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1. Barriers to Physical Activity in Children and Adults Living With Type 1 Diabetes: A Complex Link With Real-life Glycemic Excursions

Author: Cassandra Parent, Elodie Lespagnol, Serge Berthoin, Sémah Tagougui, Joris Heyman, Chantal Stuckens, Iva Gueorguieva, Costantino Balestra, Cajsa Tonoli, Bérengère Kozon, Pierre Fontaine, Jacques Weill, Rémi Rabasa-Lhoret, Elsa Heyman, Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 (URePSSS), Université d'Artois (UA)-Université du Littoral Côte d'Opale (ULCO)-Université de Lille, Université de Rennes (UR), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Haute Ecole de Bruxelles (HE2B), Vrije Universiteit Brussel [Bruxelles] (VUB), CIC CHU ( Lille)/inserm, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université du Québec à Montréal = University of Québec in Montréal (UQAM), Université de Lille, Univ. Artois, Univ. Littoral Côte d’Opale, Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369, Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 [URePSSS], Université de Rennes [UR], Haute Ecole de Bruxelles [HE2B], Vrije Universiteit Brussel [Bruxelles] [VUB], Génomique Intégrative et Modélisation des Maladies Métaboliques (EGID) - UMR 8199, Université du Québec à Montréal = University of Québec in Montréal [UQAM], Physiotherapy, Human Physiology and Anatomy, Anatomical Research and Clinical Studies, Brussels Heritage Lab, Human Physiology and Sports Physiotherapy Research Group, and Faculty of Physical Education and Physical Therapy
Subjects: barriers to physical activity, diabète de type 1, exercise, étude portant sur des personnes non hospitalisées, type 1 diabetes, Endocrinology, Diabetes and Metabolism, [SDV]Life Sciences [q-bio], General Medicine, exercice, hyperglycemia, hyperglycémie, hypoglycemia, hypoglycémie, outpatient study, sobstacle à l’activité physique, étude ambulatoire, Endocrinology, Internal Medicine
Abstract: OBJECTIVES: Ever since the first research on barriers to physical activity (PA) highlighting fear of hypoglycemia as a major barrier, many studies have attempted to understand their demographic and behavioural determinants. However, no research has been conducted on whether these perceived barriers toward PA are based on real-life-experienced adverse glycemic effects of exercise. METHODS: Sixty-two adults and 53 children/adolescents living with type 1 diabetes along with their parents completed the Barriers to Physical Activity in Type 1 Diabetes-1 (BAPAD-1) questionnaire on barriers to PA. Continuous glucose-monitoring data were collected during 1 week of everyday life for 26 adults and 33 children/adolescents. Multiple linear regressions were used to explore links between BAPAD-1 scores and glycemic excursions experienced during and after everyday-life self-reported PA sessions, controlling for behavioural (accelerometry) and demographic confounders. RESULTS: In children/adolescents, the more time spent in hypoglycemia on nights after PA sessions, the more they reported hypoglycemic risk as a barrier (ß=+0.365, p=0.034). Conversely, in adults, the higher the proportion of PA sessions accompanied by a drop in blood glucose, the less hypoglycemia was a barrier (ß=-0.046, p=0.004). In parents, BAPAD-1 scores were unrelated to children/adolescents' everyday-life exercise-induced hypo/hyperglycemia. CONCLUSIONS: In children/adolescents, fear of hypoglycemia was predominant in those exposed to nocturnal hypoglycemia associated with PA sessions. In adults, fewer barriers may mean they accept a bigger drop in their glycemia during PA. This shows the importance of finding and promoting age-specific solutions to prevent exercise-induced hypoglycemia.
Published: 2022
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2. A curriculum based certification of competence in gynaecologic surgical oncology

Author: Gwenael Ferron, Frederic Guyon, Pierre Collinet, Vincent Lavoué, Denis Querleu, Catherine Uzan, Cherif Akladios, François Golfier, Emile Daraï, Fabrice Lecuru, CHU Strasbourg, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Institut Curie [Paris], Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Pitié-Salpêtrière [AP-HP], CHU Pontchaillou [Rennes], CRLCC Eugène Marquis (CRLCC), Oncogenesis, Stress, Signaling (OSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Bergonié [Bordeaux], UNICANCER, Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Société européenne d’oncologie gynécologique
Subjects: Cancer gynécologique, Reproductive Medicine, Political science, Gynaecologic cancer, Compétence chirurgicale, Surgical skills, Obstetrics and Gynecology, Formation chirurgicale, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Humanities, Surgical training, Certification professionnelle
Abstract: International audience; Objective - In France, we are lacking an identified pathway for training in gynaecological cancer surgery. The four competent French learned societies, the SFOG, the CNGOF, the SFCO and the SCGP, supported by the CNU of Obstetrics &Gynaecology- and UNICANCER, agreed to materialize this course and attest it by a certification awarded by a national jury. Material and methods - The national committee of certification in gynaecological oncology made up of 10 members, representing the 6 concerned organizations, set itself 5 objectives: the definition of the eligibility criteria for training centres; the determination of a check-list to be filled by the candidate; the determination of a targeted curriculum for the training in gynecological oncological surgery; the determination of the assets necessary for the certification of a candidate already in practice; and the practical organization of the certification. Results - Criteria for approval of centres for training included 150 gynaecological cancer cases per year, among which 100 excisional surgeries, including 20 advanced-stage ovarian cancers. For certification of candidate who followed the curriculum established by the committee or by validation of prior experience for an actual practitioner, a candidate must validate a logbook and fill out a checklist including 4 parts: theoretical and practical training; research and publications; teaching and subscription to a continuing education program. The accomplished elements of the logbook and the checklist will be evaluated by a score. The first certification session is planned for the end of 2021. Conclusion - The optimisation of the surgical management of patients treated for gynaecological cancer is achieved through the identification of a training course and the certification, by a national jury, of the skills of surgeons who have completed it.
Published: 2022
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3. AFU and SALF recommendations for the evaluation of male infertility

Author: Eric, Huyghe, Florence, Boitrelle, Charlotte, Methorst, Roger, Mieusset, Pierre F, Ray, William, Akakpo, Isabelle, Koscinski, Céline, Chalas, Nathalie, Rives, Ingrid, Plotton, Geoffroy, Robin, Rabi, El Osta, Sylviane, Hennebicq, Florence, Eustache, François, Marcelli, Hervé, Lejeune, CHU Toulouse [Toulouse], Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Biologie de la Reproduction, Environnement, Epigénétique & Développement (BREED), Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-École nationale vétérinaire d'Alfort (ENVA)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service d'Urologie, CHU des quatre ville, Centre Hospitalier Universitaire [Grenoble] (CHU), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Rouen, Normandie Université (NU), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Jean Verdier [AP-HP], Service d'Urologie, andrologie et transplantation rénale [CHRU Lille], and Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
Subjects: Male, Male infertility, Andrologie, Infertilité masculine, Spermogramme, Humans, Spermogram, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, Andrology, Azoospermie, OATS, Infertility, Male, Azoospermia
Abstract: International audience; Background. — The aim of these Association Franc ̧aise d’Urologie (AFU) and Sociétéd’Andrologie de Langue Franc ̧aise (SALF) common recommendations are to provide practiceguidelines for the French Urological and Andrological community regarding the evaluation ofinfertile men.Material and methods. — Literature search in PubMed using the keywords ‘‘male infertility’’, ‘‘diagnosis’’, ‘‘management’’ and ‘‘evaluation’’ limited to clinical articles in English and French prior to 01/01/2020. To inform the level of evidence, the HAS grading system (2013) was applied.Results. — Concerning the evaluation of infertile men, the AFU and the SALF recommend : (1)a systematic interview exploring the family history, the fertility history of the man outside thecouple, the patient’s personal history that may have an impact on his fertility, lifestyle habits,treatments, symptoms and possible sexual difficulties of the couple; (2) a general physical examination to assess signs of hypogonadism and secondary sexual characters; (3) a scrotal physical examination performed by an urologist or andrologist to assess (i) the testes for volume and consistency, (ii) vas deferens and epididymes for total or partial absence or nodules, and(iii) presence of varicoceles; (4) Performing two semen analyses, according to World HealthOrganization guidelines, if the first one has at least one abnormaly; (5) a scrotal ultrasoundas part of routine investigation, that can be completed with an endorectal pelvic ultrasound according to the clinic; (6) an endocrine evaluation with at least a Testosterone and FSH serum determination; (7) Karyotype analysis in infertile men with a sperm concentration ≤ 10 106/mL;(8) assessment of Yq microdeletions in infertile men with a sperm concentration ≤ 1 106/mL;(9) Cystic fibrosis trans membrane conductance regulator gene evaluation in case of suspicion for bilateral or unilateral congenital agenesis of vas deferens and seminal vesicles.; Contexte. — Ces recommandations communes de l’Association Française d’Urologie (AFU) et de la Société d’Andrologie de Langue Franc ̧aise (SALF) ont pour objectif de fournir des directives pratiques à la communauté urologique et andrologique Française concernant l’évaluation des hommes infertiles.Matériel et méthodes. —Recherche bibliographique dans PubMed en utilisant les mots-clés «male infertility», «diagnosis», «management» et «evaluation» limitée aux articles cliniques en anglais et en français antérieurs au 01/01/2020. Pour renseigner le niveau de preuves, le système de gradation de l’HAS (2013) a été appliqué.Résultats. — Concernant l’évaluation des hommes infertiles, l’AFU et la SALF recommandent :(1) un interrogatoire systématique explorant les antécédents familiaux, les antécédents de fertilité de l’homme hors couple, les antécédents personnels du patient pouvant avoir un impact sur sa fertilité, ses habitudes de vie, ses traitements, ses symptômes et les éventuelles difficultés sexuelles du couple ; (2) un examen physique général pour évaluer les signes d’hypogonadisme et les caractères sexuels secondaires ; (3) un examen physique scrotal par un urologue ou un andrologue pour évaluer (i) le volume et la consistance des testicules, (ii)les canaux déférents et les épididymes à la recherche d’une absence totale ou partielle ou des nodules, et (iii) la présence de varicocèle ; (4) d’effectuer 2 spermogrammes, conformément aux recommandations de l’Organisation mondiale de la santé (OMS), si le premier présente au moins une anomalie ; (5) une échographie scrotale systématique, pouvant être complétée par une échographie pelvienne endorectale selon la clinique ; (6) un bilan hormonal comportant au moins une détermination de la testostérone sérique et de FSH ; si la testostérone est basse, la LH permettra de différencier hypogonadisme hypogonatrope (central) et hypogonadisme périphérique ; (7) un caryotype chez les hommes infertiles ayant une concentration de spermatozoïdes ≤ 10,106/ml ; (8) l’évaluation des micro délétions du chromosome Y chez les hommes infertiles ayant une concentration de spermatozoïdes ≤ 1,106/ml ; (9) l’évaluation du gène CFTR en cas de suspicion d’agénésie bilatérale ou unilatérale des canaux déférents et des vésicules séminales. La place de l’analyse de l’intégrité de l’ADN du sperme (SCSA, TUNEL par exemple) dans le bilan de l’homme infertile est encore en cours d’évaluation. Conclusion. — Ces recommandations peuvent être appliquées en pratique clinique en routine chez tout homme infertile.
Published: 2021
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4. Republication de : Recommandations Formalisées d’Experts. Prise en charge de la patiente avec une pré-éclampsie sévère - RFE Communes Société Française d’Anesthésie-Réanimation (SFAR) - Collège National des Gynécologues et Obstétriciens Français (CGNOF)

Author: Bonnet, Marie-Pierre, Garnier, Marc, Keita, Hawa, Compère, Vincent, Arthuis, Chloé, Raia-Barjat, Tiphaine, Berveiller, Paul, Burey, Julien, Bouvet, Lionel, Bruyère, Marie, Castel, Adeline, Clouqueur, Elodie, Gonzalez Estevez, Max, Faitot, Valentina, Fischer, Catherine, Fuchs, Florent, Lecarpentier, Edouard, Le Gouez, Agnès, Rigouzzo, Agnès, Rossignol, Mathias, Simon, Emmanuel, Vial, Florence, Vivanti, Alexandre, Zieleskiewicz, Laurent, Sénat, Marie-Victoire, Schmitz, Thomas, Sentilhes, Loïc, Service d'anesthésie-réanimation [CHU Trousseau], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'Anesthésie réanimation [CHU Tenon], CHU Tenon [AP-HP], Service d'Anesthésie Réanimation [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service Anesthésie et soins intensifs [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Centre hospitalier universitaire de Nantes (CHU Nantes), Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Saint-Etienne, Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Biologie de la Reproduction, Environnement, Epigénétique & Développement (BREED), École nationale vétérinaire - Alfort (ENVA)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Pôle d'anesthésie Réanimation [CHU de Toulouse], CHU Toulouse [Toulouse], Centre Hospitalier Tourcoing, Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Department of Anesthesiology, Intensive care and Perioperative medicine - Hautepierre Hospital, Strasbourg, Hôpital Cochin [AP-HP], Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Intercommunal de Créteil (CHIC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), AP-HP - Hôpital Antoine Béclère [Clamart], Département d’Anesthésie-Réanimation-SMUR [Hôpital Lariboisière], Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Marseille, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Pôle d'Obstétrique Reproduction Gynécologie Centre Aliénor d'Aquitaine, Hôpital Pellegrin, Bordeaux, France., Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), École nationale vétérinaire d'Alfort (ENVA)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU de Toulouse, Pole d'anesthésie Réanimation, Hôpital Paule de Viguier, Toulouse F-31059, France, Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), BREED, INRAE, Pôle Anesthésie Réanimation [CHU de Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], Neonatal morbidity, Severe pre-eclampsia, Guidelines, Maternal morbidity
Abstract: International audience; To provide national guidelines for the management of women with severe pre-eclampsia. Design: A consensus committee of 26 experts was formed. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independently of any industrial funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE(r)) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised. The last SFAR and CNGOF guidelines on the management of women with severe pre-eclampsia were published in 2009. The literature is now sufficient for an update. The aim of this expert panel guidelines is to evaluate the impact of different aspects of the management of women with severe preeclampsia on maternal and neonatal morbidities separately. The experts studied questions within 7 domains. Each question was formulated according to the PICO (Patients Intervention Comparison Outcome) model and the evidence profiles were produced. An extensive literature review and recommendations were carried out and analysed according to the GRADE(r) methodology. The SFAR/CNGOF experts panel provided 25 recommendations: 8 have a high level of evidence (GRADE 1+/−), 9 have a moderate level of evidence (GRADE 2+/−), and for 7 recommendations, the GRADE method could not be applied, resulting in expert opinions. No recommendation was provided for 3 questions. After one scoring round, strong agreement was reached between the experts for all the recommendations. Conclusions: There was strong agreement among experts who made 25 recommendations to improve practices for the management of women with severe pre-eclampsia.
Published: 2021
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5. L’exercice aérobie continu apparaît protecteur contre les hyperglycémies de récupération précoce, en période post-absorptive, en comparaison de l’exercice intermittent intense, chez des enfants et adolescents atteints d’un diabète de type 1

