Office Hysteroscopy for Infertility: A Series of 557 Consecutive Cases

Objective. To study incidence of abnormal hysteroscopic findings according to age. Methods. We retrospectively studied 557 consecutive office hysteroscopies in patients referred for incapacity to conceive lasting at least 1 year or prior to in vitro fertilization. Rates of abnormal findings were reviewed according to age. Results. In 219 cases, hysteroscopy showed an abnormality and more than a third of our population had abnormal findings that could be related to infertility. Rates of abnormal findings ranged from 30% at 30 years to more than 60% after 42 years. Risk of abnormal finding was multiplied by a factor of 1.5 every 5 years. Conclusion. Our data are an additional argument to propose office hysteroscopy as part of first-line exams in infertile woman, regardless of age

Neoadjuvant chemotherapy or primary surgery for stage III/IV ovarian cancer: contribution of diagnostic laparoscopy

<p>Abstract</p> <p>Background</p> <p>The aims of this retrospective study were to evaluate laparoscopic triage of patients with advanced ovarian cancer towards primary surgery or neoadjuvant chemotherapy, and to analyze outcome according to the treatment.</p> <p>Methods</p> <p>Between January 2001 and December 2006, 55 patients with stage III – IV ovarian cancer underwent diagnostic laparoscopy. Primary surgery was performed when complete cytoreduction was considered feasible, while the other patients received neoadjuvant chemotherapy (platinum-based combination with taxanes) and interval surgery. All the patients received adjuvant chemotherapy.</p> <p>Results</p> <p>Patients treated with neoadjuvant chemotherapy (n = 29) had a higher mean body mass index (P = 0.048), higher serum CA 125 levels (P = 0.026), and more metastases (P = 0.045) than patients treated with primary surgery (n = 26). In patients treated with primary surgery, complete cytoreduction and a residual tumour size ≤ 2 cm were obtained in respectively 54% and 77% of cases. Complete cytoreduction was achieved in respectively 100% and 33% of cases when primary surgery was performed by an oncologic gynaecologist and by a non-oncologic gynaecologist (P = 0.002). Interval surgery yielded complete cytoreduction and a residual tumour size ≤ 2 cm in respectively 73% and 85% of cases. With a median follow-up of 24 months (range 7 – 78 months), the survival rates after primary surgery and interval surgery were 61% and 66% respectively.</p> <p>Conclusion</p> <p>Diagnostic laparoscopy is useful for identifying patients with stage III/IV ovarian cancer who qualify for primary cytoreduction. Surgeon experience was a determining factor for the success of complete cytoreduction.</p

Breast cancer stroma frequently recruits fetal derived cells during pregnancy

Breast carcinomas associated with pregnancy display a high frequency of inflammatory types, multifocal lesions and lymph node metastasis. Because pregnancy results in transfer to mothers of foetal stem cells that can migrate and differentiate into various tissues, we addressed the issue of whether such cells are present in breast carcinoma associated with pregnancy

PLACE DES MACROBIOPSIES PAR ASPIRATION AVEC LE SYSTEME MAMMOTOME DANS LA PRISE EN CHARGE DES LESIONS INFRA-CLINIQUES DU SEIN (DES GYNECOLOGIE-OBSTETRIQUE)

PARIS6-Bibl. St Antoine CHU (751122104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Rôle de l'orthodontiste dans la prise en charge du syndrome des apnées obstructives du sommeil

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

DREPANOCYTOSE ET GROSSESSE (A PROPOS DE 37 CAS)

ST QUENTIN EN YVELINES-BU (782972101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Le placenta humain et ses pathologies: l’oxygène en question

Au moment de la placentation, l’embryon s’entoure d’une couche de trophoblaste où s’organisent l’arborisation des villosités et la circulation utéro-placentaire. L’analyse des modalités de l’arrivée du sang maternel a mis en évidence une hypoxie physiologique s’interrompant en fin de premier trimestre. De plus, les cultures d’explants villositaires ont montré le rôle de l’oxygène dans la prolifération du trophoblaste extravillositaire, l’invasion de la décidue et le remodelage des artères spiralées. L’oxygène apparaît maintenant comme un facteur clé dans le mécanisme de la placentation en raison du contrôle qu’il exerce sur la transcription de certains gènes. Ce contrôle s’effectue grâce à une molécule sensible à la pression partielle d’oxygène. On attribue à l’oxygène un rôle dans la genèse de plusieurs pathologies de la grossesse. Il est notamment mis en cause dans la séquence des événements conduisant à la pré-éclampsie. Des corrélations ont été mises en évidence entre l’environnement en oxygène et l’arborisation anormale des villosités, dans le retard de croissance intra-utérin, ou lors de situations comme l’anémie maternelle ou la gestation en altitude.At the time of placentation, the conceptus surrounds itself with a trophoblastic layer where the villous tree develops and the uteroplacental circulation takes place. Analysis of the modalities of maternal blood entrance demonstrated a physiological hypoxia ending with the first trimester of pregnancy. Moreover, cultures of first trimester villous explants have shown the role of oxygen in extravillous cytotrophoblast proliferation, decidual invasion and spiral artery remodeling. Oxygen appears to be a key factor controlling the mechanism of placentation by regulating the transcription of several genes, such as VEGF (vascular endothelial growth factor), leptin, etc. These genes are turned on or off as a function of oxygen partial pressure via an oxygen sensor. Oxygen is now considered to be implicated in the development of several pathologies of pregnancy. It is involved at different steps in the cascade of events leading to preeclampsia. Positive correlations have been observed between oxygen partial pressure and abnormal development of the villous tree in intrauterine growth retardation, and in maternal anemia or pregnancy in altitude

A case-control study of polymorphic eruption of pregnancy.

International audienceBACKGROUND: Polymorphic eruption of pregnancy (PEP) is a pruritic disease that usually occurs in primiparous women, most commonly in the last trimester of pregnancy. The origin and pathomechanisms still remain unknown. OBJECTIVES: We attempted to determine the parameters that may be associated with or complicate the course of PEP. METHODS: Data of 200 pregnant women (40 PEP and 160 control) were studied retrospectively and compared statistically using univariable and multivariable analysis. RESULTS: In multivariate analysis, pregnancy with male fetuses (P = .02) and delivery by cesarean section (P = .012) were overrepresented in the PEP group. A tendency toward more multiple gestation pregnancy in PEP was found (P = .07). The risk of PEP was not related to excessive maternal or fetal weight gain. LIMITATIONS: This was a retrospective study. CONCLUSION: This large case-control study confirms the already suspected association of PEP with male fetuses and cesarean deliveries in multivariate analysis. The higher rate of multiple gestation pregnancy was also established