J.-L. Brun's research while affiliated with Centre Hospitalier Universitaire de Nancy and other places

Publications (106)

Article
Résumé Objectif: Émettre des recommandations pour la prise en charge des femmes ayant des ménorragies. Conception: Un comité de 26 experts a été constitué. Une politique de déclaration et de suivi des liens d’intérêts a été appliquée et respectée durant tout le processus de réalisation du référentiel. De même, celui-ci n’a bénéficié d’aucun finance...
Article
It is recommended to classify Borderline Ovarian Tumors (BOTs) according to the WHO classification. Transvaginal and suprapubic ultrasonography are recommended for the analysis of an ovarian mass (Grade A). In case of an undetermined ovarian lesion on ultrasonography, it is recommended to perform a pelvic MRI (Grade A) with a score for malignancy (...
Article
Objectives: Ovarian borderline tumors (OBT) represent a heterogeneous group of lesions with specific management for each histological sub-type. Thus, the correct histological diagnosis is mandatory. Material and methods: References were searched by PubMed from january 2000 to january 2018 and original articles in French and English literature we...
Article
This work was carried out under the aegis of the CNGOF (Collège national des gynécologues et obstétriciens français) and proposes guidelines based on the evidence available in the literature. The objective was to define the diagnostic and surgical management strategy, the fertility preservation and surveillance strategy in Borderline Ovarian Tumor...
Article
Study Objective To evaluate efficacy of a 3 months course of ulipristal acetate on abnormal uterine bleeding in adenomyosis Design A multicenter randomized trial with a 3:1 ratio. Setting In five different teaching hospitals Patients or Participants Women with adenomyosis confirmed on MRI or sonography and abnormal uterine bleeding with PBAC sco...
Article
Objectives: The Collège national des gynécologues obstétriciens français (CNGOF), in agreement with the Société de chirurgie gynécologique et pelvienne (SCGP), has set up a commission in 2017 to define endometriosis expert centres, with the aim of optimizing endometriosis care in France. Methods: The committee included members from university an...
Article
Objectives: To characterize and describe treatment with ulipristal acetate (UPA) in a pre-operative setting and to evaluate the safety, effectiveness, and Health Related Quality of Life (HRQoL) outcomes in a French population treated according to standard clinical practice. Materials and methods: Multi-centre, prospective, non-interventional stu...
Article
Objective: The aim of this study was to evaluate 36 quality indicators (QIs) for monitoring the quality of care of uterine cancer to be implemented in the EFFECT (effectiveness of endometrial cancer treatment) project. Methods: The 36 QIs were evaluated in the first 10 patients diagnosed with endometrial cancer and managed in 14 French hospitals...
Article
La principal causa de útero cicatricial es la cesárea (en más del 95% de los casos). En Francia, por ejemplo, cuando a las pacientes que tienen un útero cicatricial se les propone una prueba de trabajo de parto, el 75% da a luz por vía vaginal. El riesgo de ruptura uterina aumenta de forma significativa durante una prueba de trabajo de parto, en co...
Article
Introduction La léiomyomatose héréditaire cutanée et utérine est une maladie génétique résultant de la mutation de l’intron 3 du gène de la fumarate hydratase. Cette mutation est à l’origine du développement de léiomyomes cutanés et utérins et majore aussi le risque de cancer papillaire de type 2 du rein. Le risque de léiomyosarcome est quant à lui...
Article
Full-text available
Introduction Depuis quelques années, Mycoplasma genitalium est une cause reconnue d’urétrite sexuellement transmissible chez l’homme. Chez la femme, M. genitalium est en train de devenir une cause émergente d’infection sexuellement transmissible, on parle de « nouveau chlamydia ». De nombreuses études ont montré une association positive entre M. ge...
Article
El cancer de cuello uterino es frecuente en las mujeres jovenes o entre la poblacion inmunodeprimida. Su carcinogenesis esta obligatoriamente inducida por el virus del papiloma humano (VPH) de tipo oncogenico. Existe una filiacion obligatoria entre las lesiones preinvasivas y el cancer invasivo. La evolucion de las lesiones intraepiteliales hacia l...
Article
Introduction Depuis quelques années, Mycoplasma genitalium est une cause reconnue d’urétrite sexuellement transmissible chez l’homme. Chez la femme, M. genitalium est en train de devenir une cause émergente d’infection sexuellement transmissible, on parle de « nouveau chlamydia ». De nombreuses études ont montré une association positive entre M. ge...
