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F Paulin

Publications and source records attributed to F Paulin.

At least 19 recordsLinked to original sources
PubMed2006

Successful management of intrauterine twin and concomitant cervical pregnancy: a case report.

Use of in vitro fertilization techniques increases the frequency of pathological implantation. However, simultaneous pregnancies are a rarity. Ectopic implantation of the embryo may occur in the cervical canal. This is the first case report, which describes successful management of an intrauterine twin pregnancy which occurred simultaneously with a cervical pregnancy. Diagnostic and therapeutic options are discussed along with the outcome of pregnancies. The cervical pregnancy was removed by aspiration, without dilation of cervical canal, which saved the lives of intrauterine fetuses and preserved fertility for following pregnancies. Finally we review the advanced methods in the literature.

Cervix Uteri↗
PubMed2002

The effects of postmenopausal hormone replacement therapy on hemostatic variables: a meta-analysis of 46 studies.

The aim of the study was to summarize and reanalyze all available data from the literature to study the overall effect of postmenopausal hormone replacement therapy (HRT) and its various forms on hemostatic variables. Studies were identified from literature searches by Medline and Index Medicus, review articles and personal communications. Reference lists of all articles were checked to find additional studies. Principal investigators were contacted and asked to provide additional data if required. Data were collected separately for each factor of the hemostatic system. Studies written in any language were included. Each collection of studies was analyzed using standard methods for meta-analysis. A total of 76 arms of 48 studies were eligible for analysis. This included 6,119 women using HRT and 24,974 non-users. The age of investigated women was 40-68 years. HRT was associated with significantly decreased levels of fibrinogen, factor VIII, antithrombin III, and proteins C and S, but significantly increased plasminogen levels. HRT with estrogen alone or in combination with progestins, oral vs. transdermal regimens, different estrogen preparations and various progestins induced significantly different changes in many cases. In conclusion, HRT was associated with changes that could explain the increased rate of venous thrombotic events, and also with some changes that could account for beneficial vascular effects. Surprisingly, the addition of progestins induced favorable changes in many cases. Also, transdermal use was associated with more beneficial effects than oral regimens in some cases.

Adult↗
PubMed2001

[Increased fetal risk of primary venous thrombosis presenting at a young age].

Based on the hypothesis that the predisposition to thrombosis in women suffering from deep venous thrombosis at young age can disturb also the uteroplacental circulation, the authors retrospectively analyzed the fetal outcome of 333 pregnancies in 101 women with thromboembolic event before 40 years of age and compared it to the fetal outcome of 2943 pregnancies in 1000 randomly selected obstetrical patients without thrombosis. The relative risks of adverse fetal outcomes in thromboembolic women were as follows: 1.85 (95% C.I.: 1.35-2.55) for the spontaneous miscarriage, 3.9 (95% C.I.: 2.20-6.93) for the second-trimester miscarriage, 1.74 (95% C.I.: 1.15-2.64) for the low birth weight, 2.82 (95% C.I.: 1.28-6.30) for the perinatal loss and 7.17 (95% C.I.: 2.64-19.47) for the abruption of placentae. Data obtained suggest that women with deep venous thrombosis at young age should encounter a higher risk of the uteroplacental thrombosis which results in increasing fetal morbidity and mortality during the second and third trimesters of gestation.

Abortion, Spontaneous↗
PubMed2001

Clinical importance of vascular LH/hCG receptors--a review.

It was believed for a long time that functional LH/hCG receptors were present only in gonads. Recent studies have demonstrated, however, that these receptors are also present in several nongonadal organs in the human body. Uterus is one of them. Besides two uterine layers, endothelial cells and smooth muscle of blood vessels in the uterus also contain these receptors. In vivo administration of hCG decreased vascular resistance in the human uterus and in vitro treatment increased vasodilatory and decreased vasoconstrictive eicosanoids in the vessels. These findings led us to investigate whether hCG administration to patients with signs of threatened abortion has any beneficial effect. Patients were treated with either magnesium or progesterone and/or hCG. The results showed that the frequency of patients reaching second trimester was higher when hCG was used, which was paralleled by a significant decrease in uterine vascular resistance. Patients who reached term after treatment had decreased incidence of preterm delivery and intrauterine growth retardation. In conclusion, we suggest that uterine vascular LH/hCG receptors play an important role in the peri-implantation period by increasing uterine blood flow through vasodilatation and also perhaps through angiogenesis and trophoblast invasion, resulting in therapeutic benefit.

