[Hysteroscopic tubal sterilization with Essure® devices: a retrospective descriptive study and evaluation of hypnosis]. / Stérilisation tubaire par voie hystéroscopique avec le système Essure®: étude descriptive et évaluation de l'efficacité de l'hypnose.

OBJECTIVES: The Essure(®) system is a hysteroscopic sterilization method. The aim of our study is to retrospectively evaluate the sterilization procedure with Essure(®) devices, with and without anesthesia, and in particular with hypnosis. PATIENT AND METHODS: The descriptive study includes all tubal sterilization with Essure(®) performed during the year 2009 at the Maternité régionale de Nancy. Hypnosis efficiency is retrospectively evaluated with Verbal Numeric Rating Scale (VNRS) for peroperative pain, and analgesic medication use for postoperative pain. RESULTS: Ninety-four sterilizations are performed, 85% (85/94) of them without anesthesia. The mean VNRS is 3.0. The mean operative time is 8.7 minutes, positively correlated with the VNRS (P=0.0005). The rate of successful insertion is 94%. At 3 months, 91% of the implants have a correct location. Inadequate locations are more frequent when anesthesia have been performed (37% vs 4%, P=0.016). There is no significant difference between groups with and without hypnosis for the VNRS, the failure rate and the use of analgesic medication. CONCLUSION: Tubal sterilization with the Essure(®) system is a quick and efficient method. Our study does not demonstrate efficiency of hypnosis in pain control. This remains to be explored with a prospective study, including others parameters, such as anxiety.

[An isolated vasculitis of uterine cervix and isthmus]. / Une vascularite isolée du col et de l'isthme utérins.

Isolated lesions of vasculitis are described in different organs, notably female genital tract. Exhaustive clinic and paraclinic exams are necessary to exclude an occult systemic vasculitis. We report a case of vasculitis that was restricted to uterine cervix and isthmus, fortuitously discovered by a 45-years-old woman after hysterectomy. At histological examination, necrotizing vasculitis of small and medium-sized arteries was found, suggesting diagnosis of polyarteritis nodosa. There was no argument for systemic vasculitis.

[Determinants of success and recurrence after suburetral free tape procedure for female urinary incontinence]. / Existe-t-il des facteurs pronostiques conditionnant le succès de la chirurgie de l'incontinence urinaire d'effort parbandelette sous-urétrale libre?

OBJECTIVE: To provide a critical assessment on the tension free vaginal tape procedure used to support the urethra in female urinary incontinence. MATERIAL AND METHODS: We identified articles related to Tension free vaginal tape through a MEDLINE search of English published literature from May 1998 to May 2006. Randomised control trial (RCTs) and retrospective clinical trials were selected including 478 publications on TVT (Tension-free Vaginal Tape), 55 on TOT) (Transobturator Tape), 17 on SPARC (Supra Pubic Arc), 2 on TPP) (Pre Pubic TVT). For the analysis of the functional results of the tape were not available: papers with a mean follow-up under 6 months, the invitation papers or non reviewed manuscript, the redundant papers in the same department, specific case control study. RESULTS/DISCUSSION: Preoperative age over 70years old and morbid obesity do not seem to be a risk factor for failure of the TVT procedure; however, there is an increase of de novo urgency for age over 70 years old and BMI over 35. Suburetral tape procedure is highly effective in women with intrinsic sphincter deficiency. The urethral hypermobility increases the efficacy of the procedure, however women with fixed urethra, are at significantly increased risks for failure of the procedure. In the same way, preoperative mixed urinary incontinence and voiding difficulties alter the success rate of the procedure. The mode of anaesthesia and the topography of the tape (retropubic or transobturator) have no incidence on the results. There is a definite learning curve (n=20) for the efficiency and the morbidity of the procedure. Cranial topography of the tape and associated procedures are associated with urgency and voiding difficulties. CONCLUSION: The prognosis factors having an effect on the success of the procedure are the urethral mobility, the mixed urinary incontinence, the learning curve, and the type of protheses.

