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Biomedical subjects

H Fernandez

Publications and source records attributed to H Fernandez.

At least 253 records · Page 14Linked to original sources
PubMed1991

[The administration of tobramycin in the 2nd and 3rd trimester of pregnancy: contribution to a pharmacokinetic study for the adaptation of posology].

Aminoglycosides are currently used during pregnancy for the treatment of Staphylococcus, Enterobacteriaceae, Listeria monocytogenes, and Pseudomonas aeruginosa infections. The pharmacokinetics of tobramycin, an aminoglycoside antibiotic, was investigated after a 2.5 mg/kg short intravenous infusion and a once-daily dose regime in 18 pregnant women divided into 2 groups of 9 during the second (Group I: from 20 to 28 weeks of amenorrhoea) and the third (Group II: greater than or equal to 28 weeks of amenorrhoea) trimesters of pregnancy (during these period, risks of infectious diseases are increased). Plasma concentrations of tobramycin were measured by fluorescence polarization immunoassay (FPIA). The decrease of clearance (decrement of 27.6%), at 28 weeks and more gestation leads to an increase in the half-life and the MRT observed in the second group (increment of 49% and 41% respectively), whereas the volume of distribution remained unchanged in the two groups. No accumulation of the drug was observed in pregnant women. Pharmacokinetic disorders are correlated with the duration and moreover with the weight deviation of the women i.e., the growth of the conceptus. In 10 cases, a feto-maternal concentration ratio was calculated at delivery using an umbilical cord blood sample. This findings suggest a phenomenon of accumulation in the conceptus. To limit the potential nephrotoxicity and ototoxicity of tobramycin for the mother and the fetus, a once-daily dose regime seems to be an advanced solution for treatment of nonneutropenic pregnant women.

Absorption↗
PubMed1991

[Fertility after extra-uterine pregnancy in Africa. Follow-up of a cohort of 145 patients over 5 years].

Gabon has one of the lowest fertility rates in Central Africa (116 children per 1,000 women); and ectopic pregnancy occurs in 1 per 62.5 live births. We have studied fertility following ectopic pregnancy with a 5 years follow-up in a cohort of 145 women treated for an ectopic pregnancy in the general hospital of Franceville, Gabon. 17% of these women had an intra uterine pregnancy, 10% had a repeat ectopic pregnancy and 73% were infertile 5 years after the ectopic pregnancy. We compared the fertile group and the infertile group after ectopic pregnancy: the main factors for fertility were the fertility of these women before the ectopic pregnancy and the staging of the Fallopian tube and pelvic cavity. Pelvic adhesions following pelvic inflammatory diseases were correlated with infertility. The main causative agent of infertility after ectopic pregnancy were sexual transmitted diseases and their sequelae and late diagnosis.

Adult↗
PubMed1990

Advanced combined intra-uterine and ovarian gestations: case report.

Combined intra-uterine and ectopic gestations are uncommon. Heterotopic gestations in which the ectopic pregnancy is located in the ovary are exceptional. We are reporting a 22 week heterotopic gestation with two live fetuses, one fetus was developing in the uterus and one in the ovary. Surgical excision of the ovarian pregnancy was conducted without disturbing the intra-uterine live fetus who was ultimately delivered uneventfully at term.

Adult↗
PubMed1990

Transfusion syndrome in a triplet pregnancy.

A case is reported of a transfusion syndrome in a triplet pregnancy with intrauterine death of two of the fetuses. This is an exceptional occurrence in a triplet pregnancy and raises the problem of the management of multiple pregnancies associated with the death of one or more of the fetuses. The problem of the method of delivery and the complications arising in triplet dizygotic pregnancies is discussed.

Adult↗
PubMed1990

[A study of fetal pulmonary maturity using amniotic fluid obtained from the vagina after premature rupture of membranes].

