348 results on '"Philippe, Descamps"'
Search Results
2. The role of peak serum estradiol level in the prevention of multiple pregnancies in gonadotropin stimulated intrauterine insemination cycles
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Pierre-Emmanuel Bouet, Mariette Bruand, Kevin Bellaïche, Bruno Vielle, Guillaume Legendre, Philippe Descamps, Romain Corroenne, Pascale May-Panloup, and Hady El Hachem
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Medicine ,Science - Abstract
Abstract The objective was to assess whether the measurement of serum estradiol (E2) level on trigger day in controlled ovarian stimulation with intrauterine insemination (COS-IUI) cycles helps lower the multiple pregnancy (MP) rate. We performed a unicentric observational study. We included all patients who underwent COS-IUI and had a subsequent clinical pregnancy (CP) between 2011 and 2019. Our main outcome measure was the area under Receiver-Operating Characteristic (ROC) curve. We included 455 clinical pregnancies (CP) obtained from 3387 COS-IUI cycles: 418 singletons, 35 twins, and 2 triplets. The CP, MP, and live birth rates were respectively 13.4%, 8.1% and 10.8%. The area under ROC curve for peak serum E2 was 0.60 (0.52–0.69). The mean E2 level was comparable between singletons and MP (260.1 ± 156.1 pg/mL vs. 293.0 ± 133.4 pg/mL, p = 0.21, respectively). Univariate and multivariate logistic regression analysis showed that E2 level was not predictive of MP rate (aOR: 1.13 (0.93–1.37) and 1.06 (0.85–1.32), respectively). Our study shows that, when strict cancelation criteria based on the woman’s age and follicular response on ultrasound are applied, the measurement of peak serum E2 levels does not help reduce the risk of MP in COS-IUI cycles.
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- 2022
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3. Late fetal demise, a risk factor for post-traumatic stress disorder
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Lucile Abiola, Guillaume Legendre, Andrew Spiers, Elsa Parot-Schinkel, Jean-François Hamel, Philippe Duverger, Pierre-Emmanuel Bouet, Philippe Descamps, Caroline Quelen, Philippe Gillard, and Elise Riquin
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Medicine ,Science - Abstract
Abstract Late-term fetal demise including fetal death in utero, late miscarriage and late termination of pregnancy are relatively frequent occurrences. Post-traumatic stress disorder (PTSD) is a pathology that finds its roots in exposure to a life-threatening event or an event related to death. Exposure to fetal death during a late-term fetal demise is, therefore, a situation at risk of trauma. The objective of this study was to assess the prevalence of PTSD symptoms in the short term among patients faced with late fetal demise, and to identify potential risk factors. All women were assessed at 15 days, one month, and three months after late fetal demise using the Impact of Event Scale-Revised (IES-R) and the Peritraumatic Dissociative Experiences Questionnaire (PDEQ). At 15 days, 44.2% of patients presented a pathological score on the IES-R (≥ 33). At one month and three months, this figure was 34.1% and 9.1% respectively. Factor associated with PTSD symptoms were: peritraumatic dissociation (p = 0.014), seeing the fetus during hospitalization (p = 0.035), holding the fetus in one’s arms (p = 0.046), and the organization of a funeral service (p = 0.025). Patients experiencing late fetal demise are at significant risk of trauma. Care providers should remain vigilant to identify high-risk situations to offer appropriate care. Clinical trials registration number: NCT03433989.
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- 2022
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4. Machine learning algorithms as new screening approach for patients with endometriosis
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Sofiane Bendifallah, Anne Puchar, Stéphane Suisse, Léa Delbos, Mathieu Poilblanc, Philippe Descamps, Francois Golfier, Cyril Touboul, Yohann Dabi, and Emile Daraï
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Medicine ,Science - Abstract
Abstract Endometriosis—a systemic and chronic condition occurring in women of childbearing age—is a highly enigmatic disease with unresolved questions. While multiple biomarkers, genomic analysis, questionnaires, and imaging techniques have been advocated as screening and triage tests for endometriosis to replace diagnostic laparoscopy, none have been implemented routinely in clinical practice. We investigated the use of machine learning algorithms (MLA) in the diagnosis and screening of endometriosis based on 16 key clinical and patient-based symptom features. The sensitivity, specificity, F1-score and AUCs of the MLA to diagnose endometriosis in the training and validation sets varied from 0.82 to 1, 0–0.8, 0–0.88, 0.5–0.89, and from 0.91 to 0.95, 0.66–0.92, 0.77–0.92, respectively. Our data suggest that MLA could be a promising screening test for general practitioners, gynecologists, and other front-line health care providers. Introducing MLA in this setting represents a paradigm change in clinical practice as it could replace diagnostic laparoscopy. Furthermore, this patient-based screening tool empowers patients with endometriosis to self-identify potential symptoms and initiate dialogue with physicians about diagnosis and treatment, and hence contribute to shared decision making.
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- 2022
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5. Applied TRL Calibration Method to Differential Devices Embedded in a Test Board.
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Kassem Hamze, Daniel Pasquet, Philippe Descamps, and Edouard De Ledinghen
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- 2019
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6. Simulation and analysis of DC and RF performances degradation of NMOS transistors under hot carrier injection mechanism.
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Insaf Lahbib, Aziz Doukkali, Patrick Martin, Philippe Descamps, and Guy Imbert
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- 2017
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7. Endometriosis Associated-miRNome Analysis of Blood Samples: A Prospective Study
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Sofiane Bendifallah, Yohann Dabi, Stéphane Suisse, Léa Delbos, Mathieu Poilblanc, Philippe Descamps, Francois Golfier, Ludmila Jornea, Delphine Bouteiller, Cyril Touboul, Anne Puchar, and Emile Daraï
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endometriosis ,miRNA ,NGS ,bioinformatics ,Medicine (General) ,R5-920 - Abstract
The aim of our study was to describe the bioinformatics approach to analyze miRNome with Next Generation Sequencing (NGS) of 200 plasma samples from patients with and without endometriosis. Patients were prospectively included in the ENDO-miRNA study that selected patients with pelvic pain suggestive of endometriosis. miRNA sequencing was performed using an Novaseq6000 sequencer (Illumina, San Diego, CA, USA). Small RNA-seq of 200 plasma samples yielded ~4228 M raw sequencing reads. A total of 2633 miRNAs were found differentially expressed. Among them, 8.6% (n = 229) were up- or downregulated. For these 229 miRNAs, the F1-score, sensitivity, specificity, and AUC ranged from 0–88.2%, 0–99.4%, 4.3–100%, and 41.5–68%, respectively. Utilizing the combined bioinformatic and NGS approach, a specific and broad panel of miRNAs was detected as being potentially suitable for building a blood signature of endometriosis.
