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Y Vincent

Publications and source records attributed to Y Vincent.

18 recordsLinked to original sources
PubMed2000

[Value of amnioculture for choosing antibiotic treatment for premature rupture of membranes before 34 weeks gestation].

OBJECTIVE: This study attempts to answer the following question: is systematic amniocentesis an efficient tool for adjusting an antibiotic treatment in case of preterm premature rupture of membranes? METHODS: Retrospective study of 76 cases of preterm premature rupture of membranes that occurred between January 1994 and February 1997 in a French teaching hospital. RESULTS: Amniocentesis was impossible for 28 patients (Group I). In this group there was a 46% rate of neonatal sepsis (n=13). Amniocentesis was successful in 48 patients. 24 delivered within 48 hours after amniocentesis (Group IIa). In this group there was a 29% rate of neonatal sepsis (n=7), and amniotic fluid culture was positive in 33% of the cases. 24 delivered beyond 48 hours after amniocentesis (Group IIb). In this group there was a 21% rate of neonatal sepsis (n=5) and amniotic fluid culture was positive in 12.5% of the cases. Group I and IIa had a high risk of neonatal sepsis and could not benefit from amniocentesis culture results. CONCLUSION: Group IIa and IIb cannot be distinguished a priori, therefore systematic amniocentesis can only have a restricted impact on the management of antibiotic therapy. Even in the case of a negative amniotic fluid culture, antibiotic therapy is mandatory. If a systematic amniocentesis policy is used, one hundred amniocentesis have to be performed in order to adapt six antibiotic therapies. In the group with the highest risk of neonatal sepsis (severe oligohydramnios), amniocentesis cannot be performed. A policy of systematic amniocentesis restricted to the cases that are not delivered within the first 48 hours could be evaluated in a prospective randomized trial. Such a policy could help in deciding whether to stop, adapt, or continue the antibiotic therapy, or to induce the delivery in case of an asymptomatic chorioamniotitis.

Amniocentesis↗
PubMed1998

Fertility after radical surgery for tubal pregnancy.

OBJECTIVE: To evaluate fertility after salpingectomy performed for ectopic pregnancies (EPs). DESIGN: Retrospective cohort study. SETTING: Tertiary care university hospital. PATIENT(S): Three hundred forty patients (213 with surgery by laparoscopy and 127 by laparotomy) between January 1985 and July 1994, with a mean follow-up period of 73 months (36-162 months). INTERVENTION(S): Salpingectomy performed either by laparotomy or by laparoscopy as indicated. MAIN OUTCOME MEASURE(S): Rate of intrauterine pregnancy (IUP), live births, and recurrent EP. RESULT(S): Forty-seven (13.8%) patients were lost to follow-up, and 68 (20%) did not want to become pregnant. The overall rate of spontaneous conception was 70.4% in the laparoscopy group and 53.2% in the laparotomy group. The rate of live births was 50% and 37%, respectively; the mean time until conception was 11 and 17.2 months; and the rate of recurrent EP, 10.6% and 9.6%. The multivariate analysis showed a rate of IUP of 82.1% among women younger than 30 years of age with a normal contralateral tube, laparoscopic surgery, and no history of infertility. CONCLUSIONS: In this study of fertility after salpingectomy for EP, laparoscopic treatment was superior to laparotomic treatment. Fertility was equivalent to that after conservative treatment in a subgroup of young patients treated with laparoscopy and with no history of tubal pathology.

Adult↗
PubMed1998

Ki 67 expression in 35 borderline ovarian tumours: relations with clinicopathologic parameters and ploidy.

