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Biomedical subjects

F Courtois

Publications and source records attributed to F Courtois.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Programmed autologous transfusion in obstetrics. Blood samples in 100 patients in the last month of pregnancy].

OBJECTIVES: Evaluation (usefulness and safety) of programmed autologous transfusion in obstetrics. SITE. Blood Transfusion Centre, Hôpital Louis-Mourier, F 92700 Colombes. PATIENTS: Prospective study of 150 patients for whom blood withdrawal was planned during the last month of pregnancy. Entry criteria were either a risk of haemorrhage or persistent patient request. PROTOCOL: Two withdrawals were planned during the last month of pregnancy at the out-patient clinic at a one-week interval. The autologous units were transfused per-partum in case of haemorrhage and/or post-partum in case of anaemia. RESULTS: One hundred pregnant women entered the protocol (43 had a risk of haemorrhage). Both preplanned withdrawals were made in 60 of these patients. Per-partum transfusions were necessary in only 7 patients including 4/43 with a risk factor (9%) and 3/57 with no risk factor (5%). Post-partum transfusions were made in 22 other patients. Consequently, 117 of the 160 units collected were not used (73%). CONCLUSION: Despite good tolerance (5% incidence) due to the known problems in evaluating the risk of haemorrhage and the small percentage of patients without risk factors who were transfused per-partum, we have decided to reserve this protocol for patients with an authentically identified risk of haemorrhage (placenta praevia, cesarean section, uterine scar tissue).

Adult↗
PubMed1994

Telemetric monitoring of intracavernous pressure in freely moving rats during copulation.

Changes in intracavernous pressure (ICP) were recorded in freely moving rats by means of a catheter implanted in the corpus cavernosum and connected to a pressure transducer located subcutaneously. Intracavernous pressure changes and copulatory events (mounts, intromissions and ejaculations) were recorded during several overnight testing sessions with 12 rats in the presence of receptive females. Video recordings of sexual behavior in the implanted and nonimplanted rats revealed that the ICP device did not impair copulatory behavior. Comparison between copulatory behavior and ICP changes revealed that ICP profiles could identify the number of intromissions and ejaculations as well as the timing of these events. The results showed that during mounts, intromissions and ejaculations, ICP increases were 36.9 mm. Hg, 62 mm. Hg and 106.3 mm. Hg in 4 rats. The increases in ICP during mounts and intromissions appeared higher in sexually experienced as compared with sexually naive rats. These results demonstrate the reliability of the telemetric measurement of ICP in freely moving rats under natural physiological conditions. The model provides quantitative data for research on the neurophysiology of penile erection and evaluation of oral treatments for impotence.

Animals↗
PubMed1994

Detection and quantitation of serum HCV-RNA by branched DNA amplification in anti-HCV positive blood donors.

The detection of serum HCV-RNA needs to be standardized. The aim of this study was to assess the effectiveness of the branched DNA amplification method in detecting and quantitating serum HCV-RNA in 54 blood donors, 33 with and 21 without increased serum alanine aminotransferase levels and with detectable serum HCV-RNA by polymerase chain reaction. HCV-RNA was detected by branched DNA signal amplification in 42/54 (77%) of the blood donors. Positivity rates were not different among the 21 blood donors with normal and the 33 blood donors with increased serum alanine aminotransferase levels (86% and 76%, respectively). Median serum HCV-RNA levels were not different among donors with or without increased serum alanine aminotransferase levels (28.6 x 10(5) Eq/ml and 14.7 x 10(5) Eq/ml, respectively). There was no significant correlation between serum alanine aminotransferase levels and serum HCV-RNA levels. These findings show that branched DNA signal amplification identifies most of the donors with true hepatitis C virus viremia and that the level of hepatitis C virus replication is not correlated to serum alanine aminotransferase levels.

Adult↗
PubMed1994

[Normovolemic hemodilution: application to the treatment of refractory cutaneous ulcers. Transfusion Techniques and Therapeutics Group].

Resistant cutaneous leg ulcers have a long evolution and are not easily cured by traditional therapeutics. Normovolemic haemodilution was proposed in 1984 by Guenneguez and Ouvry, who studied a small number of patients with good results, by using a local protocol, and a manual procedure. Recent data about physiopathology of cutaneous leg ulcers seem to confirm the benefit that Normovolemic Haemodilution should bring to the treatment of this pathology. Therefore a multidisciplinary group was created to lead a multicentric study about the treatment of resistant cutaneous leg ulcers by long term Normovolemic Haemodilution.

Blood Volume↗
PubMed1994

Hepatitis C virus (HCV) viremia in human immunodeficiency virus-seronegative and -seropositive patients with indeterminate HCV recombinant immunoblot assay.

