Daily practice management of septate uterus: reproductive outcome after septoplasty.

peer reviewed("[en] BACKGROUND: Septate uterus is the most common uterine malformation found in women presenting poor reproductive history. Hysteroscopic septoplasty (HS) restores the uterine anatomy in a safe procedure. OBJECTIVES: The goal of our study is to determine the reproductive outcomes after HS of symptomatic septate uterus. MATERIALS AND METHODS: In a retrospective observational single centre study the reproductive outcomes and complications after HS were evaluated in 31 women with symptomatic septate uterus. The patients were separated into two groups according to the symptoms - infertility or recurrent pregnancy loss (RPL). MAIN OUTCOME MEASURES: were the pregnancy and live birth rate and secondarily the complication rate. Furthermore, the results were analysed depending on the need of assisted reproductive techniques (ART). RESULTS: The treatment has resulted in an overall pregnancy rate of 71% for both groups. The spontaneous pregnancy rate is 45% and 8 pregnancies resulted from ART (26%). The overall first live birth rate is 51.6%. A decrease has been noticed in the miscarriage rate from 95.24% to 24% (p<0.001) in the overall population. CONCLUSIONS: In patients with a symptomatic septate uterus hysteroscopic septoplasty is a safe and effective procedure. The favourable results pointing out the benefits of surgery on the reproductive outcomes as well as the relatively simple and safe technique of HS make the intervention attractive.","[en] ",""

La dyspareunie féminine, not a simple functional disorder !.

editorial reviewedDyspareunia is defined as pain during sexual intercourse. It will be qualified as superficial if it occurs during the vaginal penetration and as deep when it appears in the lower abdomen or further in the vagina. It concerns between 10 and 28 % of women during their lifetime and will have a significant impact on their quality of life. Multidisciplinary care will allow an accurate diagnosis and optimal treatment. The collaboration between general practitioner, gynecologist, physiotherapist and psychologist is mandatory in order to improve the quality of life of patients.La dyspareunie se définit par une douleur lors du rapport sexuel. Elle sera qualifiée de superficielle si elle survient lors de la pénétration du vagin, et de profonde lorsqu’elle apparaît lors de la pénétration complète et est décrite dans le bas du ventre ou dans le fond du vagin. Elle concerne entre 10 et 28 % des femmes au cours de leur vie et impactera de manière importante leur qualité de vie. Une prise en charge multidisciplinaire permettra un diagnostic précis et un traitement optimal. La collaboration entre médecin traitant, gynécologue, physiothérapeute et psychologue est une condition sine qua non pour l’amélioration de la qualité de vie des patientes

An approach to analyse the specific impact of rapamycin on mRNA-ribosome association

<p>Abstract</p> <p>Background</p> <p>Recent work, using both cell culture model systems and tumour derived cell lines, suggests that the differential recruitment into polysomes of mRNA populations may be sufficient to initiate and maintain tumour formation. Consequently, a major effort is underway to use high density microarray profiles to establish molecular fingerprints for cells exposed to defined drug regimes. The aim of these pharmacogenomic approaches is to provide new information on how drugs can impact on the translational read-out within a defined cellular background.</p> <p>Methods</p> <p>We describe an approach that permits the analysis of de-novo mRNA-ribosome association in-vivo during short drug exposures. It combines hypertonic shock, polysome fractionation and high-throughput analysis to provide a molecular phenotype of translationally responsive transcripts. Compared to previous translational profiling studies, the procedure offers increased specificity due to the elimination of the drugs secondary effects (e.g. on the transcriptional read-out). For this pilot "proof-of-principle" assay we selected the drug rapamycin because of its extensively studied impact on translation initiation.</p> <p>Results</p> <p>High throughput analysis on both the light and heavy polysomal fractions has identified mRNAs whose re-recruitment onto free ribosomes responded to short exposure to the drug rapamycin. The results of the microarray have been confirmed using real-time RT-PCR. The selective down-regulation of TOP transcripts is also consistent with previous translational profiling studies using this drug.</p> <p>Conclusion</p> <p>The technical advance outlined in this manuscript offers the possibility of new insights into mRNA features that impact on translation initiation and provides a molecular fingerprint for transcript-ribosome association in any cell type and in the presence of a range of drugs of interest. Such molecular phenotypes defined pre-clinically may ultimately impact on the evaluation of a particular drug in a living cell.</p

