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Biomedical subjects

H Beauregard

Publications and source records attributed to H Beauregard.

53 records · Page 3Linked to original sources
PubMed1977

Amenorrhea following the use of oral contraceptives.

Clinical aspects and the incidence of the various underlying etiologic factors were studied in 86 patients with post-oral contraceptive amenorrhea. Patients were divided into two groups according to the presence or absence of detectable galactorrhea. Group I was composed of 55 amenorrheic patients without detectable galactorrhea and group II included 31 patients with amenorrhea associated with galactorrhea. Both groups were comparable for age, gravidity, duration of intake of oral contraceptives, and duration of amenorrhea. The incidence of previous oligomenorrhea and late menarche was high in both groups. The most striking difference between the two groups was in the incidence of pituitary prolactin-secreting tumor--32% among patients with galactorrhea and less than 2% among patients without galactorrhea. Identification of galactorrhea and accurate diagnosis of its causes are mandatory for successful management of postpill amenorrhea.

Adolescent↗
PubMedDate not supplied

Development of noninvasive and quantitative methodologies for the assessment of chronic ulcers and scars in humans.

Chronic ulcers are a significant and common cause of morbidity and mortality worldwide. They disrupt the epidermis and dermis, resulting in a loss of barrier function. Keloids and hypertrophic scars (benign cutaneous tumors) represent an abnormal healing response. These fibroproliferative disorders are characterized by an overabundance of collagen and accumulation of extracellular matrix due to an imbalance between synthesis and degradation, culminating in excessive scarring. The objectives of this study were to evaluate and compare noninvasive biophysical methods for the measurement of outstanding quantitative parameters of scars and chronic ulcers, and to establish correlations between the parameters measured and the results of conventional subjective clinical evaluations. The development of new technologies, based on ultrasonography and laser Doppler, makes possible new dermatological evaluation methods. Fifteen patients (6 females and 9 males) with 15 chronic ulcers (4 diabetic ulcers, 10 venous ulcers and 1 pressure ulcer) and 30 patients (19 females and 11 males) with 30 scars (25 hypertrophic and 5 keloids) were included in this study. Clinical evaluation was performed by a dermatologist, an aesthetic surgeon and an endocrinologist. Biophysical measurements were used to assess local blood flow by laser Doppler flowmetry (Moor DRT4), thickness and echogenicity by high frequency ultrasonography (20 MHz, Dermascan C) and ulcer linear dimensions by image analysis. Our results show that blood flow within the ulcers and scars was higher than within normal skin. Also, skin thickness of chronic ulcers was decreased when compared to normal skin; the thickness of hypertrophic scars, but not of keloids, was increased in comparison to normal skin, and presented the possibility of measuring wound and scar surfaces with precision. In summary, this pilot study established the feasibility of measuring various biophysical parameters and adapted their potential utility to research on wounds.

Adult↗
PubMedDate not supplied

[Diagnostic value of the determination of blood urea in dehydrated patients with and without central diabetes insipidus].

Dehydrated patients usually present with an elevated serum urea level, owing in part to increased renal reabsorption of urea mediated by antidiuretic hormone (ADH). This study was carried out in order to examine whether, during dehydration, the variations in the serum urea level could discriminate patients with central diabetes insipidus (CDI) from those with dehydration due to other causes. We studied retrospectively 27 episodes of dehydration in 23 patients with CDI and 14 episodes in 14 patients without CDI. The mean serum urea level was 2.9 mmol/L in the CDI group and 15.4 mmol/L in the patients without CDI (p less than 0.001) while the mean serum sodium level was 155 mmol/L in both groups. During dehydration, patients with CDI decreased their serum urea level (4.0 +/- 2.3 vs 2.9 +/- 1.5 mmol/L, p less than 0.001). In addition, a positive correlation was found in the patients with CDI between the magnitude of diuresis and the percentage decrease in the serum urea level compared with the level before dehydration (r = 0.70, p less than 0.001). A striking increase in the clearance of urea (0.8 +/- 1 vs 2.1 +/- 1 ml/s, P less than 0.01), which exceeded the creatinine clearance (1.8 +/- 0.5 ml/s), was observed during dehydration in the six patients in whom clearance studies were done. Therefore, our results suggest that serum urea values can be used to distinguish patients dehydrated because of CDI from those with hypertonic dehydration but without ADH deficiency and that during dehydration the reabsorption of urea is mainly dependent on the renal action of ADH.

