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Biomedical subjects

E Robert

Publications and source records attributed to E Robert.

At least 127 records · Page 7Linked to original sources
PubMed1980

The combined use of oral medroxyprogesterone acetate and methyltestosterone in a male contraceptive trial programme.

A male contraceptive trial was undertaken in 23 men using a combination of oral medroxyprogesterone acetate (MPA) and oral methyltestosterone (MeT). The men were divided into four groups according to varying drug dosages and were followed for 15 months (control - 3 months, treatment - 6 months, follow-up - 6 months). The parameters assessed included sperm count and motility, serum gonadotropins and sex steroids, and several biochemical and hematological tests. A questionnaire dealing with side-effects and changes in sexual function was administered intermittently. Although sperm count was suppressed (most dramatically at the highest drug doses, MPA 20mg,MeT 20mg), it was not suppressed to infertile levels. Sperm motility was unaltered; LH was modestly suppressed, FSH was not suppressed; testosterone was suppressed even at low doses; dihydrotestosterone responses were inconsistent. No significant biochemical abnormalities or side-effects occurred although some men experienced mild transient acne, gynecomastia and decreased testicular size. We conclude that in the doses used in this trial, the combination of MPA and MeT is not effective for male contraceptive, purposes and that higher doses may induce severe and undesirable side-effects.

Clinical Trials as Topic↗
PubMedDate not supplied

An international collaborative study of the epidemiology of esophageal atresia or stenosis.

Epidemiologic data were analyzed for a total of 2,693 infants with esophageal atresia registered in nine congenital malformation registries around the world. The average recorded prevalence at birth was 2.6 per 10,000 births, with a significant variability among programs--and sometimes within a program--and a maximum prevalence of above 3 per 10,000 births. Clusters of infants with esophageal atresia were observed but may be random. An increasing rate was seen during the period 1965 to 1975 (Norway, South America, Sweden). The type of esophageal atresia was specified in only 439 cases, but no major differences were seen in the epidemiologic characteristics of infants with the most common type (distal fistula) and infants with other types. There was an excess of low birth weight and preterm birth, and infants with esophageal atresia had a birth weight 500 to 1,000 g less than normal infants in each gestational week. There was an excess of twins, apparently mainly or exclusively due to monozygotic twinning, but in only two pairs did both twins have esophageal atresia. There was no effect seen of maternal age, but low parity, irrespective of maternal age, was associated with an increased risk for esophageal atresia. Infant survival varied among programs and depended heavily on associated malformations. Among 1,107 sibs born before the proband and 385 born after the proband, only 25 (1.7%) had a serious malformation; three had esophageal atresia. In 57.3% of the infants with esophageal atresia, no other malformations were present, in 36.4% other major malformations were recorded, and in 6.3% there were chromosomal anomalies. The malformations present associated with esophageal atresia were analyzed: a large proportion entered the constellation sometimes called "caudal mesoderm spectrum of malformations": VATER, Potter, and caudal regression sequences.

Birth Weight↗
PubMedDate not supplied

Birth defects and high voltage power lines: an exploratory study based on registry data.

This is an exploratory study on birth defects in municipalities through which overhead high voltage power lines (HVPL) pass. It was aimed to test the association between maternal residencial proximity to HVPL and congenital anomalies through a case-control study based on data from the Central-East France Registry of Congenital Malformations. Each of the 1688 malformed infants identified through the register was matched with two randomly selected controls in the same maternal age group of the general population. No excess of any specific type of malformation was observed in infants exposed to HVPL. An inverse association was even found between maternal residence in municipalities with potentially high exposure to electromagnetic fields from overhead power lines and congenital anomalies of all types. This was accounted for by low numbers of exposed infants with two types of malformations: skeletal defects and cardiac defects. Difficulties in interpretation of data are addressed and limitations of the study are discussed. If an inverse association were upheld in further work, a possible mechanism might be that exposure to electromagnetic fields may increase the risk of spontaneous abortion of fetuses with anomalies.

