Effect of adding pelvic floor muscle training to weight loss intervention on urinary incontinence in overweight women: A randomized controlled trial

ObjectiveOur objective was to study the effect of the association of weight loss intervention and pelvic floor muscle training (PFMT) on unirary incontinence (UI) in obese women.MethodsThis prospective study included 107 obese women with urinary incontinence (UI) randomized into three groups: G1 including women who underwent a training program with a low calorie diet, G2 women who underwent the same training associated to a PFMT and G3 women without any therapeutic intervention. An evaluation was realised a week before the beginning and after 12 months.ResultsA reduction of the BMI (body mass index) was noted in G1 and G2 (P<0.001). Sixty-six percent of women in G1 and 85.3% of women in G2 reported that their condition improved. The score of PFM strength was significantly improved only in G2 (P<0.001). Only in the two first group, we noted a significant reduction in the number of voiding and of leakages per day (P<0.001), a significant amelioration in the 24-hour pad test (P<0.001) and a significant improvement of the Urinary Disability Measure (UHM) and the score of quality of life (P<0.001). The improvement of all these parameters was more important in G2 (P<0.001).DiscussionThere are studies that report the effect of either weight loss intervention or PFMT for treating female UI [1,2]. However, there is no study that reveals whether or not there were additional effects of adding weight loss intervention to PFMT for UI in obese women. This work shows that the best management for UI in obese women must include weight loss intervention and PFMT with making women aware of their floor pelvic muscles. However, the limited nature of follow-up beyond the end of treatment means that the long-term outcomes of use of PFMT or weight loss intervention remain uncertain

Lupus érythémateux systémique à début pédiatrique: à propos d’un cas

Le lupus érythémateux systémique (LES) est une maladie systémique auto-immune d'étiologie inconnue qui touche essentiellement les femmes àl'âge adulte. Le lupus pédiatrique est une entité rare. Nous rapportons une nouvelle observation. Il s'agissait d'un nourrisson âgé de 7 mois quiprésentait des lésions cutanées purpuriques, une polyarthrite fébrile. Le bilan immunologique était positif (AAN et anti-ADN). Une améliorationclinique et biologique a été notée sous corticothérapie générale avec une récidive lors de la dégression du traitement

Carcinome basocellulaire métatypique : a propos de deux cas

Introduction : : Le carcinome métatypique est une entité rare. Il touche essentiellement la région cervico-faciale chez un sujet de sexe masculin. Les auteurs étudieront, à travers deux observations, les caractéristiques cliniques et évolutives du cancer métatypique ainsi que les difficultés thérapeutiques. Observation 1 : Un homme âgé de 41 ans, a présenté un carcinome métatypique temporo-pariétal droit traité initialement par chirurgie. Cinq ans plus tard, il a été réopéré pour une récidive locale et ganglionnaire et a bénéficié ensuite d’une cobaltothérapie, stabilisant ainsi la maladie pendant 4 ans au bout desquels on a noté la survenue d’une deuxième récidive locale avec des métastases pulmonaires. Le malade est décédé, à 10 ans de recul, dans un tableau de pneumopathie diffuse avec septicémie sévère. Observation 2 : Un homme de 71 ans, a présenté un carcinome métatypique de la région rétro- auriculaire. Il a eu une exérèse tumorale avec des limites chirurgicales envahies. Il a présenté plusieurs récidives locales traitées par des exérèses larges jusqu’à une pétrectomie totale. Les limites chirurgicales étaient toujours tumorales. Une radiothérapie postopératoire a été réalisée pour chaque récidive. A 7 ans de recul, il a présenté une récidive locale envahissant l’angleponto-cérébelleux et le cerveau, jugée en dehors de toutes ressources thérapeutiques. Discussion : Le carcinome métatypique est caractérisé par son agressivité et sa tendance à la récidive. Son traitementest essentiellement chirurgical. Une large marge de sécurité lors de l’exérèse est indispensable. La radiothérapie est un traitement adjuvant, devenu incontournable vu le haut risque de récidive. Le rôle de la chimiothérapie n’est pas encore prouvé.

Quel bilan d’extension faut-il faire pour les carcinomes indifferencies du nasopharynx ?

