Sexual harassment and menstrual disorders among Italian university women: A cross-sectional observational study.

AIMS: Menstrual disorders and sexual harassment are common among young women and interfere with their life and activities. We aimed to describe the association of sexual harassment and menstrual disorders among female university students. METHODS: This cross-sectional, observational study examined the association between sexual harassment and menstrual disorders in a sample of 349 university students in Italy. Students answered an anonymous self-administered questionnaire. Descriptive bivariate analyses and logistic regression analyses were performed. Main outcome measures were associations between levels of exposure to sexual harassment (none, levels 1 and 2) and five menstrual disorders (premenstrual symptoms, heavy bleeding, pain, irregular cycles, and amenorrhea). RESULTS: Among the women interviewed (mean age 20.4 ± 1.45 years), 146 (41.8%) had experienced sexual harassment in the previous 12 months: 91 (26.1%) level 1 and 55 (15.7%) level 2. The frequency of premenstrual symptoms was 31.9% ( n=110); heavy bleeding, 35.3% ( n=124); pain, 51.4% ( n=181); irregular cycles, 55.5% ( n=195); and amenorrhea, 6.7% ( n=23). After adjustment for age, place of birth, being in a couple relationship and receiving hormone therapy, the frequency of menstrual disorders, except for amenorrhea, was increased with sexual harassment, with a regular gradient from no harassment to level 2 harassment. Introducing factors of depression, specific gynaecological problems and lifetime sexual violence did not change the results. For instance, the adjusted odds ratios of premenstrual symptoms were 2.10 [1.19-3.68] for women with level 1 harassment and 3.58 [1.83-7.03] for women with level 2 compared with women without harassment exposure. CONCLUSIONS: Sexual harassment is related to the prevalence of menstrual disorders. Healthcare providers should encourage dialogue with patients and address the issue of sexual violence or harassment.

[Prevention of scar formation by polyglactin 910 (Vicryl) mesh after lumbar laminectomy in the rat]. / Prévention de l'épidurite par un treillis de polyglactine 910 (Vicryl) après laminectomie lombaire chez le rat.

Laminectomy in lumbar spine surgery often produces disabling adhesive arachnoiditis. We have tested, on the rat, polyglactin 910 mesh with collagen or not, with a mail 0.9 mm large. We have used 34 Wistar male rats. L5 laminectomy were realised on all the rats. Rats were ranged in four groups: group 1: control, L5 laminectomy alone, 6 months follow up--group 2: one month follow up, L5 laminectomy, vicryl mesh with collagen or not--group 3: two months follow up, L5 laminectomy, vicryl mesh with collagen or not--group 4: six months follow up, L5 laminectomy, vicryl mesh with collagen or not. On 28 rats, the histologic study have demonstrated: group 1 control: important and adhesive fibrosis scar--group 2: no or minimal reaction--group 3: fibroblastic or few cellular, non or little adhesive fibrosis--group 4: moderate adhesive fibrosis in half of the cases with vicryl mesh without collagen, minimal non adhesive fibrosis with collagen vicryl mesh.

[Mammary staphylococcal cellulitis of the newborn]. / Dermohypodermite mammaire staphylococcique néo-natale.

BACKGROUND: Neonatal cellulitis is usually caused by staphylococcal infection of the mammary gland which has generally reached the stage of abscess formation at the time of diagnosis. The circumstances of onset and possible complications remain poorly known. We report a recent case. CASE REPORT: A female neonate developed major bilateral mammary hypertrophy. Her mother had tried to express the breasts, fearing "congestion". Three days later, the right breast showed signs of inflammation with a fluctuant central zone suggestive of a cellulitic infectious abscess confirmed at ultrasound. Recovery was achieved with incision and antistaphylococci antibiotic therapy. DISCUSSION: Mammary cellulitis of the newborn appears to generally occur following an attempt to manipulate a pre-existing physiological hypertrophy of the breast. Staphylococcus aureus is the most commonly found agent. Early surgical care is generally required as there is a real risk of progression to necrotizing faciitis.

[Hemorheologic characteristics in beta-thalassemic homozygotes before and after splenectomy]. / Caratteristiche emoreologiche nella beta-talassemia omozigote prima e dopo splenectomia.

In a group of 36 homozigous beta-thalassaemic children we studied the effect of splenectomy on hemorheologic characteristics. The aim of the work was to evaluate the importance of such operation either on anemia or on erythrocyte deformability. Whole blood viscosity was measured with a Brookfield Microviscometer (LVT) and erythrocyte deformability was evaluated with the erythrocyte filtration technique using policarbonate membranes. The more the erythrocyte deformability decreases, the more the erythrocyte filtration rate decreases. Our data show that splenectomized children, have worse hemorheologic characteristics according to the longer survival time of pathological red blood cells in spite of their reduced deformability. This behaviour can be modified only by blood transfusion that we have seen to be able to reduce whole blood viscosity and to increase erythrocyte filtration rate in splenectomized children. We think that splenectomy must be delayed as long as possible so that hemodinamyc conditions cannot be worsened. An hemorheologic monitorage could be useful for diagnostic and prognostic evaluations both in splenectomized and not splenectomized children.