Abnormalities, Radiation-Induced↗
PubMedDate not supplied

Neural tube defects and maternal weight reduction in early pregnancy.

We present data from a case series in France of pregnant women who lost 2 to 14 kg during the first month after conception and whose fetuses developed neural tube defects (NTDs). Preliminary epidemiologic evidence from other data sets suggest that relative lack of weight gain during pregnancy may be associated with NTDs. The role of starvation, diabetes, and valproic acid in the etiology of NTDs is established. This etiologic information coupled with our data suggest an hypothesis that ketoacidosis induced by weight loss in early pregnancy is a risk factor for NTDs.

Adult↗
PubMedDate not supplied

Exposure to organic solvents during pregnancy and oral clefts: a case-control study.

Prior studies on the relationship between maternal exposure to organic solvents in relation to oral clefts have been inconsistent. We re-examined this relationship in a case-control study conducted in the Rhône-Alpes region of France during the years 1985 to 1989. For each case, we selected two controls without congenital anomalies in the same delivery unit born during the same month. We interviewed each mother within the first five days after delivery about previous reproductive history and exposures during the first two months after conception. If the mother had an occupational activity at that time, we asked her occupational physician to confirm the exposures. We compared maternal exposure to any organic solvent between 200 infants with cleft lip and/or cleft palate and 400 controls and the estimated odds ratio was 1.62 (95% CI 1.04-2.52). Then we compared exposures to nine subgroups of solvents. Only the ratio associated with halogenated aliphatic solvents (4.40, 95% CI 1.41-16.15) was significantly different from unity. Control of potential confounders-sex of child, family history, maternal epilepsy-did not alter this odds ratio estimate.

Analysis of Variance↗
PubMedDate not supplied

Subfertility and atresias of the alimentary tract.

In a descriptive study on alimentary tract atresias (ATA), a protective effect at parity 2 compared to parity 1 led us to expect an increased rate of fertility problems in mothers of these infants. To test the hypothesis we looked at sex hormones exposures around conception in 811 cases collected between 1982 and 1993 by the France Central-East registry of malformations. Exposure to progestins was compared for combined ATA (at two or more different levels) vs. single ATA with an odds ratio of 2.51 (95% CI 0.43-9.96). Although not statistically significant, this odds ratio raises the question of an association that would be interesting to test elsewhere. Combined ATA also occurred after stimulation of ovulation more often than did isolated forms of ATA: OR = 3.52 (95% CI 0.98-10.31). Stimulation of ovulation was more often reported for infants with ATA than for those with other malformations: OR = 1.87 (95% CI: 1.24-2.81). These indications in favor of an increased risk of ATA for infants born to subfertile mothers/couples should encourage other groups to test the hypothesis on available data sets.

Anal Canal↗
PubMedDate not supplied

Pregnancy outcome after treatment with the ergot derivative, cabergoline.

The goal of this article is to assess the reproductive safety of cabergoline, a new ergot derivative proposed in hyperprolactinemic disorders. Investigated in different animal species, the drug showed no teratogenic or embryotoxic effects on rabbits. Considering the dose envisaged for humans, large safety margins exist. Our sample consists of 226 pregnancies occuring in 205 women. Follow-up is available for 204. There were 24 miscarriages and three abortions induced because of major malformations (one Down syndrome in a 42-year-old woman, one limb-body wall complex, one hydrocephalus). Two of the 148 single liveborn infants had significant malformations: one megaureter, one scaphocephaly. This series shows no increase in miscarriage rate, a distribution of birthweights and sex ratio within the expected range, and no increased rate of congenital malformations. Follow-up of babies, limited to 107 cases, thus far indicates normal physical and mental development.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Drinking water chlorination and delivery outcome-a registry-based study in Sweden.

