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Biomedical subjects

H Bili

Publications and source records attributed to H Bili.

At least 19 recordsLinked to original sources

[Small intestine bacterial overgrowth: six case reports and literature review].

INTRODUCTION: Small intestinal bacterial overgrowth syndrome (SIBOS) has various clinical and biological presentations. Six observations are described in this review which is aimed at reporting recent data on SIBOS and proposing diagnosis and therapeutic attitudes. CURRENT KNOWLEDGE AND KEY POINTS: Chronic diarrhea, malabsorption syndrome and exsudative enteropathy are the main criteria of diagnosis. Breath hydrogen testing is commonly performed to confirm diagnosis, with a 78% sensitivity and a 89% specificity. The aim of therapy is reparation of malabsorption consequences, reduction of intestinal bacterial overgrowth, and surgical correction of intestinal stasis. In the absence of consensus, norfloxacin or amoxicillin-clavulinic acid (administered for a mean of 7 to 15 days) seem the more appropriate antibiotics. When possible, surgery represents the primary treatment of SIBOS recurrences. FUTURE PROSPECTS AND PROJECTS: Diagnosis of small intestinal bacterial overgrowth syndrome must be evoked on the basis of either surgical or medical context, i.e., the existence of chronic diarrhea, malabsorption syndrome (complete or not), and exsudative enteropathy. This review reports essential factors for diagnosis and treatment.

Aged↗

Intracytoplasmic sperm injection. Survey of world results.

The widespread application of intracytoplasmic sperm injection (ICSI) has raised concern about the efficacy and safety of this novel technique. The European Society of Human Reproduction and Embryology (ESHRE) has established an ICSI Task Force to collect annually the clinical results, the outcome of pregnancy, and the follow-up of children after ICSI using ejaculated, epididymal, and testicular sperm in order to address these important issues in a relatively short time. Over a 3-year span (1993-1995), the number of centers for ICSI increased from 35 to 101, and the total number of ICSI cycles per year rose from 3,157 to 23,932. The incidence of oocytes damaged by the procedure remained low (< 10%), whereas the fertilization rates obtained with ejaculated, epididymal, and testicular spermatozoa for 1995 were 64%, 62%, and 52%, respectively. Thus, 86-90% of the couples had embryo transfer, and the viable pregnancy rate was 21% for ejaculated, 22% for epididymal, and 19% for testicular sperm, while the incidence of multiple gestations was 29%, 30%, and 38%, respectively. It is noteworthy that no difference was found in ICSI results concerning the etiology of azoospermia, for example, obstructive (congenital or acquired) or nonobstructive. Furthermore, 3,149 transfers of frozen-thawed embryos after ICSI with ejaculated, epididymal, or testicular sperm were performed, and in 11%, 9%, and 7% of them, respectively, a viable pregnancy was achieved. The ICSI results were similar during this 3-year period, irrespective of the origin of the sperm. The perinatal outcome of children born after ICSI was not different from that after in vitro fertilization or natural conception and was only affected by multiplicity. Moreover, the incidence of major or minor malformations was not increased, but the chromosomal, especially the sex chromosomal, aberration rate was slightly elevated (approximately 2%). Therefore, ICSI has opened new horizons in the treatment of male infertility. The achievement of pregnancy after ICSI using ejaculated, epididymal, or testicular sperm is very satisfactory. The procedure seems to be safe, but further follow-up of the children is necessary to more accurately assess its safety.

Abortion, Spontaneous↗

Cytokines in the human ovary: presence in follicular fluid and correlation with leukotriene B4.

