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1.
Pediatr Obes ; 12(6): 494-501, 2017 12.
Article in English | MEDLINE | ID: mdl-27492865

ABSTRACT

BACKGROUND: Telehealth offers opportunities to extend clinical and research interventions for paediatric obesity. OBJECTIVES: To assess utility of a telephone intervention, implemented through a national primary care paediatric research network, for promoting differentiation in dietary intake, consistent with either a low-glycemic load (Low GL) or Low Fat prescription, among overweight/obese school-age children. METHODS: Five-week telephone dietary counselling intervention for parents of overweight/obese school-age children recruited through the Slone Center Office-based Research Network. Parent-child dyads were randomized to Low GL or Low Fat diet. Primary outcomes were dietary GL and dietary fat, adjusted for energy intake and assessed by 24-h dietary recall. RESULTS: Subjects were randomized to Low GL (n = 11, 8.1 ± 1.7 years, 45.5% male) or Low Fat (n = 11, 8.2 ± 2.0 years, 36.4% male), with no baseline differences. Overall, 86% of subjects attended at least four of five counselling sessions, and study completion rate was 91% (based on completion of the final dietary recalls). Reported satisfaction was high. In adjusted analyses limited to 'recall completers,' reduction in dietary GL (g/1000 kcal) achieved within the Low GL group was significant (p = 0.01) and greater than the change in dietary GL in the Low Fat group (mean ± SE; -12.9 ± 4.4 vs. 5.1 ± 4.9, p = 0.03). Similarly, reduction in dietary fat (% of total energy) within the Low Fat group was significant (-5.6 ± 2.5, p = 0.046) but with no difference between groups (p = 0.25). CONCLUSION: A telephone-based dietary intervention for overweight/obese children, implemented through a national paediatric research network, fostered prescribed dietary changes. ClinicalTrials.gov registration: NCT00620152.


Subject(s)
Diet, Carbohydrate-Restricted/methods , Diet, Fat-Restricted/methods , Overweight/diet therapy , Pediatric Obesity/diet therapy , Primary Health Care/methods , Child , Child, Preschool , Female , Humans , Male , Telemedicine , Telephone , Treatment Outcome
2.
Eur J Surg Oncol ; 38(3): 222-9, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22231127

ABSTRACT

AIMS: We compared histological patterns after lumpectomy for non-palpable breast cancers preoperatively localized by radioguided occult lesion localization plus sentinel node localization (SNOLL) versus wire-guided localization. METHODS: To ensure a homogeneously treated cohort and rigorous comparisons, only patients with invasive cancer and measurable opacity by imaging were included. Exclusion criteria were one or more parameters that could interfere with localization and/or the surgical procedure. Forty-three SNOLL were compared with 86 WGL plus sentinel node (SN) localization. Cancer localization effectiveness was based on careful assessment of histological data from only the first resected glandular specimen, as any additional resection specimens were guided by intraoperative histological examination. RESULTS: Reexcisions to ensure free tissue margins were performed during the same procedure in 13.9% of SNOLL versus 31.3% of WGL; p = 0.02. Significantly more women in SNOLL (53.4%) also had free nearest margins of >9 mm after the first procedure compared with WGL (33.7%); p = 0.03. The median centricity ratio after the first procedure was better in SNOLL (2.8, range 1.3-14) than WGL (5, range 1-50); p = 0.008. The median number of SN detected by lymphoscintigraphy was the same in SNOLL and WGL (1, range 0-9, vs. 1, range 0-8). Intraoperative SN detection by blue dye and/or gamma probe was successful for 97.6% of SNOLL versus 93% of WGL. CONCLUSION: In this study, SNOLL was effective and safe, and this procedure significantly improved the rate of negative margins in the first specimen and the rate of reexcision for positive margins compared with WGL.


