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Biomedical subjects

V Tanos

Publications and source records attributed to V Tanos.

At least 19 recordsLinked to original sources
PubMed2004

Transvaginal laparoscopy proposed as an investigation procedure for patients at high-risk for ovarian cancer.

Transvaginal laparoscopy (TVL) was performed in 23 patients at high risk for ovarian cancer (OC). The patients were placed in the lithotomy position after sedation and a veres needle was inserted in the posterior vaginal vault. A trocar followed and warm normal saline was injected into the pelvis. The needle was removed and a telescope connected to a light source and monitor was introduced. Excellent visualization was achieved in all cases examined and the average time of TVL was 30 min. All patients except one found TVL a simple and painless procedure. TVL helped in the diagnosis of six benign ovarian lesions and ruled out OC in the other 17 cases. TVL is an easy method to learn with reliable results. TVL can reduce the number of unnecessary laparoscopies and/or laparotomies and it seems to be useful in ruling out OC.

Adult↗
PubMed2001

Ovulation induction and risk of endometrial cancer: a pilot study.

OBJECTIVE: To determine whether women with endometrial carcinoma are more likely to have been exposed to fertility drugs, in particular clomiphene, than healthy population controls. STUDY DESIGN: A nationwide case-control, pilot study. About 128 living women 35-64 years old, with a histologically confirmed diagnosis of endometrial carcinoma that was first diagnosed and reported to The Israel Cancer Registry between 1 January 1989 and 31 December 1992 were enrolled. The controls were 255 women from the same dialing areas selected by random digit dialing. A variety of demographic and clinical parameters were compared between cases and controls. A multivariate logistic model, controlling for age, was used to assess the independent effects of factors found to be significantly associated with endometrial cancer on univariate analysis. RESULTS: About 7 women with endometrial carcinoma (5.5%) and 10 healthy controls (3.9%) reported that they had used any fertility drug (crude odds ratio (OR) 1.4; 95% confidence interval (CI) 0.47-4.2). Use of fertility drugs did not meet the criteria for entry into the logistic model. The following parameters were found to be independently associated with endometrial cancer controlling for age, European-American background OR=2.2, (95% CI 1.3-3.7, P=0.004); nulliparity OR=2.7 (95% CI 1.1-6.5, P=0.03); history of infertility OR=1.8 (95% CI 1.0-3.3, P=0.05); BMI> or =27 OR=2.3 (95% CI 1.4-3.9, P=0.001). The use of oral contraceptives and IUD were found to be protective, OR=0.29 and 0.37, respectively, (95% CI 0.14-0.61, P=0.001 and 0.19-0.70, P=0.003, respectively). CONCLUSIONS: We found no evidence that the use of ovulation induction agents, including clomiphene citrate, are associated with a higher risk of endometrial carcinoma. The association between infertility drugs and endometrial carcinoma should be examined in other, larger studies.

Case-Control Studies↗
PubMed1999

Expression of the imprinted H19 oncofetal RNA in epithelial ovarian cancer.

STUDY: To examine the expression of the imprinted maternally expressed H19 gene in benign, low malignant potential (borderline) and malignant surface epithelial ovarian tumors. DESIGN: In situ hybridization for H19 RNA using S-labeled and digoxigenin-labeled probes was performed on paraffin sections of ovarian surface epithelial tumors. The serous tumors included nine section cystadenomas, twelve serous tumors of low malignant potential and twenty serous carcinomas, grade I-IIII (FIGO classification). A smaller group included two mucinous cystadenomas, four mucinous tumors of low malignant potential and two mucinous cystadenocarcinomas. RESULTS: H19 expression was found to be positive in 6/9 (67%) serous cystadenomas, 9/12 (75%) of serous tumors of low malignant potential and 13/20 (65%) of invasive serous carcinomas. Expression in mucinous tumors was confined to the stroma beneath the epithelial lining. CONCLUSION: H19 is expressed in the majority of serous epithelial tumors. Taking into consideration the high percentage of H19 expressing serous ovarian neoplasms we suggest that H19 RNA may be used as an adjuvant tumor marker for the diagnosis and mainly for staging and follow-up of patients with serous ovarian carcinoma.

Adenocarcinoma↗
PubMed1997

Effect of epidural analgesia on duration and outcome of induced labor.