Introduction: Nasopharyngeal carcinoma prognosis is often correlated with its local extension but especially lymphatic node and metastatic.The aimof our work was to study sensitivity and the specificity of clinical and paraclinic explorations in the initial assessmentPatients and methods : It .s about a retrospective study of 366 patients having nasopharyngeal carcinoma, diagnosed over eleven years period between 1993 and 2003 in Sfax hospital. Into pretherapeutic, all the patients had a complementary assessment including:- Nasopharyngeal tomodensitometry (TDM), in all the cases, extended to the cervical area in 112 cases and a magnetic resonnance Imagery (MRI) of the nasopharynx and cerebral in 18 cases.- Metastatic assessment: comprising systematically a chest radiography, an abdominal ultrasonography and an osseous scintiscanning. The statistical study comprised a descriptive study and an analytical study.Results : The metastasis diagnosis was retained in 39 cases (10,7%): osseous in 82%, hepatic in 23% and pulmonary in 12,8% of the cases. The tumour was associated to lymph node N3 in 25 cases (64%). At univariate study, we retained the presence of significant difference between the groups of the metastatic and lack metastatic patients for : the male sex, reason for consultation (cervical node, rhinologic signs and otologic signs) and cervical node at the examination.The multivariate analysis for all the factors was without interest. We choose the parameters according to the result of the univariate study, the literature and parameters' found among all patients with discovered CNP. It comes out from this study that the following elements are providers of metastases: age between 40 and 45years, male sex and cervical node N3a stage.Discussion : The assessment of extension is not standardized for all the authors. Indeed, for the study of the pulmonary extension (AJCC)/ (UICC) recommends the systematic practice of the chest radiography. For (NCCN), the practice of chest radiography is only for patients classified at the stage 2 and 3 in WHO classification. For KUMAR, LEUNG and our results, it is recommended systematically to practice the chest radiography . This radiography would be supplemented by a thoracic tomodensitometry with the least suspect lesion. For the hepatic assessment, some recommend the systematic practice of abdominal echography for the advanced nodestages (N3). For others, it will be indicated only for the symptomatic patients. For (AJCC)/ (UICC) abdominal echography is systematic.For the osseous assessment, KRAIPHIBUL recommends the practice of the osseous scintiscanning only for patients having signs of osseous call but LEUNG and SHAM recommend the practice of the osseous scintiscanning only for the patients having cervical node N3.Key words: Nasopharyngeal carcinoma/ extension assessment/ metastasis

Polysaccharides from Phormidium versicolor (NCC466) protecting HepG2 human hepatocellular carcinoma cells and rat liver tissues from cadmium toxicity: Evidence from in vitro and in vivo tests

© 2018 Elsevier B.V. The in vitro antioxidant, cytotoxic and cytoprotective properties and in vivo hepatoprotective activities of crude polysaccharides extracted from cyanobacteria Phormidim versicolor NCC466 (CFv-PS) were investigated. The CFv-PS, identified as heteropolysaccharides with molecular weight of 63.79 kDa, exhibited relatively strong antioxidant activity, in a concentration-depended manner, in vitro assays. Additionally, CFv-PS did not induce cytotoxic effect on HepG2 human hepatocellular carcinoma cells within the range of tested concentrations (25–150 μg·mL−1) while preventing them against Cd. Moreover, in rats subjected to Cd-induced hepatotoxicity, CFv-PS pretreatment significantly (P < 0.05) reduced the level of ALAT, ASAT, biliburin, MDA, protein carbonyl and DNA damage, and markedly increased enzyme activities in liver tissues. These findings suggest that the cyanobacteria Phormidium versicolor is a potential source of natural products possessing antioxidant, cytoprotective and hepatoprotective properties

Bioactive Lipids, Antibacterial, Hypoglycaemic, and Antioxidant Potentials of Immature and Mature Vicia faba L. Seeds Cultivated in Tunisia

Both the immature and mature Vicia faba L. seeds are used for human consumption. However, there is a lack of information on the phytochemical composition and the potent biological properties of the immature seeds. The aim of the present study was to establish the profile of bioactive lipids as well as the antibacterial, antioxidant, and α-amylase and α-glucosidase inhibitory capacities of the immature and mature Vicia faba L. seeds. The studied petroleum ether extracts contain different bioactive compounds such as β-sitosterol, lupeol, β-amyrin, α-tocopherol, and γ-tocopherol. The extracts of the immature seeds exhibited higher antioxidant and antibacterial activities than those of mature ones. All tested extracts exerted higher inhibition on α-glucosidase than α-amylase. The immature seeds appeared as promising sources of natural antioxidants, antibacterial compounds, and α-amylase and α-glucosidase inhibitors. Thus, the immature Vicia faba L. seeds have a great potential as functional foods providing health beneficial properties

