Evaluation of in vivo properties of Velosorb™ fast versus Vicryl™ rapide in a functional rabbit model of intradermic suture and episiotomy.

OBJECTIVE: Fast-absorbing polyglactin 910 is commonly used to suture skin and vaginal incisions. In vitro studies have shown similar tensile strength properties between Velosorb™ Fast and Vicryl™ Rapide (Al-Qattan MM. J Hand Surg Br Eur. 2005;30(1):90-91). This randomized study compared Velosorb™ Fast (Covidien) with Vicryl™ Rapide (Ethicon) in a rabbit model of intradermic suture and episiotomy. MATERIALS AND METHODS: This randomized prospective study was performed on 20 New Zealand rabbits, in which we realized a mediolateral perineo-vaginal incision and two vertical skin incisions of about 8 cm on the abdominal wall. The sutures were randomized between Velosorb™ Fast (Covidien) and Vicryl™ Rapide (Ethicon), and each rabbit was treated with the same suture on both vaginal incision and left abdominal incision, while the right abdominal incision was closed with an alternate suture. A macroscopic examination was performed on days 5 and 11. On day 11, animals were sacrificed for histological (Badylak quantitative score) and electron microscopic examinations. Differences were considered significant at p < .05. RESULTS: All of the rabbits survived and were included in the final results. Fifty-one sutures were visible by histologic analysis (27 in the Velosorb™ Fast group and 24 in the Vicryl™ Rapide group). The power of the study was ≥80%. There was no significant difference between the two groups based on the total histologic Badylak score analysis or the Badylak sub-score analysis. CONCLUSIONS: Velosorb™ Fast seems to be as efficient as Vicryl™ Rapide for use in perineal and skin closure.

[Assessment of gynecology obstetric interns training on birth simulator]. / Évaluation de la formation des internes de gynécologie obstétrique sur simulateur d'accouchement.

OBJECTIVE: The aim of this study was to assess the gynecology obstetric residents training on a birth simulator. MATERIALS AND METHODS: This is a prospective monocentric study, which had included residents at the beginning of their formation and performed on SIMone™, 3B SCIENTIFIC(®) birth simulator. It had included four sessions (supervised by two seniors registrar): two on instrumental extraction (vacuum and forceps) and two on labor monitoring. The two sessions were performed at one month. A theoretical formation was accomplished after the first assessment. Three assessments were performed based on two score scales (extraction and labor monitoring). A free training was allowed at each extraction session. RESULTS: Twelve interns were included in this study. There was a significant scores improvement between first and third session for instrumental extraction (2.4 points on 11 [±1.8] vs. 8 [±0.9]; [P<0.05]) and for labor monitoring (5.2 [±1.4] points on 9 vs. 6.6 [±1.3]; [P<0.05]). Interns considered this training improved their theoretical and practical knowledge for respectively 11 and 12 interns on 12. For 9 interns, a most important debriefing with teachers was desirable. CONCLUSION: Training on birth simulator allows an improvement of knowledge and skill of gynecology obstetric interns. A structured debriefing should be instituted after the sessions.

Malassezia pachydermatis en lesiones de piel en pacientes de la Quinta región de Chile / Malassezia pachydermatis on skin lesions in patients from the Fifth region of Chile

Introducción: M. pachydermatis es una levadura zoofílica que puede provocar pitiriasis versicolor y dermatitis seborreica. Objetivos: determinar la presencia de M. pachydermatis en pacientes con pitiriasis versicolor y dermatitis seborreica, además de evaluar el rendimiento del examen microscópico directo y cultivo, en estas infecciones. Materiales y Método: estudio descriptivo prospectivo realizado en el Hospital Carlos van Buren de Valparaíso, Chile, durante el período 2011-2013. Se seleccionaron pacientes con diagnóstico clínico de pitiriasis versicolor y dermatitis seborreica. La confirmación micológica fue realizada con examen microscópico directo y/o cultivo, además de pruebas especiales. Resultados: ingresaron al estudio 66 pacientes. El 60,6% fueron hombres, con un promedio de edad de 43 años. El 70% con VIH (+). El 90,9% presentó pitiriasis versicolor (principalmente hipopigmentadas en el tronco) y el 9% dermatitis seborreica. El examen microscópico directo fue positivo en el 95,4% de los casos y en el 62,12% de los cultivos. La especie más frecuente fue M. pachydermatis, seguida por M. furfur. Del total de pacientes: 50 se trataron por vía tópica, 15 con tópico más sistémico y 1 no fue tratado. Conclusiones: la mayoría de los pacientes ingresados a este estudio fueron hombres, VIH(+) y con lesiones de pitiriasis versicolor hipopigmentadas de tronco. La especie más frecuente fue M. pachydermatis. El tratamiento tópico fue el más indicado.