Article
Introduction La léiomyomatose héréditaire cutanée et utérine est une maladie génétique résultant de la mutation de l’intron 3 du gène de la fumarate hydratase. Cette mutation est à l’origine du développement de léiomyomes cutanés et utérins et majore aussi le risque de cancer papillaire de type 2 du rein. Le risque de léiomyosarcome est quant à lui...
Article
El tratamiento de la adenomiosis depende de la semiología y del deseo de preservación de la fertilidad. El tratamiento médico inicial de las menorragias incluye los progestágenos y los agonistas de la hormona liberadora de gonadotropina (Gn-RH). El dispositivo intrauterino de levonorgestrel suele preferirse a los progestágenos por vía oral por ser...
Article
Full-text available
The rarity of genital tuberculosis and the non-specificity of its manifestations lead to delayed diagnosis and the need to treat this disease at an advanced stage. We report two cases observed and treated at the Fianarantsoa Teaching Hospital: two young women (aged 22 and 33 years) discovered during work-ups for primary infertility and secondary am...
Article
Introduction Les lésions de néoplasie intra-épithéliale cervicale de haut grade (HSIL) regroupent les dysplasies modérées (CIN2) et sévères (CIN3 ou carcinome in situ). Ces lésions sont habituellement traitées par conisation, aux conséquences obstétricales non négligeables. L’évolution des CIN2 diffère de celle des CIN3, avec un taux de régression...
Article
In this review we aimed to update the possibilities of adenomyosis treatment in women excluding those with a desire for pregnancy. Adenomyosis is defined as the presence of endometrial tissue within the myometrium and frequently underestimated. Over the last decades, its pathophysiology has been better known. The diagnosis is essentially based on c...
Article
Post-term pregnancy in the broad ligament is rarely described in the literature. A 33-year-old woman, grava 2 para 1, not followed-up during gestation was admitted at 44 weeks of gestation. The fetus was dead and in transversal position, as shown by ultrasound. A cesarean section was performed and the fetus was extracted from the right broad ligame...
Article
Post-term pregnancy in the broad ligament is rarely described in the literature. A 33-year-old woman, grava 2 para 1, not followed-up during gestation was admitted at 44 weeks of gestation. The fetus was dead and in transversal position, as shown by ultrasound. A cesarean section was performed and the fetus was extracted from the right broad ligame...
Article
Cancer Antigen 125 (CA125) and Human Epididymis Protein 4 (HE4) are the most studied ovarian tumor markers. Their diagnostic performance for identification of ovarian cancer are superior to CA19-9, CA72-4, and carcinoembryonic antigen, which are no more recommended for the diagnosis of presumed benign ovarian tumor. HE4 (> 140 pmol/L) is superior t...
Article
Cancer Antigen 125 (CA125) and Human Epididymis Protein 4 (HE4) are the most studied ovarian tumor markers. Their diagnostic performance for identification of ovarian cancer are superior to CA19-9, CA72-4, and carcinoembryonic antigen, which are no more recommended for the diagnosis of presumed benign ovarian tumor. HE4 (>140pmol/L) is superior to...
Article
Since the 1993 French consensus conference on uncomplicated pelvic inflammatory diseases (uPID), new antibiotics appeared and bacterial resistances did evoluate. This methodic analysis of the literature updates different aspects of its treatment. Antibiotherapy must be established early (EL3). Inpatient and intravenous treatment is not superior to...
Article
El cáncer del ovario representa alrededor del 4% de los cánceres femeninos y es responsable de más del 5% de los fallecimientos por cáncer. Las mujeres de raza blanca o que viven en los países desarrollados son las más expuestas. Los índices de incidencia y de mortalidad, estables entre 1980 y 2000, tienden a disminuir gracias al empleo de la antic...
Article
At present, it is estimated that fibroids may be associated with infertility in 5 to 10% and are possibly the sole cause of infertility in 1 to 3%. Their effects on fertility remain debated. The aim of this review of published studies between January 1990 and November 2010 was to clarify the relation between myoma and fertility, and to assess the r...
Article
At present, it is estimated that fibroids may be associated with infertility in 5 to 10% and are possibly the sole cause of infertility in 1 to 3%. Their effects on fertility remain debated. The aim of this review of published studies between January 1990 and November 2010 was to clarify the relation between myoma and fertility, and to assess the r...
Article
To define the involvement of myomas and myomectomy in all stages from conception to post-partum in women of reproductive age. A literature review was conducted using the Medline and Cochrane databases to March 2011 by matching the keywords "fertility, infertility, miscarriage, pregnancy, delivery" with "myomas, fibroids, myomectomy". An association...
