Impact of laparoscopic sacrocolpopexy learning curve on operative time, perioperative complications and short term results

International audienc

A Novel microCT Method for Bone and Marrow Adipose Tissue Alignment Identifies Key Differences Between Mandible and Tibia in Rats.

Bone homeostasis is influenced by the bone marrow adipose tissue (BMAT). BMAT distribution varies from one anatomical location in the skeleton to another. We developed an advanced microfocus computed tomography imaging and analysis protocol that allows accurate alignment of both the BMAT distribution and bone micro-architecture as well as calculation of the distance of the BMAT adipocytes from the bone surface. Using this protocol, we detected a different spatial BMAT distribution between the rat tibia and mandible: in the proximal metaphysis of the tibia a large amount of BMAT (~ 20% of the total BMAT) was located close to the bone surface (< 20 µm), whereas in the alveolar ridge ~ 30% of the total BMAT was located between 40 and 60 µm from the bone surface. In the alveolar ridge of rats, the trabecular bone volume was 48.3% higher compared to the proximal metaphysis of the tibia (p < 0.0001) and the percentage of adiposity determined to the relative marrow volume was lower (1.5%) compared to the proximal metaphysis of the tibia (9%, p = 0.0002). Interestingly, in the tibia a negative correlation was found between the percentage of adiposity in the total volume and the trabecular thickness (r =- 0.74, p = 0.037). The present study highlights that in comparison to tibial proximal metaphysis, the mandibular bone exhibits a massive trabecular network and a low BMAT content with almost no contact with the bone surface. These findings are of great interest because of the importance of the fat-bone interaction and its potential relevance to several resorptive bone diseases

Gel electrophoresis of human sperm: a simple method for evaluating sperm protein quality

Résumé Contexte Les limites des analyses conventionnelles du sperme ont mis en évidence la nécessité de moyens supplémentaires d’évaluation de la qualité du sperme. Matériel et Méthodes La méthode d’électrophorèse unidimensionnelle a été utilisée pour évaluer la teneur et la qualité protéique dans des échantillons d’éjaculats individuels de 245 hommes avec des paramètres spermatiques connus. Résultats La teneur en protéines du sperme variait d’un échantillon à l’autre, en particulier dans la gamme des poids moléculaires élevés. L’intensité des bandes de 80–110 kDa était corrélée à la mobilité progressive (r = 0,15, p = 0,015) et était significativement plus élevée (p = 0,0367) dans le groupe des hommes avec des paramètres conventionnels spermatiques supérieurs aux valeurs de référence (OMS, 2010) comparé au groupe d’hommes dont l’éjaculat présentait au moins un paramètre spermatique (volume de sperme, concentration de spermatozoïdes, numération des spermatozoïdes, motilité progressive, formes normales et indice d’anomalies multiples) en deça de la valeur de référence. Les bandes dans la gamme de 80–110 kDa ont été identifiées en spectrométrie de masse et se sont révélées être des protéines de la gaine fibreuse du flagelle: la protéine d’ancrage A-kinase 4, la protéine d’ancrage A-kinase 3 et l’hexokinase de type 1. Conclusion La méthode d’électrophorèse unidimensionnelle constitue une méthode simple, rapide, fiable et peu coûteuse pour analyser la qualité des protéines du sperme dans les éjaculats humains individuels

18F-FDG positron emission tomography scanning in systemic sclerosis-associated interstitial lung disease: a pilot study