Adult↗
PubMedDate not supplied

[Treatment of the non-functioning hypophyseal adenoma].

Non-functioning pituitary adenoma is a lesion usually large enough to produce loss of vision and often loss of libido. Transsphenoidal microsurgery is the treatment of choice of these patients. Postoperative radiation therapy should be performed in patients with significant residual pituitary adenoma. Some studies have recently reported that somatostatin analogue may be useful as adjuvant medical therapy, at least in order to improve visual field defects.

Adenoma↗
PubMedDate not supplied

[The treatment of prolactinoma].

Prolactinoma is the most common type of secretory pituitary tumor. The clinical presentation varies with age and sex, and the size of the adenoma. The differential diagnosis with nonfunctioning adenoma and hyperprolactinemia is particularly important in selecting an appropriate therapy. The choice of therapy depends on a number of factors including the patient's preference. In cases of radiologically undetectable microprolactinomas, we prefer observation only. However, hypogonadic patients are treated with bromocriptine. Generally, it is our recommendation that almost all of the patients with micro--and macroprolactinomas undergo a primary medical therapy, provided they are willing to continue such therapy on a long term basis. We recommend transsphenoidal surgery for patients who refuse long term medical therapy and in rare cases of prolactinomas which are unresponsive to medical therapy. We also consider surgery as a valuable alternative to medical therapy in patients with microprolactinomas and prolactin below 200 micrograms/L.

Adolescent↗
PubMedDate not supplied

[The treatment of Cushing's disease].

The differential diagnosis of Cushing's disease remains difficult to establish. The selective transsphenoidal adenomectomy is the initial treatment of choice. In a group of 65 patients, 50 (77%) initially responded to surgery with correction of their hypercortisolism. Forty-three out of 51 (84%) patients with small pituitary tumors responded favourably to surgery, but recurrency occurred in 10% of the cases. Medical treatment with steroids inhibitors or antagonists is only an adjuvant treatment. In case of surgery failure or recurrency, bilateral adrenalectomy is usually performed. Conventional radiotherapy may be used after surgery in presence of macroadenomas or invasive adenomas. Correction of the hypercortisolism, after a second surgery, was achieved in 50% of the cases and was always associated with a panhypopituitarism.

Adenoma, Basophil↗
PubMedDate not supplied

[The treatment of acromegaly].

Acromegaly is a rare disease which can significantly reduce life expectancy. Clinical features are diverse and the patient may consult a variety of medical and surgical specialists before the diagnosis is suspected. However, the disease is easily confirmed by the appropriate laboratory tests, namely GH and IGF1 measurements. In most cases, acromegaly is secondary to a micro or macrosomatotrope pituitary adenoma. Those lesions are easily visualized by a pituitary CT Scan or Magnetic Resonance Imaging. Visual fields have to be evaluated by a neuro-ophthalmologist, and a thorough evaluation of other pituitary functions have to be performed. Selective removal of the adenoma by the transsphenoidal route is the treatment of choice for acromegaly. When performed by an experienced neurosurgeon, normalization of GH secretion can be expected in approximately 75% of cases. The surgical outcome is modulated by the volume, the extension of the tumor and the preoperative GH level. Octreotide, radiotherapy or bromocriptine are indicated whenever the patient remains with an elevated level of GH with persistency of symptoms.

Acromegaly↗
PubMedDate not supplied

[Hypothalamic astrocytoma presenting as obesity with hypogonadism].

We report herein a case of a 30 year old male patient who consulted for a long standing obesity since childhood. Clinical examination reveals the presence of hypogonadism and gynecomastia without galactorrhea. Endocrine assessment showed an hypogonadotrophic hypogonadism with a moderate insufficiency of the adrenocortical axis. Neuro-ophthalmological examination disclosed an inferior bitemporal quadranopsia. MRI showed an extra-axial suprasellar mass, lightly hypointense in T1 and hyperintense in T2. After craniotomy and conservative biopsy, pathological examination of the tumor showed regular cells surrounded with collagen and reticulin marked with immunoperoxidase against S100 protein and GFAP (glial fibrinolytic acidic protein) strongly suggesting the diagnosis of juvenile pilocytic astrocytoma.

Adult↗