Article
This retrospective monocenter study focused on confined placental mosaicisms a priori from meiotic origin (i.e. non-mosaic type 3 confined placental mosaicisms). From a series of 14,967 chorionic villus samplings performed in our Fetal Medicine Center, 10 non-mosaic type 3 confined placental mosaicisms were identified. These abnormalities only invo...
Article
This retrospective monocenter study focused on confined placental mosaicisms a priori from meiotic origin (i.e. non-mosaic type 3 confined placental mosaicisms). From a series of 14,967 chorionic villus samplings performed in our Fetal Medicine Center, 10 non-mosaic type 3 confined placental mosaicisms were identified. These abnormalities only invo...
Article
Background: Normal menstrual periods last 3-6 days and involve blood loss of up to 80ml. Menorrhagia is defined as menstrual periods lasting more than 7 days and/or involving blood loss greater than 80ml. The prevalence of abnormal uterine bleeding (AUB) is estimated at 11-13% in the general population and increases with age, reaching 24% in those...
Article
Full-text available
Menstruation is associated with a striking increase in matrix metalloproteinase (MMP) activity. However, it is still unknown whether the level of MMP activity correlates with the amount of menstrual bleeding. We used histochemistry to investigate the degradation of the extracellular matrix (ECM), and immunohistochemical labelling and zymographic an...
Article
To assess the efficacy of therapies in menorrhagia related to atypical endometrial hyperplasia, polyps, myoma, adenomyosis and arteriovenous malformation of the uterus. Medline and Cochrane contents were searched to June 2008. Atypical endometrial hyperplasia is classically treated by hysterectomy, but may temporarily regress under hormone therapy...
Article
Évaluer l’efficacité des traitements des ménométrorragies associées aux hyperplasies endométriales atypiques, polypes, myomes, adénomyose et malformations artério-veineuses de l’utérus.
Article
To assess the efficacy, the tolerance, the duration of protection and the limitations of papillomavirus vaccines and to determine the potential indications for prophylactic vaccination. Medline, Biosis and Pascal contents were searched to July 2007. Of 546 abstracts, 30 studies were selected. Prophylactic vaccines are composed of L1 virus-like part...
Article
Objectives To assess the efficacy, the tolerance, the duration of protection and the limitations of papillomavirus vaccines and to determine the potential indications for prophylactic vaccination. Materials and methods Medline, Biosis and Pascal contents were searched to July 2007. Of 546 abstracts, 30 studies were selected. Results Prophylactic...
Article
El tratamiento de la adenomiosis depende de la sintomatología y del deseo de embarazo que tenga la mujer. Si la paciente no quiere tener más hijos, las hemorragias se tratan en primer lugar con métodos farmacológicos del tipo de gestágenos orales o intrauterinos o agonistas de la hormona liberadora de gonadotropinas (GnRH). A menudo se prefiere el...
Article
Human papillomavirus is a necessary cause for the development of cervical cancer. Cervical cancer is attributed to 15 high-risk oncogenic HPV among the 120 genotypes present in human. The infection affects about 3 out of 4 women and is often transient thanks to immunological modulators leading to viral clearance. This characteristic made it possibl...
Article
Curettage and endometrial ablation aggress the endometrium of menorragic women, thus decreasing the menstrual volume. Curettage only ablates the superficial layer of the endometrium and menorragia reappears in 50% of the cases at one year. Various techniques of endometrial ablation result in a destruction of the basal layer, avoiding theoretically...
Article
The objectives were to estimate the prevalence of Chlamydia trachomatis infection in subfertile couples and to study the relationship between markers of C. trachomatis infection and male infertility as well as pregnancy rates after in vitro fertilization (IVF). All consecutive couples consulting for infertility and IVF in Pellegrin Hospital were sc...
Article
Endometrial hyperplasias can be divided into two categories based on the presence or absence of cytological atypia and further classified as simple or complex according to the extent of architectural abnormalities. They are usually diagnosed because of irregular bleeding in perimenopause. Hysteroscopy with a biopsy gives a more accurate diagnosis t...
Article
Endometrial hyperplasias can be divided into two categories based on the presence or absence of cytological atypia and further classified as simple or complex according to the extent of architectural abnormalities. They are usually diagnosed because of irregular bleeding in perimenopause. Hysteroscopy with a biopsy gives a more accurate diagnosis t...