PURPOSE: This study was undertaken to correlate the follicular levels of interleukin (IL)-1 alpha, IL-2, tumor necrosis factor-alpha (TNF-alpha), and leukotriene (LT) B4 with oocyte maturity, fertilization, and achievement of pregnancy. METHODS: The material was obtained from 22 women undergoing IVF, 8 of whom became pregnant and 14 of whom did not. RESULTS: All of the studied cytokines and LT B4 were found in follicular fluids, but there were no significant differences according to oocyte maturity, fertilization, embryo quality, and achievement of pregnancy. On the other hand, a significant positive correlation was found between IL-1 alpha and TNF-alpha, IL-1 alpha, and LT B4 as well as between TNF-alpha and LT B4 in follicular fluids with subsequently fertilized oocytes. CONCLUSIONS: It seems that IL-1 alpha, TNF-alpha and LT B4 may take part in the process of follicle wall degradation, and their follicular correlations may suggest more optimal follicular and oocyte development and maturation.

Adult↗

[Panhypopituitarism disclosing empty sella turcica syndrome].

INTRODUCTION: Empty sella syndrome is sometimes associated with anterior pituitary insufficiency, the latter being mostly partial or dissociated. EXEGESIS: We report a case of a profound panhypopituitarism revealing an empty sella syndrome. This case shows that empty sella syndrome, although a generally benign and asymptomatic condition, can be associated with hypopituitarism. CONCLUSION: In case of empty sella syndrome, especially if an endocrine dysfunction is clinically suspected, minimal hormonal analysis must be requested.

Adrenocorticotropic Hormone↗

Survey on intracytoplasmic sperm injection: report from the ESHRE ICSI Task Force. European Society of Human Reproduction and Embryology.

Intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of male infertility, since normal fertilization and ongoing pregnancies can be achieved with severely affected spermatozoa. Hence, the application of ICSI is rapidly expanding around the world, necessitating an accurate assessment of the efficacy and safety of this novel technique. The European Society of Human Reproduction and Embryology (ESHRE) Task Force is gathering data annually on the clinical results, the pregnancy outcome and the follow-up of children born after ICSI using ejaculated, epididymal and testicular spermatozoa, in order to be able to provide reliable information on these important issues. During the 3 years 1993-1995, the number of centres performing ICSI increased from 35 to 101, and the total number of ICSI cycles performed per year rose from 3157 to 23932. The incidence of oocytes damaged by the procedure remained low (<10%) and the fertilization rates obtained with ejaculated, epididymal and testicular spermatozoa in 1995 were 64, 62.5 and 52% respectively. Thus, approximately 90% of the couples had an embryo transfer and the viable pregnancy rate was 21% for ejaculated, 22% for epididymal and 19% for testicular spermatozoa (with 25-30% multiple pregnancies). Furthermore, 3149 transfers of frozen-thawed embryos were performed and 7-11% of them resulted in a viable pregnancy. The ICSI results were similar during this 3 year period, irrespective of the origin of the spermatozoa. The perinatal outcome of children born after ICSI was not different from those born after in-vitro fertilization (IVF) or natural conception, and was only affected by multiplicity. Moreover, the incidence of major or minor malformations was not increased, but the chromosomal, especially the sex-chromosomal, aberration rate was slightly elevated. To summarize, a very high success rate is obtained by ICSI independently of the source of the spermatozoa, verifying the superiority of ICSI over conventional IVF. The procedure seems to be safe, but further follow-up of the children is necessary in order to be able to assess its safety more accurately.

Abortion, Spontaneous↗

[Autoimmune cholangitis successfully treated with corticotherapy. One case].

Autoimmune cholangitis is a rare cause of chronic liver disease which has recently been described and associates the clinical, biological, and histological patterns of primary biliary cirrhosis without serum anti-mitochondrial antibodies. We report a case of this disease in a 67-year-old female. The patient presented with jaundice and marked biological cholestasis associated with pulmonary fibrosis and salivary and lacrymal sicca syndrome. Serum anti-smooth muscle antibodies were found without anti-mitochondrial antibodies. Corticotherapy resulted in rapid improvement of clinical and hepatic abnormalities, as well as of pulmonary lesions. The patient was still healthy 18 months later, with low dose corticotherapy. This report emphasizes the possible effectiveness of corticotherapy in autoimmune cholangitis.

Aged↗