Search PubMed⌕ Search

Biomedical subjects

J B Gouyon

Publications and source records attributed to J B Gouyon.

150 records · Page 9Linked to original sources
PubMedDate not supplied

Prophylactic ibuprofen versus placebo in very premature infants: a randomised, double-blind, placebo-controlled trial.

BACKGROUND: Patent ductus arteriosus is a common complication of prematurity that frequently requires surgical or medical treatment. The benefit of prophylactic treatment by indometacin, a cyclo-oxygenase inhibitor, remains uncertain compared with curative treatment. This benefit could be improved with ibuprofen, another cyclo-oxygenase inhibitor with fewer adverse effects than indometacin on renal, mesenteric, and cerebral perfusion. We aimed to compare prophylactic and curative ibuprofen in the treatment of this abnormality in very premature infants. METHODS: We did a randomised controlled trial in infants younger than 28 weeks of gestation, who were randomly assigned to receive either three doses of ibuprofen or placebo within 6 h of birth. After day 3, symptomatic patent ductus arteriosus was treated first by open curative ibuprofen, then back-up indometacin, surgery, or both. The primary endpoint was need for surgical ligation. Analysis was per protocol. FINDINGS: The study was stopped prematurely after 135 enrollments because of three cases of severe pulmonary hypertension in the prophylactic group. 65 infants received prophylactic ibuprofen, and 66 received placebo. Prophylaxis reduced the need for surgical ligation from six (9%) to zero (p=0.03), and decreased the rate of severe intraventricular haemorrhage from 15 (23%) to seven (11%) (p=0.10). However, survival was not improved (47 [71%] placebo vs 47 [72%] treatment, p=1.00), because of high frequency of adverse respiratory, renal, and digestive events. INTERPRETATION: In premature infants, prophylactic ibuprofen reduces the need for surgical ligation of patent ductus arteriosus, but does not reduce mortality or morbidity. Therefore, it should not be preferred to early curative ibuprofen.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

[Cesarean section in the Burgundy perinatal network: reasons for differences in the management of mothers].

OBJECTIVE: The aim of our study is to determine the relative risk of cesarean section at term induced by medical, organizational and personal factors in a regional healthcare network. PATIENTS AND METHODS: Our retrospective study covered all 17,062 full-term births, not including pre-birth transfers, in the 20 maternity hospitals of Burgundy in 2001. Statistical analysis was performed on the data collected, which was exhaustive and validated for all 18,278 births of our perinatal network. RESULTS: The percentage of cesarean sections performed at term was 16.4% (overall percentage of cesarean sections was 17.5%, equivalent to our national rate in 1998). But there was significant inverse relationship between the percentage of cesarean sections and the level of our maternity hospitals (17.4, 16.1 and 14.1% for types I, II, and III respectively). And 4 of our 20 establishments had a higher rate of ceasarean sections, with no medical justification. DISCUSSION AND CONCLUSIONS: Our study shows that for a pregnant woman at term, the simple fact of benefiting from care in such a maternity hospital corresponds to a risk factor for cesarean section (OR = 1.9), which is higher than IUGR (OR = 1.6) diabetes (OR = 1.6) or macrosomia (OR = 1.3). It also shows the feasibility of such an objective analysis of medical practices, providing that data collection is exhaustive and validated for the whole population of the perinatal network, and providing that it includes medical, organizational and personal factors.

Cesarean Section↗
PubMedDate not supplied

[Posthemorrhage porencephalic cysts in the neonatal period. Diagnosis. Etiology. Development. Value of transfontanellar echography].

Cerebral echotomography interest in showing neonatal cerebral hemorrhage and their follow up toward porencephaly is pointed out in 4 neonates. The authors recall the electroencephalographic features which can lead to the diagnosis. Then, they insist upon a new concept which is the long delay between onset of the cyst and onset of hemiplegia. The rationnal for this concept is the gradual maturation of the pyramidal tracts in infancy.

Brain Diseases↗