Author: Heyman, E. (Elsa), Lespagnol, E. (Elodie), Heyman, J. (Joris), Tagougui, S. (Sémah), Stuckens, C. (Chantal), Dupire, M. (Marion), Dewaele, A. (Aline), Weill, J. (Jacques), Gueorgieva, I. (Iva), Berthoin, S. (Serge), Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 (URePSSS), Université d'Artois (UA)-Université du Littoral Côte d'Opale (ULCO)-Université de Lille, Université de Rennes (UR), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Lille University Management Lab - ULR 4999 (LUMEN), Université de Lille, Environnement périnatal et croissance - EA 4489 (EPS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Univ. Artois, Univ. Littoral Côte d’Opale, Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369, Université de Rennes [UR], Lille University Management Lab (LUMEN) - ULR 4999, Environnement Périnatal et Santé - EA 4489, and Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille]
Subjects: [SDV]Life Sciences [q-bio]
Abstract: International audience; INTRODUCTION-QUESTIONDès le plus jeune âge, l’exercice est une clé de la prise en charge du diabète de type 1 (DT1). Néanmoins, la peur de l’hypoglycémie est un frein majeur à l’activité physique (Livny et coll. 2019). Chez l’adulte atteint de DT1, l’ajout de répétitions de séquences intenses lors d’un exercice continu modéré semble limiter la baisse de glycémie (Guelfi et coll. 2005). L’objectif est d’évaluer l’impact de l’intensité et de la modalité d’exercice sur les excursions glycémiques au décours de l’exercice chez l’enfant/adolescent atteint de DT1.MATERIELS ET METHODESCinq garçons et 7 filles atteints de DT1 (9,8±1,4ans; HbA1c 7 ,5±0,7%) réalisent en période post-absorptive, sur ergocycle, en ordre randomisé (visites espacées de >48h), un exercice continu modéré (CONT) et un exercice intermittent intense (INT) de durée et charge mécanique totale identiques [20min; 50%PWC170 vs. 15sec(150%PWC170)/30sec récupération passive). Lesvariations glycémiques (glycémie capillaire pendant l’exercice et glucose interstitiel à la récupération) sont comparées entre les types d’exercice et une condition sédentaire (SED), en prenant en compte la glycémie initiale, les glucides et l’insuline (covariables dans les modèles mixtes linéaires).RESULTATSAucune hypoglycémie symptomatique n’est survenue. Alors que la glycémie capillaire diminuait à l’exercice pour CONT (−26,5mg/dL), elle restait stable pour INT (différence inter-condition, P
Published: 2020

6. Autotransplantation of cryoconserved ovarian tissue: First experience in Universitary Hospital Center of Lille

Author: Christine Decanter, P. Piver, B. Leroy-Martin, D. Vinatier, P. Collinet, L. Pouypoudat, L. Keller, Service d'Obstétrique et de Médecine fœtale [CHRU Nancy], Université de Lorraine (UL)-Service d'Obstétrique et de Gynécologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), SLAC National Accelerator Laboratory (SLAC), Stanford University, Gamétogenèse et Qualité du Gamète - ULR 4308 (GQG), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Gynécologie-Obstétrique [CHU Limoges], and CHU Limoges
Subjects: medicine.medical_specialty, 030219 obstetrics & reproductive medicine, Fertilité, business.industry, Ovarian tissue, medicine.medical_treatment, Obstetrics and Gynecology, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, Autotransplantation, Early ovarian failure, Surgery, 03 medical and health sciences, 0302 clinical medicine, Fertility, Reproductive Medicine, 030220 oncology & carcinogenesis, medicine, Ovarian tissue cryopreserved, Center (algebra and category theory), business, Insuffisance ovarienne précoce, ComputingMilieux_MISCELLANEOUS, Tissu ovarien cryoconservé
Abstract: International audience
Published: 2019
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7. Allergie aux protéines du lait de vache : guide pratique de la réintroduction des protéines du lait de vache : quand, comment réintroduire

Author: Bidat, E., Deschildre, A., Lemoine, A., Benoist, G., Valleteau de Moulliac, J., Tressol, C., Garcette, K., Juchet, A., Michaud, E., Languepin, J., Lamireau, T., Lachaux, A., Tounian, P., Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Ambroise Paré [AP-HP], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, CHU Limoges, Service d'Hépato-Gastro-Entérologie et Nutrition [CHU Limoges], hôpital des Enfants [CHU Bordeaux], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), and Hospices Civils de Lyon (HCL)
Subjects: Enfant, Test de provocation par voie orale, Lait de vache, Immunothérapie, Food allergy, Oral food challenge, Immunotherapy, Allergie alimentaire, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Cow's milk
Abstract: International audience; Once cow’s milk protein allergy (CMA) has been diagnosed, the question is when and how it should be reintroduced. Current knowledge makes it possible to offer treatments suited to the diversity of clinical presentations. After a summary analysis of recent advances in different forms of CMA, based on current knowledge about cow’s milk immunotherapy, we propose practical approaches for indications and reintroduction methods in both non-IgE-mediated and IgE-mediated CMA. This article reflects a recent literature analysis as well as the experiences of various contributors.; Une fois le diagnostic d’allergie aux protéines du lait de vache (APLV) effectué se posent les questions du moment et des modalités de la réintroduction. Les connaissances actuelles permettent de proposer des prises en charge adaptées à la diversité des tableaux cliniques de l’APLV. Après avoir rappelé les acquis récents dans les différentes formes d’APLV, envisagé les connaissances actuelles sur l’immunothérapie au lait de vache, nous proposerons des attitudes pratiques sur les indications et les modalités de réintroduction dans les APLV de forme non IgE médiée et IgE médiée. Cet article reflète l’analyse récente de la littérature et les expériences des différents contributeurs.
Published: 2019
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8. [Extragenital endometriosis: Parietal, thoracic, diaphragmatic and nervous lesions. CNGOF-HAS Endometriosis Guidelines]

Author: B. Merlot, Stéphane Ploteau, Horace Roman, Pierre Collinet, C. Hocke, A Abergel, Xavier Fritel, C. Rubob, Michel Canis, Institut d'astrophysique spatiale (IAS), Université Paris-Sud - Paris 11 (UP11)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS), Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Service de gynécologie et obstétrique [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Gamétogenèse et Qualité du Gamète (GQG), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, Droit et Santé-Université de Lille, CHU Rouen, Normandie Université (NU), Hôpital Jeanne de Flandres, and Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
Subjects: medicine.medical_specialty, Thoracic endometriosis, Diaphragm, Endometriosis, Diaphragmatic breathing, Catamenial pneumothorax, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Endométriose pariétal, Endométriose diaphragmatique, 03 medical and health sciences, Abdominal wall, 0302 clinical medicine, Medicine, Sacral roots endometriosis, Surgical treatment, Laparoscopy, Neurolysis, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, medicine.disease, 3. Good health, Surgery, Reproductive Medicine, 030220 oncology & carcinogenesis, Endométriose racines nerveuses sacrées, business, Endométriose thoracique, Pneumothorax cataménial
Abstract: International audience; According to some studies, extragenital endometriosis represents 5% of the localisations. Its prevalence seems to be underestimated. The extra pelvic localisation can make the diagnosis more difficult. Nevertheless, the recurrent and catamenial symptomatology can evoke this pathology. Surgery seems to be the unique efficient treatment for parietal lesions. Pain linked to nervous lesions (peripheric and sacral roots) seems to be underestimated and difficult to diagnose because of various localisations. Neurolysis seems to have encouraging results. Diaphragmatic lesions are often discovered either incidentally during laparoscopy, or by pulmonary symptomatology as recurrent catamenial pneumothorax or cyclic thoracic pain. Surgical treatment seems as well to be efficient.
Published: 2018
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9. Prise en charge de l’endométriose : recommandations pour la pratique clinique CNGOF-HAS (texte court)

Author: Pierre-Adrien Bolze, Horace Roman, Benoit Rabischong, J. Loriau, Charles-André Philip, J. Cohen, Guillaume Legendre, Gil Dubernard, Christine Decanter, Hervé Fernandez, C Chauffour, M. Canis, C. Rubod, Julien Niro, A. Denouel, Arnaud Fauconnier, Pierre Panel, Pierre Collinet, C. Revel-Delhom, François Golfier, Nathalie Chabbert-Buffet, B. Merlot, J. Boujenah, M. Sauvan, Christophe Poncelet, C. Yazbeck, N. Clary, Stéphane Ploteau, Bruno Borghese, Antoine Torre, N. Bornsztein, Pietro Santulli, E. Mathieu-d’Argent, Nicolas Bourdel, J.-M. Wattier, Cyrille Huchon, Xavier Fritel, T. Brillac, Isabelle Thomassin-Naggara, Tristan Gauthier, Philippe Paparel, Marcos Ballester, Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie et obstétrique [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC), Gamétogenèse et Qualité du Gamète - ULR 4308 (GQG), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Service de Gynécologie-Obstétrique [CHU Limoges], CHU Limoges, GeoRessources, Institut national des sciences de l'Univers (INSU - CNRS)-Centre de recherches sur la géologie des matières premières minérales et énergétiques (CREGU)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Applications des ultrasons à la thérapie, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Agence Universitaire de la Francophonie (AUF), Service de gynécologie et obstétrique [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHRU de Lille, Hôpital Jeanne de Flandre, Service de gynécologie, 59000 Lille, France, Aerospatiale Societe Nationale Industrielle, Aerospatiale, Service de Radiologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Unité INSERM U 472. Faculté de Médecine Paris Sud. 63 rue Gabriel Péri. 94276 Le Kremlin Bicêtre Cedex, CHU Tenon [APHP], Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Gamétogenèse et Qualité du Gamète (GQG), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, Droit et Santé-Université de Lille, Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, Poissy, France., Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)-Centre de recherches sur la géologie des matières premières minérales et énergétiques (CREGU)-Institut national des sciences de l'Univers (INSU - CNRS), Service de gynécologie et obstétrique [Rouen], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Service de Gynécologie - Obstétrique [Lille]
Subjects: Infertility, medicine.medical_specialty, French National Authority for Health, medicine.medical_treatment, Endometriosis, Physical examination, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, 03 medical and health sciences, 0302 clinical medicine, medicine, Levonorgestrel, Fertility preservation, French National College of Obstetricians and Gynecologists (CNGOF), Pelvic examination, ComputingMilieux_MISCELLANEOUS, Gynecology, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, medicine.disease, 3. Good health, Reproductive Medicine, 030220 oncology & carcinogenesis, Hormonal therapy, Hormone therapy, business, medicine.drug
Abstract: First-line investigations to diagnose endometriosis are clinical examination and pelvic ultrasound. Second-line investigations include pelvic examination performed by a referent clinician, transvaginal ultrasound performed by a referent echographist, and pelvic MRI. It is recommended to treat endometriosis when it is symptomatic. First-line hormonal treatments recommended for the management of painful endometriosis are combined with hormonal contraceptives or levonorgestrel 52mg IUD. There is no evidence to recommend systematic preoperative hormonal therapy for the unique purpose of preventing the risk of surgical complications or facilitating surgery. After endometriosis surgery, combined hormonal contraceptives or levonorgestrel SIU 52mg are recommended as first-line therapy in the absence of desire of pregnancy. In case of initial treatment failure, recurrence, or multiple organ involvement by endometriosis, medico-surgical and multidisciplinary discussion is recommended. The laparoscopic approach is recommended for the surgical treatment of endometriosis. HRT may be offered in postmenopausal women operated for endometriosis. In case of infertility related to endometriosis, it is not recommended to prescribe anti-gonadotropic hormone therapy to increase the rate of spontaneous pregnancy, including postoperatively. The possibilities of fertility preservation should be discussed with the patient in case of surgery for ovarian endometrioma.
Published: 2018
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10. Endometriosis and fertility preservation: CNGOF-HAS Endometriosis Guidelines