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- 2022
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8. Endometriosis-associated infertility diagnosis based on saliva microRNA signatures
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Yohann Dabi, Stéphane Suisse, Anne Puchar, Léa Delbos, Mathieu Poilblanc, Philippe Descamps, Julie Haury, Francois Golfier, Ludmila Jornea, Delphine Bouteiller, Cyril Touboul, Emile Daraï, and Sofiane Bendifallah
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Reproductive Medicine ,Obstetrics and Gynecology ,Developmental Biology - Abstract
Can a saliva-based miRNA signature for endometriosis-associated infertility be designed and validated by analysing the human miRNome?The prospective ENDOmiARN study (NCT04728152) included 200 saliva samples obtained between January 2021 and June 2021 from women with pelvic pain suggestive of endometriosis. All patients underwent either laparoscopy, magnetic resonance imaging, or both. Patients diagnosed with endometriosis were allocated to one of two groups according to their fertility status. Data analysis consisted of identifying a set of miRNA biomarkers using next-generation sequencing, and development of a saliva-based miRNA signature of infertility among patients with endometriosis based on a random forest model.Among the 153 patients diagnosed with endometriosis, 24% (n = 36) were infertile and 76% (n = 117) were fertile. Small RNA-sequencing of the 153 saliva samples yielded approximately 3712 M raw sequencing reads (from ∼13.7 M to ∼39.3 M reads/sample). Of the 2561 known miRNAs, the feature selection method generated a signature of 34 miRNAs linked to endometriosis-associated infertility. After validation, the most accurate signature model had a sensitivity, specificity and area under the curve of 100%.A saliva-based miRNA signature for endometriosis-associated infertility is reported. Although the results still require external validation before using the signature in routine practice, this non-invasive tool is likely to have a major effect on care provided to women with endometriosis.
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- 2023
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9. ConFIRM trial - conversion of in vitro fertilization cycles to intrauterine inseminations in patients with a poor ovarian response to stimulation: a protocol for a multicentric, prospective randomized trial
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Léa Delbos, Elsa Parot-Schinkel, Hady El Hachem, Guillaume Legendre, Philippe Descamps, Lisa Boucret, Véronique Ferré-L’Hotellier, Pauline Jeanneteau, Cécile Dreux, Catherine Morinière, Pascale May-Panloup, and Pierre-Emmanuel Bouet
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IVF ,Conversion to IUI ,Poor ovarian response ,Medicine (General) ,R5-920 - Abstract
Abstract Background To date, there is no consensus on the ideal management strategy of patients with poor ovarian response (POR) to controlled ovarian stimulation (COS) for in vitro fertilization (IVF). Currently, these patients are given the choice of: (1) canceling the cycle; (2) proceeding with COS regardless of the poor response, and performing the oocyte retrieval and transfer of embryos when available; or (3) conversion to an intrauterine insemination (IUI). When the decision to proceed with the COS cycle is taken, it is not clear whether IVF or conversion to IUI is the best choice. If live birth rates were comparable between the two strategies, conversion to IUI would be the better option for poor responders, since it is less invasive and is associated with a lower cost. Methods We designed a non-inferiority, multicentric, randomized controlled trial that will be conducted in 18 French Reproductive Medicine centers. We defined POR as the presence of only two or four mature follicles ≥ 14 mm on ovulation trigger day. Patients with POR will be randomized into two parallel arms: “IVF” and “conversion to IUI.” Our main objective is to compare the efficiency of IVF and conversion to IUI in patients with POR to COS. The primary outcome is the live birth rate, defined as the birth of a living infant after 22 weeks’ gestational age, or weighing ≥ 500 g. One of the secondary objectives is to compare the cost-efficiency of both strategies at 12 months. We will need to include 940 patients (470 in each arm), and the duration of the inclusion period is estimated to be 36 months. Discussion This is the first randomized controlled trial to compare the outcomes of IVF and embryo transfer to conversion to IUI in patients with POR to COS. If our study shows that conversion to IUI is non-inferior to IVF in terms of clinical efficiency and live birth rate, it would confirm IUI as a better alternative for patients, both individually (less invasive and more patient-friendly) and collectively (lower cost). Trials registration ClinicalTrials.gov, ID: NCT03362489. Registered on January 10th, 2018.
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- 2018
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10. An Experience of Engineering of MAS for Smart Environments: Extension of ASPECS.
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Philippe Descamps, Vincent Hilaire, Olivier Lamotte, and Sebastian Rodriguez
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- 2016
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11. Designing the MIMO SDR-based Antenna Array for 5G Telecommunication
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Meriem Drissi, Nabil Benjelloun, Philippe Descamps, and Ali Gharsallah
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Physics and Astronomy (miscellaneous) ,Management of Technology and Innovation ,Engineering (miscellaneous) - Published
- 2022
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12. An Analysis and Prototyping Approach for Cyber-Physical Systems.
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Samuel Deniaud, Philippe Descamps, Vincent Hilaire, Olivier Lamotte, and Sebastian Rodriguez
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- 2015
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13. The surgical treatment of idiopathic abnormal uterine bleeding: An analysis of 88 000 patients from the French exhaustive national hospital discharge database from 2009 to 2015.
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Lucie de Léotoing, Gwendoline Chaize, Jérôme Fernandes, Dusan Toth, Philippe Descamps, Gil Dubernard, Thomas Lafon, Ludovic Lamarsalle, and Hervé Fernandez
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Medicine ,Science - Abstract
ObjectiveThe objective of the study was to compare success rates, complications and management costs of different surgical techniques for abnormal uterine bleeding (AUB).MethodsThis was a retrospective analysis of the French national hospital discharge database. All hospital stays with a diagnostic code for AUB and an appropriate surgical procedure code between 2009 and 2015 inclusive were identified, concerning 109,884 women overall. Outcomes were compared between second generation procedures (2G surgery), first-generation procedures (1G surgery), curettage and hysterectomy. Clinical outcomes were treatment failure and complications during the follow-up period. Costs were attributed using standard French hospital tariffs.Results7,863 women underwent a 2G procedure (7.2%), 39,935 a 1G procedure, (36.3%), 38,923 curettage (35.4%) and 23,163 hysterectomy (21.1%). Failure rates at 18 months were 9.9% for 2G surgery, 12.7% for 1G surgery, 20.6% for curettage and 2.8% for hysterectomy. Complication rates at 18 months were 1.9% for 2G surgery, 1.5% for 1G surgery, 1.4% for curettage and 5.3% for hysterectomy. Median 18-month costs were € 1 173 for 2G surgery, € 1 059 for 1G surgery, € 782 for curettage and € 3 090 for hysterectomy.ConclusionCurettage has the highest failure rate. Hysterectomy has the lowest failure rate but the highest complication rate and is also the most expensive. Despite good clinical outcomes and relatively low cost, 1G and 2G procedures are not widely used. Current guidelines for treatment of AUB are not respected, the recommended 2G procedures being only used in
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- 2019
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14. Design of digital beamforming for 5G access point applications
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Meriem Drissi, Nabil Benjelloun, Philippe Descamps, and Ali Gharsallah
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Electrical and Electronic Engineering ,Condensed Matter Physics ,Atomic and Molecular Physics, and Optics ,Electronic, Optical and Magnetic Materials - Published
- 2023
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15. Figure S2 from Lactic Acidosis Together with GM-CSF and M-CSF Induces Human Macrophages toward an Inflammatory Protumor Phenotype
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Pascale Jeannin, Yves Delneste, Vincent Procaccio, Judith Kouassi Nzoughet, Cinzia Bocca, Guy Lenaers, Guillaume Tcherkez, Véronique Catros, Alain Morel, Philippe Descamps, Vincent Lavoué, Norbert Ifrah, Pedro Raro, Véronique Verrielle, Romuald Wernert, Mario Campone, Louise-Marie Chevalier, Valérie Seegers, Pascale Pignon, Simon Blanchard, Laurence Preisser, Céline Beauvillain, Clément Adam, and Léa Paolini
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Figure S2
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- 2023
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16. Data from Lactic Acidosis Together with GM-CSF and M-CSF Induces Human Macrophages toward an Inflammatory Protumor Phenotype
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Pascale Jeannin, Yves Delneste, Vincent Procaccio, Judith Kouassi Nzoughet, Cinzia Bocca, Guy Lenaers, Guillaume Tcherkez, Véronique Catros, Alain Morel, Philippe Descamps, Vincent Lavoué, Norbert Ifrah, Pedro Raro, Véronique Verrielle, Romuald Wernert, Mario Campone, Louise-Marie Chevalier, Valérie Seegers, Pascale Pignon, Simon Blanchard, Laurence Preisser, Céline Beauvillain, Clément Adam, and Léa Paolini
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In established tumors, tumor-associated macrophages (TAM) orchestrate nonresolving cancer-related inflammation and produce mediators favoring tumor growth, metastasis, and angiogenesis. However, the factors conferring inflammatory and protumor properties on human macrophages remain largely unknown. Most solid tumors have high lactate content. We therefore analyzed the impact of lactate on human monocyte differentiation. We report that prolonged lactic acidosis induces the differentiation of monocytes into macrophages with a phenotype including protumor and inflammatory characteristics. These cells produce tumor growth factors, inflammatory cytokines, and chemokines as well as low amounts of IL10. These effects of lactate require its metabolism and are associated with hypoxia-inducible factor-1α stabilization. The expression of some lactate-induced genes is dependent on autocrine M-CSF consumption. Finally, TAMs with protumor and inflammatory characteristics (VEGFhigh CXCL8+ IL1β+) are found in solid ovarian tumors. These results show that tumor-derived lactate links the protumor features of TAMs with their inflammatory properties. Treatments that reduce tumor glycolysis or tumor-associated acidosis may help combat cancer.
