289 research outputs found
Vincent Lagardère. — Les Almoravides jusqu'au règne de Yusuf b. Tasfin (1039-1106), 1989 (" Hist. et perspectives méditerranéennes ")
No full textPeyronnet Georges. Vincent Lagardère. — Les Almoravides jusqu'au règne de Yusuf b. Tasfin (1039-1106), 1989 (" Hist. et perspectives méditerranéennes "). In: Cahiers de civilisation médiévale, 36e année (n°142), Avril-juin 1993. pp. 196-197
Elementos de dibujo lineal, geometria y agrimensura : dispuestos para todos los sistemas de enseñanza y expresamente escritos para las escuelas de instrucción primaria y las diferentes profesiones que necesitan del dibujo / por J. B. Henry (des Vosges) ; revisados por Thenot ; nueva edicion en francés, traducida por J. B. Peyronnet.
No full textElementos de dibujo lineal, geometría y agrimensura : adaptados para todos los sistemas de enseñanza y expresamente escritos para uso de las escuelas de instrucción primaria y de las diferentes profesiones que necesitan del dibujo
No full textPrevalence, Diagnosis, and Management of Stress Urinary Incontinence in Women: A Collaborative Review
No full textBackground and objective: Stress urinary incontinence (SUI), defined as any involuntary leakage of urine associated with physical activity, remains underdiagnosed and undertreated. This review aims to provide an updated overview of the prevalence, diagnosis, and treatment of SUI in women, drawing upon recent evidence-based literature and clinical guidelines. Methods: A systematic search of the MEDLINE database was conducted to identify only the most up-to-date and relevant studies published up to February 26, 2024, including the reference ESTER systematic review. The search was limited to systematic reviews published in the preceding 1 yr. Any additional included publications were limited to those published or referenced as part of the existing/current guidelines. Key findings and limitations: Diagnosis of SUI involves a comprehensive assessment, including medical history, physical examination, and in some cases, invasive urodynamics. Pelvic floor muscle training emerges as a first-line management strategy, showing efficacy in symptom improvement when good educational instructions and supervision are provided. Surgical interventions with midurethral and single-incision slings offer a second-line option, although concerns regarding mesh-related complications persist with a decrease in its use. Moreover, the long-term efficacy of single-incision slings remains to be confirmed. Urethral bulking agents, colposuspension, and autologous fascial slings are existing alternatives supported by robust evidence, albeit with a different adverse event profile. Management of complicated and severe SUI remains challenging, with autologous fascial sling and artificial urinary sphincters being established treatments, but high-quality data remain lacking. Conclusions and clinical implications: Heightened awareness and accessibility to SUI treatment are imperative to address the gap between prevalence and medical care–seeking behavior. Pelvic floor muscle training and surgical interventions represent key modalities. However, a notable escalation in invasiveness and complication rates when transitioning to surgical interventions is clear and has resulted in a hesitance among patients to proceed along the treatment continuum, particularly in light of mesh-related complications. Ongoing research is necessary to optimize outcomes and ensure patient safety, particularly for complicated SUI where data on comparative effectiveness remain limited
Beyond antimuscarinics. A review of pharmacological and interventional options for overactive bladder management in men
No full textContext: The role of overactive bladder (OAB) treatment in women beyond antimuscarinics has been evaluated extensively. Beta-3 agonists, botulinum toxin-A (BTX-A), and nerve stimulation are indicated in these patients. However, data on male patients in this clinical scenario are scarce. Objective: The aim of this systematic review was to evaluate the evidence on treatment options beyond antimuscarinics in men with OAB. Evidence acquisition: A search of PubMed, EMBASE, Scopus, Web of science, Cochrane Central Register of Controlled Trials, and Cochrane Central Database of Systematic Reviews databases was performed for relevant articles published between January 2000 and October 2020, using the following Medical Subject Headings: “male/man,” “LUTS,” “overactive bladder,” “storage symptoms,” “urgency,” “nocturia,” “incontinence,” “beta-3 agonist,” “PDE-5 inhibitors,” “botulinum toxin,” “sacral nerve stimulation/neurostimulation,” “percutaneous/transcutaneous tibial nerve stimulation,” “PTENS,” and “combination therapy.” Evidence acquisition was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. PROSPERO registration number is CRD42020201223. Evidence synthesis: Overall, 24 studies were retrieved. In male OAB, mirabegron (MIRA) is the most intensively investigated pharmacological option. A pooled analysis of five randomized clinical trials (RCTs), including 1187 patients, concluded that MIRA 50 mg was associated with a greater reduction in frequency versus placebo (–0.37, 95% confidence interval [CI]: –0.74, –0.01, p < 0.05). A pooled analysis of three RCTs, including 1317 male patients, has also shown that the addition of MIRA 50 mg in men receiving the α1-blocker tamsulosin improved the mean number of micturitions per day (–0.27, 95% CI: –0.46 to –0.09, p < 0.05), urgency episodes (–0.50, 95% CI: –0.77 to –0.22, p < 0.05), total OAB symptom score (–0.66, 95% CI: –1.00 to –0.38, p < 0.05), and mean volume voided (+10.76 ml, 95% CI: 4.87–16.64, p < 0.05). MIRA treatment is well tolerated in men. Other pharmacological treatment options, such as phosphodiesterase-5 (PDE-5) inhibitors, should be considered investigational. BTX-A seems to be effective as third-line treatment in male OAB patients. A higher rate of intermittent self-catheterization (5–42%) is observed in male than in female patients. Data on nerve stimulation are scarce. Conclusions: MIRA has the most robust data in terms of safety and efficacy in this patient population. Preliminary data in men suggest that BTX-A is indicated as an interventional treatment. Evidence for PDE-5 inhibitors and nerve stimulation is too limited to provide recommendations. Future studies in this population should aim to better define the best treatment sequence and to identify predictors for treatment response and failure, to determine a therapeutic approach tailored to patients’ characteristics. Patient summary: Overactive bladder is highly prevalent in men. Mirabegron 50 mg is the treatment option supported by the highest level of evidence when antimuscarinics failed. Botulinum toxin A injections seems to be an effective treatment as interventional option. Roles of nerve stimulation and phosphodiesterase inhibitors in male OAB patients are still to be defined
Elementos de dibujo lineal, geometria y agrimensura : adoptado en todos los sistemas de enseñanza y espresamente escrito para uso de la escuelas primarias de los pueblos ...