Author: Pietro Santulli, Christine Decanter, J. Boujenah, E.M. d’Argent, C Chauffour, Pierre Collinet, Christophe Poncelet, Gamétogenèse et Qualité du Gamète - ULR 4308 (GQG), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: 0301 basic medicine, Infertility, medicine.medical_specialty, endocrine system diseases, Endométriose, Endometriosis, Congélation de tissu ovarien, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Ovarian tissue Cryopreservation, Oocyte vitrification, Ovocytes, 03 medical and health sciences, 0302 clinical medicine, Vitrification ovocytaire, Medicine, Ovarian tissue cryopreservation, Fertility preservation, ComputingMilieux_MISCELLANEOUS, Gynecology, Follicles, 030219 obstetrics & reproductive medicine, Follicules, business.industry, Obstetrics and Gynecology, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, medicine.disease, Préservation de la fertilité, 3. Good health, Premature ovarian failure, 030104 developmental biology, Reproductive Medicine, Ovarian Endometriosis, Oocytes, business, Cohort study
Abstract: Fertility preservation (FP) techniques are progressing rapidly these past few years thanks to the oocyte vitrification. Indication of FP techniques is now extended to non-oncological situation that may induce risk of premature ovarian failure. Ovarian endometriosis can lead to premature ovarian failure and further infertility due to the high risk of ovarian cysts recurrence and surgery. To date, there is no cohort study regarding FP and endometriosis as well as no recommendation. Our purpose is to review the arguments in favor of FP in this specific area and to elaborate strategies according to each clinical form.
Published: 2018
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11. [Epidemiology and diagnosis strategy: CNGOF-HAS Endometriosis Guidelines]

Author: Fauconnier, Arnaud, Borghese, B., Huchon, C., Thomassin-Naggara, I., Philip, C.-A., Gauthier, T., Bourdel, N., Denouel, A., Torre, A., Collinet, P., Canis, M., Fritel, X., Service de gynécologie et obstétrique [Poissy - Saint-Germain-en-Laye]], CHI Poissy-Saint-Germain, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Radiologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Service de Gynécologie et Obstétrique [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de Gynécologie-Obstétrique [CHU Limoges], CHU Limoges, Ciblage individuel et prévention des risques de traitements immunosupresseurs et de la transplantation (IPPRITT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), CHU Clermont-Ferrand, Image Science for Interventional Techniques (ISIT), Clermont Université-Centre National de la Recherche Scientifique (CNRS)-Université d'Auvergne - Clermont-Ferrand I (UdA), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie et obstétrique [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université d'Auvergne - Clermont-Ferrand I (UdA)-Centre National de la Recherche Scientifique (CNRS)-Clermont Université
Subjects: Diagnostic Imaging, Health-related quality of life, Recommandations, Endometriosis, Diagnostic laparoscopy, Guidelines, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Decision Support Techniques, Pelvic pain, Dysmenorrhea, Pelvic examination, Information, Humans, Diagnostic d’endométriose, Endometriosis diagnosis, Questionnaire, Transvaginal ultrasound, Douleur pelvienne, Cœlioscopie diagnostique, Dyspareunia, Dysménorrhée, Examen pelvien, Dyspareunie, Female, Laparoscopy, Counselling, Gynecological Examination, Échographie vaginale, Qualité de vie liée à la santé, IRM, MRI
Abstract: International audience; Based on the best evidence available, we have provided guidelines for clinical practice to target the nature of endometriosis as a disease, the consequences of its natural history on management, and the clinical and imaging evaluation of the disease according to the level of care (primary care, specialized or referral). The frequency of endometriosis is unknown in the general population; endometriosis requires management when it causes symptoms (pain, infertility) or when it affect the function of an organ. In the absence of symptom, there is no need for follow-up or screening of the disease. Endometriosis may be responsible for various pain symptoms such as severe dysmenorrhea, deep dyspareunia, painful bowel movements or low urinary tract signs increasing with menstruation, or infertility. A careful evaluation of the symptoms and their impact on the quality of life should be made. The first-line examinations for the diagnosis of endometriosis are: digital examination and pelvic ultrasound. The second-line examinations are: the pelvic exam by an expert clinician, the pelvic MRI and/or the transvaginal ultrasound by an expert. MRI and ultrasound carrying different and complementary information. Other examinations may be considered as part of the pre-therapeutic assessment of the disease in case of specialized care. Diagnostic laparoscopy may be suggested in case of clinical suspicion of endometriosis whereas preoperative examinations have not proved the disease, it must be part of a management plan of endometriosis-related pain or infertility. During management, it is recommended to give comprehensive information on the different therapeutic alternatives, the benefits and risks expected from each treatment, the risk of recurrence, fertility, especially before surgery. The information must be personalized and take into account the expectations and preferences of the patient, and accompanied by an information notice given to the patient.
Published: 2018
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12. Management of assisted reproductive technology (ART) in case of endometriosis related infertility: CNGOF-HAS Endometriosis Guidelines

Author: J. Boujenah, Christophe Poncelet, Christine Decanter, Pierre Collinet, Michel Canis, Pietro Santulli, Emmanuelle Mathieu d’Argent, Xavier Fritel, Candice Chauffour, Charles Chapron, Bruno Borghese, Jean-Luc Pouly, J. Cohen, Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie et obstétrique [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Gamétogenèse et Qualité du Gamète - ULR 4308 (GQG), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Service de Gynécologie-Obstétrique [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], CHU Tenon [APHP], Gamétogenèse et Qualité du Gamète (GQG), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, Droit et Santé-Université de Lille, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Infertility, medicine.medical_specialty, Fertilité, medicine.drug_class, Endométriose, media_common.quotation_subject, Endometriosis, Endométriose profonde, Fertility, Context (language use), Reproductive technology, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, ICSI, 03 medical and health sciences, 0302 clinical medicine, medicine, Endometrioma, Medical prescription, reproductive and urinary physiology, ComputingMilieux_MISCELLANEOUS, Endométriome, media_common, Gynecology, fertility, Pregnancy, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics and Gynecology, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, Deep endometriosis, medicine.disease, female genital diseases and pregnancy complications, FIV, 3. Good health, Reproductive Medicine, IVF, 030220 oncology & carcinogenesis, business, Progestin, hormones, hormone substitutes, and hormone antagonists
Abstract: The management of endometriosis related infertility requires a global approach. In this context, the prescription of an anti-gonadotropic hormonal treatment does not increase the rate of non-ART (assisted reproductive technologies) pregnancies and it is not recommended. In case of endometriosis related infertility, the results of IVF management in terms of pregnancy and birth rates are not negatively affected by the existence of endometriosis. Controlled ovarian stimulation during IVF does not increase the risk of endometriosis associated symptoms worsening, nor accelerate the intrinsic progression of endometriosis and does not increase the rate of recurrence. However, in the context of IVF management for women with endometriosis, pre-treatment with GnRH agonist or with oestrogen/progestin contraception improve IVF outcomes. There is currently no evidence of a positive or negative effect of endometriosis surgery on IVF outcomes. Information on the possibilities of preserving fertility should be considered, especially before surgery.
Published: 2018
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13. Minimal and mild endometriosis: Impact of the laparoscopic surgery on pelvic pain and fertility. CNGOF-HAS Endometriosis Guidelines

Author: Michel Canis, Horace Roman, Xavier Fritel, Pierre Collinet, B. Merlot, Stéphane Ploteau, Gamétogenèse et Qualité du Gamète (GQG), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, Droit et Santé-Université de Lille, CHU Rouen, Normandie Université (NU), Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie et obstétrique [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Gamétogenèse et Qualité du Gamète - ULR 4308 (GQG), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, Institut Pascal (IP), and SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)
Subjects: Infertility, medicine.medical_specialty, Fertilité, Cœlioscopie, Endométriose, Endometriosis, Context (language use), [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Pelvic pain, Medicine, 030212 general & internal medicine, Stage (cooking), Laparoscopy, ComputingMilieux_MISCELLANEOUS, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, Douleur pelvienne, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, Adhesion barrier, medicine.disease, 3. Good health, Surgery, Fertility, Reproductive Medicine, medicine.symptom, business
Abstract: Minimal and mild endometriosis (stage 1 and 2 AFSR) can lead to chronic pelvic pain and infertility but can also exist in asymptomatic patients. The prevalence of asymptomatic patients with minimal and mild endometriosis is not clear but typical endometriosis lesions are found in about 5 to 10% of asymptomatic women and more than 50% of painful and/or infertile women. Laparoscopic treatment of minimal and mild endometriotic lesions is justified in case of pelvic pain because their destruction decrease significatively the pain compared with diagnostic laparoscopy alone. In this context, ablation and excision give identical results in terms of pain reduction. Moreover, literature shows no interest in uterine nerve ablation in case of dysmenorrhea due to minimal and mild endometriosis. Then, it is recommended to treat these lesions during a laparoscopy realised as part of pelvic pain. On the other hand, it is not recommended to treat asymptomatic patients. With regard to treatment of minimal and mild endometriosis in infertile patients, only two studies can be selected and both show that laparoscopy with excision or ablation and ablation of adhesions is superior to diagnostic laparoscopy alone in terms of pregnancy rate. However, it is not recommended to treat these lesions when they are asymptomatic because there is no evidence that they can progress with symptomatic disease. There is no study assessing the interest to treat these lesions when they are found fortuitously. Adhesion barrier utilisation permits to reduce post-operative adhesions, however literature failed to demonstrate the clinical profit in terms of reduction of the risk of pain or infertility.
Published: 2018
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14. Synthèse des stratégies et prise en charge chirurgicale de l’endométriose, RPC Endométriose CNGOF-HAS

Author: Roman, H., Ballester, M., Loriau, J., Canis, M., Bolze, P.A., Niro, J., Ploteau, S., Rubod, C., Yazbeck, C., Collinet, P., Rabischong, B., Merlot, B., Fritel, X., Gamétogenèse et Qualité du Gamète - ULR 4308 (GQG), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, CHU Rouen, Normandie Université (NU), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Service de Gynécologie - Obstétrique [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Foch [Suresnes], Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie et obstétrique [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and CHRU de Lille, Hôpital Jeanne de Flandre, Service de gynécologie, 59000 Lille, France
Subjects: Adult, Urologic Diseases, Cœlioscopie, Endométriose, Endométriose profonde, Endometriosis, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, Deep endometriosis, Cystectomy, Hysterectomy, Colonic Diseases, Rectal Diseases, Humans, Endometrioma, Surgery, Female, Laparoscopy, Chirurgie, Endométriome
Abstract: International audience; The article presents French guidelines for surgical management of endometriosis. Surgical treatment is recommended for mild to moderate endometriosis, as it decreases pelvic painful complaints and increases the likelihood of postoperative conception in infertile patients (A). Surgery may be proposed in symptomatic patients with ovarian endometriomas which diameter exceeds 20mm. Cystectomy allows for better postoperative pregnancy rates when compared to ablation using bipolar current, as well as for lower recurrences rates when compared to ablation using bipolar current or CO2 laser. Ablation of ovarian endometriomas using bipolar current is not recommended (B). Surgery may be employed in patients with deep endometriosis infiltrating the colon and the rectum, with good impact on painful complaints and postoperative conception. In these patients, laparoscopic route increases the likelihood of postoperative spontaneous conception when compared to open route. When compared to conservative rectal procedures (shaving or disc excision), segmental colorectal resection increases the risk of postoperative stenosis, requiring additional endoscopic or surgical procedures. In large deep endometriosis infiltrating the rectum (>20mm length of bowel infiltration), conservative rectal procedures do not improve postoperative digestive function when compared to segmental resection. In patients with bowel anastomosis, placing anti-adhesion agents on contact with bowel suture is not recommended, due to higher risk of bowel fistula (C). Various other recommendations are proposed in the text, however, they are based on studies with low level of evidence.
Published: 2018
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15. Systematic proposal of fertility preservation by mature oocyte cryopreservation for recurrent benign ovarian tumors

Author: P. Collinet, Christine Decanter, Y. Dadoun, H. Azaïs, L. Keller, E. d’Orazio, École polytechnique (X), SLAC National Accelerator Laboratory (SLAC), Stanford University, Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Gamétogenèse et Qualité du Gamète - ULR 4308 (GQG), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Lille, and Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
Subjects: 0301 basic medicine, Tumeurs ovariennes bénignes, 030219 obstetrics & reproductive medicine, Obstetrics and Gynecology, Benign ovarian tumors, Benign ovarian cysts, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, Préservation de la fertilité, Oocyte vitrification, 3. Good health, Oocyte accumulation, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Vitrification ovocytaire, Accumulation ovocytaire, Reproductive Medicine, Fertility preservation, ComputingMilieux_MISCELLANEOUS, Kystes ovariens
Abstract: Resume Objectifs Etudier prospectivement la reponse ovarienne a la stimulation et la cohorte ovocytaire eligible a la vitrification chez de jeunes patientes porteuses de volumineuses tumeurs ovariennes benignes a haut potentiel de recidive dont le traitement chirurgical expose au risque d’alteration de la reserve folliculaire ovarienne. Methode Les criteres d’eligibilite etaient : âge entre 18 et 36 ans, presence d’au moins une volumineuse tumeur ovarienne benigne (≥ 5 cm) a haut risque de recidive. Les patientes ont beneficie d’une stimulation ovarienne controlee au moins 3 mois apres leur chirurgie et apres evaluation de leur reserve (AMH et comptage folliculaire). Les ovocytes en metaphase II etaient congeles par vitrification. Resultats Vingt-quatre patientes de 25 ± 5 ans en moyenne et presentant des kystes dermoides, mucineux ou endometriosiques ont ete incluses entre janvier 2015 et juillet 2016. Toutes avaient un antecedent chirurgical ovarien. Le taux moyen d’AMH etait de 15,3 pmol/L. Les nombres moyens d’ovocytes totaux recueillis par patiente et d’ovocytes en metaphase II etaient respectivement de 7 ± 5 et 4,4 ± 4. Parmi les patientes, 38 % ont faiblement repondu a la stimulation ; 86 % des patientes avaient un nombre d’ovocytes M II inferieur ou egal a huit. Sept patientes ont souhaite beneficier d’un second recueil ovocytaire a des fins d’accumulation ovocytaire. Conclusion Cette etude demontre la faisabilite et la bonne adhesion des patientes a la proposition systematique de preservation par congelation d’ovocytes. Du fait des chirurgies anterieures et d’une moindre reserve ovarienne de base, l’incidence des mauvaises reponses ovariennes est elevee dans cette serie avec, en consequence, un nombre d’ovocytes eligibles a la vitrification par cycle relativement bas. Une strategie d’accumulation ovocytaire pour augmenter les chances ulterieures de grossesse est preconisee.
Published: 2017
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16. Tumeurs bénignes du sein : recommandations pour la pratique clinique du Collège national des gynécologues et obstétriciens français (CNGOF) – Texte court [Benign breast tumors: Recommendations of Collège National des Gynécologues Obstétriciens Français (CNGOF) – Short text]

