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Biomedical subjects

V Tzingounis

Publications and source records attributed to V Tzingounis.

At least 19 recordsLinked to original sources

The effects of recombinant human erythropoietin given immediately after delivery to women with anaemia.

OBJECTIVE: Anaemia is a common problem during pregnancy and the puerperium. This study was designed to determine the efficacy and safety of giving recombinant human erythropoietin (EPO) to anaemic women during the puerperium. METHOD: Thirty-seven women received a single dose of EPO (20 000 IU intravenously) immediately after delivery. A control population (n = 37) matched according to age and haemoglobin concentration was evaluated. All women received oral iron supplementation for 40 days after delivery. Haemoglobin concentrations were measured 4 and 40 days after delivery. Blood transfusions were given depending on clinical condition and haemoglobin level. RESULTS: Patients treated with EPO had a significantly higher mean haemoglobin concentration than control patients at days 4 and 40. No women in the EPO group required a transfusion, compared with six in the control group. No side-effects and fewer anaemia-related symptoms were observed during EPO treatment. CONCLUSION: EPO given at delivery is effective in decreasing the need for blood transfusion and the incidence of problems associated with anaemia during the puerperium.

Adult↗

Anticardiolipin antibodies levels in healthy pregnant and non-pregnant woman.

To determine the prevalence of anticardiolipin antibodies in healthy non pregnant women and during normal pregnancy, 110 healthy women of mean age 25 years old and 53 healthy pregnant females of mean age 24.5 years old, who no one suffered from any autoimmune disease, were studied. In all women the anticardiolipin antibodies were measured in duplicate by the Enzyme Linked Immunosorbent Assay (ELISA). There was no difference in the percentage of the positive anticardiolipin antibodies between non pregnant and pregnant healthy women (9.1% and 5.6% respectively). Also, there was no difference in the antibodies levels during normal pregnancy, as well as, during an equal time of observation in non pregnant women. The positive anticardiolipin antibodies levels were low.

Adolescent↗

Investigation of kinetic of lead during pregnancy and lactation.

Lead concentration was estimated in peripheral blood, milk as well as in cord blood in 47 women and their infants, using atomic absorption spectrophotometry. Mean maternal blood lead concentration was 14.9 +/- 4.1 microg/dl, while in milk a mean level of 2.0 +/- 0. 5 microg/dl was estimated. Mean lead concentration in cord blood was 13.1 +/- 3.7 microg/dl. Analysis of these data showed a statistically significant correlation between lead maternal and cord blood concentration (r = 0.413, p = 0.01) or maternal blood and milk (r = 0.543, p < 0.01). The difference between maternal and cord blood might be indicative of a small filtering effect of placental tissue on lead transfer to the fetus. Placenta can determine 57.4% of the level of lead transferred to the fetus in a dynamic modus, while 42.6% depends on the pollution's level of mothers.

Adolescent↗

Tenoxicam versus lynestrenol-ethinyl estradiol treatment of dysfunctional uterine bleeding cases during adolescence.

BACKGROUND: The purpose of this study was to compare the effectiveness of tenoxicam versus lynestrenol-ethinyl estradiol (L-EE) in the treatment of severe cases of dysfunctional uterine bleeding (DUB) during adolescence. METHODS: Forty-eight patients with objective DUB completed a randomized comparative trial of treatment with tenoxicam (20 mg daily, n = 23) or L-EE (1 tablet containing 0.05 mg + 2.5 mg, respectively, 3 times daily, n = 25). Treatment was given during menorrhagia until bleeding ceased. Mean age of the patients was 13.74 +/- 2.1 years (range, 11-18 years). RESULTS: A significantly higher level of hematocrit (35.9% v 32.6%, t = 2.1, P = 0.0217) and hemoglobin (11.5 v 10.4 g%, t = 1.7, P = 0.0495), and significantly less hospitalization (5.75 v 8.33 days, t = 2.45, P = 0.0106) was seen in the tenoxicam group in comparison to L-EE group after completion of the treatment. Three patients were submitted to curettage and seven to transfusion in the group receiving L-EE, but no patients in the tenoxicam group required these procedures. CONCLUSIONS: Tenoxicam is considered an effective medication for the management of DUB during adolescence.

