Reconstruction d'un équivalent urétral par méthode d'auto-assemblage en génie tissulaire

Plusieurs maladies sont à l'origine de désordres urétraux. Pour traiter ces troubles, des biomatériaux acellulaires ou des tissus non-urologiques natifs sont utilisés mais mènent régulièrement à des complications post-opératoires. Dans le cadre de mon projet de maîtrise, nous avons évalué la faisabilité de produire, par la méthode d'auto-assemblage, un modèle tubulaire urétral autologue. Par la suite, nous avons regardé la possibilité d'adapter l'équivalent reconstruit au modèle animal choisi, soit le porc, puisque son système urinaire est physiologiquement similaire à celui de l'humain. Pour atteindre le premier objectif, un modèle tubulaire urétral constitué de cellules humaines fut élaboré. S'en est suivi une caractérisation pour évaluer sa fonctionnante et sa viabilité. Ensuite, pour atteindre notre deuxième but, des tests préliminaires pour établir et déterminer les paramètres optimaux de culture furent réalisés pour produire un feuillet à partir de fibroblastes porcins. En résumé, l'équivalent urétral développé dans notre laboratoire est un modèle innovateur dans le domaine de la reconstruction urologique. La production d'un feuillet avec des fibroblastes de porc est une étape importante qui va permettre de compléter le modèle urologique autologue porcin et de passer aux tests précliniques chez le porc

IGO s’ Initiatives as a Response to Crises and Unforeseen Needs

This article aims at reviewing the practice of ‘initiatives’ by Intergovernmental Organizations ( IGO s) when responding to crises or the unforeseen needs of their respective memberships. It forms part of a broader research project on the role of IGO s in international law where more than 100 initiatives were identified so far, focusing on 14 IGO s. The notion of an IGO ’s initiative, conceptualised as activities of the Executive Heads and the secretariat’s staff that enhance the remit of an organization beyond those functions initially or formally envisaged by its constituent instrument, is examined. A descriptive analysis of over 30 initiatives indicate that they may be successful in addressing modern unforeseen challenges, whether they stem from international emergencies, climate change, dynamic technological advancements, or global health crises such as the covid -19 pandemic- especially when such initiatives are accepted and supported by IGO s’ members.</p

Predicting Acute Postoperative Pain Trajectories and Long-Term Outcomes of Adolescents after Spinal Fusion Surgery

Objectives. Acute pain trajectories are associated with long-term outcomes such as persistent pain and functional disability in adults. However, there are limited data on acute postoperative pain trajectories in the pediatric population. The aims of this study were to investigate acute postoperative pain trajectories, their predictors, and their impact on long- term outcomes in adolescents with idiopathic scoliosis. Methods. We evaluated the preoperative pain intensity, use of analgesics, psychosocial measures and physical functioning of adolescents scheduled to undergo spinal fusion, and their average 6-hour self-reported pain intensity scores for their entire hospital stay. Six months after surgery, baseline variables were reassessed. We used growth mixture modeling to conduct acute postoperative pain trajectory analysis and to identify predictors of pain trajectories. Generalized linear models were conducted to determine whether acute pain trajectories predict long-term outcomes. Results. One hundred and six patients were included in the best-fitted acute pain trajectory model that included four classes that differed in initial pain intensity and rates of change over time. Preoperative pain catastrophizer status and use of analgesics significantly predicted pain trajectory membership. Furthermore, at the 6-month follow-up, patients experiencing moderate-to-severe pain in the acute postoperative period were more likely to report higher levels of pain severity, use pain medication, and miss a greater number of school/work days due to back pain in the last three months. Discussion. Preoperative assessment and analyzing the progression of pain in the acute postoperative period can help identify those at risk of negative long-term outcomes after surgery

Adolescent anxiety and pain problems: A joint, genome-wide investigation and pathway-based analysis.

Both common pain and anxiety problems are widespread, debilitating and often begin in childhood-adolescence. Twin studies indicate that this co-occurrence is likely due to shared elements of risk, rather than reciprocal causation. A joint genome-wide investigation and pathway/network-based analysis of adolescent anxiety and pain problems can identify genetic pathways that subserve shared etiopathogenetic mechanisms. Pathway-based analyses were performed in the independent samples of: The Quebec Newborn Twin Study (QNTS; 246 twin pairs and 321 parents), the Longitudinal Study of Child Development in Quebec (QLSCD; n = 754), and in the combined QNTS and QLSCD sample. Multiple suggestive associations (p<1×10-5), and several enriched pathways were found after FDR correction for both phenotypes in the QNTS; many nominally-significant enriched pathways overlapped between pain problems and anxiety symptoms (uncorrected p<0.05) and yielded results consistent with previous studies of pain or anxiety. The QLSCD and the combined QNTS and QLSCD sample yielded similar findings. We replicated an association between the pathway involved in the regulation of myotube differentiation (GO:0010830) and both pain and anxiety problems in the QLSDC and the combined QNTS and QLSCD sample. Although limited by sample size and thus power, these data provide an initial support to conjoint molecular investigations of adolescent pain and anxiety problems. Understanding the etiology underlying pain and anxiety co-occurrence in this age range is relevant to address the nature of comorbidity and its developmental pathways, and shape intervention. The replication across samples implies that these effects are reliable and possess external validity