Author: Lavoue, V., Fritel, X., Antoine, M., Beltjens, F., Bendifallah, S., Boisserie-Lacroix, M., Boulanger, L., Canlorbe, G., Catteau-Jonard, S., Chabbert-Buffet, N., Chamming's, F., Chéreau, E., Chopier, J., Coutant, C., Demetz, J., Guilhen, N., Fauvet, R., Kerdraon, O., Laas, E., Legendre, G., Mathelin, C., Nadeau, C., Thomassin Naggara, I., Ngo, C., Ouldamer, L., Rafii, A., Roedlich, M. -N., Seror, J., Séror, J. -Y., Touboul, C., Uzan, C., Darai, E, Oncogenesis Stress Signaling ( OSS ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -CRLCC Eugène Marquis ( CRLCC ), CHU Pontchaillou [Rennes], Service de gynécologie et obstétrique [Poitiers], Université de Poitiers-Centre hospitalier universitaire de Poitiers ( CHU Poitiers ), Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers ( CHU Poitiers ) -Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Theranoscan, Université Pierre et Marie Curie - Paris 6 ( UPMC ), CHU Tenon [APHP], Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Centre Régional de Lutte Contre le Cancer Oscar Lambret, Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Pole of Obstetrics and Gynaecology, Senology Unit, Hôpital de Hautepierre [Strasbourg], Centre hospitalier universitaire de Poitiers ( CHU Poitiers ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Nutrition, croissance et cancer (U 1069) ( N2C ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Tours, UPRES EA 2396, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -UPRES EA 2396, Department of Gynaecology and Obstetrics, Oncogenesis Stress Signaling (OSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Développement embryonnaire précoce humain et pluripotence EmbryoPluripotency (UMR 1203), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-CHU Montpellier, CHU Saint-Antoine [AP-HP], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Lille Nord de France (COMUE)-UNICANCER, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours, and Université Pierre et Marie Curie - Paris 6 (UPMC)-UPRES EA 2396
Subjects: Mammographie, Benign breast tumour, ésTumeur bénigne du sein, Échographie, Histologie, Sonography, [ SDV ] Life Sciences [q-bio], BI-RADS classification, [SDV]Life Sciences [q-bio], Mammogram, Classification BI-RADS, Pathological analysis, skin and connective tissue diseases
Abstract: National audience; L’échographie est nécessaire avec la mammographie pour explorer une masse clinique du sein (grade B), un écoulement unipore coloré du mamelon (grade C), ou une mastite (grade C). La classification BI-RADS est recommandée pour décrire et classer les anomalies en imagerie du sein. Pour les abcès du sein, une biopsie percutanée est recommandée en cas de masse ou de symptômes persistants (grade C). Pour les mastodynies, lorsque l’imagerie du sein est normale, ni l’IRM, ni une biopsie n’est recommandée (grade C). La biopsie percutanée est recommandée pour les masses classées BI-RADS 4-5 (grade B). Pour les lésions érythémateuses persistantes aréolomamelonnaires ou les lésions d’eczéma atypique, une biopsie est recommandée (grade C). Pour la distorsion ou l’asymétrie mammaire, une macrobiopsie est recommandée en raison du risque de sous-estimation par microbiopsie (grade C). Pour les microcalcifications BI-RADS 4-5 sans signal à l’échographie, une macrobiopsie d’au moins 11 jauges est recommandée (grade B) ; en l’absence de microcalcifications sur les clichés des carottes, des prélèvements supplémentaires sont recommandés (grade B). Pour l’hyperplasie canalaire atypique, l’hyperplasie lobulaire atypique, le carcinome lobulaire in situ, la métaplasie cylindrique avec atypies, la cicatrice radiaire avec traduction radiologique, la mucocèle avec atypie, l’exérèse chirurgicale est habituellement recommandée (grade C). L’abstention est possible après concertation multidisciplinaire (grade C). Pour ces lésions, lorsque l’excision n’est pas in sano, aucune excision complémentaire n’est recommandée sauf pour le CLIS pléomorphe ou avec nécrose (grade C). Pour la phyllode de grade 1, la résection chirurgicale in sano est recommandée ; pour la phyllode de grade 2, des marges de 10 mm sont recommandées (grade C). Pour les lésions papillaires sans atypie, la disparition complète du signal radiologique est recommandée (grade C). Pour les lésions papillaires avec atypies, la résection chirurgicale complète est recommandée (grade C). Summary Breast sonography is required with mammogram to explore clinical breast mass (grade B), colored unipore breast nipple discharge (grade C), or mastitis (grade C). Bi-RADS system is recommended to describe and classify breast-imaging abnormalities. For breast abscess, a percutaneous biopsy is recommended in case of mass or persistent symptoms (grade C). For mastodynia, when breast imaging is normal, no MRI neither breast biopsy is recommended (grade C). Percutaneous biopsy is recommended for BI-RADS 4–5 mass (grade B). For persistent erythematous breast nipple or atypical eczema lesion, a nipple biopsy is recommended (grade C). For distortion and asymmetry, a vacuum core needle biopsy is recommended because of the risk of underestimation by simple core needle biopsy (grade C). For BI-RADS 4–5 microcalcifications without ultrasound signal, a vacuum core needle biopsy of at least 11 gauges is recommended (grade B); in the absence of microcalcifications on radiograph carrots, additional samples are recommended (grade B). For atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, flat epithelial with atypia, radial scar, mucocele with atypia, surgical excision is commonly recommended (grade C). Expectant management is feasible after multidisciplinary concertation. For these lesions, when excision is not in sano, no new excision is recommended except for pleomorphic or with necrosis CLIS (grade C). For grade 1 phyllode tumour, in sano surgical resection is recommended; for grade 2 phyllode, 10-mm margins are recommended (grade C). For breast papillary without atypia, complete disappearance of the radiologic signal is recommended (grade C). For breast papillary with atypia, complete surgical excision is recommended (grade C)
Published: 2015
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17. Intérêt de l'ostéodensitométrie chez les sujets chuteurs

Author: Patrick Seret, Olivier Beauchet, Véronique Breuil, Laure Chapuis, Pascal Guggenbuhl, Michel Brazier, Yves Rolland, Christian Marcelli, Maurice Audran, Michel Laroche, Patrice Fardellone, Karine Briot, Florence Trémollières, Georges Weryha, Cédric Annweiler, Jean-Bernard Gauvain, Thierry Thomas, Sauveur Bendavid, Philippe Orcel, Athanase Benetos, Olivier Hanon, Claude-Laurent Benhamou, Eric Lespessailles, Jean-Marc Feron, Valérie Bousson, François Puisieux, Brigitte Letombe, Gilles Berrut, Christian Roux, Martine Cohen-Solal, Eric Mallet, Jean-Claude Souberbielle, Hubert Blain, Bruno Sutter, Bernard Cortet, Roland Chapurlat, Patricia Dargent, Sami Kolta, Department of Geriatrics - Efficiency and Deficiency Laboratory, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Gérontopôle, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Toulouse [Toulouse], Département de Médecine Interne et Gérontologie clinique, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service de médecine interne et gérontologie clinique [Angers], Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), Imagerie Multimodale Multiéchelle et Modélisation du Tissu Osseux et articulaire (I3MTO), Université d'Orléans (UO), Service de médecine gériatrique, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de médecine aïgue gériatrique [Nantes], PRES Université Nantes Angers Le Mans (UNAM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Groupe d'Études Remodelage Osseux et bioMatériaux (GEROM), Université d'Angers (UA), Médecine générale, Inconnu, Service de radiologie Ostéo-Articulaire, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Caractérisation du Tissu Osseux par Imagerie : techniques et applications, Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de rhumatologie, CHU Amiens-Picardie, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Centre hospitalier de Vitré, Physiopathologie, diagnostic et traitements des maladies osseuses / Pathophysiology, Diagnosis & Treatments of Bone Diseases (LYOS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Os et articulations, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de rhumatologie[Lille], Hôpital Roger Salengro [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Centre de médecine gériatrique, Centre Hospitalier Régional d'Orléans (CHRO), Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Centre de rhumatologie, CHU Purpan, Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de référence des maladies rares du calcium et du phosphore, CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Service de Rhumatologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Service de gériatrie, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de recherche Croissance et signalisation (UMR_S 845), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut Calot, Institut Calot [Fondation Hopale], Centre de ménopause, Service d'Endocrinologie [CHRU Nancy], Biologie intégrative du tissu osseux, Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre de Rhumatologie [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Biologie Intégrative du Tissu Osseux (LBTO), Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5), Hôpital Paule de Viguier, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Gérontopôle de Toulouse, CHU Toulouse [Toulouse], CHU Angers, Université d'Angers ( UA ) -CHU Angers, Imagerie Multimodale Multiéchelle et Modélisation du Tissu Osseux et articulaire ( I3MTO ), Université d'Orléans ( UO ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), PRES Université Nantes Angers Le Mans ( UNAM ) -Centre hospitalier universitaire de Nantes ( CHU Nantes ), Remodelage osseux et biomatériaux, Université d'Angers ( UA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], CHU Nice-Hôpital l'Archet, Physiopathologie, diagnostic et traitements des maladies osseuses / Pathophysiology, Diagnosis & Treatments of Bone Diseases ( LYOS ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Roger Salengro-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de Picardie Jules Verne ( UPJV ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de chirurgie orthopédique, CHU Saint-Antoine [APHP], Centre Hospitalier Régional d'Orléans ( CHR ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), CHU Caen, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Lariboisière, Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Centre de recherche Croissance et signalisation ( UMR_S 845 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), and Université Jean Monnet [Saint-Étienne] ( UJM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM )
Subjects: [ SDV.MHEP.RSOA ] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Rheumatology, Ostéodensitométrie, Prise en charge, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Ostéoporose, Recommandations, Chute, Fragilité
Abstract: National audience; La présente revue de la littérature a pour objectif d'argumenter les nouvelles recommandations françaises publiées en 2012 retenant le risque de chute, évalué par l'antécédent de chute dans la dernière année, comme indication de la mesure de la densité minérale osseuse (DMO) par l'absorptiométrie biphotonique par rayons X (DXA). Cette recommandation repose sur le fait que premièrement, l'ostéoporose et le risque de chute représentent les deux premiers facteurs de risque de fracture non vertébrale après la ménopause. Deuxièmement, la mesure de la DMO par DXA apporte une information significative sur le risque de fracture, indépendamment du risque de chute. Ainsi, un sujet chuteur aura d'autant plus de risque de se fracturer qu'il aura une DMO basse. Troisièmement, les traitements anti-ostéoporotiques n'ont montré une efficacité anti-fracturaire qu'en cas d'ostéoporose ostéodensitométrique. Quatrièmement, la prévalence de l'ostéoporose est élevée chez les sujets chuteurs d'autant que ceux-ci sont fragiles [chutes répétées, sarcopénie (faible masse et force musculaire), réduction de mobilité, perte de poids, en particulier], ces facteurs étant des facteurs de risque communs d'ostéoporose et de chute. Cependant, l'indication de la DXA doit être nuancée chez les sujets chuteurs dont l'espérance de vie est limitée, les traitements n'ayant montré une efficacité anti-fracturaire qu'après 12 mois d'administration et en cas de faible accessibilité à la DXA (éloignement, patients dépendants, ayant une altération cognitive sévère par exemple). Des travaux sont souhaitables pour mieux définir comment intégrer le risque de chute et la fragilité dans l'évaluation du risque de fracture par la DMO et le score FRAX®
Published: 2014
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18. Creatine and guanidinoacetate reference values in a French population