[Voiding disorders in childhood: from symptoms to diagnosis]. / Troubles mictionnels de l'enfant : de la symptomatologie au diagnostic.

The new definitions of voiding disorders in children should be used in clinical practice. Two major kinds of voiding disorders are identified: 1) isolated primary enuresis as a disorder occurring exclusively during sleep with no daytime leakage; 2) urinary dysfunctions that include uninhibited detrusor contraction, sphincter hypertonicity, and urethral instability. These dysfunctions may be primary or secondary. Constipation as an underlying cause is frequent and usually underestimated. The diagnostic process requires one (or more) long consultations. After ruling out a urine leak without a voiding disorder and secondary causes (constipation, inadequate hydration, poor voiding hygiene, crystalluria, etc.), the aim is to distinguish isolated sleep-time disorders (primary enuresis) from daytime ± sleep-time symptoms (primary urinary dysfunctions). Anamnesis, long and accurate, can be sensitized by a questionnaire completed at home. The physical examination focuses on the exclusion of anatomic abnormalities and local inflammation (vulvitis, balanitis, etc.). Diagnostic tests are rarely required at the beginning. Urodynamic exploration may be indicated, never at the first consultation, in case of primary urinary dysfunction. This diagnostic approach provides an appropriate therapeutic decision.

[Voiding disorders in childhood: from physiology to symptomatology]. / Troubles mictionnels de l'enfant : de la physiologie à la symptomatologie clinique.

Micturition is a natural event occurring several times a day, the result of a complex and partially unknown physiology. It involves different muscles (striated and smooth) as well as the central and autonomic nervous systems in an innate voiding reflex. This reflex is controlled after 2 years of age. If there is a failure or dysfunction of one of these elements, a miction disorder may appear. Two types of miction disorders are identified: neuromuscular disorders of the bladder and defective central control. Multiple factors such as constipation, bladder irritation, or an increase in abdominal pressure can interfere with the voiding reflex. The new international definitions and classifications of voiding disorders allow an easier clinical approach through careful and complete questioning and a simple clinical exam, efficient enough in most cases to provide the diagnosis and adapted treatment.

[Voiding disorders in childhood: from diagnosis to treatment]. / Troubles mictionnels de l'enfant : du diagnostic au traitement.

In voiding disorders in childhood, after a precise diagnosis, treatment can be provided. Aspecific hygienic and dietetic measures are the basis of care in all micturating disorders and frequently must be established to allow a precise diagnosis. In case of enuresis, restriction of beverage and diuretic foods is recommended in the evening. Other treatments for enuresis should be proposed to motivated children. In the polyuric form of enuresis, the treatment is desmopressin (DDAVP) and in the form with low bladder capacity, alarms or a combination of these 2 treatments. In dysfunctional voiding, after caring for the secondary causes, and depending on the characteristics of the disorder, the first-step treatment is pelvic floor rehabilitation with or without anticholinergic therapy. Other medical treatments are used in a second step. Isolated urethral instability remains controversial.

Birth defects observed with maternal carbimazole treatment: Six cases reported to Nice's Pharmacovigilance Center.

GOALS: To report cases of embryopathy occurring following first trimester exposure to anti-thyroid drugs. METHODS: Retrospective screening of the database of our Pharmacovigilance Center from 1987 to date. RESULTS: We report six cases of embryopathy, all following carbimazole exposure during the first trimester: two cases of abdominal wall defect, including one associated with facial dysmorphia; one case of digestive malformation (patent omphalomesenteric duct); two cases of aplasia cutis including one with facial dysmorphism; one case of bilateral choanal atresia with aorta coarctation associated with poorly controlled insulin dependent diabetes. Four out of five patients were euthyroid with treatment during the first trimester. We found a context suggesting genetic predisposition to congenital malformation in three cases: two cases of parental cleft lip/palate, one case of consanguinity. Outcome was favorable in all cases. CONCLUSIONS: We want to raise awareness about the potential teratogenicity of carbimazole, probably on a predisposed genetic background. We suggest better reporting of congenital anomalies in children of women with Graves'disease, with or without in utero exposure to anti-thyroid drugs. In light of current literature, propylthiouracil should be the first line treatment for hyperthyroid women wishing a pregnancy.

[Fracture of the lumbar spine in a child, simulating Scheuermann's disease]. / Fracture du rachis lombaire chez l'enfant simulant une maladie de Scheuermann.

The association of a low back pain and kyphosis in children has not a unique diagnosis. A type of fracture of lumbar spine in the child simulates Scheuermann's disease. As in Scheuermann's disease, a traumatic event in sport is frequently associated with the onset of symptoms. But the location of intraspongious herniation to the anterior margin of vertebral body signs the fracture of lumbar spine.

[Post-traumatic spinal arachnoid cyst]. / Kyste arachnoïdien rachidien post-traumatique.