Introduction: M. pachydermatis is a zoophilic yeast that can cause pityriasis versicolor and seborrheic dermatitis. Objectives: to determine the presence of M. pachydermatis in patients with pityriasis versicolor and seborrheic dermatitis, in addition to evaluating the performance of direct microscopic examination and culture in these infections. Materials and Method: a prospective descriptive study conducted in the Carlos van Buren Hospital in Valparaíso, Chile, during the period 2011-2013. Patients with clinical diagnosis of pityriasis versicolor and seborrheic dermatitis were selected. Mycological confirmation was made with direct microscopic examination and / or culture, and special tests. Results: 66 patients entered the study. 60.6% were men, with an average age of 43 years. 70% with HIV (+). 90.9% had pityriasis versicolor (mostly hypopigmented in the trunk) and seborrheic dermatitis 9%. Direct microscopic examination was positive in 95.4% of cases and 62.12% of the cultures. The most frequent species was M. pachydermatis, followed by M. furfur. Of the patients: 50 were treated topically with 15 more systemic plus topical and 1 was untreated. Conclusions: most patients admitted to this study were men, HIV (+) and hypopigmented pityriasis versicolor lesions in the trunk. The most frequent species was M. pachydermatis. Topical treatment was the most appropriate.

[Impact of a training workshop on residents and senior registrar skill in diagnosis and repair of anal sphincter and rectal mucosae obstetrical injuries]. / Impact d'un atelier de formation au diagnostic et à la réparation des lésions obstétricales du sphincter anal et de la muqueuse rectale sur les compétences des internes et chefs de clinique.

OBJECTIVE: To evaluate the impact of a training workshop on residents and senior registrar skill in repair of anal sphincter and rectal mucosae obstetrical injury. MATERIAL AND METHODS: Residents and senior registrar practical and theoretical knowledge were evaluated by a questionnaire sent, using AGOF (association des gynécologues-obstétriciens en formation) mailing list. This questionnaire includes questions about epidemiology, risk factors and sutures types. Scores were compared according to the participation or not at the workshop. RESULTS: There were 106 residents or senior registrar (48.4%) in the workshop group and 113 (51.6%) in the control group. Scores were significantly higher in the workshop group than in the control group for theoretical knowledge (4.1 vs. 3.7), practical knowledge (17.6 vs. 15.9) and global scores (21.7 vs. 19.7). There was no difference according to the participation before or after the third residency semester. Residents global scores were statistically higher in the workshop group compared to the control group (21.8 vs. 19.5) but there was no significant difference between the senior registrar of the two group. Participants in the workshop group estimate themselves significantly more efficient than in the control group concerning anal sphincter injury repair and rectal mucosae repair. CONCLUSION: A training workshop seems to improve the theoretical and practical skill. LEVEL OF EVIDENCE: 4.

[A case of digestive occlusion on an endometriosis lesion after treatment by GnRH agonist]. / Un cas d'occlusion digestive sur lésion d'endométriose sous agoniste de la GnRH.

Endometriosis concerns 10% of childbearing age women and frequently affects the digestive tract. We report here the case of a 31-year-old patient presenting a severe occlusive syndrome while being treated with GnRH agonist, within the framework of an in vitro fertilization. The surgical treatment will find a deep endometriosis affecting the sigmoid and colorectal junction and leading to a colorectal resection. These endometriosis lesion recurrences during ovarian stimulation or by GnRH flare up effect is rare and often debated. The surgical treatment of the lesions, before the medically assisted procreation, seems to prevent these complications.