Subject(s)
Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Multimodal Imaging , Positron-Emission Tomography , Sentinel Lymph Node Biopsy , Tomography, X-Ray Computed , Case-Control Studies , Chi-Square Distribution , Coloring Agents , Female , Humans , Lymphatic Metastasis/diagnostic imaging , Lymphatic Metastasis/pathology , Lymphoscintigraphy , Mastectomy, Segmental , Middle Aged , Neoplasm Invasiveness , Radiopharmaceuticals , Reoperation , Retrospective Studies , Statistics, Nonparametric , Technetium Tc 99m Sulfur Colloid
3.
J Visc Surg ; 148(2): e153-5, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21497149

ABSTRACT

Combined positron emission tomography and computerized tomography (PET/CT) using 18-fluorodeoxyglucose (18-FDG) is the most effective study to identify invasion of pelvic and/or para-aortic lymph node chains in cancers of the uterine cervix. We report the case of a patient who underwent laparoscopic hysterectomy and cytoreductive surgery for endometrial cancer; postoperative PET/CT identified an intense localization of 18-FDG in the region of the right common iliac chain. This finding led to an open re-exploration at which the only finding was a granuloma arising in reaction to a hemostatic sponge.


Subject(s)
Granuloma, Foreign-Body/diagnostic imaging , Lymphatic Metastasis/diagnostic imaging , Postoperative Complications/diagnostic imaging , Surgical Sponges/adverse effects , Adenocarcinoma/surgery , Endometrial Neoplasms/surgery , False Positive Reactions , Female , Fluorodeoxyglucose F18 , Granuloma, Foreign-Body/etiology , Humans , Middle Aged , Positron-Emission Tomography , Radiopharmaceuticals , Tomography, X-Ray Computed
4.
J Gynecol Obstet Biol Reprod (Paris) ; 39(8): 614-23, 2010 Dec.
Article in French | MEDLINE | ID: mdl-21036491

ABSTRACT

OBJECTIVE: To compare functional results following retropubic and transobturator mid-urethral sling procedures. METHODS: Multicenter randomized controlled trial. Power calculation was based on the rate of bladder injury. The current study concerns an analysis of secondary judgment criteria. RESULTS: One hundred and forty-nine patients were randomly allocated to either TVT (n=75) or TVT-O (n=74). Among them, 132 women completed a 24-month follow-up. There was no significant difference between the two groups, concerning urodynamics data (excluding uroflowmetry) at 12 months follow-up, functional and sexual results at 6, 12 and 24 months follow-up. Concerning sexual results, an improvement in visual analogue scale scores was observed in both groups at 24 months follow-up with no difference between the two groups: median score increased from 70 (IQR: 50-80) pre-operatively to 90 (IQR: 70-100) at 24 months follow-up (P=0,0004) in TVT-O group and from 70 (IQR: 50-80) to 85 (IQR: 70-100) (P=0,0009) in TVT group. CONCLUSION: TVT and TVT-O procedures are both associated with an increase in quality of life with no significant differences in functional results at 2 years follow-up.


Subject(s)
Prosthesis Implantation , Suburethral Slings , Urinary Incontinence, Stress/surgery , Adult , Female , Humans , Intraoperative Complications/epidemiology , Middle Aged , Prosthesis Implantation/adverse effects , Quality of Life , Sexual Dysfunction, Physiological/epidemiology , Sexual Dysfunction, Physiological/etiology , Suburethral Slings/adverse effects , Treatment Outcome , Urinary Bladder/injuries , Urodynamics
5.
J Visc Surg ; 147(6): e389-94, 2010 Dec.
Article in English | MEDLINE | ID: mdl-21094113