Chorionic Gonadotropin↗
PubMed2000

Postmenopausal hormone replacement therapy and cardiovascular mortality in Central-Eastern Europe.

BACKGROUND: The leading cause of death among elderly women is cardiovascular (CV) disease in the United States and in Western Europe as well. The protective effect of postmenopausal hormone replacement therapy (HRT) on coronary heart disease has been verified in epidemiologic studies. There are no data available on the rate of HRT use in Eastern Europe. Our goals were to study the rates of HRT in Eastern Europe, to compare them to those of the United States and Western Europe, as well as to compare their CV mortality rates. METHODS: The use of HRT in Eastern Europe was calculated from sales records obtained from all pharmaceutical companies that ship HRT preparations to the given area. Data on HRT in Western countries were taken from the literature. Mortality rates were obtained from the World Health Organization. RESULTS: The rate (mean +/- SD) of HRT in Eastern Europe was 2.88 +/- 2.67%, whereas 12.67 +/- 9.97% in Western Europe and the United States, p < .05. The cardiovascular mortality rate per 100,000 women older than 45 years in Eastern Europe was higher (1766 +/- 158.3) than in the Western countries (1155 +/- 164.1, p < .001). CONCLUSIONS: The rate of HRT is markedly lower. whereas CV mortality rates are notably higher in Eastern Europe than in the United States or Western Europe. Because HRT seems to be underutilized in Eastern Europe, to increase its use might be an important tool to improve CV mortality rates. However, due to the risks associated with HRT, other measures to prevent coronary heart disease, such as smoking cessation programs, and other efforts should also be considered in Eastern Europe.

Aged↗
PubMed1999

Urodynamic investigation of women operated on for genuine stress incontinence.

Anterior colporrhaphy (Kelly-Stoeckel suture) was performed on 22 women suffering from grade-I or grade-II genuine stress incontinence. Urodynamic investigation was performed on every patient before surgery and 6 months postoperatively. 21 patients were cured and 1 patient improved. After operation the functional urethral length was increased by 28.8%, and urethrovesical pressure transmission was improved by 22.9%. Maximum urethral closure pressure decreased postoperatively by 21.1%. Pressure transmission was clearly improved by the surgical intervention and urinary continence was restored in spite of the fact that maximal urethral closure pressure decreased. Based on these results it is suggested to consider performing anterior colporrhaphy in cases of weak urethral closure pressure, because of the increased risk of worsening the complaints of these patients.

Adult↗
PubMed1998

[Severe genital mycoplasma infection following cesarean section].

Authors report a serious case of post-caesarean delivery endometritis caused, probably exclusively, by genital mycoplasmas: Ureaplasma urealyticum and Mycoplasma hominis. The initial treatment of the patient with various penicillins, ceftriaxone, gentamicin, metronidazole and nystatine proved ineffective. Subsequently, as microbiological tests turned out positive for genital mycoplasmas, a therapy of doxycyclin was introduced and a full recovery could be attained. Authors' experience is consistent with the observation of American scientists that U. urealyticum is an important pathogen in post-caesarean delivery endometritis. Since the carriage of U. urealyticum in women is frequent in Hungary, it is suggested that microbiological investigations related to sectio caesarea always include tests for genital mycoplasmas.

Adolescent↗
PubMed1998

[Systemic lupus erythematosus and pregnancy (effect of pre-conception hematologic disorders on fetal outcome)].

The aim of the study was to determine the fetal and neonatal outcomes of pregnancies conceived during the inactive phase of systemic lupus erythematosus (SLE). Fetal and neonatal outcomes in 75 pregnancies of 33 patients with SLE were analyzed. In 19 patients (57.6%) the SLE also had hematological autoimmune presentations prior to gestation, such as anemia, thrombopenia, garnulocytopenia, and antiphospholipid antibody and/or lupus anticoagulant (APA). Out of 75 pregnancies, 19 elective terminations were carried out because the disease was active or for non-medical reasons. The adverse fetal outcomes of those 56 pregnancies which occurred during the inactive phase were compared with those of the control patients. In SLE, the rates of spontaneous abortions (46.4%) and newborns with low (< 2500 gr) birthweight (36.7%) were found to increase roughly three times that of the controls and the perinatal fetal loss (16.7%) also increased significantly as compared with the control group (28.5 per thousand). APA noted at any time before pregnancy increased the low birthweight rate (75%) six fold and the perinatal loss (33.3%) more than ten fold but did not affect the rate of spontaneous abortions. Any kind of hemocytopenias without APA, noted before pregnancy did not worsen the fetal outcome in SLE. Neonatal lupus was diagnosed in 2 out of the 30 newborns. Our results suggest that among the hematologic manifestations of SLE presenting before pregnancy, APA can predict the high risks of low birthweight and perinatal fetal loss as opposed to hemocytopenias.

