Contraception. More than ever!
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Contraception↗
Biomedical subjects
Jean-Jacques Amy
Publications and source records attributed to Jean-Jacques Amy.
Mitomycin C and epirubicin: functional bladder damage in rats after repeat intravesical instillations.
PURPOSE: We studied functional damage in the bladder after intravesical administration of mitomycin C or epirubicin in rats. MATERIALS AND METHODS: A total of 40 rats were divided into 4 groups. Rats in 3 groups received intravesical instillations of mitomycin C, epirubicin or saline. Rats in group 4 received no intravesical instillations and served as normal controls. The doses of drugs administered were based on those used for therapeutic purposes. Changes in vesical capacity and bladder wall compliance were determined. Compliance was defined as the change in vesical volume induced by a given change in pressure. RESULTS: Weekly instillations of 1 mg/ml mitomycin C caused a statistically significant decrease in vesical volume and compliance, which persisted 3 weeks after the cessation of therapy. Epirubicin also induced changes in vesical volume and compliance but only that in bladder compliance achieved statistical significance. These changes were not seen in NaCl treated animals or in normal controls. CONCLUSIONS: Repeat intravesical instillations of mitomycin C have a prolonged effect on bladder function that is not seen after saline solution or epirubicin instillation.
Administration, Intravesical↗
A tale of medical shopping or the hazards of repetitious cytological screening of the cervix.
A 65-year-old woman had on her own initiative three cervical smears taken at very short intervals. The second smear was taken only 1 day after the first one. It contained necrotic cellular material with atypia due to the scraping on the day before; it was at first mistakenly interpreted as showing malignant features. This led to the performance of various diagnostic procedures, and a considerably greater cost for the medical insurance system.
Aged↗
Who will benefit from pelvic floor muscle training for stress urinary incontinence?
OBJECTIVE: The purpose of this study was to determine which patient characteristics are predictive of outcome before pelvic floor muscle training for stress urinary incontinence. STUDY DESIGN: This was an observational study at a single-center outdoor patient clinic in Brussels, Belgium, that comprised 447 women, aged 26 to 80 years (mean, 52.7 years), who had urinary stress incontinence. All the women received individual pelvic floor muscle training under the guidance of the same physiotherapist. Twenty-two patient characteristics were considered for outcome measurements. RESULTS: Forty-nine percent of the women considered their treatment to be successful; 51% of the women had experienced only some improvement, no change, or a worsening of their condition or had interrupted therapy. Three independent predictors of treatment failure were > or =2 leakages per day before treatment ( P < .0001), the chronic use of psychotropic medication ( P = .002), and a baseline positive stress test result at first cough ( P = .042). The odds were only 15% for an individual patient to be treated successfully when these 3 predictors were present. CONCLUSION: Pelvic floor muscle training is beneficial in one half of the patients who are treated in this manner. Two or more leakages per day at baseline and the chronic use of psychotropic medication significantly predicted therapy failure.
Adult↗
Outcome after elective labor induction in nulliparous women: a matched cohort study.
OBJECTIVE: To determine whether elective induction of labor in nulliparous women is associated with changes in fetomaternal outcome when compared with labor of spontaneous onset. STUDY DESIGN: All 80 labor wards in Flanders (Northern Belgium) comprised a matched cohort study. From 1996 through 1997, 7683 women with elective induced labor and 7683 women with spontaneous labor were selected according to the following criteria: nulliparity, singleton pregnancy, cephalic presentation, gestational age at the time of delivery of 266 to 287 days, and birth weight between 3000 and 4000 g. Each woman with induced labor and the corresponding woman with spontaneous labor came from the same labor ward, and they had babies of the same sex. Both groups were compared with respect to the incidence of cesarean delivery or instrument delivery and the incidence of transfer to the neonatal ward. RESULTS: Cesarean delivery (9.9% vs 6.5%), instrumental delivery (31.6% vs 29.1%), epidural analgesia (80% vs 58%), and transfer of the baby to the neonatal ward (10.7% vs 9.4%) were significantly more common (P <.01) when labor was induced electively. The difference in cesarean delivery was due to significantly more first-stage dystocia in the induced group. The difference in neonatal admission could be attributed to a higher admission rate for maternal convenience when the women had a cesarean delivery. CONCLUSION: When compared with labor of spontaneous onset, elective labor induction in nulliparous women is associated with significantly more operative deliveries. Nulliparous women should be informed about this before they submit to elective induction.
Adult↗
Myomatous erythrocytosis syndrome.
Uterine myomas are common but erythrocytosis caused by these is rarely seen. We report a case that illustrates the conjunction of various aetiological factors required for this clinical entity to evolve. A voluminous, retroperitoneally located and focally degenerated myoma was associated with severe secondary erythrocytosis (haematocrit: 65.5%) which resolved after hysterectomy. It has been demonstrated previously that myomatous tissue is the source of excessive production of erythropoietin. Local tissue hypoxia, which is more prone to develop in a pedunculated myoma, stimulates the process. Other prerequisites are a very large size of the myoma and the absence of menometrorrhagia of a severity such as to cause a depletion in iron reserves.
Adult↗