OBJECTIVE: To test the diagnostic and prognostic interest of Ki 67 expression and DNA ploidy in ovarian tumours. METHODS: The reactivity of tumour cells with the monoclonal antibody MIB 1 against Ki 67, was assessed by an indirect immunoperoxidase staining technique applied to 25 benign, 35 borderline and 20 malignant tumours of the ovary. In each cases, ploidy was analyzed by DNA flow cytometry. RESULTS: Ki 67 immunopositivity was detected in three benign tumours (12%), 14 borderline tumours (40%) and 14 ovarian carcinomas (70%). The mean and standard deviation of Ki 67 positive cells in benign, borderline and malignant tumours were: 1% +/- 8, 5% +/- 9.6 and 44.5% +/- 31 respectively. A difference in Ki 67 immunostaining was found between carcinomas and benign tumours (P < 0.0001), and between borderline and carcinomas (P = 0.001) but not between benign and borderline tumours. Evaluable DNA histograms from flow cytometry were generated in 77 cases (96.2%) of ovarian tumours. All 25 benign, 97.1% of 35 borderline and 44.5% of 20 malignant ovarian tumours were diploid. A difference was found between borderline and carcinomas (P = 0.001), but not between borderline and benign tumours. CONCLUSION: Ki 67 labelling was correlated with neither histologic and prognostic parameters, nor with survival, nor with DNA ploidy in borderline ovarian tumours.

Adult↗
PubMed1997

[Nasal obstruction].

When we talk about nasal obstruction, we should define this notion by differentiating between a nasal obstruction, linked to the presence of a physical or inflammatory obstacle on the level of the nasal passages, and the feeling of a nasal obstruction or breathing discomfort described by the patient. The ear, nose and throat explanation will have to take an interest in all the possible causes. The methods of investigation associate anamnesis and clinical examination, helped by endoscopes or fibroscopes, immunological and allergological examinations, computed tomography and magnetic resonance imaging, rhinomanometry and less often use examinations such as muco-ciliary examinations, nasal cellular examinations or the examination of the sense of smell. Nasal obstruction can also be caused by anomalies in the structure of the nasal passages or paranasal cavities, or by anomalies in the mucosa in the nasal passages, or by tumours. Subjective nasal obstruction or nasal discomfort is a pathology at the limit of the conscious and subconscious whose working bases are still not fully explained. Treatment of nasal obstruction can be medical or surgical, but it must absolutely take into account the aetiology and not just the symptoms.

Endoscopy↗
PubMed1996

[Value of ultrasonography in utero-vaginal aplasia].

The usefulness of pelvic ultrasound in the diagnosis of Rokitansky-Kuster-Hauser syndrome was evaluated retrospectively in 44 patients. Ultrasonography confirmed the diagnosis in 32%, however was wrong in 68% as a uterus was found, though generally described as hypoplasic. The reasons for the low sensitivity of ultrasonography are discussed.

Abnormalities, Multiple↗
PubMed1996

[Role of conservative therapy and medical treatment in ectopic pregnancy: literature review and clinical trial comparing medical treatment and conservative laparoscopic treatment].

OBJECTIVE: to compare methotrexate (MTX) to laparoscopic salpingotomy for conservative management of ectopic pregnancy (EP). DESIGN: prospective randomized study. PATIENTS: eighty-nine patients were randomized into 2 groups using a random number table. Inclusion criteria were an EP visualized by ultrasound with a pretherapeutic score < or = 13 as assessed by 6 criteria graded from 1 to 3: gestational age, hCG level, P level, abdominal pain, volume of the hemoperitoneum, and diameter of the hematosalpinx. INTERVENTIONS: 1 mg/kg of MTX injected transvaginally into the ectopic pregnancy without anaesthesia or IM administration (1.5 mg/kg) when EP cannot be safely or easily punctured (group 1) versus laparoscopic salpingotomy (group 2). RESULTS: the success rates defined by hCG levels returned to normal (< 10 mlU/mL) were 43 out of 46 in group 1 and 40 out of 43 in group 2. Medical treatment was significantly associated with shorter post-operative stay (24 vs 46 hours). hCG return to normal was quicker after laparoscopic treatment (13 vs 29 days). Reproductive performances were similar in both groups. CONCLUSIONS: in selected cases of EP with a pretherapeutic score < or = 13, MTX treatment appeared to be as safe and efficient as was conservative treatment by laparoscopy, an expectant management should be offered as a treatment option only in women fulfilling the criteria for a good prognostic.

