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Biomedical subjects

J Barbot

Publications and source records attributed to J Barbot.

At least 19 recordsLinked to original sources
PubMed1994

[Management of drug addicts (heroin addicts) by general practitioners].

A telephone survey has been undertaken in a random sample of 150 General Practitioners (GPs) in four regions of France. 25% refused to answer. The study showed that drug addiction (use of heroin) is a serious issue for many of these physicians: 15% follow more than 20 drug addicts per year and only 12% see none; extrapolating the mean number of drug addicts followed yearly (9.4 per GP) to all GPs in the four regions (26,000, that is to say half of all french GPs) give an "active file" of 250,000 drugs addicts per year. Only 15% if the GPs feel they are educated for the management of drug addicts, although 70% say they prescribe medication such as hypnotics and anxiolytics (97%), the most cited being Tranxene 50 (Chlorazepate 50 mg), antalgics (84%), morphinic or morphine-like drugs (49%), mainly Temgesic, and at last antidepressants and neuroleptics (39%). GPs suffer from being isolated in their practices, as contacts with collegues or institutions specialized in drug addiction are few. If one third of the GPs wish an active participation in the management of drug addicts, and one third wish at least to "do something", they are all much ambiguous in their attitudes toward drug addiction. Their behaviors vary from medical pride to anxiety and even fear. They all mention a lot of practical problems with respect to reputation, practice, lack of time... Unanimous wishes concern opportuneness of setting up continuous medical education on this topic, of working out guidelines for prescription, of improving relationships with other institutions.

Anti-Anxiety Agents↗
PubMed1992

Novel promoter and splice junction defects add to the genetic, clinical or geographic heterogeneity of beta-thalassaemia in the Portuguese population.

In order to delineate the spectrum and the relative abundance of beta-globin gene defects causing thalassaemia in the Portuguese population, a representative sample was analysed including 51 beta-thalassaemia carriers along with 26 patients representing different clinical phenotypes. Seven mutations were identified, four of which [codon 39 (C----T), 39%; intervening sequence (IVS) 1 nucleotide (nt) 1 (G----A), 26%; IVS 1 nt 110 (G----A), 17%; IVS 1 nt 6 (T----C), 15%] account for 97% of 93 beta-thalassaemia chromosomes. Two previously undescribed mutations, namely a C----T substitution at position--90 in the proximal CACCC box, and the deletion of nucleotides 4 and 5 (AG) in IVS2 were identified. The uncommon, though ubiquitous, G----T transversion at codon 121 was found once upon haplotype V. Direct prenatal diagnosis can be offered to 95% of couples at risk of bearing a thalassaemic child.

Chromosome Aberrations↗
PubMed1985

[Use of the CO2 laser in tubal microsurgery: comparative study of the results of the lysis of adhesions by laparascopic control on the 8th day. Apropos of 172 cases].

Two groups of microsurgical tubal plastic operations have been compared. The first group consisted of 78 cases carried out without using Laser at the Port-Royal maternity unit, and the second group was of 94 cases where CO2 Laser was used at the Hospital Saint-Jacques. All the patients who had plastic tubal operations with associated lysis of adhesions were followed by laparoscopic assessment on the 8th day after operation to see what the results were. The adhesions in the pelvis were classified according to the international classification of Madrid and the lysis operations were classified according to the type of adhesions, i.e. 2nd degree for Type B adhesions, 3rd degree for severe Type C adhesions. In the 1st group, 136 adnexae were treated, associated with 65 2nd degree lysis procedures and 71 3rd degree procedures. In the 2nd group there were 158 adnexae operated on with 53 lysis of the 2nd degree and 105 of the 3rd degree. Control laparoscopy on the 8th day showed that in the 2nd degree lysis cases there were 15% in the group that were operated on without Laser and 9% in the group that were operated on with Laser. In the 3rd degree lysis cases there were 25% recurrences recurrences without Laser and 19% if the Laser was used. It does seem that using Laser improves the results of operations for lysis of adhesions although there was no statistically significant difference (p greater than 0.05).

Carbon Dioxide↗
PubMed1985

[Microsurgical treatment of tuboperitoneal lesions. I. Results of distal tuboplasties: apropos of 135 cases].

