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Biomedical subjects

J Barrier

Publications and source records attributed to J Barrier.

At least 73 records · Page 4Linked to original sources
PubMed1985

[Evolution of the indications for cesareans. Comparison of 1971-1976 and 1976-1979 at the Maternity Center of the Louis-Mourier Hospital. Review of the literature].

Changes in the indications for caesarean operations were studied over a period of 9 years from 1971-1979 and two periods from 1971-1975 and 1976-1979 were compared. The principal changes that show up are: an increase in the total number of caesarean sections from 5.3% in 1971 to 15.4% in 1979; modifications in the indications which were mainly due to much greater use of electronic means of monitoring the fetus and an improvement in the methods of resuscitation of the newborn (there were approximately the same number of caesareans for breech presentations, an increase in the number of repeat caesarean operations and of caesarean operations for fetal distress and for dystocia as well as for toxaemia of pregnancy); the improvement in the state of infants at birth seems to be parallelled by the increase in the number of caesarean operations. Though there was 8% neonatal morbidity, only 1% of these at the most could be put down to the caesarean; no maternal death occurred, although caesarean section is accompanied by an increased maternal morbidity of 27%. Reviewing the literature shows that the same tendencies occur in other places. This makes it possible to point out the ways in which action can be taken to limit the number of caesareans in those categories where the indications seem to be most frequent, namely dystocia, repeat caesareans, fetal distress and breech presentation. The optimum level of caesarean sections at 15% with 9% being first caesareans and 6% repeat caesareans should be kept to.

Breech Presentation↗
PubMed1984

[Gougerot-Sjögren's syndrome. Clinical and biological correlations with the serology of Yersinia infections].

An unusual case of Sjögren's syndrome (SS) induced or revealed by a Yersinia pseudotuberculosis serotype IV infection has prompted the authors to undertake a retrospective study of 32 patients with that syndrome. High titers of antibodies to Y. pseudotuberculosis serotype IV (greater than 1/200 th) were found in 4 patients with primary Sjögren's syndrome and Sharp's syndrome. Seven other patients (5 with primary Sjögren's syndrome, 1 with systemic lupus erythematosus and 1 with Sharp's syndrome) had positive serology with low titres, of doubtful significance. Serology was negative in the 20 remaining patients. Nine out of 25 patients had anti-thyroid antibodies, and their relationship with positive Y. pseudotuberculosis IV serology is discussed. The responsibility of the infection in the induction or disclosure of Sjögren's syndrome may be considered. However, since the syndrome frequently develops before serology becomes positive (8/12 cases with a 1 to 6 years' follow-up), an alternative hypothesis would be that diminished digestive defences in Sjögren's syndrome result in an increased frequency of Yersinia infections.

Adult↗
PubMed1984

[Superior vena cava syndrome disclosing Behçet's disease].

While venous manifestations are common in Behçet disease and often occur as a presenting feature, thromboses of the vena cava are less frequent and usually occur several years after onset. We report the unusual case of a patient whose Behçet disease was revealed by vena cava thrombosis. Most authors underscore the difficulties encountered in ascribing vena cava thrombosis to Behçet disease and the frequent latency of inferior vena cava involvement. Pathological changes in these venous thromboses are identical to those found in other organs involved in Behçet disease: they consist in inflammation of the venous wall with perivascularitis and secondary thrombosis. Lastly, there is a general agreement as to the adverse prognostic significance of the venous involvement.

Adult↗
PubMed1984

[Recurrent polychondritis with renal microaneurysms and segmental necrotizing glomerulonephritis].

The authors report a case of relapsing polychondritis, in a 41 year-old man, with renal complication. Immunofluorescence study of this segmental necrotizing glomerulonephritis showed an important fibrin fixation without immunoglobulins. Selective renal arteriography, preliminary to the biopsy, showed lobular arterial aneurysms. Because of other exceptional cases of literature, relation between periarteritis nodosa and relapsing polychondritis is discussed.

Adult↗
PubMed1984

HLA DR4 and giant cell arteritis.

We reported the data of HLA-DR frequencies in a new series of 40 unrelated patients suffering from giant cells arteritis (Horton's disease). As previously reported by us, a large increase of HLA-DR4 antigen frequency is noted in patients compared with 146 healthy controls. Moreover, gathering together these 40 patients with the 48 other patients of our first published data, increase of the DR4 frequency is largely confirmed with a Pc less than 0.001.

Arteritis↗
PubMed1983

[Diagnosis of hematomas in the Retzius space during anticoagulant therapy. Prospective study (11 cases)].