Author: Gilles Simard, Gajja S. Salomons, Olivier Douay, Marc Tardieu, François Rivier, Nicole Porchet, Marion Gérard, Gaelle Pitelet, David Cheillan, Jean-Marie Cuisset, François Cartault, Joseph Vamecq, Karine Mention-Mulliez, Delphine Héron, Alice Goldenberg, Vincent des Portes, Richard Delorme, Soumeya Bekri, Brigitte Chabrol, L. Lion-François, Vassili Valayannopoulos, JM Pinard, Jean-François Benoist, Allel Chabli, Gilbert Briand, Kumaran Deiva, Fabienne Prieur, Christine Vianey-Saban, Dries Dobbelaere, Alexandra Afenjar, Marie Joncquel-Chevalier Curt, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Laboratoire d'Hormonologie, Métabolisme-Nutrition & Oncologie (HMNO), Département de Biochimie et Biologie Moléculaire-Centre de Biologie et Pathologie (CBP) Pierre-Marie Degand-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Mass Spectrometry Application Laboratory, Université de Lille, Droit et Santé, Metabolic Unit, Department of Clinical Chemistry-VU University Medical Center [Amsterdam], Hôpital Jeanne de Flandre [Lille], Centre de Référence des Maladies Héréditaires du Métabolisme, Hôpital Jeanne de Flandres-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de référence des maladies héréditaires du métabolisme de l'enfant et de l'adulte, Centre Hospitalier Universitaire de Lille (CHU de Lille), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), Laboratoire de Biochimie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Service de neurologie pédiatrique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Stress Oxydant et Pathologies Métaboliques (SOPAM), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neuropédiatrie, Hôpital Bicêtre, Génétique Médicale et Génomique Fonctionnelle (GMGF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Centre National de la Recherche Scientifique (CNRS), Unité Fonctionnelle de Génétique Clinique [CHU Pitié Salpétrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Service de Neurologie Pédiatrique, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Génétique Clinique Chromosomique et Moléculaire, CHU Saint-Etienne, Service de génétique, Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion], Hôpital l'Archet, Service de génétique [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Laboratoire de biochimie générale [Rouen], Normandie Université (NU)-Centre hospitalier universitaire de Rouen, Université de Lorraine (UL), Service Psychiatrie de l'Enfant et de l'Adolescent, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Clinical chemistry, and NCA - Brain mechanisms in health and disease
Subjects: Male, Endocrinology, Diabetes and Metabolism, [SDV]Life Sciences [q-bio], Choreoathetosis, Physiology, Urine, Biochemistry, chemistry.chemical_compound, Epilepsy, Plasma, 0302 clinical medicine, Endocrinology, Reference Values, Intellectual disability, Child, Dystonia, Aged, 80 and over, 0303 health sciences, education.field_of_study, Age Factors, Middle Aged, 3. Good health, Child, Preschool, Creatinine, Female, France, medicine.symptom, Adult, medicine.medical_specialty, Ataxia, Adolescent, Population, Glycine, Creatine, White People, 03 medical and health sciences, Young Adult, Sex Factors, Internal medicine, Genetics, medicine, Humans, education, Molecular Biology, Amino Acid Metabolism, Inborn Errors, 030304 developmental biology, Aged, Guanidinoacetate, business.industry, Infant, Newborn, Laboratory values, Infant, medicine.disease, chemistry, Case-Control Studies, business, 030217 neurology & neurosurgery
Abstract: International audience; Creatine and guanidinoacetate are biomarkers of creatine metabolism. Their assays in body fluids may be used for detecting patients with primary creatine deficiency disorders (PCDD), a class of inherited diseases. Their laboratory values in blood and urine may vary with age, requiring that reference normal values are given within the age range. Despite the long known role of creatine for muscle physiology, muscle signs are not necessarily the major complaint expressed by PCDD patients. These disorders drastically affect brain function inducing, in patients, intellectual disability, autistic behavior and other neurological signs (delays in speech and language, epilepsy, ataxia, dystonia and choreoathetosis), being a common feature the drop in brain creatine content. For this reason, screening of PCDD patients has been repeatedly carried out in populations with neurological signs. This report is aimed at providing reference laboratory values and related age ranges found for a large scale population of patients with neurological signs (more than 6 thousand patients) previously serving as a background population for screening French patients with PCDD. These reference laboratory values and age ranges compare rather favorably with literature values for healthy populations. Some differences are also observed, and female participants are discriminated from male participants as regards to urine but not blood values including creatine on creatinine ratio and guanidinoacetate on creatinine ratio values. Such gender differences were previously observed in healthy populations; they might be explained by literature differential effects of testosterone and estrogen in adolescents and adults, and by estrogen effects in prepubertal age on SLC6A8 function. Finally, though they were acquired on a population with neurological signs, the present data might reasonably serve as reference laboratory values in any future medical study exploring abnormalities of creatine metabolism and transport.
Published: 2013
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19. In utero. L’origine développementale de la santé et des maladies (DOHaD), une science en évolution

Author: Junien, Claudine, Charlier, Madia, Cotinot, Corinne, Harscoët, Jean-Michel, Vieau, Didier, Pejoan, Hélène, Rossignol, Sylvie, Turck, Dominique, Eustache, Florence, Lévy, Rachel, Adler, Marion, Mandelbrot, Laurent, Biologie du Développement et Reproduction (BDR), Institut National de la Recherche Agronomique (INRA), Génétique Animale et Biologie Intégrative (GABI), AgroParisTech-Institut National de la Recherche Agronomique (INRA), Service de Néonatalogie, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Laboratoire environnement périnatal et croissance, Université de Lille, Sciences et Technologies, Centre Hospitalier Régional de Neuilly-Courbevoie (CHR), Service de Pédiatrie, CHU Trousseau [APHP], Service de Gastroentérologie et Nutrition de l'Enfant, Hôpital Jeanne de Flandres, AMP-CECOS, Hôpital Jean Verdier [Bondy], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Service de Biologie de la Reproduction, Hôpital Antoine Béclère, Service de Gynécologie Obstétrique, Hôpital Louis Mourier, ProdInra, Archive Ouverte, Biologie du développement et reproduction (BDR), École nationale vétérinaire - Alfort (ENVA)-Institut National de la Recherche Agronomique (INRA)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA)-AgroParisTech, Environnement périnatal et croissance - EA 4489 (EPS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Congres-Medical. FRA., École nationale vétérinaire d'Alfort (ENVA)-Institut National de la Recherche Agronomique (INRA)-Centre National de la Recherche Scientifique (CNRS), and Centre National de la Recherche Scientifique (CNRS)-École nationale vétérinaire d'Alfort (ENVA)-Institut National de la Recherche Agronomique (INRA)
Subjects: obésité, épigénétique, [SDV.BDD] Life Sciences [q-bio]/Development Biology, consultation périconceptionnelle, leptine, tabagisme, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, lactation, [SDV.BDD]Life Sciences [q-bio]/Development Biology, [SDV.BDLR] Life Sciences [q-bio]/Reproductive Biology, dimorphisme sexuel, amp, perturbateurs endocriniens
Abstract: Le dimorphisme sexuel s'établit dès la conception, avant même l'intervention des hormones. Il dépend des chromosomes sexuels et de l'expression des gènes soumis à l'influence de l'environnement. Influence elle-même transmissible au fil des générations.L'AMP prédispose à un faible«sur» risque de certaines pathologies très rares. Ces anomalies sont d'origine épigénétique et portent sur la modification de gènes soumis à empreinte parentale. L'obésité maternelle impacte le développement de la glande mammaire dans la descendance.La naissance ouvre une courte fenêtre de plasticité durant laquelle des remaniements épigénétiques ont lieu. La leptine pourrait jouer un rôle central dans la programmation métabolique au momentde la lactation.L'exposition aux perturbateurs endocriniens est délétère pour le fœtus et le nouveau-né. Des études doivent être poursuivies pour préciser les effets de faibles doses de mélanges complexes sur le long terme, les mécanismes d'action et l'impact transgénérationnel de ces substances. Les effets nocifs directs et indirects du tabagisme ne sont plus à démontrer et l'arrêt du tabac doit être un objectif mieux pris en compte par les médecins.La mise en place d'une consultation préconceptionnelle permettrait d'informer et de conseiller les futures mères sur le rôle joué par l'environnement..
Published: 2012

20. NOUVEAUX DEVELOPPEMENTS POUR L'IMAGERIE MALDI :VERS L'IMAGERIE CLINIQUE A HAUT DEBIT

Author: Ducoroy, P., Fournier, I., Lemaire, R., Salzet, M., Tabet, Jc., Vinatier, D., Wisztorski, M., Courcelle, C., Jardin-Mathé, O., Plateforme protéomique, Cancéropôle du Grand Est-IFR100 - Structure fédérative de recherche Santé-STIC, Neuroimmunologie des annélides (NA), Université de Lille, Sciences et Technologies-Centre National de la Recherche Scientifique (CNRS), Synthèse, Structure et Fonction de Molécules Bioactives (SSFMB), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), ACI, CNRS, MENRT, Plateforme protéomique [Dijon], and Salzet, Michel
Subjects: [SDV.IB] Life Sciences [q-bio]/Bioengineering, [CHIM.ANAL] Chemical Sciences/Analytical chemistry, [SDV.CAN] Life Sciences [q-bio]/Cancer, MALDI imaging, [CHIM.ANAL]Chemical Sciences/Analytical chemistry, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, mass sepctrometry, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.IB]Life Sciences [q-bio]/Bioengineering
Abstract: International audience; La protéomique connaît un essor considérable depuis ces dernières années comme le démontre les nombreux travaux réalisés dans le domaine. Elle a permis de conduire à l'identification de nombreuses protéines. Cependant, malgré la puissance de cette stratégie, l'information concernant la localisation des composés au sein des tissus ne peut être conservée. En revanche, le développement de méthodologies nouvelles, comme l'analyse directe de tissus par spectrométrie de masse permet d'obtenir cette information. Dans le cadre de l'analyse des biomolécules sous leur forme intacte, les sources MALDI sont bien adaptées. Ainsi, il est possible de réaliser l'analyse directe de composés au sein des tissus de biomolécules en MALDI. L'automatisation de cette méthode ouvre vers l'imagerie par spectrométrie de masse MALDI au travers de cartes de répartition moléculaires dans le tissu. Néanmoins, cette méthodologie nécessite encore de nombreux développements afin d'améliorer les qualités d'analyse et la résolution des images. Nous nous sommes plus intéressés à développer différents aspects de cette technologie. Ces développements ont été appliqués à l'étude du cancer de l'ovaire et la recherche de nouveaux biomarqueurs de cette pathologie. L'analyse directe différentielle de biopsies de patientes présentant une tumeur et de patientes témoins (descente d'organe) a conduit à la mise en évidence de plusieurs biomarqueurs potentiels.
Published: 2005

21. [The expert panel for Script Concordance Tests: A truly adequate reference?]

Author: Dauchet L, Bentegeac R, Ghauss H, Hazzan M, Truffert P, Amouyel P, Gauthier V, and Hamroun A
Subjects: Humans, Clinical Reasoning, France, Students, Medical statistics & numerical data, Uncertainty, Education, Medical standards, Education, Medical methods, Bayes Theorem, Educational Measurement methods, Educational Measurement standards, Clinical Competence standards
Abstract: The Script Concordance Tests (SCTs) are an examination modality introduced by decree in the French National Ranking Exam for medical students in 2024. Their objective is to evaluate clinical reasoning in situations of uncertainty. In practice, SCTs assess the impact of new information on the probability of a hypothesis formulated a priori based on an authentic clinical scenario. This approach resembles probabilistic (or Bayesian) reasoning. Due to the uncertainty associated with the explored clinical situation, SCTs do not compare the student's response to an expected one in a theoretical knowledge reference. Instead, the distribution of responses from a panel of experienced physicians is used to establish the question's scoring scale. Literature data suggest that physicians, even experienced ones, like most humans, often exhibit biased intuitive probabilistic reasoning. These biases raise questions about the relevance of using expert panel responses as scoring scales for SCTs., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
Published: 2024
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22. [Management of asthma attack in children aged 6 to 12 years].

Author: Marguet C, Benoist G, Werner A, Cracco O, L'excellent S, Rhagani J, Tamalet A, Vrignaud B, Schweitzer C, Lejeune S, Giovannini-Chami L, Mortamet G, and Houdouin V
Subjects: Child, Humans, Anti-Asthmatic Agents therapeutic use, Anti-Asthmatic Agents administration & dosage, Asthma therapy, Asthma diagnosis, Asthma epidemiology
Published: 2024
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23. [Palliative care in hematopoietic stem-cell transplanted patients: Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)].

Author: Polomeni A, Prod'homme C, Ainaoui M, Bellec A, Berr A, Bonneau J, Charbonnier A, Coiteux V, de Berranger E, Descamps T, Gire M, Goncalves M, Ruscassié A, Yakoub-Agha I, and Borel C
Subjects: Advance Directives, Allografts, Attitude of Health Personnel, Bacterial Proteins, Child, Clinical Decision-Making, Clinical Deterioration, Glucosyltransferases, Health Care Surveys methods, Health Care Surveys statistics & numerical data, Hematopoietic Stem Cell Transplantation psychology, Humans, Interdisciplinary Communication, Interprofessional Relations, Prognosis, Qualitative Research, Quality of Life, Societies, Medical, Terminal Care, Hematologic Neoplasms therapy, Hematopoietic Stem Cell Transplantation adverse effects, Palliative Care organization & administration, Palliative Care psychology
Abstract: Allogeneic hematopoietic cell transplantation (allo-HCT), the only curative therapy for numerous hematological malignancies, carries a significant risk of morbidity and mortality. The patients and families' expectations regarding the procedure, the prognosis uncertainties, as well as the existence of potential new therapeutic possibilities, lead to frequent use of intensive care. Even though the transplant physicians are highly skilled in acute care, their knowledge of palliative approach is limited, making the use of palliative care insufficient and often late. By promoting reflection on the proportionality of care and the patients' quality of life, palliative care may contribute to the allo-HCT patients management. Nevertheless, obstacles to this approach remain. The objective of this work is to propose recommendations to promote the implementation of palliative care into transplant units., (Copyright © 2021 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
Published: 2021
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24. [How I do… an evaluation of the proper placement and effectiveness of an intrauterine tamponade balloon for postpartum hemorrhage?]

