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V Pascal-Vigneron

Publications and source records attributed to V Pascal-Vigneron.

8 recordsLinked to original sources
PubMed2000

Successful pregnancy and birth after sequential cotreatment with growth hormone and gonadotropins in a woman with panhypopituitarism: a new treatment protocol.

OBJECTIVE: To report a successful pregnancy in a woman with panhypopituitarism who received 3 months of pretreatment with growth hormone (GH) before ovulation induction. Prior attempts at ovulation induction had failed for this patient. DESIGN: Case report. SETTING: Department of Endocrinology. PATIENT(S): A 32-year-old woman with panhypopituitarism and secondary infertility. INTERVENTION(S): GH (1 IU/day) alone for 3 months; during the next cycle, 1 IU/day of GH; 3 ampules of hMG per day during days 1-21; 1 ampule of hCG on day 21. GH was discontinued on day 35 when a pregnancy test was positive. MAIN OUTCOME MEASURE(S): Pregnancy and delivery. RESULTS: Pregnancy and birth of a normal child after a single ovulation stimulation using GH and gonadotropins. CONCLUSION(S): This case report suggests interest in a new protocol for follicular stimulation in women with hypopituitarism who are responding poorly to gonadotropin therapy.

Adult↗
PubMed1999

Selective estrogen receptor modulators.

Selective estrogen receptor modulators are a growing class of nonsteroidal compounds with estrogen-like actions in bone, lipid metabolism, and antiestrogenic actions in the breast. Tamoxifen and its derivatives have a weak estrogenic action in the uterus and are responsible for endometrial hyperplasia. Raloxifene does not stimulate endometrial growth but is less effective than tamoxifen for the treatment of patients with breast cancer. The duality of selective estrogen receptor modulators and 1 7B-estradiol actions is explained by several hypotheses referring to the molecular biology of estrogen receptor. Clinical trials are conducted with raloxifene in post-menopausal women. The results show a significant decrease in vertebral fracture risk and a decrease of low-density lipoprotein cholesterol, with no change in triglyceride levels. Endometrial thickness does not change. Interestingly, the risk for newly diagnosed breast cancer decreases significantly with no change in risk for estrogen receptor-negative tumors. Selective estrogen receptor modulators might change the way we manage hormone replacement therapy of postmenopausal women.

Bone Density↗
PubMed1997

Clinical consequences of activating germline mutations of TSH receptor, the concept of toxic hyperplasia.

Activating mutations of TSH-R have been described in toxic nodules and more recently in familial nonautoimmune thyrotoxicosis. This last entity is still confused with familial Graves' disease and the aim of this study is to define its phenotype. Based on 49 patients coming from our first family and on the 4 other kindreds secondarily described in the literature, the phenotypic expression is: a high incidence of hyperthyroidism, an early onset of disease, a higher men/women ratio (17/32) than in Graves, disease, the absence of ophthalmopathy and of circulating and intrathyroid signs of immunity, a pathology similar to toxic nodule, the need for a total destruction of thyroid tissue to cure the patients. The total analogy with toxic nodule leads us to name this new entity "toxic hyperplasia'. Among 92 successive diffuse nonfamilial thyrotoxicosis cases (initially considered as Graves) we isolated 5 cases without extra- and intrathyroidal autoimmunity, raising the question of the existence of an apparent "sporadic' form of toxic hyperplasia (neomutation?).

Animals↗
PubMed1995

[Hyperprolactinemic amenorrhea:treatment with cabergoline versus bromocriptine. Results of a national multicenter randomized double-blind study].

OBJECTIVES: Cabergoline is a new, long-acting D2 agonist, highly effective in suppressing prolactin and restoring gonadal function in hyperprolactinaemic amenorrhoea. This study compares its efficacity and safety with that of the reference compound, bromocriptine. METHODS: A prospective study involved 21 French Centres and 120 women, with hyperprolactinaemic amenorrhoea, randomized to either cabergoline (CAB 0.5-1 mg twice weekly) or bromocriptine (BRC 2.5-5 mg twice daily). Treatment is given under double-blind conditions for the first 8 weeks, and subsequently in open conditions in further 16 weeks with dose adjustments according to response. Patients were assessed for biochemical and clinical efficacy and drug safety (adverse symptoms and biology). RESULTS: Normoprolactinaemia was achieved in 56/60 (93.3%) taking CAB and 27/58 (48.2%) taking BRC (p < 0.0001). Ovulatory cycles or pregnancy were recorded in 71.6% and 48.2% of patients (p = 0.001). Prolactin suppression to below 50% of the baseline value was observed in 1.6% and 15.5% (p = 0.007). Adverse symptoms were recorded in 31/60 (51.6%) and 40/58 (69.2%) patients respectively in the double-blind period, and 53.3% versus 65.5% for the full course of the study. There were significantly fewer gastro-intestinal symptoms in the CAB group, 36.6% versus 84.5% (p < 0.0001). CONCLUSION: Cabergoline is a new prolactin-lowering drug, more effective and better tolerated with fewer gastrointestinal symptoms than the reference compound, bromocriptine.

Adolescent↗
PubMed1994

[Rhinorrhea and otorrhea: rare complications of the medical treatment in invasive prolactinomas].

Cerebrospinal fluid rhinorrhea and otorrhea are rare complications of conservative and medical management of invasive macroprolactinomas. The slow shrinkage of the tumor during therapy is responsible for delayed rhinorrhea and otorrhea which carry the risk of meningitis. The operative procedure for closure of the fistulae is needed. We report the occurrence of CSF rhinorrhea in two patients with macroprolactinoma who were treated by bromocriptine. In one patient the fistulae is surgically treated and the treatment by bromocriptine is maintained. In the other patient the rhinorrhea is associated with otorrhea and the operation is not required because of the massive destruction of skull base. The CSF rhinorrhea and otorrhea stopped after diminution of bromocriptine doses.

Adult↗
PubMed1993

Osteogenic anaplastic carcinoma of the thyroid.

An unusual osteogenic anaplastic carcinoma of the thyroid developed in a 68-year-old man and showed follicular and osteosarcomatous components. Seven months after surgery and 70 mCi 131I treatment, a local tumor recurrence was found and showed an intense uptake of 99mTc-MDP on the bone scan. After a second operation, pathologic and immunostaining analysis revealed no more thyroid carcinoma but only osteosarcomatous cells. Chemotherapy was ineffective and the patient died with diffuse pulmonary metastases 26 months after the diagnosis. The importance of osteogenic sarcomatous differentiation is proven by the bone scan. Osteosarcoma of the thyroid is a rare but well known tumor. Usually these tumors do not contain any cells originating from the thyroid epithelium and only comprise sarcomatous components. Ten cases of undifferentiated carcinoma of thyroid origin with osteogenic component have been reported. These tumors have been recently included in undifferentiated carcinomas in the second edition of the WHO classification. The evolution and pathologic findings favor the hypothesis of a transdifferentiation of the thyroid cell into osteogenic cells.

Aged↗