[Pelvic pain. Diagnostic orientation].
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Adolescent↗
Biomedical subjects
C Colette
Publications and source records attributed to C Colette.
Urinary calcium oxalate saturation in 'stone formers' and normal subjects: an application of the EQUIL2 program.
OBJECTIVE: To produce an index of lithogenic risk which identifies patients at risk of stone recurrence and facilitates the monitoring of prophylactic treatments. PATIENTS AND METHODS: The EQUIL2 program provides an evaluation of the state of urinary saturation, particularly of calcium oxalate, based on the pH and total concentrations (mmol/l) of sodium, potassium, calcium, magnesium, uric acid, chloride, ammonium, citrate, phosphate, sulphate, oxalate, pyrophosphate and carbon dioxide. The morning urinary calcium oxalate saturation coefficient was thus calculated for 30 stone-formers (Group 1) and 30 normal control subjects (Group 2). RESULTS: Urine from the majority of individuals was saturated, with no significant difference between the two groups. There appeared to be a correlation between the state of saturation and the urinary calcium oxalate molar product in both stone-formers (r = 0.931) and controls (r = 0.914). CONCLUSION: In future studies on urinary calcium oxalate saturation, it should be possible to supplement the sophisticated coefficient determined by the EQUIL2 program with the molar product, except in cases where monitoring therapies have little or no effect on urinary oxalate or urinary calcium levels.
Adult↗
Renal handling of calcium in hypercalciuric calcium oxalate nephrolithiasis.
In order to gain further insight into the mechanisms of calcium (Ca) homeostasis in hypercalciuria, we studied 32 lithiasic patients who were divided into three groups: normocalciuric patients (NC; n = 11), patients with absorptive hypercalciuria (AH; n = 12) and patients with renal hypercalciuria (RH; n = 9). The patients were investigated on 3 occasions: during a random diet, after a Ca-restricted diet and during a Ca tolerance test. The following determinations were made: Ca intake, Ca tubular reabsorption (Ca TR), plasma 1,25-dihydroxyvitamin D [1,25(OH)2D] and parathyroid hormone (PTH) levels, natriuresis and urinary protein-bound Gla. The latter was measured as a marker of urinary nephrocalcin excretion. Ca TR was decreased in hypercalciuric patients (HC). AH but not RH patients normalized their Ca TR during fasting. Plasma PTH and 1,25(OH)2D levels were similar in all the groups on the 3 occasions. Natriuresis was elevated in RH during the fasting period (p < 0.02 vs. AH). Compared with NC, protein-bound Gla urinary excretion rates (UER) were enhanced in AH after the Ca-restricted period (p < 0.02) and in RH during fasting (p < 0.02). In AH, a strong positive correlation was found between Ca TR and protein-bound Gla UER (r = 0.79, p = 0.002) following a Ca-restricted diet. In the HC group as a whole, fasting protein-bound Gla UER were correlated to plasma 1,25(OH)2D levels (r = 0.68, p < 0.001). In conclusion, the results suggest that PTH directly or indirectly through 1,25(OH)2D increases nephrocalcin synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)
Absorption↗
[Pregnancy without medical monitoring: obstetrical and neonatal prognosis. A retrospective study of 88 cases].
Unregistered and unmonitored pregnancies account for 0.2 to 0.6 p. cent of all pregnancies. They essentially concern young, single, primiparous mothers from disadvantaged social backgrounds. Labour and delivery are generally without difficulty but the neonatal prognosis is impaired by a high proportion of premature and underdeveloped infants, often requiring a long stay in a pediatric unit.
Adolescent↗
[Ivemark syndrome: 2 case reports].
Ivemark Syndrome is a multiple organ syndrome associated with splenic abnormalities, complex cardiac pathology and an abnormality of the abdominal viscera. The incidence in our department is 1/6000 deliveries and the teratogenic effect seems to occur between the 30th and 40th days of intrauterine life, but the cause is unknown. The principal warning signal is bradycardia. Prenatal diagnosis can be made by ultrasound. The prognosis depends on the degree of malformation of the heart.
