Biomedical subjects

A Pigné

Publications and source records attributed to A Pigné.

30 records · Page 2Linked to original sources

PubMed1988

[Stress urinary incontinence in women. Epidemiologic inquiry. Apropos of 500 cases].

Nearly 50% of women in Tunisia have urinary incontinence, and 30% of these are highly embarassed. This condition is under-estimated in Tunisia by doctors in as far as its functional effects are concerned because the country has other diseases which are more urgent and take priority. Stress incontinence causing invalidism is very frequent: 31.4%. The principal factors that lead to it are home delivery, multiparity, menopause and large babies. There are two frequent associated conditions: incontinence during pregnancy and cystocoele. A contribution is made by the clinical diagnosis, but if investigations stop there a definite diagnosis cannot be made and therefore there is a risk of failure of treatment. In fact the treatment should be according to the cause: it is medical when are purely urinary troubles and surgical or physiotherapeutic when there is true stress incontinence. The best treatment would be to prevent the condition by good obstetrics and this by better methods of delivering the babies.

Adult↗

PubMed1988

[Treatment of acute non-chlamydial salpingitis. Study of the efficacy and tolerance of a single-therapy antibiotic: Augmentin].

An open randomised comparative trial of the efficacy and safety of Augmentin as against the triple therapy of penicillin-gentamicin-metronidazole in acute salpingitis was conducted in forty women admitted to hospital. Laparoscopy was performed routinely to confirm the diagnosis. The two groups of patients were comparable as to age and clinical and biological symptoms and the severity of the salpingitis (grade I to IV, with the presence or absence of Fitz-Hugh-Curtis syndrome). Treatment was started immediately after the laparoscopy, first by parental route until the patient had been apyrexic for 48 hours. Oral follow-up was then commenced. Twenty women received Augmentin and twenty the triple antibiotic therapy. Specimens for bacteriological study were obtained before treatment (culture of the urine, culture from the IUD and from the cervix, and swabs were taken laparoscopically). This made it possible to identify aerobic and anaerobic organisms. (The gonococcus was found more often in the group treated with triple antibiotics). On discharge, cures had been obtained in 12 women and 6 more were responding out of the Augmentin group. Out of the triple therapy group 8 were cured and 10 were responding. There was one failure in each group (persisting fever). Long-term assessment was carried out in the out-patients three weeks after discharge. 11 out of the 13 reviewed in the Augmentin group and 8 out of the 14 in the triple therapy group were considered as definitely cured. The clinical safety of both treatments was good. These results demonstrate that Augmentin is as effective as the combined therapy in treating acute salpingitis and with the added advantage of its easy use and lower cost.

Acute Disease↗

PubMed1988

[Clinical and urodynamic results of the Burch colposuspension operation in the treatment of female urinary stress incontinence. A study apropos of 370 cases].

The surgical treatment of female genuine stress incontinence remains a not wholly solved problem. We prefer since 1980 the indirect colposuspension according to Burch as it represents 76% of our operations for genuine stress incontinence. We report 370 cases. The operation has been: isolated in 153 cases; associated with a total hysterectomy in 160 cases; associated with an indirect sacral fixation with a prosthesis of non adsorbable tissue in 57 cases. Clinical examination has always been completed with a urodynamic investigation pre-operatively and in the year following the operation. After two years or more, 188 urodynamic controls could be done. Clinical and urodynamic results are excellent and lasting after 5 years. Clinical failures represent only 4.6% of the cases and seem to be in relationship with technical defects as they occur in 78.4% of the cases in the first year following surgery. Associated sacral fixations, second hand cases, sphincter insufficiency appearing after surgery are the main factors giving way to the failures.

Adult↗

PubMed1988

[Value and dangers of indomethacin used in pregnancy. Apropos of 304 treated patients].

When Indomethacin in a dosage of 175 mg/day was used to treat threatened premature labour more than 70% of cases carried on until 37 weeks. This treatment therefore is an interesting alternative treatment to beta-mimetics whose the maternal side effects can be serious. As far as the cardiovascular systems of the fetus and neonate are concerned the effects in the dosage used are negligible. On the other hand there may be renal failure which is transitory at birth when delivery has taken place while treatment was going on. The treatment should not be prolonged for more than three weeks because Indomethacin causes oligohydramnios and this can cause in its place malpositions and maldevelopment of the lungs. Finally, it is not certain whether this treatment has any effect on fetal growth causing diminished growth, possibly.

Abortion, Threatened↗

PubMed1988

[Treatment of urogenital prolapse with exertion-induced urinary incontinence using the Bologna technic. Apropos of 90 cases].

