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Biomedical subjects

B Blondel

Publications and source records attributed to B Blondel.

At least 19 recordsLinked to original sources
PubMed1992

Home uterine activity monitoring in France: a randomized, controlled trial.

OBJECTIVES: We assessed the effectiveness of ambulatory tocodynamometry in reducing the preterm delivery rate in women at risk of preterm delivery such as women with risk factors and women previously hospitalized and discharged. STUDY DESIGN: In four public maternity units these women were randomly allocated to two groups: 84 had home uterine activity monitoring and daily midwife contact and 84 were given the standard care for high-risk women, which generally includes home visits by community midwives. RESULTS: The proportion of deliveries before 37 weeks' gestation was slightly higher in the monitored group than in the control group (32% vs 22%). The corresponding odds ratio was 1.7 (95% confidence interval: 0.9 to 3.5). CONCLUSION: Although the sample was small, these results suggest that home uterine activity monitoring was probably not beneficial to the population studied, or at least that any benefit would have been too small to justify extending this monitoring in this high-risk population.

Cardiotocography↗
PubMed1992

Assessment at 1 year of the psychological consequences of having triplets.

The purpose of this study was to assess the psychological difficulties encountered by mothers 1 year after the birth of triplets. Twelve mothers entered the study having delivered triplets in a public hospital in Paris. Nine pregnancies had been initiated after in-vitro fertilization (IVF) or gamete intra-Fallopian transfer (GIFT), two after ovarian stimulation and one was spontaneous. The method consisted of tape-recorded semi-structured interviews at the mothers' homes. At 1 year, a majority of mothers reported considerable fatigue and stress. In most cases, home help was no longer provided by social services or by relatives. A majority suffered from social isolation and had difficulties in going out because of a lack of help, and inquisitive looks and questions from other people. Most mothers said that having triplets placed a strain on the marital relationship. The relationship with the children was often disturbed. Mothers reported that it was difficult to give adequate attention to the three children at the same time. Most of them tended to become emotionally detached. Eight mothers expressed psychological difficulties and three of them were treated for depression. Families with triplets should be provided with increased help, special attention, counselling and support, either at home, in clubs or in special clinics.

Emotions↗
PubMed1992

Home visits for pregnancy complications and management of antenatal care: an overview of three randomized controlled trials.

OBJECTIVE: To examine whether a policy of home visits reduces the amount of antenatal care provided by hospital maternity units. DESIGN: A meta-analysis of three randomized controlled trials. SETTING: 9 maternity units in France. SUBJECTS: 1410 women with pregnancy complications. INTERVENTION: 1 or 2 home visits a week by a midwife. MAIN OUTCOME MEASURES: Admission rate and length of stay in hospital. RESULTS: The home-visiting system did not affect the hospital admission rate (typical odds ratio = 0.9; 95% CI = 0.7-1.2). In each trial, the length of hospital stay did not differ between the intervention and the control groups. CONCLUSIONS: The home-visiting system did not greatly alter the practice of antenatal hospital admission in the maternity units studied. The results question the way the health services were used and suggest that a better integration of hospital and home services is needed to make a more rational use of health care resources.

Female↗
PubMed1991

Comparison of vaginal examination findings in two antenatal clinics.

Findings of routine vaginal examinations during pregnancy were compared in two teaching hospitals located in the same area of Paris. We selected 2943 women who had had at least one antenatal visit between 29 and 31 weeks of gestation. Large differences in the frequency of maturation signs were observed between the two hospitals for mid-position, soft consistency and expanded lower uterine segment, although the higher frequency of each sign was not found in the same hospital. No difference was observed for dilatation of the internal os. A better reliability in assessing dilatation than other signs of maturation may explain our results and the role of dilatation in the prediction of preterm delivery.

Adult↗
PubMed1991

An indicator of adverse pregnancy outcome in France: not receiving maternity benefits.