ABSTRACT

PURPOSE: To evaluate the clinical and cosmetic results of our treatment of recurrent periareolar abscess. PATIENTS AND METHODS: Our technique was applied to 27 patients with recurrent periareolar abscess who had been previously surgically treated three or more times between January 2001 and December 2008. Our treatment combined resection of the fistula, the terminal milk ducts, and mammary gland involved in the inflammatory process. This was associated with glandular remodeling and a lift of the periareolar skin. Long-term clinical results and evaluation of cosmetic result are analyzed. RESULTS: The median age of patients was 36 years and the median course of disease was 5 years (2-11 years). The duration of follow-up was 37 months. Before being treated in our service, patients had a median of four prior surgeries for this condition (3-12). The average hospital stay was 3.2±0.6 days after surgery. One recurrence occurred among the 24 patients reviewed. She was treated by excision of the nipple and areola. Six patients (25%) rated their outcome excellent and 13 patients (54%) considered their results good. Five patients assessed their overall result as fair (21%), and no patients judged their results as poor. CONCLUSIONS: Our technique is simple and feasible and the results are encouraging. It can be used regardless of the location of the fistula around the periphery of the nipple-areola complex and it is perfectly suited to the management of chronic fistulous abscess.


Subject(s)
Abscess/surgery , Breast Diseases/surgery , Mammaplasty/methods , Nipples , Adult , Humans , Middle Aged , Prospective Studies , Recurrence , Young Adult
8.
J Radiol ; 90(7-8 Pt 1): 787-802, 2009.
Article in French | MEDLINE | ID: mdl-19752784
9.
J Gynecol Obstet Biol Reprod (Paris) ; 36(7): 660-2, 2007 Nov.
Article in French | MEDLINE | ID: mdl-17611040

ABSTRACT

Münchausen's syndrome is a psychiatric disease with behaviour disorders including self-injuries. Self mutilations interest all the body, and among others the abdominal wall, who can mimic complications of surgery. We report the history of a woman consulting for an abdominal wall panniculitis two years after a caesarean. Medical history, histological patterns and the psychological history of the patient excluded the diagnosis of a surgical complication and Münchausen's syndrome was strongly evocated. The treatment was surgical, with excision of the cutaneous necrosis. The healing was obtained by treatment with Vacuum Assisted Closure System (VAC).


Subject(s)
Abdominal Wall/pathology , Munchausen Syndrome/diagnosis , Self-Injurious Behavior/diagnosis , Skin/pathology , Abdominal Wall/surgery , Adult , Cesarean Section , Dermatologic Surgical Procedures , Female , Humans , Necrosis/etiology , Necrosis/surgery
10.
Eur J Surg Oncol ; 33(3): 301-6, 2007 Apr.
Article in English | MEDLINE | ID: mdl-17110076

ABSTRACT

AIMS: Doughnut mastopexy lumpectomy (DML) is a unique breast resection in which a tissue segment is removed and the breast reshaped through a periareolar incision. The present prospective investigation compares DML and standard lumpectomy (SL) in relation to surgical variables, histological parameters, postoperative morbidity and cosmetic outcome. METHODS: 127 patients with breast cancer were offered the choice between two conservative surgical approaches: doughnut mastopexy lumpectomy (DML group, n=39) or standard lumpectomy (SL group, n=88). The groups were comparable for radiological tumour size, tumour location within the breast, histological size, and pT category. Comparison was performed in term of surgical variables, histological parameters, postoperative morbidity and cosmetic outcome. RESULTS: The patients undergoing DML were younger than the patients who chose SL. In the DML group, the skin incision was 3-fold longer than in the SL group but was obtained with a final scar located around the nipple areola complex without further postoperative complications. The average volume of the breast specimen was higher in the DML group compared with SL group. The clinician assessment of cosmetic outcome reported a higher rate of acceptable result in the DML group than in the SL group. However, patient's assessment did not show difference of cosmetic satisfaction between groups. CONCLUSION: Our comparative study indicates that DML may be a useful alternative to SL not only in terms of accurate breast tissue resection but also in term of cosmetic results.


