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Biomedical subjects

C Colette

Publications and source records attributed to C Colette.

At least 55 records · Page 3Linked to original sources

[The reduction of prematurity by telephone follow-up].

Twice-daily check-up of the uterine contractions by the pregnant women is a recognized and accepted necessity. Using the "green" free-phone number to report the number of contractions, to answer the questions asked and to receive the instructions given has made it possible to reduce the prematurity rate and the duration of the consequent specific hospitalization. This new method of follow-up, applied to two identically recruited groups of pregnancies offers an undeniable low-cost improvement over the systems used previously.

Female↗

[Diagnosis of ovular infection associated with premature rupture of the membranes].

Premature breaking of the membranes carries with it a serious risk of immediate or delayed ovular infection which compromises the prognosis. No diagnostic test with an acceptable error level was available to reduce the morbidity and mortality, in particular prior to 37 weeks of amenorrhea. The oligoamnios which accompanies the rupture increases the accuracy of the tocokinetic diagnosis, thus permitting a new and rigorous treatment in function of the stage of the pregnancy and the possibility of artificially inducing labor.

Chorioamnionitis↗

[Artificially induced labor. Experience of the maternity unit of the Besançon teaching hospital].

The authors describe 190 cases in which labor was artificially induced between 29 and 42 weeks. They compare different methods (120 induced by oxytocin-like agents, 70 by prostaglandins) in some cases associated with mechanical methods. Various parameters were investigated, notably the Bishop score at the time labor was induced, the method of delivery and the impact on the offspring of these techniques.

Apgar Score↗

[How to reduce the number of cesareans in teaching hospitals?].

The authors analyze their indications for cesareans for the year 1989, stressing the possibility of doing fewer. They carry out a critical analysis of the various indications by comparing them with literature data. Thus, 157 of the 2,055 deliveries are described, or 7.60 percent.

Cesarean Section↗

[Consequences of a deliberate fluctuation in the number of episiotomies].

The indications for episiotomy have been considerably extended until it has become a virtually routine operation in primiparous mothers and for previously incised multiparous women. These excesses must be clearly demonstrated. For one year, a policy of persuasion was applied: by comparing the results, it was obvious that a reduction in the number of episiotomies was accompanied by an increase in the number of intact perinea with non increase in the incidence of serious tears. The restriction of the indications should be continued in the light of recent studies.

Episiotomy↗

[Tocokinetics of infected newborn infants].

The diagnosis of fetal infection, other than in association with premature rupture of the membranes, requires the evaluation of various parameters. Children suspected are four to five times greater in number than those truly threatened. A new and important parameter has emerged as a result of tocokinetic investigation: in one case out of two 48 hours before birth and in three cases out of four during the day before birth, fetal motility, together with cardiac reactivity or not, appear to be very markedly decreased when the newborn will in fact be found to be infected. Tocokinetic study is thus a new source of help in the obstetric/pediatric decisions which must be taken in this context.

Fetal Diseases↗

[Clinostatic variations of the lumbosacral spine and obstetrical mechanics].

An X-ray study of the lumbar spine after childbirth in 2 groups of patients (one control group and one group with engagement dystocia) picked up one difference between the groups. The patients who gave birth spontaneously, presented with hyperlordosis which was relieved when lying down. In contrast, the patients who had presented engagement dystocia, presented with hyperlordosis which was aggravated when lying down.

Adult↗

[Influence of the initial treatment of endometriosis and results obtained by in-vitro fertilization].

The authors have investigated the results obtained by in-vitro fertilization in cases of pelvic endometriosis. Fifty-eight (58) stimulation cycles have been analyzed in function of the previous curative treatment, which may have been a combine medico-surgical treatment or a conventional surgical treatment. Six pregnancies which progressed to full term were achieved in the 8 patients who had previously received medico-surgical treatment. Twenty punctures were performed. In patients who received an initial medical treatment, there were no pregnancies carried to full term and three clinical terminations of pregnancy for a total of 15 punctures. A celioscopy check-up revealed persistent endometriosis in 10 of the patients involved. No clinical pregnancy was observed following primary surgical treatment. In all these cases, there were lesions affecting the ovary and the numbers of ovocytes and embryos were significantly reduced.

Adult↗

Structural abnormality in LDL from diabetic patients as revealed by resonance Raman spectroscopy.

