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Biomedical subjects

J Barrat

Publications and source records attributed to J Barrat.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Changes in the cesarean section percentage].

More and more cesarean sections (C/S) are done, rate multiplied by 3 or 4 in occidental countries in these post two decennials, but are really too many done (?), as it is regularly reproched to the obstetricians, even though perineonatal morbidity and mortality rates have improved. By help of files studied in the gynecological and obstetrical Ward of Saint Antoine's Hospital Paris over 60 years, the authors have tried to answer to a few basic questions: The reason to be of the first C/S before labor and during labor, and the reason to be of iterative C/S in the same conditions. What results is: The rate of C/S has barely changed fur the following causes: Important dystocia known before or during labor, or Chronic foetal distress. On the other hand it increased because of: Acute foetal distress revealed during labor by alteration of the foetal heart beat (FHB). Stagnation of dilatation often accompanied by alteration of the FHB. An increase of iterative C/S due themselves to the increased number of scarred uteri. To reduce the progression of the number of C/S, we should therefore try to: Reduce the amount of scarred uteri, therefore have better knowledge of the indication of the first C/S. But is it feasible without compromising the benefits acquired by modern obstetrics, in means of perineonatal mortality and morbidity? Accept more often birth by vaginal route on the scarred uteri, the actual means of surveillance of labor appear to be able to permit it.

Cesarean Section↗
PubMed1990

[The diagnostic value of hysteroscopy in extra-uterine pregnancy].

Hysteroscopy was carried out in 30 in-patients who were admitted with suspicion of ectopic pregnancy between January and November 1989. The presence of a continuing intra-uterine pregnancy was excluded in each case. Twenty one ectopic pregnancies and nine non-viable intra-uterine pregnancies were assessed in this way. Carrying out plasma Beta HCG level assessments and transvaginal ultrasound had not made it possible to diagnose the condition before operation in 16 (53%) of the patients. In one case where it was difficult to interpret the hysteroscopic findings laparoscopy was carried out but this was not helpful; in all the other cases hysteroscopy gave the exact diagnosis. This examination appears to us as a result of this study to be useful in differentiating an extra-uterine pregnancy from a non progressive intra-uterine pregnancy.

Chorionic Gonadotropin↗
PubMed1990

[The in vivo effect of the local administration of progesterone on the mitotic activity of human ductal breast tissue. Results of a pilot study].

Breast tissue samples were taken during surgery in premenopausal women with various benign breast diseases. Surgery was scheduled between day 11 to 13 of their menstrual cycle, before presumed ovulation and endogenous production of progesterone. Each patient was treated 11 to 13 days before surgery by daily percutaneous topical application on breast of either a placebo gel, a gel containing progesterone or a gel containing estradiol. Treatments were assigned at random and the study conducted double-blind. The mean estradiol concentration in breast tissue was significantly higher (3,409 pg/g) in the estrogen-treated group than in the placebo (365 pg/g) and the progesterone (523 pg/g) treated groups. The mean progesterone concentration in breast tissue was significantly higher (69.1 ng/g) in the progesterone treated group than in the placebo (1.95 ng/g) and the estradiol (3 ng/g) treated groups. Mitotic activity was calculated by counting with light microscopy mitoses in epithelial cells of normal lobular area. Mean mitotic activity was significantly lower in progesterone treated group (0.04/1,000 cells) than in placebo (0.10/1,000 cells) or in estradiol (0.22/1,000 cells) treated groups. High concentration of progesterone sustained in human breast tissue in vivo during 11 to 13 days does not increase, but actually decreases mitotic activity in normal lobular epithelial cells.

Administration, Cutaneous↗
PubMed1989

Survival after second-look laparotomy in advanced ovarian epithelial cancer. Study of 86 patients.

Second-look laparotomy (SLL) was performed after chemotherapy in 86 patients with advanced epithelial ovarian cancer. Seventy-one patients received cisplatin-based regimens. Median follow-up was 66 months. Negative SLL was found in 32 patients who had a 5-year survival rate of 48.3% after SLO. Microscopic residual disease was present in seven patients whose 5-year survival rate was 35.7%. Maximum residual tumor of 2 cm or less was found in 13 patients with a 5-year survival rate of 30%. Residual tumor larger than 2 cm after secondary cytoreduction was present in 20 patients; their 3-year survival rate was 19.7%. Fourteen patients with bulky residual disease who did not have cytoreduction were all dead within 17 months. Patients with initial residual tumor at first laparotomy less than 2 cm had a nearly significant advantage in survival rate over patients with residual disease greater than 2 cm and stage IV (P = 0.07). Non-responders to initial chemotherapy had a survival rate similar to that of partial responders. These findings justify discontinuation of conventional systemic chemotherapy for patients showing residual disease after SLL and secondary tumor removal in case of residual tumor at SLL. Therapeutic trials are needed in advanced ovarian cancer testing initial aggressive surgery or early debulking to avoid bulky residual disease, and consolidation therapy in patients who achieved complete pathological response or minimal residual disease.