OBJECTIVE: To evaluate the effect of epidural block on the duration of labor and maternal and fetal outcome in induced-labor patients. METHOD: 210 women admitted for induction of labor at a level III university hospital, during the year 1991, were studied. Of these, 112 were given an epidural block and 98 served as controls. Outcome measures studied were: induction time and time in labor, c-section and instrumental delivery rates, intra-partum and post-partum complications, and Apgar scores at 1 and 5 min. RESULT: Multiple regression analysis revealed that epidural analgesia, before and after adjustment for confounding factors, significantly prolonged labor time (P < 0.0001) and was associated with an increase in instrumental delivery rates (P < 0.04). A significant reduction in intra-partum complication rate (FHR changes, meconium) was observed (OR = 0.32; P < 0.03), while c-section rate and Apgar scores were not found to be influenced by epidural analgesia. CONCLUSION: Epidural anesthesia, significantly prolongs labor time in induced patients. While instrumental delivery was more prevalent in these parturients, c-section rate was not increased and intra-partum complications were significantly reduced in these patients.

Adult↗
PubMed1997

High risk pregnancy outcome following induction of labour.

OBJECTIVE: To evaluate whether induction of labour, performed in a high risk obstetric population, when medically indicated, carries an increased risk for operative delivery and maternal and fetal complications. The secondary goal was to study the effect of the various induction methods used on these outcomes and labour time. STUDY DESIGN: This study was carried out at a level [1] university hospital. A group of 210 women who were induced for various indications, were compared to our general parturient population. Main outcome measures were cesarean section (CS) and instrumental delivery rates, intra-partum and post-partum complications, APGARs 1' and 5' and labour time by induction method. RESULTS: No significant increase in the rates of primary CS (8.6 vs. 7.1%) and instrumental delivery (15.7 vs. 12.7%), were found in the induction high risk group as compared to our general obstetric population. Intra-partum complications and fetal outcome were comparable in both groups. A comparison of methods of induction used (oxytocin, PgE2, Amniotomy) revealed a less favorable outcome with the oxytocin induction method which showed an elevated intra-partum complication rate (P < 0.01) and a tendency toward lower Apgar scores and higher CS rate. CONCLUSIONS: Induction of labour performed in a high-risk obstetric population is safe, carrying no significant increase in CS and neonatal complication rates. Of the three methods of induction used, oxytocin induction showed the least favorable outcome for both mother and her offspring.

Adult↗
PubMed1997

The product of the imprinted H19 gene is an oncofetal RNA.

AIMS/BACKGROUND: The H19 gene is an imprinted, maternally expressed gene in humans. It is tightly linked and coregulated with the imprinted, paternally expressed gene of insulin-like growth factor 2. The H19 gene product is not translated into protein and functions as an RNA molecule. Although its role has been investigated for more than a decade, its biological function is still not understood fully. H19 is abundantly expressed in many tissues from early stages of embryogenesis through fetal life, and is down regulated postnatally. It is also expressed in certain childhood and adult tumours. This study was designed to screen the expression of H19 in human cancer and its relation to the expression of H19 in the fetus. METHODS: Using in situ hybridisation with a [35S] labelled probe, H19 mRNA was detected in paraffin wax sections of fetal tissues from the first and second trimesters of pregnancy and of a large array of human adult and childhood tumours arising from these tissues. RESULTS: The H19 gene is expressed in tumours arising from tissues which express this gene in fetal life. Its expression in the fetus and in cancer is closely linked with tissue differentiation. CONCLUSIONS: Based on these and previous data, H19 is neither a tumour suppressor gene nor an oncogene. Its product is an oncofetal RNA. The potential use of this RNA as a tumour marker should be evaluated.

Biomarkers, Tumor↗
PubMed1996

Predictive score for vaginal birth after cesarean section.

OBJECTIVE: Our purpose was to evaluate the relative weight of the different variables that may influence the chances of vaginal birth after one cesarean delivery, with the aim of developing a predictive score for success of such a trial. STUDY DESIGN: In this retrospective study, which covered a 10-year period (1981 to 1990), 471 women who attempted vaginal birth at a level III university hospital after one abdominal delivery were studied as to the subsequent delivery outcome. An attempt to identify possible prognostic factors for success of such a trial was made. RESULTS: A trial of labor was successful in 368 (78.1%) of women and 103 (21.9%) had a repeat cesarean section. Variables of significant predictive value were vaginal birth before cesarean section (odds ratio 1.8), malpresentation (odds ratio 1.9), pregnancy-induced hypertension (odds ratio 2.3), and Bishop score > or = 4 (odds ratio 6.0). Cephalopelvic disproportion and failure to progress did not demonstrate a significant predictive value (odds ratio 0.81) for success or failure in subsequent delivery. In fact, 63.8% of women with this indication have successfully undergone vaginal delivery. Maternal age (odds ratio 0.9) had no bearing on vaginal delivery success rates, whereas both macrosomia (odds ratio 0.2) and intrauterine growth retardation tended to decrease the chances for vaginal birth after cesarean section. CONCLUSIONS: A trial of labor after one cesarean section should be encouraged in most women who are willing to attempt it, provided no obstetric contraindication exists. A scoring system that may help to identify women with a greater chance for vaginal delivery is proposed.

