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Biomedical subjects

P Boyer

Publications and source records attributed to P Boyer.

At least 19 recordsLinked to original sources
PubMed1992

A survey of zidovudine use in pregnant women with human immunodeficiency virus infection.

BACKGROUND AND METHODS: The expanding indications for zidovudine treatment make it important to elucidate the safety and toxicity of this drug for pregnant women and their fetuses. We asked pediatricians and obstetricians at the AIDS (acquired immunodeficiency syndrome) Clinical Trials Units to report information about pregnant women infected with the human immunodeficiency virus (HIV) who were continuing their pregnancies and had received, or were receiving, zidovudine during gestation. RESULTS: Reports of 43 women were received from 17 institutions. Doses of zidovudine ranged from 300 to 1200 mg per day, and 24 women took the drug for at least two trimesters. There were two reported instances of maternal toxicity (one gastrointestinal and one hematologic). No teratogenic abnormalities occurred in the 12 infants with first-trimester exposure to zidovudine. All the infants, including two sets of twins, were born alive. The 38 singleton infants born at term for whom birth weights were reported had a mean birth weight of 3287 +/- 670 g; two cases of intrauterine growth retardation were reported among the infants delivered at term. Hemoglobin values, which were available for 31 newborns, ranged from 7.0 to 12.4 mmol per liter (11.2 to 20 g per deciliter); 3 of the 7 newborns with hemoglobin values of less than 8.4 mmol per liter (13.5 g per deciliter) were born prematurely. CONCLUSIONS: Zidovudine was well tolerated by the pregnant women and was apparently not associated with malformations in the newborns, premature birth, or fetal distress. No pattern of hematologic toxicity was observed in the newborns, but the anemia and growth retardation seen in a minority of the infants could, in part, have resulted from their mothers' treatment with zidovudine.

Abnormalities, Drug-Induced↗
PubMed1992

Teratogenic Agent Information Centre: fifteen years of counseling and pregnancy follow-up.

The Teratogenic Agent Information Centre was set up 15 years ago in response to a growing demand from a medical profession struggling to cope with the problem of teratogenic risk. Our goal was to provide information on the real nature of the risk and to monitor all at-risk pregnancies so as to obtain data in a field where there are still, unfortunately, many gaps in our knowledge. The results of these 15 years have been most encouraging, in that physicians have been provided with specialized information and the follow-up of gestations had provided considerable clinical data, which has contributed to advancing our understanding in this domain.

Counseling↗
PubMed1991

Early memories as expressions of relationship paradigms: a preliminary investigation.

Earliest childhood memories (EMs) have been utilized as expressions of relationship paradigms, but few empirical studies have been conducted. This study outlines the construction and development of an EM relationship scoring system and scale utilizing nonclinical and clinical samples. It was hypothesized that relationship episodes could be reliably coded using EMs and that they would demonstrate convergent validity with measures of attachment style (Separation-Individuation Test of Adolescence), mood (Profile of Mood States), and clinical symptomatology (Symptom Checklist 90-revised [SCL-90-R] and the Minnesota Multiphasic Personality Inventory [MMPI]). The hypotheses received broad support. Findings indicate that relationship episodes may be reliably coded from EMs. Associations between individual EM variables, the EM relationship scale, and objective measures suggest that the quality of relationships expressed in EMs is associated with degree of general maladjustment. Suggestions for further research are discussed.

Adult↗
PubMed1990

Therapeutic target for cognition enhancers: diagnosis and clinical phenomenology.

Uncertainty concerning therapeutic targets has probably retarded the development of cognition-enhancing drugs. While enhancement of normal cognitive function may be a legitimate goal it is unlikely that drugs developed without a clear clinical indication will ever be approved by regulatory authorities. Normal aging as a target would also appear to be excluded. The main debate is whether drugs should be developed for specific disease states (e.g., Alzheimer's), particular syndromes (e.g., AAMI) or for treating symptoms (e.g., memory deficits). Although targeting disease states appears the least problematic, it would be difficult to include many potentially treatable patients in such studies. In this respect, the status of AAMI is still the subject of much debate. In any case, it is important that trial populations be as homogeneous as possible, with clear diagnostic criteria (e.g., defined memory impairment, Hachinski score, CT scans) and that patients be moderately to severely affected.

Aging↗
PubMed1990

Retrograde tubal transfer of human embryos.

This preliminary study was designed to evaluate retrograde cannulation of the Fallopian tubes up to the isthmo-interstitial junction using the new technique of tubal embryo stage transfer (TEST). Follicular aspiration was performed under the guidance of a vaginal ultrasound probe in 51 women treated with GnRH + HMG. The oocytes retrieved were inseminated in vitro with 50,000 motile spermatozoa and kept in Menezo B2 medium without serum, at 37 degrees C, in an atmosphere of air + 5% CO2. The eggs were checked 24 and 36 h after insemination. No fertilization occurred in 23 patients. Cleaved embryos were obtained in the 28 other patients. One to seven embryos at the 2-4-cell stage were transferred with the 'Baudelocque Black Catheter' (BBC) into one tube and spare embryos were frozen. Five pregnancies occurred after retrograde TEST, for a pregnancy rate of 9.8% per cycle and 17.9% per transfer. One patient has given birth to a normal full-term baby. One singleton and one twin pregnancy are ongoing (8 months in June 1989). The other two pregnancies were ectopic.