135 patients were operated on using a microsurgical technique for distal plastic repairs between April 1978 and April 1983. Recurrences and cases with two lesions were excluded. The patients were classified in the group which corresponded to the tube that was less affected when the lesions were not symmetrical according to the I.F.F.S. classification. Out of 59 operations for fimbrioplasty, 31 had an on-going pregnancy, which is 52.5%, and 8 had an extra-uterine pregnancy, which is 13.5%. Of 76 cases that had neosalpingostomies, 28 had an on-going pregnancy, which was 36.8%, and 17 an extra-uterine pregnancy, which was 22.3%. When we looked at the results as a function of the initial lesion (the 9 cases of mixed lesions being excluded), 39 out of 83 cases of phimosis had an on-going pregnancy (47%) and 15 an extra-uterine pregnancy (18%). Out of 43 cases of hydrosalpinx 17 had an on-going pregnancy (39.5%) and 5 an extra-uterine pregnancy (41.6%). The levels of success obtained after operation on distal tubal lesions according to the criteria of definite selection are relatively satisfactory if one compares the present results with those obtained for in vitro fertilisation. It is therefore still correct to operate on these lesions. All the same, distal reparative surgery does give rise to a high risk of extrauterine pregnancy, which is nearly 20%. In our series the basically more significant rate at p less than 0.05 was shown after making neosalpingostomy in cases of phimosis. The consequences of this complication can now be limited by the progress that has been made in laparoscopic surgery.

Adult↗
PubMed1985

[Microsurgical treatment of tuboperitoneal lesions. II. Results of the release of adhesions: apropos of 46 cases].

Between April 1978 and April 1983 46 patients were operated on for division of adhesions of a first and second degree according to the Madrid classification. They were operated on by laparotomy. 36 patients, which was 78.3%, had an on-going pregnancy and 3 had an extra-uterine pregnancy, which was 6.5%. We give three reasons to explain these results: antibiotic and anti-inflammatory treatment before the operation. This is important because of the high rate of infection and in particular chlamydia trachomatis. This is on-going in these patients. A technique for division of adhesions that was carried out according to a precise and stereotyped protocol used by all three operators. a follow-up of 43 out of these 46 patients that allowed them to be treated in the months following surgery to deal with other factors contributing to lowered fertility.

Adult↗
PubMed1984

[Racket-shaped tubal-uterine anastomosis. Technic and results].

Proximal tubal lesions that are discovered when a case of sterility is being worked out are polymorphic in nature and they are variable in extent. Fortunately it is rare that a proximal tubal lesion should involve the whole interstitial portion and the uterine os of the tube. This is why many surgeons have taken up the method of tubo-uterine implantation advocated by Palmer. Salat-Baroux and Cornier published a paper on microsurgical tubo-interine implantation in 1979. We since 1978 have been carrying out a technique of tubo-uterine anastomosis in raquette shape (mostly isthmo-uterine). This is described in detail in this article. The first results on 32 anastomose carried out in 23 patients who were operated on of whom 17 cases had pure cornual lesions and 6 cases bipolar lesions seem to be encouraging with a patency rate 6 months later of 69% and a rate of intra-uterine pregnancy of 23.2% (0.10-0.41) at 12-18 months and 31.1% (0.14-0.56) at 18-24 months (using an actuarial method). Up to now we have not had an extra-uterine pregnancy near the site of suture. Our technique seems to us to give a worthwhile alternative microsurgical method to implantation in interstitial lesions that are widespread and deep.

Actuarial Analysis↗
PubMed1984

[Should one operate on bifocal tubal lesions in 1984? Apropos of 54 cases].

We have analysed 54 cases where the patients had two lesions in the tubes and were treated with microsurgery. The results of histological examinations show that chronic salpingitis in the major lesion. Infection was the aetiological cause in 76% of the cases. The results of microsurgical treatment are poor with a low rate of intra-uterine pregnancy: [19.4% (0.08-0.42) at 24-30 months for pregnancies that were continuing and for abortions, 11.7% (0.04-0.33) at 24-30 months using actuarial techniques for estimating pregnancies that were continuing]. There was a high risk of extra-uterine pregnancy [35% (0.18-0.58) at 24-30 months]. These results make us wonder whether microsurgery or in vitro fertilisation should be the treatment of preference in these cases where the tubes are affected in two areas.

