CANCER DU COL, DYSPLASIE, DYSPLASIE SEVERE, MICRO INVASION : CARACTERISTIQUE DE LA PRISE EN CHARGE PENDANT la grossesse ?

Approximately 30% of cervical cancers occur in women of childbearing age. In early pregnancy , it is now recommended that a new cervical cytology if the previous rise to 2 years or more , or in the absence of regular monitoring. The methods of conventional cytology smears or said liquid medium are easily achievable. Pregnancy makes available the junction area and changes of pregnancy do not reduce the diagnostic value of smears after informing the cytologist. During pregnancy colposcopy examination remains essential to assess the cytological abnormalities . If the smear shows a high-grade lesion , an ASC- H, or low - grade and ASC-US or glandular atypia (AGC) colposcopy and directed biopsy is performed. Rates dysplasia found is of course variable but to behave similarly. The aim of our work is referred to the particularities of the association of cervical cancer and pregnancy in different diagnostic and therapeutic steps.Environ 30 % des cancers du col surviennent chez des femmes en âge de procréer. En début de grossesse, il est actuellement recommandé de réaliser une nouvelle cytologie cervicale si la précédente remonte à 2 ans ou plus, ou en l’absence de suivi régulier. Les méthodes de cytologie conventionnelle dite de Papanicolaou ou en milieu liquide sont facilement réalisables. La grossesse rend accessible la zone de jonction et les modifications gravidiques ne diminuent pas la valeur diagnostique du frottis après information du cytologiste. Pendant la grossesse la colposcopie demeure l’examen indispensable pour évaluer les anomalies cytologiques. Si le frottis montre une lésion de haut grade, une ASC-H, ou de bas-grade et ASC-US ou une atypie glandulaire (AGC) on réalise une colposcopie et biopsie dirigée .Le taux de dysplasie retrouvé est bien sûr variable mais la conduite à tenir est similaire. Le but de notre travail est d’évoqué les particularités liées à l’association cancer du col et grossesse aux différentes étapes diagnostiques et thérapeutiques

Corrigendum: Prefrontal Cortex Oxygenation Evoked by Convergence Load Under Conflicting Stimulus-to-Accommodation and Stimulus-to-Vergence Eye-Movements Measured by NIRS

[This corrects the article DOI: 10.3389/fnhum.2018.00298.]

Oxygenation and hemodynamics do not underlie early muscle fatigue for patients with work-related muscle pain.

Patients suffering from work-related muscle pain (WRMP) fatigue earlier during exercise than healthy controls. Inadequate oxygen consumption and/or inadequate blood supply can influence the ability of the muscles to withstand fatigue. However, it remains unknown if oxygenation and hemodynamics are associated with early fatigue in muscles of WRMP patients. In the present study we applied near-infrared spectroscopy (NIRS) on the extensor carpi radialis (ECR) and trapezius (TD) muscles of patients with WRMP (n = 18) and healthy controls (n = 17). Our objective was to determine if there were group differences in endurance times for a low-level contraction of 15% maximal voluntary contraction (MVC)--sustained for 12-13 min, and to see if these differences were associated with differences in muscle oxygenation and hemodynamics. At baseline, oxygen saturation (StO2%) was similar between groups for the ECR, but StO2% was significantly lower for TD for the WRMP patients (76%) compared to controls (85%) (P<0.01). Also, baseline ECR blood flow was similar in the two groups. For both muscles there were a larger number of patients, compared to controls, that did not maintain the 15% MVC for the allotted time. Consequently, the endurance times were significantly shorter for the WRMP patients than controls (medians, ECR: 347 s vs. 582 s; TD: 430 s vs. 723 s respectively). Responses in StO2% during the contractions were not significantly different between groups for either muscle, i.e. no apparent difference in oxygen consumption. Overall, we interpret our findings to indicate that the early fatigue for our WRMP patients was not associated with muscle oxygenation and hemodynamics

Oxygenation and hemodynamics do not underlie early muscle fatigue for patients with work-related muscle pain.

Patients suffering from work-related muscle pain (WRMP) fatigue earlier during exercise than healthy controls. Inadequate oxygen consumption and/or inadequate blood supply can influence the ability of the muscles to withstand fatigue. However, it remains unknown if oxygenation and hemodynamics are associated with early fatigue in muscles of WRMP patients. In the present study we applied near-infrared spectroscopy (NIRS) on the extensor carpi radialis (ECR) and trapezius (TD) muscles of patients with WRMP (n = 18) and healthy controls (n = 17). Our objective was to determine if there were group differences in endurance times for a low-level contraction of 15% maximal voluntary contraction (MVC)--sustained for 12-13 min, and to see if these differences were associated with differences in muscle oxygenation and hemodynamics. At baseline, oxygen saturation (StO2%) was similar between groups for the ECR, but StO2% was significantly lower for TD for the WRMP patients (76%) compared to controls (85%) (P<0.01). Also, baseline ECR blood flow was similar in the two groups. For both muscles there were a larger number of patients, compared to controls, that did not maintain the 15% MVC for the allotted time. Consequently, the endurance times were significantly shorter for the WRMP patients than controls (medians, ECR: 347 s vs. 582 s; TD: 430 s vs. 723 s respectively). Responses in StO2% during the contractions were not significantly different between groups for either muscle, i.e. no apparent difference in oxygen consumption. Overall, we interpret our findings to indicate that the early fatigue for our WRMP patients was not associated with muscle oxygenation and hemodynamics

NIRS, EMG and EKG responses for the ECR muscle contraction.

<p>Mean changes in StO₂%, HbT, RMS, MPF, IBI, pNN50, RMSSD and SDNN for the ECR during the sustained contraction.</p

Subjective Fatigue Ratings.

<p>Mean changes in subjective fatigue ratings over time for the ECR (left) and TD (right) muscles. Ratings were assessed before the sustained contraction (before cont.), immediately after the sustained contraction (immed. after), and during the recovery period (15 min and 30 min) for patients and controls.</p

Endurance times.

<p>Median endurance times represented by the lines in the boxes for healthy controls and patients with WRMP for the ECR (left) and TD (right). The lower and upper endpoints of the boxes represent the 25^th percentiles (lower quartile) and 75^th percentiles (upper quartiles), respectively. The distances between these endpoints represent the interquartile ranges. The endpoints of the bars extending out from the boxes represent the minimum and maximum values.</p

Test Protocol.

<p>Experimental protocol for the ECR and TD muscles showing the performances of test contractions (TC), venous occlusions (VO) before and after the sustained contraction, sustained submaximal isometric contraction 15% MVC to a maximum of 12 min. NIRS, EMG and EKG were recorded continuously throughout the experiment.</p