[Avoidable perinatal mortality. Attempted evaluation and significance].
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France↗
Biomedical subjects
G Muller
Publications and source records attributed to G Muller.
Aluminum transfer through milk in female rats intoxicated by aluminum chloride.
Female rats received an ip injection of aluminum chloride (10 mg Al/kg/d) during the first 12 d after parturition; this treatment led to a reduction in food intake associated with a reduction in body wt. Pups of the intoxicated dams showed a growth retardation after postnatal day 7. One day after treatment, the female rats intoxicated with aluminum had a considerably higher level of aluminum in milk than controls. The aluminum levels of plasma, liver, spleen, and kidneys were also significantly higher in treated female rats than controls. On the contrary, in the same tissues of pups from treated or not treated dams, no differences in aluminum levels were observed. No effect of aluminum treatment was detected on plasma silicon levels in dams and pups.
Aluminum↗
[Management of the scarred uterus].
On the basis of 899 cases of uterine scarring following cesarean section, the authors carried out a prophylactic cesarean in 42% of cases. Labor ended in childbirth by the genital tract in 44% of cases. The very low incidence of uterine rupture since segmental hysterotomy has become widespread and the improved fetal and maternal prognosis are all reasons to prefer delivery by the genital tract. One of the factors in choosing the method of childbirth is radiopelvimetry and estimation of the fetal weight; however, the suspicion of a threshold pelvis is not a contraindication to the labor test which was successful in 70% of the authors cases. On condition that strict obstetrical monitoring is possible, oxytocic drugs can be used to induce labor or correct hypokinesia and to administer a peridural analgesic. Routine extraction is no longer necessary during the expulsion phase but the authors remain faithful to uterine revision. In general, the labor test should be suggested as often as possible and should receive the same monitoring and treatment methods as for an intact uterus.
Birth Weight↗
[Prophylactic antibiotic therapy: comparison between elective and emergency cesarean section].
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Adult↗
Changing trends in preterm childbirth.
Progress in perinatal care has been accompanied recently by increasing numbers of induced premature deliveries because of fetal distress. This is confirmed by study of 26,796 consecutive births in the Caen Hospital Group between 1980 and 1987. Study of the fate of these children shows that this attitude has not led to any excess mortality when the share of the IPD before 32 weeks are regularly growing. This would imply that the prematurity rate is no longer a sufficiently accurate epidemiological index for the evaluation of prenatal care policies.
Female↗
Oesophageal involvement in rheumatoid arthritis patients: a study with oesophageal radionuclide transit using 81Krm.
Rheumatoid arthritis (RA) is an inflammatory disease affecting mainly the joints. In addition, signs of systemic disease are likely to be present although they are not always clinically evident. Oesophageal motility dysfunction, present in 75% of progressive systemic sclerosis patients, was also reported in various other connective tissue diseases. The present study involved 32 rheumatic patients devoid of any gastrointestinal complaints or diseases: 16 RA, nine Raynaud's syndrome and seven mild osteoarthritis as controls. Oesophageal transit was assessed by using 81Krm radionuclide scan, a sensitive and non-invasive technique. Diffusing lung capacity for carbon monoxide (DLCO) was performed as evidence of subclinical systemic involvement. Abnormal oesophageal transit was observed in 5/16 RA (31%). Two of them were subsequently discarded due to the presence of asymptomatic goiter and asymptomatic gastrointestinal reflux leaving 3/14 RA for analysis. They all had extra-articular features (EAF) (pericarditis, nodules) and two of them had diminished DLCO. Two with Raynaud's syndrome had abnormal oesophageal transit but none of the controls had abnormal oesophageal transit. Upper gastrointestinal dysfunction after exclusion of symptomatic patients appears thus to be not very frequent in RA, even when a sensitive technique is used. Radionuclide transit scanning of the oesophagus is not a more useful method than others in detecting early EAF in RA.
Adult↗
The supramolecular organization of ovomucin. Biophysical and morphological studies.
Ovomucin participates in the ovomucin-gel-forming properties because of its shape and its ability to interact in a specific spatial organization. Purified from chicken egg-white by exclusion chromatography with Sephacryl S-300 and Sepharose CL-2B and analysed by light-scattering, it exhibited an Mr of about 40 x 10(6). This large Mr can be explained by the aggregation of polymers that can be degraded into 3 x 10(6)-Mr fragments by reduction with dithiothreitol. The values for hydrodynamic parameters such as Mr, radius of gyration, hydrodynamic radius, mass per unit length and combinations of them suggested that ovomucin is a linear and highly flexible molecule conferring upon it a random-coil-like structure in 0.2 M-NaCl solution. Analysis of the ovomucin molecules by electron microscopy revealed its linear character but also indicated a lower Mr than that obtained in the light-scattering experiments. By temperature-induced non-specific aggregation of an ovomucin solution containing other globular egg proteins, an attempt was made to find out what conditions are required for gel formation and to examine the quality of aggregation that is obtained under these conditions. Results show that the viscosity of the solution did not increase after heat treatment. Apparently, in the ovomucin gel, specific spatial organization of the ovomucin molecules is required for hydrogel formation.