Abnormalities, Multiple↗
[Toxoplasmosis and pregnancy: is it possible to simplify the diagnostic procedures?].
About 1% of all pregnancies in France are complicated by a primary infection with toxoplasmosis. The risk for the fetus being affected increases during the pregnancy but the seriousness of the effect on the fetus becomes less with more advanced pregnancies. Treatment of the mother using Spiramycin have been proven to be efficient, lessening the risk for the fetus being affected. The diagnosis of the fetus being affected rests on a whole bundle of presumptive evidence culled from non-invasive methods and invasive methods which are not without risk. (Direct or over-enthusiastic diagnostic techniques or none at all). We have studied a series of 101 primary infections with toxoplasmosis for which we have not carried out any invasive diagnostic techniques. The long term results in 77 infants show no difference in fetal morbidity and better results as far as mortality are concerned. We therefore propose simplifying the diagnostic approach in cases of primary infection with toxoplasmosis during pregnancy.
Decision Trees↗
Determination of protein-bound urinary gamma-carboxyglutamic acid in calcium nephrolithiasis.
Nephrocalcin is a urinary gamma-carboxyglutamic acid (Gla) containing protein that may be a physiological inhibitor of calcium oxalate nephrolithiasis. Nephrocalcin isolated from urine of stone formers seems to be abnormal in lacking Gla that is required for inhibitory activity. In order to study this hypothesis, we compared the protein-bound urinary Gla contents in 32 calcium oxalate stone formers and in 24 controls. Protein-bound Gla was resolved by reversed-phase high-performance liquid chromatography after elimination of free Gla, alkaline hydrolysis and precolumn derivatization with o-phthalaldehyde and mercaptoethanol. Protein-bound urinary Gla concentrations were similar in stone formers (0.83 +/- 0.38 mumol/l, mean +/- SD) and controls (0.81 +/- 0.27) and were less than 5% of free urinary Gla. However, excretion rates of free and protein-bound Gla (nmol/min) were higher in stone formers (P = 0.006 and P = 0.002). Positive correlations (P = 0.000) were observed between free and protein-bound Gla both in controls and in stone formers. These results do not support the hypothesis of a lacking Gla nephrocalcin in stone formers.
1-Carboxyglutamic Acid↗
[Telephonic surveillance of pregnant women at risk of premature labor after hospitalization].
Manual evaluation of uterine contractility through the abdominal wall performed twice a day for 1 hour and reported by telephone every other day keeps pregnant women at risk of premature labour in a state of continual attention. When the women are disciplined, the recommendations, prescriptions and encouragements they receive in return result in a statistically significant reduction in the number of premature deliveries. More generally, this new and relatively inexpensive method leads to substantial savings. Such were the results obtained by comparing the courses of 2 series of pregnancies after hospitalization for the indispensable intravenous tocolysis.
Adult↗
High-dose intravenous methylprednisolone treatment and serum bone Gla-protein.
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Arthritis, Psoriatic↗
[Screening for hepatitis B carriers at the maternity unit of Besançon teaching hospital].
There are more than 280 carriers of the hepatitis B virus worldwide. The risk of chronic carriers, and a fatal outcome due to hepatocarcinoma, is estimated to be about 50% in Asian children contaminated by materno-fetal transmission. Serovaccination of the neonatal infant born to a HBV carrying mother provides protection in nearly 100% of cases. Routine screening for HBV carriers at the Besançon teaching hospital maternity unit led to the vaccination of 1.12% of the babies born in 1990, which corresponds to the current national average.
Carrier State↗
[The reduction of prematurity by telephone follow-up].