Adult↗
PubMed1989

Immunoreactive renin variations during fertile and infertile hyperstimulated cycles with in-vitro fertilization and embryo transfer or gamete intra-fallopian transfer.

The concentrations of prorenin (PR) and active renin (AR) were determined sequentially during ovarian hyperstimulated cycles for in-vitro fertilization-embryo transfer or gamete intra-Fallopian transfer. AR and PR increased during the early luteal phase and PR was highly correlated with the progesterone concentration. In fertile cycles, AR increased more rapidly after HCG injection and AR and PR levels were significantly higher during the late luteal phase. These results confirm the role of the renin angiotensin system in ovarian physiology.

Adult↗
PubMed1989

Salivary oestradiol in spontaneous and stimulated menstrual cycles.

The determination of steroids in saliva provides useful information in the clinical study of various endocrine functions, and salivary progesterone concentration has been widely used for assessing corpus luteum function during the spontaneous menstrual cycle and early pregnancy. However, the determination of oestradiol in saliva (SE2) has previously been found unsatisfactory. SE2 profiles and saliva/plasma E2 ratios were established (during the different periods of the menstrual cycle) by a highly sensitive radioimmunoassay method during normal menstrual cycle. During cycles hyperstimulated for in-vitro fertilization and embryo transfer, the SE2 pattern is similar to the corresponding profile in plasma with a peri-ovulatory oestradiol peak. There is a significant difference between fertile and non-fertile cycles with a higher saliva/plasma ratio in conception cycles.

Adult↗
PubMed1988

Review of treatment of symptomatic cerebral vasospasm with nimodipine.

A number of randomized studies have shown the efficacy of nimodipine, administered either orally or intravenously, for the prevention of vasospasm and its clinical consequences in patients with subarachnoid haemorrhage following rupture of an intracranial aneurysm. It remained to be proven that nimodipine could also act on already established vasospasm. This was the aim of a multicentre study carried out in France between 1984 and 1986. Of a total of 127 patients with known clinically and/or angiographically diagnosed vasospasm, 73 (group N) underwent intravenous treatment with nimodipine and 54 (group P) with placebo within 24 hours of the onset of vasospasm. There was shown to be a significant reduction in mortality and morbidity in group N (33%) compared with group P (52%). Where vasospasm was the sole determining factor (63% of all patients), the decrease in mortality and severe morbidity rate was even greater in group N (11%) compared with group P (31.5%). These results can be viewed as confirmation of the efficacy of nimodipine in treating the ischaemic consequences of established vasospasm.

Brain↗
PubMed1988

Ovarian stimulation for in-vitro fertilization combining administration of gonadotrophins and blockade of the pituitary with D-Trp6-LHRH microcapsules: pilot studies with two protocols.

In women undergoing in-vitro fertilization and embryo transfer (IVF-ET), a total of 408 IVF cycles were stimulated using human menopausal gonadotrophin (HMG) or pure follicle stimulating hormone (FSH) plus HMG in combination with a single injection of D-Trp6-LHRH microcapsules in order to enhance the ovarian response to gonadotrophins and to avoid spontaneous LH surges. Sixty-seven pregnancies were achieved. Two protocols were employed. In protocol 1 ('blocking protocol', n = 268), the pituitary was first inhibited with a full dose (3.75 mg) of D-Trp6-LHRH in microcapsules and ovarian stimulation was started after the hypogonadotrophic hypogonadal state was ascertained (E2 less than 50 pg/ml). In protocol 2 ('flare-up protocol', n = 140), the treatment with D-Trp6-LHRH microcapsules (half-dose = 1.80 mg) and the ovarian stimulation with gonadotrophins were started at the same time. Higher doses of gonadotrophins were needed (39.5 +/- 11.2 ampoules FSH and/or HMG) in protocol 1, in which the pituitary was blocked prior to and during the stimulation, than in protocol 2 (20 +/- 9 ampoules) where the exogenous gonadotrophin stimulation appeared to be augmented by the initial agonistic effect of the injection of D-Trp6-LHRH microcapsules. In patients with purely tubal infertility, under 38 years old and no male factor, the results obtained with protocols 1 and 2 were similar in terms of pregnancy rate per cycle or per embryo transfer: 22.6 versus 20.5% and 28.3 versus 27.4%, respectively. However, considering the cost benefit, 'flare-up' protocols appeared to be a better choice and could be recommended.

