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J Barrat

Publications and source records attributed to J Barrat.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Postpartum perineal rehabilitation by early electrostimulation at home. Preliminary study].

The authors report a preliminary trial of post-partum perineal physiotherapy by functional electric stimulation at home starting from Day 15. Fifteen primipara used the technique. Perineal muscle testing and urodynamic investigations took place before Perineal muscle testing and urodynamic investigations took place before and after physiotherapy. Testing of the levators showed complete recovery in 20 p. cent of cases and partial in 80 p. cent. Urodynamic results showed a significant increase in resting urethral pressure. Acceptability of physiotherapy was perfect. The early start offered the twin advantages of better muscular recovery and easier motivation of the patient. Physiotherapy at home enabled these women, already busy, to carry out their perineal physiotherapy with minimum difficulty.

Adult↗
PubMed1992

Hysteroscopic diagnosis of ectopic pregnancy.

Although vaginal ultrasonography combined with plasma beta-hCG determination can provide a reliable diagnosis and location of ectopic pregnancy, the results can be difficult to interpret in the early stages when hCG levels are low. Hysteroscopy can be used in such cases to differentiate between ectopic pregnancy and non-viable uterine pregnancy when viable uterine pregnancy has been ruled out. General anaesthesia and laparoscopy are avoided. We performed 60 hysteroscopic procedures between January 1989 and December 1990 in patients with suspected ectopic pregnancies. The pregnancy had been located by means of vaginal ultrasonography in every case in which the hCG was above 1500 IU/ml and in 36% of cases in which the beta-hCG was below this level. Hysteroscopy was hindered by metrorrhagia in three cases and was inconclusive in one, necessitating laparoscopy. Diagnosis was possible in all the remaining cases, as follows: ectopic pregnancy in 41 cases, with an empty uterus and occasional bleeding from an ostium; non-viable uterine pregnancy in 18 cases, with the presence of material within the cavity. Hysteroscopy therefore confirmed the diagnosis in 55% of the cases and was itself diagnostic in a further 43% of cases. Its sensitivity for the diagnosis of ectopic pregnancy was 100% and its specificity 95%. We propose a diagnostic decision tree.

Chorionic Gonadotropin↗
PubMed1992

In utero early suspicion of superfetation by ultrasound examination: a case report.

We report the case of a dichorionic and diamniotic pregnancy with the unique feature of an early ultrasound diagnosis of a 4-week size difference, which persisted throughout pregnancy. At birth, the twins had a 1-month difference in physical and neurological maturity. We believe that only the phenomenon of a superfetation can explain this difference. We report the cases found in the literature.

Journal Article↗
PubMed1992

Potential pathogenicity for rodents of vaccines intended for oral vaccination against rabies: a comparison.

Different oral vaccines intended to control fox rabies were administered to 271 wild rodents. Vaccines were administered orally or by the mucosal route to four different European species belonging to the genera Apodemus, Arvicola, Clethrionomys and Microtus. These rodents are likely to consume baits and to have contact with the vaccine. Two genetically engineered vaccines were tested: SAG1 (an avirulent mutant of the rabies virus) and V-RG (vaccinia recombinant virus expressing the rabies glycoprotein gene). Both were found to be completely innocuous when administered orally or by the mucosal route. The residual pathogenicity of conventional modified live vaccines derived from the SAD strain was confirmed.

Administration, Oral↗
PubMed1992

[Analgesic effect of ibuprofen in pain after episiotomy].

The relief of post-episiotomy pain was investigated in three groups of women, ranked ASA 1 or 2, using either a single dose of 400 mg of ibuprofen (n = 31), or 1 g of paracetamol (n = 28) or placebo (n = 31). Pain intensity was assessed with a visual analogic scale, a verbal scale and pain relief scores after half an hour, 1, 2, 3, 4, 5 and 6 h. The day after treatment, patients rated the quality of pain relief, and were asked whether they wished to take again the same drug for the same type of pain. In the placebo and paracetamol groups, respectively 22 and 16 patients asked for usual treatment before the sixth hour, whereas only 5 did so in the ibuprofen group (p less than 0.001). Ibuprofen was more effective after one hour than either of the other two drugs, whatever the scale or parameter used. In the ibuprofen group, the lower pain score was observed at the third hour. At six hours, the pain score did not differ from that three hours earlier. On the day after treatment, 22 patients from the ibuprofen group considered pain relief to have been good or excellent, versus 8 and 5 in the paracetamol and placebo groups respectively (p less than 0.001). Similarly, 24 patients from the ibuprofen group would accept the same drug again for the same type of pain, as opposed to 8 and 5 from the paracetamol and placebo groups respectively (p less than 0.01). The only side-effect reported was abdominal pain in one patient (placebo group).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetaminophen↗
PubMed1992

[Major sickle cell anemia and pregnancy. Systematic prophylactic transfusions. 13 case reports].

