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Place of Selective Tubal Catheterization in the Management of Female Infertility in Togo

Open Journal of Radiology 2023年第1期13卷 77-85页

作者： Komlanvi Etteh victor Adjénou Hassiatou Sabi Couscous Ndouandju Saha Kwokwo Kafupi Etsri Wallace Sonhaye Lantam Amadou Abdoulatif Adambounou Kokou Lama Kegdigoma Agoda-Koussema Department of Radiology and Medical Imaging CHU Campus Lomé Togo Center for Radiology and Medical Imaging Clinique Autel d’Elie Lomé Togo Faculty of Health Sciences University of Lomé Lomé Togo

Objective: To determine the effectiveness of selective tubal catheterization in the management of female infertility due to proximal tubal obstruction. Method: This was a longitudinal descriptive study, conducted over a period of 24 months, which included 73 patients presenting with objectified bilateral proximal tubal obstruction after standard HSG. The intervention was performed on an outpatient basis, during the follicular phase with negative β-hCG assay the day before, in the interventional radiology room and under antibiotic coverage. Confirmatory hysterosalpingography was performed as the first step followed by selective tubal catheterization after the failure of spontaneous tubal opacification. The parameters studied related to socio-epidemiological, clinical and radiological data. Results: The age of our patients was between 24 and 42 years with an average of 33.97 years. The average duration of infertility was 3.95 years, with a predominance of primary infertility in 83.56% of cases. Voluntary termination of pregnancy (38.89%) and fibromyomas (33.33%) were the most represented gynecological-obstetrical antecedents. Selective tubal catheterization was successful in 92.14% of cases (129/140 tubes). It was possible bilaterally in 93.02% of cases and unilaterally in 6.98% of cases. The confirmatory HSG allowed a spontaneous opacification of 4.10% of the fallopian tubes. At the end of the procedure, all the recanalized tubes were opacified;62.01% of them were normal, against 37.99% pathological with a preponderance of inflammatory tubes 26.61% followed by hydrosalpinx in 5.03% of cases. No major complications were encountered. The fertility rate was 23.29%. Conclusion: Selective tubal catheterization is a simple technique, without major complications with an efficiency close to natural fertility. It should be proposed as the first intention before any other procedure in the treatment of infertility by proximal tubal obstruction.

关键词： Female Infertility Selective Tubal Catheterization Togo

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Reliability Study of a New Electromechanical Device Designed to Measure the Relative Dorsal Mobility of the First Ray of the Foot

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Open Journal of Orthopedics 2022年第10期12卷 383-392页

作者： Nils Reymond Quentin Praz Spyridon Schoinas Navindravadhanam Sockalingam Antoine Acker victor Dubois-Ferrière Philippe Passeraub Mathieu Assal Centre Assal for Foot and Ankle Surgery Clinique La Colline Geneva Switzerland Institute of Industrial Technologies and Sciences University of Applied Sciences and Arts Western Switzerland (HES-SO Geneva/HEPIA) Geneva Switzerland

Introduction: A new electromechanical instrument has been developed to measure relative dorsal mobility of the first ray in an objective and reliable way by simulating ground reaction forces during gait. This device equally applies a standardized, electronically controlled, and precise force under the first metatarsal head M1 as well as under the heads of the lesser metatarsals M2 to M5. The relative dorsal mobility between these two bearings is then measured. The purpose of this study is to assess the intra- and inter-examiners reliabilities of the measurements obtained with this device. Methods: The protocol included two examiners and 36 feet (18 volunteers with healthy feet and no history of forefoot disorders). A total of nine measurements were performed on each foot separated into three sets of three trials for the assessment of inter-rater and intra-rater reliability. For this purpose, the interclass correlation coefficient (ICC), the error of measurement (SEM) and the Bland and Altman (B&A) graphical analysis were computed. Results: Excellent ICC values (≥0.91) were obtained with the novel device for inter-rater and intra-rater reliability when using the FRRM calculation. The B&A analysis presented a bias between examiners of -0.25 mm ranging from -1.66 to 1.18 mm. Conclusion: This study demonstrated the capability of the developed device to reliably measure the relative dorsal mobility of the first ray of the foot. This is a promising first step for further studies to better understand, qualify and quantify first ray hypermobility.

