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Y Darbois

Publications and source records attributed to Y Darbois.

At least 19 recordsLinked to original sources
PubMed1992

[Laparoscopic surgery versus laparotomy. Comparative analysis of stress markers].

The place of laparoscopic surgery continues to increase in the field of surgery in our specialty. Although the advantages would seem to be obvious, it seemed to us interesting to quantify, if possible, the parameters of operative stress and compare laparoscopic surgery with conventional surgery. Markers studied are Prolactin, Cortisol, Adrenaline, Nor-Adrenaline, Dopamine and the Beta-Endorphins. The only marker that shows any difference in the two procedures in our study is Beta-Endorphin which is significantly less raised in laparoscopic surgery directly after the operation (p less than 0.01). This was very specific for pain, which is one of the benefits of this technique and shown in this parameter which confirms the clinical impression. The curves of the changes in the different markers have been analysed and discussed.

Adult↗
PubMed1992

[Pregnancy and obesity. A case control study of 140 cases].

A retrospective study of 70 fat women and 70 women of normal weight was carried out to compare their obstetric performance. The patients were assessed before pregnancy for corpulence by estimating the body mass index (IMC). Obesity was defined by having an index of 30 or above. The mean weight of the obese patients at delivery was 142 kgs and of the controls 65.4 kgs. The main risk in obese patients is a raised blood pressure (34%); and in spite of this no child showed intrauterine growth retardation. The mean weight of the newborn infants was 3.7 kgs against a mean weight of 3.2 kgs in the control group. Eighteen infants born to obese mothers were very heavy (25%). The increase in fetal weight explains why the caesarean section rate was three times as high in the obese patients as in the control due to disproportion (25%). These differences are statistically significant. Neonatal morbidity was similar in the two groups. It is debatable whether a slimming diet was worthwhile. All the same calorie intake reduced slightly to about 1.800 calories a day together with vitamin supplements is advisable. It does not have any ill effect on the fetus.

Adult↗
PubMed1992

[Hydatid cyst of the breast. Case report].

The rarity of mammary echinococcosis leads the authors to report the demonstrative case of a 45-year-old woman, para 9, gravida 9, who had always breast fed, undergoing surgery for a cyst of the right breast and which was found histologically to be a hydatid cyst. Progression of the tumour was particularly slow (approximately 10 years). Mammography forms an essential part of pre-treatment evaluation since it enables circumscription of the lesions and study of regional lymph nodes which are normal in all cases. At any event, cystectomy is the only effective method of treatment, recognised by all authors. Clinical and mammographic evaluation after 2 years of our patient was normal.

Biopsy, Needle↗
PubMed1991

[Celioscopy with peridural anesthesia. Techniques, indications, results in 220 cases].

The authors used epidural anaesthesia to carry out laparoscopy in 220 patients. The chief indications for the laparoscopies were GIFT (intratubal transfer of gametes) and tubal sterilization. The technique used was slightly different according to the indications for the use but they had to be sure of anaesthetising up to T4. In 90% of cases the patients tolerated the procedure well. No change in ventilation or in metabolic measurements. As far as fertilization was concerned studies carried out in various parameters failed to show any untoward side effects due to the use of local anaesthetics. Finally so long as the anaesthesia is only used for a short length of time this technique seems to be suitable for day cases.

Ambulatory Care↗
PubMed1991

[Heart transplantations: impact on female fertility].

Improvements in the management of patients with cardiac transplantation make it possible for these patients in the child-bearing age to expect a pregnancy. In fact, since 1987, several cases of pregnancy after cardiac transplantation have been reported. We report here two cases of successful pregnancy two years after cardiac transplantation. First Case. Pregnancy was uneventful until 36 weeks of gestation with no evidence of transplant rejection. At 38 weeks of gestation, a cesarean section was performed for increasing blood pressure, cholestatic pruritus and cephalopelvic disproportion. Cesarean section was performed under regional anesthesia and a healthy baby boy of 2680 gr was delivered. The patient was discharged one week after. Eighteen months after, both the mother and the baby are in good condition. Second case. Pregnancy was complicated by severe maternal anemia and fetal hypotrophia. Because of increasing renal insufficiency and pre eclampsia, a cesarean section was performed under regional anesthesia at 36 weeks of gestation. Delivery of a healthy baby girl of 1700 g. Five other cases have been reported. Cesarean section performed in september 1984 for a patient who underwent cardiac transplantation in 1980. Delivery of a healthy baby of 3280 gr. Death of the mother five months after following heart transplant rejection. Vaginal delivery performed in august 1986 for a patient who underwent cardiac transplantation in 1984. Delivery of a preterm baby at 31 weeks of gestation who survived without any sequelae. Vaginal delivery performed in august 1987 for a patient who underwent cardiac transplantation in april 1985. Delivery of a healthy baby of 2550 gr at 38 weeks of gestation. Vaginal delivery of twins (baby girl of 1200 and 1100 gr) in april 1988 of a patient who underwent cardiac transplantation in 1986. Vaginal delivery at 38 weeks of gestation performed in november 1990 for a patient who underwent cardiac transplantation in 1986. All the cases reported showed that: The foetus is not affected by the immuno-suppressive treatment of the mother. This was already known for pregnant patients with renal transplant. The cardiovascular changes associated with pregnancy are well tolerated by the heart transplant. Preexisting hypertension is increased, particularly during the third trimester of pregnancy and during labour. The incidence of preterm labor is increased in patients with heart transplant. Transplant rejection never occurred during pregnancy.