Subject(s)
Breast Neoplasms/surgery , Mastectomy, Segmental/methods , Breast Neoplasms/pathology , Chi-Square Distribution , Esthetics , Female , Humans , Middle Aged , Postoperative Complications , Prospective Studies , Regression Analysis , Statistics, Nonparametric , Treatment Outcome
11.
Ann Chir ; 131(4): 256-61, 2006 Apr.
Article in French | MEDLINE | ID: mdl-16530156

ABSTRACT

UNLABELLED: The integration of oncoplastic techniques with a concomitant contralateral symmetrization procedure is a novel surgical approach that allows wide excisions and prevents breast deformities. AIM OF THE STUDY: This prospective study was undertaken to compare the accuracy of breast resection, between standard narrow lumpectomy and oncoplastic surgery. PATIENTS AND METHODS: Ninety-nine consecutive women undergoing breast cancer resection were enrolled in a prospective study comparing oncoplastic surgery (42 women) and standard lumpectomy (57 women). The size of the glandular resection, the width of the nearest margins, the ratio of clear margins and the need for further surgery were recorded. RESULTS: The oncoplastic approach resulted in significantly greater glandular resection and wider free histological margins than did standard lumpectomy. The need for re-exicsional surgery was significantly lower in the oncoplastic group than in the lumpectomy group. Furthermore, a trend towards fewer secondary mastectomies was seen for the oncoplastic approach versus standard lumpectomy. CONCLUSIONS: The use of oncoplastic techniques and concomitant symmetrization of the contralateral breast allows extensive resections for conservative treatment of breast carcinoma achieves accurate tumour resection and reduces the need for further surgery.


Subject(s)
Breast Neoplasms/surgery , Mastectomy, Segmental , Female , Humans , Mastectomy/methods , Middle Aged , Prospective Studies
12.
Br J Radiol ; 77(920): 701-3, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15326055

ABSTRACT

We report a young patient suffering from a uterine rhabdomyosarcoma. Particular features of the present case are: accuracy of the tumour spread evaluation performed by MRI of the pelvis; and the use of pre-operative arterial embolisation. The present multimodal management highlights the usefulness of cooperation between surgeons and radiologists in lowering operative bleeding and finally permitting uterine conservation.


Subject(s)
Embolization, Therapeutic/methods , Rhabdomyosarcoma/therapy , Uterine Neoplasms/therapy , Adolescent , Combined Modality Therapy , Female , Humans , Magnetic Resonance Imaging , Rhabdomyosarcoma/diagnosis , Rhabdomyosarcoma/surgery , Uterine Neoplasms/diagnosis , Uterine Neoplasms/surgery
13.
Diabetes Metab Res Rev ; 19(6): 464-8, 2003.
Article in English | MEDLINE | ID: mdl-14648805

ABSTRACT

BACKGROUND: It has been recently demonstrated that apoptosis is involved in beta-cell destruction in the NOD mouse model of diabetes. The aim of the present study was to investigate whether IL-15, a cytokine involved in the modulation of the apoptotic process, is capable of modifying the natural history of diabetes and/or insulitis in pre-diabetic NOD mice. The rationale for the use of IL-15-IgG2b recombinant cytokine is related to its long half-life (28 +/- 4 h). METHODS: At 10 weeks of age, 2 groups of 24 female mice were treated with single or multiple i.p. doses of IL-15-IgG2b respectively. As control, 2 groups of 24 age- and litter-matched female mice were injected intra-peritoneally with single or multiple doses of IgG2b immunoglobulin. RESULTS: Diabetes incidence at 33 weeks of age was lower in the group of mice treated with multiple doses than in the control group (p = 0.03). The cumulative incidence of diabetes at 33 weeks of age between single-dose treated mice and the control group was similar. No significant differences in the calculated index of insulitis were observed in all treated and control mice. CONCLUSIONS: We conclude that IL-15-IgG2b reduces the cumulative incidence of diabetes, without affecting the extent and severity of the insulitis process. Considering this and the well-defined anti-apoptotic effects of IL-15, we suggest that the reduction of diabetes incidence could be due to a down-regulation of beta-cell apoptosis.