关键词： First Ray Dorsal Mobility Instability Hypermobility Medical Device Reliability Study Foot

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EGFR Expression Is Unreliable to Decide for Cetuximab Treatment in Patients with Metastatic Colorectal Cancer: Results from “ERBITUX-OUEST”

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Open Journal of Internal Medicine 2016年第2期6卷 56-67页

作者： Jean-Philippe Metges Erick Gamelin Alain Volant Olivier Capitain Jean-François Ramée Jean-Luc Raoul Jean-Yves Douillard Pierre-Luc Etienne Isabelle Cumin Olivier Dupuis Roger Faroux Marie-Aude Coulon Philippe Deguiral Karine Bideau Nacr Eddine Achour Alain Gourlaouen Corinne Alleaume Annie Wdowik Laurent Miglianico Yann Touchefeu Vincent Klein Alain Penchet Ludovic Rosenfeld Daniel Martin Claire Stampfli Jean-Jacques Auger Alain Bargain Murielle Broyer-Petit Jérome Chettrit Louis-Rémi De Ybarlucea Serge Eloit Pierre Marie Girardot Nathalie Heresbach Christian Laboisse Eric Lavoine Gilles Lemasson Claire Magois Sophie Michalak Norbert Padilla Joseph Politis Frédéric Staroz Bruno Turlin Arnaud Uguen Viorel Vasiliu Véronique Verriele Fanny Marhuenda Delphine Déniel Lagadec Christian Riché Françoise Grudé Observatoire dédié au Cancer des régions Bretagne et Pays de la Loire France Centre Hospitalier Régional Universitaire (CHRU) Brest France Institut de Cancérologie de l’Ouest (ICO) Paul Papin Angers France Centre Catherine de Sienne Nantes France CRLCC Eugène Marquis Rennes France ICO René Gauducheau Nantes France Centre CARIO-HCPA Plérin France Centre Hospitalier Bretagne Sud (CHBS) Lorient France clinique victor hugo Le Mans France Centre Hospitalier Départemental (CHD) La Roche-sur-Yon France CH Le Mans France clinique Mutualiste de l’Estuaire Saint-Nazaire France CHIC Quimper France clinique Pasteur Lanroze Brest France CH MORLAIX France CH Saint-Brieuc France CHBA Vannes France CHP Saint-Grégoire France CHU Nantes France Hopital Privé Océane Vannes France clinique Saint-Michel et Sainte-Anne Quimper France Pole Santé Sarthe et Loire La Flèche France Polyclinique du Maine Laval France Polyclinique Sud Quimper France CH Laval France Polyclinique Cesson Sévigné France Laboratoire d’anatomie et de cytologie pathologiques Cholet France Cabinet d’anatomie et de cytologie pathologiques Saint-Malo France Laboratoire d’anatomie et de cytologie pathologiques Lorient France Institut d’histopathologie Nantes France Laboratoire de Pathologie Médicale Laval France ARMOR Pathologie Plérin France Laboratoire d’anatomie et de cytologie pathologiques Rennes France Laboratoire d’anatomie et de cytologie pathologiques Angers France Laboratoire Analyses Biologie Glasgow Brest France CHU Angers France Centre d’anatomie et de cytologie pathologiques Le Mans France Cabinet d’anatomie et de cytologie pathologiques Vannes France Laboratoire d’anatomie et de cytologie pathologiques Quimper France CHU Rennes France

Purpose: Although controversial, assessment of epidermal growth factor receptor (EGFR) expression is required for the approved indications of Cetuximab in metastatic colorectal cancer (mCRC). With the objective of improving patient selection, “ERBITUX-OUEST” study aimed at analyzing EGFR status in a large cohort of mCRC patients who received cetuximab without preliminary EGFR screening, and assessing the correlation between EGFR status and response to treatment retrospectively. Patients and methods: 332 patients treated with Irinotecan Cetuximab based regimen after progression on irinotecan or oxaliplatin therapy were included. EGFR status was assessed using three available immunohistochemistry (IHC) tests and in situ hybridization in case of negativity. Clinical outcomes of EGFR-positive and EGFR-non-detected (or considered as negative with at least one test) patients were compared. Results: Of the 332 samples centrally screened, 194 were classified as full-positive (i.e., EGFR-positive for all three tests), 86 as full-negative, and 52 as discordant. One third of the 131 negative samples with FDA approved test should be reclassified as positive with at least one of the two others tests. Regarding results from FDA approved test only, neither objective response rate (ORR), progression-free survival (PFS) nor overall survival (OS) differed significantly between EGFR-negative and EGFR-positive patients (P = 0.788, 0.326 and 0.888, respectively). Similarly, comparison of full-negative to other groups did not show any significant difference in terms of ORR (P = 0.507), PFS (P = 0.222) or OS (P = 0.686). Conclusion: These data strongly argue against mCRC patients selection for Cetuximab treatment based on EGFR expression as measured by currently available IHC technics.

关键词： Metastatic Colorectal Cancer Cetuximab EGFR Expression

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