Positivity of recombinant immunoblot assay (RIBA) for detection of antibodies to hepatitis C virus (anti-HCV) is usually associated with HCV viremia. The significance of an indeterminate RIBA result, defined by reactivity to only one HCV antigen, is unclear. Whether anti-human immunodeficiency virus (HIV)-negative or -positive subjects with an indeterminate RIBA have HCV viremia detectable by polymerase chain reaction was investigated. An indeterminate RIBA was found in 48 (15%) of 318 anti-HIV-negative and 38 (23%) of 167 anti-HIV-positive subjects (P < .05). Clinical stage was IV-C-1 or IV-C-2 in 82% of those anti-HIV-positive. HCV viremia was found more frequently in anti-HIV-positive (89%) than in anti-HIV-negative subjects (50%) with an indeterminate RIBA (P < .05). These results suggest an impaired anti-HCV response associated with HIV infection.

Alanine Transaminase↗
PubMed1992

Transmission of HIV by transfusion of HIV-screened blood: the value of a national register. The 'Recipients' Study Group of the French Society of Blood Transfusion.

A National Register of transfusion-transmitted infections was opened by the French Society of Blood Transfusion on 1 October, 1986. Out of 54 initially reported cases of HIV-infection, allegedly transmitted by blood components, further investigation could be completed in 33 cases. The transfusional origin of contamination was considered as established or probable in 28/33 cases, either because a potentially infectious unit was identified among those transfused to the recipient (23/28), or because the recipient was known to be seronegative before transfusion (5/28), or both (10/28). In 5/33 cases transfusion was considered as presumably responsible for contamination because no other risk factor was found in the recipient. Among the 33 documented cases of HIV-transmission by screened blood, 29 (88%) occurred between 1985 and 1987, and four (12%) during 1988. Out of 19 implicated donors later found seropositive, 16 belonged to a high-risk group for HIV-infection. The majority of HIV-infections occurred as a consequence of blood donation in the window period between contamination and the appearance of detectable antibodies in the donor's serum (11/19). In three instances, however, human and operational errors led to the release of seropositive units. We conclude that the main value of this Register is to provide a potential trend-indicator of transfusion-related infectious risks, to allow objective documentation of reported cases and to contribute to the improvement of blood transfusion practice.

AIDS Serodiagnosis↗
PubMed1991

[Sexual examination of spinal cord injured males].

This article describes the sexual examination of spinal cord injured males. It comprises a clinical interview followed by a neurological exam which purpose is to distinguish the lesion level with respect to sacral and thoracic-lumbar innervation of the genitalia. It also comprises a physiological recording of sexual responses to reflexogenic and psychogenic stimulation. The neurological exam allows prediction of sexual responses in 83% of the cases, while the clinical interview only allows a prediction in 47% of the cases. With this sexual examination it has been possible to determine the sexual capacity of spinal cord injured males, a capacity which is discusses with respect to the lesion level and the type of stimulation inducing erection.

Humans↗
PubMed1990

Validation of a non-invasive device to measure intracavernous pressure as an index of penile rigidity.

Many authors agree with the importance of developing devices to measure penile rigidity. The devices that have been developed over recent years have defined penile rigidity in terms of stiffness. Penile stiffness, however, is believed to result from an increase in intracavernous pressure. The device presented here was therefore designed to estimate intracavernous pressure, rather than penile stiffness, as an index of penile rigidity. Validation of the penile cuff device was achieved by simultaneously recording penile cuff pressure and intracavernous pressure on patients undergoing artificial erections. The results showed a linear relationship and highly positive correlation coefficients between the 2 measures. The results demonstrate that the penile cuff may be used to estimate intracavernous pressure as an index of penile rigidity. The findings are discussed in terms of the possible applications of the cuff as a clinical tool to measure both penile tumescence and penile rigidity.

Adult↗
PubMed1989

Bulbocavernosus reflex: its validity as a diagnostic test of neurogenic impotence.

Measurement of the bulbocavernosus reflex is used widely to diagnose underlying neurogenic disorders in erectile dysfunction. A prolonged bulbocavernosus reflex latency (that is more than 45 msec.) or the absence of a reflex response of the bulbocavernosus muscles during electrical stimulation of the glans penis is considered a sign of neurological disease. Since only a few experimental studies have been performed in man related to the neurophysiological mechanism of erection, and since the results of these studies were contradictory the diagnostic validity of bulbocavernosus reflex measurement was reassessed. We determine whether men with abnormal bulbocavernosus reflex latencies have concomitant organic erectile dysfunction as confirmed by nocturnal plethysmographic and rigidity recordings. The bulbocavernosus reflex was recorded in 90 subjects and 19 had abnormal bulbocavernosus reflex latencies. Of these 19 subjects 8 had normal nocturnal erections, thus, confirming a diagnosis of psychogenic impotence. These results cast some doubts on the validity of bulbocavernosus reflex measurement for the diagnosis of organic erectile dysfunction due to a neurological disease.