No full textReply to Satoshi Funada, Takashi Yoshioka, and Yan Luo's Letter to the Editor re: Cosimo De Nunzio, Benjamin Brucker, Thomas Bschleipfer, et al. Beyond antimuscarinics: a review of pharmacological and interventional options for overactive bladder management in men
No full textour
review covers a highly relevant clinical topic that has not
been summarised in such depth before and it provides upto-date information for clinicians (as acknowledged by
Funada et al). We strongly believe, for the aforementioned
reasons, that the methodological points raised by the
Funada et al have no impact on the validity of our
conclusions
Syndrome douloureux vésical : Deux phénotypes à distinguer
No full textNational audienceBLADDER PAIN SYNDROME. Bladder pain syndrome (BPS), often associated with other pelvic pain syndromes, is defined as perceived chronic pain or discomfort related to the bladder, associated with other urinary symptoms such as pollakiuria or a constant urge to urinate, in the absence of organic pathology. It more often affects women. Assessment is clinical, including a voiding schedule and standardized questionnaires measuring impact on quality of life. The key examination is cystoscopy, under local or general anaesthetic, to rule out the differential diagnosis of bladder tumour and separate VDS into two entities or phenotypes: hypersensitive bladder, with no lesion of the bladder wall, and \"interstitial cystitis\" with parietal lesion, characterized by the presence of specific histological and sometimes endoscopic lesions such as Hunner’s ulcerations. Pathophysiology is thought to differ between these entities, involving multiple factors such as inflammation, autoimmunity, infection, environment, urothelial barrier dysfunction, pelvic or central sensitization and extra-vesical disorders. BPS requires comprehensive, multidisciplinary patient management. The first line of treatment usually includes cystoscopy with hydrodistension in the case of parietal forms, introduction of amitriptyline, physiotherapy, diet and TENS (Transcutaneous Electrical Nerve Stimulation). A better understanding of the underlying mechanisms would enable us to propose an even more individualized treatment, specific to the BPS phenotype.SYNDROME DOULOUREUX VÉSICAL. Le syndrome douloureux vésical (SDV), souvent associé aux autres syndromes douloureux pelviens, est défini comme une douleur ou un inconfort chronique en relation avec la vessie, associé à d’autres symptômes urinaires tels qu’une pollakiurie ou une envie permanente d’uriner, en l’absence de pathologie organique. Il touche plus souvent les femmes. Le bilan clinique comprend un calendrier mictionnel et des questionnaires standardisés mesurant l’impact sur la qualité de vie. L’examen clé est la cystoscopie, sous anesthésie locale ou générale, permettant d’éliminer le diagnostic différentiel de tumeur de la vessie et de séparer le SDV en deux entités ou phénotypes : la vessie hypersensible, sans lésion de la paroi vésicale, et la « cystite interstitielle », avec lésion pariétale, caractérisée par la présence de lésions histologiques spécifiques et parfois endoscopiques type ulcérations de Hunner. La physiopathologie serait différente entre ces entités, impliquant de multiples facteurs, tels que l’inflammation, l’auto-immunité, les infections, l’environnement, une dysfonction de la barrière urothéliale, la sensibilisation pelvienne ou centrale et les troubles extravésicaux. Le SDV nécessite une prise en charge globale et multidisciplinaire. La première ligne de traitement comprend habituellement une cystoscopie avec hydrodistension en cas de forme pariétale, l’introduction de l’amitriptyline, la kinésithérapie, un régime alimentaire et la TENS transcutaneous electrical nerve stimulation, neurostimulation électrique transcutanée). Une meilleure compréhension des mécanismes sous-jacents permettrait de proposer un traitement encore davantage individualisé, spécifique du phénotype de SDV
Volume 16, No. 1
No full textAuriac-Peyronnet, Emmanuelle and Marie-France Daniel. “A Case Study of Pupils Aged 11 and 12 Years.” 23-31.
Hall, Darcy. “Is Elfie a Human or a Rabbit?” 49-50.
Kohan, Walter. “Education, Philosophy and Childhood: The Need to Think an Encounter.” 4-11.
Lushyn, Pavel. “The Paradoxical Nature of Eco Facilitation In the Community Of Inquiry.” 12-17.
Matthews, Gareth B. “Thinking in Stories: The Little Prince by Antoine de SaintExupery.” 1.
Sukhomlinska, Olga. “Philosophizing with Children In soviet Ukraine: The Heritage of Vasyl Sukhomlinky.” 42-48.
ThayerBacon, Barbara. “An Exploration of Myles Horton’s Caring Reasoning at Highlander Folk School.” 32-41.
Vazquez, Stella Maris. “Argumentative Text: An Instructional Proposal.” 18-22
Néphrectomie partielle dans les indications électives : jusqu’ou doit-on aller ? [Elective partial nephrectomy: How far should we go?]
No full textNational audienceno abstrac
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