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Biomedical subjects

R Ecochard

Publications and source records attributed to R Ecochard.

86 records · Page 5Linked to original sources
PubMed1992

[Mammary microcalcifications: is there a consensus on interpretation and management?].

Twenty two view mammograms without magnification, with microcalcifications corresponding to non palpable breast lesions, were submitted to 23 experienced observers, either gynaecologists or radiologists. These mammograms consisted of 10 malignant lesions and 10 benign lesions; all of them underwent surgical procedures. The microcalcifications were graded and categorized into one of the four groups: malignant; suspect; slightly suspect; benign. One of the four options was proposed: biopsy; mammogram within 3 months; mammogram within 6 months; mammogram within a year. Twelve observers out of 23 have referred to a classification. The mammograms were assessed according to a consensus. The validity of that diagnostic test was studied in various clinical situations and the lack of homogeneity of the responses was quantified. In the trade-off situation between sensitivity and specificity (suspect or malignant considered as positive), sensitivity is 50% and specificity is 70%. Moreover, the responses are not homogeneous at all and this lack of homogeneity is found to be statistically significant, greater than by chance alone. The diagnosis of cancer is more frequently put forward by the radiologists. This study explains the low predictive value of non palpable microcalcifications undergoing surgical procedures: from 11.5 to 44% in the literature. Similarly, there is no agreement on the frequency of the follow-up for these microcalcifications when they do not lead to surgical procedures.

Breast Diseases↗
PubMed1991

Meta-analysis.

Meta-analysis corresponds to all systematic methods which use statistical techniques for combining results from several independent studies. The aim is to get a consistent estimation of the global effect of a procedure on a specified outcome. The technique allows us to increase the power of statistical testing, and to get information which cannot be drawn from one individual study. Two approaches are possible, and often combined: the qualitative approach consists of weighing various studies according to their methodological quality; the quantitative approach consists of pooling the results of different studies, in order to generate results with a higher statistical power. A meta-analysis is a long and rigorous process, which follows several steps: statement of objectives; definition of articles inclusion and exclusion criteria; literature search; collection of data and evaluation of the quality of each study; tests for homogeneity; pooling; sensitivity analyses; presentation of results; and conclusions. Meta-analysis has several advantages: it estimates the size of an effect; it improves the generalizability; it compels to rigor; it lessens the part of subjectivity. When meta-analysis is cautiously and properly done, it brings new useful information, and helps physicians and health policy makers in answering to a specific question.

Data Collection↗
PubMed1991

Transient secretory IgA deficiency in mice after cyclophosphamide treatment.

Cyclophosphamide (Cy), an alkylating agent widely used in chemotherapy of leukemia and cancer, causes a well-documented toxicity on hematopoietic and lymphoid cells. Neutropenia is thought to be the main factor involved in infectious complications following antimitotic chemotherapy. Little is known on the effects of these therapies on the mucosal associated lymphoid system which is one of the main barriers against environmental pathogenic agents. The present study examined the effects of a single administration of Cy (200 mg/kg) on murine T and B cell populations of Peyer's patches (PPs), IgA secretion in the proximal part of the small intestine, and plasma cells of the lamina propria. Cy induced in mice a transient decrease in the T and B cell populations of the PPs with a drastic fall of B cell counts and a profound decrease of intestinal IgA secretion due to a reduction of lamina propria plasma cells. This transient secretory IgA deficiency may contribute to the infectious complications following antimitotic chemotherapy.

Animals↗
PubMed1991

Influence of associated valvular lesions on long-term prognosis of mitral stenosis. A 20-year follow-up of 202 patients.

Other valvular lesions associated with pure MS were studied in 202 consecutive patients whose mean age was 43.4 +/- 12.7 years; 76.7% were females. MS was isolated in 63.4%, associated with aortic regurgitation (AR) in 27.7%, aortic stenosis in 1.0%, tricuspid stenosis (+aortic valve lesion) in 1.0%. In isolated MS, 42.4% were NYHA class III or IV, compared with 49.0% in MS + aortic valve lesion. One hundred and sixty-nine (85.4%) patients were operated on; 23.1% had mitral valve replacement, 76.9% had closed (31.4%) or open (45.6%) mitral commissurotomy; 7.1% had associated aortic valve replacement. There were perioperative complications in 20.4%, and the perioperative death rate was 4.1%. Two patients were reoperated in the postoperative course, and 28 patients after this period. The follow-up was 13.3 +/- 4.5 years. The survival rate was 77.7 +/- 4.6% (SE) for isolated MS, and 71.1 +/- 6.3% for MS associated with an aortic valve lesion (NS). The prognosis of MS is very good: the survival rate at 20 years follow-up is 75%. The association of aortic stenosis or tricuspid stenosis does not appear to alter this survival, but numbers are small. Important aortic regurgitation is a significant predictor of higher mortality in patients with MS.

Adolescent↗
PubMed1991

Hyperactivated motility of sperm from fertile donors and asthenozoospermic patients before and after treatment with ionophore.

