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Biomedical subjects

J Bringer

Publications and source records attributed to J Bringer.

At least 91 records · Page 5Linked to original sources
PubMed1991

[The use of LHRH analogs in ovulation induction].

The use of LH-RH agonists is appropriate for the stimulation of ovulation. In contrast, in the case of induction of ovulation in a patient with deficient ovulation, suppression of influences of the hypothalamo-pituitary axis does not modify the pathological condition responsible for the ovulatory anomaly.

Clinical Protocols↗
PubMed1990

[Influence of abnormal weight and imbalanced diet on female fertility].

The cult of a slim body without the slightest bit of adipose tissue and the food restriction or selection habits it creates are extremely common in our society. Their influence on menstrual cycle and female infertility is not negligible. A vegetarian low calorie diet may induce cycle disorders and a short luteal phase. Disturbances in the pulsatility of gonadotropic hormones are responsible for anovulation, and they occur when slimness with excessive reduction of the body fat mass is associated with psycho-socio-professional stress factors or with intensive sporting activities. The greater frequency of dysovulation in obese women, notably those who put on weight rapidly, is accompanied by numerous hormonal changes, including reduced sex hormone-binding globulin, increased ovarian and adrenal androgen production, increased peripheral aromatization of androgens to oestrogens, and altered gonadotropin pulsatile secretion. The hyperinsulinism consecutive to insulin resistance in obese subjects might act as co-factor of the luteinizing hormone and as such participate in abnormalities of follicular maturation by stimulating the insulin-like growth factor and the ovarian androgens. However, the relative importance of these various factors in the physiopathology of abnormal ovulation remains to be determined. Overweight reduces the effectiveness of clomiphene citrate, menopausal gonadotropins and gonadotropin-releasing hormone in stimulating the follicles. Weight loss reduces hormonal disturbances and facilitates follicular maturation and ovulation in spontaneous or induced cycles.

Androgens↗
PubMed1990

[Methods of analysis of hormonal pulsatility].

Methods for detection and characterization of episodic fluctuations in circulating hormone levels are frequently used for endocrine investigations, related to the physiological importance of the pulsatile nature of hormone secretion in modulating target-cells response. Several sophisticated methods of pulse analysis have been recently developed and validated, aiming to minimize the false-positive and false-negative error rates. The present report mainly devoted to the clinician aims to analyze and discuss the main features of the most widely used methods for pulse detection.

Blood Chemical Analysis↗
PubMed1990

[Hormone therapy in the 40-year-old woman].

Hormone replacement therapy is frequently prescribed in 40-year old women because of the hormonal changes which start to occur at this age. A progestogen-only treatment is often prescribed to restore the oestrogen/progestogen balance. This treatment alone can be sufficient on the therapeutic level as well as on the contraceptive level. However, in order to minimize the risks of such a treatment, a non-androgenic derivative must be chosen. There are no contra-indications for oral contraceptives in women who are over 40 years old on condition that the risk factors are not cumulated. Here also, it is advisable to use the lowest possible dose of steroids which has an adequate contraceptive action and enables a good cycle control. As for oestrogens, the minimum ethinyloestradiol dose must be sought. For the progesterone dose, a non-androgenic derivative should be chosen. The GnRH agonists may have some indications, but their exact place is yet to be defined.

Adult↗
PubMed1990

Effects of ACE-inhibition on glucose metabolism.

ACE inhibition is widely used for treatment of arterial hypertension or congestive heart failure. No change occurs in glucose metabolism either in diabetic or non diabetic subjects. No change occurs in glucose metabolism in patients with chronic renal failure. Glucose intolerance induced by diuretics is attenuated when ACE inhibitor is associated with thiazides. In some very rare circumstances (with high plasmatic levels of norepinephrine), insulin sensitivity seems to be enhanced by captopril. Then, in clinical use, no adverse effect occurs with ACE inhibition in non diabetic or diabetic subjects. Under thiazide treatment, ACE inhibitors protect against glucose intolerance.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1989

[Pulsatile administration of LH-RH: diagnostic and therapeutic applications].

Hypothalamic hypogonadotropic hypogonadism (HHH), a disorder occurring in both sexes, is characterized by a partial or complete inability to synthesize and/or release LH-RH from the hypothalamus which result in absence or defects of amplitude and frequency of gonadotropin secretion. Long term substitution by pulsatile exogenous LH-RH usually result in complete normalization of both pituitary and gonadic hormones. Such a treatment allows differentiation between hypothalamic and pituitary causes of hypogonadotrophic hypogonadism. Ovulation and fertility can be achieved in most of women with hypothalamic amenorrhea treated with pulsatile LH-RH using i.v. bolus doses of 25-100 ng/kg at 1-2 h intervals. In opposite LH-RH therapy yields inferior results to human menopausal gonadotropin (hMG) in chronic anovulatory patients with persistent LH secretion or polycystic ovary syndrome (PCOS) as shown by one randomized and several non-controlled studies. Successful pulsatile LH-RH treatment following a 2 months LH-RH analog suppression in PCOS previously refractory to LH-RH alone represents a new promising approach. The majority of men with complete HHH begin to produce sperm only after 1 year of therapy. Both the testicular volume and the mean sperm concentrations were below the normal values after 2 years of treatment in spite of normalization of testosterone, LH and FSH levels. Pulsatile LH-RH does not seem significantly improve the treatment of infertile HHH men compared to hMH/hCG.

Amenorrhea↗
PubMed1988

[Value of triiodothyroacetic acid as suppressive treatment of the thyrotropin secretion in thyroid pathology].