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- 2023
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17. Table S1 from Lactic Acidosis Together with GM-CSF and M-CSF Induces Human Macrophages toward an Inflammatory Protumor Phenotype
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Pascale Jeannin, Yves Delneste, Vincent Procaccio, Judith Kouassi Nzoughet, Cinzia Bocca, Guy Lenaers, Guillaume Tcherkez, Véronique Catros, Alain Morel, Philippe Descamps, Vincent Lavoué, Norbert Ifrah, Pedro Raro, Véronique Verrielle, Romuald Wernert, Mario Campone, Louise-Marie Chevalier, Valérie Seegers, Pascale Pignon, Simon Blanchard, Laurence Preisser, Céline Beauvillain, Clément Adam, and Léa Paolini
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Table S1
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- 2023
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18. Is the Admission Cardiotocography Test Predictive of an Emergent Cesarean Delivery During Labor in Prolonged Pregnancies?
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Audrey Astruc, Caroline Verhaeghe, Guillaume Legendre, Philippe Descamps, and Romain Corroenne
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- 2022
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19. Assessment of the self-confidence of obstetrics and gynecology fellows to perform a postpartum hemostasis hysterectomy
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Ludivine Dion, Carla Sousa, Guillaume Legendre, Krystel Nyangoh-Timoh, Maëla Le Lous, Olivier Morel, Vincent Lavoue, Philippe Descamps, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
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Reproductive Medicine ,[SDV]Life Sciences [q-bio] ,Obstetrics and Gynecology ,Training ,Hemostasis hysterectomy ,[SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics ,Learning curve ,Residency - Abstract
International audience; INTRODUCTION: Hemostasis Hysterectomy (HH) is a last resort surgical procedure performed in situations of uncontrolled post-partum hemorrhage in maternity wards. The chances of being confronted with this situation are scarce during residency, and the situation is not well suited for teaching. Nevertheless, every obstetrician-gynecologist can be confronted with this stressful situation, and should therefore possess the surgical competence required, regardless of his routine practice. The aim of the present study is to evaluate clinical exposure and self-awareness concerning HH amongst obstetrics and gynecology residents and fellows. MATERIEL AND METHODS: We performed a survey amongst French obstetrics and gynecology fellows. An anonymous survey was sent by email between December 1, 2020 to July 1, 2021. RESULTS: Half of the interrogated fellows had practiced (as operator) an HH during residency with a senior and only 22,6% in post-residency. During the last year of residency 70% of them had performed less than 10 scheduled hysterectomies as primary operator. The laparoscopic approach was the most frequently practiced. Very few hysterectomies were performed as primary operator. Fellows with a surgical or mixed activity (both gynecological surgery and obstetrical activity in current practice) felt significantly more capable of performing HH compared to those with exclusive obstetrical or reproductive medicine activity; respectively 60% vs 36%, p = 0.008; Odds Ratio: 2.629 (95% CI 1.2214; 5.8094). CONCLUSION: The number of scheduled hysterectomies or HH performed as primary operator is very low during residency or fellowship. It remains largely inferior to the number deemed necessary in previous publications about the learning curve for scheduled hysterectomy, which varies from 18 to 80 interventions. Nowadays, the increasing number of residents, added to the decrease of hemostasis hysterectomies through better management of post-partum hemorrhage, pushes towards the development of specific training, such as "damage control simulation".
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- 2023
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20. Multi-Agent System for intelligent Scrum project management.
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Yishuai Lin, Philippe Descamps, Nicolas Gaud, Vincent Hilaire, and Abderrafiaa Koukam
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- 2015
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21. Dührssen’s cervical incision: An old story
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Emmanuel Drouin, Jean-Marc Classe, and Philippe Descamps
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Reproductive Medicine ,Obstetrics and Gynecology - Published
- 2023
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22. Performances of RF PA classes in LINC systems.
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Ronald Montesinos, Corinne Berland, Mazen Abi-Hussein, Olivier Venard, and Philippe Descamps
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- 2012
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23. Influence of the output harmonic networks of classes F and F-1 power amplifiers in LINC systems.
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Ronald Montesinos, Corinne Berland, Mazen Abi-Hussein, Olivier Venard, and Philippe Descamps
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- 2012
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24. Use of artificial intelligence to predict mean time to delivery following cervical ripening with dinoprostone vaginal insert
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Guillaume Legendre, Romain Corroenne, Patrick Saulnier, Philippe Gillard, Hady El Hachem, Caroline Verhaeghe, Fanny Levast, Philippe Descamps, Clementine Jouffray, and Pierre-Emmanuel Bouet
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medicine.medical_specialty ,Obstetrics ,business.industry ,food and beverages ,Obstetrics and Gynecology ,Ripening ,Induction of labor ,University hospital ,Dinoprostone ,Administration, Intravaginal ,Reproductive Medicine ,Artificial Intelligence ,Pregnancy ,Oxytocics ,medicine ,Humans ,Female ,Labor, Induced ,Prospective Studies ,business ,Vaginal insert ,Cervical Ripening ,Retrospective Studies - Abstract
To validate a mathematical model to predict the mean time to delivery (TTD) following cervical ripening with dinoprostone vaginal insert (DVI), and assess its impact on the risk of nocturnal deliveries.We performed a case-control retro-prospective study at Angers University Hospital. In the control group, we retrospectively included 405 patients who underwent cervical ripening with DVI between 01/2015 and 09/2016. Based on the delivery outcomes, we developed a mathematical model that integrates all the factors influencing TTD following cervical ripening with DVI. In the study group, we prospectively included 223 patients who underwent cervical ripening with DVI between 11/2017 and 11/2018. The timing of insertion was calculated using the mathematical model developed in the control group, in order to prevent the occurrence of nocturnal deliveries.The calculated mean TTD was significantly shorter than the real mean TTD (21h46 min ± 3h28 min versus 25h38 min ± 12h10 min, p 0.001), and for 44% of patients, there was at least 10 h difference between the two. The real TTD (25h38 min ± 12H10 min versus 20h39 min ± 10h49, p 0.001), and the rate of nocturnal deliveries (30.5% versus 21.2%, p = 0.01) were significantly higher in the study group compared to the control group.The mathematical model did not help predicting TTD following cervical ripening with DVI, and or reducing the number of nocturnal deliveries.
