PubMed HealthSearch

Biomedical subjects

V Beaumont

Publications and source records attributed to V Beaumont.

At least 19 recordsLinked to original sources

Hyperhomocyst(e)inemia, anti-estrogen antibodies and other risk factors for thrombosis in women on oral contraceptives.

Hyperhomocyst(e)inemia was shown to be associated with vascular occlusion in atherosclerotic patients. We have conducted a study to determine if hyperhomocyst(e)inemia was also related to the vascular events observed in women on oral contraceptives, presumably having little or no atherosclerosis. Two hundred women receiving oral contraceptives were included in the study: 100 were healthy controls and 100 had documented vascular occlusion. Determination of serum homocyst(e)ine and anti-estrogen antibody levels wore performed under blind conditions. They were evaluated in logistic regression models in which age and smoking were also included. Women with vascular occlusion had higher levels of homocyst(e)ine (P less than 0.001) and of anti-estrogen antibodies (P less than 0.001) when compared to controls. They were also older (P less than 0.001) and more frequently smokers (P less than 0.05). The above mentioned variables were, in isolation, independent predictors of vascular occlusion. Moreover, a model assessing those variables and their interactions indicated that the levels of anti-estrogen antibodies and smoking increased the predictability in older women, as well as the levels of age-adjusted homocyst(e)ine. The study suggests that the above factors can identify women at risk and that determination of anti-estrogen antibodies and homocyst(e)ine levels may help to detect women predisposed to vascular occlusions when taking oral contraceptives.

Adult

Oral contraceptives, sex steroid-induced antibodies and vascular thrombosis: results from 1318 cases.

The role of antiethinyl estradiol antibodies (anti EE Ab) and associated risk factors was evaluated in 1318 cases of venous or arterial thrombosis in oral contraceptives (OC) users, and compared to 61 non-users and 124 healthy current users. Anti EE Ab were absent in non-users and present in 33% of healthy users and 72% of those with thrombosis, either arterial or venous. Age, duration of use, hyperlipidaemia and smoking were factors associated with thrombosis only in women with an arterial disease. While the two predominant factors, anti EE Ab and smoking may be risk factors in their own right, the combination of both was found in 47.7% of women with thrombosis. It is proposed that thrombosis associated with OC use may be explained by an immunological disease in which anti EE Ab and their complexes with the circulating synthetic hormones may be harmful to the vessels, as also suggested by the type of lesions already described in OC users. The determination of anti EE Ab in healthy users may identify a group at risk of thrombosis.

Adult

[Vascular risk of oral contraceptive agents: realities and mechanisms. II. Mechanisms of vascular accidents: their prevention].

The mechanism of the vascular complications related to oral contraception is still unclear. In the present paper are discussed: (a) the possibility of accelerated atherosclerosis, suggested by the presence of a number of risk factors, a hypothesis which is not confirmed by pathological findings; (b) the possibility of a coagulation disease leading to thrombosis; (c) the arguments in favor of an immunological mechanism. This hypothesis is supported by the strong correlation between vascular complications and presence of antibodies against the synthetic hormones contained in the drug. It is also consistent with the aspect of the lesions, which might be induced by circulating immune complexes and antibodies. It is proposed that women at risk should be detected by systematic determination of antiethinylestradiol antibodies.

Adult

[Vascular risk of oral contraceptive agents: realities and mechanisms. I. Risk evaluation].

The suspected risk of oral contraception was confirmed when large scale epidemiological studies became available. The present work recalls the methodology of a good evaluation, the pros and cons of retrospective and prospective studies, the different appreciations provided by measuring "relative risk" or "attributable risk". In terms of public health, the data obtained supported the necessity to include mortality related to oral contraception in an evaluation of reproductive mortality. This work compares the incidence of vascular complications evaluated through different studies, according to the criteria selected and the type of vascular disease. The advantage of lowering estrogen content is considered.

Abortion, Spontaneous

Antiestrogen antibodies, oral contraception and systemic lupus erythematosus.

Oral contraceptives (OC) are suspect to play a role in systemic lupus erythematosus (SLE). It has previously been shown that OC can induce immune reactions in a number of normal women. Antiethinylestradiol antibodies (anti-EE Ab) have been detected with a radioimmunoassay method in 25-30% of healthy OC users. In the present paper, a comparative study of 123 controls and 55 SLE patients, with or without OC use, indicates (1) that in the disease-free group, anti-EE Ab were detected in 30% of OC users, and only in OC users; (2) that in the SLE group, anti-EE Ab were observed in 57% of female OC users, and, surprisingly, in 13% of men also, a finding already reported by other authors.

Adolescent

[Demonstration of specific antibodies against diethylstilbestrol during treatment of prostatic cancer].

Antibodies against diethylstilboestrol were detected in prostatic cancer patients treated with diethylstilboestrol (DES). Direct radioimmunoassay (DRIA) was performed in 109 patients divided into three groups: a control group of 33 patients (group I), a group of 38 patients treated by DES and free of cardiovascular complications (group II), and a group of 38 patients treated by DES with cardiovascular complications (group III). Antibody count was significantly higher in group III than in the two other groups (p less than 0.05). These results suggest that DES antibodies may play a role in estrogen-associated cardiovascular toxicity. For this reason, DES should not be used in patients with a positive assay.

