Etude de la transmission du VIH pendant l'allaitement maternel sous trithérapie au centre de prévention de la transmission mère enfant de Pointe-Noire au Congo Brazzaville

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Risk of coexisting endometrial carcinoma in case of atypical endometrial ă hyperplasia diagnosed on total hysteroscopic resection

International audienceObjective: To evaluate the rate of coexisting endometrial carcinoma or ă atypical endometrial hyperplasia (AEH) residue in patients who had a ă total hysteroscopic resection with diagnosis of AEH and without ă suspicious lesions detected during hysteroscopy. ă Study design: This retrospective bicentric study included patients ă diagnosed with AEH on hysteroscopic resection products, and who ă subsequently underwent secondary hysterectomy. Cases of hysteroscopic ă appearance suggesting an endometrial carcinoma were excluded. ă Histopathological results of hysterectomy specimen determined the ă persistence or absence of AEH and the possible presence of coexisting ă endometrial carcinoma. ă Results: Thirty-two patients were selected. Histopathological analysis ă of hysterectomy specimens diagnosed an absence of AEH in 24/32 (75%) ă subjects, an AEH residue in 6/32 (18.8%) subjects and a coexisting ă endometrial carcinoma in 2/32 (6.2%) subjects. ă Conclusion: The risk of missing an endometrial carcinoma in patients ă diagnosed with AEH based on total hysterocopic resection is low when ă there is no suspicious hysteroscopic aspect, but this risk cannot be ă entirely excluded. Total hysteroscopic resection may be a possible ă alternative to hysterectomy in patients with AEH who refuse hysterectomy ă or are a high surgical risk. These patients require a close and long ă term follow-up due to the risks of residual lesion. (C) 2016 Elsevier ă Ireland Ltd. All rights reserved

Outcome and Follow-up of Patients with Endometrial Carcinoma Diagnosed ă on Operative Hysteroscopic Resection Specimens

International audienceAim: To study outcomes of patients diagnosed with endometrial carcinoma ă (EC) after histological analysis of endometrial resections retrieved ă during operative hysteroscopy performed for a presumed benign lesion. ă Patients and Methods: A retrospective study was conducted using medical ă records of patients who underwent operative hysteroscopy for a presumed ă benign lesion with a final diagnosis of EC between January 1994 and ă April 2014 in two tertiary academic centers. Results: A total of 29 ă patients were selected. International federation of gynecology and ă obstetrics (FIGO) classification was distributed as follows: 16 stages ă IA, 7 stages IB, 4 stages II and 2 stages III. Peritoneal cytology was ă positive in one case (stage IIIA). Median follow-up was 4.2 years ă (range=0.3-20.51). Two deaths were observed and were attributed to ă endometrial cancer. Conclusion: Operative hysteroscopy does not appear ă to influence stage of EC nor cause retrograde seeding of EC for 27/29 ă (93%) patients. For 2 patients, the impact of operative hysteroscopy ă remains uncertain

Factors influencing sexual function in women with genital prolapse

Background. To evaluate the impact of the different types of genital prolapse and associated factors, on sexual quality of life in women presenting a genital prolapse. Design and methods. Forty-four women were included in this prospective observational study. We collected clinical data. Genital prolapse was quantified according to the Pelvic Organ Prolapse Quantification scale (POP-Q). Sexual function was evaluated using a validated questionnaire (PISQ-12). Statistical analysis between POP-Q stages, clinical characteristics and PISQ-12 scores was undertaken. Results. A history of abdominal surgery significantly decreases the sexual quality of life (P=0.03). PISQ-12 scores were poorly affected by the type and the severity of genital prolapse. Conclusions. The only factor influencing sexual quality of life was a history of previous abdominal surgery. The type and severity of genital prolapse did not influence sexual function. These results must be confirmed further studies with a higher sample size

Effect of laparoscopy by single-port endoscopic access in benign adnexal surgery: study protocol for a randomized controlled trial