Actuarial Analysis↗
PubMed1983

[Longitudinal salpingotomy and fertility. Experimental study in the female rabbit].

A microsurgical technique of salpingotomy has been put forward for the treatment of ampullary distal lesions responsible for infertility. --An experimental research has been carried out before proposing any application on women. --The consequences on the fertility of a female rabbit of a longitudinal salpingotomy followed by a microsuture have been thoroughly studied. --21 female rabbits have been operated under microscope. --In every case the tubal permeability has been maintained and the rabbits became pregnant. --In some cases histological lesions in front of the suture area have been noticed, what aroused several possibilities as to their origin.

Animals↗
PubMed1983

[Microsurgical treatment of proximal lesions of the fallopian tubes. Apropos of 51 cases].

Microsurgical anastomosis was carried out on 51 patients who had proximal tubal lesions that were either purely isthmal, interstitial or isthmo-interstitial. 18-24 months later there were, using an actuarial method of calculation, 64% of intra-uterine pregnancies (+/- 2 X 8% skew) (line 8, Table IV). There has not been a single case of extra-uterine pregnancy so far. These results confirm the superiority of microsurgical anastomosis over implantation of the tube into the uterus.

Fallopian Tube Diseases↗
PubMed1982

[Exploratory salpingotomy].

One of the difficulties in tubal surgery concerning the distal portion of the tube is the accurate assessment of the value of the ampullary muscularis and mucosa on which depend the choice of the right operative procedure and the prognosis. The difficulties are most important in case of total terminal occlusion particularly when the site of the former ostium is no longer visible. An exploratory salpingotomy preceding any repair is made under the operating microscope. The simple technique that we describe allows: --an accurate assessment of the inner ampulla; --lysis of the mucosal adhesions inside the ampulla; --detection of the former ostium from the inside and the incision in the right place. The functional consequences of such an incision are difficult to appraise because the number of cases is so far too small and the follow up too short. However, those consequences seem slight when compared to the advantages, which are better precision in the investigation, the indication and the execution of the surgical repair.

Fallopian Tube Diseases↗
PubMed1980

Contact hysteroscopy: another method of endoscopic examination of the uterine cavity.

Recently there has been renewed interest in hysteroscopy which, since its discovery a century ago, has been in a state of uncertainty. Classical hysteroscopes all require the dilatation of the uterine cavity by the injection of a fluid under pressure. With contact hysteroscopy, the image is obtained by the applciation of the end of the apparatus against the uterine mucosa. This simplifies the equipment and opens up new possibilities. The results of more than 1,000 contact hysteroscopies done in the various circumstances of gynecology and the pathology of pregnancy are presented. The facility of this technique should contribute to the increased use of visual exploration of the uterine cavity, the advantages of which have already been shown.

Congenital Abnormalities↗
PubMed1979

[Tubal repermeabilisation after sterilisation. Techniques and results (author's transl)].

Requests for repermeabilisation surgery, previously rare, are becoming more common. The indications for reparative surgery are analysed. Microsurgery is possible when the length of the remaining tube us adequate, more than 5 cm, and the ampulla undamaged. It is made difficult when the initial sterilisation procedure has destroyed too long a segment of the tube: electrocoagulation, resection of a long loop of tube. It is impossible when the ampulla and the adjacent portion of the tube have been damaged. Microsurgical techniques certainly improve the results of reparative surgery. After end-to-end anastomosis of the medial half of the tube, 60 to 75% of pregnancies going to term are obtained, and more than 90% secondary permeability. New methods for surgical sterilisation such as clips or rings should make it possible to achieve even better results in the future.

Animals↗
PubMed1979

[Early control laparoscopy after tubal microsurgery (author's transl)].

It is essential to carry out laparoscopic control to determine the result of plastic tubal surgery. This is classically done 12 to 18 months after the operation, yet it has been suggested that this control should be carried out earlier between the 4th and the 8th weeks or even on the 8th day following the operation. The authors have carried out 63 early control laparoscopies after microsurgical operations on the tube at different dates: 33 times between 4 and 8 weeks after the operation, 5 times between the 10th and the 13th day, and 25 times on the 8th day. They are in favour of early laparoscopic control with the reserve that it will require much more experience to tell whether the procedure is harmless.

Fallopian Tubes↗