By using the Swedish Medical Birth Registry and official data on drinking water chlorination, three cohorts were identified and compared: women who lived in areas where drinking water was disinfected with chlorine dioxide, women who lived in areas that used sodium hypochlorite disinfection, and women who lived in areas where there was no chlorination of the drinking water. There was a statistically significant increase in short gestational duration and low birth weight and especially in short body length and very small head circumference in areas using sodium hypochlorite, but no significant effects on these variables were found in areas using chlorine dioxide. No effects on congenital malformations, childhood cancer, infant mortality, low Apgar score, neonatal jaundice, or neonatal hypothyroidism were associated with either of the two drinking water chlorination methods. Because the exposure information in this study was based on the chlorination method and not the amount of byproducts in the water, the general lack of significant effects could be due to a low concentration of such byproducts.

Adult↗
PubMedDate not supplied

Antenatal exposure to atenolol and retroperitoneal fibromatosis.

We present a case of retroperitoneal fibromatosis in a fetus whose mother took atenolol during pregnancy. A 25-year-old obese woman was treated for hypertension with 100 mg atenolol daily from the second month until the end of pregnancy. At 29 weeks, echography disclosed a retroperitoneal mass and at 37 weeks, a boy was delivered. A biopsy of the tumor showed a fibromatosis with medullary compression, treated by antimitotics until 3 months of age. At the age of 4, the mass had disappeared but severe scoliosis was present. This in utero exposure to atenolol drew our attention because the retroperitoneal localization of the tumor is similar to that of fibroses reported in adults after exposure to atenolol and for other reasons: transplacental carcinogenesis has been demonstrated in humans, at least for diethylstilboestrol, atenolol crosses the placental barrier, the drug was taken during nearly the whole pregnancy, and retroperitoneal fibromatosis is exceptional as a neonatal tumour.

Adult↗
PubMedDate not supplied

The epidemiology of preaxial limb malformations.

The epidemiology of preaxial limb malformations was studied in an effort to find similarities and differences between different types that could help to define suitable groups of malformations for etiologic studies. Material from three large congenital malformation registers was used, with a total of 1646 infants with such malformations among over 5 million births. We compared different types of preaxial malformations with respect to bilaterality, maternal age and parity, racial differences, sex distribution, twinning, and associated malformations. From many epidemiologic aspects, different types of preaxial malformations showed similarities, but there were some distinct differences between upper and lower limb anomalies. We conclude that in searches for etiologic factors, it may be useful to group all preaxial malformations together but to differentiate between upper and lower limb defects.

Abnormalities, Multiple↗
PubMedDate not supplied

[Down syndrome and ionizing radiation: causal effect or coincidence].

Annual and monthly prevalence of Down's Syndrome has been analyzed in Belarus for a 19-year period (1981 to 1999). The distribution of 2786 DS cases during this period showed no significant long-term prevalence trend. Meanwhile, 2 marked increases of DS prevalence were registered in 1987 and 1990. The most remarkable annual increases were observed in 1987 in Minsk city, in Vitebsk oblast (considered as contamination-free administrative district) and in Minsk oblast (partially contaminated area), data not shown in the text. Much more marked and significant increases were recorded in January 1987, in Minsk city, Gomel oblast and Minsk oblast. However it is impossible to establish a causal relationship between these clusters of DS and exposure to the Chernobyl fallout, at a geographical level. The presence of such a cluster 9 months after the explosion in one of the most exposed area (Gomel oblast) should incite to careful conclusions and prompt further studies.

Cluster Analysis↗
PubMedDate not supplied

[In utero exposure to benzodiazepine. Is there a risk for anal atresia with lorazepam?].