Subject(s)
Diabetes Mellitus, Type 1/prevention & control , Interleukin-15/pharmacology , Recombinant Fusion Proteins/pharmacology , Animals , Diabetes Mellitus, Type 1/epidemiology , Glycosuria , Humans , Immunoglobulin G/pharmacology , Incidence , Mice , Mice, Inbred NOD , Time Factors
14.
Gynecol Obstet Fertil ; 31(2): 139-40, 2003 Feb.
Article in French | MEDLINE | ID: mdl-12718988

ABSTRACT

In cases of cervical cancer, there are 2 major advantages to preserving the ovaries, with or without transposition: hormone function is maintained during subsequent cancer treatment and patient quality of life is improved. We report the first case of pregnancy in a surrogate mother following stimulation of a transposed ovary before irradiation and chemotherapy for a squamous cell carcinoma of the uterine cervix. Because of the wide dissemination of information on the technical progress in this area, patients are now in a position to make therapeutic choices that are no longer guided by strictly medical considerations.


Subject(s)
Carcinoma, Squamous Cell/surgery , Fertilization in Vitro , Ovary/surgery , Surrogate Mothers , Uterine Cervical Neoplasms/surgery , Adult , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/radiotherapy , Chemotherapy, Adjuvant , Female , Humans , Ovary/drug effects , Ovary/radiation effects , Pregnancy , Radiotherapy, Adjuvant , Uterine Cervical Neoplasms/drug therapy , Uterine Cervical Neoplasms/radiotherapy
15.
Rev Prat ; 51(13): 1444-8, 2001 Sep 01.
Article in French | MEDLINE | ID: mdl-11601074

ABSTRACT

Endometrial cancer is the most common gynaecologic cancer and its incidence increases with age. Prognosis is good because in over 80% of cases the cancer is discovered early. Preoperative work-up should include definition of the operability of such patients, who are often elderly with frequent co-morbidity. Preoperative evaluation and operative findings allow guiding the treatment and evaluating the prognosis. Main determinants are local extension, penetration into the myometrium, histologic stage of the tumour and involvement of lymph modes or peritoneum. Surgery is the first approach since it establishes the evaluation and comprises the first step of treatment. When necessary, subsequent treatment uses irradiation. Treatment with hormones or antimitotic drugs is less effective and is used for forms that are locally advanced, metastatic or recurrent after initial treatment.


Subject(s)
Endometrial Neoplasms/diagnosis , Endometrial Neoplasms/therapy , Sarcoma/diagnosis , Sarcoma/therapy , Adenosarcoma/diagnosis , Adenosarcoma/therapy , Adult , Aged , Antineoplastic Agents/therapeutic use , Carcinosarcoma/diagnosis , Carcinosarcoma/therapy , Endometrial Neoplasms/radiotherapy , Endometrial Neoplasms/surgery , Female , Humans , Hysterectomy , Hysteroscopy , Leiomyosarcoma/diagnosis , Leiomyosarcoma/therapy , Middle Aged , Neoplasm Metastasis , Prognosis , Radiotherapy Dosage
16.
Fertil Steril ; 76(2): 388-9, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11476793

ABSTRACT

OBJECTIVE: To present a case of IVF-surrogate pregnancy in a patient with ovarian transposition who had undergone chemotherapy and total pelvic irradiation. DESIGN: Case report. SETTING: Teaching hospital. PATIENT(S): A 29-year-old woman who had undergone Wertheim's hysterectomy for a bulky carcinoma of the uterine cervix. INTERVENTION(S): Ovarian transposition before chemotherapy and total pelvic irradiation. Standard IVF treatment, transabdominal oocyte retrieval, and transfer to the surrogate mother. MAIN OUTCOME MEASURE(S): Results of the IVF cycle. RESULT(S): A twin pregnancy at the first cycle and two live newborns. CONCLUSION(S): This is the first reported case of ovulation induction and oocyte retrieval performed on a transposed ovary.