International audienceBackground: Interstitial lung disease is a common complication of systemic sclerosis (SSc-ILD), and it remains difficult to accurately predict its course. Progressing ILD could be more metabolically active, suggesting that the 18F-FDG tracer could be a tool in the managing of SSc-ILD.Methods: In our center, SSc patients and controls (non-Hodgkin lymphoma cured after first-line regimen) who had received a PET/CT were screened retrospectively. The FDG uptake (visual intensity, pattern, SUVmax) was systematically recorded in > 30 regions of interest (ROIs) linked to SSc in a blind reviewing by 2 independent nuclear medicine physicians using a standardized form.Results: Among the 545 SSc patients followed up in our center, 36, including 22 SSc-ILDs, had a PET/CT, whose indication was cancer screening in most cases. The mean ± SD age was 57.9 ± 13.0 years with 20/36 females. Fourteen patients had a disease duration of less than 2 years. A third had anti-centromere antibodies and 27.8% had anti-topoisomerase antibodies. Pulmonary FDG uptakes were higher in SSc patients than in controls (n = 89), especially in those with ILD compared with those without ILD. Pulmonary FDG uptakes were positively correlated with the ILD severity (fibrosis extent, %FVC, and %DLCO). No significant difference was found in the FDG uptakes from extrathoracic ROIs. Progressing SSc-ILDs within the 2 years after PET/CT (n = 9) had significant higher pulmonary FDG uptakes at baseline than stable SSc-ILDs (n = 13).Conclusion: PET/CT could be a useful tool in the assessment of the severity and the prediction of pulmonary function outcome of SSc-ILD

Compulsory Hospitalization, Severity of Disorders and Territorial Landscape: A French Study

International audienceINTRODUCTION: The objective of this study, carried out in France, was to analyse important psychiatric sector disparities in the rate of compulsory hospitalizations as a function of the severity of disorders among the people hospitalized, and of certain variables linked to the territorial landscape (socio-demographic context, and primary and psychiatric care offer).METHODS: The 125 sectors that took part in this study were divided into three groups on the basis of their compulsory hospitalization rates.RESULTS: The results did not reveal any link between compulsory hospitalization rate and severity of disorders.The hospitalization rate was correlated with variables specific to urban areas: it was higher in more densely populated areas with a larger proportion of people living alone and a greater number of shelters and social rehabilitation centres. It was also higher in the sectors with larger hospitalization capacity, with longer mean hospitalization durations, but with a lower rate of resort to psychiatry and larger human resources.CONCLUSIONS: The frequency of resort to involuntary hospitalization in France does not seem to be linked to the severity of patients’ disorders, but it is higher in sectors with a profile specific to urban areas, larger hospitalization capacities and human resources

Hospitalisations d'Office et Soins sur Décision du Représentant de l'Etat, sévérité des troubles et paysage territorial

National audienc

Prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in France - The EPIPAGE-2 Cohort Study

International audienceOBJECTIVE: Our main objective was to examine if parental prenatal preferences predict delivery-room management of extremely preterm periviable infants. The secondary objectives were to describe parental involvement and the content of prenatal counseling given to parents for this prenatal decision.DESIGN: Prospective study of neonates liveborn between 22 and 26 weeks of gestation in France in 2011 among the neonates included in the EPIPAGE-2 study.SETTING: 18 centers participating in the "Extreme Prematurity Group" substudy of the EPIPAGE-2 study.PATIENTS: 302 neonates liveborn between 22-26 weeks among which 113 with known parental preferences while parental preferences were unknown or unavailable for 186 and delivery room management was missing for 3.RESULTS: Data on prenatal counseling and parental preferences were collected by a questionnaire completed by professionals who cared for the baby at birth; delivery room (DR) management, classified as stabilization or initiation of resuscitation (SIR) vs comfort care (CC). The 113 neonates studied had a mean (SD) gestational age of 24 (0.1) weeks. Parents of neonates in the CC group preferred SIR less frequently than those with neonates in the SIR group (16% vs 88%, p < .001). After multivariate analysis, preference for SIR was an independent factor associated with this management. Professionals qualified decisions as shared (81%), exclusively medical (16%) or parental (3%). Information was described as medical with no personal opinion (71%), complete (75%) and generally pessimistic (54%).CONCLUSION: Parental involvement in prenatal decision-making did not reach satisfying rates in the studied setting. When available, prenatal parental preference was a determining factor for DR management of extremely preterm neonates. Potential biases in the content of prenatal counselling given to parents need to be evaluated