Building an XML document warehouse

International audienceData Warehouses and OLAP (On Line Analytical Processing) technologies are dedicated to analyzing structured data issued from organizations' OLTP (On Line Transaction Processing) systems. Furthermore, in order to enhance their decision support systems, these organizations need to explore XML (eXtensible Markup Language) documents as an additional and important source of unstructured data. In this context, this paper addresses the warehousing of document-centric XML documents. More specifically, we propose a two-method approach to build Document Warehouse conceptual schemas. The first method is for the unification of XML document structures; it aims to elaborate a global and generic view for a set of XML documents belonging to the same domain. The second method is for designing multidimensional galaxy schemas for Document Warehouses

Recommendations for the surgical treatment of endometriosis. Part 2: deep endometriosis

Study question: How should surgery for endometriosis be performed? / Summary answer: This document provides recommendations covering technical aspects of different methods of surgery for deep endometriosis in women of reproductive age. / What is known already: Endometriosis is highly prevalent and often associated with severe symptoms. Yet compared to equally prevalent conditions it is poorly understood and a challenge to manage. Previously published guidelines have provided recommendations for (surgical) treatment of deep endometriosis, based on the best available evidence, but without technical information and details on how to best perform such treatment in order to be effective and safe. / Study, design, size, duration: A working group of the European Society for Gynaecological Endoscopy (ESGE), European Society of Human Reproduction and Embryology (ESHRE) and the World Endometriosis Society (WES) collaborated on writing recommendations on the practical aspects of surgery for treatment of deep endometriosis. / Participants, materials, setting, methods: This document focused on surgery for deep endometriosis, and is complementary to a previous document in this series focusing on endometrioma surgery. / Main results and the role of chance: The document presents general recommendations for surgery for deep endometriosis, starting from preoperative assessments and first steps of surgery. Different approaches for surgical treatment are discussed and are respective of location and extent of disease; uterosacral ligaments and rectovaginal septum with or without involvement of the rectum, urinary tract or extrapelvic endometriosis. In addition, recommendations are provided on the treatment of frozen pelvis and on hysterectomy as a treatment for deep endometriosis. / Limitations, reasons for caution: Owing to the limited evidence available, recommendations are mostly based on clinical expertise. Where available, references of relevant studies were added. / Wider implications of the findings: These recommendations complement previous guidelines on management of endometriosis and the recommendations for surgical treatment of ovarian endometrioma. / Study funding - Competing interest(s): The meetings of the working group were funded by ESGE, ESHRE and WES

An observational study on the expression levels of MDM2 and MDMX proteins, and associated effects on P53 in a series of human liposarcomas

Background: Inactivation of wild type P53 by its main cellular inhibitors (MDM2 and MDMX) is a well recognised feature of tumour formation in liposarcomas. MDM2 over-expression has been detected in approximately 80% of liposarcomas but only limited information is available about MDMX over-expression. To date, we are not aware of any study that has described the patterns of MDM2 and MDMX co-expression in liposarcomas. Such information has become more pertinent as various novel MDM2 and/or MDMX single and dual affinity antagonist compounds are emerging as an alternative approach for potential targeted therapeutic strategies. Methods. We analysed a case series of 61 fully characterized liposarcomas of various sub-types by immunohistochemistry, to assess the expression levels of P53, MDM2 and MDMX, simultaneously. P53 sequencing was performed in all cases that expressed P53 protein in 10% or more of cells to rule out mutation-related over-expression. Results: 50 cases over-expressed MDM2 and 42 of these co-expressed MDMX at varying relative levels. The relative expression levels of the two proteins with respect to each other were subtype-dependent. This apparently affected the detected levels of P53 directly in two distinct patterns. Diminished levels of P53 were observed when MDM2 was significantly higher in relation to MDMX, suggesting a dominant role for MDM2 in the degradation of P53. Higher levels of P53 were noted with increasing MDMX levels suggesting an interaction between MDM2 and MDMX that resulted in a reduced efficiency of MDM2 in degrading P53. Of the 26 cases of liposarcoma with elevated P53 expression, 5 were found to have a somatic mutation in the P53 gene. Conclusions: The results suggest that complex dynamic interactions between MDM2 and MDMX proteins may directly affect the cellular levels of P53. This therefore suggests that careful characterization of both these markers will be necessary in tumours when considering in vivo evaluation of novel blocker compounds for MDM proteins, as a therapeutic strategy to restore wild type P53 function