La diffusion des méthodes modernes de contraception : une étude dans une consultation hospitalière

Leridon Henri, Mayen Michèle and Levaillant Jean-Marc. The Distribution of Modem Contraceptive Means : a Survey in a Hospital Department. Modem contraceptive means (the pill and IUD) are available in France solely through strictly medical channels. In certain obstetrics and gynaecology sections of public hospitals there exist specialised departments and this article will strive to analyse their role. A survey was performed in a teaching hospital in the Paris region (the CHU at Créteil) in two stages : an analysis of the files of the consulting patients and an enquiry by correspondence into those women who had already used the department's facilities at least once. It seems that the consultation plays a useful start-up role in modern contraception, or one of resumption after a few months. The correspondence enquiry made it possible to reveal that the very great majority of them continued, nonetheless, to employ the contraceptive method prescribed.Leridon Henri, Mayen Michèle et Levaillant Jean-Marc. La diffusion des méthodes modernes de contraception : une étude dans une consultation hospitalière. Les méthodes modernes de contraception (pilule et stérilet) ne sont accessibles, en France, que par des canaux strictement médicaux. Dans certains départements d'obstétrique et de gynécologie des hôpitaux publics existent des consultations spécialisées, dont le présent article tente d'analyser le rôle. Une étude a été réalisée dans un centre hospitalier de la région parisienne (CHU de Créteil), en deux étapes : une analyse des dossiers des consultantes, et une enquête par correspondance auprès des femmes qui avaient déjà consulté dans le service au moins une fois. Il apparaît que la consultation joue un rôle utile de démarrage de la contraception moderne, ou de reprise de celle-ci après une grossesse, et touche une population différant peu de la clientèle normale de l'hôpital. Une forte proportion des femmes, cependant, abandonne cette consultation après quelques mois. L'enquête par correspondance a permis de montrer qu'une très forte majorité d'entre elles continuait néanmoins d'utiliser la méthode de contraception qui lui avait été prescrite.Leridon Henri, Mayen Michèle y Levaillant Jean-Marc. La difusión de los métodos de contracepción modernos : un estudio en un consultorio de un hospital. Los modernos métodos de contracepción (píldora y dispositivo intrauterino) no pueden adquirirse en Francia sino que a través de las prescripciones médicas. En ciertos departamentos de obstetricia y ginecologia de los hospitales públicos existen consultorios especiales para tal efecto. En un centro hospitalario de la región de Paris (CHU de Créteil), se hizo un estudio sobre la difusión de estos métodos, en dos etapas : un análisis de las fichas médicas de las consultantes y una encuesta por correspondencia de las mujeres que habian hecho por lo menos una consulta. Se observa que el consultorio tiene un papel util para el comienzo del uso de los métodos de contracepción modernos о para recomenzar a usarlos después de un embarazo, y las mujeres atendidas no se diferencian mucho de la clientela normal del hospital. Sin embargo una gran proporción de las mujeres abandona el consultorio después de algunos meses. La encuesta por correspondencia demuestra que en esos casos la gran mayoria de esas mujeres continua a utilizar el método que se le habia prescrito.Leridon Henri, Mayen Michèle, Levaillant Jean-Marc. La diffusion des méthodes modernes de contraception : une étude dans une consultation hospitalière. In: Population, 32ᵉ année, n°4-5, 1977. pp. 777-805

Aspects sociaux et médicaux de l'avortement. Deux enquêtes en Bretagne et à Créteil (1975-1977)