Abortion, Induced↗
PubMed1997

[Therapeutic importance of the diagnosis of Kallmann syndrome].

Hyposmia with hypogonadotropic hypogonadism was diagnosed as Kallmann syndrome in a 24 years old dizygotic female twin. This syndrome indicates the importance of smell in the sexual development through the progenitor cells in the olfactory placode because luteinizing-hormone-releasing hormone (LHRH) secreting cells of hypothalamus arise from these cells. In addition, substitution therapy may be successful in the treatment of the lack of secondary sex traits and primary amenorrhoea as the presented case demonstrated.

Adult↗
PubMed1995

[Effect of preeclampsia on neonatal morbidity].

In this study the outcome of two groups of premature infants born by caesarean section were compared from 52 hypertensive mothers with severe pre-eclampsia and from 30 normotensive mothers. The indication of caesarean section in pre-eclampsia was: proteinuria (> 500 mg/24 h), high blood pressure (> 160/100 mmHg), abnormal cardiotocogram and abnormality in flowmetry (fetal distress). Every infant was premature as well as in the control group. Significantly smaller mean birthweight and longer nursing-time in neonatal intensive care unit (NICU) were found in the pre-eclamptic group. Neonatal illnesses and complications are more frequent in the pre-eclamptic group. The time of ventilation was also longer. There are more early neurological disorders in the pre-eclamptic group than in the control one. The authors can establish that pre-eclamptic toxemia increases the morbidity in the neonatal period. This is due to the chronic intrauterine fetal distress as well as the retardation.

Cesarean Section↗
PubMed1995

[Insulin concentration in amniotic fluid in mid-term pregnancy].

Insulin concentrations of 284 amniotic fluid samples were assessed, obtained from pregnant women by genetic amniocentesis between the 16-18 gestational weeks. The indication of amniocentesis was either advanced maternal age (> 35 years) or high risk genetic history. The amniotic fluid insulin concentration (mean +/- SD) was found 3.8 +/- 3.0 microIU/ml. The insulin concentration in 4.3% of all pregnant women was higher than the mean value +2 SD (9.8 microIU/ml) which represents individual pathological value, characteristic for gestational diabetes. Our data suggest that one part of gestational diabetes might be detected between the 16-18 gestational weeks, therefore we propose an earlier screening as the usual one. At institutes where the possibility of genetic amniocentesis is given the determination of insulin level in amniotic fluid may be reasonable. We could analyze the outcome of 230 pregnancies analysed. A close correlation was found between the amniotic fluid insulin concentration and birthweights of female newborns. It could not found such correlation at male newborn. A more careful screening test for gestational diabetes should be performed at mothers with female fetuses.

Amniocentesis↗
PubMed1993

[Monitoring of arterial pressure according to the "womb to tomb" program taking into account the human chronome].

The concept of "chronome" is discussed in this article. A lot of data of monitoring of arterial blood pressure in healthy people from babies till senile people are reported. This chronobiologic approach allows to optimize diagnosis in a group of people with elevated blood pressure and to exclude people with false positive and false negative diagnosis of hypertension. At the same time physicians can optimize therapy of hypertensive people with taking into account chronotherapy principle.

Adolescent↗
PubMed1991

[Successful pregnancy after surgery for hypophyseal microadenoma].

The authors report on a successful conception, development of pregnancy and lasting symptom-free post-partum state of a young female patient who has been operated previously because of an hypophysis microadenoma. Delivery ended with Cesarean section. A living and mature newborn was born, with a weight of 2900 g.

Adult↗
PubMed1989

[A microbiology clinic in outpatient gynecologic service].

The authors report on their experiences gained at the sexually transmitted disease clinic they established at the First Department of Obstetrics and Gynecology of Semmelweis Medical University. A total of 456 patients presenting with signs and symptoms of lower genital tract infection have been examined in one year. The investigation of patients included aerobic and anaerobic culture of vaginal bacteria, vaginal smear and the identification of sexually transmitted Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasmatales and Gardnerella vaginalis. The authors conclude that a sexually transmitted disease clinic is appropriate to contribute to the prevention of horizontal and vertical spread of the sexually transmitted bacterial infections.

Ambulatory Care Facilities↗