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- 2021
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25. Assessment of an oocyte retrieval simulation training program for residents: from training to clinical practice
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Amelie Watelet, Benoit Brilland, Hady El Hachem, Cecile Dreux, Pauline Jeanneteau, Guillaume Legendre, Philippe Descamps, Pascale May-Panloup, and pierre-emmanuel bouet
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Objective: To assess the impact of an oocyte retrieval simulation training program (ORSTP) on the clinical performance of residents. Design: Prospective comparative study. Setting: A tertiary care center. Population: All OR performed by residents between May 2017 and November 2020. Methods & main outcome measures: The Simulation (S) group included OR performed by residents who had undergone an ORSTP before performing them on patients (n=422) and the control (C) group included OR performed by residents who had not received prior simulation training (n= 329). Our main outcome measure was the OR rate (ORR) (number of oocytes collected/number of follicles aspirated) during the first 3 months of the rotation. Results: In the S group, 6 residents aspirated 657 ovaries while in the C group, 5 residents aspirated 508 ovaries. The mean ORR during the first 3 months of rotation were comparable between the S and C groups (59% vs 58%). ORR during the first and second month, and at the end of the rotation were also comparable between the S and C groups (54% vs 63%, 58% vs 59% et 58% vs 58%, respectively). There was no significant difference in the rate of failed OR (3.3% vs 1.8%) between the S and C groups. Finally, 16% of residents in the S group reported being stressed before their first OR compared to 40% in the C group. Conclusions: The ORSTP does not improve the residents’ clinical performance, but it could decrease their stress in clinical practice.
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- 2022
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26. Reducing substrate noise coupling in a 3D-PICS Integrated Passive Device by localized P+ guard rings.
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Miled Ben Salah, Daniel Pasquet, Frederic Voiron, Philippe Descamps, Jean Luc Lefebvre, and Dominique Lesenechal
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- 2013
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27. Sentinel lymph node biopsy and morbidity outcomes in early cervical cancer: Results of a multicentre randomised trial (SENTICOL-2)
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Yves Fouche, Marc Baron, Florent Boutitie, G. Houvenaeghel, Daniel Raudrant, Eric Leblanc, Catherine Uzan, V. Fourchotte, J-M Classe, P. Morice, Anne-Sophie Bats, Fabrice Lecuru, C. Pomel, L. Boulanger, Jean Levêque, G. Mage, Olivier Graesslin, Patrice Mathevet, Frederic Guyon, Emile Daraï, Vanessa Conri, Philippe Descamps, Jean-Jacques Baldauf, Henri Marret, A S Bats, Denis Querleu, Virginie Fourchotte, Laurent Magaud, B. Ott, Serge Douvier, E. Stoeckle, P. Rouanet, P. Mathevet, Manuel González Barón, D. Lanvin, and Y. Delpech
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Adult ,0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Sentinel lymph node ,Uterine Cervical Neoplasms ,Adenocarcinoma ,Hysterectomy ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Prospective Studies ,Radical surgery ,Radical Hysterectomy ,Lymph node ,Cervical cancer ,Sentinel Lymph Node Biopsy ,business.industry ,Middle Aged ,Sentinel node ,Prognosis ,medicine.disease ,Surgery ,Survival Rate ,Dissection ,030104 developmental biology ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Lymph Node Excision ,Female ,Lymphadenectomy ,Morbidity ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Introduction Pelvic lymph node dissection has been the standard of care for patients with early cervical cancer. Sentinel node (SN) mapping is safe and feasible and may increase the detection of metastatic disease, but benefits of omitting pelvic lymph node dissection in terms of decreased morbidity have not been demonstrated. Materials and methods In an open-label study, patients with early cervical carcinoma (FIGO 2009 stage IA2 to IIA1) were randomly assigned to SN resection alone (SN arm) or SN and pelvic lymph node dissection (SN + PLND arm). SN resection was followed by radical surgery of the tumour (radical hysterectomy or radical trachelectomy). The primary end-point was morbidity related to the lymph node dissection; 3-year recurrence-free survival was a secondary end-point. Results A total of 206 patients were eligible and randomly assigned to the SN arm (105 patients) or SN + PLND arm (101 patients). Most patients had stage IB1 lesion (87.4%). No false-negative case was observed in SN + PLND arm. Lymphatic morbidity was significantly lower in the SN arm (31.4%) than in the SN + PLND arm (51.5%; p = 0.0046), as was the rate of postoperative neurological symptoms (7.8% vs. 20.6%, p = 0.01, respectively). However, there was no significant difference in the proportion of patients with significant lymphoedema between the two groups. During the 6-month postoperative period, the difference in morbidity decreased over time. The 3-year recurrence-free survival was not significantly different (92.0% in SN arm and 94.4% in SN + PLND arm). Conclusion SN resection alone is associated with early decreased lymphatic morbidity when compared with SN + PLND in early cervical cancer.