Adult↗
PubMed1996

The impact of endometrial preparation on implantation following cryopreserved-thawed-embryo transfer.

The efficacy of three protocols of endometrial preparation (spontaneous cycles, A: artificial preparation, B; ovarian stimulation, C) for cryopreserved-thawed human embryo transfer (CT-ET). The implantation and clinical pregnancy rates per cycle in 236 women undergoing 381 consecutive CT-ETs were evaluated according to the endometrial preparation protocol. No statistically significant difference was found in implantation rates per embryo transfer (A = 5.6%, B = 5.6%, C = 4.6%) and clinical pregnancy rates per cycle (A = 16.9%, B = 16.5%, C = 15.6%) between the three endometrial preparation protocols used. In conclusion, the specific method of endometrial preparation for CT-ET had no significant impact upon the implantation rate.

Adult↗
PubMed1995

Comparison between nafarelin acetate and D-Trp6-LHRH for temporary pituitary suppression in in vitro fertilization (IVF) patients: a prospective crossover study.

PURPOSE: Nafarelin acetate is a new gonadotropin releasing (GnRH) agonist analogue with unique potency, intranasal administration, and convenient storage. Hence, nafarelin was considered as an alternative for temporary pituitary suppression in patients undergoing ovulation induction in IVF. A crossover treatment in a prospective study was performed including 40 women with bilateral obstructed tubes and normal ovarian function, treated in 80 ovulation induction cycles using the long protocol. Twenty patients used nafarelin acetate 600 micrograms/daily in their first cycle and received D-Trp6-LHRH, 0.5 mg/daily, in their following cycle. The other 20 women used decapeptyl in their cycle and received nafarelin in the second. RESULTS: Estradiol suppression was achieved by both D-Trp6-LHRH and nafarelin at equal time intervals. The average total number of ampoules (P = 0.0005) and the length of administration of hMG required for ovarian stimulation (P = 0.0002) and the time interval between GnRHa initiation to oocyte retrieval (P = 0.04) was significantly lower in nafarelin cycles. The number and the distribution between large and small follicles as well as the average number of oocytes retrieved did not differ between the two GnRH analogues. CONCLUSION: Our results demonstrate that nafarelin acetate is comparable to D-Trp6-LHRH for temporary pituitary suppression used for controlled ovarian stimulation in IVF patients. However, using nafarelin ovarian stimulation was achieved with few ampoules of hMG, administered for a shorter period of time, thus with a lesser cost.

Adult↗
PubMed1994

Cesarean scar endometriosis.

A mass located in a scar area during examination is an infrequent phenomenon. Such a mass can be associated with keloid, hematoma, granuloma, hernia or neoplasm. Two cases of scar endometriosis are reported. The late onset of symptoms after surgery (average 4.5 years) is the usual reason for misdiagnosis. Awareness of this infrequent and late postoperative complication would increase the detection rate. Surgical excision remains the treatment of choice and should be accomplished without complications.

Adult↗
PubMed1994

Hyperreactio luteinalis associated with non-immune hydrops fetalis--the role of pituitary hormones.

The level of pituitary hormones was measured in the serum and cysts' aspirate in a case of hyperreactio luteinalis (HL) complicating non-immune hydrops fetalis. The level of follicular stimulating hormone (FSH), prolactin and growth hormone (GH) was within normal range for pregnancy in both the serum and cysts' aspirate. The importance of increased luteinizing hormone (LH) level which was demonstrated in the cysts' fluid should further be determined.

Adult↗
PubMed1994

Recurrent gestational trophoblastic disease following in-vitro fertilization.

Recurrence of gestational trophoblastic disease (GTD) following two attempts at in-vitro fertilization (IVF)/embryo transfer is reported in a childless couple after 17 years of unsuccessful trials of ovulation induction. The diagnosis of bilateral tubal obstruction was finally established, indicating IVF treatment. After the first IVF/embryo transfer treatment, the woman developed GTD and was treated with methotrexate. After a second IVF attempt, GTD was again diagnosed. This time there was no response to methotrexate, thus necessitating second-line chemotherapy. Etoposide, methotrexate, actinomycin D, cyclophosphamide, oncovine was used, and after only four treatment cycles the beta-human chorionic gonadotrophin (HCG) dropped to < 5 mIU/ml. After 26 months of follow-up, the beta-HCG continues to be undetectable. Preimplantation evaluation and ovum donation are described as measures to minimize the risk for GTD recurrence in a future IVF/embryo transfer.

Adult↗
PubMed1994

Comparison of cefonicid and cefazolin prophylaxis in abdominal hysterectomy.