Amniotic fluid was obtained from the vagina not more than 24 hours before delivery in 100 patients who had premature rupture of the membranes. Thirty per cent of these cases had contamination with blood or with meconium. Phosphatidylglycerol (PG) estimate the degree of lung maturity using an immunological method (AMNIOSTAT-FLM test). In the 22 cases where the gestational age was 35 weeks or less there were two cases of hyaline membrane disease. In 68% of the 22 cases, the PG was negative, intermediate in 14% and positive in 18%. One of the cases of hyaline membrane disease was accompanied by fluid that was not infected and that was negative for PG; the other case had infection with S. faecalis and the PG was intermediate. On the other hand in the 78 cases when the pregnancies had lasted longer than 35 weeks there were no children who had hyaline membrane disease. The PG reaction was positive in only 57% of these cases. Search for bacteria showed infection in 10 cases (three with alpha-haemolytic streptococci, four with group B beta-haemolytic streptococci and three with E. coli). Determination of PG on the supernatant of reference strain cultures showed positive results for S. faecalis and E. coli. In conclusion, the poor specificity of the test (48%) and the possibility that when there was bacterial contamination false positive results were obtained shows that looking for fetal maturity by testing amniotic fluid from the vagina is unreliable and is contra-indicated.

Amniotic Fluid↗
PubMed1990

Fetal levels of tobramycin following maternal administration.

A single dose of tobramycin 2 mg/kg was given intravenously to a woman who presented a 22-week heterotopic pregnancy with both intrauterine and ovarian gestations and two living fetuses. After excision of the adnexum, tobramycin levels were measured in the maternal serum and in the fetal fluids and tissues. Antibiotic levels were especially high in the fetal spleen and kidney.

Adult↗
PubMed1990

[The Zavanelli maneuver: use during breech retention of the head in the birth canal. Apropos of a case].

A case is presented where Zavanelli's manoeuvre was carried out when the chin of the fetus was caught up above the symphysis pubis. This new concept for managing partially born infants that cannot be delivered vaginally, by Cesarean section improves greatly the prospect for survival of the fetus with minimal extra risk for the mother. It is easier to carry out the manoeuvre when the patient is under epidural analgesia.

Adult↗
PubMed1989

An obstetric analysis of fifty consecutive pregnancies after transfer of cryopreserved human embryos.

This report describes the obstetric outcome in 50 pregnancies resulting from the transfer of human embryos that had been cryopreserved for up to 2 years. The duration of cryopreservation did not influence the pregnancy rate after thawed embryo transfer. Thirty-one babies have been born from 28 pregnancies and a further seven pregnancies are currently in the second and third trimesters. Twenty-eight percent of the pregnancies failed to progress beyond the first trimester. One pregnancy was terminated at 22 weeks' gestation because of severe fetal malformation. Important antenatal events included premature uterine activity in six patients although only one patient with a singleton pregnancy ultimately was delivered prematurely. Retroplacental hemorrhage occurred in four patients but was of clinical consequence in only one. There was a high incidence of breech presentation at term in singleton pregnancies (12%). The cesarean section rate in this series was 21%. An international registry of cryopreserved pregnancies would facilitate data collection in this relatively new clinical field.

Adult↗
PubMed1989

Acetylcholinesterase molecular forms in muscle and non-muscle cells of rat heart.

Experiments were performed to determine the cellular associations of the molecular forms of acetylcholinesterase (AChE) in adult rat heart. For this purpose, a cardiac muscle and a non-muscle fraction were isolated from rat heart ventricles after perfusion with collagenase and hyaluronidase, extracts of these fractions were subjected to ultracentrifugation on linear density gradients of sucrose (5-20%), and fractions of these gradients were analyzed for AChE activity. The results show that only globular AChE molecular forms were present in isolated cardiac muscle cells. Globular AChE forms were also present in the non-muscle cells fraction but in different proportions. The proportions of globular AChE forms plus the high specific activity of choline acetyltransferase in the non-muscle cell fraction suggest that this fraction contains cholinergic nerve fragments. The results of this study also show that asymmetric AChE is released during the perfusion of heart with the digestive enzymes, which suggests that asymmetric AChE is bound to the extracellular matrix of heart.

Acetylcholinesterase↗
PubMed1989

[Simulation of ovulation using two types of LH-RH agonists].