STUDY OBJECTIVE: The aim was to compare the social characteristics, the pregnancy outcome, and the antenatal care of women in France who did not receive maternity benefits to women who did. These benefits (860 FF, approx 86 pounds per month) are given to every pregnant woman, starting in the second trimester. Payments are made on the condition that at least three antenatal visits are made, the first being before the end of the first trimester. DESIGN: The study involved a random sample of women who were interviewed after delivery during their stay in hospital. Data on pregnancy outcome were collected from medical records. SETTING: The study was carried out in four public maternity units in different regions of France. PARTICIPANTS: 1692 women were included in the analysis (86.8% of the selected sample). Of 257 exclusions, 40 had multiple pregnancies, 189 had missing data, and 28 did not answer the question concerning maternity benefits. MEASUREMENTS AND MAIN RESULTS: 4.3% of the women did not receive any maternity benefits. These women lived in poorer social conditions than the women who received the benefits. They had a higher preterm delivery rate, after controlling for risk factors in a logistic regression. Women without maternity benefits were characterised by a lower level of care, yet the majority began their antenatal care during the first trimester or had more than six visits. CONCLUSIONS: Not receiving maternity benefits during pregnancy is an index of an underprivileged situation and a risk factor for pregnancy outcome.

Age Factors↗
PubMed1991

Effect of angiotensin II on cytosolic free calcium in neonatal rat cardiomyocytes.

The effect of angiotensin II (ANG II) on cytosolic free Ca2+ concentration ([Ca2+]i) was studied in cultured neonatal rat ventricular myocytes. [Ca2+]i was estimated in groups of one to three cells by dual-wavelength microfluorometry or in cell populations using conventional fluorometry. ANG II (10(-8) M) produced an acute short-lived increase over the control basal diastolic [Ca2+]i and increased the frequency of the [Ca2+]i transients. The amplitude of the [Ca2+]i transients was decreased to 64.4% of basal values. The effect of ANG II on [Ca2+]i was blocked by the selective AT1 receptor subtype antagonist Du Pont 753 but not by the AT2 antagonist PD 123319. Removal of extracellular Ca2+ or blockade of voltage-gated Ca2+ channels in cells cultured for 5-7 days abolished the [Ca2+]i transients, but only partially diminished the effect of ANG II on [Ca2+]i. Thapsigargin, an inhibitor of sarcoplasmic reticulum Ca(2+)-Mg(2+)-ATPase, reduced or abolished the [Ca2+]i response to ANG II. Phorbol 12-myristate 13-acetate (PMA), 10(-6) and 10(-7) M, also decreased the amplitude of the Ca2+ transients similar to ANG II. Pretreatment with 10(-6) M PMA or 10(-6) M 1-oleoyl-2-acetyl-glycerol (OAG) inhibited the initial rise in [Ca2+]i and the Ca2+ transients. Thus ANG II produces an acute rise in [Ca2+]i which is derived predominantly from sarcoplasmic reticulum intracellular stores. This acute effect is followed by a significant reduction in the amplitude for the Ca2+ transient and may be mediated by activation of protein kinase C.

Angiotensin II↗
PubMed1991

[Psychological and social evaluation].

The purpose of psychological and social assessment of health programs is the measurement of psychological well-being and lifestyle in targeted populations (i.e. pregnant women, mothers, children or teenagers) and interactive effects on other family members. A psychological and social evaluation should contain the following elements: social and/or cultural factors that facilitate participation in a health program, the opinion of and satisfaction with the program, the psychological and social consequences of the program. Three types of tools can be utilized to measure psychological and social indicators: standardized questionnaires, questionnaires designed specifically for the study in question, and interviews. Study protocols, data collection and analyses must be done using the same methods as those used in any other type of medical evaluation. The investigator must be particularly sensitive to the quality of the measurement tools, the size of the sample and the effects of confounding factors. Social and psychological aspects are essential in the evaluation of a health program. On the one hand, they allow for an understanding of how a health program is accepted and applied within a population. On the other hand, they enable the verification of whether or not there has been any change in the quality of life among individuals and their families.

Adult↗
PubMed1991

[Evaluation of screening programs].

This paper discusses the specific aspects involved in the assessment of screening programmes, compared to the assessment of other types of public health interventions. Screening programmes are aimed at healthy asymptomatic individuals, who, in case of a positive test, will be exposed to subsequent investigations or treatments. This paper stresses upon the several aspects to be taken into consideration when assessing the potential benefits and hazards of a screening programme, especially in order to limit hazards linked to false positive results: predictive value of the test according to its diagnostic value and the disease prevalence, existence of effective "treatments" in case of positive test. It underlines the need for adequate methods to evaluate positive and negative health effects, and psychological and social consequences.

Anxiety↗
PubMed1990

Stromal influences on transformation of human mammary epithelial cells overexpressing c-myc and SV40T.

