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Biomedical subjects

S Massad

Publications and source records attributed to S Massad.

7 recordsLinked to original sources
PubMed1993

Papanicolaou smear screening augmented by a magnified chemiluminescent exam.

OBJECTIVES: Since the adequacy of screening for cervical cancer and pre-cancer with Papanicolaou smear alone has been questioned, a number of adjunctive tests have been evaluated. This study evaluated whether a magnified chemiluminescent visual screening exam can improve cervical screening when performed coincident with cytologic sampling. METHODS: Patients were evaluated using the Papanicolaou smear, magnified chemiluminescent visual exam (MCE) and colposcopy at 10 study centers. Screening with either Papanicolaou smear alone or in combination with MCE (Pap and MCE), was evaluated using colposcopy directed biopsy as the highest diagnostic standard. RESULTS: The Papanicolaou smear alone detected 9/29 (31%) of women with significant pathology (cervical neoplasia) on biopsy, whereas the combination of the Pap and MCE detected 24/29 (83%) of the women (P < 0.001). Patients in whom both tests results were negative (negative Pap and MCE) were extremely unlikely to harbor significant pathology (1% of those screened). Pap and MCE was especially helpful in the detection of low grade cervical lesions when compared with the Papanicolaou smear alone. CONCLUSIONS: These data indicate that MCE enhances the sensitivity of cervical screening. MCE appears to be particularly useful as a triage instrument in women with otherwise negative Papanicolaou smears. Further studies of cost effectiveness of this combined screening protocol using non-colposcopists is warranted.

Adolescent↗
PubMed1975

Are chlamydial infections the most prevalent venereal disease?

We studied two population groups (more than 1,600 patients) to determine the prevalence and clinical associations of genital tract infections with chlamydiae and herpesviruses. Base-line isolation rates for asymptomatic women having routine pelvic examinations were much lower than rates for symptomatic women. In both groups, chlamydiae were more prevalent than herpesviruses. Chlamydial infection was associated much more commonly with cervicitis (36.6%) than with vaginitis only (4.1%). Among 282 symptomatic men, the cultures of 19.9% yielded chlamydiae, and 4.3%, herpesviruses. Chlamydiae were recovered from 35.5% (27 of 76) of specimens from men with nongonococcal urethritis, and from an even larger proportion, 57% (24 of 42), of the specimens from men with frank discharge.

Adult↗
PubMedDate not supplied

Whole-abdominal radiation in endometrial carcinoma: an analysis of toxicity, patterns of recurrence, and survival.

PURPOSE: The purpose of this study was to determine the toxicity, patterns of recurrence, and survival in high-risk endometrial cancer patients treated with whole-abdominal radiation. MATERIALS AND METHODS: All patients with endometrial cancer treated at Northwestern University since 1994 and at Rush University since 1993 were retrospectively reviewed. Patients believed to be at high risk for intra-abdominal recurrence and who received whole-abdominal radiation were reviewed for this study. RESULTS: A total of 30 patients completed whole-abdominal radiation (WAR) and were available for study. The mean and median follow-up was 2.3 and 2.1 years, respectively, with a range of 0.13 to 6.1 years. Seventy-eight percent of the cohort received surgical staging with bilateral salpingo-oophorectomy/total abdominal hysterectomy/lymph node sampling. Forty-seven percent of the patients were found to have serous histology as a component of their tumor. Surgical staging results included 19% stage 1B, 4% stage IC, 8% stage IIB, 37% stage IIIA, 26% stage IIIC, and 7% stage IVB. Two patients had gross residual disease at the completion of surgery. Megestrol acetate (Megace) was used as an adjuvant treatment in 37% of patients, and no cases received initial chemotherapy. All patients received WAR with a mean total dose and dose per fraction of 2620 and 143 cGy, respectively. Twenty-two percent of patients received a para-aortic boost. The mean total pelvic dose was 4956 cGy. Seventy percent of patients received a vaginal cuff boost. Eight percent of patients had grade 3 acute gastrointestinal morbidity, and 4% had grade 4 acute gastrointestinal morbidity. No other grade 3 or greater acute or long-term morbidity was noted. At last follow-up, seven (23%) patients had experienced recurrence. The pattern of first recurrence was 0% in the vaginal cuff, 3% other vaginal, 7% pelvic, 7% upper abdominal, 3% lung, 7% bone, and 7% para-aortic lymph nodes. Ultimate recurrences were similar. At last follow-up, 77% patients had no evidence of disease, 13% were alive with disease, and 10% had died of disease. CONCLUSIONS: Utilizing a conservatrive total whole-abdominal radiation dose and limited para-aortic nodal boost resulted in very tolerable treatments. The patterns of recurrence and survival in this early report are encouraging.

Abdominal Neoplasms↗