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Unlabelled: Background The objective was to evaluate the effect of a HPV vaccination program on the incidence proportion of a proxy, genital warts (GW), in women in France.Methods: The number of primary GW cases was prospectively recorded over two 4-month periods before (T0: Dec 2008 to March 2009) and after (T1: Dec 2011 to March 2012) a HPV vaccination program. A total of 160 gynaecologists participated in T0 and 189 in T1. Primary genital herpes (HSV) infection was used as a control.Results: During T0, 39190 15- to 26 year-old women were seen, of whom 176 were diagnosed with GW (incidence proportion: 0.45%) and 155 with primary HSV infection (incidence proportion: 0.39%). During T1, 45628 females were seen [229 with GW (incidence proportion: 0.50%) and 202 with HSV (incidence proportion: 0.44%)]. In the 15-20 years age category, the incidence proportion of primary GW decreased from 0.41% to 0.30% (P=0.128) between T0 and T1, and the proportion of women newly diagnosed with primary genital herpes diseases slightly increased from 0.34% to 0.38% (P=0.620). In the 15-18 years age group, this decrease became significant (0.34% to 0.18%; P=0.048).Conclusions: A trend for a non-significant decreased incidence proportion of GW was observed in young women below 20 years who are more frequently vaccinated. This may be the result of HPV vaccination and suggests that a substantial increase in vaccine coverage could lead to a more pronounced decreased incidence proportion of GW in the future. [ABSTRACT FROM AUTHOR]

Introduction La prévalence du diabète gestationnel (DG) est en augmentation partout dans le monde, parallèlement à celle de l’obésité chez la femme en âge de procréer. Le DG est associé à une morbi-mortalité materno-fœtale à court terme mais également à plus long terme. L’objectif de notre étude était d’évaluer si la mise en place de règles hygiéno-diététiques (RHD) précoces, chez des femmes enceintes à risque, pouvait prévenir la survenue de DG. Patients et méthodes Nous avons débuté, le 1 er janvier 2012, une étude interventionnelle comparative avant et après mise en place de RHD simples avec suivi mensuel, chez un groupe de femmes présentant au moins un facteur de risque de développer un diabète gestationnel. Résultats Après 9 mois, 82 patientes avaient bénéficié de l’intervention en 2012 et ont été comparées à un groupe de 100 femmes ayant reçu un suivi traditionnel, en 2011, dont les données étaient relevées rétrospectivement. La mise en place de RHD a permis de réduire significativement le risque de survenue d’un diabète gestationnel, même après ajustement sur les différents facteurs de risque (Odds Ratio ajusté : 0,37 ; p = 0,018). La prise de poids en fin de grossesse était significativement diminuée après l’intervention (9,1 kg vs 11,3 kg ; p = 0,018) après ajustement sur l’indice de masse corporelle de départ. Conclusion Notre intervention a été efficace sur la prévention du diabète gestationnel et sur la prise de poids gestationnelle. Une étude à plus grande échelle est nécessaire pour confirmer ces résultats. Déclaration d’intérêt Les auteurs déclarent ne pas avoir d’intérêt direct ou indirect (financier ou en nature) avec un organisme privé, industriel ou commercial en relation avec le sujet présenté. [ABSTRACT FROM AUTHOR]

Summary: In cases of serious bleeding postpartum, resuscitation and surgical techniques are complementary and should be adapted to both the etiology and severity of bleeding. In extremely severe cases, the performance of a hysterectomy should not be delayed. For women with stable hemodynamic status, so-called “conservative” surgical techniques can instead be used. In this study, we describe and discuss the indications and feasibility of various techniques of vascular ligation. Uterine mattress suture compression techniques and abdomino-pelvic packing are also described. When conservative management is feasible, the first line approach should be bilateral distal ligation of the uterine arteries: this simple and low-risk technique is immediately effective in 80% of cases. If bleeding persists, uterine devascularization can be completed by a triple ligation as described by Tsirulnikov, with or without supplemental proximal ligation of the uterine arteries. This procedure should be performed in preference to the so-called “stepwise ligation sequence”, which involves ligation of the ovarian pedicles and poses a risk of subsequent ovarian failure. Bilateral hypogastric artery ligation is also an effective and widely used first-line technique for experienced surgeons. This approach is technically challenging for less-experienced surgeons and is reserved for cases of failed triple ligation. [Copyright &y& Elsevier]

Objective: This study was designed to assess the ability of an ultrasound-guided radiofrequency (RF)-driven procedure to induce complete and irreversible cord occlusion using a 90 days fetal sheep model. Study Design: Twenty 90 days gestation sheep underwent general anesthesia. The first ten fetuses were exposed under hysterotomy, and RF electrode was inserted visually in the middle of the umbilical cord and deployed. Fetuses were then replaced into the amniotic fluid and RF procedure (average target temperature of 100°C during 10 minutes) was applied. For the next ten fetuses, RF electrode was inserted into the cords under trans-parietal ultrasound guidance and the same RF procedure was applied. Cord occlusion was assessed by Doppler examination (absence of cordonal flows at the end of the procedure and until fetal heart failure occurred) and by subsequent histopathological analysis. Results: Cord occlusion was always complete at Doppler examination at the end of RF procedure for the ten experiments realized under hysterotomy. No cordonal reperfusion was observed until fetal heart failure. Histopathological analysis confirmed cordonal occlusion at the site of impact. Neither cordonal rupture nor cordonal bleeding was observed for any of the ten experiments. When RF electrode was inserted under ultrasound guidance, complete occlusion could be obtained only for 6 of the ten experiments. Conclusion: Our results suggest that RF might be an appropriate method for selective termination of pregnancy. Yet, optimal insertion of the electrode is required to engender a complete and irreversible cord occlusion, and ultrasound-guidance training seems necessary before current human application. [Copyright &y& Elsevier]