Drugs of the Benzodiazepine family are among the most frequently prescribed in France. Since anxiety disorders, for which these substances are mostly indicated, affect 10% of pregnant women, it is very likely that such a treatment could expose many foetuses to BZD during the first three Months of pregnancy. We know that the teratologic effect is not necessarily based on dose rate, but that it is associated with fetal drug exposure during the first 12 weeks of gestation, when organ formation occurs. Most epidemiologists concur that the baseline incidence of congenital damage is 2-2,5% in Europe. The results from a large number of stu-dies on associations between the use of BZDs in pregnancy and congenital malformations are conflicting. An in-depth analysis of existing literature shows results that are hardly comparable, if not contradictory, due to extreme differences in methodological approaches. In a recent meta-analysis case-control studies and cohort studies were analyzed separately. Among the case-control studies significant associations were found between BZD exposure and both, major malformations and oral clefts, whereas the cohort studies showed no association between BZD and any kind of malformation. The purpose of our study is to search for a specific teratogenic effect of this class of drugs, using data collected (1976-1997) by the French Central-East (FCE) registry of congenital malformations, member of the International Clearinghouse for Birth Defects Monitoring Systems (ICBDMS) located in Lyon, France. This registry monitor malformations among 100,000 births per Year. We analyzed 13,703 cases where information is available on whether or not the mother took a drug during her first trimester of pregnancy. Among them, 3,603 (28%) actually took a drug, and 262 (6.8%) took some sort of benzodiazepine (BDZ). BZD were divided into 9 categories, 8 being the most frequently present, plus one broad category of "others". Malformations were divided into ten categories: congenital anomalies of heart, cleft lip and/or cleft palate, neural tube defects, other anomalies of central nervous system, hypospadias, urinary malformations, anal atresia, other digestive anomalies, limb reduction defects, and genetic anomalies, including chromosome aberrations and monogenic conditions. Other malformations were grouped in an eleventh category. The interesting aspect of this study is that it takes into account the BZD metabolism. It is worth noting that the hepatic catabolism of benzodiazepine is a very complex one, because it leads to derived molecules which are sometimes active and/or present in the common metabolic route of major commercial drugs. Our hypothesis is that if one BZD is associated specifically to a certain type of congenital defect, we may find this BZD to be overrepresented, as compared with other BZDs, in newborns exhibiting some type of congenital defect. The analysis was run according to a case-control approach. Odd ratios (OR) and their 95% confidence intervals were calculated by logistic regression with adjustment for maternal age and parity. When one category of defects was considered, infants having the corresponding malformation were considered as cases, while infants with other malformations were considered as controls. In a similar way infants having being exposed to a given drug were considered as exposed, while infants exposed to any other drug were considered as unexposed. The analysis then was run in 4 steps. Step 1: full sample. With 13,703 cases. We observed no increased risk for any specific malformation type associated with use of BZD. Step 2: further defining drug exposure as a specific BZD, and all others unexposed, a significant association was seen between lorazepam and anal atresia. OR=6.2 (95% CI2.4-15.7, p=0.01). Step 3: this finding was upheld and no other emerged when exposure was defined as the drug or any of its active metabolites. This step was performed because hepatic catabolism of BDZs leads to derived molecules that are sometimes active and/or present in the common metabolic route of major marketed BZDs. Step 4: similarly, the lorazepam/anal atresia finding was upheld when the analysis was restricted to the 262 malformed infants exposed to BZDs in utero. Six cases of anal atresia were found among all newborns exposed to BZD in utero, and five of them were exposed to lorazepam, representing a hypothesis to be tested in further. We are not aware of other reports of this association, and it should be regarded as preliminary until confirmed in other data sets.

Anus, Imperforate↗
PubMedDate not supplied

[Anti-cardiolipin antibodies in lupus erythematosus].

Anti-cardiolipin antibodies (ACA) were investigated in the serum of 79 patients with lupus erythematosus by means of ELISA method. 34 patients (43%) had ACA in their serum. 63.6% of the patients with ACA had 4 or more ARA criteria and 75% of them had malar rash. None of our patients had the "anti-cardiolipin antibodies syndrome" but three of them with thrombocytopenia had ACA.

Adult↗