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- 2021
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28. Quand le féminin est mis à mal … À propos d’une prise de poids significative chez des jeunes femmes en post-annonce diagnostique d’une agénésie utéro-vaginale
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Karinne Gueniche, Nicole Nataf, Catherine Pienkowski, Magali Viaud, Yves Aigrain, Pierre Leguevaque, Maïa Guinard, Philippe Descamps, Maud Bidet, Emile Daraï, Michel Polak, Chloé Ouallouche, Roman Rouzier, Alaa Cheikhelard, Karine Morcel, Amandine Baptiste, Christine Louis-Sylvestre, Sarah Vibert, Jean-Luc Brun, Caroline Elie, Patrice Lopes, Jean-Bertrand Paniel, and Aline Ranke
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03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,General Arts and Humanities ,030227 psychiatry - Abstract
Resume Objectifs En appui sur les donnees issues d’une vaste recherche medico-psychopathologique proposee a des jeunes filles atteintes d’une agenesie utero-vaginale — syndrome de Rokitansky ou Mayer-Rokitansky-Kuster-Hauser (MRKH) — notre travail propose l’analyse psychodynamique de la valeur et de la fonction pour l’economie psychosomatique d’une reaction frequente a l’annonce diagnostique : le developpement d’un desordre alimentaire de type prise de poids chez 4 patientes sur 40. La mise en perspective de l’analyse de deux cas de patientes permet d’affiner la comprehension du sens de cette emergence alimentaire dont nous faisons l’hypothese qu’elle constitue a la fois une modalite defensive signalant les impasses du processus de construction du feminin mais aussi possiblement un levier de transformation psychique de ses incidences traumatiques. Methode Quarante jeunes femmes MRKH âgees de 19 a 34 ans (avec un âge moyen de 25 ans ½) ont ete rencontrees. La recherche leur a ete proposee de 2 a 17 ans apres leur annonce diagnostique et le travail clinique a consiste en une analyse retrospective de leur experience traumatique adolescente. Le recit des patientes a ete recueilli a l’aide d’un entretien clinique a visee de recherche non directif. Deux epreuves projectives (Rorschach et Thematic Apperception Test – TAT) leur ont egalement ete proposees pour apprehender plus finement les modalites de leur fonctionnement psychique. Les donnees des entretiens font l’objet d’une analyse clinique thematique ; les protocoles du Rorschach et du TAT sont analyses selon la methode d’interpretation de l’Ecole Francaise referee a la theorie psychanalytique du fonctionnement psychique. Le materiel issu des rencontres avec deux patientes diagnostiquees a l’âge de 17 ans et ayant presente dans la suite de cette annonce une prise de poids de 10 kg est ici compare de maniere approfondie. Resultats Le reperage de contrastes en termes de problematiques et de niveaux d’elaboration entre l’entretien et les protocoles projectifs est saisissant pour chaque patiente. A travers l’analyse de l’entretien, le symptome alimentaire de la patiente 1 parait survenir dans un contexte psychique ou l’interiorite feminine semble irrepresentable. Les protocoles projectifs revelent a l’inverse l’acces a un travail du feminin conflictuel et symbolise. De meme, le discours de la patiente 2 sur son symptome est a premiere vue bien plus elabore que celui de la patiente 1 puisque celle-ci etablit un lien subjectif entre le renoncement au projet de maternite implique par l’annonce du MRKH et la dimension compensatoire procuree par la prise de poids. Pourtant, le contraste offert par les tests projectifs dont les productions traduisent au contraire les fragilites identitaires et une insuffisante symbolisation du sexuel temoigne de la valeur defensive de l’exces de symbolisation de son discours manifeste dans l’entretien. Discussion Ces contrastes amenent a envisager le remplissage alimentaire comme une tentative de traitement d’une sexualite feminine deja conflictuelle voire en impasse avant la decouverte du MRKH. Ses accents traumatiques sont reactualises et potentialises a la faveur de l’annonce diagnostique. Les differents niveaux de problematiques reperes peuvent cohabiter chez une meme femme, qu’il s’agisse d’un feminin ni construit ni integre, d’un impossible investissement du corps interne ou d’un contre-investissement de l’impossible maternite. Dans ce contexte, l’etiopathogenie de la prise de poids qui succede a l’annonce du diagnostic est pour chaque jeune fille singuliere mais toujours en lien avec un feminin et/ou un maternel atteint. Conclusion En conclusion, si la prise de poids qui suit le diagnostic traduit une entrave voire une impasse (eventuellement ponctuelle) du traitement psychique de ses effets, cette annonce medicale a l’adolescence peut constituer une nouvelle chance pour ces jeunes filles, celle d’un apres-coup a la valeur potentiellement mutative.
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- 2020
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29. Benefits of an oocyte pickup simulation training program using a high-fidelity simulator (PickUpSimTM) for obstetrics and gynaecology residents: an observational survey study
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C. Dreux, Didier Riethmuller, Caroline Verhaeghe, Romain Corroenne, Pauline Jeanneateau, Pierre-Emmanuel Bouet, Pascale May-Panloup, Hady El-Hachem, Guillaume Legendre, Katherine Zhu, and Philippe Descamps
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030219 obstetrics & reproductive medicine ,business.industry ,media_common.quotation_subject ,Obstetrics and Gynecology ,Fidelity ,Survey research ,Simulation training ,03 medical and health sciences ,0302 clinical medicine ,High fidelity ,Obstetrics and gynaecology ,030220 oncology & carcinogenesis ,Medicine ,Observational study ,business ,Simulation ,media_common - Abstract
The aim of this study was to evaluate an oocyte pick-up (OPU) simulation training program for residents using the high fidelity PickUpSimTM (Accurate, Cesena, Italy) simulator. The authors carried ...
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- 2020
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30. Comparison of neonatal outcomes of caesarean sections performed after conversion from neuraxial to general anaesthesia with caesarean sections performed under general anaesthesia from the outset: a retrospective study
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Yasmine Souala-Chalet, Caroline Verhaeghe, Romain Corroenne, Guillaume Legendre, Philippe Descamps, Hady El Hachem, Flavie Duc, Emmanuel Rineau, Sigismond Lasocki, Maxime Leger, and pierre-emmanuel bouet
- Abstract
Objectives: To compare the neonatal morbidity of caesarean sections (CS) performed after conversion from neuraxial (NA) to general anaesthesia (GA) with CS performed under GA from the outset, and to assess whether the increase in DDI in urgent and extremely urgent cases with conversion from NA to GA increased the risk of neonatal morbidity. Design: Retrospective cohort study. Setting: University-affiliated hospital. Population: All CS performed under GA between 2015 and 2019. Methods & main outcome measures: Our main criteria used for assessing neonatal morbidity were: neonatal pH
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- 2022
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31. Insight on Non-Coding RNAs from Biofluids in Ovarian Tumors
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Yohann Dabi, Amélia Favier, Léo Razakamanantsoa, Léa Delbos, Mathieu Poilblanc, Philippe Descamps, Francois Golfier, Cyril Touboul, Sofiane Bendifallah, and Emile Daraï
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Cancer Research ,Oncology - Abstract
Ovarian tumors are the most frequent adnexal mass, raising diagnostic and therapeutic issues linked to a large spectrum of tumors, with a continuum from benign to malignant. Thus far, none of the available diagnostic tools have proven efficient in deciding strategy, and no consensus exists on the best strategy between “single test”, “dual testing”, “sequential testing”, “multiple testing options” and “no testing”. In addition, there is a need for prognostic tools such as biological markers of recurrence and theragnostic tools to detect women not responding to chemotherapy in order to adapt therapies. Non-coding RNAs are classified as small or long based on their nucleotide count. Non-coding RNAs have multiple biological functions such as a role in tumorigenesis, gene regulation and genome protection. These ncRNAs emerge as new potential tools to differentiate benign from malignant tumors and to evaluate prognostic and theragnostic factors. In the specific setting of ovarian tumors, the goal of the present work is to offer an insight into the contribution of biofluid non-coding RNAs (ncRNA) expression.
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- 2023
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32. Determination of temperature change inside IC packages during laser ablation of molding compound.
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P. Schwindenhammer, H. Murray, Philippe Descamps, and Patrick Poirier
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- 2008
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33. Isolating failing sites in IC packages using time domain reflectometry: Case studies.