Adolescent↗

Treatment of recurrent genital herpes with interferon alpha-2alpha.

The purpose of the present study was to evaluate the efficacy and safety of parenteral administration of interferon alpha-2alpha in the treatment of recurrent herpes genitalis. A total of 97 patients (66 males, 31 females, mean age 34.86 +/-16.74 years), who had at least five recurrences of genital herpes during the previous 12 months, participated in a prospective open study on the effects of treatment with interferon alpha-2alpha (Roferon-A; Roche). The patients were treated with interferon alpha-2alpha (3 x 10(6) IU) by subcutaneous injection, three times weekly for 4 weeks, and the same schedule was repeated after 3 and 6 months. All patients were asymptomatic at the start of the study. After initiation of treatment, all patients reported to the clinic every 3 months for 2 years (the males were submitted to peoscopy and the females to Pap test and colposcopy) at the time of their recurrences. Comparison was made of the number of recurrences, duration of lesions, duration and severity of pain, and itching and burning. Prophylactic administration of interferon alpha-2alpha prevented recurrences of genital herpes virus infection in 51 patients (20 males and 31 females). Interferon administration shortened the healing time from 8.5 days before treatment to 2.5 days after treatment (p < 0.001). There was a significant reduction in the number of recurrences during the study period, from 7.46 before treatment to 2.64 after treatment (p < 0.001). On the basis of the overall efficacy and adverse effects, this regimen may be of value in the routine treatment of recurrent herpes.

Adolescent↗

Gynecologic cancer and surgical infectious morbidity.

The purpose of this study was to evaluate retrospectively the surgical infectious morbidity in gynecologic cancer. We examined 1,180 gynecologic oncology patients: 608 women had carcinoma of the endometrium, 510 cancer of the cervix, 48 ovarian cancer and 14 vulvar cancer. Thirty-five (6%), 92 (18%), 7 (15%) and 2 (14%) were complicated by infection in carcinoma of the endometrium, cancer of the cervix, ovarian cancer and vulvar cancer, respectively. Our conclusion is that the highest surgical infectious morbidity occurs in patients with cervical cancer and the lowest in patients with carcinoma of the endometrium.

Adult↗

Peoscopic diagnosis of flat condyloma and penile intraepithelial neoplasia. Clinical manifestation.

Peoscopy was performed in order to assess penile lesions in the male sexual partners of 326 women with cervical intraepithelial neoplasia (CIN) or flat condyloma (FC). Each patient was submitted to a careful naked-eye inspection, peoscopy and biopsy of any suspicious lesion which was confirmed histologically and immunohistochemically. A brush cytologic examination of the distal portion of the urethra was also performed. The distribution of penile lesions was as follows: (1) 8 patients with herpes virus infection; (2) 37 patients with condyloma accuminata (CA); (3) 89 patients with FC; (4) 51 patients with FC and CA; (5) 18 patients with penile intraepithelial neoplasia grade 1 (PIN-I); (6) 2 patients with PIN-II; (7) 17 patients with PIN-III; (8) 92 patients with no penile lesions; (9) 7 patients with human papilloma virus infection of papillae coronae glandis, and (10) 5 patients with FC of the distal portion of the urethra. Naked-eye inspection revealed the presence of penile lesions in 39 of 233 patients (16.73%). Peoscopic examination revealed the presence of penile lesions in 233 of 326 patients (71.48%). In 135 of 155 patients the peoscopic findings were in accordance with the histologic diagnosis (87.09%). Immunohistochemical (by indirect peroxidase-antiperoxidase method) detection of virus antigens was positive in 16 of 34 patients (47.03%). It is concluded that peoscopy of the male sexual partners of women with CIN or FC should be performed to better assess the treatment used in the couple.

Antigens, Viral↗

Treatment of penile intraepithelial neoplasia (PIN) with interferon alpha-2a, CO2 laser (vaporization) and 5-fluorouracil 5% (5-FU).