Twice-daily check-up of the uterine contractions by the pregnant women is a recognized and accepted necessity. Using the "green" free-phone number to report the number of contractions, to answer the questions asked and to receive the instructions given has made it possible to reduce the prematurity rate and the duration of the consequent specific hospitalization. This new method of follow-up, applied to two identically recruited groups of pregnancies offers an undeniable low-cost improvement over the systems used previously.
Female↗
[Diagnosis of ovular infection associated with premature rupture of the membranes].
Premature breaking of the membranes carries with it a serious risk of immediate or delayed ovular infection which compromises the prognosis. No diagnostic test with an acceptable error level was available to reduce the morbidity and mortality, in particular prior to 37 weeks of amenorrhea. The oligoamnios which accompanies the rupture increases the accuracy of the tocokinetic diagnosis, thus permitting a new and rigorous treatment in function of the stage of the pregnancy and the possibility of artificially inducing labor.
Chorioamnionitis↗
[Artificially induced labor. Experience of the maternity unit of the Besançon teaching hospital].
The authors describe 190 cases in which labor was artificially induced between 29 and 42 weeks. They compare different methods (120 induced by oxytocin-like agents, 70 by prostaglandins) in some cases associated with mechanical methods. Various parameters were investigated, notably the Bishop score at the time labor was induced, the method of delivery and the impact on the offspring of these techniques.
Apgar Score↗
[How to reduce the number of cesareans in teaching hospitals?].
The authors analyze their indications for cesareans for the year 1989, stressing the possibility of doing fewer. They carry out a critical analysis of the various indications by comparing them with literature data. Thus, 157 of the 2,055 deliveries are described, or 7.60 percent.
Cesarean Section↗
[Consequences of a deliberate fluctuation in the number of episiotomies].
The indications for episiotomy have been considerably extended until it has become a virtually routine operation in primiparous mothers and for previously incised multiparous women. These excesses must be clearly demonstrated. For one year, a policy of persuasion was applied: by comparing the results, it was obvious that a reduction in the number of episiotomies was accompanied by an increase in the number of intact perinea with non increase in the incidence of serious tears. The restriction of the indications should be continued in the light of recent studies.
Episiotomy↗
[Tocokinetics of infected newborn infants].
The diagnosis of fetal infection, other than in association with premature rupture of the membranes, requires the evaluation of various parameters. Children suspected are four to five times greater in number than those truly threatened. A new and important parameter has emerged as a result of tocokinetic investigation: in one case out of two 48 hours before birth and in three cases out of four during the day before birth, fetal motility, together with cardiac reactivity or not, appear to be very markedly decreased when the newborn will in fact be found to be infected. Tocokinetic study is thus a new source of help in the obstetric/pediatric decisions which must be taken in this context.
Fetal Diseases↗
[Clinostatic variations of the lumbosacral spine and obstetrical mechanics].
An X-ray study of the lumbar spine after childbirth in 2 groups of patients (one control group and one group with engagement dystocia) picked up one difference between the groups. The patients who gave birth spontaneously, presented with hyperlordosis which was relieved when lying down. In contrast, the patients who had presented engagement dystocia, presented with hyperlordosis which was aggravated when lying down.
Adult↗
[Influence of the initial treatment of endometriosis and results obtained by in-vitro fertilization].
The authors have investigated the results obtained by in-vitro fertilization in cases of pelvic endometriosis. Fifty-eight (58) stimulation cycles have been analyzed in function of the previous curative treatment, which may have been a combine medico-surgical treatment or a conventional surgical treatment. Six pregnancies which progressed to full term were achieved in the 8 patients who had previously received medico-surgical treatment. Twenty punctures were performed. In patients who received an initial medical treatment, there were no pregnancies carried to full term and three clinical terminations of pregnancy for a total of 15 punctures. A celioscopy check-up revealed persistent endometriosis in 10 of the patients involved. No clinical pregnancy was observed following primary surgical treatment. In all these cases, there were lesions affecting the ovary and the numbers of ovocytes and embryos were significantly reduced.
Adult↗