Gynecologie Obstetrique & Fertilite最新文献

The oocyte grows within a follicle composed of layers of somatic cells. It undergoes with the cumulus cells that form the innermost layer a dialogue that is critical for its maturation. Based on the assumption that the transcriptome of the cumulus cells reflects the physiology of the oocyte, it may prove a useful non-invasive tool in embryo selection to improve assisted reproduction outcomes. During the past decade, various studies have been conducted with the objective of identifying cumulus biomarker genes as prognosis tools for oocyte quality and competence. Remarkably no common biomarkers stand out among all these studies. In this review we perform a critical analysis of the literature in order to reveal some of the parameters that may account for these discrepancies, such as patients’ inclusion criteria (maternal age, stimulation protocols), day of embryo transfer (day 3 or 5), outcome criteria (oocyte potential, embryo competence, pregnancy). Moreover there is a lack of standardization in the experimental designs used for RNA extraction and gene expression assessment (microarrays, RT-qPCR) and for the statistical analyses. In conclusion, critical analyses such as the present one are indispensable to pave the way for future searches of predictive biomarkers of pregnancy.

Objectives

Male breast cancer is rare; it constitutes 0.2–1.5 % of all malignant tumors in men and 1 % of all breast cancers.

Methods

The goal of this retrospective study is to analyze the epidemiologic, clinic, therapeutic and evolutive profiles of this disease in 140 cases collected at the National Institute of Oncology and military hospital in Rabat, Morocco, between the years 1998 and 2007.

Results

The mean age was 61 years. A high incidence of overweight was found. The most frequent clinical presentation was a firm subareolar lump in 83 % of cases. The most common pathological type was an infiltrating ductal carcinoma (93 %). Hormone receptors were positive in 86 % of cases. Eighty-five percent of patients underwent simple mastectomy and axillary dissection, 68 % chest wall irradiation after surgery, 54 % received chemotherapy and 82 % hormonal therapy. Median follow-up was 91.1 months. The estimated 5-year and 10-year overall survival was respectively 68 % and 74 %.

Conclusion

The management of male and female breast carcinoma is the same, as well as their prognosis at equal stages. Future research for better understanding of this disease are needed to improve the management and prognosis of male patients.

Participation in recreational physical activity is widely acknowledged to provide significant health benefits. Conversely, intense training imposes several constraints, such as intermittent or chronic metabolic and psychogenic training stressors and maintenance of very low body fat to maximize performance. Adolescent and adult athletic women are therefore at risk of overtraining and/or poor dietary intake, which may have several consequences for endocrine function particularly on hypothalamic-pituitary-gonadal axis. Female athletes, particularly those participating in sports needing leanness or low body weight, present a high prevalence of menstrual disorders with clinical manifestations ranging from delayed menarche, oligomenorrhea to primary and secondary amenorrhea. A high degree of variability according to the type of sport and the intensity of the practice is however observed. Exercise-related reproductive dysfunction may have some consequences for growth velocity and peak bone mass acquisition during adolescence and bone pathologies in adults. Recent findings highlight the endocrine role of adipose tissue and energy balance in the regulation of homeostasis and reproductive function. A better understanding of the mechanisms whereby intense training affects the endocrine systems may orient research to develop innovative strategies probably based on individualized nutritional approach to improve the medical care of these female athletes and protect their reproductive function.

Anemia of prematurity remains a common complication despite recent advances in perinatal and neonatal medicine. The delayed cord clamping (at least 30 seconds as recommended) has several benefits: increased hemoglobin and hematocrit levels at birth, improved initial hemodynamic, decreased incidence of transfusions and intraventricular hemorrhages. When the birth transition is difficult, wait 30 seconds before clamping can be impossible. So as not to interfere with the neonatal resuscitation, the “milking” has been proposed as an alternative method to the delayed cord clamping. This is a safe and easy method, which can be done either by an obstetrician or pediatrician with comparable results for the child on his hemodynamic, hematological and neurological status. It still lacks technical information on this method and neurodevelopmental outcomes of these preterm infants.