This study was undertaken to assess the effectiveness of CO2 laser (vaporization), 5-FU topical application and Interferon (IFN alpha-2a) parenterally in the therapy of penile intraepithelial neoplasia (PIN). From March 1986 to September 1991, 1,372 men, sexual partners of women with condylomata accuminata or flat or cervical intraepithelial neoplasia (CIN), were submitted to peoscopy, of 1,019 men who presented with various lesions caused by human papillomavirus (HPV)-confirmed histologically-208 were treated for PIN. The best treatment modalities irrespective of grade of lesion were found to be the combination of 5-FU plus CO2 laser vaporisation plus IFN alpha-2a (high dose) (96.15%), the combination of 5-FU plus CO2 laser vaporization (87.09%) and the combination of CO2 laser vaporization plus IFN alpha-2a (high dose) (80%). It is concluded that IFN alpha-2a (low dose) can be used as first line treatment in combination with 5-FU in patients with PIN II and as an adjuvant treatment (high dose) in patients with recurrent PIN I and PIN III.

Administration, Topical↗

Postmenopausal uterine bleeding.

The purpose of this study was to evaluate the incidence of the etiologic factors of postmenopausal uterine bleeding and the recurrence rate of uterine bleeding before total hysterectomy. Six hundred and twenty-eight patients (mean age 52.2) with postmenopausal uterine bleeding were studied. Atrophic endometrium was found in 522 cases (83.1%), carcinoma of the endometrium in 70 cases (11.1%), proliferative endometrium in 29 cases (4.6%) and secretory endometrium in 7 cases (1.1%). The recurrence rate of uterine bleeding was very high in carcinoma of the endometrium, moderate in proliferative endometrium and low in secretory and atrophic endometrium.

Atrophy↗

Treatment of men with flat (FC) or acuminata (CA) condylomata with interferon alpha-2a.

This study was undertaken to assess the effect of CO2 laser vaporization, 5-fluorouracil 5% (5-FU) topical application and Interferon alpha-2a (IFA alpha-2a) in the treatment of C.A. or F.C. of the male genital tract. From March 1986 to September 1991, 1372 men, sexual partners of women with F.C. or C.A. or cervical intraepithelial neoplasia, were submitted to peoscopy. One thousand and nineteen (74.27%) men presented with various penile lesions caused by HPV (histologically confirmed); of these 505 were treated for C.A. or F.C. or a combination of F.C. and C.A. The best treatment modalities, irrespective of the kind of lesion, were found to be the combination of 5-FU plus IFN alpha-2a (high dose) (98.27%), the combination of CO2 laser vaporization plus 5-FU plus IFN alpha-2a (high dose) (93.93%) and the combination of CO2 laser vaporization plus 5-FU (87.23%). In conclusion we believe that IFN alpha-2a can be used with excellent results as first line treatment in combination with CO2 laser vaporization or/plus 5-FU in patients with C.A. or F.C. or combined condylomata.

Administration, Topical↗

Short-term verus long-term prophylactic tocolysis in patients with preterm premature rupture of membranes.

A randomised prospective clinical trial was conducted over a 7-year period (1987-1993) in the Department of Obstetrics and Gynaecology, University of Patras. The purpose of this study was to compare two management protocols of Preterm Premature Rupture of Membranes (PPROM). Two-hundred forty-one women entered the study and were assigned randomly to one of two groups. Group A consisted of 105 subjects who were managed expectantly (tocolysis used for 48 h only, if necessary, to permit full course of steroid therapy), while Group B consisted of 136 subjects, in whom aggressive tocolysis was utilised. The differences in the latency period (time from rupture of membranes to the onset of labour) were not statistically significant between the two groups. On the contrary, statistically significant differences in the incidence of chorioamnionitis and postpartum endomyometritis were found between the two groups (higher in Group B). Twelve subjects in Group A (12/105, 11.4%) and 40 in Group B (40/136, 29.4%) had chorioamnionitis. The relative risk (RR) was 2.47 (95% C.I. 1.42-4.66, P < 0.001). Endomyometritis was diagnosed in 20 subjects in Group A (20/105, 19%) and in 45 in Group B (45/136, 33.3%). The RR was 1.74 (95% C.I. 1.10-2.75, P < 0.05). These data suggest that long term prophylactic tocolytic therapy in patients with PPROM, while without demonstrated benefit, may result in an increased risk of maternal infectious morbidity, and raise the cost of treatment.