Animals↗
Developmental alterations in offspring of female rats orally intoxicated by aluminum lactate at different gestation periods.
Pregnant rats were treated orally with aluminum lactate (400 mg Al/kg/day) during three periods of gestation to determine the treatment's influence on mortality, weight gain, neuromotor maturation, and learning abilities of their pups. No effect of treatment on litter size, mortality rate, and weight gain of pups was detected. In the negative geotaxis test, the scores of pups from females treated during the second and third weeks of gestation were diminished. In the locomotor coordination and the operant conditioning tests, significant differences in the comparison of controls vs. the three treated groups were found, indicating long-term effects of early intoxication upon the central nervous system.
Animals↗
Regnauld procedure for hallux valgus.
Between 1975 and 1986, 75 female patients with painful hallux valgus deformity underwent 100 Regnauld procedures. Of these 75 patients, 50 patients underwent unilateral surgery and 25 patients had simultaneous bilateral surgery. The average age of our patient was 45 years. These operations were performed by two different orthopedic surgeons. Over 90% of our patients were satisfied with the operation. Eighty-five percent had no pain, had a satisfactory cosmetic result, and had no complaints about their footwear. Only one patient had severe problems with high heels. Mobility and radiographic evaluation did not correspond with the clinical results. This type of procedure can be performed as an alternative to the Keller-procedure in the middle-aged or elderly patient with no severe arthritis and no osteoporosis.
Adult↗
[Value of a velocimetric study of the uterine arteries in retroplacental hematoma. 3 case reports].
Retroplacental hematoma is a sudden event with a poor prognosis, the latter being aggravated by the very frequent lack of predictive clinical, laboratory or echographic signs. Does studying the velocity of blood flow in uterine arteries have a predictive value in this disease? The equipment used was a continuous Döppler with spectral analysis and probe of 4 MHz, without echographic identification. Each examination systematically included the study of the 2 uterine arteries and the umbilical flow. The technique for recording flow in the uterine arteries is described. A report is given of three cases of retroplacental haematoma. An increase in the resistance index in one of the uterine arteries was found in the three cases (twice on the right, and once on the left), with a protodiastolic notch on the curve, whereas the umbilical index itself was normal and there were no other sign that indicated the placental event. The Döppler is already known to be of value in numerous indications in obstetrics: it should be possible to extend these indications even further, particularly if this preliminary study is confirmed on a broader scale.
Adult↗
Molybdenum. Normal plasma values at delivery in mothers and newborns.
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Female↗
[A comparative study of pulsed Doppler versus continuous Doppler technic without spectral analysis in obstetrics].
We conducted a study in 48 parturients in order to: --assess the possibilities of continuous Doppler examination without preliminary ultrasonographic localization and without spectral analysis, to measure the traditional hemodynamic parameters of fetal development (in particular on the umbilical cord). --to compare these results with those obtained using pulsed Doppler-scan as reference. The protocol was very strict and neither of the two practitioners was aware of the other practitioner's results. With the continuous Doppler examination, the uterine arteries were systematically localized and recorded. The technique is simple in trained hands. The material included an ultrasonograph fitted with two probes (3.5 and 5 MHz, equipped with a pulsed Doppler) and a continuous Doppler (only the 4 MHz probe was used). Because the tests were sometimes repeated, 63 measurements were obtained in 48 parturients, mean age was 29.3 years and mean gestational age was 32.9 weeks. The reason for the examination varied: intrauterine growth retardation and/or maternal hypertension, diabetes, etc. The results obtained from the cord proved to be very encouraging: 42 of the 54 measurements were comparable (77.7%) showed an index difference less than or equal to 0.05. Only 4 (7.4% of the measurements) maximum deviations were observed (exceeding 0.10). The mean Pourcelot index on the Doppler scan was 0.677. With the continuous Doppler, it was 0.676. The 13 abnormal measurements with the pulsed Doppler were also abnormal with the continuous Doppler. The uterine arteries were recorded and measured with the continuous Doppler 42 times on the right (68.8% of the cases) and 34 times on the left (55.7%).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Tubal adenocarcinoma. Apropos of 4 cases and review of the literature].
The authors describe 4 cases of tubal cancer reported in the gynaecology department of the University Hospital in Caen and review the international literature. If all authors are in agreement on the early symptoms (leukorrhea, haemorrhages, pelvic pain), the lack of diagnosis before the procedure, the lack of information regarding the staging and the grading, as well as the surgical and radiation treatment, there is, above all, controversy regarding the use of chemotherapy, since the low number of patients in the different series does not permit reaching a conclusion.
Adenocarcinoma↗
[From the management of the medical record to clinical research in obstetrics].
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Computer Systems↗
[Blood levels of molybdenum, selenium and copper at delivery].