The seriousness of sickle cell disease together with pregnancy has led doctors to look for therapies which have yet scarcely shown their worth. Systematic blood transfusions in pregnancy did seem to improve the prognosis for both mother and fetus. Prophylactic transfusion has made it possible for us to carry thirteen pregnancies to term. There was no mortality either of fetus or mother while the morbidity either of fetus or mother while the morbidity was significantly cut down to new pathologies which were easily treated. The absence of any side effects from the transfusions encourages us to contribute this treatment working together with a highly competent blood transfusion bank.

Adult↗
PubMed1992

[Ovarian hyperstimulation syndrome during in vitro fertilization stimulations. Comparison between the experience of the Center for Medically Assisted Procreation of the Saint Antoine maternity department and a review of the literature].

The authors present their experience with the severe ovarian hyperstimulation syndrome when they were using stimulation for IVF and ET and they compare it with the literature. Over a period of 23 months. 154 stimulations were carried out using a long protocol associated with a CnRH agonist and hMG. 142 vaginal aspirations were carried out. The clinical pregnancy rate was 19% per aspiration and 21.9% per transfer. Of the 142 patients who were aspirated five had severe ovarian hyperstimulation with a favourable outcome. The authors suggest a physiopathological comparison for ovarian hyperstimulation and the management to be carried out when this complication occurs. They emphasise how potentially serious this complication is and that there has been no physiopathological explanation for its recrudescence since GnRH agonist have started to be used.

Adult↗
PubMed1992

[A uterus with two scars: can we allow vaginal delivery?].

This study gives the results of a year in which the active conduct of a trial of labour was carried out on uteruses that had scars in them. This approach allowed 22% of women to deliver vaginally out of a total of 41 patients. Of 17 patients (41.4%) that were put down for a tentative trial delivery, 9 (53%) did deliver vaginally. This approach seems to have been reasonable and beneficial so long as proper precautions were taken. The prognosis is better if there has been a previous vaginal delivery.

Cesarean Section↗
PubMed1991

Identification of sylvatic Trichinella (T3) in foxes from France.

Thirty-three foxes (Vulpes vulpes) from a sample of 1912 collected in France were found to be infected with Trichinella spp. Four isolates were obtained for genetic identification. Isoenzymatic and biological analysis of these isolates revealed the presence of two distinct genetic types of Trichinella, Trichinella spiralis s.str. (T1) and Trichinella sp. (T3) (Trichinella nelsoni according to Soviet authors) in the fox population. The reproductive capacity index of these isolates in Wistar rats was high for T. spiralis and low for T3. This is the first report of T3 type from wild animals in France. The epidemiological implications are discussed.

Animals↗
PubMed1991

Pregnancy-associated idiopathic intrahepatic cholestasis. Hypotheses of physiopathology: a therapeutic case report.

By modification of the circulating pool of biliary acids, the administration of ursodesoxycholic acid has permitted the restoration of normal maternal hepatic function during a triple pregnancy complicated by the precocious onset of an intrahepatic cholestasis. The marked regression in clinical and biological markers of the disease confirms the role of biliary acids in the aggravation of hepatic abnormalities.

Adult↗
PubMed1991

[Primary biliary cirrhosis and pregnancy. Apropos of a clinical case. Review of the literature].

The appearance of pruritus and abnormal liver function tests (cellular damage) during pregnancy should of course suggest the diagnosis of intrahepatic cholestasis of pregnancy. However, these signs must also be recognized as signs of other hepatic diseases, especially primary biliary cirrhosis. The diagnosis is based on the search for antimitochondrial antibodies. This mode of presentation must not be overlooked because of major therapeutic consequences. The disease course often stabilizes with ursodeoxycholic acid, if administrated early.

Adult↗
PubMed1991

[Rupture of hemorrhagic ovarian cysts. Value of celioscopic surgery].

