[Mini-sling versus transobturator sling: Efficiency and morbidity]. / Mini-bandelette sous-urétrale versus bandelette transobturatrice : efficacité et morbidité.

OBJECTIVE: To compare the effectiveness of an ALTIS® mini-sling and a conventionnal suburethral sling TVT-ABBREVO® for treatment of female stress urinary incontinence. METHODS: A single-center retrospective study included all female patients fitted with a conventional transobturator tape (TVT-ABBREVO®) or mini-sling (ALTIS®), during 2015, in Angers university hospital. The success rate was defined by no urine leakage during a cough test on clinical examination, improved quality of life defined by a PGI-I (Patient Global Impression of Improvement) score of 1 to 3, and no stress urinary incontinence on USP (Urinary Symptom Profile) questionnaire. Morbidity associated with slings and perioperative data were also recorded. RESULTS: Ninety-two patients were included (39 in the ALTIS group and 53 in the ABBREVO group). The average follow-up was 13.55 months. The success rate was not significantly different in ALTIS group for the negative cough test (89.7% vs 94.3% in ABBREVO group, P=0.45), for the absence of urinary leakage reported on the USP questionnaire (87.2% vs 90.6% in ABBREVO group, P=0.61), or for the improvement of the quality of life with a PGI-I score between 1 and 3 (82.1% vs 86.8% in ABBREVO group, P=0.53). On the other hand, more patients were fully satisfied, with a PGI-I quality of life score of 1, in ABBREVO group than in ALTIS group (67.9% compared with 46.2%, P=0.03). Immediate postoperative pain was significantly less intense in ALTIS group than in ABBREVO group (average VAS score of 0.5 comparated with 1.3, P=0.01), but this difference had disappeared one week after surgery. The rates of other complications were similar in both groups. CONCLUSION: The functional results of the ALTIS and TVT-ABBREVO® slings appear similar in the treatment of female stress urinary incontinence.

Pre-Main-Sequence Star Candidates in the Bar of the Large Magellanic Cloud

Candidate pre-main-sequence stars were observed in the bar of the Large Magellanic Cloud during the search for dark matter in the galactic halo. Seven blue stars of apparent visual magnitude 15 to 17 had irregular photometric variations and hydrogen emission lines in their optical spectra, which suggested that these stars are pre-main-sequence stars of about 10 solar masses. These stars are slightly more massive and definitely more luminous than are Herbig AeBe pre-main-sequence stars in our own galaxy. Continued observations of these very young stars from another galaxy, which are probably at the pre-hydrogen-burning stage, should provide important clues about early stages of star formation.

[Pulmonary edema occurring 2 days after elective cesarean section]. / Oedème pulmonaire deux jours après une césarienne réglée.

Two days after an elective Caesarean section, a 30-year-old woman suffered a pulmonary oedema. The diagnosis of cardiomyopathy was obtained with echocardiography, right heart catheterization and a myocardial biopsy. Peripartum cardiomyopathy is defined as a heart failure occurring in the last trimester of pregnancy or up to the third postpartum month and the lack of another etiology. The cause of myocarditis resulting in peripartum cardiomyopathy remains yet unknown. An immunosuppressive therapy can be associated with the treatment of the congestive heart failure.

[Repeated convulsions after abrupt benzodiazepine withdrawal]. / Convulsions itératives après sevrage brutal en benzodiazépines.

Benzodiazepines are widely used and well-known for their safety; serious complications may, nevertheless, occur in the particular case of an abrupt withdrawal, which is quite common after general anaesthesia. The case reported emphasizes the seriousness of the syndrome : after vascular surgery the patient presented with repeated epileptic seizures and a short lasting cardiac arrest. The patient used to absorb large quantities of benzodiazepines, without medical prescription. The convulsions stopped after the benzodiazepine had been taken again. The exact mechanism of the withdrawal syndrome remains hypothetical. There are numerous risk factors which increase the probability and seriousness of the withdrawal symptoms. The prevention of withdrawal accidents depends on the physician, and especially the anesthetist, knowing the patient's drug intake. This shows yet again the importance of the preanaesthetic visit.