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1.
Gynecol Obstet Fertil Senol ; 49(3): 172-179, 2021 03.
Artigo em Francês | MEDLINE | ID: mdl-33166705

RESUMO

OBJECTIVES: Fetal therapy is part of the available care offer for several severe malformations. The place of these emergent prenatal interventions in the prenatal path of care is poorly known. The objective of this study is to describe the decision-making process of patients facing the option of an emergent in utero intervention. METHODS: We have conducted a retrospective monocentric descriptive study in the department of maternal-fetal medicine of Necker Hospital. We collected data regarding eligibility or not for fetal surgery and the pregnancy outcomes of patients referred for myelomeningocele, diaphragmatic hernia, aortic stenosis and low obstructive uropathies. RESULTS: All indications combined, 70% of patients opted for fetal surgery. This rate was lower in the case of myelomeningocele with 21% consent, than in the other pathologies: 69% for diaphragmatic hernias, 90% for aortic stenoses and 76% for uropathy. When fetal intervention was declined, the vast majority of patients opted for termination of pregnancy: 86%. In 14% of the considering fetal surgery, the patient was referred too far. CONCLUSION: The acceptance rate for fetal surgeries depends on condition. It offers an additional option and is an alternative for couples for which termination of pregnancy (TOP) is not an option. Timely referral to an expert center allows to discuss the place of a fetal intervention and not to deprive couples of this possibility.


Assuntos
Aborto Induzido , Terapias Fetais , Hérnias Diafragmáticas Congênitas , Feminino , Humanos , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Ultrassonografia Pré-Natal
2.
Am J Physiol ; 264(2 Pt 1): C317-22, 1993 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8447364

RESUMO

We have examined the mineralocorticoid specificity in a TBM 18-23 cell line derived from the toad bladder epithelium. In cells grown on porous substrate, corticosterone was more potent than aldosterone in stimulating a sodium transport response, measured by the short-circuit current method 6 h after hormone addition [mean affinity constant (K0.5) for corticosterone = 1 nM vs. K0.5 for aldosterone = 8 nM]. The time course of effects and saturation kinetics were identical for both agonists, suggesting interaction with identical receptors. Whereas the dose-response relationship for aldosterone did not change with time of incubation (6 vs. 24 h), the dose-response curve for corticosterone became biphasic at 24-h incubation (apparent K0.5 as high as 40 nM), demonstrating that corticosterone became apparently less potent with time. Pretreatment with carbenoxolone, a potent inhibitor of 11 beta-hydroxysteroid dehydrogenase (11 beta-HSD), restored full sensitivity at 24-h incubation to corticosterone. The 11 beta-HSD activity was low during the first 3 h of incubation in the presence of 3 nM corticosterone, and only a small fraction (approximately 7%) of corticosterone was metabolized. At 24-h incubation, 11 beta-HSD activity increased approximately 2.5-fold (P < 0.001, n = 8). We conclude that 11 beta-HSD activity is induced by its own substrate in TBM cells in parallel with the induction of the carbenoxolone-sensitive sodium transport response.


Assuntos
Corticosterona/farmacologia , Hidroxiesteroide Desidrogenases/metabolismo , Mineralocorticoides/metabolismo , Bexiga Urinária/metabolismo , 11-beta-Hidroxiesteroide Desidrogenases , Aldosterona/farmacologia , Animais , Ligação Competitiva , Transporte Biológico/efeitos dos fármacos , Bufo marinus , Carbenoxolona/metabolismo , Carbenoxolona/farmacologia , Linhagem Celular , Relação Dose-Resposta a Droga , Epitélio/metabolismo , Sódio/metabolismo , Fatores de Tempo , Bexiga Urinária/citologia
3.
J Chir (Paris) ; 110(6): 533-42, 1975 Dec.
Artigo em Francês | MEDLINE | ID: mdl-770489

RESUMO

The authors review in 100 patients, 182 wounds of flexor tendons of the fingers at the level of the hand emphasize the definite preponderance in young workers, their frequency which is all the greater as one moves away from the thumb, and approches the area of the fibrous pulleys, their common misdiagnosis, especially at the level of the thumb, their prognosis which is all the worse as one approaches the fifth finger and the areas of the pulleys. The poor results simply confirm their reputation of seriousness from an economic and social point of view. The technical problems raised by stiffening of the proximal interphalangeal joints and, above all, the formation of adhesions, are far from solved, it seems that an improvement in the results might be obtained if these wounds were repaired by specialised surgeons in a unit dealing exclusively with surgery of the hand which, under present conditions, is not always the case.


Assuntos
Traumatismos dos Dedos/cirurgia , Técnicas de Sutura , Traumatismos dos Tendões/cirurgia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias
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