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Dolphin Abessolo-Bidzo, Patrick Poirier, Philippe Descamps, and Bernadette Domengès
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- 2005
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34. Multilayer antenna dedicated to MIMO Beamformig antenna for 5G telecommunication applications
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Meriem Drissi, Nabil Benjelloun, Philippe Descamps, and Ali Gharsallah
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- 2021
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35. Salivary MicroRNA Signature for Diagnosis of Endometriosis
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Sofiane Bendifallah, Stéphane Suisse, Anne Puchar, Léa Delbos, Mathieu Poilblanc, Philippe Descamps, Francois Golfier, Ludmila Jornea, Delphine Bouteiller, Cyril Touboul, Yohann Dabi, Emile Daraï, Centre Expert en Endométriose [CHU Tenon] (GRC6 C3E), CHU Tenon [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), Ziwig Health, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Hospices Civils de Lyon (HCL), Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), and Gestionnaire, HAL Sorbonne Université 5
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endometriosis ,[SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics ,saliva ,diagnostic ,signature ,miRNA ,Medicine ,General Medicine ,[SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics - Abstract
International audience; Background: Endometriosis diagnosis constitutes a considerable economic burden for the healthcare system with diagnostic tools often inconclusive with insufficient accuracy. We sought to analyze the human miRNAome to define a saliva-based diagnostic miRNA signature for endometriosis. Methods: We performed a prospective ENDO-miRNA study involving 200 saliva samples obtained from 200 women with chronic pelvic pain suggestive of endometriosis collected between January and June 2021. The study consisted of two parts: (i) identification of a biomarker based on genome-wide miRNA expression profiling by small RNA sequencing using next-generation sequencing (NGS) and (ii) development of a saliva-based miRNA diagnostic signature according to expression and accuracy profiling using a Random Forest algorithm. Results: Among the 200 patients, 76.5% (n = 153) were diagnosed with endometriosis and 23.5% (n = 47) without (controls). Small RNA-seq of 200 saliva samples yielded ~4642 M raw sequencing reads (from ~13.7 M to ~39.3 M reads/sample). Quantification of the filtered reads and identification of known miRNAs yielded ~190 M sequences that were mapped to 2561 known miRNAs. Of the 2561 known miRNAs, the feature selection with Random Forest algorithm generated after internally cross validation a saliva signature of endometriosis composed of 109 miRNAs. The respective sensitivity, specificity, and AUC for the diagnostic miRNA signature were 96.7%, 100%, and 98.3%. Conclusions: The ENDO-miRNA study is the first prospective study to report a saliva-based diagnostic miRNA signature for endometriosis. This could contribute to improving early diagnosis by means of a non-invasive tool easily available in any healthcare system.
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- 2021
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36. In Reply
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Caroline, Verhaeghe, Romain, Corroenne, Andrew, Spiers, Philippe, Descamps, Géraldine, Gascoin, Pierre-Emmanuel, Bouet, Elsa, Parot-Schinkel, and Guillaume, Legendre
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- 2021
37. Magnetic Microscopy for IC Failure Analysis: Comparative Case Studies using SQUID, GMR and MTJ systems.
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Olivier Crépel, Patrick Poirier, Philippe Descamps, Romain Desplats, Philippe Perdu, Gérald Haller, and Abdellatif Firiti
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- 2004
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38. Study and validation of a power-rail ESD clamp in BiCMOS process with a reduced temperature dependency of its leakage current.
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F. Barbier, Fabrice Blanc, A. Le Grontec, R. Colclaser, Theo Smedes, M. Johnson, Serge Bardy, and Philippe Descamps
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- 2004
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39. Magnetic emission mapping for passive integrated components characterisation.
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Olivier Crépel, Romain Desplats, Y. Bouttement, Philippe Perdu, C. Goupil, Philippe Descamps, Felix Beaudoin, and L. Marina
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- 2003
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40. Magnetic field measurements for Non Destructive Failure Analysis.
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Olivier Crépel, C. Goupil, Bernadette Domengès, Philippe Descamps, Philippe Perdu, and A. Doukkali
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- 2002
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41. Comprehensive failure analysis of leakage faults in bipolar transistors.
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Bernadette Domengès, P. Schwindenhammer, Patrick Poirier, Felix Beaudoin, and Philippe Descamps
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- 2002
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42. Tratamiento de las sinequias uterinas
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Hervé Fernandez, S Tixier, Philippe Descamps, J.-M. Levaillant, and G Legendre
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03 medical and health sciences ,030219 obstetrics & reproductive medicine ,0302 clinical medicine ,030220 oncology & carcinogenesis - Abstract
Las sinequias son una de las principales causas de infertilidad secundaria. La prevalencia de las sinequias probablemente este subestimada debido a la heterogeneidad de la sintomatologia. Existen varias clasificaciones de las sinequias. Es preciso realizar una actualizacion sobre el origen, las consecuencias, el diagnostico, el tratamiento y los metodos de prevencion de las adherencias intrauterinas. Se ha realizado una revision de la literatura utilizando Medline, Pubmed, la biblioteca Cochrane y la Web of Science para actualizar los origenes, las consecuencias y los metodos de prevencion de las sinequias. Las sinequias son susceptibles de producirse despues de cualquier procedimiento endouterino debido a una disregulacion de la cadena de activacion de la coagulacion relacionada con el proceso inflamatorio. Tambien se sabe que las sinequias causan complicaciones obstetricas precoces y tardias. La tecnica recomendada actualmente para una histeroscopia diagnostica es la vaginoscopia con histeroscopio rigido, de diametro menor o igual a 3,5 mm, con una distension mediante suero fisiologico a temperatura ambiente, sin aplicar ninguna anestesia ni preparacion farmacologica, asi como sin desinfeccion vaginal ni profilaxis antibiotica. Se han desarrollado varias vias de investigacion inspiradas en la via intraabdominal para la prevencion de las adherencias pelvicas. Sin embargo, ningun metodo de prevencion actual ha demostrado ser eficaz en terminos de mejora de la fertilidad espontanea. La mejora de las practicas quirurgicas, el diseno de nuevos dispositivos medicos intrauterinos y las nuevas vias de investigacion, en particular en el ambito de las celulas madre endometriales, tal vez permitiran reducir la tasa de sinequias y sus complicaciones despues de una intervencion quirurgica endouterina.
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- 2019
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43. Health economic evaluation of an mRNA high-risk human papillomavirus (HR-HPV) assay versus a DNA HR-HPV assay for the proposed French cervical screening programme
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Caroline A, Dombrowski, Georgie Mf, Weston, Pr Philippe, Descamps, Pr Jacques, Izopet, Elisabeth J, Adams, and Elisabeth, Adams
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Cost-Benefit Analysis ,Papillomavirus Infections ,Humans ,Mass Screening ,Uterine Cervical Neoplasms ,Female ,DNA ,RNA, Messenger ,General Medicine ,Alphapapillomavirus ,Uterine Cervical Dysplasia ,Papillomaviridae ,Early Detection of Cancer - Abstract
Population screening programmes must make good use of resources for the health system and users. To evaluate impacts of the type of diagnostic test in the new French cervical screening programme, an messenger ribonucleic acid (mRNA) high-risk human papillomavirus assay was compared to a deoxyribonucleic acid (DNA) high-risk human papillomavirus assay for a hypothetical cohort of women aged 25 to 65 years.This evaluation takes the perspective of the French healthcare system.France.A decision tree model reflecting the French cervical screening algorithms was parametrised using French cost and population data and the Danish Horizon study. The outcomes were total costs, and number of colposcopies, HPV tests and cytology tests for the cohort. One-way and probabilistic sensitivity analyses and scenarios analyses were conducted to test the robustness of results to parameter and structural uncertainty.Adopting an mRNA versus DNA assay as part of national cervical screening in France is estimated to save €6.5 million (95% credibility intervals €-1.3 - €13.5 million) and prevent 47,795 (95% credibility intervals 35,309 - 60,139) unnecessary colposcopies, 38,666 unnecessary HPV tests and 121,670 cytology tests over two years for a cohort of 2,168,806 million women aged 25 to 65 years. Sensitivity analyses indicated robust results across a range of inputs.The choice of high-risk human papillomavirus assay makes a significant difference to resource use and costs and is important to consider when implementing cervical screening in France. Using an mRNA versus DNA assay can result in cost savings and reductions in unnecessary testing and procedures, which in turn benefits women and the health care system.