Adult↗
PubMed1988

Ovarian programming and GIFT.

The procedures used for programming and ovarian stimulation in GIFT are identical to those used for in-vitro fertilization. At the Baudelocque Hospital, the hypophyseal gonadal axis is suppressed by administering a gonadotrophin-releasing hormone analogue (Decapeptyl, D-Trp-6-LHRH). Programming for the week of GIFT is then possible by controlling three stages: the beginning of treatment, which is independent of the date of the patient's period, the duration of treatment, which has 5 days' maximum variation, and an end-point of suppressing the spontaneous LH surge.

Female↗
PubMed1988

Platelet serotonin content and plasma tryptophan in peri- and postmenopausal women: variations with plasma oestrogen levels and depressive symptoms.

Platelet serotonin content was measured by high pressure liquid chromatography in 56 peri- and postmenopausal women, in order to study variations of this parameter with hormonal status and depressive mood symptoms. Clinical symptoms were assessed by a self-report depression symptom scale (CES-D of NIMH). Thirty-eight women with a score of 16 or more were considered as presenting depressive symptoms (mean score +/- SD = 28.8 +/- 10.5), while the others formed the control group (n = 18, score = 4.4 +/- 4.2). Platelet serotonin contents were significantly lower in the 'depressed' group (0.302 +/- 0.010 vs. 0.366 +/- 0.020 nmol 10(-8) platelets, means + SEM, P less than 0.001 by Mann-Whitney U-test). In 'depressed' women who had been treated for one or more depressive episodes, platelet 5-HT contents (0.283 +/- 0.023, n = 18, P less than 0.01) were significantly lower with respect to controls. In patients without previous episodes of depression, serotonin expressed in nmol 10(-8) platelets did not differ significantly from controls but serotonin expressed in nmol ml-1 of blood was slightly lower than control values (0.890 +/- 0.085, n = 20 vs. 1.088 +/- 0.090 nmol ml-1, n = 18, P less than 0.02). Platelet serotonin content was positively correlated to plasma oestrone and oestradiol concentrations among the control group but not in the 'depressed' group.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Platelets↗
PubMed1988

[Immunoradiometric assay for active renin and plasma prorenin during cycles stimulated by IVFET or GIFT].

Prorenin (PR) an inactive high molecular weight form of renin normally circulates in human plasma at a concentration of about 10 times that of active renin (AR) and this proenzyme seems to be linked to the reproductive function. It has been demonstrated that AR and PR are present at high concentrations in follicular fluid when the ovaries are stimulated with gonadotropins and that the PR plasma levels increase steadily after hCG injection with a correlation between blood PR and the number of developing follicles and corpora lutea. From September 1986 we studied the profile of immunoreactive active renin (AR) and prorenin (PR) in plasma during hyperstimulated cycles for IVFET or GIFT. All women were treated with a protocol combining GnRH analog (Decaptyl Ipsen Biotech, Paris France) and human menopausal gonadotropins until injection of 5,000 IU hCG. AR has been assayed in frozen samples by specific immunoradiometry (Renin RIA code 79 795, Pasteur Diagnostic, France) using two complementary monoclonal antibodies. A second assay of total renin was carried out after trypsin activation which revealed the inactive form. Progesterone (P), estradiol (E2) were measured by radioimmuno-assays. During the follicular phase, from day 1 of hMG administration to the day before hCG, no significant difference could be found between two groups, 63 pregnant or 60 nonpregnant cycles matched for age and number of oocytes retrieved, for E2, P, PR and AR. During the periovulatory period (D - 1, Do = day of hCG injection and D 1) no difference could be found for E2, P and PR (tabl. 1). In the 2 groups the mean E2 levels increased after hCG injection, as well as P and PR. But a significant difference appeared for AR which increased in the plasma immediately after hCG administration in the pregnant group whereas it decreased in the non-pregnant group (+2.5 vs -2 pg/ml) the mean variation between Do and D + 1 being significantly different in fertile cycles and in nonfertile cycles.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1987

Progesterone and estradiol in saliva after in vitro fertilization and embryo transfer.

The importance of the luteal function to ensure adequate implantation prompted us to assay salivary estradiol (SE2) and salivary progesterone (SP) concentration serially after embryo transfer by simple and rapid radioimmunoassays to allow a noninvasive easily repeatable approach. SE2, which has fallen 1 day after human chorionic gonadotropin injection, increased after reimplantation (day 3), plateaued during approximately 1 week, and returned to basal levels before menstruation in absence of conception or in chemical pregnancy, whereas it increased steadily in successful pregnancy. SP increased in all the cases, formed a plateau, and returned progressively to basal levels before menstruation, whereas in ongoing pregnancy there was a transitory decline in the midluteal phase followed by a rapid and continuous increase, with a significantly higher ratio day 13/day 10 in successful pregnancy.

Adult↗