The few published reports on pregnancy complicated by systemic ma

The few published reports on pregnancy complicated by systemic mastocytosis indicate favorable maternal and fetal outcomes in gravidas known to have systemic mastocytosis.

CASE: A pregnant woman treated with terbutaline at 31 weeks of gestation developed severe hypotension which resulted in fetal demise; this was initially diagnosed to be an anaphylactic reaction. The finding of persistently high maternal tryptase levels led to the diagnosis of systemic mastocytosis. In her subsequent pregnancy she was treated with an H1 blocker. Hypotension during her

cesarean delivery was managed with steroid and epinephrine therapy.

CONCLUSION: Exacerbations of systemic mastocytosis during pregnancy can lead to significant maternal and fetal complications. p53 inhibitor Treatment with H1 blockers,

and when indicated, steroids and epinephrine, can reduce these complications. (Obstet Gynecol 2012;119:486-9) DOI: 10.1097/AOG.0b013e318242d3c5″
“This study was conducted to investigate the prognostic factors of pulmonary metastases, focusing on the time of detection of selleck inhibitor pulmonary metastases related to adjuvant chemotherapy in patients with colorectal cancer (CRC).

Between June 2003 and December 2010, 84 patients underwent pulmonary metastasectomy for pulmonary metastasis (PM) from CRC. The clinicopathological data of colorectal surgery and pulmonary metastasectomy were analysed retrospectively. Disease-free intervals (DFIs) were specifically classified into the following three groups related to adjuvant chemotherapy after colorectal operation: Group 1, metastasis detected at initial presentation;

Group 2, metastasis detected during adjuvant chemotherapy; Group 3, metastasis detected after completion of chemotherapy. The prognostic influence of these variables on disease-free survival was analysed using the log-rank test for univariate analysis and the Cox proportional hazards model for multivariate analysis.

The median follow-up durations for patients after 5-Fluoracil curative resection of CRC and pulmonary metastasectomy were 48.6 and 28.8 months, respectively. After pulmonary metastasectomy, recurrence was seen in 49 (58.3%) patients-pulmonary recurrence in 37 and extrathoracic recurrence in 12. Young age (< 54 years old) at CRC operation, more than one PM, a DFIs of < 12 months, detection synchronously or under adjuvant chemotherapy, and high CEA level before metastasectomy were worse prognostic factors by univariate analysis. From multivariate analysis, the number of pulmonary metastases (multiple metastases, HR = 2.121, 95% confidence interval 1.081-4.159, P = 0.029) and DFIs related with adjuvant chemotherapy (Group 1+2, HR = 1.982, 95% confidence interval 1.083-3.631, P = 0.027) were found to be independent predictors of disease-free survival.

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