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- 2022
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44. Impact of the type of endometrial oestrogen preparation for frozen-thawed embryo (vaginal or transdermal) on perinatal outcomes in an artificial cycle
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Guillaume Legendre, Emeric Dubois, Pascale May-Panloup, Romain Corroenne, Lisa Boucret, Pierre-Emmanuel Bouet, and Philippe Descamps
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Adult ,medicine.medical_specialty ,Birth weight ,Context (language use) ,Administration, Cutaneous ,Cohort Studies ,Route of administration ,Pregnancy ,medicine ,Birth Weight ,Humans ,Transdermal ,Retrospective Studies ,Cryopreservation ,Estradiol ,Obstetrics ,business.industry ,Transdermal route ,Obstetrics and Gynecology ,Estrogens ,Embryo Transfer ,Embryo transfer ,Administration, Intravaginal ,Reproductive Medicine ,Female ,Live birth ,business ,Live Birth ,Cohort study - Abstract
Introduction Serum oestradiol concentration at the time of frozen embryo transfer (FET) in artificial cycle are lower when using transdermal administration of oestrogen for endometrial preparation compared to the vaginal route. This difference could have consequences for placentation and establishment of maternal-foetal circulation. The aim of our study was to compare the birth weight of newborns and the perinatal issues after FET in an artificial cycle with regard to the route of administration of oestrogens. Methods Retrospective monocentric cohort study in the medically assisted reproduction department of the University Hospital of Angers, France, between January 2017 and October 2020. Inclusion criteria were age >18 years old and one live birth after FET in an artificial cycle. The main outcome was the birth weight of the newborns. The choice of oestrogens administration (transdermal or vaginal) was left to the patient. Results 804 FET in artificial cycle were included in our study. Oestrogens were administrated in 356/804(36.6%) patients using transdermal route and in 448/804(45.9%) patients using vaginal route. There were 68/345 (19.1%) live births in the transdermal group and 85/448 (19%) in the vaginal group. There was no difference in the birth weight of the newborns (3320[2100-4165] grams in the transdermal group vs 3327.5[915-4650] grams in the vaginal group, p=0.72). All the other perinatal issues were comparable between the two groups. Conclusion Birth weights and perinatal issues were comparable with regard to the route of administration of oestrogens (vaginal or transdermal) in the context of endometrial preparation before FET in an artificial cycle.
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- 2021
45. Risk factors for operative vaginal delivery after a previous instrumental delivery
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Marlène Brognard, Guillaume Legendre, Sebastien Madzou, Philippe Descamps, and Romain Corroenne
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Parity ,Reproductive Medicine ,Pregnancy ,Risk Factors ,Infant, Newborn ,Humans ,Obstetrics and Gynecology ,Female ,Delivery, Obstetric ,Labor Presentation ,Retrospective Studies - Abstract
The aim of the present study was to assess factors associated with a repeat operative vaginal delivery (OVD) in women with a previous history of OVD.A single-centre retrospective observational study was performed in the maternity ward of the Angers University Hospital between 20/09/2010 and 01/04/2021. All the patients who underwent an OVD between 01/09/2010 and 31/10/2013 (delivery n°1, n = 1215) and who subsequently delivered up to the 01/04/2021 (delivery n°2, n = 652) were included. Multivariate logistic regression was used to assess the risk of subsequent recurrent OVD, adjusted for clinical potential confounder based on univariate analysis.Among the 520/652 (79.7%) patients who delivered vaginally during delivery n°2, 51/520 (9.8%) had undergone a repeated OVD. Gestational age, parity, history of uterine scars, percentage of labour's induction and the duration of labor were similar between patients who delivered spontaneously and those who required an OVD during delivery n°2. There were 7/51 (13.7%) patients who underwent an OVD during delivery n°2 with a newborn in cephalic posterior presentation compared to 20/469(4.3%) in cases of spontaneous vaginal delivery n°2 (p 0.01). A posterior cephalic presentation increased the risk of subsequent OVD by 3.7 [Confidence Interval 95% (1.4-9.6), p 0.01] CONCLUSION: In the case of a history of OVD, a low proportion of women required a repeated OVD (9.8%). The only factor associated with the need for repeated OVD was a persistent fetal cephalic posterior presentation at the time of delivery.
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- 2022
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46. Delivery Mode After Manual Rotation of Occiput Posterior Fetal Positions: A Randomized Controlled Trial
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Pierre-Emmanuel Bouet, Romain Corroenne, Guillaume Legendre, Philippe Descamps, Andrew Spiers, Caroline Verhaeghe, Géraldine Gascoin, and Elsa Parot-Schinkel
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Adult ,Male ,medicine.medical_specialty ,Rotation ,Ultrasonography, Prenatal ,law.invention ,Labor Presentation ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Randomized controlled trial ,law ,Labor Stage, Second ,Pregnancy ,Clinical endpoint ,medicine ,Humans ,030212 general & internal medicine ,Version, Fetal ,Watchful Waiting ,030219 obstetrics & reproductive medicine ,Intention-to-treat analysis ,business.industry ,Vaginal delivery ,Cesarean Section ,Absolute risk reduction ,Infant, Newborn ,Parturition ,Obstetrics and Gynecology ,Extraction, Obstetrical ,Delivery mode ,medicine.disease ,Surgery ,Intention to Treat Analysis ,Gestation ,Female ,business - Abstract
Objective To evaluate whether manual rotation of fetuses in occiput posterior positions at full dilation increases the rate of spontaneous vaginal delivery. Methods In an open, single-center, randomized controlled trial, patients with a term, singleton gestation, epidural analgesia, and ultrasonogram-confirmed occiput posterior position at the start of the second stage of labor were randomized to either manual rotation or expectant management. Our primary endpoint was the rate of spontaneous vaginal delivery. Secondary endpoints were operative vaginal delivery, cesarean delivery, and maternal and neonatal morbidity. Analyses were based on an intention-to-treat method. A sample size of 107 patients per group (n=214) was planned to detect a 20% increase in the percent of patients with a spontaneous vaginal delivery (assuming 60% without manual rotation vs 80% with manual rotation) with 90% power and alpha of 0.05. Results Between February 2017 and January 2020, 236 patients were randomized to either manual rotation (n=117) or expectant management (n=119). The success rate of the manual rotation maneuver, defined by conversion to an anterior position as confirmed by ultrasonogram, was 68%. The rate of the primary endpoint did not differ between the groups (58.1% in manual rotation group vs 59.7% in expectant management group (risk difference -1.6; 95% CI -14.1 to 11.0). Manual rotation did not decrease the rate of operative vaginal delivery (29.9% in manual rotation group vs 33.6% in expectant management group (risk difference -3.7; 95% CI -16.6 to 8.2) nor the rate of cesarean delivery (12.0% in manual rotation group vs 6.7% in expectant management group (risk difference 5.3; 95% CI -2.2 to 12.6). Maternal and neonatal morbidity was also similar across the two groups. Conclusion Manual rotation of occiput posterior positions at the start of second stage of labor does not increase the rate of vaginal delivery without instrumental assistance. Clinical trial registration ClinicalTrials.gov, NCT03009435.