Adolescent↗
PubMed1995

Is median thoracic artery a target organ artery for estradiol and progesterone? A comparison with uterine artery.

PURPOSE: The aim of this study was to show the parallel evolution of the pulsatility index of the uterine artery and the one of the median thoracic artery. STUDY DESIGN: The study involved seven volunteer women, below 38, suffering from premature ovarian failure, who received E2 and progesterone replacement therapy. Plasma levels of E2, progesterone, follicle stimulating hormone and luteinizing hormone were measured and PI were studied and compared before treatment and on Days 13, 27 and 41. RESULTS: Before treatment, a high-resistance vascular for both arteries is uniformly found. The curves show with the increasing of the E2 plasma levels, a decrease in the PI of UA and MTA with a fall at Day 13. We compared the mean values in MTA and UA PI. No statistical difference between the three mean values in PI obtained at Day -1, Day 13 and Day 41 was demonstrated. CONCLUSION: The results suggest that median thoracic artery is a target organ artery. Such as the UA, the MTA vascular resistance is according to the variations of plasma levels of E2. In consideration of it rectilinear and superficial type, this led us to study this artery when we use different sorts of replacement therapy, and particularly in the oocyte donation program.

Adult↗
PubMed1995

Ultrasound evaluation of the length of the fetal nasal bones throughout gestation.

Subtle facial abnormalities, including smallness of the nose, are common findings in trisomy 21 and numerous other genetic conditions. The aim of this study was to construct a normal range for the length of the fetal nasal bones with gestation in a Caucasian population. Ultrasound measurements were performed on a strictly mid-sagittal profile in 376 normal singleton fetuses at 14-34 (mean 24) weeks' gestation. It was found that the length of the nasal bones increased from 4 mm at 14 weeks to 12 mm at 35 weeks' gestation, and that there was a linear relationship between the length of these bones and biparietal diameter and femur length. We conclude that the length of nasal bones can easily be measured in fetuses at 14-34 weeks' gestation and that such measurements might prove useful in the evaluation of pregnancies at high risk for associated fetal abnormalities.

Embryonic and Fetal Development↗
PubMed1993

[Assisted embryo hatching].

In spite of the progress in in vitro fertilization (IVF), implantation rate of IVF embryos remains low. Many factors seem to be involved in these results. Among them, impairment of the hatching process was incriminated by some authors. Assisted hatching seems to be an interesting method for repeated failures of IVF.

Adult↗
PubMed1992

[Chickenpox and pregnancy].

The authors report a case of chickenpox exposure during the first three months of pregnancy. Ultrasonographic monitoring of the fetus revealed signs of fetal infection starting from 32 weeks of amenorrhea (hepatomegaly, ascites, pleural effusion) but clinical examination of the child at birth showed nothing abnormal. The diagnosis was confirmed by the development of herpes zoster in the child after birth. The difficulty of determining a fetal prognosis during pregnancy is emphasised.

Adult↗
PubMed1984

[Personal experience with sinus endoscopy. Apropos of 120 cases of chronic sinusitis].

One hundred and twenty adults have benefitted from a full staging of their chronic maxillary sinusitis. The authors detail the place of endoscopy in the assessment and management of the different clinical presentations. The endoscopy will be useful only if a systematic examination is performed, of nose and paranasal cavities, both optically and manometrically. Nature and severity of the disease can be evaluated by summarizing of the patient findings of story, clinical, radiological examinations and biological data. Endoscopy constitutes nor a valuable diagnostic tool, nor a therapeutic approach, conducting conservative treatment and avoiding some radical surgery.

Adolescent↗
PubMed1983

[Differential diagnosis of intranasal masses in children. Apropos of a case of meningoencephalocele with glioma].