Fifty-six patients were treated with triiodothyroacetic acid (TRIAC) for its suppressive effect on the pituitary-thyroid function. Thirty of these patients had undergone partial thyroidectomy for benign goitre, and among these 14 had developed hyperplasia of the remaining thyroid tissue (group I); 18 presented with homogeneous or nodular goitre (group II); 8 had been thyroidectomized for carcinoma (group III). Before TRIAC was prescribed, thyroid hormones had been used in 33 patients, exerting a suppressive effect on the thyrotropic hormone in 4 patients of group III and producing signs of intolerance in 24 cases. TRIAC was administered in doses of 700-1,750 micrograms/day to all patients of group I and II, and combined with LT4 100 micrograms/day to group III patients. Suppression of the thyrotropic secretion was obtained in all group III patients and in 88 p. 100 of groups I and II patients. Thyroid gland hypertrophy regressed or disappeared in 21 patients of groups I and II, and no relapse or metastasis was observed in group III. TRIAC was well tolerated in all but one patients.

Adolescent↗
PubMed1988

Correlations between free plasma estradiol and estrogens determined by bioluminescence in saliva, plasma, and urine during spontaneous and FSH stimulated cycles in women.

Estrone and estradiol (E1 + E2) concentrations in saliva were compared with four other parameters of estrogen status in five normal ovulatory women and ten FSH stimulated women selected for an in vitro fertilization program. E1 + E2 in saliva, plasma, and urine were assessed by a rapid, specific and sensitive enzymatic assay using bioluminescence. The free fraction of plasma estradiol was determined by equilibrium dialysis and total plasma estradiol by conventional radioimmunoassay. The pattern of E1 + E2 variation in saliva was similar to that of free plasma estradiol and the two parameters were correlated in both spontaneous and stimulated cycles. However, the lower correlation coefficient (r = 0.52, P less than 0.001) in spontaneous cycles compared with the high (r = 0.96, P less than 0.001) in the stimulated cycles shows that salivary E1 + E2 could be representative of plasma free estradiol in stimulated cycles but not in normal cycles. The free fraction of plasma estradiol reproduced the variation of total plasma estradiol in spontaneous as well as in FSH stimulated cycles and both parameters were strongly correlated (r = 0.91, P less than 0.001 and r = 0.90, P less than 0.001), respectively. The data show that salivary E1 + E2 concentrations are highly representative of the free fraction of E2 in plasma and at a lesser extend (r = 0.72, P less than 0.001) of total plasma E2 in FSH stimulated cycles.

Adult↗
PubMed1988

Contrasting effects of captopril and nifedipine in normotensive patients with incipient diabetic nephropathy.

Microalbuminuria is a reliable predictor of the eventual development of overt diabetic nephropathy and blood pressure is known to accelerate the course of this nephropathy. In the present studies, the effect of a 6-week treatment by placebo (n = 7), nifedipine (n = 7) and captopril (n = 8) on renal function and urinary excretion of albumin (UAE) was investigated in normotensive, insulin-dependent, diabetic patients with incipient nephropathy (UAE greater than 15 micrograms/min). No change in arterial pressure, renal function or UAE was observed in the placebo group. In response to captopril and nifedipine, mean arterial pressure decreased slightly and similarly in both groups. Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) increased to a similar extent in the nifedipine group, thus resulting in no change in filtration fraction (FF). In response to captopril, GFR was unchanged whilst ERPF increased; as a consequence FF decreased. Opposite changes in UAE were observed in response to the two treatments; UAE decreased by 40% in the captopril group and by 40% in nifedipine-treated patients. These results indicate that intrarenal changes may be crucial with respect to the effect of therapy on UAE. It is suggested that only agents which reduce FF and probably intraglomerular capillary pressure, such as converting enzyme inhibitors, alter UAE and may possibly interfere with the course of incipient diabetic nephropathy in normotensive patients.

Adolescent↗
PubMed1988

Recurrent abnormal follicular maturation and ovarian stimulation for in-vitro fertilization.

A total of 1078 cycles were stimulated for in-vitro fertilization between 1 January 1986 and 31 July 1987. One-hundred-and-ninety-six cycles had to be cancelled because of an abnormal ovarian response (18.2%). The majority of these cancellations were due to the phenomenon of follicular atresia (45%) or the absence of follicular growth (30%). Bad responder patients who had undergone cancellation during at least two successive cycles, when compared with normal responder patients, were somewhat older and had more frequent periovarian adhesions and ovulatory defects. The use of a GnRH agonist allowed correction of a certain number of ovarian response inadequacies, but follicular atresia and absence of folliculogenesis remained frequent phenomena.

Adult↗
PubMed1987

Ovarian stimulation by a combination of a gonadotropin-releasing hormone agonist and gonadotropins for in vitro fertilization.

In the first of two studies, 20 patients were selected on the basis of tubal infertility and were randomly assigned to two groups receiving different ovarian stimulation protocols. In group A, 10 patients were given follicle-stimulating hormone (FSH), FSH was continued until the criteria for human chorionic gonadotropin (hCG) administration were satisfied. In group B, 10 patients received Buserelin (0.3 ml twice a day subcutaneously) for 14 days to induce pituitary desensitization. Stimulation with FSH was then started, and Buserelin treatment was continued until hCG administration. In the second study, patients were included if they had had at least two previous attempts at ovarian stimulation that failed to reach the stage of follicular aspiration. Ovarian stimulation was conducted with a combination of Buserelin and human menopausal gonadotropin. Use of the gonadotropin-releasing hormone (GnRH) agonist in in vitro fertilization increased the number of oocytes collected, the fertilization rate, the length of the luteal phase and the pregnancy rate. The GnRH agonist also contributed to a generally better ovarian response in patients whose estradiol production had previously responded poorly to conventional ovarian stimulation protocols.

Adult↗