Luteinizing hormone-releasing hormone (LH-RH) agonists are being increasingly used in ovulation stimulation protocols in IVF programs. The results of two methods of utilization of LH-RH agonists are compared. There was difference in the ovarian response on the day of human chorionic gonadotropin (hCG) higher in the short protocol (69% vs 56%, P less than 0.001). The ongoing pregnancy rate per treatment cycle was similar in both groups (18% in the long protocol and 16% in the short protocol).

Chorionic Gonadotropin↗
PubMed1989

Chorionic villus sampling (CVS). Randomized study of efficacy of two transcervical biopsy methods: aspiration canulas and small forceps.

A randomized study of two transcervical biopsy methods was performed. One method involved the use of an aspiration catheter and the other a tissue biopsy forceps. 120 chorionic villus samplings were performed in 30 patients. The percentage of success in taking biopsies and the resulting number of karyotypes were identical in both groups. The amount of removed trophoblastic tissue was greater when the forceps was employed. When the aspiration catheter was used, a sufficient amount of trophoblastic tissue was obtained for karyotyping purposes. It was easier to insert the aspiration catheter than the forceps. The echogenicity of the catheter and forceps were identical. The aspiration catheter has two advantages. Firstly, it is malleable and fits to the anatomy of the cervical canal and the site from which the biopsy is to be taken. Secondly, it is disposable.

Adolescent↗
PubMed1989

Phase I clinical trial of monoclonal anti-human chorionic gonadotropin antibody in women with an ectopic pregnancy.

A phase-I clinical trial of a mouse monoclonal anti-human chorionic gonadotropin (hCG) antibody designated as HT13 was conducted in three patients treated for ectopic pregnancy. Doses of 5 and 25 mg of purified antibody were injected into patients. Monoclonal antibody serum levels dropped to 0 within 1 to 5 days. Human antibodies directed against mouse immunoglobulins were not detected at up to 41 days after injection. In one patient, the tubal pregnancy resolved, as confirmed by hCG levels of less than 10 mUl/mL and by tubal patency at hysterosalpingography. The time of resolution was 30 days. In two patients, salpingectomy was performed because of persistence of elevated hCG levels, whereas HT13 had a striking effect on progesterone (P) and estradiol (E2) serum levels. The injection of anti-hCG antibody did not appear to interfere with the subsequent fertility of patients, and two out of three patients later developed a successful pregnancy. While the precise role of antibody injection in the interruption of ectopic pregnancy remains speculative, the injection of monoclonal anti-hCG antibody appears to induce a dramatic decrease in the production of both P and E2.

Antibodies, Monoclonal↗
PubMed1989

[Management of triple pregnancies].

A retrospective study of triplet pregnancies is presented. Data concerning 24 triplet pregnancies which were followed up to delivery and for a period of 11 years afterwards at the Maternity Center of the Antoine Beclere Hospital, are analysed. Early diagnosis of triplet pregnancy leads to a strong prognostic indication for prematurity. This allows time to institute preventive measures principally by reducing maternal physical activity. Because of the establishment of specific prenatal surveillance of the mothers, the rate of prematurity in triplet pregnancies be notably lowered. The mean gestational age at delivery was 33.9 weeks. The use of corticosteroid therapy between 28 and 34 weeks of gestation seems to helps prevent hyaline membrane diseases. Delivery is performed by elective cesarean section. The perinatal mortality rate was 6%.

Adult↗
PubMed1989

[Ambulatory practice of breast surgery].

Breast surgery on an outpatient basis has been indicated by control trials to investigate the efficacy of mass screening with single-view mammography in reducing mortality. These trials have also increased surgery in benign breast pathology. Sixty patients were investigated and forty-seven answered a questionnaire. Ninety-two per cent of those who answered were satisfied with this short-stay hospitalisation and ninety-four per cent would be willing to do the same again if necessary. Seventeen per cent of the patients would have preferred to stay in the hospital the night after surgery. All patients preferred to be admitted the morning of surgery. Forty-three per cent of patients had local or regional anaesthesia and were satisfied to know the diagnosis during surgery. All personnel of the health service concerned find a benefit of this outpatient arrangement, that is, both patients and hospital authorities. This has been found to be a cost-saving measure as well as an effective way of diagnosing and treating benign breast tumors.

Ambulatory Surgical Procedures↗