[Contribution of the pre-operative Mri-coloscan couple in the surgical planning of deep digestive pelvic endometriosis]. / Apport du couple IRM-coloscanner pré-opératoire dans la planification chirurgicale de l'endométriose digestive.

INTRODUCTION: The digestive involvement of endometriosis accounts for up to 20-25% of deep localisations. Precise mapping of digestive lesions is essential in order to plan surgery and specialized teams. The aim of this study is to assess the contribution of the MRI-coloscan couple in the preoperative assessment of digestive endometriosis. METHODS: We analyzed 45 files of patients referred for suspected digestive endometriosis. They had all undergone a preoperative MRI and coloscan associated with surgery throughout the year. We first compared the data collected in imaging, and then compared the synthesis of this data with the surgical procedure performed. RESULTS: 35 patients required digestive surgery. 24 of 45 files were concordant in MRI and coloscanner. Data from MRI alone matched with surgery in 69% of cases, against 84% for the coloscan. The synthesis allowed a concordance of 89%. 25 segmental resections, 2 discoid and 16 shaving were performed. The use of coloscan made up for nine extra cases: the detection of four additional cases of multifocality, a single undiagnosed case of a deep lesion, and allowed to specify the depth of the involvement in four cases. On the contrary, the MRI was correct compared to the CT in four cases. The presence of a digestive surgeon was necessary in 53% of cases. CONCLUSION: In the era of imaging staging, it would seem interesting to turn towards a subclassification of the digestive involvement of endometriosis in order to decide which surgery to perform. In our experience, the coloscan is a useful complement of MR, especially to assess the depth of involvement and the multifocality.

Increased incidence of cholecystectomy related to gallbladder disease in France: Analysis of 807,307 cholecystectomy procedures over a period of seven years.

PURPOSE: Gallstones are one of the most common abdominal reasons for admission to hospital. The aim of this study was to analyze trends and outcomes in patients undergoing cholecystectomy with gallbladder related disease in France from 2008 to 2014. PATIENTS AND METHODS: We carried out a population-based, retrospective cohort study using data extracted from the French nationwide hospital discharge database (PMSI). We included all patients having a cholecystectomy related to gallbladder disease from January 2008 to December 2014. Patients' demographics, primary diagnosis, procedure type, length of stay (LOS), admission in an intensive care unit, discharge disposition, complications, and in-hospital mortality were analyzed. RESULTS: Overall, 807,307 cholecystectomies were performed in France over the study period, with an increase in the national incidence rate from 167.5 (95%CI [166.5; 168.5]) to 182.6 (95%CI [181.6; 183.6]) per 100,000 inhabitants. Females accounted for 66.5% of procedures (P<0.001). The mean age was lower for females than for males: 52.1 versus 60.2 (P<0.001). The ratio of laparoscopic cholecystectomy significantly increased from 90% in 2008 to 94% in 2014 (P<0.001). Average inpatient LOS decreased significantly from 6.5 days in 2008 to 4.7 days in 2014 (P<0.001). Most common complication type was intra-abdominal (23.1%) for laparoscopic procedure (95%CI [22.7; 23.5]), and in-hospital mortality significantly decreased over time from 0.45% in 2008 to 0.38% in 2014 (P<0.005). CONCLUSION: Our results showed that the national incidence rate of cholecystectomy related to gallbladder disease increased from 2008 to 2014.

Novel tetra-propyl/butylammonium encapsulated Keggin-type polyoxotungstates: synthesis, structural characterization, and catalytic capability in oxidative cleavage of unsaturated fatty acids.

Four tungsten oxide (TO)-based catalysts, (1) TO (without any organic moiety), (2) TO-TMA, (3) TO-TPA, and (4) TO-TBA (TMA: tetramethylammonium, TPA: tetrapropylammonium, and TBA: tetrabutylammonium cations) were straightforwardly prepared via a mild hydrothermal approach, based on oxidative dissolution of tungsten bare powder, followed by a facile encapsulation of the tetraalkylammonium cations (NR4+). The significant impact of the NR4+ cations on crystallization of the amorphous and metastable peroxotungstic species, formed during the synthesis, has been discussed through different characterization techniques including XRD, FTIR, TGA and DTG, TEM, EDS, N2 adsorption/desorption isotherms, zeta potential measurement, and elemental analysis. TO-TPA and TO-TBA were composed of two novel hybrid inorganic-organic polyoxotungstates, [(CH3CH2CH2)4N]2.75[H5.25W12O40]·7.42H2O and [(CH3CH2CH2CH2)4N]3.31[H4.69W12O40]·1.08H2O, respectively. The capability of the synthesized catalysts in oxidation of unsaturated fatty acids (UFAs) has been examined in the reaction of oleic acid, the most abundant UFA, with H2O2. This is the first report on employing heterogeneous Keggin clusters of tungsten oxide in the oxidative cleavage of UFAs. The catalysts exhibited excellent efficiencies, particularly TO-TPA and TO-TBA, owing to the strong and organo-protected acidity of their Keggin structures, which resulted in full conversion of oleic acid and superior yields of the desired products. Despite their pseudo-homogeneous behavior in the reaction, the NR4+-encapsulated catalysts demonstrated efficient recovery and steady reusability without any significant decay in their activities up to at least 4 cycles.