Search PubMed⌕ Search

Biomedical subjects

A Bongain

Publications and source records attributed to A Bongain.

68 records · Page 4Linked to original sources
PubMed1993

[Endoscopic surgery during pregnancy. A case report of cholecystectomy].

Pregnancy used to be considered a contraindication for endoscopic surgery of the digestive tract. We report a case of cholecystectomy carried out laparoscopically for complicated gall stones in a woman who was 14 weeks pregnant. There was no post-operative maternal or fetal morbidity. The mother carried on the pregnancy to term normally and gave birth to a normal infant. The same results have been reported in the literature for three other cases of cholecystectomy and six of appendicectomy. The sole technical precautions that had to be undertaken were in introducing and placing the trocars, taking into account the size of the uterus. There has been no scientific proof that CO2 is toxic for the fetus. Clinical practice shows that endoscopic surgery is possible without any obstetrical risk including thrombo-emboli, nor specific sepsis occurring in any of the three trimesters of pregnancy. The advantages of the endoscopic approach are that there is less post-operative pain and therefore less need to take analgesics. There are no complications because of an abdominal wound and the patient can both feed and walk about immediately after the operation with a reduction of the time spent in hospital. There is probably less risk of aborting when compared with classical laparotomy. The endoscopic route can be chosen when surgery is needed in the digestive tract during pregnancy.

Adult↗
PubMed1992

[Drug addiction and pregnancy].

In drug-addicted women pregnancy is always at risk and difficult to supervise owing to the social and psycological profiles of these women. At the moment, we are dealing in France mainly with pregnancies that occur in heroin addicts and frequently have the following complications: lack of follow-up, prematurity, short child stature, infections (notably HIV infection) and weaning syndrome in the newborn. Due to improvements in the management of these patients, the neonatal mortality has been considerably reduced and has become exceptional. In the USA the number of pregnancies occurring in cocaine addicts has increased, and complications similar to those of heroin addicts have been observed, particularly with crack. It is not impossible that we might soon be confronted with this type of drug addiction.

Female↗
PubMed1992

[Pregnancy in HIV infected women. Current therapeutic indications].

This paper deals with the management of pregnant women with HIV infection. The virus is transmitted by the mother to 20-30 percent of the infants, and therapeutic abortion should be offered to women whose pregnancy does not exceed 26 weeks of amenorrhoea. If pregnancy is pursued, the mother must be investigated for sexually transmitted diseases which are particularly frequent in this population and may have repercussions on the newborn. Pneumocystis carinii pneumonia is the most common opportunistic infection in pregnancy. In case of T4-cell depletion chemotherapy with pentamidine must be instituted. Hygienic and dietetic measures should be applied to avoid listeriosis and toxoplasmosis. Serological tests for toxoplasmosis are necessary in all HIV patients, with chemoprophylaxis in case of increased IgG levels. Thrombocytopenia usually responds to human immunoglobulins. At delivery, there is no need to modify the usual obstetrical procedures. During the post-partum period, another pregnancy must be avoided by good compliance with a reliable contraceptive method. As for the preventive treatment of mother-to-child HIV transmission, at the moment only AZT can be considered, but its effectiveness remains to be evaluated in therapeutic trials.

Abortion, Therapeutic↗
PubMed1992

The labelling index in carcinoma of the uterine cervix: its correlation with tumour sterilization.

The pre-treatment labelling index (LI) was measured in 72 patients with carcinoma of the cervix. It was not correlated with patient age, stage of the disease or histological grade. 46 patients underwent hysterectomy after intracavitary irradiation with or without external radiotherapy. The mean LI in patients with tumour sterilization or microscopic residue was significantly higher than in patients with gross disease. These results suggest that tumours with low LI may be difficult to sterilize with conventional therapeutic measures, or that doomed cells may require several weeks to be eliminated in tumours with low LI.

Adenocarcinoma↗
PubMed1991

[Primary mammary focus of malignant non-Hodgkin's lymphoma. Apropos of 10 cases].

The authors describe 10 cases of malignant non-Hodgkin's lymphoma in a mammary site in women aged 38 to 82 years. The clinical examination and the sometimes suggest an adenocarcinomatous lesion, thus leading to a useless surgical exeresis. An initial histological study provides the diagnosis. A complete assessment of extension allows an accurate staging and the refinement of the therapeutic schedule. Exclusive radiation therapy seems to be justified in low-malignancy forms remaining strictly confined to the breast. For the high- and medium-malignancy forms, the essential weapon is chemotherapy, which seems to improve the duration and rate of remission.

Adult↗
PubMed1990

[Modes of contamination in children].