The proto-oncogene c-myc and the oncogene SV40T, both of which have been implicated in the process of cellular immortalization in vitro, have been introduced via amphotropic retroviral expression vectors into the human mammary epithelial cell (HMEC) line 184A1N4 (A1N4). Two stable cell lines were established by growth in selective medium and were found to overexpress either c-myc (A1N4-myc) or SV40T antigen (A1N4-T). Neither the A1N4, A1N4-myc, or A1N4-T cells will grow in soft agar or form tumors in nude mice. However, A1N4-T or A1N4-myc cells, but not the parental A1N4 cells, form colonies in soft agar in response to either epidermal growth factor (EGF), transforming growth factor alpha (TGF alpha), or basic fibroblast growth factor (bFGF). Like EGF and TGF alpha, bFGF is moderately mitogenic for the anchorage-dependent growth (ADG) of all three cell lines. Further, co-cultivation of A1N4-T or A1N4-myc cells with primary diploid mammary fibroblasts can also induce the anchorage-independent growth (AIG) and stimulate the ADG of A1N4-T or A1N4-myc. In addition, conditioned medium obtained from these mammary fibroblasts also stimulated the AIG of the A1N4-T and A1N4-myc cells and was found to contain immunoreactive TGF alpha and bioactive FGF. The mammary fibroblasts express specific mRNA transcripts for bFGF and acidic FGF (aFGF). These results suggest that growth factors such as TFG alpha or FGF, which may be derived from the adjacent mammary stroma, might influence in a paracrine manner the phenotypic characteristics of a population of human mammary epithelial cells toward transformation.

Agar↗
PubMed1990

Prediction of preterm delivery: is it substantially improved by routine vaginal examinations?

The ability of routine vaginal examinations to improve the prediction of preterm delivery was assessed in a group of 6909 women who were registered at each prenatal visit and on whom this examination had been carried out. We compared two risk scores, one including known risk factors (maternal characteristics and symptoms reported by women), and the other including these factors and the findings of vaginal examination. These risk scores were computed by multiplying the adjusted odds ratio estimations obtained by logistic regressions. The prediction of preterm delivery was improved significantly by vaginal examination at 25 to 28 weeks' and 29 to 31 weeks' gestation. However, the improvement was not very large: when 30% of nulliparous women were classified as high risk at 29 to 31 weeks, the sensitivity was 55% when considering only the risk factors and 63% when adding the findings of vaginal examination; the percentages were 52% and 55%, respectively, for parous women. These results partially explain why the medical practice of routine vaginal examinations varies from country to country.

Adolescent↗
PubMed1990

Structural factors modulate the activity of antigenic poliovirus sequences expressed on hybrid hepatitis B surface antigen particles.

We have studied the functional expression of antigenic poliovirus fragments carried by various hybrid hepatitis B surface antigen (HBsAg) particles. Several constructions were made by using two different insertion sites in the HBsAg molecule (amino acid positions 50 and 113) and two different sequences, one derived from poliovirus type 1 (PV-1) and the other from PV-2. The inserted fragments each encompassed residues 93 to 103 of the capsid protein VP1, a segment which includes the linear part of the neutralization antigenic site 1 of the poliovirus. The antigenicity and immunogenicity of the hybrid particles were evaluated and compared in terms of poliovirus neutralization. A high level of antigenic and immunogenic activity of the PV-1 fragment was obtained by insertion at position 113 but not at position 50 of HBsAg. However, a cooperative effect was observed when two PV-1 fragments were inserted at both positions of the same HBsAg molecule. Antibodies elicited by the PV-2 fragment inserted at amino acid position 113 did not bind or neutralize the corresponding poliovirus strain. They did, however, bind a chimeric poliovirus in which the homologous antigenic fragment of PV-1 had been replaced by that of PV-2. The only virions that were neutralized by these antibodies were certain mutants carrying amino acid substitutions within the PV-2 fragment. These results show that position, constraints from the carrier protein, and nature of the inserted sequences are critically important in favoring or limiting the expression of antigenic fragments as viral neutralization immunogens.

Amino Acid Sequence↗
PubMed1990

Inverse relationship between glucose metabolism and glucose-induced insulin secretion in rat insulinoma cells.