Author: Pauchet M, Berveiller P, and Garabedian C
Subjects: Female, Humans, Pregnancy, Uterus, Postpartum Hemorrhage therapy
Published: 2021
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25. [AFU and SALF recommendations for the evaluation of male infertility].

Author: Huyghe E, Boitrelle F, Methorst C, Mieusset R, Ray PF, Akakpo W, Koscinski I, Chalas C, Rives N, Plotton I, Robin G, El Osta R, Hennebicq S, Eustache F, Marcelli F, and Lejeune H
Subjects: Humans, Male, Infertility, Male diagnosis
Abstract: Background: The aim of these Association Française d'Urologie (AFU) and Société d'Andrologie de Langue Française (SALF) common recommendations are to provide practice guidelines for the French Urological and Andrological community regarding the evaluation of infertile men., Material and Methods: Literature search in PubMed using the keywords "male infertility", "diagnosis", "management" and "evaluation" limited to clinical articles in English and French prior to 1/01/2020. To inform the level of evidence, the HAS grading system (2013) was applied., Results: Concerning the evaluation of infertile men, the AFU and the SALF recommend : (1) a systematic interview exploring the family history, the fertility history of the man outside the couple, the patient's personal history that may have an impact on his fertility, lifestyle habits, treatments, symptoms and possible sexual difficulties of the couple; (2) a general physical examination to assess signs of hypogonadism and secondary sexual characters; (3) a scrotal physical examination performed by an urologist or andrologist to assess (i) the testes for volume and consistency, (ii) vas deferens and epididymes for total or partial absence or nodules, and (iii) presence of varicoceles; (4) Performing two semen analyses, according to World Health Organization guidelines, if the first one has at least one abnormaly; (5) a scrotal ultrasound as part of routine investigation, that can be completed with an endorectal pelvic ultrasound according to the clinic; (6) an endocrine evaluation with at least a Testosterone and FSH serum determination; (7) Karyotype analysis in infertile men with a sperm concentration ≤10 10 6 /mL; (8) assessment of Yq microdeletions in infertile men with a sperm concentration ≤1 10 6 /mL; (9) Cystic fibrosis transmembrane conductance regulator gene evaluation in case of suspicion for bilateral or unilateral congenital agenesis of vas deferens and seminal vesicles. The interest of tests analyzing DNA fragmentation (TUNEL, SCSA) is still under investigation., Conclusion: These guidelines can be applied in routine clinical practice in all infertile men., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
Published: 2021
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26. [Guidelines for surgical management of gynaecological cancer during pandemic COVID-19 period - FRANCOGYN group for the CNGOF].

Author: Akladios C, Azais H, Ballester M, Bendifallah S, Bolze PA, Bourdel N, Bricou A, Canlorbe G, Carcopino X, Chauvet P, Collinet P, Coutant C, Dabi Y, Dion L, Gauthier T, Graesslin O, Huchon C, Koskas M, Kridelka F, Lavoue V, Lecointre L, Mezzadri M, Mimoun C, Ouldamer L, Raimond E, and Touboul C
Subjects: COVID-19, Coronavirus Infections transmission, Cytoreduction Surgical Procedures, Female, France, Genital Neoplasms, Female complications, Humans, Minimally Invasive Surgical Procedures, Pandemics, Pneumonia, Viral transmission, Practice Guidelines as Topic, SARS-CoV-2, Societies, Medical, Betacoronavirus, Coronavirus Infections complications, Genital Neoplasms, Female surgery, Gynecologic Surgical Procedures adverse effects, Pneumonia, Viral complications
Abstract: Introduction: Recommendations for the management of patients with gynecological cancer during the COVID-19 pandemic period., Material and Method: Recommendations based on the consensus conference model., Results: In the case of a COVID-19 positive patient, surgical management should be postponed for at least 15 days. For cervical cancer, the place of surgery must be re-evaluated in relation to radiotherapy and Radio-Chemotherapy-Concomitant and the value of lymph node staging surgeries must be reviewed on a case-by-case basis. For advanced ovarian cancers, neo-adjuvant chemotherapy should be favored even if primary cytoreduction surgery could be envisaged. It is lawful not to offer hyperthermic intraperitoneal chemotherapy during a COVID-19 pandemic. In the case of patients who must undergo interval surgery, it is possible to continue the chemotherapy and to offer surgery after 6 cycles of chemotherapy. For early stage endometrial cancer, in case of low and intermediate preoperative ESMO risk, hysterectomy with bilateral annexectomy associated with a sentinel lymph node procedure should be favored. It is possible to consider postponing surgery for 1 to 2 months in low-risk endometrial cancers (FIGO Ia stage on MRI and grade 1-2 endometrioid cancer on endometrial biopsy). For high ESMO risk, it ispossible to favor the MSKCC algorithm (combining PET-CT and sentinel lymph node biopsy) in order to omit pelvic and lumbar-aortic lymphadenectomies., Conclusion: During COVID-19 pandemic, patients suffering from cancer should not lose life chance, while limiting the risks associated with the virus., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
Published: 2020
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27. [Renal failure after allogeneic hematopoietic stem cell transplantation: Recommendations of the Francophone Society of Bone Marrow transplantation and cellular Therapy (SFGM-TC)].

Author: Detrait M, de Berranger E, Dulery R, Ménard AL, Thépot S, Toprak SK, Turlure P, Yakoub-Agha I, and Guillaume T
Subjects: Anti-Infective Agents adverse effects, Graft vs Host Disease diagnosis, Graft vs Host Disease etiology, Graft vs Host Disease therapy, Humans, Immunosuppressive Agents adverse effects, Incidence, Nephrotic Syndrome etiology, Renal Insufficiency diagnosis, Renal Insufficiency therapy, Severity of Illness Index, Thrombotic Microangiopathies, Transplantation Conditioning adverse effects, Transplantation, Homologous, Hematopoietic Stem Cell Transplantation adverse effects, Renal Insufficiency etiology, Renal Insufficiency prevention & control
Abstract: Acute and chronic renal failures are very common after allogeneic HSCT. These complications have a real impact on mortality and morbidity of transplant recipients. Within the framework of the ninth workshops of practice harmonization of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) held in Lille in September 2018, various causes and mechanisms of renal failure, diagnostic work-up, treatment and recommendations to limit renal failure after transplantation are reviewed. Recommendations to adjust medications to avoid renal failure are also proposed in this article., (Copyright © 2019 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
Published: 2020
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28. [Oral feeding of patient hospitalized for allogeneic stem cells transplantation: Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)].

Author: Dendoncker C, Brouillat C, Daufrene L, Deledicque V, El Cheikh J, Gibault-Joffe C, Guilbert Y, Guidi V, Hadrot L, Haran I, Kermeur G, Kernoa K, L'Hostette A, Mercier L, Mouneydier K, Servais S, Withofs S, Yakoub-Agha I, and Farrugia C
Subjects: Allografts, Cooking, Diet, Food adverse effects, Food classification, Food standards, Food Handling standards, Food Microbiology, Food Preservation, Humans, Inpatients, Enteral Nutrition methods, Enteral Nutrition standards, Hematopoietic Stem Cell Transplantation
Abstract: Given the absence of consensus on oral feeding of patients undergoing allogeneic hematopoietic transplantation, the ninth workshops of practice harmonization of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) allocated one session to address this topic, especially during the hospitalization. A questionnaire was sent to all SFGM-TC pediatric and adult centers in order to investigate oral feeding practices. The results demonstrated a large disparity among centers regarding oral feeding. Here, we report our recommendations regarding the oral feeding after allogeneic hematopoietic cell transplantation in terms of quality, quantity and bacterial authorized load., (Copyright © 2019. Published by Elsevier Masson SAS.)
Published: 2020
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29. [Hepatobiliary complications following allogeneic hematopoietic cell transplantation: Recommendations of the Francophone Society of Bone Marrow transplantation and cellular Therapy (SFGM-TC)].

Author: Detrait M, de Berranger E, Dulery R, Ménard AL, Thépot S, Toprak SK, Turlure P, Yakoub-Agha I, and Guillaume T
Subjects: Allografts, Biliary Tract Diseases diagnosis, Biliary Tract Diseases therapy, Chemical and Drug Induced Liver Injury diagnosis, Chemical and Drug Induced Liver Injury etiology, Chemical and Drug Induced Liver Injury therapy, Disease Management, Graft vs Host Disease diagnosis, Graft vs Host Disease etiology, Graft vs Host Disease therapy, Hepatitis, Viral, Human diagnosis, Hepatitis, Viral, Human therapy, Hepatitis, Viral, Human transmission, Humans, Iron Overload diagnosis, Iron Overload etiology, Iron Overload therapy, Liver Diseases diagnosis, Liver Diseases therapy, Time Factors, Transplantation Conditioning adverse effects, Biliary Tract Diseases etiology, Hematopoietic Stem Cell Transplantation adverse effects, Liver Diseases etiology
Abstract: Hepatobiliary complications are frequent in the context of allogeneic hematopoietic cell transplantation (allo-HCT) and contribute largely to the morbidity and mortality after transplantation. Within the framework of the ninth workshops of practice harmonization of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) held in Lille in September 2018, diagnostic approaches and treatments of hepatobiliary dysfunctions prior to and following transplantation were reviewed according to the analysis of published studies., (Copyright © 2019 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
Published: 2020
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30. [Hypertension and menopausal hormone therapy].

Author: Mounier-Vehier C, Angoulvant T, Boivin JM, and Plu-Bureau G
Subjects: Administration, Cutaneous, Administration, Oral, Age Factors, Algorithms, Blood Pressure drug effects, Contraindications, Drug, Estrogen Replacement Therapy adverse effects, Female, Humans, Middle Aged, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Time Factors, Breast Neoplasms chemically induced, Cardiovascular Diseases chemically induced, Estrogen Replacement Therapy methods, Hypertension, Menopause
Abstract: Can menopausal hormone therapy (HT) be used in hypertensive women? The group of experts of the French Society of Hypertension has carried out a review of the recent literature in order to answer this question, based on the most recent scientific publications. If use of oral HT is associated with a discreet increase in blood pressure, the transdermal route seems to be safer. The first results of major randomized trials of HT had alerted to an increase in cardiovascular events and breast cancer with the use of oral HT, generally, tipping the benefit-risk balance of the deleterious side. Complementary analyzes have shown the importance of the window of intervention (less than 10 years after the menopause) and the age of the woman to start the HT. On the contrary, they have shown a significant decrease of the coronary events. For woman suffering from hypertension and important climacteric symptoms, it is important to evaluate the whole cardiovascular risk in order to decide the possibility of prescribing a HT. Thus, the group of experts proposes a prescription assistance algorithm based on the stratification of cardiovascular risk, always favoring, when it is authorized, HT by transdermal route of administration., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
Published: 2019
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31. [Management of epithelial ovarian cancer. Short text drafted from the French joint recommendations of FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa].

Author: Lavoue V, Huchon C, Akladios C, Alfonsi P, Bakrin N, Ballester M, Bendifallah S, Bolze PA, Bonnet F, Bourgin C, Chabbert-Buffet N, Collinet P, Courbiere B, De la Motte Rouge T, Devouassoux-Shisheboran M, Falandry C, Ferron G, Fournier L, Gladieff L, Golfier F, Gouy S, Guyon F, Lambaudie E, Leary A, Lecuru F, Lefrere-Belda MA, Leblanc E, Lemoine A, Narducci F, Ouldamer L, Pautier P, Planchamp F, Pouget N, Ray-Coquard I, Rousset-Jablonski C, Senechal-Davin C, Touboul C, Thomassin-Naggara I, Uzan C, You B, and Daraï E
Subjects: Antineoplastic Agents therapeutic use, Bevacizumab therapeutic use, Chemotherapy, Adjuvant, Female, France, Humans, Hyperthermia, Induced, Lymph Node Excision, Magnetic Resonance Imaging, Phthalazines therapeutic use, Piperazines therapeutic use, Societies, Medical, Ultrasonography, Carcinoma, Ovarian Epithelial diagnostic imaging, Carcinoma, Ovarian Epithelial drug therapy, Carcinoma, Ovarian Epithelial pathology, Carcinoma, Ovarian Epithelial surgery, Fallopian Tube Neoplasms diagnostic imaging, Fallopian Tube Neoplasms drug therapy, Fallopian Tube Neoplasms pathology, Fallopian Tube Neoplasms surgery, Ovarian Neoplasms diagnostic imaging, Ovarian Neoplasms drug therapy, Ovarian Neoplasms pathology, Ovarian Neoplasms surgery, Peritoneal Neoplasms diagnostic imaging, Peritoneal Neoplasms drug therapy, Peritoneal Neoplasms pathology, Peritoneal Neoplasms surgery
Abstract: Faced to an undetermined ovarian mass on ultrasound, an MRI is recommended and the ROMA score (combining CA125 and HE4) can be proposed (grade A). In case of suspected early stage ovarian or fallopian tube cancer, omentectomy (at least infracolonic), appendectomy, multiple peritoneal biopsies, peritoneal cytology (grade C) and pelvic and para-aortic lymphadenectomy are recommended (grade B) for all histological types, except for the expansive mucinous subtype where lymphadenectomy may be omitted (grade C). Minimally invasive surgery is recommended for early stage ovarian cancer, if there is no risk of tumor rupture (grade B). Adjuvant chemotherapy with carboplatin and paclitaxel is recommended for all high-grade ovarian or Fallopian tube cancers, stage FIGO I-IIA (grade A). In case of ovarian, Fallopian tube or primitive peritoneal cancer of FIGO III-IV stages, thoraco-abdomino-pelvic CT scan with injection (grade B) is recommended. Laparoscopic exploration for multiple biopsies (grade A) and to evaluate carcinomatosis score (at least using the Fagotti score) (grade C) are recommended to estimate the possibility of a complete surgery (i.e. no macroscopic residue). Complete medial laparotomy surgery is recommended for advanced cancers (grade B). It is recommended in advanced cancers to perform para-aortic and pelvic lymphadenectomy in case of clinical or radiological suspicion of metastatic lymph node (grade B). In the absence of clinical or radiological lymphadenopathy and in case of complete peritoneal surgery during an initial surgery for advanced cancer, it is possible not to perform a lymphadenectomy because it does not modify the medical treatment and the overall survival (grade B). Primary surgery is recommended when no tumor residue is possible (grade B). After a complete first surgery, it is recommended to deliver 6 cycles of intravenous (grade A) or to propose intraperitoneal (grade B) chemotherapy, to be discussed with patient, according to the benefit/risk ratio. After a complete interval surgery for a FIGO III stage, the hyperthermic intra peritoneal chemotherapy (HIPEC) can be proposed in the same conditions of the OV-HIPEC trial (grade B). In case of tumor residue after surgery or FIGO stage IV, chemotherapy associated with bevacizumab is recommended (grade A)., (Copyright © 2019 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)
Published: 2019
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32. [Part II drafted from the short text of the French guidelines entitled "Initial management of patients with epithelial ovarian cancer" developed by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa. (Systemic and intraperitoneal treatment, elderly, fertility preservation, follow-up)].

