Hemostasis, Prostacyclin and Preeclampsia.
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Biomedical subjects
Publications and source records attributed to A Fournie.
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The association of IPT (idiopathic thrombocytopenic purpura) and pregnancy happens rarely, but when it does it gives rise to two problems, the maternal and the neonatal. On the maternal level the risk is haemorrhage. Furthermore, the role of splenectomy in pregnancy still needs to be discussed; whereas all authors agree that treatment with corticoids and perhaps even with platelet transfusion may be necessary. As far as the newborn are concerned, it is common to find a low level of platelets which means that the newborn has particular risks of blood vessel rupture and intra-cranial haemorrhage (our observation). The attitude that the authors propose as far as the obstetric management of these cases is concerned is to carry out routine Caesarean section at term before labour starts. They analyse the other methods of dealing with these cases from the point of view of the maternal platelets and also from the fetal platelets estimated from scalp blood during labour.
The levels of the three components of factor VIII complex (VIII R:AG, VIII R:WF, VIII:C) were measured during normal late pregnancy, in pre-eclampsia and in pregnancies complicated by fetal growth retardation. In late normal pregnancy, there was a steady increase in factor VIII complex and the highest level was reached at delivery; in primary fetal growth retardation, the values were similar. In pregnancies complicated by pre-eclampsia, with or without fetal growth retardation, there was a significant increase of VIII R:AG VIII R:WF; the more severe the course of the disease, the greater the increase. The level of VIII R:AG-VIII R:WF appears to be an indicator of vascular pathology and it is suggested that this assessment may be of value in monitoring high risk pregnancies.
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Sixty patients with Paget's disease underwent bone scintigraphy and a radiological and biological exam. The use of scintigraphy in this disease is of double importance: it allows the spread of the disease to be diagnosed without doing X-rays of the entire skeleton. In twenty per cent of cases this disease cannot be located using X-rays and is detected by scintigraphy. It also supplies an additional objective criteria for judging the development of this disease, especially under treatment. The authors study the different hypotheses concerning the fixation to the bone of the isotope tracer in the Paget zone.
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Ketoprofen administered via the rectal route seemed to be valuable when given at night to patients with various rheumatic syndromes and may be particularly useful for patients who show gastric intolerance of the capsules. Anal intolerance was noted in 12% of the patients.
The authors demonstrated in the urine of certain patients a peptide form of hydroxyproline and of glutamic acid. This peptide was found in patients with Paget's disease who presented clinical and laboratory signs of an evolutive episode and in other patients who presented restructuration of bone of a radiologicaly type. This peptide was one of the factors determining the increase in the total hydroxyprolinuria. The demonstration of the peptide provokes discussion as to its origin, and also of the possibility of using it as a biochemical parameter.
After a brief survey of some physiologic properties of Von Willebrand factor activity (VIII r WF) the numerous clinical states with an increase of this activity are described. The authors report their own results concerning sepsis, chronic arteritis of lower limbs, diabetes, toxemia of pregnancy. In most cases the increase of VIII r WF activity appears as a sign of vascular injury and/or the consequence of tissular damage.
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