Slowly growing X-ray-induced rat insulinomas and derived cell lines have been used as a model system for glucose-induced insulin release. During perfusions of tumors transplanted under the kidney capsule, the carbohydrates glucose and D-glyceraldehyde increased insulin secretion. These stimuli and the amino acids leucine and alanine also provoked insulin release in freshly isolated tumor cells. Under these conditions, glucose utilization had a Km of 4.6 mM and maximal velocity of 0.9 nmol/min/10(6) cells. A continuous cell line was established from such a preparation. In culture, glucose-induced insulin secretion was no longer detectable while responses to D-glyceraldehyde and amino acids were retained. Glucose metabolism in the cell line showed a decrease in Km to 0.7 mM glucose and an increased maximal velocity of 1.4 nmol/min/10(6) cells. Attempts to revert these alterations were undertaken using glucose-deficient culture medium to diminish glycolytic flux. Basal insulin release was lowered, while the growth pattern of the cells remained unchanged. Another approach involved the use of sodium butyrate which has been demonstrated to promote differentiation in other cell systems. Whereas sodium butyrate markedly increased cellular insulin content, the secretory responses were not improved. These results provide evidence that the loss of glucose-induced insulin secretion is paralleled by alterations in glucose metabolism.

Animals↗
PubMed1990

Effect of maternal and fetal characteristics on diagnosis of intrauterine growth retardation.

We studied the fetal and maternal characteristics that affect the diagnosis of intrauterine growth retardation and lead to variations in the sensitivity, specificity and predictive values. The population comprised the 18,166 women who consulted and delivered in two teaching hospitals in Paris from 1978 to 1983. Specificity was lower when a child was born before 37 weeks, with a small weight-for-gestational age, and when the mother had experienced complications during either her obstetric history or current pregnancy. Conversely, sensitivity was higher when these maternal and fetal characteristics were present. Positive predictive values rose in the presence of a risk factor for small-for-dates, but the rise was smaller than would have been expected if sensitivity and specificity had remained at the levels observed in the low-risk group.

Birth Weight↗
PubMed1990

Efficient induction of focus formation in a subclone of NIH3T3 cells by c-myc and its inhibition by serum and by growth factors.

In both experimental and spontaneous tumors, c-myc expression is often enhanced following its amplification or its rearrangement adjacent to a strong promotor/enhancer. However, c-myc by itself does not induce foci efficiently in fibroblast cultures. The effect of high levels of c-myc expression from a retroviral construct was investigated in several rodent fibroblast cell lines grown in medium containing 10% fetal calf serum or in serum-free PC-1 medium. c-myc-infected NIH3T3 clone 7 cells exhibited efficient quantitative focus formation when grown in PC-1 medium, whereas foci were not detected when grown in serum-supplemented medium. NIH3T3 clone 7 was the only cell line found to be sensitive to c-myc; other clones of NIH3T3 or other rodent fibroblast cell lines proved to be resistant to c-myc focus formation. At least two major types of morphologically distinct c-myc-induced foci were observed; the first was similar to ras-transformed foci induced in NIH3T3 and other fibroblast cell lines, and the second type was composed of adipocyte-like cells similar to NIH3T3 L1 cells. The c-myc infected cells cloned from these two types of foci expressed high levels of retrovirus-derived c-myc RNA and exhibited elevated levels of immunoreactive myc protein, as detected by immunofluorescent staining with an anti-myc polyclonal antibody. c-myc-transformed clones displayed only a limited ability to grow in soft-agar in the presence of serum and were not tumorigenic in nude mice. Focus formation by c-myc was quantitatively inhibited by the addition of interferon alpha + beta (INF alpha, beta), tumor necrosis factor alpha (TNF alpha) or transforming growth factor beta 1 (TGF beta 1) to the serum-free PC-1 medium, and, in correlation, NIH3T3 clone 7 cells produced the lowest level of endogenous TGF beta of the various cell lines tested.

Animals↗
PubMed1989

Ultrasound in obstetrics: do the published evaluative studies justify its routine use?

A review of surveys assessing the use of ultrasound in obstetrics was undertaken to determine why this examination has spread so rapidly. Seven randomized controlled trials (RCTs) published to date as well as 182 papers published in four obstetric journals between 1979 and 1984 were reviewed. The value of routine ultrasound scanning to improve the diagnosis of intrauterine growth retardation or gestational age was demonstrated in the RCTs, but the results of the RCTs measuring the effects on health of this screening procedure did not give strong evidence for its routine use. Of the 182 papers identified, 137 were related to the diagnostic assessment of ultrasound, 14 concerned the effects on medical practice and only nine papers studied the effects of ultrasound scanning on health. Most of these 137 papers came out in favour of this procedure. Thus the spread of ultrasound scanning was based mainly on evaluative surveys which assessed its diagnostic value.

Evaluation Studies as Topic↗