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Biomedical subjects

J Buvat

Publications and source records attributed to J Buvat.

At least 91 records · Page 5Linked to original sources
PubMed1982

[Blood prolactin in 845 cases of clinically idiopathic sexual dysfunction].

Serum prolactin levels were measured in 845 subjects presenting with clinically idiopathic sexual dysfunction, including impotence, premature or defective ejaculation and frigidity in women. Stimulation tests using thyrotrophin-releasing hormone (TRH) and sulpiride were performed in 80 men. One p. cent of impotent subjects had high serum prolactin levels associated with pituitary adenoma in 4/5 cases; 2.2% of impotent men, 10% of men with premature ejaculation and 5.6% of frigid women had moderate hyperprolactinaemia (50 ng/ml), probably not responsible for the sexual disorder. Mean serum prolactin levels were slightly below normal values (p less than 0.05) in impotent subjects. The results of stimulation tests were normal in all but one case. The mean area under the TRH response curve was moderately reduced in subject with impotence or defective ejaculation (p less than 0,05). The present study suggests that serum prolactin levels should be systematically measured in subjects with sexual impotence.

Female↗
PubMed1982

[Influence of primary hyperprolactinemia on human sexual behavior].

Eighty per cent of men with hyperprolactinaemia are impotent. Sexual deficiency, which for a long time is the only sign of the disease, is partly due to inhibition of testosterone secretion by high prolactin levels but also, probably, to reduced conversion of testosterone to dihydrotestosterone and, perhaps, to a direct effect of prolactin on the neurotransmitters involved in sexual activity. Eighty per cent of women with hyperprolactinaemia have reduced sexual drive and inability to reach orgasm; the underlying mechanisms are as yet unknown. In women, however, the initial symptoms are menstrual disorders. Most sexual disorders in both sexes regress after return to normal of plasma prolactin levels.

Female↗
PubMed1982

Lack of correlations between penile thermography and pelvic arteriography in 29 cases of erectile impotence.

We studied 29 cases of penile impotence to determine whether thermography could be used to screen for cases of vascular origin and, therefore, candidates for arteriography. Sixteen thermographic parameters were used to compare 3 groups of patients having normal, mildly altered and severely stenotic arteries on arteriography of the aortic bifurcation and selective catheterization of the hypogastric arteries. The averages of these parameters were computed for each of the 3 groups, and 104 comparisons then were made using student's t test. A significant difference was found between 2 groups in only 2 of the comparisons (p less than 0.05) and no threshold for significant differences was found. Penile thermography did not correlate with pelvic arteriography and does not appear useful in the selection of candidates for arteriography.

Adult↗
PubMed1982

[Prolactin, bromocriptine and gonadic function in women: recent discoveries. I. The physiology of prolactin and the physiopathology and diagnosis of hyperprolactinaemias].

Estrogens are involved in the regulation of the secretion and release of prolactin, and so are a large number of neurotransmitters and neuropeptides. This explains why the circulating level of prolactin is very labile. Most of these elements work by bringing about small changes in the tone of the dopaminergic inhibitor system, which is the principal controlling factor for this hormone. Most hyperprolactinaemias of a pathological nature seem to be the result of a failure of this dopaminergic inhibiting system. Prolactin has a rudimentary luteotrophic function, but it does act as an inhibitor of female gonadic function as soon as the circulating level reaches about 30 ng/ml, and it exerts its effects at two levels--the ovarian and the hypothalamic. Estimating levels of prolactin should be carried out according to a strict protocol so that many causes of non-pathological rise can be excluded. Hyperprolactinaemia should be sought whenever anovulation is found whether it is accompanied by galactorrhoea or not. Certain cases of hyperprolactinaemia are secondary to different types of aetiology which have to be searched for. When confronted with a case of primary hyperprolactinaemia the search should be towards diagnosis of a pituitary adenoma, which is often present although very small. Two examinations that are of most value to diagnose this condition are standard X-rays of the pituitary fossa and scanning tomography.

Adenoma↗
PubMed1982

[Prolactin, bromocriptine and gonadal function in women: recent advances. II. Treatment of female hyperprolactinemia and other indications for the use of bromocriptine].

The surgical treatment of prolactinomas protects against the complications that these tumours have, but by itself does not cure the infertility which is found in at most 50% of all cases. The value of radiotherapy is limited to those cases where there is a contra-indication for carrying out surgery and in the tumours that have been incompletely removed and when pregnancy is not desired. The principal drugs used to lower prolactin are the dopamine agonist, which is bromocriptine and the serotonin antagonist which is methergoline which is less powerful than bromocriptine. Bromocriptine brings about normal prolactinaemia and ovulation is re-established and menstruation returns in most cases of idiopathic hyperprolactinaemia and in many cases where hyperprolactinaemia is due to a tumour. It, in certain cases, has an antitumoral effect and can definitely cure some hyperprolactinaemias whether they are tumoral or not. So bromocriptine is the specific treatment of women whose sterility is due to hyperprolactinaemia and no teratogenic effect has been reported. The only complications that have occurred in pregnancies that have been induced by this drug have been growths in the tumours in women who have pituitary adenomata, but these complications are far less frequent and serious in cases of micro-adenomata. Since the antitumoral effect of bromocriptine has been discovered the indications for surgery have lessened but it is often all the same necessary. The medical treatment of adenomata can only be considered when strict supervision is going to be undertaken. Bromocriptine can also establish ovulation in a few categories where ovulation occurs in normoprolactinaemic women and it can also be used as a treatment for the premenstrual syndrome.