The various ways in which infants may be contaminated with HIV are described. Transmission by blood perfusion persists in only some countries where HIV detection in blood products is not performed and sterilization is doubtful. Transplacental contamination is well documented by the finding of HIV in various foetal tissues, amniotic fluid, placenta and foetal blood; it seems to be predominant. Transmission during delivery and breast-feeding plays a lesser role, but it cannot be excluded. Horizontal transmission is extremely rare. The frequency of vertical transmission varies from one series to another, but the most often quoted figure is approximately 30 p. 100. An Atlanta C.D.C. stage III or IV and a low percentage of T4 lymphocytes are thought to facilitate the mother-to-foetus transmission. Many elements are still imperfectly known; their elucidation requires further studies on large series of subjects.

Breast Feeding↗
PubMed1990

[Preliminary study on the transport of AZT (Retrovir-zidovudine) through the placenta].

The authors selected six patients who were HIV positive and who had requested termination of pregnancy to study the passage of zidovudine through the placenta. After the patients had been warned about the procedure and given consent, 1 gram of zidovudine (Azitothymine) was given in five doses of 200 mg each orally. Ethical Committee consent had been obtained. At a mean age of 17.5 weeks of amenorrhoea, samples were taken from the mothers' blood, from the amniotic fluid and from the fetal blood between one and two hours and forty five minutes after the last dose of AZT had been taken. Pregnancy was terminated immediately after the amniotic fluid had been obtained. The levels of zidovudine and its metabolite glucuronide (G-AZT) were carried out using High Performance Liquid Chromatography (HPLC). The concentrations of the drug in the liquor and in the fetal blood were higher or equalled those found in the maternal blood. This makes it likely that the half life elimination was longer and the metabolism of the product slower when it had been metabolised to glucuronide. This study does not concern the teratogenic effect or the toxicity for the fetus. The drug remains contra-indicated in pregnancy. There is no proposal at present to use it to lessen transmission of the virus from the mother to the fetus.

Abortion, Therapeutic↗
PubMedDate not supplied

[Twin pregnancy in a unicornuate uterus with a rudimentary horn].

We describe the case of a rudimentary horn pregnancy coexistent with an intrauterine pregnancy. This situation is usually associated with rupture of the rudimentary horn and death of the correspondent twin. This is the first report on a multiple gestation with the two siblings successfully delivered by caesarean section in the two horns of a unicornuate uterus with rudimentary horn before any complication. Since the maternal mortality is higher in this situation, early ultrasound diagnosis is important to make the right decisions.

Adult↗
PubMedDate not supplied

[Primary breast sites of malignant non-Hodgkin's lymphoma. Apropos of 10 cases].

The authors describe 10 cases of malignant non Hodgkin's lymphoma in a mammary site in women aged 38 to 82 years. The clinical examination and the sometimes suggest an adenocarcinomatous lesion, thus leading to a useless surgical exeresis. An initial histological study provides the diagnosis. A complete assessment of extension allows an accurate staging and the refinement of the therapeutic schedule. Exclusive radiation therapy seems to be justified in low-malignancy forms remaining strictly confined to the breast. For the high- and medium-malignancy forms, the essential weapon is chemotherapy, which seems to improve the duration and rate of remission.

Adult↗
PubMedDate not supplied

[Monitoring of pregnancy in HIV seropositive women].

The management of pregnancy in a seropositive woman implies awareness of the effects of the disease on pregnancy and, inversely, of the pregnancy on HIV infection. It is important to be aware of the risk of materno-fetal transmission, as well as of the recent positive results of therapeutic trials of AZT during pregnancy regarding the prevention of such transmission. This quite stereotyped management approach is relatively simple, both clinically and regarding laboratory investigations, and in particular when the patient is at an asymptomatic stage of the disease. Obstetric management is, for the present, the same as in normal women. It is important to stress the need for specialised management of the newborn infant and of taking advantage of the postpartum period to ensure future effective contraception.

Abortion, Therapeutic↗
PubMedDate not supplied

[Thrombophlebitis of the ovarian vein with a floating clot in the inferior vena cava].

The authors report two recent observations of thrombophlebitis of the right ovarian vein. The first occurred after a cesarotomy, due to a bigeminal pregnancy, and the second, after a breech delivery. The diagnosis was given when faced to a febrile syndrome and pains of the right flank and confirmed in both cases by an abdominal tomodensimetric examination. In both cases, an enlargement of the lower vena cava thrombosis was observed with a floating clot that reached the renal veins. Both patients underwent a surgery. The latter consisted in both cases in a thrombectomy of the lower vena cava as well as a ligature of the right ovarian vein. In both cases, the evolution was positive, thanks to a remote-control of the lower vena cava via tomodensimetry. This therapeutic procedure and other potential therapies were discussed.

Adult↗