Adult↗
PubMed1989

[Prognosis in ovarian cancer as a function of the results of the second-look laparatomy].

Second-look laparotomy (SLL) was performed after chemotherapy in 106 patients with epithelial ovarian cancer. Thirteen were stage I and II and 93 stage III and IV. Seventy-eight patients received cisplatin-based regimens. Median follow-up was 60 months. Negative SLL was found in 32 patients who had a 5-year survival rate of 43.4% after SLO. Microscopy residual disease was present in 9 patients whose 5-year survival rate was 25%. Maximum residual tumor of 2 cm or less was found in 13 patients with 5-year survival rate of 30%. Residual tumor larger than 2 cm after secondary cytoreduction was present in 21 patients, their 3-year survival rate was 18.3%. Eighteen patients with bulky residual disease who did not have cytoreduction were all dead within 17 months. Patients with initial residual tumor at first laparotomy less than 2 cm had a near significant advantage in survival rate over patients with residual disease greater than 2 cm and stage IV (p = 0.07). Non-responders to initial chemotherapy had a survival rate similar to that of partial-responders. These findings justify discontinuation of conventional systemic chemotherapy for patients showing residual disease after SLL and secondary tumor removal in case of residual tumor at SLL. Therapeutic trials are needed in advanced ovarian cancer testing initial aggressive surgery or early debulking to avoid bulky residual disease and consolidation therapy in patients who achieved complete pathological response or minimal residual intraperitoneal disease.

Adult↗
PubMed1988

[Diagnosis of rabies by cell culture].

Mouse inoculation test (MIT) is a highly sensitive test for rabies diagnosis but slow and expensive. To detect rabies virus an in vitro technique using Neuro 2a cell culture (CC) was compared with MIT in two laboratories. In one laboratory, CC appeared to be on the whole more sensitive than MIT, nevertheless MIT was the only one to detect some positive samples. In the other laboratory, MIT was more sensitive. These results justify the use of CC for epidemiological diagnosis but emphasize the interest of MIT (the reference technique) for special cases.

Animals↗
PubMed1988

Platelet serotonin content and plasma tryptophan in peri- and postmenopausal women: variations with plasma oestrogen levels and depressive symptoms.

Platelet serotonin content was measured by high pressure liquid chromatography in 56 peri- and postmenopausal women, in order to study variations of this parameter with hormonal status and depressive mood symptoms. Clinical symptoms were assessed by a self-report depression symptom scale (CES-D of NIMH). Thirty-eight women with a score of 16 or more were considered as presenting depressive symptoms (mean score +/- SD = 28.8 +/- 10.5), while the others formed the control group (n = 18, score = 4.4 +/- 4.2). Platelet serotonin contents were significantly lower in the 'depressed' group (0.302 +/- 0.010 vs. 0.366 +/- 0.020 nmol 10(-8) platelets, means + SEM, P less than 0.001 by Mann-Whitney U-test). In 'depressed' women who had been treated for one or more depressive episodes, platelet 5-HT contents (0.283 +/- 0.023, n = 18, P less than 0.01) were significantly lower with respect to controls. In patients without previous episodes of depression, serotonin expressed in nmol 10(-8) platelets did not differ significantly from controls but serotonin expressed in nmol ml-1 of blood was slightly lower than control values (0.890 +/- 0.085, n = 20 vs. 1.088 +/- 0.090 nmol ml-1, n = 18, P less than 0.02). Platelet serotonin content was positively correlated to plasma oestrone and oestradiol concentrations among the control group but not in the 'depressed' group.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Platelets↗
PubMed1988

Serological survey of herpesvirus infections in wild ruminants of France and Belgium.

The presence of antibodies against bovine herpesvirus 1 (BHV-1), bovid herpesvirus 6 (BHV-6), herpesvirus of Cervidae type 1 (HVC-1), reindeer herpesvirus, bovine herpesvirus 2 (BHV-2) and bovid herpesvirus 4 (BHV-4) was investigated in wild ruminants of France and Belgium between 1981 and 1986. There were no animals serologically positive for BHV-4. Antibodies against BHV-2 were demonstrated in roe deer (Cervus capreolus) (less than 1%) and chamois (Rupicapra rupicapra) (1%) in France. Animals seropositive to the four related viruses (BHV-1, BHV-6, HVC-1, reindeer herpesvirus) were detected in red deer (Cervus elaphus) in France and Belgium (1% and 11%, respectively), in roe deer (less than 1%) from France, in chamois (4%) in France and in ibex (Capra ibex) (4%) from France. The presence of antibodies against HVC-1, especially in red deer from Belgium, may suggest that wild ruminants in continental Europe are now infected with this virus, which previously has been isolated only in Scotland.

Animals↗
PubMed1988

[Treatment of acute non-chlamydial salpingitis. Study of the efficacy and tolerance of a single-therapy antibiotic: Augmentin].

