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Biomedical subjects

D Dargent

Publications and source records attributed to D Dargent.

At least 109 records · Page 6Linked to original sources
PubMed1984

[Polycystic ovaries. Round table].

Because of the variety and inconstancy of the clinical symptoms, it is difficult to establish a classification of the clinical forms. However, the laboratory profile, essentially a raised serum LH, is fairly constant in every case. The pathophysiology of the disequilibrium of androgen and gonadotrophin secretion can be explained on the basis of various initial functional abnormalities, such as an excess of adrenal androgens or LH or, conversely, a deficiency of FSH. Cystic disease is very common in veterinary medicine and presents a number of specific features. The treatment of polycystic ovaries depends on the symptoms (hirsutism, amenorrhea, sterility). In the case of sterility, inducers of ovulation are effective, but are very difficult to manipulate. A number of authors propose surgical excision (removal of the larger of the two ovaries).

Adrenal Cortex Hormones↗
PubMed1983

[Value of differential cytology in the diagnosis of preclinical forms of cervix uteri cancer].

The value of "differential cytology" in the diagnosis of preclinical carcinoma of the cervix uteri was assessed from serial sections of operative specimens in a series of 452 patients. Although not absolute, this value was found to be considerable. Used to supplement colposcopy-guided biopsy, it makes it possible to decide on the therapeutic approach (notably simple destruction by laser) without having recourse to conization. However, the results are only valid for the team which presents them, and before deciding to treat intra-epithelial carcinomas by laser destruction, each team must perform the same "quality control".

Carcinoma↗
PubMed1981

[Prolapse after hysterectomy. A study of 45 cases (author's transl)].

The authors report 45 cases of prolapse occurring after hysterectomy (26 after subtotal hysterectomy, 9 after total abdominal hysterectomy and 10 after total vaginal hysterectomy). These prolapses are rare and their incidence does not seem to vary with the type of hysterectomy that preceded them. although in some cases hysterectomy could be incriminated as the cause of the prolapse, in the majority of cases the reason was a prolapse that had been neglected when the hysterectomy had been carried out, or a prolapse that appeared a long time after hysterectomy because of the inevitable ageing of the supporting tissues of the pelvis. From the anatomical point of view it is important to distinguish those prolapses where the vaginal vault does not descend and those where there is total descent including the vault of the vagina. The prolapses give rise to difficult problems of therapy. The choice of operation has to take into account anatomical components of the prolapse, the functional repercussions, the urinary symptoms and whether the patient wishes to does not wish to continue sexual activity. If it is not necessary to keep the vagina open an operation that involves colpectomy or colpocervicectomy can give rise to very good anatomical and urinary results. When it is necessary to keep the vagina functioning as a vagina in the case of prolapse after subtotal hysterectomy, it is important to treat the case as though on was dealing with an ordinary prolapse. All the same, when dealing with procidentia it may be wiser to add a colpopexy procedure by the abdominal route. When dealing with a prolapse after total hysterectomy when the vaginal vault is in place, it is sufficient to carry out the usual form of perineal plastic operation general;y to obtain a good result, but when the vaginal vault has come down it is as well to carry out a colpopexy procedure by the abdominal route.

Adult↗
PubMed1981

[The risk of thrombo-embolism in pregnancy and in the post-partum period. A review of 28,828 pregnancies (author's transl)].

Looking through a retrospective study of 28,828 deliveries the authors have been able to work out the frequency of thrombo-embolic complications of pregnancy (1 per 1000) and of the post-partum (3.95 per 1000). It is possible to point to different risk factors. Some are well known, these are varicose veins, Caesarean section, maternal age above 35. Other factors that are usually considered to be aetiological now appear to be less significant. These are: a history of previous thrombo-embolic conditions and post-partum sterilization. To be added to the classic risk factors are inhibition of lactation which, whatever procedure is used, significantly raises the incidence of thrombo-embolic complications. It would seem to be desirable, in view of these different parameters, that a risk score should be drawn up which would allow for medical treatment to be given prophylactically in the patients who are particularly exposed to risk.

Age Factors↗
PubMed1980

[Vaginal hysterectomy. Our experience between the years 1970 to 1979 (556 operations) (author's transl)].

The authors present a series of 556 vaginal hysterectomies carried out between the 1st October 1970 and the 30th September 1979. In the same period they carried out 338 abdominal hysterectomies. The main complication of using the vaginal route consists of the higher incidence of post-operative sepsis. But it is possible to prevent this. The vaginal route, on the other hand has the obvious advantages of speed of operation, less operative trauma, and above all lowering of the risk of thrombo-embolic disease (0.3 per cent as against 1.7 per cent in other reported series).