Resonance Raman spectra of low-density lipoprotein (LDL) isolated from the plasma of diabetic patients (age range 13-77 yr, mean age 37 yr) and age- and sex-matched control subjects were recorded in the 1000- to 1600-cm-1 region as a function of temperature (0-50 degrees C). Both nondiabetic and diabetic LDL yield spectra characterized by two major bands near 1160 and 1530 cm-1 due to the carotenoid component of lipoproteins. The relative intensity of 1530- and 1160-cm-1 bands, assigned to -C = C- and = C-C = stretchings, respectively, i.e., I1530-I1160 ratio, was plotted against temperature. For nondiabetic control subjects, the plots showed an inflection in the temperature range of 30-39 degrees C, which corresponded to the thermal transition of LDL. This transition was abolished in the LDL of diabetic patients (P less than 0.001), suggesting an altered lipid structure. The transition (30-39 degrees C) was also abolished in the in vitro glycosylated nondiabetic LDL. Lipid analysis did not show any appreciable change between nondiabetic control subjects and diabetic patients. The change in the thermal transition properties of diabetic LDL has been attributed to the organizational change in the LDL protein.

Adolescent↗

Vitamin D metabolism in psoriasis before and after phototherapy.

Epidermis plays a major role in vitamin D synthesis and is a target tissue for 1,25 (OH)2 vitamin D, which could be involved in abnormal proliferation and differentiation of psoriatic keratinocytes. We investigated plasma calcium, phosphorus, alkaline phosphatases, parathyroid hormone, 25 (OH) D, 24,25 (OH)2 D and 1,25 (OH)2 D in 15 control subjects and 20 psoriatic patients before and after 3 weeks of phototherapy (UVB or PUVA). Before irradiation, all parameters were similar in psoriatics and controls, except for serum phosphorus (lower in psoriasis p less than 0.01). After phototherapy, P rose to normal values in psoriatic patients; 25 (OH) D and 24,25 (OH)2 D were dramatically increased by UVB (but not by PUVA) in psoriatic patients as well as in controls; 1,25 (OH)2 D was unmodified in controls but was significantly increased in psoriasis. Since 1,25 (OH)2 D has been reported to be an effective treatment for psoriasis, the UV-induced increase in 1,25 (OH)2 D could account for the beneficial effect of phototherapy in psoriasis.

24,25-Dihydroxyvitamin D 3↗

[Comparative study of 2 protocols for antibiotic therapy. Maternal-fetal non-specific bacterial infections during labor].

Two protocols for prophylaxis by antibiotics in labour were compared to see how effective they were in preventing materno-fetal infection in patients who had signs of chorio-amnionitis. There was in increase in E. coli infections in 40% of liquor which were resistant to amoxycillin which had been used right up to now. 135 cases of patients who had received antibiotic treatment in labour were studied. 61 of these were treated with amoxycillin and 74 with piperacillin. The results show that there was a drop of 11.05% in the number of newborns who were infected in the group of patients who were treated with piperacillin. It was not possible using piperacillin to avoid all infections of the mother and fetus. The severity of the infection in the fetus, as judged by the Apgar score and the opinion of the paediatricians, was less serious in the group that was treated with piperacillin. The death rate for both groups was identical: one in each group. Both were caused by E. coli infections. A drop of 11% in post partum maternal infections was noted. Its was shown that piperacillin was more efficacious, but this way of preventing of infections in the mother and fetus lay in finding as early as possible the situation that could increase the risk of infection.

Amoxicillin↗

Failure to achieve tight control of plasma cholesterol and apolipoprotein B with intraperitoneal insulin infusion in type 1 diabetes.

The best route of insulin administration by infusion pumps remains a subject of controversy. For that reason plasma lipids and apolipoproteins were compared in three groups of nine patients who had been treated for several months or years with conventional treatment (group I), continuous subcutaneous insulin infusion (CSII, group II) or continuous intraperitoneal insulin infusion (CPII, group III). Plasma cholesterol and apolipoprotein B remained increased on CPII compared with CSII even when similar satisfactory or even tight diabetic control was achieved with both techniques. This study suggests that cholesterol and perhaps apolipoprotein B biosynthesis by the liver is increased in patients treated with CPII compared to those treated with CSII.

Adult↗

Intestinal adaptation in patients with short bowel syndrome. Measurement by calcium absorption.

Functional adaptation of remaining intestine was evaluated in 30 patients with extensive small bowel resection. Calcium and xylose absorption tests were compared. Calcium absorption was measured by a double-radiotracer technique. Serum xylosemia was measured 2 hr after D-xylose ingestion. Patients were divided into two groups according to the time interval between surgery and evaluation: less (group I) or more (group II) than two years. A statistically significant correlation was found between xylosemia and remaining small bowel length (r = 0.71; P less than 0.001) and between calcium absorption and remaining small bowel length (r = 0.75; P less than 0.001) in group I. A significant correlation was also observed between calcium absorption and time after surgery (r = 0.65; P = 0.001) but not for xylose absorption. Calcium absorption value was significantly increased in group II patients compared with group I patients matched for remaining small bowel length (36.2 +/- 12.5% vs 14.5 +/- 9.1%; P less than 0.001) while no difference was observed between the two groups concerning xylose absorption. These data indicate that intestinal calcium absorption continues to increase for more than two years after a major bowel resection in man. The intestine does not seem to recover all its functions at the same time.

