PubMed Health⌕ Search

Biomedical subjects

C Hocke

Publications and source records attributed to C Hocke.

12 recordsLinked to original sources
PubMed1995

Prospective cohort study of the effect of pregnancy on the progression of human immunodeficiency virus infection. The Groupe d'Epidémiologie Clinique Du SIDA en Aquitaine.

OBJECTIVE: To study the prognostic role of pregnancy on the progression of human immunodeficiency virus (HIV) infection. METHODS: In a prospective cohort study at the Bordeaux University Hospital, France, 57 women who completed a pregnancy during the course of their HIV infection were compared with 114 HIV-infected women who never conceived. The two groups were matched on CD4 lymphocyte count (CD4), age, and year of HIV diagnosis. The main outcome measures were death, occurrence of a first AIDS-defining event, and drop of the CD4 below 200/mm3. RESULTS: The mean follow-up period in pregnant women was 61 months from HIV diagnosis (median CD4 at entry 455/mm3) and 54 months from beginning of pregnancy. Nonpregnant women were followed-up for 50 months since HIV diagnosis (median CD4 460/mm3). The proportion of asymptomatic women at entry in the study was 51 of 57 (90%) in pregnant and 87 of 114 (76%) in nonpregnant women. No significant difference was observed between the two groups with regard to the different end points studied, even after adjustment for other prognostic variables. Adjusted hazard ratios (pregnant/nonpregnant) were 0.92 for death (95% confidence interval [CI] 0.40-2.12), 1.02 for occurrence of a first AIDS-defining event (95% CI 0.48-2.18), and 1.20 for drop of the CD4 to less than 200/mm3 (95% CI 0.63-2.27). CONCLUSION: In a cohort of HIV-infected women with mild to moderate immunosuppression, pregnancy did not accelerate progression to AIDS or death.

Adolescent↗
PubMed1995

[Thromboembolism and ovarian hyperstimulation].

Three new cases of thromboembolic accidents involving the superior vena cave were associated with ovarian hyperstimulation and multiple pregnancy. On the basis of a review of the literature, three syndromes were individualized. First embolic arteries are infrequent and serious with an important morbidity; low doses of gonadotrophines is sufficient for causing this pathology. Second, thrombosis of the superior vena cava is late, during in vitro fertilization regimens with GnRH analogs complicated with serious hyperstimulation (degree III). Third, pregnancy is always present; pulmonary complications are very uncommon. Thrombosis of inferior vena cava is late, pregnancy is often present but women are frequently at risk of thromboembolic accident. Prevention of hyperstimulation is important. When present, HBPM is recommended for prevention of thromboembolism. Diagnostic of thrombosis is made with clinical examination and morphologic complementary exams such colour-vascular Doppler and magnetic resonance imaging. Curative treatment requires heparinization.

Adult↗
PubMed1994

[Evaluation of 3 diagnostic methods in premature rupture of membranes: diamine-oxidase assay, alpha-fetoprotein assay, colorimetric method evaluating the pH].

The authors set out to assess the three diagnostic methods available which can detect early breaking of the membranes: radio-enzymatic assay of diamine-oxidase (DAO), radioenzymatic assay of alpha-fetoprotein (AFP), colorimetric method for determining pH (Amnicator). Between June 1991 and March 1992, 114 samples of vaginal secretions were taken from 104 pregnant patients being followed up at Maternity Unit A, Bordeaux (France). The results of the assays were expressed in quantitative terms (microU/ml for DAO and ng/ml for AFP); ROC (Receiver Operating Characteristic) curves were used to determine the positivity threshold in terms of the sensitivity and specificity (20 microU/ml for DAO and 15 ng/ml for AFP). The sensitivity of the pH test was 97.5%, which was significantly better than that of DAO (90.2%) and even that of AFP (82.9%). However, there was no difference between the specificities of the pH, DAO and AFP tests (93.3%, 96.6% and 93.5% respectively). The data were compared with those in the literature. The problems in collecting the vaginal secretions probably accounts for the better results of the colorimetric test. This is a reliable, fast and easily reproducible test; these qualities make it the preferred test in EBM, and it can be completed using a radioenzymatic method (DAO) or immunoradiometric test (AFP).

Adult↗
PubMed1993

[Prognostic role of pregnancy on the course of HIV infection: a retrospective cohort study (1985-92)].

In a hospital-based cohort study of HIV-infected patients, we compare the progression of the disease (occurrence of CDC group IV, death, decline of CD4 below 200/mm3) between 55 women with delivery and 89 matched control HIV positive women with no history of pregnancy. After a mean follow-up of three years, no significant difference was observed between the two groups even after adjustment on prognostic variables.

Cohort Studies↗
PubMed1992

[Induction in the scarred uterus].