Poster
Full-text available
Assement of the usefulness of the different markers which led to the prenatal diagnosis of trisomy 21
Poster
Full-text available
allow couples at risks for down syndrome to have prenatal diagnosis of chromosomal anomalies in third trimester without exposing them to the risks of fetal loss during first and second trimester of pregnancy
Article
Objectif Évaluer l’index de résistance (IR = S-D/S) des artères cervico-vaginales comme moyen prédictif de l’accouchement prématuré. Méthodes Quarante-deux patientes présentant des signes cliniques de menace d’accouchement prématuré (MAP) sans étiologie retrouvée ont eu une évaluation clinique de la modification du massif cervical sous la forme d’...
Article
We assessed survival and compared clinical and pathological prognostic factors of women with invasive cervical cancer according to the age in order to define a cutoff point where screening should become useless. The survival of 308 women with invasive cervical cancer treated at Bordeaux University Hospital between 1976 and 1996 was evaluated on Dec...
Article
To assess complications and after-effects of conizations and follow-up of patients treated with 3 conization methods. Materials and methods. Two hundred and forty-one conizations were performed for cervical dysplasia using cold knife (100 cases), electric knife (39 cases) or loop electrosurgical excision (102 cases). Residual disease, post-operativ...
Article
The synthetic pentasaccharide, fondaparinux, is the first of a new antithrombotic class: selective factor Xa inhibitors. Comparative clinical trials of fondaparinux versus heparins in prevention and treatment of venous thromboembolism are ongoing. Little is known about fondaparinux during pregnancy, as women of child-bearing potential were excluded...
Article
To compare maternal and perinatal outcomes in twin pregnancy patients without any fetal or maternal disease, managed by labor induction or expectant management after 36 weeks gestation. We conducted a case-control study of 81 patients: labor induction (n=36) vs. expectant management (n=45). Labor was induced using oxytocin (n=18), vaginal prostagla...
Article
Endometrial hyperplasias are mainly regarded as a response to unopposed endogenous estrogenic stimulation and concern 12% of perimenopausal women. They are usually diagnosed because of irregular bleeding. They are divided into two categories based on the presence or absence of cytological atypia and further classified as simple or complex according...
Article
The synthetic pentasaccharide, fondaparinux, is the first of a new antithrombotic class: selective factor Xa inhibitors. Comparative clinical trials of fondaparinux versus heparins in prevention and treatment of venous thromboembolism are ongoing. Little is known about fondaparinux during pregnancy, as women of child-bearing potential were excluded...
Article
Most of symptomatic functional ovarian cysts (FOC) are treated by surgery. Oral contraceptives and ultrasound-guided puncture are not more efficient than expectant management for treating asymptomatic FOC in non menopausal women. The probability of a cyst being functional or benign in asymptomatic postmenopausal women is assessed by transvaginal ul...
Article
SR49059 is an antagonist of vasopressin V(1a)receptors currently developed as a tocolytic drug. We investigated the transplacental transfer of SR49059 in vitro using the single pass dually perfused human cotyledon model. Thirteen placentae were collected from normal term pregnancies immediately after delivery. The placental transfer of SR49059 was...
Article
Full-text available
We report the cvs of ten thousand seven hundred and forty one singleton pregnancies at risk of chromosome abnormalities (96.3%) and gene disorders (2.8%) which were referred from 1990 to 1999 to our fetal medicine unit. CVS was performed transabdominally after 11 weeks, using a modified freehand ultrasonographically guided technique by 5 operators...
Article
To describe a population of high risk pregnancies transported to a regional perinatal care centre (level III) and to analyze the advantages and limitations of the organization of this perinatal care network. Retrospective study of 263 patients transported to the University Hospital of Bordeaux between September 1996 and September 1998. Maternal tra...
Article
This study reports the fatty acid composition of subcutaneous adipose tissue in French women with special emphasis on the content of trans fatty acids originating from two main dietary sources, ruminant fats and partially hydrogenated vegetable oils (PHVO). Adipose tissue trans fatty acid levels from 71 women, recruited between 1997 and 1998, were...
Article
Thermal balloon endometrial ablation is indicated for women suffering from menorrhagia. This easy technique can be performed safely, without using operative hysteroscopy. The rate of minor complications is low (< 4%). Thermotherapy treats the endometrium and superficial myometrium tissues without risk of injury to the bladder and bowels. The succes...
Article
To evaluate survival and assess prognostic factors in patients with epithelial ovarian cancer. Retrospective analysis of 287 patients treated between 1975 and 1995. All operations were performed by senior surgeons. Histologic sections were reviewed by the same pathologist. Successive adjuvant chemotherapy regimens are described. Survival was evalua...
Article
Urinary incontinence in elderly women, though due to several factors, is not inevitable; case-by-case management is often effective.