Adult↗
PubMed1990

[Analysis of 10 cases of pregnancy after renal transplantation].

Renal transplantation has changed completely the fertility of women who had been dialysed. Our study is on 10 pregnancies which we followed up in 7 women who had had renal transplants in the University Hospital of Pitié Salpêtrière (Professor Y. Darbois) between 1979 and 1985. All patients were treated by the same technique and the same methods of prevention of rejection of the transplant. The mean interval between the transplant and pregnancy was 53 months. In 3 cases there was hypertension and raised creatinine levels (more than 150 in 3 cases). In 2 cases the two conditions were associated. The prognosis is bad when a raised blood pressure or a change in renal function occurs before pregnancy starts, leading to a real deterioration in renal function during the pregnancy when such function was abnormal before the pregnancy started. As far as the infants were concerned, the most common complication was IUGR (intrauterine growth retardation) which was found in half of all cases. Blood flow studies in these fetuses are particularity interesting. There were two cases of intra-uterine fetal death. The reasons for these were not necessarily connected with the deterioration in renal function. All the deliveries were by caesarean section, for medical reasons in 7 out of 10 cases. The average duration of the pregnancy was 35 weeks of amenorrhoea. As far as the mothers were concerned, they did not have more infections than other women in spite of being immuno-suppressed (this was excluding urinary tract infections).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Are unexpected pregnancy over age 40 at high risk?].

A study concerning 5 years of activity at the Maternity of La Pitié, has shown differences in the population of pregnant women after the age of 40: decreased absolute number, relative increase of primiparous women, improvement of the socio-economic level, resulting in a decreased maternal and fetal pathology. The perinatal mortality remains almost 3 times higher than for the overall population.

Adult↗
PubMed1989

Epidural blood patch in the treatment of post dural puncture headache: a double blind study.

A randomised double blind controlled trial of 'epidural blood-patch' as treatment for post-dural puncture headache is presented. The method was successful in 11 out of 12 cases on its first application, the twelfth patient being relieved by a second procedure. None of six patients reported benefit from a 'sham' procedure. The rationale for the use of the technique is discussed.

Adolescent↗
PubMed1989

[Epilepsy and pregnancy. Apropos of 50 cases].

This work is a report on the follow-up of 50 pregnant epileptic women who were looked after in the Gynaecological and Obstetric Service of La Pitié-Salpêtrière in Paris. These patients had a generalised form of the disease. Well controlled patients usually had simple pregnancies. On the other hand half of those who had frequent attacks were worse during the pregnancy. It is rare for complications to occur either in the mothers or the neonates. The element that is most serious is the risk of malformation, which is three times as great whatever treatment is used and it does seem to increase according to the number of attacks occurring during the pregnancy. It therefore seems important that all epileptics should be stabilised before each pregnancy and medication should be given and controlled. It is important all the same that these are at-risk pregnancies that require clinical and ultrasound supervision.

Abnormalities, Drug-Induced↗
PubMed1988

[Genital condylomas in women. Treatment using a CO2 laser: analysis of 141 cases].

141 patients who had lesions caused by human papilloma virus (HPV) in the vulva and vagina (63 cases) or in the cervix (78 cases) were routinely treated solely by using CO2 laser. The lesions were vaporized when they were localised to the perineum and in certain selected cases in the cervix after they had been examined colposcopically and had biopsies taken. We resorted to conisation when lesions were not completely visible or when they were associated with CIN III (severe dysplasia and carcinoma in situ). Vulvo-vaginal condylomata present with certain characteristics: the infected population is young (a mean age of 27), most (81%) have diffuse forms of the condition, of the partners examined 68% were contaminated. Association with flat cervical lesions with or without dysplasia is not rare (18% of cases). Finally, treatment using only CO2 laser seems to us to be disappointing: only 55% were cured after one treatment and 84% after repeated treatments. When the condylomatous lesions on the cervix were flat we found an associated intra-epithelial neoplasia (CIN) in 66% of cases. In these cases the mean age of the patients was 28 years when these were pure viral lesions and 33 years of age when there was an associated dysplasia. Here the results after laser treatment can be considered as satisfactory because they were respectively 97 and 94% of cures whether the lesions had or did not have dysplasia. On the other hand, in our series the junction between pavement and cylindrical cells was always visible after treatment with the laser, and that made it easy to follow up these patients.

Adolescent↗