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Biomedical subjects

J Goujard

Publications and source records attributed to J Goujard.

At least 73 records · Page 4Linked to original sources
PubMed1977

Possible teratogenic effect of phenothiazines in human beings.

A prospective survey was carried out by the French National Institute of Health and Medical Research (INSERM) in 12 University hospitals in Paris and included 12,764 women; 189 gave birth to babies with unequivocal, non-chromosomally based, malformations. There was a significant excess of malformed infants when women had taken phenothiazines during the first three months after the last menstrual period. This association did not seem due to chance or to bias and could not be explained by the influence of the outcome of previous pregnancies. These data are to be added to results of recent surveys showing a significant increase of malformations in children exposed in utero to anticonvulsants, carbamates, benzodiazepines, tricyclic antidepressants, and amphetamines.

Abnormalities, Drug-Induced↗
PubMed1975

Smoking during pregnancy, stillbirth and abruptio placentae.

In a prospective investigation on 9,169 pregnant women which showed a substantial increase in stillbirths among smokers, a large proportion of this increase is due to abruptio placentae. The percentage of smokers in this category rises to 46% while it is only 12% in the group of livebirths. Smoking appears to be an important risk factor in this occurence, the etiology of which is little known. The effect of parity and its possible interaction with smoking are discussed.

Abruptio Placentae↗
PubMed1975

Smoking during pregnancy and placental weight: a multivariate analysis on 3759 cases.

The analysis of a survey of 3759 births shows that the difference in placental weight between smokers and nonsmokers is, if not nil, at least minimal, and that is definitely less than might be expected taking birth weight and other factors into consideration in a multivariate analysis (Tab. II). The distortion between the fetal and placental weights, which are very closely correlated, assigns to smoking a peculiar place among the factors influencing these two weights, a result which may lead to various interpretations.

Analysis of Variance↗
PubMedDate not supplied

On the symmetry of limb deficiencies among children with multiple congenital anomalies.

In humans, unpaired organs are placed in a highly ordered pattern along the left-right axis. As indicated by animal studies, a cascade of signaling molecules establish left-right asymmetry in the developing embryo. Some of the same genes are involved also in limb patterning. To provide a better insight into the connection between these processes in humans, we analysed the symmetry of limb deficiencies among infants with multiple congenital anomalies. The study was based on data collected by the International Clearinghouse for Birth Defects Monitoring Systems (ICBDMS). Registries of the ICBDMS provided information on infants who, in addition to a limb deficiency, also had at least one major congenital anomaly in other organ systems. We reviewed 815 such cases of which 149 cases (18.3 %) were syndromic and 666 (81.7 %) were nonsyndromic. The comparisons were made within the associated limb deficiencies, considering the information on symmetry, using a comparison group with malformations associated not involved in the index association. Among the non-syndromic cases, the left-right distribution of limb deficiencies did not differ appreciably between limb deficiency subtypes (e.g., preaxial, transverse, longitudinal). The left-right distribution of limb anomalies did not differ among most types of non-limb anomalies, though a predominance of left-sided limb deficiencies was observed in the presence of severe genital defects - odds ratio [OR], 2.6; 95 % CI, 1.1-6.4). Limb deficiencies (LDs) were more often unilateral than bilateral when accompanied by gastroschisis (OR, 0.1) or axial skeletal defects (OR, 0.5). On the contrary, LDs were more often bilateral than unilateral when associated with cleft lip with or without cleft palate (OR, 3.9) or micrognathia (OR, 2.6). Specifically, we found an association between bilateral preaxial deficiencies and cleft lip, bilateral amelia with gastroschisis and urinary tract anomalies, and bilateral transverse deficiencies and gastroschisis and axial skeleton defects. Of 149 syndromic cases, 62 (41.6 %) were diagnosed as trisomy 18. Out of the 30 cases of trisomy 18 with known laterality, 20 cases were bilateral. In the remainder the right and left sides were equally affected. Also, in most cases (74.4 %) only the upper limbs were involved. In conclusion the left-right distribution of limb deficiencies among some non-limb anomalies may suggest a relationship between the development of the limb and the left-right axis of the embryo.

Abnormalities, Multiple↗
PubMedDate not supplied

Management of the fetus with a correctable malformation in Paris maternity units: evolution 1985-1994.

OBJECTIVE: To analyze the evolution of the management of delivery and neonatal care in a population of children with correctable malformations born in Parisian maternity hospitals during the period 1985-1994. METHODS: Data were collected by the Paris Registry of Congenital Anomalies from 400,000 births recorded in Parisian maternity hospitals over a 10-year period. Chromosomal anomalies were excluded. The evolution between the first period (1985-1989) and the second (1990-1994) was analyzed for the following indicators in the management of liveborn children: place of delivery; frequency of prenatal diagnosis; transfer to intensive care units, and mortality. RESULTS: More than 60% of the births of malformed children took place in public maternity hospitals where better management is offered. Most of them were prenatally diagnosed, except for esophageal and anorectal atresia for which the rate of prenatal diagnosis was low. For malformations with poor prognoses (diaphragmatic and abdominal wall anomalies), the rate of deliveries in public maternity hospitals reached about 90%, mostly in those with intensive care units. The evolution between the two periods was characterized by a quicker transfer to intensive care units, during the first day of life for most cases. Lethality during the first day, which was already low during the first period, decreased further. The early neonatal mortality rate decreased for cardiac anomalies, but not significantly. The prognosis remained poor for diaphragmatic anomalies: 49% of liveborn children died during the first week of life.

Abdominal Muscles↗
PubMedDate not supplied

[Evaluation of risks related to human growth hormone (hGH) treatment. Results of an epidemiologic survey conducted in France of patients treated from 1959 to 1985].

Following the notification in the USA and England of four cases of Creutzfeldt-Jacob disease (MCJ) in patients previously treated with hGH, an epidemiological inquiry has been done in France to set up a clinical evaluation of all patients treated from 1959 to 1985. 1698 patients were registered for treatment. Current information (less than three months old) was obtained for 1622 patients (95.5%). Death was reported in 32 patients (2.0%), one is possibly related to a viral infection (malignant lymphoma), but none could be related to MCJ. Accidents were observed in 213 living patients (13.1%). Among them, 4 cases were classified as possibly related to a viral infection: acute lymphoid leukaemia, polyradiculoneuritis associated with hepatitis, acute encephalitis (2 cases). Even though the clinical symptomatology is not consistent with MCJ, a relationship with hGH therapy could not be completely excluded. Finally, six patients undertreatment developed malignancies. During the three last years, the question of side effects of hGH therapy has been raised in the literature two times running: risk of MCJ and risk of leukaemia. Then, the question of the long term vigilance of all treated patients with hGH deficiency should be done.

Creutzfeldt-Jakob Syndrome↗
PubMedDate not supplied

Epidemiologic survey of juvenile chronic arthritis in France. Comparison of data obtained from two different regions.

An epidemiologic survey of JCA was carried out in two regions of France, the western part of Paris and Brittany, differing in terms of geological background and demography. The prevalence was 0.77 and 0.100% and the incidence 0.019 and 0.013%, respectively. The type of onset, the course of the disease, the immunological data and the degree of final disability were similar in both regions. These data were compared to other studies and the factors of possible discrepancy analysed.

Adolescent↗