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- 2020
47. Female urine incontinence: vaginal erbium laser (VEL) effectiveness and safety
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Nicolas Rygaloff, Jean Marc Ayoubi, David Elia, Eleonora Russo, Niko Heiss, Jean Marc Bohbot, Nicolas Berreni, René Druckmann, Hugues Geoffrion, Philippe Descamps, François Haab, and Marco Gambiacciani
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medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Rehabilitation ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Therapeutic effect ,030232 urology & nephrology ,Urine incontinence ,Urinary incontinence ,General Medicine ,Placebo ,Overactive bladder syndrome ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Erbium laser ,Relative risk ,Physical therapy ,Medicine ,medicine.symptom ,business ,Molecular Biology - Abstract
Urinary incontinence is a common health problem that impacts the quality of life of women at different ages. Its physiopathology is not unequivocal, and it is necessary to consider the stress urinary incontinence (SUI), the overactive bladder syndrome and the mixed incontinence (MUI). According to the type of incontinence, its impact on the quality of life and age of the patients, therapeutic strategies are currently summarized in physiotherapy, surgery and drug treatments. We already know the benefit/risk ratio of each of these strategies. Our objective is to evaluate the potential effectiveness and safety of the VEL, an innovative vaginal laser technique (VEL – Vaginal Erbium Laser, erbium yttrium-aluminum-garnet -Er: YAG) a non-invasive laser proposed as a treatment for SUI, overactive bladder syndrome and MUI. The mechanisms of action of lasers are discussed in general and those of VEL in particular with the description of the Smooth® mode. To do this, we have collected the 21 published studies including the first randomized vs. placebo and two pilot studies of intra-urethral VEL. In conclusion: VEL procedures already have their place between the rehabilitation of the perineal floor and surgery. Further properly sized, randomized studies are needed to evaluate the laser treatments in comparison with other therapies, as well as to assess the duration of the therapeutic effects and the safety of repeated applications.
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- 2020
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48. Benefits of an oocyte pickup simulation training program using a high-fidelity simulator (PickUpSim
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Romain, Corroenne, Guillaume, Legendre, Didier, Riethmuller, Hady, El-Hachem, Katherine H, Zhu, Cecile, Dreux, Pauline, Jeanneateau, Caroline, Verhaeghe, Pascale, May-Panloup, Philippe, Descamps, and Pierre-Emmanuel, Bouet
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Obstetrics ,Gynecology ,Pregnancy ,Surveys and Questionnaires ,Feasibility Studies ,Humans ,Internship and Residency ,Oocyte Retrieval ,Female ,Simulation Training - Abstract
The aim of this study was to evaluate an oocyte pick-up (OPU) simulation training program for residents using the high fidelity PickUpSim
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- 2020
49. Quality of advanced ovarian cancer surgery: A French assessment of ESGO quality indicators
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Cécile Loaec, Frank Priou, Xavier Aireau, Marie-Mélanie Gac, Romuald Wernert, C. Bourgin, Fabienne Empereur, Edouard Vaucel, Jean-Marc Classe, Hugues Bourgeois, Valérie Delecroix, Paule Augereau, Loïc Campion, Pascaline Deblaye, Philippe Descamps, Johanna Silve, Alain Lortholary, Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, Réseau régional de Cancérologie Onco Pays de la Loire [Nantes] (Plateau des écoles), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier de Cholet (CHC), Centre Catherine-de-Sienne [Nantes] (CCS), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CHD Vendée - Hôpital Les Oudairies [La Roche sur Yon], Clinique Victor Hugo [Le Mans], Clinique Mutualiste de l'Estuaire (Saint Nazaire), Integrative Oncogenomics of Multiple Myeloma Pathogenesis and Progression (CRCINA-ÉQUIPE 11), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), CRLCC René Gauducheau, Université de Nantes (UN), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), and Bernardo, Elizabeth
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medicine.medical_specialty ,Quality Assurance, Health Care ,media_common.quotation_subject ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Gynecologic oncology ,03 medical and health sciences ,Gynecologic Surgical Procedures ,0302 clinical medicine ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Ovarian cancer ,Operative report ,Humans ,Medicine ,Quality (business) ,Quality Indicators, Health Care ,Retrospective Studies ,media_common ,Ovarian Neoplasms ,Advanced ovarian cancer ,030219 obstetrics & reproductive medicine ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Quality assurance ,3. Good health ,Surgery ,Clinical trial ,Oncology ,030220 oncology & carcinogenesis ,Female ,France ,Quality of treatment ,business ,Follow-Up Studies ,Cohort study - Abstract
International audience; Objectives: In 2016, the European Society of Gynecology Oncology (ESGO) published indicators defining the quality of surgical management of advanced ovarian cancer. The objective of the study was to assess the quality of ovarian cancer patient management in regional centers authorized for gynecological cancer, based on the ESGO list of quality indicators. Methods: A multicenter retrospective observational cohort study was conducted from January 1 to June 30, 2016. The following quality indicators 1 "rate of complete surgical resection", 4 "center participating in clinical trials in gynecologic oncology", 5 "treatment planned and reviewed at a multidisciplinary team meeting", 6 "required preoperative workup", 8 "minimum required elements in operative reports" and 9 "minimum required elements in pathology reports" were selected. Results: 91 patients were evaluated in 16 centers. The required preoperative workup was incomplete in 25% of cases. Treatment was not planned at a multidisciplinary team meeting for 24%. An evaluation score of peritoneal involvement was included in 40% of the operative reports and the quality of surgical resection was reported in 72%. Primary surgery was most often performed in a peripheral hospital (48%), interval surgery in a private center (37%), and closure surgery in a regional cancer center (43%). No institution respected the six quality indicators evaluated. One regional cancer center respected five items and two private centers did not respect any. Conclusion: Whilst the ESGO quality indicators provide objective, validated and evaluable support which centers can use to improve quality of care, we observed heterogeneous practices amongst the centers evaluated.
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- 2020
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50. Effects of clitoral reconstruction for female genital mutilation on perinatal outcomes: A retrospective case-control study
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Guillaume Legendre, Charlemagne Ouedraogo, L. Catala, Soazig Herve, Sebastien Madzou, Philippe Descamps, Katherine Zhu, Chloé Reau-Giusti, Romain Corroenne, Vanessa Combaud, Philippe Gillard, and Caroline Verhaeghe
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Episiotomy ,Female circumcision ,Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Matched-Pair Analysis ,Perineum ,Instrumental delivery ,Clitoris ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Pregnancy ,Perineal tear ,Confidence Intervals ,Medicine ,Humans ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Outcome measures ,Case-control study ,Obstetrics and Gynecology ,Gestational age ,Plastic Surgery Procedures ,University hospital ,Delivery, Obstetric ,medicine.anatomical_structure ,Reproductive Medicine ,030220 oncology & carcinogenesis ,Case-Control Studies ,Circumcision, Female ,Female ,business - Abstract
Objectives: To investigate the perinatal outcomes of women with a history of female genital mutilation (FGM) who underwent clitoral reconstruction (CR) compared with women with FGM who did not undergo CR. Design: Retrospective case-control study Setting: Angers University Hospital, between 2005 and 2017 Methods: Inclusion criteria: pregnant women >18 years who underwent CR after FGM. Only the first subsequent delivery after CR was included. Each woman with CR was matched for age, ethnicity, FGM type, parity, and gestational age at the time of delivery with two women with FGM who did not undergo CR during the same period of time. Main outcome measures: at birth: need for episiotomy and intact perineum Results: 84 women were included (28 in the CR group; 56 in the control group). In the CR group, patients required significantly fewer episiotomies (5/17[29.4%]) compared to the control group (28/44[63.6%], p=0.02), even after excluding operative vaginal deliveries (2/13[15.4%] vs 21/36[58.3], p
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- 2020
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