The authors describe this operation, which is carried out as a single procedure which they have been doing since 1982. Then the results in 90 patients are studied. The post-operative controls carried out on the clinical state of the patient and on the urodynamic tests show that this operation is very successful, both in curing stress incontinence and in giving a good anatomical result for correcting prolapse of the anterior wall of the vagina. In over one-third of the cases the post-operative follow-up has been carried out for 2 years or more. This follow-up has shown that the relapse rate over a period of time, both for the stress incontinence and the prolapse, is nil. The principal snags that still remain are: post-operative infection in about a third of cases; the rare but possible development of an enterocele and of dyspareunia (2%).

Adult↗

PubMed1987

[Normal pregnancy after a Budd-Chiari syndrome treated by shunting: apropos of a case, review of the literature].

A patient who had a meso-atrial by-pass for a Budd-Chiari syndrome a year before conception carried her pregnancy to term. The authors have reviewed the literature. When they had studied the literature the authors took into account cirrhoses of the liver and portal hypertension in association with pregnancy. They concluded that a patient who had had a Budd-Chiari syndrome, particularly when she had also had a porto-caval shunt, was not in principle unable to have a pregnancy.

Adult↗

PubMed1987

[Urethral instability].

This study was carried out on 121 sets of records of uretrocystomanometry and 25 records of uretrocystomanometry combined with dynamic sphincterometry. The patients consulted us either for stress incontinenceor urgency incontinence. The mean age was 41 years. The urethra was considered to be unstable when variations in pressure reached 20 cm of water or higher. There are four different types of instability described and these correspond to different urodynamic pictures. The treatments that have been proposed resulted from the different aetiologies that we have been proposed resulted from the different aetiologies that we have worked out. Some of these cases are due to an inadequate perineal floor. This has been shown by changes in striated urethral sphincter behaviour and in the improvement that can be brought about by re-education of the levator and muscles.

Adult↗

PubMed1986

[Chemotherapy in 143 advanced epithelial cancers of the ovary. Experience at the Hôtel-Dieu of Quebec and Hôpital Saint-Antoine (Paris)].

Results of initial chemotherapy in 143 patients with advanced epithelial ovarian cancer are presented. Twenty-five patients were treated with alkylating agents, their median survival was 13 months and 15% were alive at 4 years. Nineteen received Cyclophosphamide-Methotrexate-5 Fluorouracil with or without Hexamethylmelamine, median survival was 22 months and 4 years survival was 20%. Forty-eight were treated with Adriamycin and Cisplatinum, their objective response rate proven by second-look laparotomy was 54.4% (26.1% complete response), median survival was 23 months and 35% were alive at 4 years. Thirty-one received Hexamethylmelamine, 5 Fluorouracil, Adriamycin and Cisplatinum with a median survival of 18 months and 4 years survival of 15%. Twenty had various other chemotherapy regimens, their median survival was only 8 months. Recent advances in the therapy of ovarian carcinoma are also discussed.

Altretamine↗

PubMed1984

[Delivery of black African women in France].

The African population is a specific entity. It is younger, the women have more babies and the pelvis is frequently narrow. Caesarean section for a narrow pelvis should be considered very carefully in this population, while the idea of feto-pelvic disproportion has to be a clinical one. Radiological pelvimetry and the use of Magnin's diagram play no part in deciding which way to deliver the women.

Adolescent↗

PubMed1984

[Bi-parietal diameter of the black African child].

The authors have made a growth cure of the bi-parietal diameter of the African infant using observations taken on 350 African women who were followed up and delivered in their department. Over all these curves of growth are smaller than the reference curves used in France. This study is a first contribution to the understanding of the mechanics of obstetrics in the African woman.

Africa, Central↗

PubMed1982

[A case of post partum gonococcal arthritis].

The authors report a case of gonorrhoea occurring immediately after delivery, characterized by acute inflammatory polyarthritis. The diagnosis was made from swabs taken from the lochia that were cultured on enriched media. The outcome of the disease treated with penicillin was good after 48 hours. The new-born's state of health after swabs take from the nostrils were positive was satisfactory all the time. A review of the literature shows how rare these conditions are, how serious they can sometimes be, and the management that should be undertaken in order to prevent complications occurring.

Adult↗

PubMed1981

[Dystocia at the onset of labour. An evaluation of the different treatments available (author's transl)].

The authors have carried out a random study on 75 cases in order to evaluate objectively the therapeutic methods usually employed in cases of dystocia in starting labour. These studies have shown the superiority of Syntocinon using an infusion together with epidural analgesia. This attitude goes against the methods of treatment usually used in France. The authors explain the reasons for their choice in the light of factors that they have observed using other therapeutic methods.

Chlorpromazine↗