• Chemotherapy for resistant or recurrent gestational trophoblastic neoplasia.

      Alazzam, Mo'iad; Tidy, John; Osborne, Raymond; Coleman, Robert; Hancock, Barry W; Lawrie, Theresa A; Department of Gynaecology, The Galway Clinic, Doughiska, Galway, Ireland. moiad@doctors.org.uk (2012-12)
      Gestational trophoblastic neoplasia (GTN) is a highly curable group of pregnancy-related tumours; however, approximately 25% of GTN tumours will be resistant to, or will relapse after, initial chemotherapy. These resistant and relapsed lesions will require salvage chemotherapy with or without surgery. Various salvage regimens are used worldwide. It is unclear which regimens are the most effective and the least toxic.
    • First-line chemotherapy in low-risk gestational trophoblastic neoplasia.

      Alazzam, Mo'iad; Tidy, John; Hancock, Barry W; Osborne, Raymond; Lawrie, Theresa A; Department of Gynaecology, The Galway Clinic, Doughiska, Galway, Ireland. moiad@doctors.org.uk (2012)
      This is an update of a Cochrane review that was first published in Issue 1, 2009. Gestational trophoblastic neoplasia (GTN) is a rare but curable disease arising in the fetal chorion during pregnancy. Most women with low-risk GTN will be cured by evacuation of the uterus with or without single-agent chemotherapy. However, chemotherapy regimens vary between treatment centres worldwide and the comparable benefits and risks of these different regimens are unclear.
    • Reinforced long saphenous vein bypass graft for infrainguinal reconstruction procedures: case series and literature review.

      Hynes, Niamh; Mahendran, Bhasakarapandian; Tawfik, Sherif; Sultan, Sherif; Department of Vascular & Endovascular Surgery, Galway, Clinic, Doughiska, Co. Galway, Ireland. (Vascular, 2006-03)
      Poor rehabilitation rates and the high-cost of managing postamputation patients justify an aggressive revascularization policy in critical lower limb ischemia. Endovascular therapy is our first choice for limb salvage in these patients. However there are patients for whom endovascular therapy is not feasible. When bypass is necessary, autologous vein is a superior conduit to synthetic material. However, varicosities usually contraindicate autologous vein bypass because of the risk of aneurysm formation, rupture and increased intimal hyperplasia compared with nonvaricose venous grafts. We report the use of varicosed long saphenous vein (LSV) with external Dacron support in infrainguinal bypass procedures for limb salvage, where endovascular therapy was not feasible. The external Dacron tube was not brought close to the distal anastomotic area itself. With a mean follow-up of 18 months, duplex ultrasonography and computed tomography angiography showed no evidence of stenosis of the reinforced vein segments or aneurysmal degeneration of the residual vein. External reinforcement with Dacron prosthesis allows the use of autogenous greater saphenous veins with varicose dilatation without compromising graft patency and limb salvage.