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Biomedical subjects

P Lopes

Publications and source records attributed to P Lopes.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Endosalpingosis or microcystic and proliferating glandular inclusion disease of the genital tract and peritoneum. Apropos of 6 cases].

Endosalpingosis, defined by the presence in an ectopic site of epithelium comparable to that of the tubal mucosa, is not a well-known entity. In reference to 6 cases of our department, the authors have been able to assess this lesion. Clinical manifestations and laboratory tests offer no arguments. Cytology represents a diagnostic trap. The diagnosis may only be made histologically and is very often fortuitous. This benign lesion is often the result of a metaplasic process but, considering the difficulty of the diagnosis, the treatment is often surgical (total hysterectomy with castration). The course is uneventful.

Adult↗
PubMed1990

[Birth before 33 weeks gestational age. The significance of in utero-to-birth transfer in the Department of Perinatology].

Systematic transfer of any woman presenting a high risk of delivery before 33 weeks of amenorrhea, for birth within a Perinatology department which was 5 advocated since 1985 (especially at 31 and 32 weeks of amenorrhea) in order to minimize the neurological consequences of the haemodynamic disorders induced by the transfer of these premature babies, has permitted to increase to 40 live newborns without any severe sequelae. This improved management, noticed in three departments (121 PNB in 1988, or a 73 p. cent progression in 4 years), must now take place as early as the 25th week and before the stage of imminent birth, in order for the couple mother-fetus to take advantage, in the same location, of physicians (obstetricians and pediatricians) and technical means suitable for this rare and severe pathology that is prematurity.

Female↗
PubMed1989

[Evaluation of the probability of the occurrence of pregnancy during oligo-astheno-teratospermia].

Analysis of several sperm counts makes possible the positive diagnosis of oligo-astheno-teratospermia. Attempts to determine their etiology and consequently their treatment, remain negative, in most cases. The physician involved must then try to answer the couple's concern about the prognosis. The prognosis depends on the alterations seen on the sperm count parameters; but there is no threshold figure under which no pregnancy is observed (except for zero), concerning the count, the gradual mobility or the morphology of the spermatozoids. Motility studies, survival tests in cervical secretions, in the female genital apparatus and in culture media or fertilization in vitro tests, improve the prognosis. However, an answer can only be provided if the fertility takes into account the age of the female partner and a study of her fertility as well as the duration of the infertility. Management will consist of a choice between discontinuation of the treatment, test of fertilization in vitro and temporizing, including trials of male treatment and treatment of possibly associated female factors.

Female↗
PubMed1989

[Value of cell cycle analysis by flow cytometry in gynecology and obstetrics].

Flow cytometry is a new technique that makes it possible to study the cell cycle and the DNA content of thousands of cells per minute. Its value in oncology is prognostic, there being a correlation between the level of DNA and mitotic activity with the power to invade tissues. After a description of the cell cycle, a review of the literature demonstrates its value in gynaecology and obstetrics. Aneuploidy and marked mitotic activity correlate well with a poor prognosis for: CIN: aneuploid lesions are less likely to regress spontaneously and are found more frequently in higher grades. This is a reason for treating aneuploid CIN. Adenocarcinoma of the endometrium: aneuploidy is the best prognostic measure when analysing cells in a multifactorial way to include the stage, the grade, the degree of myometrial invasion and the receptors. Sarcoma of the uterus: in a small series aneuploidy occurred frequently and was of poor prognosis. Molar pregnancy: flow cytometry is a diagnostic aid because the hydatidiform mole is diploid with a marked degree of mitotic activity. The prognostic value has still to be determined. Ovary: borderline tumours are always diploid. In cancers of the ovary aneuploidy is a sign of aggression and predictive of survival.

Aneuploidy↗
PubMed1988

[Circulating anticoagulants and pregnancy: a risky combination].

