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Biomedical subjects

J Guillebaud

Publications and source records attributed to J Guillebaud.

At least 91 records · Page 5Linked to original sources
PubMed1987

Two hundred out-patient laparoscopic clip sterilizations using local anaesthesia.

Female sterilization using clips applied laparoscopically under local anaesthesia was used in 200 women. Apart from two patients in whom there were technical difficulties, the operation was completed without complication and without immediate or delayed morbidity. The technique, which avoids the risks of general anaesthesia, is commended as a safe, simple method of sterilization suitable for, and acceptable to, the majority of women.

Adult↗
PubMed1986

Contraception.

Explore the source record for details and available documents.

Algorithms↗
PubMed1986

A possible mechanism of action of danazol and an ethinylestradiol/norgestrel combination used as postcoital contraceptive agents.

Twenty-seven women requesting postcoital contraception were randomly allocated to take an ethinylestradiol/dl-norgestrel combination or danazol. Urine specimens were assayed for luteinising hormone (LH) and pregnanediol-3-glucuronide (P3G) levels from the day of the postcoital treatment to the next period. In addition, the urine samples of these recruits and 12 additional women were assayed for the Beta-subunit of human chorionic gonadotropin (B-hCG). A consistent pattern of alteration in urinary steroids was lacking, indicating a heterogeneous effect on ovarian function. There was no evidence of early pregnancy in successfully treated cases. We suggest that the main mechanism of action of these drugs is at the endometrial level.

Chorionic Gonadotropin↗
PubMed1986

The biochemistry of human endometrium after two regimens of postcoital contraception: a dl-norgestrel/ethinylestradiol combination or danazol.

A combination of 0.5 mg levonorgestrel (in 1 mg dl-norgestrel) and 0.1 mg ethinylestradiol was administered to eight volunteers 48 hours after the start of the luteinizing hormone surge. A second dose was given 12 hours later. Endometrial samples were obtained 24 hours after the first dose was given. The steroid receptor concentration was compared with ovulatory spontaneous cycles. The dl-norgestrel/ethinylestradiol combination caused a significant reduction in receptor concentration. Isocitrate dehydrogenase (a progestin-sensitive enzyme) was also altered, suggesting an effect on endometrial metabolism. Danazol was used in a similar fashion, with two doses each of 400 mg. Nine volunteers were studied. A similar pattern of alteration of endometrial biochemistry was demonstrated but did not reach statistical significance. The relevance to the postcoital use of hormones is discussed.

Adult↗
PubMed1986

Hormonal contraception and cancer.

The natural menstrual cycle can influence the development of some cancers. Combined oral contraceptives, which replace normal hormonal fluctuations with steadier levels of artificial sex hormones, appear to protect against cancers of the endometrium and ovary, but their effect on carcinomas of the breast and cervix remains uncertain.

Breast Neoplasms↗
PubMed1985

Ultrasound demonstration of increased frequency of functional ovarian cysts in women using progestogen-only oral contraception.

Asymptomatic volunteer women with a regular pattern of uterine bleeding and using the progestogen-only oral contraceptive pill were compared with control women who were not exposed to hormones. Pelvic ultrasound scanning at the end of the next bleeding episode after recruitment demonstrated functional cysts with maximum diameters ranging between 30 and 58 mm in eight of the 21 pill users, four of whom also had palpable ovaries, three cysts regressed during the next cycle. Of the 13 women with normal ovaries initially, four developed a new functional cyst of which two were associated with pain. Of the 12 women with cysts seven complained of pain at some time during the monitored cycle. Among 21 control women only one symptom-free (42 mm) cyst was shown on the initial postmenstrual ultrasound scan and this resolved painlessly during the scanned cycle with ovulation from the opposite ovary. Ovulation was also demonstrated in 16 of the remainder; but in none of the three control women who developed asymptomatic functional cysts (35-47 mm in size) while under observation. Since 11 of the 14 pill-users who failed to ovulate also had a functional cyst, the contraceptive efficacy may depend in part on this association. Pain symptoms may make the method less acceptable and give rise to diagnostic problems and inappropriate therapies.

Adult↗
PubMed1984

Late failure of vasectomy after two documented analyses showing azoospermic semen.

From April 1970 to December 1980, 14 047 men underwent vasectomy for sterilisation under local anaesthetic at this clinic. In each man sterility was confirmed by two analyses of semen showing azoospermia. Allowing for a minimum follow up of three years, the wives of six of these men subsequently became pregnant between 16 months and three years after vasectomy. Analyses of semen confirmed recanalisation of the vasa deferentia in all six men. Only five similar cases initially fulfilling the same criteria for sterility have previously been reported. Full account of the rare possibility of recanalisation should be taken both when couples are counselled preoperatively and when pregnancy occurs after the male partner has been confirmed to be sterile.

Adult↗
PubMed1984

Influence of removal of intrauterine contraceptive devices on colonisation of the cervix by actinomyces-like organisms.

An overall prevalence rate of actinomyces-like organisms (ALO) in cervical smears from intrauterine contraceptive device (IUCD) users of 3% (79/2, 734) was found, with a rate of 2% and 22.6% for copper and inert IUCD users. Although the users of the inert IUCDs were older, and their devices had been in situ longer, these factors did not account for the significant difference between the two types of IUCD. Fifty-five patients were counselled and given a leaflet on ALO. Fourteen IUCD users with ALO positive smears who had their devices removed had mild or moderate pelvic pain or discharge. Six others who were asymptomatic had the IUCD removed at their own request. All fifty-five patients were re-examined six months to one year later, and a smear was repeated. Only one woman required later removal of the IUCD because of dyspareunia with pelvic tenderness. After removal of the IUCD, and without antibiotic therapy, in 100% (20/20) of the women, ALO colonisation was no longer found six to twelve months later. This applied even to seven women who had had a new copper IUCD inserted immediately after removal of the index device.

Actinomyces↗
PubMed1984

Complications of vasectomy: review of 16,000 patients.

Sixteen thousand, seven hundred and ninety-six men underwent vasectomy between 1970 and December 1983 and have been reviewed. Post-operative side effects were few and significant complications were reported in 0.9%. Failure to achieve sterility occurred in 72 men, 69 of whom have been analysed. The early recanalisation rate was 0.36%. This rate was not influenced by the operative technique used, but varied markedly between individual surgeons. Experience and care with technique should result in a failure rate of 0.2% or better. There were six cases of late recanalisation in men previously thought sterile by two consecutive azoospermic analyses 4 months after vasectomy.

Humans↗