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Biomedical subjects

J C Gagnaire

Publications and source records attributed to J C Gagnaire.

At least 19 recordsLinked to original sources

Normal pregnancies after treatment of hyperprolactinemia with bromoergocryptine, despite suspected pituitary tumors.

Bromocryptine treatment was administered to 15 patients with amenorrhea and galactorrhea (AG) and to 1 patient with amenorrhea. All of them had increased plasma PRL levels. Of these 16 patients, 4 had a normal sella turcica (ST; group STO), 4 had a slight enlargement (group ST+), and 7 had a clear enlargement of ST (ST++) but no evidence of suprasellar extension. Ovulation was restored in 15 patients by bromocryptine treatment only. In one patient, ovulation resumed only after human pituitary gonadotropin treatment in combination with bromocryptine. There was no correlation between basal prolactinemia, PRL stimulability or suppressibility, the size of ST, or the efficiency of bromocryptine treatment. Every patient with normal LH response to either LRH or clomiphene or both resumed ovulation. Ovulation resumed in 3 patients among the 4 with abnormal LH response to either LRH or clomiphene or both. Among the 14 who desired pregnancy, 13 became pregnant. To date, 12 patients (ST++, 5; ST+, 3; STO, 4) have delivered normal babies. The courses of pregnancy were normal. During pregnancy, no change of ST was noted on lateral and frontal skull x-ray performed in every patient at trimonthly intervals. There was no change in the sellar index in 10 patients after pregnancy, as compared to the pretreatment status. In the presence of a pituitary adenoma or in patients with hyperprolactinemia and amenorrhea and galactorrhea, bromocryptine treatment may cure sterility without pituitary complication during pregnancy.

Adult↗

[Personal experience with salpingoplasty. Apropos of 285 cases].

285 cases of salpingoplasty are reported and studied. Only 172 patients could be followed up recently. The percentage of pregnancies was 27-7, 20 per cent were intra-uterine pregnancies. The percentage of successful pregnancies was 45-93 if only those patients who were seen again were reviewed. The results are best when the operation is carried out in the most conservative and most anatomically restorative fashion. This fine surgery, which must be carried out so delicately and with such detail, which will appeal more and more to modern technicians using micro-surgery, should stay in the hands of specialists because there is no doubt that the level of success rises with the experience of the operator.

Fallopian Tubes↗

[Significance of pruritus during pregnancy. Relations with the hepatic disorders of gestation].

The principal clinical and biological characteristics and the origin of pruritus of pregnancy (p.p.) which occurs in a little more than two pregnancies per thousand are considered in the light of 7 cases. As with recurrent jaundice of pregnancy (r.j.p.), of which pruritus represents a minor analogue, the symptoms occur solely during pregnancy and disappear after delivery. In p.p. signs of cholestasis are seen, more marked than in a normal pregnancy coming to term but less than in icterus gravidarum. The increase in transaminases seen in p.p. and r.j.p. does not occur in normal pregnancy. The two conditions, which may be grouped together under the term hepatogestosis, are benign as far as the mother is concerned but represent a definite and significant risk of prematurity for the child. It is possible to establish a relation between p.p. and/or r.j.p. and the hepatic manifestations associated with oral contraceptives. In both instances a genetic predisposition seems to favour the development of a cholestatic syndrome. A past history of p.p. represents a contraindication to the use of oral contraceptives. Cholestyramine, a bile salt chelator, gives excellent results in persistent p.p.

Adult↗

[Injuries to the upper extremities in the newborn diagnosed at birth].

Injuries to the upper limb vary in type. The overall incidence, including the form which is revealed by paralysis, is 2.6 per 1,000 (30 cases in 13,342 deliveries). In 90 per cent of cases it followed a dystocic delivery. The prognosis for these lesions is favourable when the diagnosis is made early and the correct treatment is started in the first days of life. All the same, sequellae are not rare, being in the order of 10 per cent, and this pathological condition should not be considered as a benign one. The pathology of these lesions does not depend only on the second stage of labour, nor entirely on the choice between hysterotomy and vaginal delivery, but equally on the prevention of the birth of large children and on the treatment of maternal obesity, as well as on a better estimation of the size ofthe foetus in utero by the development of measurements of the bi-acromial diameter with the use of ultra-sonic techniques.

Arm↗