Labor was induced in 41 women with uterine scarring and a fetus in the cephalic presentation and normal pelvis size. Due to various problems, these patients would have had to undergo cesarean section if this alternative had not been attempted. The use of prostaglandins E2 to increase maturation of the cervix, of Syntocinon and peridural analgesia made it possible to obtain delivery through the genital tract in 24 cases with the same level of fetal morbidity as for the babies delivered by cesarean.

Analgesia, Epidural↗
PubMed1991

[Use of etilefrin as local vasoconstrictor in lower gynecologic surgery ].

In this randomized prospective study the authors have compared the effectiveness and side-effects of two local vasoconstrictor agents, etilefrine (Effortil) and ornithine 8 vasopressin (Por 8) in vaginal gynaecological surgery. Thirty-three patients entered the trial and were divided into two groups: G1 (15 patients) received Effortil, and G2 (18 patients) received Por 8. The products, administered at random, were diluted in saline 40 ml and injected into the cervix through 6 points. A 3-minute interval was allowed between injection and incision. The results were assessed on the basis of trans- and postoperative haemorrhage and haemodynamic variations. Palor of the cervix was achieved after 3 minutes in both groups; moderate bleeding was observed in only one of the G1 patients. Postoperative renewal of packing was necessary in 2 patients in G1 and 4 patients in G2. No electrocardiographic anomaly was recorded in any of the two groups. Diastolic BP was significantly higher in G2 than in G1 (P less than 0.002, Fisher test). Systolic BP was also elevated in that group (P less than 0.03, chi 2 test). Moderate reduction in heart rate was observed in both groups (P less than 0.3, Fischer test), but severe (48 beats/min) bradycardia was noted in one G2 patient.

Adult↗
PubMed1989

[Another case of Sertoli-Leydig cell ovarian tumor (arrhenoblastoma). Review of the literature].

In reporting another case of Sertoli-Leydig cell tumor (SLCT) treated by conservative management, the principal characteristics of these tumors are reviewed and a general review is made: SLCT (arrhenoblastomas) are rare endocrine tumors (1 p. cent of tumors of the ovary). They most frequently occur in young women, are unilateral in 98 p cent of cases, and are manifest after a long period by endocrine signs (75 p. cent of cases) whose most frequent combination is: amenorrhea-hirsutism-hoarse voice. They are classified in four histological types which have different prognoses. Their potential development varies and is variously assessed: these are tumors with a low incidence of malignancy (mean 18 p. cent). Under certain conditions, this permits the institution of conservative therapy conserving future fertility. Malignant types of tumors are treated in the same way as other malignant ovarian tumors: surgery is the main tool; radiotherapy is often insufficient and chemotherapy often provides remission more frequently than cure (80 p. cent 5 year survival).

Adult↗
PubMed1985

[Conservative loco-regional treatment of soft tissue sarcoma in adults after induction chemotherapy].

Between June, 1979 and December, 1983, 23 adult patients with non-metastatic soft tissue sarcoma were treated with induction chemotherapy since local spread precluded primary conservative surgery. Eighteen patients received a combined cyclophosphamide, vincristine, adriamycin and dacarbazine treatment and 5, a combined adriamycin, cis-platinum and vindesine treatment. Both drug combinations exhibited toxic effects, notably on blood and digestive tract. However, tumoral volume was reduced by 50 p. cent or more in 14/23 patients, including 2 complete remissions; the course of the disease remained unchanged under treatment in only 3 cases. Chemotherapy facilitated surgical excision in 14 patients, and subsequent radiotherapy resulted in complete remission in 13 of these. None of the 13 patients relapsed during a mean follow-up period of 12 months (range: 3 to 48 months). Among the 9 patients who could not be operated upon, 5 benefited from radiotherapy with satisfactory local control, but only one still remains in complete remission. Thus, induction chemotherapy made it possible to achieve local control in two-thirds of patients with locally advanced sarcoma. However, a more prolonged follow-up is necessary to confirm that these results are long-lasting and to determine the effects of chemotherapy, if any, on the metastatic potential of these tumours.

Adult↗
PubMed1985

Analysis of a series of sixty soft tissue sarcomas in adults treated with a cyclophosphamide-vincristine-adriamycin-dacarbazine (CYVADIC) combination.

From 1976 to 1983, a group of 60 adult patients presenting with metastatic and/or locally advanced soft tissue sarcomas was treated with combination chemotherapy consisting in cyclophosphamide, vincristine, adriamycin, and DTIC (CYVADIC). A tumor response was obtained for 29 patients (48.3%), with 4 (6.7%) cases of complete regression. The median duration of the response was 10 months. Responses were noted in 14/22 patients receiving induction chemotherapy for advanced, and previously nonirradiated, primary tumors; among the patients with metastatic disease tumor regression was recorded in 17/32 patients with pulmonary metastases, but in none of the patients with metastases at other sites. Moreover, the attainment of a response was found to correlated with the patient's general condition, while response duration depended on the histoprognostic grade of the tumors.

Adolescent↗