A 15 year old boy presents two fractures of the left inferior member (femur and tibia), after a motor-cycle accident. An osteosynthesis by plate and screws was performed, in emergency. In immediate post-operative days, a radicular paresia of the left inferior member appear especially on exterior popliteus sciatic nerve. The electromyogram confirm the diagnosis. However, these is nor pain nor fracture of the sacro-lumbar spine. The consolidation of femur and tibia fractures is normal. The neurologic recuperation is slow but progressive. A year after the accident, because the recuperation is not complete, an MRI is performed. An arachnoidal cyst surrounding the L5 and S1 roots is diagnosed. The surgery is decided. The ablation of the cyst is performed in the same operative time that the ablation of plate. The histology of the paries of the cyst confirm, by hemosiderimic deposits, the traumatic etiology. The arachnoïdal cyst is rare, particularly in the childhood. It is always difficult to know the relation between the cyst and the symptom. It is also impossible to be certain of traumatic etiology: traumatic cyst or traumatised cyst? The surgical indication is lawful by the existence of clinical signs, because 50 per cent of cases are improved or recovered.

[Retrospective study on abortions of malformed fetuses carried out during a 5-year period in the department of Bouches-du-Rhône]. / Etude rétrospective de 5 ans d'interruption de grossesse pour malformation dans le département des Bouches-du-Rhône.

The authors report a retrospective study of therapeutic abortions for antenatally diagnosed abnormalities, 146 fetuses are concerned during a five years period, an anatomo-pathological examination have been performed in all cases, malformations of central nervous system are the most frequent (62). 26 urologic abnormalities are especially detailed. There are 10 isolated urologic abnormalities, and 16 abnormalities multiples. All fetuses had renal lesions which could justified an intervention but the declaration at registration of congenital birth defects is not obligatory. A multidisciplinary approach to prenatal diagnosis and congenital birth must still developed for a better understanding.

[Digestive stenosis after neonatal enterocolitis]. / Sténoses digestives après entérocolite néonatale.

Nineteen clinical cases of intestinal stricture due to neonatal necrotising enterocolitis and a review of available references are presented in this paper. Intestinal strictures are estimated to arise in 20% to 30% on neonatal enterocolitis. However the delay between the acute episode and the occurrence of the stenosis is variable; the depth and the extend, of the necrosis as well as inflammation and superinfection may contribute to the building up of the intestinal stricture. The histological aspects of the lesions are not unique, more over cases of spontaneously regressive stenosis are known. Question thus arising as to the most appropriate timing for surgery and the choice of surgical technics as a function of clinical aspects and of derivation of the disease are discussed in this paper.

[Spondylodiscitis in children following lumbar puncture. Apropos of a case]. / Spondylodiscite chez l'enfant après ponction lombaire. A propos d'un cas.

We described a case of spondylodiscitis L3 L4, in a 3 year old child that appeared 3 weeks after a lumbar puncture. The infectious agent responsible wasn't found. The child recovered without sequelae with an antistaphylococcis treatment. The mecanism by inoculation has been described after surgery of the inter-vertebral disc but also after spinal anesthesis. The bone complications of the lumbar puncture are exceptionally rare but elementary aseptic precautions must not be overlooked in order minimise the infection.

Branchial dysplasia, mental deficiency, club feet, and inguinal herniae: a report of two further cases associated with paucity of interlobular bile ducts.

The observation of two new cases in a previously reported family has brought about a change in the delineation of the syndrome initially defined. To the abnormalities already described (branchial dysplasia, mental deficiency, club feet, inguinal herniae) must be added a paucity of interlobular bile duts; the relationship between this new syndrome and the Alagille syndrome requires reconsideration.

[Grave respiratory distress in the newborn infant caused by mediastinal teratoma]. / Détresse respiratoire néonatale gravissime par tératome médiastinal.

Mediastinal tumor is a rare cause of severe respiratory distress in the newborn. A recent patient was transferred++ to our intensive care nursery with severe distress due to a large mediastinal teratoma. The presence of calcifications on the plain chest roentgenogram suggest the diagnosis. At two hours of age the tumor developed in the left hemi-thorax was completely removed. Microscopically it was a typical well differentiated+ benign teratoma, but the postoperative course was marked by a continuing respiratory distress due to a paralysed left diaphragm. This situation was surgically corrected by infolding the diaphragm at twenty days of life. At the fourth postoperative day the endotracheal tube was removed and the baby is now well with a normal chest. X-ray at six month of age. Because the rarity of this tumor in the newborn, because the possibility of antenatal echographic diagnosis, we record this experience and review the literature.

[Testicular exploration by Doppler ultrasonography in children. Importance, indications, limitations. Apropos of 90 cases]. / Exploration testiculaire par ultrasonographie Doppler chez l'enfant. Intérêt, indication, limites. A propos de 90 cas.

The authors evaluate the testicular blood flow by Doppler stethoscope in 90 infants and children; they tell two indications: In emergency the most common is "acute scrotal swelling": 78 cases, 4 false negative are reported in diagnosis of torsion of the spermatic cord; the limit of the Doppler examination are the possibility of a interepididymo-testicular torsion and, above all, the inflammation of the scrotal wall. If Doppler examination are in agreement, unnecessary surgical explorations must be avoided. Outside emergency, Doppler examination may be help-full to evaluate varicocele and to control some surgical operation involving spermatic cord (12 cases).