The authors reviewed the different etiologic possibilities of nasal mass occurring in pediatric population. The report of one of their own case of meningoencephalocele gives them the opportunity to insist on the necessity of atraumatic investigations and the absence of significant correlation between clinical characteristics of the tumor and histological diagnose. Surgical exploration and external extirpation of the tumor is the treatment of choice in young patients. Current management will first consist in biopsies by olders, usually followed by multidisciplinary approach.

Diagnosis, Differential↗
PubMed1982

[Tumor of the nasal cavity unusual in our region. Apropos of a case of rhinosporidiosis].

Rhinosporidiosis is an ailment of the mucous membranes provoked by a microorganism described by Seeber in 1900. It is found in Africa, South America, India, Ceylan, Phillipines and Iran. Rhinosporidium Seeberi provokes the appearance of sessile polyps, friable on the mucous membranes. The nasal mucous membrane is affected in 72% of the cases. The symptoms in otorhinolaryngology are in most cases mucous or mucopurulent rhinorrhea, chronic epistaxis and a progressive nasal obstruction. The etiologic diagnosis is based on clinic, on the examination of rhinorrhea and especially on histopathological examination. In case of lesion at nasopharynx level rhinosporidiosis must be differentiated from inflammatory or parasitic lesions, from embryonic or malignant tumour. Prognosis is generally favourable, the treatment is mainly surgical.

Adult↗
PubMed1981

[Therapeutic embolization in ORL pathology. Indications and results].

The progress of therapeutical embolization in otolaryngology was made possible by the arrival of new techniques which allowed the embolization of the different ramifications of the arteria carotis externa. The embolization technique is based on two principles: 1. The embolus is to be injected in a super-selective way, after catheterization of the pathological blood vessels. 2. The mass of the embolus has to be big enough to be able to obstruct the pathological vessel. Therefore the femoral way is mostly used. The aim of embolization is to create a spontaneous thrombosis around the used particles. The thrombosis thus succeeds in completing the embolization. The principal counter-indications against embolization are due to facts of a technical and a geographical order. Incidents and accidents are often related either to the catheterization, or to the contrast-media, or also to the anastomoses which become functional after the embolization. The major complications are hemiplegiae, aphasiae and eyesight troubles, all problems brought about by ischaemia are: --the indications for isolated embolization, amongst which have to be pointed out the surgical counter-indications, severe epistaxis, vessel malformations, important cranio-facial angiomatosis, the telangiectasical family angiomatosis of Rendu-Osler, and the antalgic effect of embolization, in particular in cancer treatment; -- an excellent indication for embolization is the prevention of massive hemorrhages and the simplification of the surgical act, in particular in hypervascularized ORL tumours, either benign or malignant, for instance the naso-pharyngeal fibrome and the whole of the malignant tumours and of the metastases of the ORL sphere. To conclude, we may say, that, within skilled hands and when taking the usual precautions, accidents in embolization are exceptional, and that embolization remains a therapeutical process with great prospects.

Adult↗
PubMedDate not supplied

Effect of betamethasone on the fetal heart rate pattern assessed by computerized cardiotocography in normal twin pregnancies.

The effects of corticosteroids, given for enhancement of fetal lung maturation, on fetal heart rate (FHR) are controversial and may decrease its variability. FHR patterns were analyzed by computerized cardiotocography in 46 fetuses from 23 normal dichorionic twin pregnancies on days 0, 1 and 4-7 while the mothers received four intramuscular injections of 3 mg betamethasone sodium and 3 mg betamethasone acetate within 48 h to enhance fetal lung maturation. Compared with pretreatment values, FHR showed a decrease in long- and short-term variations; other parameters, e.g. the number of fetal movements, remained unchanged. However, decreased FHR variation was followed by an increase in the acceleration rate after maternal administration of betamethasone. These modifications were transient and should not lead to unnecessary anxiety or intervention in otherwise normal fetuses.

Betamethasone↗