Abstract Background Laparoscopic surgery has become the preferred surgical approach due to a reduction in postoperative pain, better recovery, shorter hospitalization, and improved esthetic outcomes. Laparoscopic surgery with single-port laparoscopy (SPL) is a laparoscopic surgery technique that is based on making a single parietal incision using a single trocar specifically designed to allow introduction of several instruments. The level of evidence regarding the advantages of SPL in terms of postoperative pain has remained low despite several randomized studies. Adult patients exhibiting a surgical indication for an a priori benign ovarian pathology or for prophylactic purposes that can be performed by laparoscopy will be randomized to receive conventional laparoscopy (CL) or SPL. The aim of our study is to evaluate whether SPL offers advantages over CL in benign adnexal surgery. Methods The patients will be evaluated preoperatively to confirm their eligibility. The perioperative data up to 24 h after the intervention, as well as the postoperative data at day 7 and at one month from the intervention will be collected. The primary outcome for the study will be the postoperative pain at 24 h ± 2 h after the intervention. The pain will be assessed by a numeric rating scale of 0–10. Other outcomes will also be assessed, such as pain at other times, the consumption of analgesics, the operative time, perioperative bleeding, the number of additional trocars in the two groups, the incidence of laparoconversion, the esthetic criteria of the scar at one month, the incidence of complications, and the quality of life at one month. Discussion If our hypothesis is confirmed, this study will provide evidence that the use of SPL can decrease postoperative pain in adnexal surgery. The standard surgical treatment of this condition would thus be modified. Trial registration ClinicalTrials.gov, NCT02739724 . Registered on 12 April 2016

Expression of BRCA1 and BRCA2 in male breast cancers and gynecomastias.

International audienceBRCA1 and BRCA2 breast cancer susceptibility genes are responsible for most of the hereditary breast cancers. Mutations in BRCA1 account for up to 40-50% of families with hereditary breast cancer only. Mutations in BRCA2 are linked to the other half of inherited breast cancer families and also to male breast cancer. On the contrary, no sporadic breast tumors have been shown to harbor mutations in BRCA1 and BRCA2 genes. It seems that altered expressions of BRCA1 and BRCA2 genes may contribute to breast cancer development. Moreover, BRCA1 and BRCA2 expressions are regulated in human breast cancer cell lines by estrogen. We addressed the issue of BRCA1 and BRCA2 expression in male breast cancers and gynecomastias. We investigated the presence of BRCA1 and BRCA2 proteins in male breast specimens by immunohistochemical analysis with a panel of antibodies elicited against BRCA1 and BRCA2. The specificity of each antibody has been verified by Western blotting in cell lines from different origins. The characterization of 6 anti-BRCA1 antibodies revealed a BRCA1 200-kDa protein detected in breast cell lines (MDA-MB 231, HBL 100, T-47D and MCF7) or in an acute leukemia (MOLT 4), known to overexpress BRCA1. All 5 anti-BRCA2 antibodies detected a BRCA2 384-kDa protein in the HBL100 and MCF7 breast cell lines. By immunohistochemistry, we found nuclear, perinuclear, endoplasmic reticulum, Golgi vesicle, secretion and apical cytoplasmic stainings in gynecomastias and sporadic and hereditary male breast cancers, for BRCA1 and BRCA2 protein expressions. We report an extensive expression of BRCA1 and BRCA2 proteins in different compartments of the mammary gland cells in male breast carcinomas and gynecomastias. This is consistent with the estrogen-dependent expression of BRCA1 and BRCA2 in human breast cells

Additional file 1: of Effect of laparoscopy by single-port endoscopic access in benign adnexal surgery: study protocol for a randomized controlled trial

SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013 Checklist: Recommended items to address in a clinical trial protocol and related documents. (DOC 122 kb

Conformational Dynamics of the Bovine Mitochondrial ADP/ATP Carrier Isoform 1 Revealed by Hydrogen/Deuterium Exchange Coupled to Mass Spectrometry*

The mitochondrial adenine nucleotide carrier (Ancp) catalyzes the transport of ADP and ATP across the mitochondrial inner membrane, thus playing an essential role in cellular energy metabolism. During the transport mechanism the carrier switches between two different conformations that can be blocked by two toxins: carboxyatractyloside (CATR) and bongkrekic acid. Therefore, our understanding of the nucleotide transport mechanism can be improved by analyzing structural differences of the individual inhibited states. We have solved the three-dimensional structure of bovine carrier isoform 1 (bAnc1p) in a complex with CATR, but the structure of the carrier-bongkrekic acid complex, and thus, the detailed mechanism of transport remains unknown. Improvements in sample processing in the hydrogen/deuterium exchange technique coupled to mass spectrometry (HDX-MS) have allowed us to gain novel insights into the conformational changes undergone by bAnc1p. This paper describes the first study of bAnc1p using HDX-MS. Results obtained with the CATR-bAnc1p complex were fully in agreement with published results, thus, validating our approach. On the other hand, the HDX kinetics of the two complexes displays marked differences. The bongkrekic acid-bAnc1p complex exhibits greater accessibility to the solvent on the matrix side, whereas the CATR-bAnc1p complex is more accessible on the intermembrane side. These results are discussed with respect to the structural and biochemical data available on Ancp