, the efficacy and toxicity of carboplatin 400 mg/m2 as a single agent (CB) to a combination of carboplatin 300 mg/m2, epirubicin 50 mg/m2 and cyclophosphamide 500 mg/m2 (CB-EC) in advanced ovarian cancer patients. The treatment was scheduled to be administered every 3 weeks for six courses. Following initial laparotomy and cytoreductive surgery, 130 previously untreated patients entered the study. 73 patients were treated with carboplatin alone while 57 received the combination chemotherapy. In the majority of the patients, the regimens had to be given every 4 weeks due to myelosuppression. Nausea, vomiting and alopecia were more severe in the CB-EC arm. Overall, clinical complete response was observed in 73 (56%) and partial response in 20 (15%) patients. The median time to progression was 16.89 months and median survival was 29.54 months. No significant differences in response rate, time to progression, disease-free survival and overall survival were observed between the two treatment arms. The prognostic role of residual disease after initial surgery, complete remission at second-look laparotomy, tumour stage and performance status was confirmed.

Adult

Prevention of post-oophorectomy bone loss with Tibolone.

The results of a 1-year placebo-controlled study in 25 women who had hysterectomy and bilateral oophorectomy receiving a daily oral dose of 2.5 mg of Tibolone (Org OD 14) are presented. Tibolone is a steroid compound with mild oestrogenic in additional to progestagenic effects. Post-oophorectomy bone loss has been reported to accelerate, at least during the first year after surgery. The efficacy of Tibolone to prevent this accelerated bone loss is questionable. All patients were scheduled to participate in the study before oophorectomy. Patients had a detailed pre-operative examination, including measurement of forearm bone density with an SP2 Lunar single photon absorptiometer and haematological and biochemical investigation. After surgery, patients were randomly allocated in two groups; 15 women received an oral dose of 2.5 mg of Tibolone and 1000 mg of Calcium, while 10 women had only 1000 mg of calcium daily. Patients were examined at the end of 6 and 12 months of observation. Bone density of the radial shaft was found to decrease significantly in the calcium group up to 6.12% (P < 0.01) at the end of 6 months and 12.4% (P < 0.001) at the end of 12 months. On the other hand, bone density of the radial shaft remained unchanged in the Tibolone-treated group during the 12 months of treatment. Bone density of the distal radius was found to decrease in the calcium-treated group up to 10.2% (P < 0.014) at the end of 6 months and up to 15.8% (P < 0.002) at the end of 12 months. Bone density of the distal radius remained almost unchanged in the Tibolone-treated group during the whole period of treatment. Urine hydroxyproline/creatinine ratio was found to increase in the calcium group at the end of 6 and 12 months (P < 0.009) and to decrease significantly (P < 0.05) in the Tibolone-treated group. It is concluded that Tibolone is effective in the prevention of the post-ovariectomy accelerated bone loss and in retaining the initial premenopausal bone mass, at least during the first post-oophorectomy year. As this period is the most crucial in developing osteoporosis, it seems that Tibolone is effective in preventing the post-oophorectomy bone loss. HRT is not obligatory in these patients, as Tibolone seems to cover the whole spectrum of post-oophorectomy consequences.

Adult

Ovarian neoplasms and pregnancy.

Sixteen cases of benign cystic ovarian neoplasms (13 serous cystadenomas and 3 dermoids) were discovered among 5,616 pregnancies. The only serious complication was torsion of the ovary containing the tumor in one case.

Abdomen, Acute

Pyometra.

Thirteen cases of pyometra without preoperative diagnosis in which vaginal or abdominal surgery was performed, are analysed in the present paper. The histologic examination revealed endocervicitis in all cases, while positive cultures for bacteria were found preoperatively in only eight of the above cases, thus, pyometra was considered to be a symptom of obstruction of the cervical canal.

Female

Post-hysterectomy morbidity after previous punch cervical biopsy plus diagnostic curettage.

The post-operative morbidity of 70 patients who underwent total abdominal hysterectomy five to thirteen days after punch-biopsy of the cervix uteri and diagnostic curettage was compared of that of a control group of patients, with hysterectomy alone. It was observed that the sequence punch-biopsy hysterectomy presented a significantly higher post-operative morbidity. This increase was mainly due to higher parametritis, excessive vaginal discharge and wound infections rates. The interval between the two operations was also found to influence the post-hysterectomy morbidity, which seems to decrease with longer intervals.

Biopsy, Needle