Biomedical subjects

D Jannet

Publications and source records attributed to D Jannet.

26 records · Page 2Linked to original sources

PubMed1993

[Laparoscopic surgical excision of adnexal cysts. Methods and indications in a series of 70 patients].

Surgical coelioscopy has become a regularly used technique for the treatment of benign cysts of the annexes. Complete exeresis and certain histological diagnosis are assured and the postoperative period is simpler than after laparotomy. The risk of pelvic adherences is reduced. We performed coeliosurgery via the transparietal or intraperitonial method in a series of 70 patients for 85 resections of cysts, ovaries or annexes. Length of hospitalization was short and complications were rare. Despite convincing clinical explorations including echography and coelioscopy, we observed one border line tumour and one stage I serous cystadenocarcinoma at histological examination after coeliosurgery. The two observations led us to question percoelioscopic treatment cysts of the annexes but also emphasize the need for careful preoperative work-up and peroperative technique. The indication for laparotomy should be seriously considered in doubtful cases.

Adult↗

PubMed1993

Nicardipine treatment of hypertension during pregnancy.

OBJECTIVE: To assess the effects of nicardipine, a dihydropyridine calcium channel blocker, on the fetus and mother in hypertensive pregnant women. METHODS: Forty pregnant patients with mild or moderate hypertension received oral nicardipine 20 mg three times a day (mean duration of treatment 9 +/- 2.1 weeks). Twenty patients with severe preeclampsia (diastolic blood pressure greater than 110 mmHg and 24-hour proteinuria greater than 500 mg) received intravenous (IV) nicardipine at 2, 4, or 6 mg/hour according to body weight (mean duration of treatment 5.3 +/- 3.6 days). RESULTS: Oral nicardipine induced a significant decrease in both systolic and diastolic blood pressures compared with pre-treatment values (P < .001). Intravenous nicardipine decreased diastolic blood pressure below 90 mmHg, at least temporarily, in all 20 patients. Nine patients taking IV nicardipine complained of headaches. Doppler velocimetry remained stable with both oral and IV nicardipine. Neonatal outcome showed no deleterious effect of the treatment. CONCLUSIONS: Oral or IV nicardipine seems to be safe in hypertensive pregnant patients with the doses used in our study. Assessment of its efficacy will necessitate further clinical randomized trials.

Administration, Oral↗

PubMed1992

Plasma assay of salbutamol by means of high-performance liquid chromatography with amperometric determination using a loop column for injection of plasma extracts. Application to the evaluation of subcutaneous administration of salbutamol.

An isocratic high-performance liquid chromatography method with amperometric detection for the assay of plasma salbutamol is described. The plasma extract is injected into the chromatographic system via a loop column. This insures the purification of the injected extracts and allows a simple and rapid liquid-solid extraction procedure. The good reliability, as shown by the low limit of detection (0.5 ng/ml) and a precision ranging between 5 and 10%, has permitted the investigation of a new mode of administration of salbutamol using a portable subcutaneous infusion pump. Our results show that subcutaneous administration yields plasma levels comparable with those obtained after usual intravenous doses.

Albuterol↗

PubMed1992

Pharmacokinetics of salbutamol in the pregnant woman after subcutaneous administration with a portable pump.

OBJECTIVE: We sought to determine whether subcutaneous administration of salbutamol resulted in plasma levels comparable to those achieved after intravenous or oral administration. METHODS: Twenty-nine women with preterm labor received subcutaneous infusion of salbutamol through a portable pump. We used three different rates of continuous infusion: a low rate of 3.33 micrograms/minute (20 subjects), an intermediate rate of 6.66 micrograms/minute (four subjects), and a high rate of 9.99 micrograms/minute (five subjects). Plasma salbutamol concentrations were assayed by high-performance liquid chromatography after 48 hours of continuous infusion in the subcutaneous tissue and after bolus injections (184 micrograms in the low-rate group and 368 micrograms in the intermediate- and high-rate groups). RESULTS: Plasma salbutamol concentrations after 48 hours of subcutaneous infusion increased almost linearly with the rate of infusion: 6.29 +/- 1.58, 15.5 +/- 1.0, and 21.7 +/- 4.26 ng/mL in the low-, intermediate-, and high-rate groups, respectively (P less than .001 between the three groups). After bolus injection, maximum plasma concentrations were significantly different between the three groups (P less than .001) and from their respective baseline values (P less than .001): 8.33 +/- 1.9, 18.85 +/- 2.0, and 25.86 +/- 4.8 ng/mL in the low-, intermediate-, and high-rate groups, respectively. CONCLUSION: Subcutaneous tocolysis can provide plasma salbutamol levels similar to the levels obtained orally or intravenously.

