ABSTRACT
OBEJECTIVES: Optimal cytoreductive surgery (CRS), followed by adjuvant chemotherapy, is a major predictor of oncological outcome in patients with advanced epithelial ovarian carcinoma (EOC). It is not clear if a delayed start of adjuvant chemotherapy negatively impacts on the oncological outcome. METHODS: Prospective registry study on 75 patients treated with CRS and hyperthermic intraperitoneal chemotherapy (HIPEC). Adjuvant chemotherapy was started within 42 days in 41 patients (55%), later on in 34 patients (45%). Multivariate analyses of preoperative factors were done on survival outcome. Outcomes were recurrence-free survival (RFS) and overall survival (OS). RESULTS: There was no difference in RFS after early introduction (median 35 months) vs. late introduction of chemotherapy (median 32 months), p = 0.17. Median OS in patients with late introduction of chemotherapy was 46 months and was not yet reached in early introduction group. CONCLUSIONS: In this exploratory study in a small group of women with advanced EOC, starting adjuvant chemotherapy more than 6 weeks after CRS and HIPEC did not deteriorate significantly RFS or OS. Well-designed clinical studies are still needed to evaluate the interplay of HIPEC and the point of time of postoperative adjuvant chemotherapy in this indication.
ABSTRACT
A prospective controlled blind study was carried out in the Special Care Unit for Newborns to assess the effect of commercially available sweetener on pain relief in newborns. Response to intramuscular injection and the pain stimulus was studied in twenty-five sick newborns, 13 preterm and 12 term, in a blinded fashion. Pain score, duration of cry, heart rate and oxygen saturations were studied. Basal response, responses with sterile water or sweetener were recorded in each baby. Responses to sweetener versus no solution and sweetener versus sterile water were compared by applying paired t-test. The reduction in pain score with sweetener was significant when compared with no solution. The difference was not significant when compared with sterile water. Similarly, duration of cry and heart rate with sweetener were significantly less when compared to sterile water or to no solution. However, the difference in oxygen saturation was not significantly different. Sweetener has an analgesic effect in sick babies. This can minimise adverse effects associated with painful procedures.
Subject(s)
Analgesics , Pain Management , Sweetening Agents/therapeutic use , Humans , Infant, Newborn , Infant, Premature , Prospective StudiesSubject(s)
Magnesium Sulfate/administration & dosage , Persistent Fetal Circulation Syndrome/drug therapy , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Humans , India , Infant, Newborn , Infusions, Intravenous , Male , Masks , Oxygen/administration & dosage , Persistent Fetal Circulation Syndrome/diagnosis , Treatment OutcomeABSTRACT
Oxygen saturations were compared, 10 min before and 10, 20 and 30 min after orogastric and nasogastric feeds, in 10 stable newborns. The mean saturations were significantly lower with mere passage of nasogastric tube and continued to be so during feeds. There was no difficulty in securing the orogastric tube and no baby aspirated milk.
Subject(s)
Enteral Nutrition/methods , Infant, Premature , Intubation, Gastrointestinal/methods , Humans , Infant, Newborn , Oxygen/bloodABSTRACT
Oxygen saturation was studied in eight newborn babies, seven preterm and one term, with and without caressing by the mother while receiving gavage feeds. The babies were stable with regard to cardiorespiratory and neurological status. Four babies were still receiving head-box oxygen. The oxygen saturation levels were similar before feeds. However, the levels were significantly higher with caressing at 10, 20 and 30 min after the feed in babies not receiving oxygen and at 20 and 30 min after feeds in babies receiving oxygen.
Subject(s)
Infant, Newborn/physiology , Infant, Premature/physiology , Mother-Child Relations , Oxygen Consumption/physiology , Oxygen/blood , Touch/physiology , Enteral Nutrition , Humans , Infant, Newborn/psychology , Infant, Premature/psychology , Oxygen Inhalation Therapy , Time FactorsABSTRACT
A retrospective analysis of 22 patients with ovarian dysgerminoma who were treated between 1980 and 1987 was carried out. The median age at presentation was 24.5 years. A total of 15 patients were in stage I, one patient was in stage II and six patients were in stage III. Bilateral ovarian involvement was present in four patients. Conservative surgery was carried out in nine patients and 11 patients underwent radical surgery. Two patients had biopsy only. Fourteen patients received adjuvant radiotherapy and three patients received salvage radiation for recurrent disease. The 10-year actuarial survival rate was 81.8%. All 15 patients in stage I were alive and disease-free at a median follow-up of 125 months. Four patients (one in stage II and three in stage III) died of progressive or recurrent abdominopelvic disease. Pelvic recurrence occurred after conservative surgery in two patients in stage IA who had a tumour size greater than 10 cm, but they were salvaged with radical surgery, chemotherapy and radiotherapy. There were seven patients aged 20 years or less. All were alive and disease-free at a median follow-up of 127 months.
Subject(s)
Dysgerminoma/radiotherapy , Ovarian Neoplasms/radiotherapy , Adolescent , Adult , Combined Modality Therapy , Dysgerminoma/surgery , Female , Humans , Middle Aged , Ovarian Neoplasms/surgery , Retrospective StudiesSubject(s)
Myxoma/pathology , Vaginal Neoplasms/pathology , Vulvar Neoplasms/pathology , Adult , Female , HumansABSTRACT
Squamous cell carcinoma arising in ovarian endometriosis is extremely rare, but a case is reported in a 62 year old woman. If such an ovarian tumour is discovered evidence of teratoma, Brenner tumour, or endometriosis should be sought. Extensive sampling is mandatory as the developing tumour often overgrows the foci of endometriosis, thus obliterating evidence of its origin.