Lamy Marie-Laurence, Jourdain Alain and Levaillant Jean-Marc. — Social and Medical Aspects of Abortion. Two Enquiries in Brittany and Créteil (1975-1977). In this study, some results from a comparative survey on women requesting an abortion carried out in 9 hospitals in West France and the Créteil university hospital complex are presented. Nearly 40 % of the women used a modern contraceptive (pill or I.U.D.) at the time of conception or had just ceased using it (often on the advice or with the agreement of their physician). In Créteil, 40 % of the women stated that they had never used any method, compared with 8 % in the West; but in this region inefficient methods of contraception (withdrawal, rhythm) were very common. After the abortion, contraceptives were prescribed systematically. In the West, the pill was prescribed for 93 % of the women, whereas in Créteil the I.U.D. was the most popular with 52 % (34 % were prescribed the pill). Over 50 % of the women were re-examined at least once at the hospital 2 to 3 weeks after the abortion.Lamy Marie-Laurence, Jourdain Alain et Levaillant Jean-Marc. — Aspects sociaux et médicaux de l'avortement. Deux enquêtes en Bretagne et à Créteil (1975-1977). Cette étude présente quelques résultats d'une étude comparative effectuée à partir des données collectées dans 9 établissements hospitaliers de l'Ouest de la France et au CHU de Créteil, auprès de femmes faisant une demande d'IVG. Près de 40 % des femmes utilisaient une méthode moderne de contraception (pilule ou stérilet) au moment de la conception, ou venaient de l'interrompre (souvent sur l'avis, ou avec l'accord de leur médecin). A Créteil, 40 % des femmes ont déclaré n'avoir jamais utilisé de méthode, contre 8 % dans l'Ouest; mais dans cette région les méthodes peu efficaces (retrait, Ogino) étaient très fréquentes. Après l'intervention, la prescription contraceptive est systématique. Dans l'Ouest, la pilule est prescrite к 93 % des femmes, tandis qu'à Créteil c'est le stérilet qui domine avec 52 % (et 34 % pour la pilule). Plus de 50 % des femmes ont été revues au moins une fois à l'hôpital 2 à 3 semaines après l'intervention.Lamy Marie-Laurence, Jourdain Alain y Levaillant Jean-Marc. — Aspectos médico-sociales del aborto. Dos encuestas comparatives en Bretagne y en Créteil (1975-1977). Este estudio présenta algunos resultados de una encuesta comparativa efectuada a partir de datos recolectados en nueve establecimientos hospitalarios situados en el Oeste de Francia y en el Centro Hospitalario de Créteil. Se interrogé a mujeres que solicitaban una interrupción voluntaria de su embarazo. Aproxi- madamente el 40 % de las mujeres interrogadas utilizaban un moderno metodo de contracepción (píldora o dispositivo intrauterino) en el momento de la concepción o habían interrumpido su uso (casi siempre por consejo o con el acuerdo de su médico). En la region de Créteil, 40 % de las mujeres interrogadas declararon no haber utilizado jamás un método anticonceptivo, contra un 8 % en el Oeste; pero en esta ultima region eran declarados con mucha frecuencia métodos pocos eficaces (retiro, Ogino). Después de la intervención, se prescribe sistemáticamente algún método anticonceptivo. En el Oeste la píldora es prescrita a un 93 % de las mujeres, mientras que en Créteil el método más recomendado es el dispositivo intrauterino a un 52 % de las mujeres, seguido por la píldora (34 %). Más del 50 % de las mujeres tuvieron un control en el hospital por lo menos una vez, dos о très semanas después de la intervención.Lamy Marie-Laurence, Jourdain Alain, Levaillant Jean-Marc. Aspects sociaux et médicaux de l'avortement. Deux enquêtes en Bretagne et à Créteil (1975-1977). In: Population, 35ᵉ année, n°3, 1980. pp. 565-579

Ultrasonographically guided fine needle aspiration cytology and core-needle biopsy in the diagnosis of breast tumors