JCO Clin Cancer Inform

PURPOSE: Many institutions throughout the world have launched precision medicine initiatives in oncology, and a large amount of clinical and genomic data is being produced. Although there have been attempts at data sharing with the community, initiatives are still limited. In this context, a French task force composed of Integrated Cancer Research Sites (SIRICs), comprehensive cancer centers from the Unicancer network (one of Europe's largest cancer research organization), and university hospitals launched an initiative to improve and accelerate retrospective and prospective clinical and genomic data sharing in oncology. MATERIALS AND METHODS: For 5 years, the OSIRIS group has worked on structuring data and identifying technical solutions for collecting and sharing them. The group used a multidisciplinary approach that included weekly scientific and technical meetings over several months to foster a national consensus on a minimal data set. RESULTS: The resulting OSIRIS set and event-based data model, which is able to capture the disease course, was built with 67 clinical and 65 omics items. The group made it compatible with the HL7 Fast Healthcare Interoperability Resources (FHIR) format to maximize interoperability. The OSIRIS set was reviewed, approved by a National Plan Strategic Committee, and freely released to the community. A proof-of-concept study was carried out to put the OSIRIS set and Common Data Model into practice using a cohort of 300 patients. CONCLUSION: Using a national and bottom-up approach, the OSIRIS group has defined a model including a minimal set of clinical and genomic data that can be used to accelerate data sharing produced in oncology. The model relies on clear and formally defined terminologies and, as such, may also benefit the larger international community

Prediction of survival with second-line therapy in biliary tract cancer: Actualisation of the AGEO CT2BIL cohort and European multicentre validations

BACKGROUND: The benefit of second-line chemotherapy (L2) over standard first-line (L1) gemcitabine plus cisplatin (GEMCIS) or oxaliplatin (GEMOX) chemotherapy in advanced biliary tract cancer (aBTC) is unclear. Our aim was to identify and validate prognostic factors for overall survival (OS) with L2 in aBTC to guide clinical decisions in this setting. METHODS: We performed a retrospective analysis of four prospective patient cohorts: a development cohort (28 French centres) and three validation cohorts from Italy, UK and France. All consecutive patients with aBTC receiving L2 after GEMCIS/GEMOX L1 between 2003 and 2016 were included. The association of clinicobiological data with OS was investigated in univariate and multivariate Cox analyses. A simple score was derived from the multivariate model. RESULTS: The development cohort included 405 patients treated with L1 GEMOX (91%) or GEMCIS. Of them, 55.3% were men, and median age was 64.8 years. Prior surgical resection was observed in 26.7%, and 94.8% had metastatic disease. Performance status (PS) was 0, 1 and 2 in 17.8%, 52.4% and 29.7%, respectively. Among 22 clinical parameters, eight were associated with OS in univariate analysis. In multivariate analysis, four were independent prognostic factors (p &lt; 0.05): PS, reason for L1 discontinuation, prior resection of primary tumour and peritoneal carcinomatosis. The model had the Harrell's concordance index of 0.655, a good calibration and was validated in the three external cohorts (N = 392). CONCLUSION: We validated previously reported predictive factors of OS with L2 and identified peritoneal carcinomatosis as a new pejorative factor in nearly 800 patients. Our model and score may be useful in daily practice and for future clinical trial design

Goya au Louvre, la formation de la collection des peintures

La formation de la collection des peintures de Goya au musée du Louvre, de 1865 à 2009, est retracée à travers l’évocation de personnalités remarquables, collectionneurs, conservateurs, marchands, artistes, couturiers et grands donateurs. Dans le troisième tiers du xixe siècle, alors que l’œuvre de Goya était de plus en plus représenté sur le marché de l’art parisien, le Louvre fit finalement peu d’acquisitions. Le legs Guillemardet permit certes de faire entrer en 1865 deux peintures, mais l’examen des archives révèle une succession d’occasions manquées pour le musée. Au tournant du siècle, la tendance s’inversa grâce à une politique d’achat plus volontariste. Mais c’est surtout la générosité de donateurs qui joua un rôle capital dans l’enrichissement progressif de la collection tout au long du xxe siècle.This study traces how the Louvre Museum established its collection of Goya paintings from 1865 to 2009, through the stories of remarkable personalities, be they collectors, curators, dealers, artists, couturiers, or major donors. In the last third of the 19th century, when Goya’s work was increasingly represented on the Parisian art market, the Louvre made few acquisitions in the end. The Guillemardet bequest did allow the entry of two paintings in 1865, but an examination of the archives reveals a succession of missed opportunities for the museum. At the turn of the century, this trend was reversed thanks to a more proactive purchasing policy. But it was above all the generosity of donors that played a crucial role in the gradual enrichment of the collection throughout the 20th century