Adenocarcinoma

Residual vascular risk of discontinued oral contraception. Role of antibodies to synthetic sex hormones.

Recent epidemiological data indicate that the risk of thromboembolic disease associated with oral contraception (OC) may persist after discontinuation of the drug. It was demonstrated on the other hand that antibodies to sex steroid hormones which develop in OC users, were significantly correlated with the incidence of thrombosis. It is well known that antibodies may persist years after the antigenic stimulation. So it was of interest to see if the eventual occurrence of thrombosis in ex-users might be correlated with the presence of anti-sex steroid antibodies remaining after stopping OC. Thirty-eight women with thrombosis on OC and positive antibody levels, who were required to stop the pill, were followed for periods ranging from 1 to 10 years. No disappearance of anti-ethinyl-estradiol antibodies (anti-EE ab) was observed except for 2 cases. On the other hand, 109 patients with thrombosis either current- (50), past- (29), or never-users (30) of OC were compared to 102 controls of similar groups. Results indicate that the levels of anti-EE ab, and the percentage of women who had anti-EE ab, were similar in those who experienced thrombosis either in the course of OC or after discontinuation. A significant difference was observed between both cases who were current- or ex-users and their controls.

Adult

Immunogenicity and the vascular risk of oral contraceptives.

Data concerning circulating immune complexes were obtained for women who had had a pulmonary embolism, myocardial infarction, or cerebral thrombosis, and for 224 healthy controls. In women with pulmonary embolism who had used oral contraceptives concentrations of circulating immune complexes were significantly higher than in healthy controls (regardless of oral contraceptive use), or in those with pulmonary embolism who had never used these preparations. Concentrations of circulating immune complexes were not raised in myocardial infarction, but these women had major risk factors for ischaemic heart disease. The group of patients with cerebral thrombosis without risk factors tended to have high concentrations of circulating immune complexes. The data provide some confirmation that immunological mechanisms may play a role in thrombotic episodes associated with oral contraceptives, especially when they occur in the absence of risk factors for vascular disease.

Adolescent

[Immunogenicity of synthetic sex hormones and thrombogenesis].

The ingestion of synthetic steroidal and non-steroidal estrogens may induce antiestrogen antibodies in women on oral contraceptives, and in prostatic patients treated with diethylstilbestrol (DES). Natural sex hormones have no such effect. A radioimmunoassay with tritiated ethinylestradiol or DES was applied to study the prevalence of synthetic sex hormone antibodies in 2 populations: 100 women on estroprogestative hormones and 93 cases of DES treated prostatic cancers. Homologous non-treated controls were compared. Results allowed to identify among treated and asymptomatic subjects an immunoreactive population of 30% women and 47% men. Furthermore, the antibodies were found with a much higher frequency (p less than 0.001) in patients who had experienced a thromboembolic disease while on treatment: 90% of women and 74% of men. The importance of these antibodies as a risk factor, their possible role in promoting vascular lesions, the interest of their detection for the prevention of the vascular risk induced by synthetic sex hormones, are considered.

Adolescent

[Type V hyperlipemia. 54 cases (author's transl)].

Type V hyperlipemia is not very common. The series of 54 cases descrubed here is the largest reported to date. Our observations were recorded when lipidograms showed the presence of chylomicrons and a large pre-beta-lipoprotein spot in the serum of fasting subjects. Type V hyperlipemia was often combined with other metabolic syndromes such as diabetes, hyperuricemia or gout, or obesity. Chronic alcoholism was also noted in half our subjects, in whom hyperlipemia quickly regressed after alcohol consumption ceased. Ischemic arterial complications, chiefly coronary, were found in one third of our cases, and the vascular risks accompanying this type of hyperlipemia rose considerably in patients with high blood pressure. Various type of treatment were administered, but all subjects were put on a special diet, comprising either the elimination of alcoholic drinks only, or, in addition to this, reduced carbohydrate or calorie intake. As a rule, these measures resulted in a distinct regression of lipid anomalies. Clofibrate or derivatives proved effective in cases where hyperlipemia failed to respond to dietary measures.

Adolescent

[Contraceptive hormones, vascular risk and abnormal precipitation of serum gamma-globulins (author's transl)].

The monoclonal anti-ethinyl-estradiol antibody previously found in the serum of a woman on oral contraceptives, was precipitated by 25% saturated ammonium sulfate à 22 degrees C. This simple test has been used to investigate the possible relationship between abnormally precipitating gamma-globulins (GAP) and the vascular risk of the pill. Four groups of women were studied: --50 women who had never used the pill; --100 women on oral contraceptives; --30 women who had stopped the pill; --17 women had experienced venous or arterial thrombosis during oral contraception. The results obtained indicate: 1) that a GAP increase is nearly always associated with the thrombotic events (90% of the cases in group 4); 2) that the presence of GAP is seen only in part of the women population on oral contraceptives representing approximately 30% of the total population investigated as indicated by a bimodal distribution. 3) that the GAP remain increased for months and even years after the pill was discontineud. The significance of this test is discussed. It is proposed that the presence of GAP in the serum appears to be related to the presence of ethinyl-estradiol binding antibodies. This hypothesis is verified by experiments in progress.

Adolescent