Anovulation↗
PubMed1981

[Treatment of the polycystic ovary syndrome (author's transl)].

A better understanding of the polycystic ovary syndrome (POS) may help to institute a more rational treatment adapted to each individual case. Seven therapeutic methods have been used until now, progestogens constituting the minimal treatment. Combined oestrogen and progestogen therapy remains basic as long as pregnancy is not desired and should include an anti-androgenic progestogen if hirsutism is to be reduced. Anti-oestrogens have dramatically improved the treatment of sterility and could be used against POS with certain precautions. Parenteral gonadotropins of the HMG variety are usually contra-indicated. Ovarian wedge resection has few indications in view of the risk of post-operative adhesions. Dexamethasone has restored ovulation in some cases. Bromocriptine has recently given promising results. The indications of these various treatments depend on the results to be achieved: endometrial carcinoma must always be prevented, regular menstrual cycles should often be re-established, hirsutism must be avoided or reduced, and fertility should be restored or at least preserved for the future by breaking the hormonal vicious circle. The high incidence of obesity and a possible desire for contraception should also be taken into account.

Androgen Antagonists↗
PubMed1981

[Changes in the gonadotrophins, in the prolactin and in the sexual steroid levels throughout the normal menstrual cycle (author's transl)].

The authors describe the hormone changes that occur in a normal woman throughout the menstrual cycle. These is no circadian rhythm in the release of gonadotrophins after puberty. LH is liberated in a pulsatile way throughout the day and the periodicity and amplitude of the episodes vary throughout the cycle with a notable peak of this hormone before ovulation. The level of FSH is greater early in the follicular phase and in mid-cycle, where there is also a cycle together with that of the LH. In spite of these variations a single estimation of gonadotrophins does represents their secretion over 24 hours. The changes in total and free oestradiol and in oestrone are parallel. There are two maxima, the one being preovulatory and preceding the gonadotrophin peak and the other throughout the whole luteal phase. Progesterone changes little throughout the day. It is low during the follicular phase and gradually starts to rise before the preovulatory peak of gonadotrophins, and stays raised throughout the whole luteal phase, following during this phase a variable curve. The 17 hydroxyprogesterone is similarly low in the follicular phase. Its cycle peak is stronger and its rise in the luteal phase weaker than that of progesterone. The secretion of androgens is marked by changes throughout the day of a circadian nature (maximal for dehydroepiandrosterone and delta 5 androstenediol) and cyclic (especially for androstenediol which rises in mid-cycle). Prolactin secretion is marked by changes throughout the day, circadian (maximum during the night) and cyclical (minimum follicular, maximum preovulatory, with a luteal level higher than the follicular level). These changes should be considered in order to work out correctly the levels of hormones that should be prescribed on the precise dates and worked out in accordance with the date of menstruation and temperature curve taken throughout the cycle.

Endorphins↗
PubMed1980

[Physiopathology of the so-called idiopathic hirsutism (author's transl)].

The so-called idiopathic hirsutism almost invariably involves hormonal disorders. Through secretion and peripheral conversion of precursors, there is an increase in androgens (mainly testosterone and androstenedione), often produced by both ovarian and adrenal glands, whilst a diminution of the binding protein leads to an increase in free testosterone. As in male puberty, this process activates a 5 alpha-reductase in the pilosebaceous glands located in areas normally reserved to male hairiness. The enzyme, in turn, transforms testosterone into dihydrotestosterone in situ, and the latter induces and maintains hair growth.

Adrenal Glands↗
PubMed1980

[Pregnancy in obese women who have had jejuno-ileal short-circuit operations (author's transl)].

The authors report two cases of obese women who had had intestinal short-circuit operations for obesity 18 months and 24 months previously. They review the indications for this type of operations and the effects the operation has on the body. It has been possible to find 85 other cases in the literature. In general the pregnancy proceeds well but it is important to carry out very strict supervision of the electrolyte balance, of the hypoprotinaemia and of the blood count. Mechanical complications of the short-circuit operation are rare. While abortions and premature labours are not more frequent in these than in other cases the child is often moderately small-for-dates. Congenital malformations can be raised and are of the order of 7 per cent. These fetal abnormalities, as well as maternal digestive troubles, are definitely more frequent if the interval between the operation and the pregnancy is short. It is therefore preferable to wait for two years before allowing a woman who has had a short-circuit type of operation to become pregnant.

Adult↗