Molybdenum (Mo), selenium (Se) and copper (Cu) plasma levels were studied at delivery in 38 women (1 twin pregnancy). The influence of parity (P) (2.5 +/- 1.7) gestational age (GA) (38.6 +/- 3.2 weeks), birthweight (BW) (3,120 +/- 695 g) and Apgar score upon these levels were assessed. Mother (M) and cord (C) blood values were 15.0 +/- 7.8 and 15.0 +/- 9.3 nmol/l respectively for Mo, 0.54 +/- 0.12 and 0.47 +/- 014 mumol/l for Se and 27.6 +/- 5.9 and 5.5 +/- 3.3 mumol/l for Cu. C and M values for Se and Cu were statistically different (alpha less than 0.02, alpha less than 0.001). There was a significant correlation between C and M for Mo levels (r = 0.41; p = 1.9%) and Cu levels (r = 0.47; p = 0.35%), between Cu C levels and GA (r = 0.54; p = 0.6%) and between Se, C levels and BW (r = 0.66; p = 1.9%). There was no correlation between the levels of the trace elements studied. This study shows that fetal levels of Mo vary with those of the mothers. On the other hand, the levels of Se in the fetus seem to be protected from variations observed in the mothers. The antagonism between Cu and Mo which had been previously demonstrated in the fetal liver was not found in blood.
Birth Weight↗
Molybdenum content of term and preterm human milk during the first 2 months of lactation.
To assess the molybdenum supply and requirements of preterm infants, Mo concentration was determined in milk from mothers of 6 term and 11 preterm newborns; no difference was found between fore- and hindmilk and no diurnal variations were found during 24-h collections. Respective values (means +/- SD) of term and preterm milks were 10.2 +/- 3.7 and 4.0 +/- 3.7 micrograms/L (106.2 +/- 38.5 and 41.7 +/- 38.5 nmol/L) at 3-5 d of lactation, 4.8 +/- 3.9 and 3.7 +/- 3.8 micrograms/L (50.0 +/- 4.6 and 38.5 +/- 39.6 nmol/L) at 7-10 d, 1.5 +/- 1.4 and 1.4 +/- 0.9 micrograms/L (15.6 +/- 14.6 and 14.6 +/- 9.6 nmol/L) at 14 d, 2.6 +/- 2.2 and 1.9 +/- 1.4 micrograms/L (27.1 +/- 22.9 and 19.8 +/- 14.6 nmol/L) at 1 mo, and 0.2 and 1.2 +/- 0.5 micrograms/L (2.1 and 12.5 +/- 5.2 nmol/L) at 2 mo. A statistical difference was found between term and preterm milk at 3-5 d of lactation. During lactation significant changes were found between the periods 3-5 d and 7-10 d, 14 d, 1 mo (p less than 0.01) and 2 mo (p less than 0.05) of lactation and between 7-10 d and 14 d (p less than 0.05). According to the requirements of the preterm infant, a supplementation of 2-3 micrograms.kg-1.d-1 by enteral route is suggested.
Circadian Rhythm↗
[Post-traumatic feto-maternal hemorrhage. Apropos of a case].
When a sinusoidal fetal heart rate pattern suggestive of severe anaemia is found one always has to think of feto-maternal haemorrhage. The diagnosis is made using the Kleihauer test. The quantity of fetal blood loss as estimated by this test must be suspect from this case history and from the figures that are quoted in the literature. It will probably be advisable to compare the Kleihauer test and electrophoresis of the haemoglobin in trying to estimate the quantity of blood that has passed from the fetus to the mother. In any case of trauma it is important to look for evidence of feto-maternal haemorrhage.
Adult↗
[Classification of perinatal deaths as a function of birth weight and gestational age. New methodologic approach].
Perinatal mortality is closely related to infant birth weight. However, the examination of both gestational age and birth weight provides a more comprehensive approach. This study presents a method of evaluation which is readily applicable. Data were obtained from the computerized files of the maternity ward of the University Hospital of Caen. This report is based on case-reports of 17,952 single births, from May 1980 to July 1985 (cases of multiple birth have not been considered since their age/weight relationships are usually different). All stillborn infants and those who died within the first week of life were considered. Any infant whose gestational age was 28 weeks or more but who showed no sign of life at birth was considered stillborn. Gestational age was determined from the mother's last menstrual period, providing it concurred with the obstetrical evaluation (i.e. echographic measurements of foetus before 20 weeks of gestation). If not, the clinical evaluation was retained. Results are presented in the form of blocks, each one representing 1 week of gestational age and a birth weight of 500 g. The perinatal mortality rate was calculated for each block. Blocks of similar mortality rates (i.e. with no significant difference) were then pooled by means of a recently published method [3]. This difference between the mortality rates of 2 blocks (in percentages) may be measured by means of the chi-square test. The test enables the evaluation of the "distance" between two adjacent zones, which can be calculated for all the blocks of the graph, by pairs.(ABSTRACT TRUNCATED AT 250 WORDS)
Birth Weight↗