Subject(s)
Fertilization in Vitro , Ovary/surgery , Surrogate Mothers , Adult , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/surgery , Chemotherapy, Adjuvant , Female , Humans , Hysterectomy , Male , Ovary/drug effects , Ovary/radiation effects , Ovulation Induction , Pregnancy , Radiotherapy, Adjuvant , Twins , Uterine Cervical Neoplasms/drug therapy , Uterine Cervical Neoplasms/radiotherapy , Uterine Cervical Neoplasms/surgery
17.
Eur J Obstet Gynecol Reprod Biol ; 97(1): 30-4, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11435005

ABSTRACT

OBJECTIVE: To compare the incidences of tachysystole, hypertonia and fetal heart rate (FHR) abnormalities in women treated by mifepristone plus prostaglandins (PGs), mifepristone alone or PGs alone for an unfavourable cervix. STUDY DESIGN: In this retrospective study, all women between 37 and 42 weeks were eligible for the study if they had undergone cervical ripening prior to labour induction. In group 1, the women were treated with mifepristone plus PGs (n=103). Group 2 women were treated with mifepristone alone (n=96) and group 3 women with PGs alone (n=100). Incidences of tachysystole, hypertonia and FHR abnormalities were compared. RESULTS: During induction of labour, tachysystole and hypertonia occurred more frequently in women treated with mifepristone. Severe bradycardia and recurrent late decelerations were more frequent after the initiation of oxytocin in groups 1 and 2 than in group 3. CONCLUSIONS: In this study, mifepristone increased the incidences of tachysystole, hypertonia and FHR abnormality.


Subject(s)
Heart Rate, Fetal/drug effects , Hormone Antagonists/adverse effects , Labor, Induced , Mifepristone/adverse effects , Oxytocin/therapeutic use , Uterus/drug effects , Adult , Bradycardia/chemically induced , Female , Gestational Age , Humans , Logistic Models , Mifepristone/administration & dosage , Odds Ratio , Oxytocin/administration & dosage , Pregnancy , Progesterone/antagonists & inhibitors , Prostaglandins/administration & dosage , Prostaglandins/therapeutic use , Retrospective Studies
18.
BJOG ; 107(3): 396-400, 2000 Mar.
Article in English | MEDLINE | ID: mdl-10740337

ABSTRACT

OBJECTIVE: To determine whether early placental drainage plus cord traction reduces the incidences of manual removal and blood loss, and to determine the risk factors associated with blood loss after delivery. DESIGN: Prospective randomised study. SETTING: University teaching hospital, Montpellier, France. METHODS: A randomised study compared 239 women who had placental cord drainage plus cord traction with 238 women with expectant delivery. The need for manual removal of the placenta and the drop in haemoglobin after delivery were assessed. The duration of the third stage of labour and the time between birth and the beginning of perineal suturing were measured. Statistical analysis used the paired t test for continuous variables, the Kruskal-Wallis test for nonparametric data and chi2 test for categoric variables. Stepwise logistic regression analyses were performed with a drop in haemoglobin as the outcome variable. RESULTS: No significant difference was found in the two groups with regard to the incidence of manual removal of retained complete or incomplete placenta or postpartum haemorrhage. The median values of the duration of the third stage of labour, birth-to-perineal suture time and drop in haemoglobin were significantly lower in the cord drainage group than in the control group. After controlling for confounding variables, parity proved to be the only significant predictor of drop in haemoglobin. CONCLUSION: Cord drainage decreases the duration of the third stage of labour and reduces blood loss but not the incidence of manual removal of the placenta.