Author: Lavoué V, Huchon C, Akladios C, Alfonsi P, Bakrin N, Ballester M, Bendifallah S, Bolze PA, Bonnet F, Bourgin C, Chabbert-Buffet N, Collinet P, Courbiere B, De la Motte Rouge T, Devouassoux-Shisheboran M, Falandry C, Ferron G, Fournier L, Gladieff L, Golfier F, Gouy S, Guyon F, Lambaudie E, Leary A, Lécuru F, Lefrère-Belda MA, Leblanc E, Lemoine A, Narducci F, Ouldamer L, Pautier P, Planchamp F, Pouget N, Ray-Coquard I, Rousset-Jablonski C, Sénéchal-Davin C, Touboul C, Thomassin-Naggara I, Uzan C, You B, and Daraï E
Subjects: Age Factors, Biomarkers, Tumor analysis, Carcinoma, Ovarian Epithelial pathology, Chemotherapy, Adjuvant, Continuity of Patient Care, Fallopian Tube Neoplasms pathology, Fallopian Tube Neoplasms therapy, Female, Fertility Preservation, France, Humans, Hyperthermia, Induced, Ovarian Neoplasms pathology, Peritoneal Neoplasms pathology, Peritoneal Neoplasms therapy, Societies, Medical, Carcinoma, Ovarian Epithelial therapy, Ovarian Neoplasms therapy
Abstract: Adjuvant chemotherapy with carboplatin and paclitaxel is recommended for all high-grade ovarian or Fallopian tube cancers, stage FIGO I-IIA (grade A). After a complete first surgery, it is recommended to deliver 6 cycles of intravenous (grade A) or to propose intraperitoneal (grade B) chemotherapy, to be discussed with patient, according to the benefit/risk ratio. After a complete interval surgery for a FIGO III stage, the hyperthermic intra peritoneal chemotherapy (HIPEC) can be proposed in the same conditions of the OV-HIPEC trial (grade B). In case of tumor residue after surgery or FIGO stage IV, chemotherapy associated with bevacizumab is recommended (grade A). For BRCA mutated patient, Olaparib is recommended (grade B)., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
Published: 2019
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33. [Part I drafted from the short text of the French Guidelines entitled "Initial management of patients with epithelial ovarian cancer" developed by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa. (Diagnosis management, surgery, perioperative care, and pathological analysis)].

Author: Lavoué V, Huchon C, Akladios C, Alfonsi P, Bakrin N, Ballester M, Bendifallah S, Bolze PA, Bonnet F, Bourgin C, Chabbert-Buffet N, Collinet P, Courbiere B, De la Motte Rouge T, Devouassoux-Shisheboran M, Falandry C, Ferron G, Fournier L, Gladieff L, Golfier F, Gouy S, Guyon F, Lambaudie E, Leary A, Lécuru F, Lefrère-Belda MA, Leblanc E, Lemoine A, Narducci F, Ouldamer L, Pautier P, Planchamp F, Pouget N, Ray-Coquard I, Rousset-Jablonski C, Sénéchal-Davin C, Touboul C, Thomassin-Naggara I, Uzan C, You B, and Daraï E
Subjects: Algorithms, Antineoplastic Agents therapeutic use, Biomarkers, Tumor analysis, CA-125 Antigen analysis, Carcinoma, Ovarian Epithelial diagnostic imaging, Carcinoma, Ovarian Epithelial pathology, Combined Modality Therapy, DNA, Neoplasm blood, Fallopian Tube Neoplasms pathology, Fallopian Tube Neoplasms therapy, Female, France, Humans, Laparoscopy, Lymph Node Excision, Membrane Proteins analysis, Neoplasm Metastasis therapy, Neoplasm Staging, Ovarian Neoplasms diagnostic imaging, Ovarian Neoplasms pathology, Perioperative Care, Peritoneal Neoplasms pathology, Peritoneal Neoplasms therapy, Proteins analysis, Societies, Medical, WAP Four-Disulfide Core Domain Protein 2, Carcinoma, Ovarian Epithelial therapy, Ovarian Neoplasms therapy
Abstract: Faced to an undetermined ovarian mass on ultrasound, an MRI is recommended and the ROMA score (combining CA125 and HE4) can be proposed (grade A). In case of suspected early stage ovarian or fallopian tube cancer, omentectomy (at least infracolonic), appendectomy, multiple peritoneal biopsies, peritoneal cytology (grade C) and pelvic and para-aortic lymphadenectomy are recommended (grade B) for all histological types, except for the expansive mucinous subtype where lymphadenectomy may be omitted (grade C). Minimally invasive surgery is recommended for early stage ovarian cancer, if there is no risk of tumor rupture (grade B). Laparoscopic exploration for multiple biopsies (grade A) and to evaluate carcinomatosis score (at least using the Fagotti score) (grade C) are recommended to estimate the possibility of a complete surgery (i.e. no macroscopic residue). Complete medial laparotomy surgery is recommended for advanced cancers (grade B). It is recommended in advanced cancers to perform para-aortic and pelvic lymphadenectomy in case of clinical or radiological suspicion of metastatic lymph node (grade B). In the absence of clinical or radiological lymphadenopathy and in case of complete peritoneal surgery during an initial surgery for advanced cancer, it is possible not to perform a lymphadenectomy because it does not modify the medical treatment and the overall survival (grade B). Primary surgery is recommended when no tumor residue is possible (grade B)., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
Published: 2019
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34. [Management of infants whose diagnosis is inconclusive at neonatal screening for cystic fibrosis].

Author: Sermet-Gaudelus I, Brouard J, Audrézet MP, Couderc Kohen L, Weiss L, Wizla N, Vrielynck S, LLerena K, Le Bourgeois M, Deneuville E, Remus N, Nguyen-Khoa T, Raynal C, Roussey M, and Girodon E
Subjects: Chlorides blood, Cystic Fibrosis genetics, Cystic Fibrosis Transmembrane Conductance Regulator genetics, DNA Mutational Analysis, Diagnosis, Differential, Follow-Up Studies, Humans, Infant, Infant, Newborn, Interdisciplinary Communication, Intersectoral Collaboration, Predictive Value of Tests, Referral and Consultation, Sweat chemistry, Cystic Fibrosis diagnosis, Cystic Fibrosis therapy, Neonatal Screening methods
Abstract: Neonatal screening for cystic fibrosis (CF) may detect infants with elevated immunoreactive trypsinogen (IRT) levels but with inconclusive sweat tests and/or DNA results. This includes cases associating (1) either the presence of at most one CF-causing mutation and sweat chloride values between 30 and 59mmol/L or (2) two CFTR mutations with at least one of unknown pathogenicity and a sweat chloride below 60mmol/L. This encompasses different clinical situations whose progression cannot be predicted. These cases require redoing the sweat test at 12 months and if possible at 6 and 24 months of life. This must be associated with extended genotyping. CFTR functional explorations can also help by investigating CFTR dysfunction. These infants must be initially evaluated in dedicated CF centers including bacteriological sputum analysis, chest radiology and fecal elastase dosage. A home practitioner must be informed of the specificity of follow-up. These infants will be reviewed in the CF center at 3, 6 and 12 months and every year. Any CF-related symptom requires reevaluation of the diagnosis. These guidelines were established by the "neonatal screening and difficult diagnoses" working group of the French CF Society. They aim to standardize management of infants with unclear diagnosis in French CF centers., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)
Published: 2017
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35. [Early prenatal interview knowledge in post-partum women: Cross-sectional study in 2011 in Lille (France)].

Author: Aernout EM and Carpentier S
Subjects: Adult, Cross-Sectional Studies, Female, France, Humans, Postpartum Period, Pregnancy, Prenatal Care standards, Health Knowledge, Attitudes, Practice, Prenatal Care statistics & numerical data
Abstract: Objectives: Early prenatal interview (EPI) is one of the flagship measures of the 2005-2007 perinatal strategy. It allows mothers to have a 45-minute interview, distinct from a medical consultation, promoting the expression of their expectations and medical, psychological or social difficulties. It should be routinely offered to all mothers in early pregnancy. The main objective of our study was to determine the proportion of women who had knowledge of Early prenatal interview and to profile women who knew it. Secondary objectives were to describe the EPI achievement rate and its terms of implementation., Materials and Methods: All women who gave birth between 16 and 20 January 2011 in one of the ten maternity hospitals of the Lille metropolis were interviewed during their stay in maternity. A mixed model logistic regression was made to draw the profile of women with knowledge of Early prenatal interview., Results: Of 311 women who gave birth during the study period, 270 were included in the survey. 148 patients (54.8 %) knew Early prenatal interview and 79 (29.3 %) had it. Women who had a high level of education were significantly more aware of this interview than those with low level of study. Other factors studied were not significantly related to knowledge of the EPI., Conclusion: While the EPI should be routinely offered to all pregnant women, only half of the patients who give birth had heard about it during their pregnancy. Women of low educational level should be more targeted by professional performing this interview., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)
Published: 2016
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36. [Hedrocele, an unknown pelvic organ prolapse].

Author: Parsy C, Cosson M, Quinton JF, Laurent N, Lucot JP, Tempremant F, and Poncelet E
Subjects: Aged, Douglas' Pouch diagnostic imaging, Female, Humans, Magnetic Resonance Imaging, Middle Aged, Pelvic Organ Prolapse surgery, Rectum diagnostic imaging, Vagina diagnostic imaging, Pelvic Organ Prolapse diagnosis
Abstract: Pelvic floor disorders are frequent and source of symptoms which can be invalidating for patients. Between them, hedrocele is a pathology often unknown and clinically difficult to diagnose. It is a herniation of fat pad, small bowel or sigmoid colon in the recto-uterine pouch (cul-de-sac of Douglas) exercising a mass effect on the anterior wall of the rectum. Pelvic magnetic resonance imaging with morphological sequences and dynamic sequences in thrust can be very useful, allowing a comprehensive study of pelvic floor dysfunction and confirming the complete diagnosis, especially before surgery. We suggest you some examples to illustrate this pathology in order to emphasize the importance of its diagnosis, especially preoperative. A better understanding of this pelvic floor dysfunction would improve the care of patients., (Copyright © 2015. Published by Elsevier SAS.)
Published: 2015
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37. [Impact of end-stage renal disease and kidney transplantation on the reproductive system].

Author: Delesalle AS, Robin G, Provôt F, Dewailly D, Leroy-Billiard M, and Peigné M
Subjects: Female, Humans, Male, Pregnancy, Pregnancy Complications etiology, Reproductive Techniques, Assisted, Sexual Dysfunction, Physiological etiology, Gonadal Disorders etiology, Kidney Failure, Chronic surgery, Kidney Transplantation
Abstract: Chronic renal failure leads to many metabolic disorders affecting reproductive function. For men, hypergonadotropic hypogonadism, hyperprolactinemia, spermatic alterations, decreased libido and erectile dysfunction are described. Kidney transplantation improves sperm parameters and hormonal function within 2 years. But sperm alterations may persist with the use of immunosuppressive drugs. In women, hypothalamic-pituitary-ovarian axis dysfunction due to chronic renal failure results in menstrual irregularities, anovulation and infertility. After kidney transplantation, regular menstruations usually start 1 to 12 months after transplantation. Fertility can be restored but luteal insufficiency can persist. Moreover, 4 to 20% of women with renal transplantation suffer from premature ovarian failure syndrome. In some cases, assisted reproductive technologies can be required and imply risks of ovarian hyperstimulation syndrome and must be performed with caution. Pregnancy risks for mother, fetus and transplant are added to assisted reproductive technologies ones. Only 7 authors have described assisted reproductive technologies for patients with kidney transplantation. No cases of haemodialysis patients have been described yet. So, assisted reproductive technologies management requires a multidisciplinary approach with obstetrics, nephrology and reproductive medicine teams' agreement., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)
Published: 2015
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38. [Clinical and paraclinical features of Klinefelter syndrome consulting for male infertility].