An open randomised comparative trial of the efficacy and safety of Augmentin as against the triple therapy of penicillin-gentamicin-metronidazole in acute salpingitis was conducted in forty women admitted to hospital. Laparoscopy was performed routinely to confirm the diagnosis. The two groups of patients were comparable as to age and clinical and biological symptoms and the severity of the salpingitis (grade I to IV, with the presence or absence of Fitz-Hugh-Curtis syndrome). Treatment was started immediately after the laparoscopy, first by parental route until the patient had been apyrexic for 48 hours. Oral follow-up was then commenced. Twenty women received Augmentin and twenty the triple antibiotic therapy. Specimens for bacteriological study were obtained before treatment (culture of the urine, culture from the IUD and from the cervix, and swabs were taken laparoscopically). This made it possible to identify aerobic and anaerobic organisms. (The gonococcus was found more often in the group treated with triple antibiotics). On discharge, cures had been obtained in 12 women and 6 more were responding out of the Augmentin group. Out of the triple therapy group 8 were cured and 10 were responding. There was one failure in each group (persisting fever). Long-term assessment was carried out in the out-patients three weeks after discharge. 11 out of the 13 reviewed in the Augmentin group and 8 out of the 14 in the triple therapy group were considered as definitely cured. The clinical safety of both treatments was good. These results demonstrate that Augmentin is as effective as the combined therapy in treating acute salpingitis and with the added advantage of its easy use and lower cost.

Acute Disease↗
PubMed1988

[Clinical and urodynamic results of the Burch colposuspension operation in the treatment of female urinary stress incontinence. A study apropos of 370 cases].

The surgical treatment of female genuine stress incontinence remains a not wholly solved problem. We prefer since 1980 the indirect colposuspension according to Burch as it represents 76% of our operations for genuine stress incontinence. We report 370 cases. The operation has been: isolated in 153 cases; associated with a total hysterectomy in 160 cases; associated with an indirect sacral fixation with a prosthesis of non adsorbable tissue in 57 cases. Clinical examination has always been completed with a urodynamic investigation pre-operatively and in the year following the operation. After two years or more, 188 urodynamic controls could be done. Clinical and urodynamic results are excellent and lasting after 5 years. Clinical failures represent only 4.6% of the cases and seem to be in relationship with technical defects as they occur in 78.4% of the cases in the first year following surgery. Associated sacral fixations, second hand cases, sphincter insufficiency appearing after surgery are the main factors giving way to the failures.

Adult↗
PubMed1988

[Value and dangers of indomethacin used in pregnancy. Apropos of 304 treated patients].

When Indomethacin in a dosage of 175 mg/day was used to treat threatened premature labour more than 70% of cases carried on until 37 weeks. This treatment therefore is an interesting alternative treatment to beta-mimetics whose the maternal side effects can be serious. As far as the cardiovascular systems of the fetus and neonate are concerned the effects in the dosage used are negligible. On the other hand there may be renal failure which is transitory at birth when delivery has taken place while treatment was going on. The treatment should not be prolonged for more than three weeks because Indomethacin causes oligohydramnios and this can cause in its place malpositions and maldevelopment of the lungs. Finally, it is not certain whether this treatment has any effect on fetal growth causing diminished growth, possibly.

Abortion, Threatened↗
PubMed1988

[Treatment of urogenital prolapse with exertion-induced urinary incontinence using the Bologna technic. Apropos of 90 cases].

The authors describe this operation, which is carried out as a single procedure which they have been doing since 1982. Then the results in 90 patients are studied. The post-operative controls carried out on the clinical state of the patient and on the urodynamic tests show that this operation is very successful, both in curing stress incontinence and in giving a good anatomical result for correcting prolapse of the anterior wall of the vagina. In over one-third of the cases the post-operative follow-up has been carried out for 2 years or more. This follow-up has shown that the relapse rate over a period of time, both for the stress incontinence and the prolapse, is nil. The principal snags that still remain are: post-operative infection in about a third of cases; the rare but possible development of an enterocele and of dyspareunia (2%).

Adult↗
PubMed1987

[Placental localization and scarred uteri. Apropos of 695 scarred uteri].

The authors studied a series of 649 uteri that had been scarred in order to try and find out whether the fact that the uteri had been operated on had made any difference to the site of the placenta as determined by ultrasound from the 32nd week of amenorrhoea onwards. The long-term effect of having a hysterotomy scar in the uterus on the position of the placenta in a subsequent pregnancy was studied. The results do not agree necessarily with those of other published series. The frequency of low-lying placentae found on ultrasound in the 3rd trimester does not seem to be higher when the uterus has a scar in it. On the other hand, there were more anterior situated placentae and more haemorrhages. Finally, it does seem that the quality of the old scar does affect the position of the placenta.

Cicatrix↗
PubMed1987

[Normal pregnancy after a Budd-Chiari syndrome treated by shunting: apropos of a case, review of the literature].

A patient who had a meso-atrial by-pass for a Budd-Chiari syndrome a year before conception carried her pregnancy to term. The authors have reviewed the literature. When they had studied the literature the authors took into account cirrhoses of the liver and portal hypertension in association with pregnancy. They concluded that a patient who had had a Budd-Chiari syndrome, particularly when she had also had a porto-caval shunt, was not in principle unable to have a pregnancy.

Adult↗