Subject(s)
Labor Stage, Third , Postpartum Hemorrhage/prevention & control , Prenatal Care/methods , Adult , Drainage , Female , Hemoglobins/analysis , Humans , Placenta, Retained/prevention & control , Postpartum Hemorrhage/blood , Pregnancy , Risk Factors , Umbilical Cord
19.
Cancer ; 86(11): 2266-72, 1999 Dec 01.
Article in English | MEDLINE | ID: mdl-10590367

ABSTRACT

BACKGROUND: During pregnancy, the need for maternal chemotherapy for breast carcinoma must be balanced against the fetal risk because modification of cancer therapy to assure the birth of a healthy infant may affect maternal prognosis adversely. To the authors' knowledge few studies have documented the oncologic and obstetric management of this association. METHODS: A retrospective nationwide survey was used to identify women treated with chemotherapy for breast carcinoma during pregnancy. Each member of the Société Française d'Oncologie Gynécologique and the Société Française de Sénologie et de Pathologie Mammaire completed a postal questionnaire regarding cancer staging, oncologic treatment, obstetric details, pregnancy outcome, fetal behavior, and postdelivery follow-up. Twenty women were accrued to the study. RESULTS: The mean gestational age at the first cycle of treatment was 26 weeks. A total of 38 cycles were administered during pregnancy, with a median of 2 cycles. Delivery was performed at a mean of 34.7 weeks. Two pregnancies that were exposed to chemotherapy during the first trimester resulted in spontaneous abortion. One pregnancy exposed in the second trimester resulted in intrauterine death. The remaining 17 pregnancies resulted in live births, although 3 women had complications related to chemotherapy (anemia, leukopenia, and fetal growth retardation) and 1 newborn died 8 days after birth without apparent etiology. Two newborns had complications related to prematurity (transient respiratory distress). At a mean follow-up of 42.3 months, all live infants were reported to have reached normal developmental milestones. CONCLUSIONS: The current study found that even when chemotherapy was initiated after the first trimester, 95% of the pregnancies resulted in live births with low related morbidity in the newborns.


Subject(s)
Antineoplastic Agents/therapeutic use , Breast Neoplasms/drug therapy , Pregnancy Complications, Neoplastic/drug therapy , Pregnancy Outcome , Adult , Breast Neoplasms/pathology , Female , France , Gestational Age , Health Care Surveys , Humans , Middle Aged , Pregnancy , Pregnancy Trimesters , Retrospective Studies
20.
Gynecol Oncol ; 75(3): 356-60, 1999 Dec.
Article in English | MEDLINE | ID: mdl-10600289

ABSTRACT

OBJECTIVE: To compare the histomorphologic and colposcopic results of cold knife conization and loop excision. METHODS: Sixty-six women were randomly allocated to have the cone specimen removed by cold knife excision (n = 38) or loop excision (n = 28). Subjects eligible for inclusion were those who presented histologically verified grade 3 cervical intraepithelial neoplasia (CIN) or grade 2 CIN with squamocolumnar junction not seen. RESULTS: The mean height of the cone specimens was greater in the cold knife group [18.9 mm (SD = 5. 5) and 12.8 mm (SD = 4.3), respectively; P = 0.0001], as was the frequency of clear margins (100 and 80%, respectively; P = 0.001). In the loop excision group, thermal injuries were present in half of the cone sections. The median (range) thickness of thermal injury was 0.98 mm (0-1.5 mm) in the ectocervix and 0.95 mm (0-1.75 mm) in the endocervix. Histologic evaluation of the endocervical margins was not possible in 2 cases (7%). At follow-up colposcopy, evaluation of the entire squamocolumnar junction was possible in 15 (39%) and 20 (71%) women, respectively (P < 0.01). Four patients in the cold knife group and 6 in the loop group had histologically confirmed persistent dysplasia (P > 0.05), yielding success rates of 90 and 79%, respectively (P > 0.05). CONCLUSIONS: Loop excision provides a sample that is adequate for histologic evaluation in most cases, results in the same success rate as cold knife conization, and allows optimal colposcopic surveillance in significantly more cases than cold knife excision.


Subject(s)
Cervix Uteri/pathology , Colposcopy , Conization/methods , Uterine Cervical Dysplasia/pathology , Uterine Cervical Neoplasms/pathology , Adult , Female , Humans
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