In the last ten years the relationship between the presence of lupus type anticoagulants in the blood and some obstetrical complications, in particular spontaneous abortions, repeated fetal deaths in utero and intra-uterine growth retardation, has been well documented. A study of the literature shows that there were only twenty live-born children out of 280 pregnancies in 71 women who had the lupus type anticoagulant factor. The presence of the factor in high levels in a pregnant woman was seen to be of poor prognostic significance for the obstetric outcome. Biologically the lupus type circulating anticoagulant should be suspected when there is a five to six seconds prolongation of clotting time and it is highly suspicious if the time is prolonged by more than seven seconds. Its presence should equally be suspected by testing for the activated partial thromboplastin time (APTT). It has been shown that early treatment directed to lessen the activity of the lupus type factor (the use of corticoid-immunosuppressors) and forestalling as far as possible placental insufficiency (by giving heparin, aspirin and dipyridamole) could help, thus enabling some women to have live children who would not otherwise be able to do so.

Autoantibodies↗
PubMed1988

[Conservative treatment of grade 3 intra-epithelial cervical neoplasms. Comparative study of CO2 laser vaporization, laser conization and cold scalpel conization].

Carbon dioxide laser was used in 79% of the 141 conservative treatments carried out for grade 3 cervical intra-epithelial neoplasia (CIN III) between the years 1982 and 1986 (41% vaporized and 38% coned out by using the laser as against 21% that were treated by scalpel conisation. The mean age of the women treated in this way by the laser was low (28.5 years of age and 32.5 years as against 38.1). Their parity was also low (0.8 and 1.2 as against 2.2). The lesions were very often spread out on the ectocervix and sometimes going into the vagina (26 and 9% as against 26%) or associated with koilocytosis (65.5 and 47.2% as against 41.3%). In one out of two cases vaporisation of the lesion is contra-indicated and the three diagnostic methods that are used (an ecto and endocervical smear, colposcopy and multiple directed small biopsies) do not make it certain that there is no underlying invasion of the tissues. Vaporisation and conisation are easily carried out under colposcopic control and are associated with widespread lesions at the squamo-columnar junction. These treatments sometimes have to be repeated; then they give a cure rate of 92-96% as against 96%. They are more reliable than conventional surgery for widespread lesions and they do make it possible to keep to the morphology of the cervix and thus make it possible for the cervix that is treated to behave more physiologically. It is also much easier and more reliable in these cases to carry out follow-up for carcinoma. This follow-up should be carried out on two occasions. The triple diagnostic method should be carried out again at the third month (2 smears, colposcopy and colposcopically directed small biopsies). This makes it possible to diagnose and treat early the cases where there has been failure of the original treatment. Then ecto and endocervical smears should be repeated at 3-monthly intervals, then at 6-monthly intervals and finally annually to screen for recurrences of these neoplastic conditions, and for koilocytosis which sometimes repeat themselves in an extensive manner.

Adult↗
PubMed1988

[Fertilization in vitro with frozen donor sperm after ovocyte stimulation with an LH-RH analog, HMG, and HCG using a short-term protocol].

Frozen cryoprotected donor sperm can be used for IVF.ET. Short administration of Gn.RH analogue with HMG and HCG (Decapeptyl) are used in 39 cycles. Seven clinical pregnancies were obtained, including one which resulted from the transfer of frozen embryos. One spontaneous abortion occurred after 7 weeks amenorrhea. Pregnancy rates are 17.9% per induction cycle, 24.1% per oocyte recovery and 26.9% per embryo transfer. Cumulative pregnancy rate for one year (3 attempts at donor sperm IVF.ET) is 44.7%, but 69.9% if we consider patients who have previously benefited from 12 to 24 AID cycles. The AID success rate is 66% for the 12 months of the first year, 42.3% in the second year and 24.2% in the third year of treatment. These data make it possible to use donor sperm with IVF.ET if tubal disease is associated with severe male factors and if the women fail to conceive after 12, 18 or 24 AID cycles, depending on their age and the existence of hormonal, cervical, tubal or pelvic associated factors.