The place of hysteroscopic septoplasty in ART

peer reviewedBackground The aim of this study was to determine the reproductive outcomes after HS of septate uterus of women undergoing intrauterine insemination (IUI) or in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI). Septate uterus is a malformation often found in women with poor reproductive history seeking assisted reproductive techniques (ART). This uterine anomaly can lead to infertility or recurrent pregnancy loss. Hysteroscopic septoplasty (HS) is a safe intervention to restore the uterine cavity surgically in such Mullerian anomalies. Methods This monocentric retrospective study included women with symptomatic septate uterus undergoing ART treatment after HS in our fertility centre. Main outcomes were the pregnancy and first live birth rate after septoplasty. Further, the results were analysed depending on the need of IUI or FIV-ICSI. Results Thirty-six patients were identified with 3 lost to follow-up. The treatment has resulted in an overall pregnancy rate (PR) of 60% (20/33) and a cumulative pregnancy rate of 78% (26/33). The overall first live birth rate (LBR) is 39.4% (13/33) and the cumulative live birth rate is 48.4% (16/33). Eight patients out of the 33 used IUI resulting in 50% of pregnancies pregnancies (4/8)) and 25% of live births (2/8). For the women needing IVF/ICSI, the PR is 64% (25 patients with 16 pregnancies) and the LBR is 44% (11/25). It should also be noted that in 42% of the patients a male factor was involved in the infertility. Conclusions In our experience hysteroscopic septoplasty is a safe and effective procedure in patients presenting a symptomatic septate uterus prior to ART treatment. It might increase the reproductive outcome for both the IUI and the IVF/ICSI patients. However, the debate is still open whether to operate or not, pending prospective studies with more patients

Should you operate on a uterine septum ?

Uterine septum is the most common congenital uterine malformation and may cause obstetric problems such as repeated miscarriages, premature deliveries or dystocial presentations. It also appears to be associated with infertility. The uterine septum can be demonstrated by ultrasound, MRI and hysteroscopy. The benefit of hysteroscopic septoplasty remains controversial although most studies agree on the benefits of this treatment. It improves the fertility and obstetrical future of women by increasing the rate of pregnancies and live births and reducing the rate of miscarriages. Resection of the uterine septum is therefore encouraged in symptomatic patients but also in prophylaxis, in asymptomatic patients in order to increase the chances of carrying their pregnancy to term

Experimental investigation of impacted multidirectional laminates under compressive static and cyclic loading

International audienceIn this paper, the static and fatigue behaviors under compression of Multi-Directional (MD) Carbon Fiber Reinforced Polymer (CFRP) laminates with impact damage were investigated. After low-velocity impact performed on three 24-ply Quasi-Isotropic Quasi-Homogeneous (QIQH) laminates having different stacking sequences, the influence of the distribution of interfaces between two plies on the compression after impact and post-impact compression fatigue properties was evaluated. The damages on the surfaces and internal delamination were accessed via visual and optical observation and ultrasonic C-scan inspection. The thermographic approach, which has been developed and validated on numerous non-impacted composite materials, was applied for the rapid determination of the fatigue limit together with the S-N curves of post-impact fatigue specimens.Experimental results showed that with 5 J impact energy, the three stacking sequences gave similar impact results. The residual strengths measured by compression after impact tests were also similar to each other, so did the global damage modes. The determined fatigue limits of impacted specimens of different stacking sequences were nearly identical and the predicted S-N curves were also close to each other despite the exact crack propagation and orientation were not the same, under both compressive static and cyclic loads