Adaptation, Physiological↗

Effect of different insulin administration modalities on vitamin D metabolism of insulin-dependent diabetic patients.

The vitamin D status of IDDs was studied in 3 groups of patients who were treated for several months with (i) conventional insulin therapy (group I, n = 17, HbA1 = 10.1 +/- 0.5%); (ii) continuous subcutaneous insulin infusion (CSII, group II, n = 11, HbA1 = 8.9 +/- 0.6%); and (iii) continuous intraperitoneal insulin infusion (CPII, group III, n = 13, HbA1 = 8.0 +/- 0.4%). In all patient groups the plasma concentration of vitamin D metabolites were within normal range. However plasma 25 OH D (ng/ml) was significantly lower in groups I (13.0 +/- 0.8, P less than 0.01) and II (12.5 +/- 1.5, P less than 0.02) than in group III: 22.1 +/- 2.3 (normal range 7-27). Plasma 24,25-(OH)2D (ng/ml) was positively correlated to plasma 25 OH D and was significantly decreased in groups I (1.5 +/- 0.2, P less than 0.05) and II (1.4 +/- 0.2, P less than 0.05) compared with group III: 2.3 +/- 0.3. No significant differences were found in plasma 1,25-(OH)2D between the three groups of diabetics. Plasma PTH was similar in the three groups. The same differences in plasma 25 OH D were observed between the patients treated with CPII and 15 subcutaneously treated patients matched for diabetic control (HbA1 less than 10 per cent). The present results seem to indicate that insulin might have a stimulatory effect on the hepatic 25 hydroxylase activity.

Adult↗

Platelet function in type I diabetes: effects of supplementation with large doses of vitamin E.

Nine Type I diabetic patients were randomized to a double-blind therapeutic trial divided into two study periods of 35 d with either 1 g vitamin E/d or a placebo. Platelet function was estimated at baseline and after treatment from ADP-induced platelet aggregation tests and from generation of oxidative products (TXB2, 12 HETE, and malondialdehyde) after platelet stimulation by 14C arachidonic acid. Platelet function, plasma lipids, and apoproteins were similar before both treatment periods. The vitamin E treatment resulted in 1) diminution of platelet aggregation with ADP 2.5 microM (56 +/- 4 vs 47 +/- 4 cm2, p = 0.05) and 5 microM (70 +/- 5 vs 57 +/- 4 cm2, p less than 0.01); 2) diminution of malondialdehyde release from platelets (6.4 +/- 0.5 vs 5.0 +/- 0.7 nmol/10(9) platelets, p less than 0.02); and 3) diminution in the percentage of 14C TXB2 (38.1 +/- 2.8 vs 33.3 +/- 3.0%, p less than 0.05). No significant changes were observed on placebo. Results indicate that high doses of vitamin E diminish ADP-induced platelet aggregation in Type I diabetic patients and suggest that this effect is partly mediated through a diminution of the cyclooxygenase activity.

Adult↗

Enteral absorption in man of eicosapentaenoic acid in different chemical forms.

After administering the equivalent of 1 g of eicosapentaenoic acid (EPA) in four different chemical forms, the kinetics of EPA incorporation into plasma triglycerides (TG) were compared by gas liquid chromatography on a capillary column following separation of the lipid fraction by thin layer chromatography. EPA incorporation into plasma TG was markedly smaller and later when EPA was administered as an ethyl ester rather than as EPA free fatty acid, EPA arginine salt or 1,3-dioctanoyl-2-eicosapentaenoyl glycerol (2-EPA). Our results and the data in the literature are compatible with the hypothesis that 2-EPA is absorbed with minimum hydrolysis and escapes random distribution between the other positions of the glycerol molecule during the absorption process.

Adult↗

Calcium absorption in corticoid treated subjects effects of a single oral dose of calcitriol.

We compared the fractional absorption of calcium (FACa, 6 h, % TD) and the radiocalcium transit (% TD per min) in seven glucocorticoid-treated patients (10-25 mg prednisolone per day) and in seven normal subjects, in the basal state and 12 h after an oral dose of synthetic 1,25-(OH)2D (3 micrograms). In the basal state, the radiocalcium transit was significantly decreased (P less than 0.02) at 15 min in patients treated with prednisolone, but FACa at 6 h was not significantly decreased (51 +/- 5 vs. 60 +/- 5% TD). 12 h after an oral dose of 1,25-(OH)2D which resulted in supraphysiologic plasma levels, FACa increased significantly (P less than 0.02) in both groups but the peak absorption rate of Ca remained lower in the corticoid-treated patients than in controls (P less than 0.02). The results suggest that glucocorticoids decrease the 1,25-(OH)2D-dependent transport of calcium across the proximal small intestine.

Aged↗