Hyperactivated motility of capacitated sperm was studied before and after contact for 30 min with the Ca2+ ionophore A23187. Sperm from fertile donors and asthenozoospermic infertile patients were incubated in the presence of increasing concentrations of A23187 in the medium. At 5-10 microM, the ionophore induced a significant increase (P less than 0.05) in the percentage of hyperactivation of sperm from asthenozoospermic subjects. Higher concentrations (20 and 30 microM) were needed to enhance hyperactivation of sperm in the fertile population. In the latter, extended contact with the ionophore induced no significant change compared to a 30-min incubation period. Since this type of movement is an essential feature of the fertilizing gamete, a low hyperactivation rate may partly explain fertilization failure in the asthenozoospermic group.

Calcimycin↗
PubMed1991

Descriptive analysis of a series of operations for prostatic adenomas in inhabitants of Lyon, France, in 1988. Urological College of Lyon.

A retrospective, population-based study was conducted in Lyon, France, to elucidate the benefits and risks of a treatment for prostatic adenoma (benign prostatic hyperplasia). Case records were reviewed for all prostatectomies performed on patients in Lyon in 1988 for benign prostatic hyperplasia. Data were obtained from all records of public and private hospitals. Of 408 procedures, 312 involved endourethral resection (transurethral resection) and 96 open surgery. The mean weight of resected tissue was 20.3 +/- 0.9 g after endourethral resection and 71.7 +/- 6.4 g after open surgery. About 20% of the resections took place in a university hospital center, 43% in a not-for-profit private hospital, and 37% in a private clinic; there were eight deaths in the first 3 postoperative months, and 11 patients required hospitalization for urologic complications. Length of hospital stay uniquely correlated with age and type of surgery.

Aged↗
PubMed1990

Gamete intra-fallopian transfer with cryopreserved donor semen following AID failure.

Results are presented of gamete intra-Fallopian transfer with cryopreserved donor semen in cases of male infertility with azoospermia or extreme oligozoospermia. The female partners had no detectable infertility problems and they had first received 10 cycles of intracervical AID without success. Forty-one GIFT cycles performed on 22 such patients gave an overall pregnancy rate of 26.8% (11/41). In 64% (9/14) of these cases, pregnancy occurred after the first GIFT attempt. From these results it is suggested that GIFT with donor semen may be a reasonable alternative after AID failure. The probable reasons for success of GIFT are discussed.

Adult↗
PubMed1989

[Characteristics of the menstrual cycles during the postpartum period without breast feeding according to the nature of the first period: ovulatory or anovulatory].

The authors have analyzed the characteristics of menstrual cycles during the post-partum without breastfeeding, according to the nature of the first period. 172 women gave the thermal curve from childbirth to the first period. Among them, 118, 111, 98 and 54 women gave the self-observation data concerning, respectively, the first, second, third and the fourth cycle after the first period. They have noticed more short luteal phases and delays in ovulation after an anovulatory first period than after an ovulatory first period. The hormonal studies in the post-partum without breastfeeding seem not to explain the whole of these anomalies ascertained beyond twelve post-partum weeks. Most authors admit that the gonadotropin axis returns to a normal state within the fifth post-partum week. Because of the peculiar kinetics of follicle development, the ovary could be an important component of the "remnant effect of gestation", that is to say, of the delay of return to post-partum ovulation following the gestation state.

Adult↗
PubMed1988

[Can analysis of previous post-partum periods provide prognostic indicators on the return of fertility after delivery?].

Evaluation of self-observation signs noted during post-partum, enables to study the physiology of this period. The signs analyzed in this study are: discharge of vaginal secretions, temperature discrepancy and bleeding. The originality of the study lies in the comparison of successive post-partum periods: 2 to 6 post-partum periods were studied in 163 women; in addition, we studied 38 cases including breast feeding time details and children reactions. The authors described especially the retention effect of the pregnancy and the inhibiting effect of breast feeding on the return of the fertility, by progressively escaping these two effects, and the part of the woman's reaction.

Body Temperature↗
PubMedDate not supplied

Variability of the response to pentoxifylline in vitro in infertile normozoospermic and asthenozoospermic patients.

The in vitro effect on the motility of spermatozoa of the methylxanthine pentoxifylline was studied in 30 patients consulting for infertility (13 normozoospermic and 17 asthenozoospermic). After separation by centrifugation on Percoll gradient, the spermatozoa were incubated for 30 min in pentoxifylline (3.6 mM), then the pentoxifylline was removed by washing and centrifugation. The residual effect of pentoxifylline was studied by computer-assisted videomicrographic analysis of the sperm motion parameters. In both groups of patients a decrease in the percentage of motile spermatozoa after exposure to pentoxifylline was observed, as compared with a control group. The effect on the motion parameters varied according to the time of observation (30, 120, 240 min). In the asthenozoospermic patients, the curvilinear velocity (VCL) was not modified in a statistically significant manner. In the normozoospermics, the VCL was increased after exposure to pentoxifylline at 120 min (p = .03) and 240 min (p = 10(-5)); similarly, the amplitude of the lateral head displacement (ALH) was greater in this group at 120 and 240 min (p = .01 for maximum ALH). However, a heterogeneity was noted in the response between individuals, which required that the statistical analyses take into account these differences.

Humans↗