Author: Rock A, Marcelli F, Robin G, Mitchell V, Leroy C, and Rigot JM
Subjects: Adult, Humans, Infertility, Male etiology, Klinefelter Syndrome complications, Male, Retrospective Studies, Young Adult, Klinefelter Syndrome diagnosis
Abstract: Purpose: To attract urologists' attention on screening of Klinefelter syndrome consulting for infertility, describing its usual phenotype, in order to propose a possible reproductive technique, to prevent and to treat associated comorbidities and to manage the frequent discovery of ultrasonographic testicular lesions., Patients and Methods: Retrospective analysis over 10 years of clinical and paraclinical features of the patients who consulted for infertility and had a 47,XX7 regular or mosaic karyotype., Results: One hundred and forty-nine patients, 31.7 year-old on average [20.7-42.7], all had a severe bilateral testicular hypotrophy, subsequently confirmed by ultrasonography (mean total testicular volume: 3.7 mL [-0.20-7.64]). One hundred and twenty-two (81.9%) had normal secondary sexual characteristics, only 4 of them (2.7%) already knew their diagnosis. Their mean total testosterone levels were low (3.12 ng/mL [0.39-5.86]) but remain normal. A total of 34.2% of patients had subclinical testicular nodules discovered by ultrasonography. Excision was performed in 12 cases, confirming Leydig cell tumors., Conclusion: Klinefelter syndrome diagnosis can be made during a first consultation with a bilateral testicular hypotrophy as "pathognomonic" point of call in an often poor clinical observation. It is completed by an azoospermia or severe oligozoospermia. If they want to, this allows to quickly guide patients to suitable medical reproductive technique but, especially, to prevent and quickly treat comorbidities associated to this diagnosis, and also to reassure patients about the frequent discovery of subclinical testicular lesions., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)
Published: 2014
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39. [Multicentric study of medical care and practices in spinal muscular atrophy type 1 over two 10-year periods].

Author: Barnérias C, Quijano S, Mayer M, Estournet B, Cuisset JM, Sukno S, Peudenier S, Laroche C, Chabrier S, Sabouraud P, Vuillerot C, Chabrol B, Halbert C, Cancès C, Beze-Beyrie P, Ledivenah A, Viallard ML, and Desguerre I
Subjects: Enteral Nutrition methods, Exercise Therapy, Female, France, Gastrostomy, Humans, Infant, Infant, Newborn, Male, Noninvasive Ventilation, Oxygen Inhalation Therapy, Retrospective Studies, Spinal Muscular Atrophies of Childhood diagnosis, Spinal Muscular Atrophies of Childhood mortality, Survival Analysis, Palliative Care methods, Spinal Muscular Atrophies of Childhood therapy
Abstract: Aim: Questions about care practices and the role of palliative care in pediatric neurodegenerative diseases have led the Neuromuscular Committee of the French Society of Neurology to conduct a retrospective study in spinal muscular atrophy type 1, a genetic disease most often leading to death before the age of 1 year., Material and Methods: A retrospective multicenter study from pediatricians included in the reference centers of pediatric neuromuscular diseases was carried out on two 10-year periods (1989-1998 and 1999-2009)., Results: The 1989-1998 period included 12 centers with 106 patients, the 1999-2009 period 13 centers with 116 children. The mean age of onset of clinical signs was 2.1 months (range, 0-5.5 months), the median age at diagnosis was 4 months (range, 0-9 months) vs 3 months. The median age of death was 7.5 months (range, 0-24 months) vs 6 months. The care modalities included physiotherapy (90 %), motor support (61 % vs 26 % for the previous period), enteral nutrition by nasogastric tube (52 % vs 24 %), and 3.4 % of children had a gastrostomy (vs 1.8 %). At home, pharyngeal aspiration was used in 64 % (vs 41 %), oxygen therapy in 8 %, noninvasive ventilatory support in 7 %. The mean age at death was 8.1 months (range, 0-24 months) vs 7 months, the time from diagnosis to death was 4 months vs 3 months. Death occurred at home in 23 % vs 17 %, in a pediatric unit in 62 % vs 41 %. The use of analgesics and sedative drugs was reported in 60 % of cases: 40 % morphine (vs 18 %) and benzodiazepines in 48 % (vs 29 %). Respiratory support was limited mostly to oxygen by nasal tube (55 % vs 54 %), noninvasive ventilation in 9 % of the cases, and intubation and assisted mechanical ventilation (2 %)., Discussion and Conclusion: These results confirm a change in practices and the development of palliative care in children with a French consensus of practices quite different from the standard care in North-America and closer to the thinking of English medical teams. A prospective study within the 2011 national hospital clinical research program (PHRC 2011) is beginning in order to evaluate practices and the role of families and caregivers., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)
Published: 2014
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40. [Pyeloplasty for pyelo-ureteric junction syndrome in children: lombo-assisted procedure versus lombotomy].

Author: Robert E, Aubry E, Pecoux F, Priso RH, Sfeir R, and Besson R
Subjects: Adolescent, Child, Child, Preschool, Female, Humans, Male, Retrospective Studies, Syndrome, Urologic Surgical Procedures methods, Kidney Pelvis surgery, Ureteral Diseases surgery
Abstract: Surgical treatment of pyelo-ureteric junction syndromes was classically at the child's, a pyeloplasty by posterior way or by lombotomy. For several years, assisted video techniques are proposed for this gesture. The purpose of our study was to compare the lombo-assisted pyeloplasty procedure with the lombotomy procedure, within the framework of this coverage. We made a retrospective study of procedures performed from January 2000 to December 2005, based on a file review of children operated for pyelo-ureteric junction syndrome. Children under the age of 2 years were excluded. Fifty-two children were divided in 2 groups: group 1: 24 children, 7 girls and 17 boys, average age of 86 months (extremes: 27-172) benefited from a lombo-assisted pyeloplasty. Group 2: 28 children, 12 girls and 16 boys, average age of 69 months (extremes: 24-129) benefited from a pyeloplasty by lombotomy. Operating times were significantly shorter in opened surgery than with the lombo-assisted procedure. There was no significant difference in terms of per- or post-operating complication, use of analgesic and hospitalization duration. On the other hand, the lombo-assisted procedure provided the same undisputable aesthetic benefit and the same muscular preservation than pure lomboscopy procedure. As a consequence, this procedure could be set up at no risk for the patient, even if it had lead to longer operating times. However, operating times stayed shorter than with the pure lomboscopy or the celioscopy procedures, compared to the literature., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)
Published: 2010
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41. [D-lactic acidosis in a child with short bowel syndrome].

Author: Dahhak S, Uhlen S, Mention K, Romond MB, Fontaine M, Gottrand F, Turck D, and Michaud L
Subjects: Acidosis, Lactic drug therapy, Acidosis, Lactic microbiology, Acidosis, Lactic therapy, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Child, Follow-Up Studies, Humans, Intestines microbiology, Lactic Acid biosynthesis, Male, Parenteral Nutrition, Sodium Bicarbonate administration & dosage, Sodium Bicarbonate therapeutic use, Time Factors, Treatment Outcome, Acidosis, Lactic etiology, Lactobacillus drug effects, Lactobacillus isolation & purification, Lactobacillus metabolism, Short Bowel Syndrome complications
Abstract: Introduction: d-lactic acidosis is a rare and severe complication of short bowel syndrome in children that may result from important ileal bacterial overgrowth by lactobacilli. Intestinal flora (Lactobacilli) is responsible for the production of d-lactic acid after fermentation of food carbohydrates., Observation: We report on the case of a 6-year-old child with a short bowel syndrome treated with both home enteral and parenteral nutrition. The patient suddenly presented with acute neurological symptoms including dysarthria and disorientation. Biological analysis revealed metabolic acidosis, increased plasma d-lactic acid assessed by organic acid chromatography analysis and a very important increase in expired hydrogen during glucose breath test. Lactobacillus fermentum (known to produce d and L isomers of lactic acid) was isolated in the gastric liquid and rectal swabs. Clinical and biological evolution was rapidly favourable after treatment with intravenous sodium bicarbonate, antibiotic therapy and interruption of enteral nutrition., Conclusion: d-lactic acidosis should be suspected when neurological symptoms occur in a child with short bowel syndrome. They can be prevented by treating intestinal bacterial overgrowth.
Published: 2008
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42. [Urethral duplication type II in a male child: a case report].

Author: Bieganski A, Launay S, Biserte J, and Robert Y
Subjects: Child, Preschool, Follow-Up Studies, Humans, Hypospadias diagnosis, Hypospadias surgery, Infant, Newborn, Male, Radiography, Sex Factors, Time Factors, Urethra diagnostic imaging, Urethra surgery, Urethra abnormalities
Abstract: Urethral duplication is a rare congenital anomaly, most common in male. The clinical presentation varies because of the various anatomical variant. A case of complete duplication with an accessory channel arising from a diverticulum, in a male child is reported. The clinical presentation, the imaging findings, and the management are described.
Published: 2002

43. [Laparoscopic sacral colpopexy: short-term results and complications in 83 patients].

Author: Cosson M, Bogaert E, Narducci F, Querleu D, and Crépin G
Subjects: Adult, Aged, Female, Humans, Hysterectomy, Intraoperative Complications, Middle Aged, Postoperative Complications, Prolapse, Retrospective Studies, Sacrococcygeal Region, Laparoscopy, Uterine Prolapse surgery, Vaginal Diseases surgery
Abstract: We retrospectively studied 77 laparoscopic sacral colpopexies performed from June 1996 to May 1998. Suspension was reinforced with two strips of synthetic mesh. Five patients had previously undergone hysterectomy and 4 others had experienced failure of surgery for prolapse of the uterus. Laparoscopy was performed in 83 women with symptomatic prolapse of the uterus. Six cases required conversion to laparotomy because of technical difficulties. All other 77 patients underwent laparoscopic sacropexy using anterior and posterior mesh reinforcement. Subtotal laparoscopic hysterectomy was associated in 60 cases, laparoscopic Burch colposuspension in 74 and levator myorraphy using the vaginal approach in 55. Operative time decreased from 292 to 180 minutes as the surgeon gained experience. The main operative complications were one rectal and two bladder injuries. Three patients required reoperations for haematoma or hemorrhage. One patient complained of chronic inflammation of the cervix and another experienced rejection of the posterior mesh 6 months after the operation. Mean follow up was 343 days. Three other patients required reoperation: one for a 3(rd) degree cystocele and two for recurrent stress incontinence. The conclusion of this study is that laparoscopic sacrocolpopexy is feasible. Operative time and postoperative complications are related to the surgeon's experience but remain comparable to those noted in laparotomy. Long term assessment is required to confirm the results of this procedure.
Published: 2000

44. [Color echo-Doppler and endometrial receptivity in in vitro fertilization].

Author: Ardaens Y, Leroy M, Lefebvre C, Tomas P, Leroy JL, and Dewailly D
Subjects: Adult, Blood Flow Velocity, Endometrium diagnostic imaging, Female, Humans, Pregnancy, Ultrasonography, Doppler, Color, Uterus blood supply, Uterus diagnostic imaging, Embryo Implantation, Fertilization in Vitro
Abstract: The chances of nidation after in vitro fertilization procedures are contingent upon the development potential of the transferred embryo(s), but they also depend on the receptivity of the endometrium and on the uterine vascular supply. It is generally accepted that the chances of pregnancy are practically nil: if the endometrium is less than 8 mm thick, and/or if the uterine pulsatility index (PI) is below 3. However, the predictive value of the Doppler evaluation alone is poor to the extent that other parameters require consideration, such as the aspect of the endometrium and/or the number of embryos transferred. This is why our group initiated a prospective study on 213 patients designed to validate a 10 point scale based on: -the PI of each uterine artery on the day of transfer; -the features of the protodiastolic notch (absent, moderate or clearcut); -the thickness of the endometrium; -the number of embryos transferred. Each parameter by itself had a poor predictive value: optimal values of endometrium thickness and pulsatility index (PI) predicted a 29% and 33% pregnancy rate, which is hardly higher than our overall pregnancy rate (24%). By contrast, a score that encompasses all these parameters increased predictive value, with a score > 9 the probability of pregnancy reach 53% and the one of multiple pregnancy 24%. Our results emphasize the usefulness of a score prior embryo transfer which should be used to adjust the number of embryos transferred. When the score is higher than 10 transferring 2 embryos will prevent the risk of multiple pregnancy. 3 embryos should be transferred when the score is between 7 and 10, and a bad score (< or = 6) should delay the transfer.
Published: 1998

45. [Contribution of Doppler color ultrasonography to the screening and surveillance of ovarian hyperstimulation syndrome].

Author: Ardaens Y, Lefebvre C, Leroy M, Thomas P, and Dewailly D
Subjects: Female, Humans, Population Surveillance, Ovarian Hyperstimulation Syndrome diagnostic imaging, Ultrasonography, Doppler, Color
Abstract: Color and power Doppler producing ovarian vascular mapping allows to realize a new functional approach of ovarian hyperstimulation syndrome (OHS); local vascular factors (ovarian angiogenesis, increase in cappillary permeability) released by hCG injection (LH effect) have in fact an important part in this syndrome. Vaginal Doppler sonography allows: -before induction, to predict potential risk of hyperstimulation: polycystic ovaries, spontaneous stromal hypervascularization; -in monitoring of ovulation stimulation, to reduce risk of multiple pregnancy and to detect early hyperstimulation, decision of hCG injection depends on number of follicles able to be fertilized (> 15 mm) and luteinized (> 10 mm); -to assess severity of OHS and search complications: ascites, hydrothorax, ovarian torsion and deep venous thrombosis. So OHS prevention imposes a monitoring by Doppler sonography and estradiol assay of all cycles induced by gonadotropins.
Published: 1996

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