Chorioamnionitis↗

Reduction of hospital cost and administration of prophylactic antibiotherapy in gynecological surgery.

The present study attempts to evaluate the efficacy and safety of three of the most popular third-generation cephalosporins, and demonstrates the reduction in cost resulting from their use. Our study included 223 women admitted for abdominal hysterectomy (mean age 54), 200 of whom were assigned randomly to one of four groups. The first group did not use an antibiotic prophylaxis. The second group used ceftriaxone, the third cefotaxime and the fourth ceftazidime. In the three treatment groups one 2-g dose of the antibiotic was provided 60 min before the operation. Additional doses were given only if post-operative infection was established. Our results indicated that one dose of antibiotic prophylaxis with third-generation cephalosporins reduces the morbidity in gynecological surgery. Cefotaxime proved to be the most cost-effective of these three cephalosporins, with low morbidity and a low rate of hospitalization.

Adult↗

[Luteal insufficiency and endometriosis. Comparative study of plasma progesterone and of the evolutionary stage].

24 patients who had more than two years of infertility were checked by laparoscopic and hormone (plasma progesterone) tests at the 21st-23rd day of the cycle. Two comparable groups were found: Group A with no visible endometriosis, and Group B with obvious endometriosis (stage I, IIa, IIb according to Kistner's classification). There is a significant difference between the two groups as far as the levels of progesterone in the plasma are concerned, because they are lower in Group B than in Group A. On the other hand, there is no correlation to be demonstrated between the severity of the endometriosis and the low level of progesterone.

Adult↗

[Changes in plasma prolactin levels after gynecologic surgery].

The effect of total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH) on serum prolactin (PRL) levels in 17 women of reproductive age was studied. Fifteen women who had minor surgery served as controls. Serum PRL levels of those women who underwent TAH as well as in those who underwent minor procedures rose significantly 24 hours after surgery. Six weeks after operation PRL levels returned to pre-operative levels in all women studied. From these data we conclude that operative stress is the cause of this rise.

Adult↗

Cefuroxime prophylaxis in caesarean section.

A double-blind, randomized prospective study was carried out in 96 women in labour requiring caesarean section to assess the value of antibiotic prophylaxis with cefuroxime compared with placebo. Forty-six patients received 750 mg cefuroxime intravenously before and every 8 hours for the first 72-hours post-operatively; the other 50 women received placebo injections. A significant decrease in post-operative morbidity was observed in the drug-treated group, there were far fewer endometrial, urinary and pulmonary injections, and those who received prophylactic cefuroxime had less days of hospitalization than the placebo-treated group. No serious side-effects were observed.

Cefuroxime↗

Local therapy of atrophic vaginal conditions with oestriol suppositories.

Twenty post-menopausal women were treated using oestriol vaginal suppositories (Ortho-Gynest). Subjective disturbances such as dyspareunia, pruritus, and kraurosis vulvae showed a good response to the therapy, while the anaplastic activity of the vaginal epithelium to the suppositories was shown by an increase in the vaginal superficial cells which followed the course of treatment. Side-effects were minimal and disappeared following cessation of treatment.

Aged↗

Danazol treatment of endometriosis: long-term follow-up.

Forty-nine women diagnosed as having pelvic endometriosis were treated with 800 mg of danazol/day for a mean duration of 6 months. The average length of the follow-up period was 78 months. Side effects were minimal, and regular ovulatory menses returned within 25 to 90 days (average 42 days). Forty-two (85.7% of these women had associated infertility. Recurrence of symptoms was reported in 33% but in no patient were the symptoms worse than before entering the study. Of 30 patients desirous of pregnancy, 20 were potentially fertile; of these, 10 conceived within 6 months of discontinuing therapy, for a conception rate of 50%. Nine of the remaining ten patients required additional therapeutic procedures (surgery and/or danazol), and four of these conceived within 12 months. These results compare favorably with those of other investigations, since most of our patients were referred to us after being subjected to a variety of regimens, both hormonal and surgical.

Danazol↗