Biomedical subjects

O Pambou

Publications and source records attributed to O Pambou.

9 recordsLinked to original sources

PubMed1996

[Multiple pregnancies prevention in in vitro fertilization: limiting the number of transferred embryos to two maximum?].

The success of an IVF-programme is mainly linked to the number and quality of embryos transferred as well as women's age, but the incidence of obstetrics complications rises significantly with the number of fetuses. Reducing the number of embryos transferred is therefore recommended in order to avoid the medical, social and financial problems associated with multiple births. Present data suggest that, when at least three embryos of good quality are available, the pregnancy rate already reaches its maximum value when two embryos are transferred. A third one merely increases the number of triple pregnancies. Further studies are needed to conclude, especially in the cases of poor quality embryos.

Adult↗

PubMed1995

[HIV seropositive pregnant women from black Africa seen at the Guy de Lorier maternity unit of Tenon hospital. Report of 33 cases].

There were 5503 deliveries between 1989 and 1991 in the Guy de Lorier Maternity Unit (Pr Salat-Baroux) of Tenon Hospital, Paris. These included 81 women testing HIV+ in the department with 33 asymptomatic black African women among 781 deliveries. Africans account for 14% of women delivered in the department but for 40% of seropositives in the unit, with a predilection for women from Zaïre (central Africa), accounting for 17 seropositives. They only represent 50% of all cases of African HIV+ and 20% of the unit, while they account for only 6% of the black African community and 0.8% of the maternity unit. Women from west Africa accounted for 45.5% of African seropositive cases, with Ivory Coast in first place with 24.3% while only 9% of women from Mali, accounting for 40% of African patients and 5% the units, tested positive (3 cases out of 309 patients). The mean age of seropositive patients was 23 +/- 4, pregnancies proceeded normally and there were 4 therapeutic abortions. There were 9 births by cesarean section, with no evidence of neonatal contamination, the same applying in the other 20 vaginal deliveries. Routine testing (informed consent) for HIV in these high-risk (endemic zone, drug addiction) or unrecognised seropositive patients is important whenever the opportunity presents itself (prenuptial examinations, prenatal visits, family planning, preoperative assessment) in order to attempt to lower infection rates and ensure the best possible care for mother and child when there is a wish to continue the pregnancy, but also to protect hospital staff from the risks to which they may be exposed.

Africa↗

PubMed1995

[Endoscopic gynecologic surgery in Africa. Luxury of necessity?].

Per- and postoperative mortality remain high in black Africa, with rates of the order of 30 to 40% according to teams. Three essential causes are generally reported: infection, hemorrhage and anesthetic complications. There can be no doubt as to the advantages of celiosurgery over open surgery: low postoperative morbidity, less than 1% serious complications, real savings in treatment costs by shortening of average hospital stay and time off work. Celio-surgery is technology-dependent and operator-dependent. The cost of equipment remains prohibitive and its maintenance delicate and expensive, potentially hampering the implantation and spread of this new technique in Africa, which also lacks specifically trained staff as well as an appropriate technical infrastructure. Nevertheless, the experience of teams in Cameroon and Gabon are encouraging with 110 and 220 patients respectively treated by celio-surgery without complications. A veritable journeyman-apprentice approach is necessary for the learning of these new techniques by teams in developing countries, in several possible ways (locally or abroad), in order that the population as a whole can enjoy the benefits of the reproducible therapeutic and diagnostic advances of new techniques (celio-surgery, MAP, antenatal diagnosis, medical imaging).

Africa↗

PubMed1994

[Electro-conization with the diathermic loop. Indications and results].

The experiment of electro-conization with diathermic loop was effected on 185 patients. The indications are represented by: a) low grade lesions: 21 cases (11.3%) only when the squamo-columnar junction was into the endocervix; b) CIN 2: 44 cases (23.7%): c) CIN 3: 118 cases (63.7%); d) cyto-histologic discordance: 2 cases. After one year, the following results could be noted: 94.1% of the patients were cured, only 11 out of the 185 presented a recurrence (or persistence). It seemed interesting to us to study the factors which could influence the "in sano" (Free margin)/or not character of the resection. It appeared that the surface of the lesion did not seem to influence its histological result since we got: 83%, 96%, 94.5% and 92.3% of "in sano" conizations to be correlated with a lesion surface equal to 1/4, 2/4, 3/4, 4/4 of the cervical area. The second factor to be studied was the patients' age. So from 15 to 25 years (96%) of the resections were "in sano". There from 26 to 35 (92%), and from 36 to 45 (91.9%). Among post-menopausal women from 46 to 55 years old only 86.4% of electro-conizations were "in sano". Histologic alterations of the histologic specimen were noted in two cases (1%), the interpretation was easy and clear in the other cases. What about the complications? In 2 cases a moderate stenosis was to be noted; in 2 other cases: post-operative hemorragiae which were treated by a selective electro-coagulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

PubMed1993

The unopened colostomy: a procedure to protect colonic anastomosis.

