[Minimal ovarian stimulation: certainly less dangerous but rarely as efficient].
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Clomiphene↗
Biomedical subjects
L Verstraete
Publications and source records attributed to L Verstraete.
Long-term follow-up after Lichtenstein hernioplasty in a general surgical unit.
This retrospective study of 142 consecutive males operated on, including the learning-curve period, is aimed at evaluating the long-term outcome (>3 years) of Lichtenstein hernia repair. The response rate was 95%. One recurrence (0.7%) and one femoral hernia occurred. Pain persisted more than 2 weeks in 26% of patients, more than 3 months in 8%, and after 3 years in 4%. The corresponding figures for discomfort without need for analgesics are 49, 14, and 11%. Paresthesia persisted over 1 year in 9%. Morbidity due to extensive section of the cremaster muscle and shooting nuisance during ejaculation occurred in four patients. The mean social inactivity period was 3.2 weeks, the time to work resumption 5.4 weeks. The Lichtenstein hernioplasty proved to have a low recurrence rate and immediate morbidity, but the prevalence of chronic pain or discomfort are not to be underestimated.
Adult↗
[Acid base balance in the fetus during labor: pathophysiology and exploration methods].
Although the majority (about 90%) of cerebral palsies are related to antenatal or postnatal causes, search for acute fetal distress during labor remains one of the primary objectives of obstetrical surveillance. Acute fetal distress leads to hypoxemia which induced hypoxia and then asphyxia of most of the organs, including the noble organs such as the brain. Most of the parameters used for fetal monitoring have good sensitivity but low specificity. Furthermore, there is a weak correlation between the different parameters measured and the neonatal status which remains difficult to predict with certainty. The general "philosophy" behind fetal monitoring consists in detecting warning signs and, when warning signs are observed, to measure one or more other parameters to assess the state of hypoxia and its consequences. Fetal heart rate is a warning sign used by all teams. Irrespective of the method used to analyze fetal heart rate when anomalies are detected, metabolic acidosis induced by anoxia is an indispensable element for assessing severity. The development of fetal hypoxia is related to two essential phenomena: anaerobic glycolysis with lactate production and glycogenolysis to meet energy needs. Metabolic acidosis can be measured directly by scalp pH or lactate measurements, or indirectly by measuring its effect on heart conduction as expressed in the ST segment. The underlying physiological mechanisms and the methods used to evaluate acid base balance are described here.
Acid-Base Imbalance↗
[Leiomyoma in the duodenum].
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Diagnosis, Differential↗
[Vaginal sonographic diagnosis of the missing umbilical cord syndrome].
The Syndrome of Missing Cord has been diagnosed in a case of early pregnancy by means of transvaginal ultrasound. The sonographic criteria of this syndrome are described and correlated with the anatomical and pathological findings.
Abdominal Muscles↗
[Reoperation following failure of anti-reflux surgery].
Reoperation is the treatment of choice of failed antireflux procedures. Preoperative full-scale evaluation of both residual anatomy and function of the upper digestive tract is mandatory. Conservative surgery is almost always feasible. Success rate of reoperations is high with experienced teams.
Gastroesophageal Reflux↗
Clinical, radiological and functional results of remedial antireflux operations.
Fifty-five patients were reoperated on for an unsatisfactory outcome after antireflux surgery. Presenting symptoms were heartburn alone (27), heartburn and dysphagia (10), dysphagia alone (9), chest pain (4), left shoulder pain (1), left shoulder pain and fever (1), and signs of anemia (3). The symptom of dysphagia was usually of immediate onset whereas heartburn reoccurred after a symptom-free period (p = 0.014). The most common failed antireflux procedure was a Nissen fundoplication (37). The incompleteness of the residual wrap, its location around the stomach and the irreducibility of the gastro-oesophageal junction below the diaphragm were accurately predicted by barium swallow study in 70, 83 and 92% of the patients, respectively. Abnormal oesophageal body motility was related to oesophagitis, herniation of the residual repair into the chest or both (16/20), and it normalized in 6 of the 11 patients evaluated at follow-up. Oesophageal acid exposure and prevalence of oesophagitis were higher in patients with heartburn than in those with other symptoms (p < 0.02). Intraoperative findings were breakdown of the repair, its location around the stomach, its herniation into the chest, its too excessive tightness, a gastric fistula, or any combination. Remedial surgery consisted of a new antireflux procedure (42), a new antireflux procedure combined with closure of a gastric fistula (3), a closure of a gastric fistula alone (1), a closure of the crura (4), an oesophageal resection (3), a total gastrectomy (1), and a duodenal diversion (1).(ABSTRACT TRUNCATED AT 250 WORDS)
Barium Sulfate↗