Adult↗
PubMed1980

[Primary surgery in the treatment of stage I and "slight" stage II carcinoma of the cervix (author's transl)].

A group of 140 patients with stage I and "slight" stage II invasive carcinoma of the cervix undergoing surgery without prior irradiation between October 1st and October 31st 1978 is presented. The 5 year survival rate, taking into account the actual characteristics of the series, corresponded to the average usually found. Primary surgery makes it possible to limit indications for irradiation to cases where there exists either true infiltration of pelvic tissue or lymph node metastases which can be assessed only by examination of an operative specimen. It is thus also possible to avoid "radiotherapy menopause" in a large number of women (in 68 of the 81 patients aged less than 50 years in the present series).

Adult↗
PubMed1979

[Study with serial sectioning of 312 preclinical cancers of the uterine cervix. Indications for selective treatment (author's transl)].

The authors have studied by step serial sectioning 312 cervix the most obtained by cold knife conization. They have studied too, the frequency of inadequate resection (i.e. non in sano conization) and clinically occult invasion according to the age of patients. Conization is adequate for the treatment of 70 per cent of women less than 30 years of age. But after 50 it is sufficient in only 22 per cent of the patients. Conization must be performed in most cases of grade III to V cervical smear (according to Papanicolaou's classification). The cervical cone must be studied by serial sectioning (every 500 microns). According to the result of this study the treatment must be selected : conization for in situ carcinoma resected in sano, simple hysterectomy for in situ carcinoma not resected in situ and Wertheim type operation for invasive carcinoma.

Adult↗
PubMed1979

[Necrotising enterocolitis and pregnancy. One case (author's transl)].

Having had a case of necrotising enterocolitis which occured on the third day after delivery and which was successfully treated by total colectomy with secondary restoration of bowel continuity, the authors discuss the pathogenicity of this condition. It can be secondary to a haemorragic or a septic obstetrical complication. It may equally be the sequel of a functional paralytic ileus which, although rare, is one of the classical complications following labour and Caesarean operations. In this way it can be compared to those cases of enterocolitis which are secondary to ileus, such as are found in patients who have a tumour of the colon or in patients who have been treated with neuroleptic drugs.

Adult↗
PubMed1979

[The obstetrical future of women who have been operated on for uterine synechiae. 107 cases operated on (author's transl)].

The authors undertake to show that the obstetric future of women who have been operated on for uterine synechiae is not as poor as would appear from previous publications. 59 p. 100 of 75 women who wanted to become pregnant did so and 46 p. 100 went on to have at least one living child. If one only takes into account those women who were able to be followed up, 71 p. 100 became pregnant and 55 p. 100 had pregnancies with a viable child. When women with only uterine synechiae and without an associated lesion were considered, 81 p. 100 of them became pregnant and 67 p. 100 had a viable child. From this it is important to screen for an associated lesion by laparoscopy. The authors also write about the value of hysteroscopy carried out to find synechiae more easily and to control the treatment.

Adult↗
PubMed1979

[Grave obstetrical phlebitis. Physiopathology, diagnosis and treatment (6 case histories) (author's transl)].

The authors detail their concepts of the physiopathology, the diagnostic methods and the treatments of grave puerperal phlebitis, having seen six cases in their two departments recently. They consist of 5 cases of iliofemoral thrombosis, 2 of whom were diagnosed during their pregnancies and 3 others whom were diagnosed after delivery. One of these died of pulmonary embolus: and there was one case of thrombosis of the right ovarian vein during post-partum. Over and above the classical factors that predispose to this condition in pregnancy, the authors draw attention to the anatomical constitutional factors that have been observed by Cockett in the physiopathology of these cases. The diagnosis is made using non-invasive methods: Doppler, plethysmography, labelled fibrinogen and isotope phlebography after delivery, supplemented when the results are positive by radiography of the iliac and vena caval systems which alone gives a precise diagnosis of the site. Therapeutic possibilities change according to the time that the condition is perceived, according to the topography of the lesions, and according to the existence or non-existence of moving thrombi. The treatment is directed to avoiding the complications of emboli and to preventing secondary functional sequellae. Finally the gynaecological problems of contraception and of further pregnancies are considered.

Adolescent↗