The results of an alternative to the classic diverting lateral colostomy when used to protect a high risk anastomosis are reported. Fourteen out of 122 patients undergoing colonic or colorectal resection had a restoration of intestinal continuity with a proximal closed loop colostomy--of these 11 did not require opening in the immediate post-operative period. These had an uneventful early post-operative course, and the return of the colostomy to the abdominal cavity was performed within 10 days post-operatively, without having been opened. In three cases where local or general complications occurred, the opening of the colonic loop led to the creation of a conventional temporary protective colostomy. This procedure allowed a reduction of the originally planned number of colostomies by 50%.

Adult↗

PubMed1991

[A fetal extraction device used in under-equipped countries: the obstetrical vacuum extractor. Results of 393 vacuum extractions in the Maternity Hospital in Sélestat. (Reflections on the use of this device in African practice)].

The level of mortality and feto-maternal morbidity in under-equipped countries is frightening. It is important to find answers. Among these: the obstetrical Ventouse is an instrument that can be used for extracting the fetus without too much difficulty. It is relatively easy to learn and to apply as compared with forceps (so long as the mechanism by which it is used is understood). The conditions under which it can be used are well defined at present: term pregnancy, the woman must be in labour, fetal membranes must be ruptured, the cervix must be completely dilated, presentation must be cephalic and the head must be engaged. 393 Ventouse extractions were carried out between 1982 and 1988 at the Maternity Hospital of Selastat and this resulted in delivery of 393 infants in good health. No maternal or fetal mortality occurred in the series. The maternal morbidity was low at 0.76% and the fetal morbidity was only 4.7%. In view of our experience, we believe that the tendency for black women to have android pelves makes it preferable to use the Ventouse as against the forceps because it has several advantages. In view of the literature and of their practice, the authors advise that the obstetric Ventouse should be used in under-equipped countries where conditions of practice are often precarious and the team poorly qualified. This will reduce the mortality and morbidity due to delivery. Pregnant women are insufficiently educated. The quality of health personnel is inadequate. The health services are inadequate for the needs of the population.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

alpha-thalassemia in Bantu population from Congo-Brazzaville: its interaction with sickle cell anemia.

Deletional alpha(+)-thalassemia (-alpha(3.7)) was investigated in four groups of unrelated individuals from the Bantu population (newborns, normal adults, sickle cells trait carriers, sickle cell anemia patients) of Brazzaville, Congo. The frequency of the (-alpha(3.7)) chromosome was similar between newborns (f = 0.40) and adult subjects (f = 0.36), and between sicklers and nonsickler subjects. The frequency of the (-alpha(3.7)) chromosome in sickle cell anemia patients (SS patients) did not change when age was stratified. The hematological characteristics of SS patients with (-alpha/alphaalpha, -alpha/-alpha) and without (alphaalpha/alphaalpha) alpha(+)-thalassemia were similar to those reported in Jamaican and US sickle cell anemia patients. alpha(+)-Thalassemia had an effect on the percentage of hemoglobin S in sickle cell trait carriers. Thus, the high frequency of alpha(+)-thalassemia in the Congolese population presumably results from this disorder having a selective advantage favoring survival. However, the frequency of alpha(+)-thalassemia was not affected by age. Although in this selective tropical environment, alpha(+)-thalassemia as elsewhere markedly affects the hematological characteristics of sickle cell anemia patients, however our data provide no evidence that alpha(+)-thalassemia increases survival of SS patients.

Adolescent↗

PubMedDate not supplied

[Testicular feminization syndrome. Prenatal diagnosis: observations apropos of 2 sisters].

The anatomo-clinical aspects and the physiopathology of the feminizing testicle syndrome, are now better known. The prenatal diagnosis of this familial genetic ailment through the determination of the fetal sex by ultrasonography and the study of fetal karyotypes by amniotic fluid analysis or biopsy of trophoblast, is currently possible. Risk groups must be defined in order to ensure a better care for these children.

Adult↗

PubMedDate not supplied

[Hysteroscopic cure under ultrasonic control of complex and/or recurrent uterine synechiae].

Hysteroscopy now plays a major role in the rapidly changing therapeutic approach to the diagnosis and treatment of uterine synechiae. The fibrous nature of the lesion and its precise localization can be determined. Operative hysteroscopy has greatly benefited from technological progress in optic fibers and instrumentation. It is now possible to control the endocavitary operation with a video-endoscope. In this report, we present preliminary results obtained in 11 patients who underwent echo-controlled hysteroscopic surgical cure of complex and/or recurrent uterine synechiae. The intra-operative echographic control was validated in the operating theatre radiographically. Intra-operative echography allowed hysteroscopic lysis of intrauterine adhesions at a controlled and equivalent distance from the uterine walls. It is thus possible to better treat the uterine cornua since the operator is informed when to limit progression to avoid massive fluid infusion into the abdominal cavity and perforation of the uterus. With this technique we obtained 8 normal cavities with bilateral tube permeability. Normal cycles were achieved in 10 patients. The effect of this newly developed technique on improving fertility cannot yet be established.

Adult↗