The present study was designed to assess the performance of fine needle aspiration cytology (FNAC) and core-needle biopsy (CNB) of breast lesions when these procedures are performed under sonographic guidance. The results obtained in 1142 FNAC procedures and 180 CNB procedures were analysed. The study took place in a University Hospital and a private practice clinic. The patients eligible for this study were a series of women, in whom at least one hypoechoic, limited mass was found at breast ultrasonography. Cystic masses were excluded from the study. Each individual mass was investigated using either FNAC or CNB under sonographic guidance. Accuracy characteristics to suspect or diagnose malignant and pre-malignant breast lesions, such as sensitivity and specificity, were calculated. The cytological results were classified into four categories according to standard criteria: benign; atypical and/or suspiscious for cancer (hyperplasia with atypia); malignant; and unsatisfactory for diagnosis specimen. Tissue specimens were classified according to the W.H.O. The 1142 lesions submitted to FNAC included 66 invasive carcinomas, 4 intraductal carcinomas, and 4 atypical hyperplasias. FNAC led to 6 false-negative examinations, equally distributed between small (volume ≤ 1 cm3), and larger lesions, and 1 false-positive examination. There were 12.9% (147/1142) inadequate smears. Only 3 inadequate samples were obtained in the presence of a discrete pathologic lesion (3/363, or 0.1%). All 3 corresponded to invasive carcinomas. The majority of inadequate samples (144/147, or 98.0%) were obtained in the normal/dystrophic group. Overall, the sensitivity is 92.1%, and the specificity is 84.8%. The 180 lesions submitted to CNB included 31 invasive carcinomas, 5 intraductal carcinomas, and 17 atypical hyperplasias. CNB, in this series, had an accuracy rate of 100%. In conclusion, US guidance increases the accuracy of breast tissue sampling procedures. This is of particular importance as the number of suspicious images to be investigated steadily increases, as the result of mass screening

Diagnosis of Sleep Apnea Without Sensors on the Patient's Face

International audienc

Neighbourhood socio-economic characteristics and the risk of preterm birth for migrant and non-migrant women: a study in a French district

ACL (Impact Factor)International audienceNeighbourhood-level deprivation is associated with preterm birth; preterm birth rates are also higher for some, but not all migrant groups. We studied the impact of neighbourhood characteristics (a deprivation score and the proportion of foreign-born residents) on singleton preterm birth in the French district of Seine-Saint-Denis for women born in France, North Africa, sub-Saharan Africa and other countries. Multilevel logistic regression models were adjusted for maternal demographic and health care characteristics. For women born in France, the preterm birth rate rose with neighbourhood deprivation quintile (3.8% in the first to 5.7% in the fifth, adjusted odds ratio: 1.40 [95% confidence interval 1.14, 1.72]) and with increasing proportions of foreign-born residents. Preterm birth rates were not higher in more deprived neighbourhoods for women born outside of France and were lower in neighbourhoods with more foreign-born residents; in multilevel models, the inverse association with deprivation remained significant for women from sub-Saharan Africa. Area-based deprivation measures should be used with caution in populations with large numbers of migrants. These results raise questions about the health benefits of clustering for migrant communities as well as the negative consequences of acculturation

Normal fetal urine production rate estimated with 3-dimensional ultrasonography using the rotational technique (virtual organ computer-aided analysis)

OBJECTIVE: The aim of this study was to assess hourly fetal urine production rates (HFUPRs) and establish a nomogram by measuring bladder volumes with 3-dimensional ultrasound. STUDY DESIGN: Fetal urine bladder volume was estimated in 167 normal singleton pregnancies with neither oligohydramnios nor polyhydramnios, at a gestational age of 20-41 weeks. HFUPR was estimated in a regression analysis that included at least 3 volumes calculated during the filling phase with the Virtual Organ Computed-aided AnaLysis (VOCAL) technique. We estimated interoperator variability for HFUPR less than 10 mL/h and HFUPR greater than 10 mL/h. RESULTS: Fetal urine production rates at 25, 30, 35, and 40 weeks were 7.5, 22.2, 56.1, and 125.1 mL/h, respectively. The intraclass correlation coefficients for interoperator variability were 99.2% for HFUPR less than 10 mL/hour and 97.1% for HFUPR greater than 10 mL/h. CONCLUSION: Prenatal measurement of HFUPR with 3-dimensional VOCAL ultrasound is reproducible and may help to determine the cause and prognosis of amniotic fluid volume abnormalities