One hundred and sixty-four patients undergoing abdominal hysterectomy for benign diseases were prospectively evaluated. The efficacy and safety of surgical prophylaxis with a single dose of the long-acting cefonicid was compared to the standard three dose regimen of cefazolin. Prophylaxis was successful in 82 of 85 (96.5%) patients receiving cefonicid and in 77 of 79 (97.5%) patients receiving cefazolin. No serious adverse effects were encountered with both drugs. It is concluded that single dose intravenous cefonicid, when given preoperatively, is as safe and effective as the standard multiple dose regimen of cefazolin in patients undergoing elective abdominal hysterectomy.

Adult↗
PubMed1994

Sonographic evaluation of fetal head extension and maternal pelvis in cases of breech presentation.

BACKGROUND: To investigate whether sonographic examination of the fetal head extension, pelvic adequacy and fetal position, could replace the traditional x-ray method in the evaluation of the breech in labor. METHODS: Seventy-two parturients admitted in labor with a breech presentation were prospectively evaluated by a newly proposed ultrasonographic approach. The head extension, obstetric conjugate and fetal attitude obtained were further compared to the gold standard radiologic measurements. RESULTS: A highly significant correlation between ultrasonic and x-ray measurements for the fetal head extension (r = 0.8696; p < 0.0001), obstetric conjugate (r = 0.8931; p < 0.0001), as well as high reliability (95.5%) in diagnosing the breech variant by ultrasound have been found. CONCLUSIONS: Ultrasonic evaluation of breech presentation, as performed by the proposed method, is simple, easy to perform and compares well with the standard radiologic studies. It is suggested that modern ultrasonic technique, which carries no risk of ionizing radiation, may replace traditional x-ray examination of the breech in labor.

Breech Presentation↗
PubMed1994

Ovarian cysts: a clinical dilemma.

The rapid development of ultrasound technology and its routine application during gynecological examinations has led to the more frequent detection of ovarian cysts. Such cysts can be diagnosed at any age or stage of a woman's life, and detected as early as the fetal stage or as late as the postmenopause. Ovarian cysts in female fetuses are usually detected during screening in pregnancy and followed after delivery as neonates. A few months are usually sufficient for spontaneous regression, although symptomatic cysts should be promptly operated. In fertile women, most cases present benign functional cysts which disappear after menstruation or can be managed easily with the combined oral contraceptive pill. When pregnancy is complicated with an adnexal mass, the second trimester is the preferable time of action in cases when operation is demanded. Transvaginal sonography plays an important role, not only in the detection of ovarian cysts but also in the diagnosis of malignancy. Large cysts, multiloculi, septa, papillae and increased blood flow are all suspected signs of neoplasia. The incidence of ovarian cancer increases with age and is predominantly a disease of peri- and postmenopausal women with an average patient age of 50-59 years. Vaginal sonography has been established as the examination of choice in screening and follow-up of patients, with complementary color Doppler studies and determination of serial serum levels of CA-125. If a malignant cyst is suspected, at any age, explorative laparotomy should be performed promptly. Sonographic or computerized tomographic scanner aspiration procedures, as well as laparoscopic surgery, should be reserved for diagnostic or therapeutic purposes in low-risk cancer patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1994

Prophylactic antibiotics in abdominal hysterectomy.

BACKGROUND: The cephalosporins, which have been widely used in gynecologic surgery, are considered by many to be the drug of choice for chemoprophylaxis. However, their benefit in total abdominal hysterectomy has remained controversial. This study was done to evaluate the effectiveness of the commonly used cephalosporins in preventing inflammatory complications which may occur after elective abdominal hysterectomy. STUDY DESIGN: A MEDLINE and manual review of the literature from the past 15 years (1977 to 1991), using the terms "prophylactic antibiotics," "abdominal hysterectomy," and "cephalosporins," was performed. Seventeen prospective trials using cephalosporin prophylaxis alone for 24 hours perioperatively were evaluated. A meta-analysis of the 2,752 study and control patients abstracted was performed to compare postoperative infection and febrile morbidity rates. RESULTS: The cephalosporin group as well as the various generations and individual drugs were found to be useful in preventing postoperative infection (p < 0.001). Febrile morbidity, however, was effectively prevented (p < 0.001) by first but not by some second and third generation drugs. Multivariate analysis revealed no advantage for the newer, more expensive second and third generation cephalosporins studied. When adjusted for confounding factors, the number of doses, the amount of the dose, and the route of administration had significant impact on the outcome events. CONCLUSIONS: Chemoprophylaxis with cephalosporins was found to be effective in preventing posthysterectomy infectious complications. A single dose, preoperative injection of first (cefazolin) or second (cefoxitin) generation cephalosporin, when administrated intravenously, has been shown to yield the best, cost-effective clinical results.

Bacterial Infections↗