Parallel assessment of male reproductive function in workers and wild rats exposed to pesticides in banana plantations in Guadeloupe

<p>Abstract</p> <p>Background</p> <p>There is increasing evidence that reproductive abnormalities are increasing in frequency in both human population and among wild fauna. This increase is probably related to exposure to toxic contaminants in the environment. The use of sentinel species to raise alarms relating to human reproductive health has been strongly recommended. However, no simultaneous studies at the same site have been carried out in recent decades to evaluate the utility of wild animals for monitoring human reproductive disorders. We carried out a joint study in Guadeloupe assessing the reproductive function of workers exposed to pesticides in banana plantations and of male wild rats living in these plantations.</p> <p>Methods</p> <p>A cross-sectional study was performed to assess semen quality and reproductive hormones in banana workers and in men working in non-agricultural sectors. These reproductive parameters were also assessed in wild rats captured in the plantations and were compared with those in rats from areas not directly polluted by humans.</p> <p>Results</p> <p>No significant difference in sperm characteristics and/or hormones was found between workers exposed and not exposed to pesticide. By contrast, rats captured in the banana plantations had lower testosterone levels and gonadosomatic indices than control rats.</p> <p>Conclusion</p> <p>Wild rats seem to be more sensitive than humans to the effects of pesticide exposure on reproductive health. We conclude that the concept of sentinel species must be carefully validated as the actual nature of exposure may varies between human and wild species as well as the vulnerable time period of exposure and various ecological factors.</p

Comment je fais… la mise en place d’un drain cannelé siliconé par voie cœlioscopique ? [How I do ... laparoscopic insertion of a silicone fluted drain?]

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Inefficiency of ulipristal acetate on uterus leiomyomas as an additional sign to suspect leiomyosarcoma

International audienceThe unexpected diagnosis of a leiomyosarcoma from a surgical specimen of a presumed leiomyoma is rare, but with deleterious consequences, especially if morcellation techniques are used. There are currently no effective methods for such a preoperative diagnosis. Ulipristal acetate has demonstrated efficacy for the preoperative treatment of leiomyomas, but not for all patients. We report two cases of leiomyosarcomas in patients treated with ulipristal acetate for a presumed leiomyoma. We propose that ineffective ulipristal acetate treatment may indicate a population in which uterine leiomyosarcoma is more prevalent. Attention should be given to any features of clinical and imaging examinations which raise the suspicion of a leiomyosarcomas in this population. Such suspicion should guide appropriate measures to avoid seeding the tumor, postponing the diagnosis, upstaging the patient and delaying the treatment (SPUD). (C) 2017 Elsevier Masson SAS. All rights reserved

Caractéristiques sociodémographiques et médicales des interruptions volontaires de grossesse des mineures en Guadeloupe [Sociodemographic and medical features of abortion among underage people in Guadeloupe (French West Indies)]

International audienceOBJECTIVE: In France, contraception is available for everybody; however, the number of abortion does not decrease, especially among young people. The aim of our study is to analyze, in the Guadeloupian context, the characteristics of underage people who ask for an abortion. METHODS: This retrospective study, analyses sociodemographic and medical characteristics of 129 teenagers, who had an abortion in 2010 in our abortion center. For 67 of them results of interviews with the psychologist were also reported. RESULTS: Preferentially from large single parent families, these underage people had a mean age of 15.9 years (± 1.12), 96.1% were born in France, 10.9% had had a previous pregnancy, 67.2% had an over 18 partner, 64.4% used contraception before the abortion. Main motivations for abortion were continuing studies and young age. Abortion occurs after 9 weeks of amenorrhea in 55.1% and 43.3% of underage people reported psychological problems linked to the abortion. CONCLUSION: From this profile, our study suggests some reflection which could help the fight against unwanted pregnancies in this particular population of underage people

Effect of a mediterranean diet during pregnancy on fetal growth and preterm delivery: Results from a French caribbean mother-child cohort study (TIMOUN)

International audienceBACKGROUND: Recent studies suggest that a Mediterranean dietary pattern during pregnancy may influence pregnancy outcomes. The aim of this study was to evaluate the effect of adherence to a Mediterranean diet (MD) during pregnancy on fetal growth restriction (FGR) and preterm delivery (PTD) in a French Caribbean island where the population is largely of African descent and presents dietary patterns similar to MD. METHODS: Using data from the TIMOUN Mother-Child Cohort Study conducted in Guadeloupe (French West Indies) between 2004 and 2007, we analysed data for 728 pregnant women who delivered liveborn singletons without any major congenital malformations. Degree of adherence to MD during pregnancy was evaluated with a semi-quantitative food frequency questionnaire based on nine dietary criteria. Multiple logistic regression models were used to analyse birth outcomes while taking potential confounders into account. RESULTS: Overall there was no association between MD adherence during pregnancy and the risk of PTD or FGR. However, pre-pregnancy body mass index was a strong effect modifier, and MD adherence was associated with a decreased risk of PTD specifically in overweight and obese women (adjusted odds ratio 0.7, 95% confidence interval 0.6, 0.9) (P heterogeneity <0.01). CONCLUSIONS: These results suggest that Caribbean diet during pregnancy may carry some benefits of MD and may contribute to reduce the risk of PTD in overweight and obese pregnant women

Évaluation de l’imminence de l’accouchement inopiné extra-hospitalier en Guadeloupe : expérience du service médical d’urgence et de réanimation de Pointe-à-Pitre [Assessment of imminence of unplanned out-of-hospital deliveries in Guadeloupe: experience of the mobile emergency and resuscitation service of Pointe-à-Pitre]

National audienceOBJECTIVES: Medical tools to determine the imminence of unplanned out-of-hospital birth have not been validated. The main goal of this study was to analyze assessments of the imminence of these deliveries, by methods such as the Manilas score and the need to push. PATIENTS AND METHODS: All calls made to the Emergency Medical Aid Service in Guadeloupe concerning risks of unplanned delivery between January 1st and June 30th 2011 were reviewed retrospectively, and 69 of the 85 cases cared for by the hospital mobile emergency unit were included. RESULTS: Risks of unplanned out-of-hospital deliveries represented 1.9% of the calls during the study period. The Malinas score was used for dispatching in only 13% and was not used for intervention in any case. It was estimated that the need-to-push feeling was used for 58% (dispatching) and 54.5% (intervention) of patients. Its sensitivity, specificity and predictive values were higher than those of the Malinas score in dispatching and substantially higher in intervention. CONCLUSION: These results argue for the development of tools for estimating the imminence of unplanned delivery. Such tools should be applicable in extra-hospital emergency situations to ensure their use in practice