[Chest pain and sulprostone during postpartum hemorrhage]. / Angor et sulprostone au cours d'une hémorragie de la délivrance.

A case of chest pain in a 31-year-old woman after vaginal delivery with epidural analgesia during sulprostone administration is described. Chest pain occurred shortly after sulprostone was started and disappeared when sulprostone was stopped. Ischaemia related data were negative. Angiographically coronary arteries were normal. Coronary artery spasm aetiology was retained. Sulprostone pharmacology is summarized. Coronary artery effects are compared with literature reports. Recommendations before sulprostone use are underlined.

[Acute salpingitis: current antibiotic protocols]. / Salpingites aiguës: les protocoles d'antibiothérapie modernes.

Nowadays, most patients with uncomplicated acute salpingitis undergo ambulatory treatment. The choice of medications must take features of PID into account: they are mult-microbial infections and a prolonged follow-up is necessary in order to decrease the risk of sequellae. To fulfil these goals, combination of antibiotics are prescribed that are active against C. trachomatis, enterobacteria and anaerobes.

[A Buschke and Lowenstein tumor in a female patient]. / La tumeur de Buschke et Löwenstein. A propos d'un cas féminin.

Although it presents clinically as a malignant formation, the Buschke-Lowenstein tumour is known to be a histologically benign tumour caused by a papillomavirus infection from an condyloma acuminatum. The Buschke-Lowenstein tumour is generally observed in male subjects, usually on the penis, and rarely occurs in women. A female case is reported. In the literature, human papillomavirus 6 is the most common type although types 11, 16 and 18 are also reported. Surgery is the only treatment for this tumour which recurs readily.

[Comparative study of ofloxacin+amoxicillin-clavulanic acid versus doxycycline+amoxicillin-clavulanic acid combination in the treatment of pelvic Chlamydia trachomatis infections]. / Etude comparative des associations ofloxacine+amoxicilline-acide clavulanique versus doxycycline+amoxicilline-acide clavulanique dans le traitement des infections génitales hautes à Chlamydia trachomatis.

OBJECTIVE: To evaluate the efficacy and safety of ofloxacin+coamoxiclav versus doxycycline-coamoxiclav in the treatment of chlamydial pelvic infections. DESIGN: An open, comparative, randomised, monocentric study. SUBJECTS: A hundred and eighteen patients (85 endometritis and 33 salpingitis) were included. Clinical, laparoscopic and bacteriological assessments were performed before treatment. 30.4% of salpingitis were considered as severe (COGIT score > 6). 25.4% of acute pelvic infections were only caused by Chlamydia trachomatis. TREATMENT: A hundred and eighteen patients were treated orally with 3 week combination ofloxacin (200 mg b.i.d.) + coamoxiclav (1 g b.i.d.) (n = 60) or with a 6 week coamoxiclav (1 g b.i.d.) + doxycycline (100 mg b.i.d.) (n = 58). RESULTS: Oral combination ofloxacin-coamoxiclav is as effective as oral combination doxycycline+coamoxyclav with respectively 96.7% versus 96.6% and 100% versus 98.4% satisfactory clinical et bacteriological results.

Determination of chlorinated hydrocarbons introduced into air/acetylene flames by Fourier transform infrared emission spectroscopy.

A Fourier transform spectrometer is used to record the infrared emission from chlorinated hydrocarbons combusted in an air/acetylene flame. In this manner, the chlorinated hydrocarbons are determined by monitoring the infrared emission of hydrogen chloride at 2653 cm(-1). Discussion is presented of the air/acetylene flame background, and the potential spectral interference from the emission of deuterated species. Practical detection limits for chloroform, carbon tetrachloride and methylene chloride in acetone, methanol, and ethanol are solvent independent and are found to be 1.1, 0.80, and 1.0%, respectively. Calibration curves for these three analytes are linear from their detection limits to approximately 55% (v/v). In addition, evidence is presented that flame flicker-noise does not lead to a multiplex disadvantage when the Fourier transform instrument is used for data acquisition.