Laparoscopic repair of an incomplete post obstetrical uterine rupture. About one case

The rate of incomplete uterine ruptures is unknown. These ruptures are usually asymptomatic but may cause chronic pelvic pain and/or intermenstrual bleeding. The conservative surgical repair techniques described in the literature are often practised by vaginal, combined (vaginal and laparoscopic) or hysteroscopic way. We propose an exclusive laparoscopic repair technique with satisfactory anatomical and functional short-term results.     

Socio-economic inequalities in cancer survival: how do they translate into Number of Life-Years Lost?

Background We aimed to investigate the impact of socio-economic inequalities in cancer survival in England on the Number of Life-Years Lost (NLYL) due to cancer.Methods We analysed 1.2 million patients diagnosed with one of the 23 most common cancers (92.3% of all incident cancers in England) between 2010 and 2014. Socio-economic deprivation of patients was based on the income domain of the English Index of Deprivation. We estimated the NLYL due to cancer within 3 years since diagnosis for each cancer and stratified by sex, age and deprivation, using a non-parametric approach. The relative survival framework enables us to disentangle death from cancer and death from other causes without the information on the cause of death.Results The largest socio-economic inequalities were seen mostly in adults <45 years with poor-prognosis cancers. In this age group, the most deprived patients with lung, pancreatic and oesophageal cancer lost up to 6 additional months within 3 years since diagnosis than the least deprived. For most moderate/good prognosis cancers, the socio-economic inequalities widened with age.Conclusions More deprived patients and particularly the young with more lethal cancers, lose systematically more life-years than the less deprived. To reduce these inequalities, cancer policies should systematically encompass the inequities component.Subject terms: Cancer epidemiology, Health policy, Prognosis, Epidemiology, Cancer     

Le défaut de soutien familial dans l’immédiat post-partum : quels impacts sur l’émergence de la détresse maternelle ?

Aim of the study

This study aims to evaluate the impact of the lack of family support in post-partum on the maternal psychic state and its evolution, 6 months after the childbirth.

Autisme et médiation thérapeutique avec le cheval monté à cru. Amplification de la qualité paternelle du holding et éclosion d’un moi-corporel

This clinic research focuses on subjects with autistic disorders, which perform equitation therapy sessions. Early work has shown the interest of the horse as a therapeutic mediation for situation with autism. Indeed, the horse favors in a suitable relational framework sensory experiences that are likely to support the construction of body's image and symbolizing effects. Our hypothesis relates specifically to the contact of the rider with the animal. The raw lift (without saddle) would sustain, through its behavioral and psychic potentialities, a gathering of the image of the body. The subject followed is 17 years old and is called Yohan. The weekly equine therapy sessions were held over six months. The clinical material results from careful observations, which were subsequently analyzed. A longitudinal assessment is performed with the Psychodynamic Assessment Scale of Changes in Autism (EPCA, Haag et al.). The analysis of the therapeutic process is then discussed with that of two other autistic subjects who benefited from this same therapeutic mediation. This study shows the value of mediation with the horse and especially the interest of the riding without saddle. The experiences gained would in this context have repercussions on the gathering of their body image, their psychic envelopes and on their internal security.     

Trends in survival after cancer diagnosis among HIV‐infected individuals between 1992 and 2009. Results from the FHDH‐ANRS CO4 cohort

Although the decline in cancer mortality rates with the advent of combination antiretroviral therapy (cART) in HIV‐infected individuals can be mostly explained by a decrease in cancers incidence, we looked here if improved survival after cancer diagnosis could also contribute to this decline. Survival trends were analyzed for most frequent cancers in the HIV‐infected population followed in the French Hospital Database on HIV: 979 and 2,760 cases of visceral and non‐visceral Kaposi's sarcoma (KS), 2,339 and 461 cases of non‐Hodgkin lymphoma (NHL) and Hodgkin's lymphoma (HL), 446 lung, 312 liver and 257 anal cancers. Five‐year Kaplan–Meier survival rates were estimated for four periods: 1992–1996, 1997–2000, 2001–2004 and 2005–2009. Cox proportional hazard models were used to compare survival across the periods, after adjustment for confounding factors. For 2001–2004, survival was compared to the general population after standardization on age and sex. Between the pre‐cART (1992–1996) and early‐cART (1997–2000) periods, survival improved after KS, NHL, HL and anal cancer and remained stable after lung and liver cancers. During the cART era, 5‐year survival improved after visceral and non‐visceral KS, NHL, HL and liver cancer, being 83, 92, 65, 87 and 19% in 2005–2009, respectively, and remained stable after lung and anal cancers, being 16 and 65%, respectively. Compared with the general population, survival in HIV‐infected individuals in 2001–2004 was poorer for hematological malignancies and similar for solid tumors. For hematological malignancies, survival continues to improve after 2004, suggesting that the gap between the HIV‐infected and general populations will close in the future.