Adult↗
PubMed1988

Relationship between perineal muscle contractions, penile tumescence, and penile rigidity during nocturnal erections.

The mechanism of penile erection and erectile dysfunction is still unclear and widely debated. The role of the perineal muscles in the erectile process, especially in changes in intracavernous pressure, is increasingly being studied on the hypothesis that perineal muscular contractions are essential to full penile rigidity. In a previous investigation we studied the correlation between voluntary perineal muscle contractions and intracavernous pressure during artificially induced erections. The purpose of the current study was to examine whether under normal conditions of nocturnal erection a similar relationship exists between the electromyographic activities of perineal muscles and changes in penile rigidity. Nocturnal penile recordings were made of seven volunteers with psychogenic erectile dysfunctions. During nocturnal erections simultaneous computerized recordings were made of penile tumescence, penile rigidity, and electromyographic activities of perineal muscles. The peaks for the three variables were reached simultaneously. The results of this study suggest the existence of two different physiologic phases: a vascular phase and a muscular phase. Furthermore, in cases of dysfunctions, specific diagnostic assessment and therapeutic management will be required for both penile tumescence and penile rigidity.

Adult↗
PubMed1988

Reflex contractions of the ischiocavernosus muscles following electrical and pressure stimulations.

In a previous study, we have demonstrated that voluntary muscular contractions of the ischiocavernosus muscles (IC) correlate with changes in intracavernous pressure and, therefore, with penile rigidity. The purpose of our current research project was to verify whether reflex contractions of the IC muscles exist and under what conditions. Our results confirm that reflex contractions occur following electrical or pressure stimulations. Following electrical stimulation, the mean latency of the reflex contractions was 67.5 ms for the IC muscles and 34.9 ms for the bulbocavernosus muscles (BC). Following pressure stimulation, the pressure threshold necessary to elicit contractions of the IC muscles varied between 18.2 mm. Hg and 34.8 mm. Hg. We also observed that pressure variation (increase and decrease) rather than a relatively constant pressure is necessary to produce this reflex response. We interpret these results to suggest that pressure stimulations on the glans penis during coitus contribute to the erectile process and, specifically, to the increase in intracavernous pressure. These findings suggest the possibility of a physiotherapeutic management for patients with penile rigidity problems.

Adult↗
PubMed1986

[Is systematic syphilis serology still useful in a department of internal medicine? A one-year prospective study using a diagnostic and therapeutic decision algorithm].

During one year syphilis serology was systematically studied, using the TPHA and VDRL tests, in each of the 1,279 patients hospitalized in an Internal Medicine department. In all cases diagnosis and treatment were analyzed by means of a decision algorithm. Only 37 patients were found to have one or both serological tests positive. No evolutive syphilis was observed, and none of these positive tests was contributive to the diagnosis of another disease. Only 14 patients received a specific antibiotic treatment on the grounds that their positive test confirmed a late asymptomatic syphilis. We conclude that systematic syphilis serological tests are not useful in an Internal Medicine department, except in some patients epidemiologically at high risk of syphilis.

Algorithms↗
PubMed1986

Correlation between intracavernous pressure and contraction of the ischiocavernosus muscle in man.

An artificial erection was induced in nine patients consulting for erectile dysfunction. Changes in the intracavernous pressure (ICP) and in the integrated EMG of the ischiocavernosus muscle were recorded during voluntary muscular contractions. During such contractions elevations in ICP, varying between 100 and 525 mm. Hg, were recorded. Changes in ICP were always in phase with changes in the integrated electromyogram (EMG) of the ischiocavernosus muscle, and correlations between the duration of changes showed an almost perfect linear relationship between both physiological events. Correlations between maximum changes in ICP and integrated EMG generally showed a positive relationship between both measures. Results are interpreted to suggest involvement of the ischiocavernosus muscle in the process of penile rigidity.

Adult↗
PubMed1979

[Clinical study of massive transfusions (108 cases)].

Amongst 108 surgical patients receiving massive transfusions, 60 died. Study of the aetiology of the haemorrhage, the circumstances of the transfusion, and the role of massive transfusions in the transmission of infectious diseases, disturbances in haemostasis, immunological, respiratory and metabolic complications led to the determination of certain simple criteria of gravity which may restrict their use:age over 60 years; the number of units used, if it exceeds 30; the existence of cirrhosis, of an acute lesion as the source of bleeding, or of peroperative haemorrhage. By contrast, the transmission of hepatitis, coagulation disturbances, immediate or delayed incompatibility accidents and variations in pH, blood potassium and calcium levels and arterial pO2 had little influence on mortality.

Adolescent↗