During a three-year, prospective study carried out at the Saint Jacques Hospital, Nantes, France, in a group of 33 patients with echographically identified intra-abdominal hematoma, 11 cases of Retzius' space hematoma were detected in patients under anticoagulant treatment (heparin or antivitamin K). This suggests that the frequency of this complication is greater than supposed. The authors emphasize two aspects of Retzius' space hematoma: on one hand, clinical symptomatology, especially involving the urinary system (transient oliguria or oligoanuria in 7 of the 11 cases), on the other, ultrasonic diagnosis (slip-page of the intraperitoneal contents along the posterior surface of the hematoma, rupture sign, denoting diffusion of the hematoma immediately below the Douglas' arch). Ordinarily, the clinical course of this complication of rectus sheath hematoma is spontaneously favorable.

Abdomen↗
PubMed1983

[Alcoholic neuroacropathy. Recent diagnostic and pathogenic attainments].

The authors report the results of a prospective study of 28 patients with alcoholic neuroacropathy or the Bureau and Barrière syndrome. The investigations included biochemical analysis of the alcoholism, electrophysiological studies and, in 4 cases, electron microscopy of the musculocutaneous nerve biopsy. Bone scintigraphy with foot and hand scans was carried out in all cases for a more exact and above all, earlier diagnosis of the neurological osteoarthropathy. The clinical syndrome was attributed to a polyneuropathy with a large sensory component of the alcoholic "dying back" variety in all cases. High VGM levels associated with high serum IgA levels appears to be a biochemical diagnostic criteria of this condition. The latter parameter was not closely related to the hepatocytic status of the patient but suggests a direct or indirect effect of the neuropathy on humoral immunity. All cases had characteristic bone scans with high uptake at points of mechanical stress of the anterior part of the foot (first metatarsophalangeal joint). This finding, which is also observed in alcoholic sensory neuropathy without trophic disturbances prompts the authors to define a preacropathic state and an evolutive and pathogenic outline of the disease.

Alcoholism↗
PubMed1983

[Bronchopulmonary manifestations of Horton's disease. Apropos of a case].

A 78 years old woman developed a pulmonary recurrence four years after the diagnosis of temporal arteritis. The lung biopsy showed the same giant-cells granulomatous lesions with central vessels as the initial biopsy. The recurrence in giant cells-arteritis has already been published but the pulmonary involvement had never been illustrated before by histological data. The difficulties of diagnosis in case of granulomatous angiitis on lung samples is emphasized.

Aged↗
PubMed1983

[Outcome, treatment and prognosis of Horton's disease].

Precise information was obtained by a computerized analysis of the treatment, prognosis and clinical outcome of 108 representative cases selected from a series of 160 patients with Horton's disease (HD) diagnosed between 1970 and 1981. At the end of the study, 18 patients had died (16,6 p. 100), the commonest cause of death being a cerebrovascular accident. Death occurred during the first two years of the illness in half these cases. Despite these early complications of the disease, from a statistical point of view, the patients did not die of HD or the complications of its treatment. The 5 years survival rate 80,1 p. 100 (actuarial analysis). Most deaths were from natural causes; an intercurrent disease was often implicated; the lower probability of survival for men (69,9 p. cent at 5 years, compared to 85,4 p. cent for women) is compatible with the lower life expectancy which is well established. The roles of intercurrent disease and sex were statistically significant. On the other hand, there was no difference in the probability of 5 year survival when the different presenting of the disease, the terrain (HLA-DR4) and choice of corticosteroid therapy were compared. The initial dose of prednisone or prednisolone should exceed 0,5 mg/kg/day, if relapse is to be avoided. No additional benefits were observed with doses in excess of 1 mg/kg/day except in cases with complications from the onset (ocular, coronary insufficiency, stenosis of the main large arteries, without being able to prejudge their mechanism).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
PubMed1983

[Assay of plasma hCG. Our experience with the diagnosis of extra-uterine pregnancies. Apropos of 45 cases].

Two groups of patients who were admitted to hospital with a possible diagnosis of ectopic pregnancy were compared. The levels of HCG in the plasma were obtained as an emergency in the first group (45 cases). The levels were not obtained in the second group (34 cases). Only those cases in the first group where the assays had shown the presence of HCG underwent laparoscopy: 12 laparoscopies revealed 7 extra-uterine pregnancies. In the second group, on the other hand, all 34 patients had laparoscopy; only 8 extra-uterine pregnancies were discovered by this method. Because of this study we found that when HCG assays were carried out there was no false positive or negative. When we wanted to rule out an L.H. peak in a doubtful case the assay was repeated. The comparison between the two groups underlines the importance of carrying out the assay: it avoids useless laparoscopies but it also shortens the length of stay in hospital.

Chorionic Gonadotropin↗