Adult↗
PubMed1988

[Ripening of the cervix uteri at term by a single intracervical application of prostaglandin E2 gel].

The efficacy and the side effects of an intracervical PGE2 gel application, as compared to placebo, for priming of the cervix have been studied in 208 patients at term (104 PGE2 and 104 placebo) with an unripe cervix (Bishop score less than 5) and with a medical indication for induction of labour. The cervical ripening success rate (as defined in methodology) is significantly higher in the treated group (58.6%) than in the control group (27.8%; p = 0.0001): 38.5% out of the PGE2 treated patients delivered within 12 hours after the gel application; 12 hours after PGE2 or placebo gel application labour was induced in the remaining patients with intravenous oxytocin infusion. Under these conditions there were 13.5% failures in the PGE2 treated group and 16.3% in the placebo group. We observed a statistically significant decrease in the length of labour of the PGE2 treated patients as compared to the control group. Since signs of myometrial hypercontractility were observed in the PGE2 treated group as compared to the control group (p = 0.01), the authors advocate careful cardiotocographic monitoring for at least three hours after the gel application. It is concluded that intracervical application of Prostaglandin E2 followed by intravenous infusion of oxytocin in an effective and safe method for induction of labour with an unfavorable cervix at term.

Adult↗
PubMed1988

[Endometriosis and fertilization in vitro. Apropos of 40 cycles].

The physiopathology and the role of endometriosis in infertility is still unclear. The use of in vitro fertilization (IVF) could be a good model for the understanding of etio-pathology and treatment when fecundity is desired. We compare results of IVF procedure in patients with endometriosis after ovulation induction with clomiphene-HMG (group 1) and Gn-Rh analog's short administration using regimen and HMG (group 2). Forty cycles have been conducted for 18 patients. Mean duration of infertility is 6.9 years and mean age of patients is 34.8 years. We observed no difference in terms of results of ovulation induction in Gr 1 or in Gr 2 compared with IVF patients without endometriosis and after the same treatment regimen, except a non significant decrease in the number of recovered oocytes. As for IVF patients without endometriosis, the use of Gn Rh analogs permits an improvement of results in terms of suppression of spontaneous premature LH surge, and increase of number of follicles and cleaved embryos. The fertilization and cleavage rates are not affected by the presence of endometriosis when compared to IVF patients without endometriosis. The number of recovered oocytes decreases with the severity of endometriosis (RAFS classification), but the pregnancy rate is not affected. Overall Third trimester pregnancy rate is 12.5% per induction cycle and 21.7% per embryo transfer. We may conclude that the presence of endometriosis does not affect the quality of the oocyte and is not a cause of exclusion in an IVF program.

Adult↗
PubMed1986

A comparison of uterine motility in the pregnant and non-pregnant cynomolgus monkey (Macaca fascicularis) and pregnant woman: a manometric and electromyographic study.

The use of a combination of manometric and electromyographic methods provided a reliable technique for evaluating variations in uterine activity in conscious macaque monkeys and women. The technique was particularly useful for obtaining data on the influence of steroid hormones. During the spontaneous menstrual cycle of the macaque, uterine motility, after being weak and poorly synchronized during the follicular phase, became still weaker with impaired synchronization during the luteal phase and then much stronger and well-synchronized at the time of menstruation. There was no evidence in vivo of any relationship between the existence of gap junctions in the myometrium of non-pregnant animals and the various patterns of uterine motility. During the last third of pregnancy in macaques, the initiation of electrical activity in various uterine areas was always synchronous with and related to mechanical contraction. The same results were obtained in preparturient women. Thus, improved uterine coordination does not appear to be the mechanism by which the uterine contractile strength increases to expulse the foetus at the end of pregnancy. Apart from the particular situation of non-pregnant animals under progestative influence, in which activity was constantly non-propagated, we could not find any evidence of a general pattern which would indicate only one site for the initiation of activity and its extension to the whole uterus.

Animals↗