[Intermediate term outcome in 70 patients with Tako-Tsubo syndromes]. / Devenir à moyen terme de 70 syndromes de Tako-Tsubo.

BACKGROUND: Tako-Tsubo syndrome is a reversible left ventricular myocardial dysfunction. There are few publications on its evolution and the purpose of this study is to describe the medium-term outcome of patients who presented this pathology. METHODS: This retrospective study included 70 patients presenting with Tako-Tsubo syndrome who were referred to Haut-Lévèque hospital between November 2003 and January 2012. The parameters included in follow-up were: number of cardiovascular events, recurrence, electrocardiographic and echocardiographic evolution. RESULTS: Sixty-eight patients had a mean follow-up of 4.8±2.4 years. The survival rate was 92%, 39 patients (57%) showed no cardiovascular symptoms, 12 (18%) had one or more new episodes of chest pain and 4 (6%) had stage II dyspnoea on the NYHA classification scale. One patient had a recurrence 6.5 years later, triggered by the same stress as the first instance. Forty-five patients (64%) had ECGs which evolved in the early days to diffuse T-wave inversion. In the medium term, 32 (54%) patients had a normal ECG, 19 (32%) had inverted T-waves in precordial leads and 2 (3%) had Q-waves. In terms of echocardiography, left ventricular ejection fraction was normal in all with variable delays. Four patients continued to have apical hypokinesia. CONCLUSION: This study shows that the medium-term outlook is favourable in terms of cardiovascular mortality and that recurrence is rare. It highlights, however, the persistence of electrocardiographic and echocardiographic abnormalities.

[The legal risk in obstetrics in XVIIth and XVIIIth centuries]. / Le risque juridique en obstétrique aux xvii(e) et xviii(e) siècle.

The implication of obstetricians in case of an unfavourable parturition ending is not a particularism nor an innovation of our present times, as modern practitioners may believe. In fact, implications in court cases and public contests are as old as the practice of midwifery itself. So it sounds interesting to present to modern obstetricians the atmosphere around contentious matters in midwifery practice along the xviith and xviiith centuries, in France, which was at thoses times the preeminent country in Europe in medecine and midwifery domains. This historic review will allow, by the way, a quick reminding of the knowledge of those times.

[Preliminary results of a new technique of endoscopic sterilization : placing a silastic ring on a tubal loop (author's transl)]. / Premiers résultats d'une nouvelle technique de stérilisation endoscopique : pose d'anneau de silastic sur une anse tubaire.

PIP: Electrocoagulation as a means of sterilization has been very much used with good results; still, even when done by experienced surgeons, it involves a danger of complications. The authors reports on their first 30 cases of sterilization by celioscopy, using the technique and equipment devised by Dr. Yoon, of the Johns Hopkins University. The procedure, which can be done under general or local anesthesia, involves the use of a special silastic ring mounted on the celioscope and introduced via a dilatator. The procedure is easy to perform, but it is not reversible. Notable advantages of the procedure are: 1) short hospitalization; the patient can go home after a couple of days, 2) reduction of costs, and 3) absence of postoperative pain. No serious side effects were noted.^ieng

[Possible immunologic factors in natural selection of the sexes]. / Rôle éventuel de facteurs immunologiques dans la sélection naturelle des sexes

The foetal graft is protected from immunological rejection by the trophoblastic barrier, antigenically neutral. A deficiency of this protective barrier puts the highly antigenic egg contents in direct contact with the maternal organism. The formation of maternal antibodies, and the rejection reaction of the egg graft due to it, probabally explains certain miscarriages. We think that the male fetus must, in these cases, be more antigenic with regard to the graft carrying maternal organism, than the female fetus. A study of 222 pregnancies, with repeated spontaneous miscarriages confirms the clear preponderance of girls, among the non-premature and well-formed children born, and the efficiency of H.C.G. in protecting threatened pregnancies with male fetus.

[Methods of natural and voluntary sex selection. Value for the prevention of sex-linked malformations and of certain recurrent abortions]. / Les méthodes de sélection naturelle et volontaire des sexes

Voluntary selection of the sex of a foetus may have an undeniable value in the prevention of certain diseases of malformations which are sex-linked. An indirect statistical control of the efficiency of these methods was carried out on 100 sterile treated couples. These couples agreed to respect a certain number of parameters which constitute the methods of voluntary selection of the sex of the foetus. Under these conditons and taking care that we were dealing only with cases where the sperm cell count was normal, the results were positive in 77%. It is probable the the results would have been above 80% if the parameter of the low pH of the vagina had been used as well. Attention was then directed to the possibility of using these methods to prevent certain sex-linked congenital malformations on the one hand (a classical idea) and prevention of certain repeated abortions on the other hand (a less well accepted idea). Three characteristic case histories have been reported to support these hypotheses.

PIP: An indirect statistical study of the efficiency of methods of voluntary sex selection was carried out with 100 couples who had been treated for sterility. Sperm count was normal in all cases. Couples agreed to respect certain parameters which constitute the methods of voluntary sex selection. Results were positive in 77% of the cases; if the parameter of low vaginal pH had been used, it is probable that results would have been above 80%. Voluntary selection of the sex of a fetus may be valuable in the prevention of sex-linked diseases or abnormalities and in prevention of certain repeated abortions.

[Voluntary choice of sex. The present state of our knowledge]. / La sélection volontaire du sexe. Point actuel de nos connaissances

Whether we like it or not, the next demand that the modern couple will make after birth control will be voluntary selection of the sex of their babies. Furthermore, this selection does have an undoubted medical value in preventing certain sex-linked congenital or hereditary diseases. Many research workers have turned their attention to these problems over the past years, especially in the U.S.A., in England and in Germany. After a historical review of the progress that has taken place in this area a study has been undertaken into the actual state of research in the U.S.A. and in Germany, in which the country the Federal Government has created a special department for scientific research. Our present knowledge into the methods that are adopted to obtain a foetus of male of female sex up to the present is then briefly explained. The results obtained by the principle research workers have been summarised. These are between 80 and 90 per cent success. The steps that have marked these discoveries in this field that is ill understood by the majority of doctors and the French public are outlined.