The rupture of haemorrhagic cysts of the ovary occur frequently and are often missed. Review of the literature and an analysis of our series of 20 patients makes it possible to summarise the typical clinical picture, which is of a young woman who has sudden severe pelvic pain in the second half of her menstrual cycle, during intercourse, or when she has pelvic trauma. Ultrasound in 90% of cases shows up signs suggesting the diagnosis and these are: a mass beside the uterus, or an intra-abdominal effusion. Endoscopic surgery is indicated particularly in women of reproductive age who suffer this pathology which is always benign. The indications to treat the patients should always take in to account the histology; 100% of these are luteal cysts. There is no reported case of cancer of the ovary or of an organic haemorrhagic cyst. On the other hand occasionally a primary ovarian pregnancy may occur and that can be confused with a haemorrhagic cyst. Finally haemorrhagic cysts can occur with an intra-uterine pregnancy and this means that the corpus luteum must be preserved. We propose the following treatment for those cases with symptoms: simple peritoneal washout when pregnancy has been ruled out on the laparoscopy exploration and when the bleeding is widespread: systematic taking of a biopsy for histology if there is the slightest doubt that there is a pregnancy in the ovary and an intraperitoneal removal of the cyst when haemorrhage persists during the operation.

Adult↗
PubMed1991

[Behavioral ecology of the transmission of rabies].

Red fox behavioural ecology was studied in a rabies-enzootic area in order to determine how population size is balanced despite rabies-induced mortality. The results suggest that the red fox rabies virus equilibrium evolves, and is due to the solitary behaviour pattern of the fox which reduces the risk of virus transmission from on territory to another; and to the subsequent autumn dispersal, which allows the local fox population to recover in the space of under a year. The hypothesis is put forward that rabies does not seem to regulate fox population size. There would therefore be no reason to fear a population explosion after oral immunisation of foxes against rabies.

Animals↗
PubMed1991

[Transmissibility and pathogenicity in the red fox of two rabies viruses isolated at a 10 year interval].

Two rabies virus strains collected from naturally infected foxes in France in 1976 and 1986 were inoculated in 2 groups each consisting of 10 foxes (approximately 50 lethal doses50 mouse intracerebral per fox). Another 20 healthy foxes were kept in the same cages as the inoculated animals in order to study the transmission of both strains. All the inoculated foxes became rabid and transmitted rabies to their cage companion. The intervals between death of the inoculated foxes and death of the cage companion were significantly more variable (P less than 0.001) with the earlier strain, from 1 to 33 days compared to the range obtained with the later strain, 10-14 days. However, the mean intervals did not differ. Epidemiological consequences of such a decrease in variability, if confirmed in the field could decrease the epidemiological extent of rabies. Viremia was demonstrated in 2 foxes inoculated with the later strain but we cannot assume this to be a characteristic of this strain compared with the earlier strain. Rabies virus (both strains) was isolated from the saliva of foxes 29 days or less before the onset of clinical symptoms. This last result raises the question of the time limit as regards security before onset of clinical symptoms in animals involved in human contamination.

Animals↗
PubMed1991

[Tick spirochetosis by Borrelia burgdorferi in wild carnivores in France. Results of serologic tests in 372 foxes].

The authors made serological examination, by passive hemagglutination, of 378 wild carnivores killed in 17 departments of western, central and eastern parts of France: 372 of foxes, of which more than 90 per cent less than one year aged, 4 raccoon dogs and 2 lynx. In foxes, they found significative seropositivity (greater than or equal to 1/200) with mean frequencies of 12.77 per cent in young animals and 42.86 % in those of 1 year and more. According the parts of France, frequency is greatly varying, being highest in the department of Ain, in Jura. The frequency of antibodies against B. burgdorferi in foxes brings the authors to think that it is necessary to define precisely their importance as reservoirs for this infection.

Age Factors↗
PubMed1991

[Rupture of a healthy uterus in a prostaglandin-induced abortion in the second trimester].

The authors report one case of uterine rupture in a non scarred uterus when an analogue of prostaglandin E2 was being transfused. It was Sulprostone used to terminate a pregnancy because of fetal death in utero after 27 weeks of amenorrhea. This case history and an analysis of the literature makes it possible to point out the need to reach the diagnosis before signs become too severe and to show that pharmacological knowledge of the drug has to be improved as well as the ways of administering prostaglandin analogue. This is to be conducted together with improving the ways of terminating pregnancies in the second trimester. It shows that mechanical accidents can occur even where there are no obvious risk factors. In this case, pain continued from the time of the rupture under epidural anaesthesia. The physiopathology is reviewed. Finally, conservative treatment of the uterus should be carried out whenever possible in order to allow a new pregnancy to occur and to lessen the morbidity of the operation.

Abortifacient Agents, Nonsteroidal↗