Adolescent↗

PubMed1991

The prevalence of autoantibodies during third-trimester pregnancy complicated by hypertension or idiopathic fetal growth retardation.

Lupus anticoagulant, anticardiolipin, antinuclear, anti-deoxyribonucleic acid, antithyroglobulin, and antithyroid microsomal antibodies were assayed during third-trimester pregnancy (100 normal, 100 with complications). In spite of a normal activated partial thromboplastin time in all instances, lupus anticoagulant was further investigated by three additional procedures: tissue thromboplastin inhibition time, platelet neutralization procedure, and cephalin neutralization test. The prevalence of autoantibodies in pregnancies with hypertension reaches 16% (four with lupus anticoagulant, two with anticardiolipin, and two with antithyroid microsomal antibodies), which is significantly greater than that for idiopathic fetal growth retardation (2%) (one with lupus anticoagulant antibodies) and normal pregnancies (3%) (two with antithyroglobulin and one with autithyroid microsomal antibodies) (p less than 0.01). Autoantibodies were equally distributed between patients with gestational hypertension and those with preeclampsia. When compared with the 42 patients with hypertension and no autoantibodies, the eight patients with autoantibody had a more frequent history of fetal growth retardation (p less than 0.05), but there was no difference in the severity of hypertension, the frequency of obstetric complications, or the outcome of pregnancy. They did not require any specific treatment.

Autoantibodies↗

PubMed1991

Maturation of the uterine cervix by repeated intracervical instillation of prostaglandin E2.

An attempt was made to ripen the uterine cervix in 100 high-risk pregnancy patients (pregnancy between 34 to 41 weeks' gestation), with the use of intracervical instillations of 0.25 mg of prostaglandin E2 mixed with a tylose gel. The maturation process was repeated every 48 hours. Forty-nine patients were delivered of infants after the first maturation and 51 patients required between two and nine instillations. In patients requiring multiple instillations, the mean delay between the first procedure and delivery was 9 +/- 4 days (range, 2.4 to 16 days). Among the 59 nulliparous women, only 23 were delivered of infants after a single maturation and 36 required multiple maturations (p less than 0.02). When the group of patients who were delivered of infants after a single maturation process was compared with the group requiring multiple maturations, no difference could be seen with regard to age, term of pregnancy, or Bishop cervical score at the time of inclusion in the study. The myometrial activity and the onset labor induced by prostaglandin E2, were similar in both groups. Fetal heart rate decelerations occurred in 16.3% (8/49) of the patients with single maturations and in 17.6% (9/51) of the patients who required multiple maturations. The outcome of the pregnancy and the rate of cesarean sections (24% and 27%) were similar in both groups. No patients required cesarean sections because of failed induction of labor. Cervical ripening after repeated applications of 0.25 mg of prostaglandin E2 seems to be safe for the fetus, providing that the patient is closely supervised.

Cervix Uteri↗

PubMed1991

Prognostic value of cervical distensibility index measurement in the outcome of pregnancies with threatened premature labor.

Threatened premature labor remains a difficult diagnostic and therapeutic problem, and various clinical scores have been designed to evaluate its prognosis. This study presents the use of a cervicotonometer to measure cervical distensibility in 58 women hospitalized for threatened premature labor. This value will be used to determine whether preterm labor is preceded by preterm cervical maturation and thus to assess prognosis. The cervical distensibility index (CDI) obtained with the cervicotonometer was significantly elevated at the time of hospitalization in women who had a preterm delivery when compared to those who delivered at or after 37 weeks of amenorrhea, whereas clinical scores showed no difference between these two groups. No preterm deliveries occurred when the CDI was normal or low at the time of hospitalization. Therefore, CDI measurement, reflecting cervical maturation, seems to be a good prognostic indicator in premature labor.

Anthropometry↗

PubMed1990

Mechanical properties of the pregnant human uterine cervix use of an instrument to measure the index of cervical distensibility.

An instrument has been designed and manufactured to measure precisely in clinical practice the distensibility index of the human uterine cervix expressed as centimeters per kilogram. Operation of the instrument and possible errors measuring the cervical distensibility index in nonpregnant patients, during gestation and during the postpartum period, are presented. The ability to easily quantify the mechanical characteristics of the uterine cervix in humans throughout gestation will now allow one to carry out precise studies concerning pharmacologically induced cervical maturation or pathological modifications of the uterine cervix in cervical incompetence or threatened premature labor.

Biomechanical Phenomena↗