Distinct Profiles of Consumers of Psychoactive Substances in People Attending French Sexual Transmitted Infections Centers.

The objective of this cross-sectional survey was to assess the prevalence of psychoactive substance use (PSU) in people attending 11 French Sexual Transmitted Infection Centers, and to specify their profiles (PSU and link with risky sexual behaviors) using the ascending hierarchical clustering method. Among the 5220 individuals who completed the survey, 55.6% were men and the median age was 24 years [IQR: 20-31]. Among the participants, 2751 (52.7%) reported PSU at least once in their life. Ascending hierarchical clustering identified seven distinct profiles of participants based on their PSU. This study shows a high prevalence of PSU and alcohol consumption in this young population. Moreover, subgroup analysis allowed identifying groups of psychoactive substance users who presented specific risks or vulnerabilities and who should be priority targets for interventions, particularly sexual minority groups.

[Role of medical treatment for symptomatic leiomyoma management in premenopausal women]. / Place des traitements médicaux : indication, durée, efficacité, chez la femme porteuse de fibromes utérins symptomatiques en période d'activité génitale.

The most frequent symptom with leiomyoma is menometrorrhagia. However, it can be responsible of pelvic pain, dysmenorrhea or urinary and digestive compression when it is particularly voluminous. These recommandations were made in order to review medical management of fibroids. If no therapy is able to have them disappear, various drugs may reduce their related symptoms. Tranexamic acid, non-steroidal anti-inflammatory drugs and high dose of oestrogen may be useful in the management of acute hemorrhagic disorders. Progestin, such as lynestrenol induces small reduction in leiomyoma volume and moderate increase in hemoglobin level before surgery. Pregnane and nor-pregnane may improve menstrual bleeding in short or mild delays. The use of Gonadotropin Releasing Hormone (GnRH) agonists can reduce menstrual bleeding with hemoglobin recovery. Add-back therapy using tibolone seems interesting since secondary effects encountered with GnRH agonists may be reduced. Levonorgestrel-releasing intrauterine system is proven to reduce increased menstrual bleeding and restore hemoglobin level. Aminoglutethimide and fadrozole have been underevaluated to conclude when letrozole seems as efficient as GnRH agonists to reduce leiomyoma volume and provide less hot flushes. Anastrozol is associated with reduction in leiomyomata volume, pain and menstrual bleeding. Mifepristone reduces the size of uterine leiomyomata, improves symptomatology, but could be associated with development of endometrial hyperplasia. SPRM evaluated in females have shown to improve leiomyoma related symptomatology. Danazol could be useful to reduce leiomyoma related symptoms in short terms. Tamoxifen and raloxifen show modest overall benefit. Because of insufficient data concerning fulvestrant, pirfenidone or interferon, their prescription cannot be recommended in patients with leiomyomata.

[The menopause. Therapeutic regimens]. / Ménopause. Les schémas thérapeutiques.

The author considers successively the hormonal and non-hormonal treatments of menopausal disorders in isolating the different therapeutic schemes adapted to different types of anomaly.

[Abdominal forms of Castleman's disease]. / Formes abdominales de la maladie de Castleman.

Two cases of Castleman's disease (angiofollicular lymphoid hyperplasia) with abdominal localisation are reported. The first case was a mesenteric localisation with compressive symptoms in a sixty year-old patient; its histological type was hyalino-vascular; the evolution was favorable one year later following cobaltherapy; but ultimately pathological examination of a peripheral lymph node led to the discovery of a malignant nodular lymphoma of the follicular center cell type. The second case involved the retroperitoneal space with multiple lymph nodes and IgA dysglobulinemia in a 49 year-old patient; its evolution was favorable as judged six months after surgical resection. Twenty cases of mesenteric and thirty one of retroperitoneal involvement of Castleman's diseases have been previously reported. The nosology and pathogenesis of this disease remain unclear.

[Bilharzial myelopathies (case report) (author's transl)]. / Les myélopathies bilharziennes (à propos d'une observation).

Report of a case of biharzial myelitis appearing 6/8 weeks after bathing in an infected river. Recovery was complete after medical treatment with niridazol and hycanthone. The authors review the 47 detailed cases previously reported, selected among 60 cases observed from 1905 to 1963. They consider the clinical and pathological aspects and discuss the various pathogenic problems. Treatment requires specific antibilharzial compounds and anti-inflammatory drugs and, in compressive forms, sometimes surgery.

[Plasma prolactin, progestrone and oestradiol during labour and postpartum (author's transl)]. / Prolactine, progestérone et oestradiol plasmatiques au cours de l'accouchement et du post-partum.

The changes in the levels of plasma prolactin, progesterone and oestradiol were studied in 20 women during labour and immediately after delivery. The study of these levels shows that there is a mechanism for inhibiting the galactopoietic action of prolactin. Lifting this inhibition allows the milk to come in. This inhibition is probably due to circulating steroids, but this study does not allow us to differentiate clearly between the respective roles of oestradiol and progesterone, chiefly because of their short half-life.