Reduced nondominant lumbar multifidi cross-sectional area is a precursor of low back injury in cricket fast bowlers.

Asymmetry in the lumbar multifidi muscle (LM) cross-sectional area (CSA) is associated with low back injury. The aim of this prospective cohort study was to investigate the symmetry of the CSA of LM at L3, L4, and L5, in the context of simultaneous injury monitoring. Injury free, male, right-handed cricket fast bowlers playing at a nonprofessional level participated in this study. LM CSA at L3, L4, and L5 vertebral levels was measured through the use of ultrasound imaging in prone. The primary outcome measure of the study was the incidence of an injury during a cricket season of eight-month duration. Twenty-six fast bowlers (aged 21.8 ± 1.8 years) participated. No difference was found between the nondominant and the dominant LM CSA among injury free bowlers (P>.05). However, in bowlers who sustained a lower back injury during the cricket season, the nondominant CSA at L3 (nondominant median 5.80 cm2 , range 3.69 cm2 ; dominant median 7.38 cm2 , range 2.61 cm2 ; P=.04) and L5 (nondominant median 6.94 cm2 , range 2.10 cm2 ; dominant median 7.38 cm2 , range 3.54 cm2 ; P=.04) is smaller compared to the dominant side. These findings may indicate that a side-to-side difference in LM CSA may be a precursor of injury.

[Laparoscopic radical prostatectomy in the elderly (>75 years old): oncological and functional results]. / Prostatectomie radicale laparoscopique chez la personne âgée (>75ans): résultats carcinologiques et fonctionnels.

OBJECTIVE: Prostate cancer incidence increases with age. Radical prostatectomy (RP) seems to be feasible for elderly well-selected patients. We report our experience with patients older than 75 years old who underwent laparoscopic RP. METHODS: From 2000 to 2007, 22 patients older than 75 years old at time of surgery were included in the study. The patient clinical characteristics, the peri- and postoperative data, and the pathological data were collected retrospectively. The overall, specific and PSA-free survival were analysed with Kaplan-Meier method. The functional results such as continence and erectile function were assessed by self-questionnaires. RESULTS: The mean patient age was 75 years (75-81), the median PSA level was 10.77 ng/ml (5-30). The mean American Society of Anesthesiologists score was 2.1 (2-3). Two (9%) perioperative complications occurred but no conversion was necessary. Five patients (23%) had a pT3 disease and the overall positive surgical margins rate was 14%. With a median follow-up of 42 months, no patient has died and five had a biochemical recurrence. At 12-month follow-up, 82% of patients were continent (no pad) and potency (erection sufficient for intercourse) rate was 36% with or without the use of phosphodiesterase-5 inhibitors. CONCLUSION: Laparoscopic RP is feasible for localized prostate cancer in elderly well-selected patients with satisfactory oncological and functional outcomes although the incontinence rate is increased comparing to younger patients.

[Impact of radiotherapy on fertility in female patients]. / Impact de la radiothérapie sur la fertilité féminine.

Although insufficiently documented, the impact of radiation therapy on fertility should not be neglected in female patients. Toxicity on reproductive function is dual and is characterized by both mechanistic deleterious effects on the genital tract and partial or complete loss of ovarian function. Moreover, gonadic toxicity may be increased by the concurrent use of chemotherapy or surgical procedure. In some circumstances, ovarian transposition may be justified for young patients. But no compromise may be accepted in terms of carcinologic results. At least, the effect of low-doses of irradiation has not been demonstrated for extra-pelvic radiotherapy.

[A rare case of primitive prostatic large B-cell lymphoma and review of literature]. / Un cas rare de lymphome B diffus primitif de la prostate et revue de la littérature.

Primary malignant non-hodgkin lymphoma involving the prostate is rare. Most of the time, it is associated with extraprostatic disease. We report a case of a 72-year-old patient presenting with acute lower urinary tract irritative symptoms, due to large B-cell lymphoma limited to the prostate. Combination of chemotherapy with extern beam radiotherapy provided long-term local control.

[Value of the informed consent in digestive surgery? Prospective study 259 cases]. / Le consentement éclairé: quelle est sa valeur en chirurgie digestive? Etude prospective sur 259 cas.

SITUATION: In 1997 the Supreme Court of Justice decreed that "the doctor is responsible for giving his patient certain information and is obliged to prove that the information has been given". French surgical societies recommend using a form of informed consent signed by the patient applicable to all practices. AIMS: To evaluate a step taken systematically since 1999 in our department. PATIENTS AND METHODS: A prospective study was put into place for 259 patients candidate for elective surgery. All patients signed and returned the "informed consent" before surgery. The day of leaving the hospital, they answered a post-operative questionnaire to evaluate what they remembered of the "informed consent form" and the quality of information. RESULTS: Ninety three per cent of them remembered it. Eight per cent signed it without reading it. Eighty two per cent of the patients think that this document is useful for their medical records. Among the patients who did not read the informed consent form: 38% wished it gave more information, whereas only 16% of those who had read it, considered the given information inadequate. This difference is statistically (p=0.03) significant. CONCLUSION: The informed consent form gives a lot of information to the patients, but the surgeon is still obliged to do likewise. Patients who did not read the consent were less satisfied with the given information than those who had read it. The positive reaction of the patients in favour of the form makes it evident that the existence of the form reassures them.