The definition of Endometriosis Expert Centres

Endometriosis is a common condition that causes pain and infertility. It can lead to absenteeism and also to multiple surgeries with a consequent risk of impaired fertility, and constitutes a major public health cost. Despite the existence of numerous national and international guidelines, the management of endometriosis remains suboptimal. To address this issue, the French College of Gynaecologists and Obstetricians (CNGOF) and the Society of Gynaecological and Pelvic Surgery (SCGP) convened a committee of experts tasked with defining the criteria for establishing a system of care networks, headed by Expert Centres, covering all of mainland France and its overseas territories. This document sets out the criteria for the designation of Expert Centres. It will serve as a guide for the authorities concerned, to ensure that the means are provided to adequately manage patients with endometriosis

Définition des centres experts en endométriose

OBJECTIVES: The Collège national des gynécologues obstétriciens français (CNGOF), in agreement with the Société de chirurgie gynécologique et pelvienne (SCGP), has set up a commission in 2017 to define endometriosis expert centres, with the aim of optimizing endometriosis care in France. METHODS: The committee included members from university and general hospitals as well as private facilities, representing medical, surgical and radiological aspects of endometriosis care. Opinion of endometriosis patients\u27 associations was obtained prior to writing this work. The final text was presented and unanimously validated by the members of the CNGOF Board of Directors at its meeting of October 13, 2017. RESULTS: Based on analysis of current management of endometriosis and the last ten years opportunities in France, the committee has been able to define the contours of endometriosis expert centres. The objectives, production specifications, mode of operation, missions and funding for these centres were described. The following missions have been specifically defined: territorial organization, global and referral care, communication and teaching as well as research and evaluation. CONCLUSION: Because of its daily impact for women and its economic burden in France, endometriosis justifies launching of expert centres throughout the country with formal accreditation by health authorities, ideally as part of the National Health Plan

Questions de jurisprudence médico-légale sur la viabilité en matière civile et en matière criminelle, la monomanie homicide et la liberté morale, la responsabilité légale des médecins ; par C. P. Collard de Martigny,...

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AOB community structure and richness under European beech, sessile oak, Norway spruce and Douglas-fir at three temperate forest sites

Abstract Background and aims The relations between tree species, microbial diversity and activity can alter ecosystem functioning. We investigated ammonia oxidizing bacteria (AOB) community structure and richness, microbial/environmental factors related to AOB diversity and the relationship between AOB diversity and the nitrification process under several tree species. Methods Forest floor (Of, Oh) was sampled under European beech, sessile oak, Norway spruce and Douglas-fir at three sites. AOB community structure was assessed by PCR-DGGE and sequencing. Samples were analyzed for net N mineralization, potential nitrification, basal respiration, microbial biomass, microbial or metabolic quotient, pH, total nitrogen, extractable ammonium, organic matter content and exchangeable cations. Results AOB community structure and tree species effect on AOB diversity were site-specific. AOB richness was not related to nitrification. Factors regulating ammonium availability, i.e. net N mineralization or microbial biomass, were related to AOB community structure. Conclusion Our research shows that, at larger spatial scales, site specific characteristics may be more important than the nature of tree species in determining AOB diversity (richness and community structure). Within sites, tree species influence AOB diversity. The absence of a relation between AOB richness and nitrification points to a possibly role of AOB abundance, phenotypic plasticity or the implication of ammonia oxidizing archaea