Reduction of apoptosis and proliferation in endometriosis

Objective: To evaluate whether endometriosis could be related to an impaired balance between apoptosis and proliferation, two processes which could be modulated by hormonal status. Design: Immunohistochemical study. Setting: Academic research laboratory. Intervention(s): Endometriotic samples obtained from peritoneum of women aged 26-40 years who were undergoing laparoscopy for pain or infertility. Main Outcome Measure(s): Apoptotic cells were detected with the use of the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay. The production of p53 and bcl-2, estrogen and Progesterone (P) receptors, and cellular proliferation were assessed by immunohistochemistry in eutopic and ectopic endometria from 30 patients with endometriosis throughout the menstrual cycle. Results were compared with those from normal endometria from 15 fertile patients. Result(s): Endometriotic lesions were characterized by reduced TUNEL and p53 stainings and by enhanced bcl-2 staining. No correlation between apoptosis and estrogen receptor or P receptor levels was found. A lower amount of steroid receptor was found in endometriotic tissues, without cyclic modulation, compared with the eutopic endometrium. Conclusion(s): Our results suggest that when endometrial tissue is located at ectopic locations, it differs from eutopic endometrium by its proliferation rate, steroid hormone levels, and markers of apoptosis. A reduced sensitivity of endometriotic cells to apoptosis could promote the dissemination and implantation of these cells to ectopic sites. (C) 2004 by American Society for Reproductive Medicine.Peer reviewe

Endométriose : pourquoi se développe-telle ?

peer reviewedL’endométriose est une maladie œstrogéno-dépendante responsable d’une morbidité importante liée notamment aux opérations multiples et aux phénomènes douloureux. De nouvelles données sur les facteurs génétiques, le rôle possible de l’environnement, du système immunitaire, de l’inflammation offrent des nouvelles perspectives concernant la physiopathogénie de cette affection permettant ainsi de nouvelles approches thérapeutiques et d’autres voies pour un diagnostic moins invasif que la cœlioscopie exploratrice.Endometriosis is an estrogen-dependent disorder that can result in substantial morbidity, including multiple operations, and pelvic pain. New findings on the genetics, the possible roles of the environment, the immune system, and the inflammation have given insight into the pathogenesis of this disorder and serve as the background for new treatments and new diagnostic approach

The impact of detailed explanatory leaflets on patient satisfaction with urodynamic consultation: A double-blind randomized controlled trial.

peer reviewedAims To develop and validate a scale that is applicable in Belgium to investigate the aspects of female patients' satisfaction with urodynamic consultation, and to use it to measure the impact of a detailed explanatory leaflet on their satisfaction. Materials and Methods Question items were obtained from a group consensus (Delphi process). Each item was scored on a five-point Likert scale. The satisfaction scale was administered to two groups of patients attending the clinics for urodynamics. One hundred twenty-nine patients were included in the study and randomized in two groups. One group (n = 60) received a detailed explanatory leaflet about urodynamic consultation and the other did not (n = 69). Responses were subjected to a reliability and principal component analysis (PCA) to achieve data reduction and analysis, and to assess the reliability of the new scale. Relevant items were retained to compare both interventions using regression analysis. Results A 15-item scale was derived from the Delphi process. Exploratory factor analysis suggested a single factor solution with 11 meaningful items. No significant difference was noted in global scores of satisfaction between the two groups (P = 0.051). Conclusions A short-form patient satisfaction scale with acceptable validity and reliability was developed and used to measure patient satisfaction with urodynamic consultation in this population of Belgian women. This study did not provide support for the effectiveness of explanatory leaflets in improving satisfaction

An unusual diagnosis of a bicornuate unicollis uterus

We present a case of an unusual diagnosis of a bicornuate unicollis uterus mimicking a uterus didelphys with blind hemivagina. Few cases of a bicornuate uterus have been reported with the primary symptom of a paracervical pyocolpos. The difficulties involved in the diagnosis and management of this particular congenital malformation are described in detail. The role of imaging techniques and adequate preoperative preparation is emphasised with a review of recent literatur

Gynaecological uses of a new class of steroids: the selective progesterone receptor modulators

Selective progesterone receptor modulators (SPRM) represent a new class of synthetic steroids, which can interact with the progesterone receptor (PR) and can exert agonist, antagonist or mixed effects on various progesterone target tissues in vivo. This review evaluates the actual and potential usefulness of SPRMs in gynaecolog

Programme excentrique dans la pathologie du coude : tendinopathie épicondylienne

Lateral epicondylitis represents a common overuse injury caused by repetitive gestures through sports activity, industrial work and hobby activities. In spite of many conservative treatment procedures, prolonged symptoms and relapse are frequently reported. The goal of our study was to compare the outcome of patients performing an adapted isokinetic eccentric training with that of patients receiving a non-strengthening classical rehabilitation. Results, dealing with pain score evaluation, disability questionnaire, muscle strength measurement and ultrasonographic examination, highlight the relevance of implementing isokinetic adapted eccentric training in the management of lateral epicondylitis