[Towards better management for sexual offenders: Presentation and conclusions of a public hearing concerning prevention, assessment, and care]. / Audition publique auteurs de violences sexuelles : prévention, évaluation, prise en charge des 14 et 15 juin 2018 : perspectives et préconisations.

In France, since the law of June 17, 1998, sexual offenders may be convicted to ambulatory mandatory care, articulated with the justice. Twenty years after the implementation of this law, while social and technological developments have redefined certain aspects of delinquency, reference documents and practice guidelines remain to be updated. This is why the professionals of the main structures and associations dealing with perpetrators of sexual violence organized a public hearing under the sponsorship of the French Federation of Resource Centers for Sexual Violence Perpetrators (FFCRIAVS) according to the methodology and with the accompaniment of the High Authority of Health. This article presents the global methodology of the public hearing "Sexual Offenders: Prevention, Evaluation and Care" which was conducted on June 14 and 15, 2018. Thirty-three experts replied to27 questions and presented their conclusions to an Audition Committee and an audience of 200 persons representative of the civil and professional society. After a public debate, the hearing committee prepared a report in which they proposed propositions in order to better care for sexual offenders.

[Female sexuality and parenthood]. / Sexualité féminine et étapes de la parentalité.

From the child conception to the early years of life, couples generally present less sexual activity. Parenthood constraints are a burden for the couple's relationships. Generally, persistent sexual difficulties six months after delivery, despite those generated by depression or altered health raise the question of an alteration in the quality of the couple's relationships and lack of satisfaction of the mother with her partner's involvement in family life. Numerous parameters can be implied, especially with persistent trouble of desire, such as fatigue, body image problems and libido lessening of the partner due to modifications of his status. Women who presented sexual difficulties before pregnancy remain the same. In all cases, appropriate information can avoid the intimacy's difficulties and contribute to maintain pleasure and intimacy even when vaginal penetration remains difficult.

Improved performance on cardiopulmonary exercise testing following DDDR pacemaker adjustment: a case report.

We report a case of improved cardiopulmonary exercise (CPX) test outcomes measured 48 h after initial CPX testing and immediately after alterations were made to the settings of a dual chamber, dual sensing pacemaker with exercise detection. The changes allowed successful abdominal surgery to be completed.

[Women's orgasmic disorders]. / Les troubles de l'orgasme féminin.

OBJECTIVE: To evaluate the clinical presentation of women's orgasmic disorders (OD) and therapeutic options, suggested in the literature. MATERIAL AND METHODS: Review of articles published on this subject in the Medline (Pubmed) database, selected according to their scientific relevance, of consensus conferences and published guidelines. RESULTS: At present it is thought that the orgasm is a potentiality which a woman can learn to develop with experience, and practice over time. Primary anorgasmia in young females (<35 years) is very often due to lack of experience or lack of skill in the partner or partners. Secondary anorgasmia is often linked to difficulties of live, more rarely to problems with the partner. In both cases, informed advice to the patient and her partner can provide simple ways of modifying and diversifying sexual practice, slight changes can be sufficient. For the woman, learning to "let go" is essential. Speaking to the partner can help to eliminate and diversify sexual behaviour which can be responsible for this problem. However, OD, particularly the secondary type, is less attributable to the male performance than to the emotional and affective aspect. Primary anorgasmia, if total, persisting in the mature woman, evokes more structural problems (body image, sexual abuse, guilt…) and requires specialized management. CONCLUSIONS: Currently, female sexual desire is often evoked, however, one woman in four suffers from OD to a greater or lesser extent. Orgasmic dysfunction in women is frequent and is the second most common reason for consulting a sexologist. Evaluating the context is essential to differentiate primary from secondary OD, in order to give an appropriate treatment.

[Sexuality and prostate cancer]. / Sexualité et cancer de la prostate.

INTRODUCTION: All treatments for prostate cancer have a negative impact on sexuality. The objective of this review is to highlight recent developments in the management of sexual dysfunction associated with prostate cancer. MATERIAL AND METHODS: We performed a literature search in the Pubmed database to select relevant articles. RESULTS: There is a specific profile of changes in the fields of sexual, urinary, bowel and general quality of life, according to the treatment modalities chosen. Maintenance of a satisfying sex life is a major concern of a majority of men facing prostate cancer and its treatments. It is essential to assess the couple's sexuality before treating prostate cancer in order to deliver comprehensive information and consider early therapeutic solutions adapted to the couple's expectations. The results of randomized studies show that robotic radical prostatectomy allows a faster recovery of natural erections compared to classic laparoscopy. Active pharmacological erectile rehabilitation (intracavernous injections or phosphodiesterase type 5 inhibitors [PDE5i] on demand, during the month following surgery) or passive (daily PDE5i after surgery) might improve the quality of erections especially in response to PDE5i. Unimpaired aspects of sexual response (orgasm) may, when the erection is not yet recovered, represent an alternative allowing the couple to preserve intimacy and complicity. Androgen blockade is a major barrier to maintain or return to a satisfying sex. CONCLUSION: After the treatment of prostate cancer, one specific support sometimes assisted by networking will optimize satisfying sex life recovery.

[Sexuality and prostate cancer]. / Sexualité et cancer de la prostate.

All treatments of prostate cancer have a negative effect on both sexuality and male fertility. There is a specific profile of changes in the fields of quality of life, sexual, urinary, bowel and vitality according to the treatment modalities chosen. Maintain a satisfying sex is the main concern of a majority of men facing prostate cancer and its treatment. It is essential to assess the couple's sexuality before diagnosis of prostate cancer in order to deliver complete information and to consider early and appropriate treatment options at the request of the couple. Forms of sexuality sexual preference settings stored (orgasm) may, when the erection is not yet recovered, be an alternative to the couple to maintain intimacy and complicity. In all cases, a specific management and networking will in many cases to find a satisfactory sexuality. Consequences of the treatment on male fertility should be part of the information of patients with prostate cancer and their partners. The choice of treatment must take into account the desire of paternity of the couple. A semen analysis with sperm cryopreservation before any therapy should be routinely offered in men with prostate cancer, particularly among men under 55, with a partner under 43 years old or without children. If the desire for parenthood among couples, sperm cryopreservation before treatment and medical assisted reproduction are recommended.

Cardiopulmonary exercise testing predicts 5 yr survival after major surgery.

BACKGROUND: Cardiopulmonary exercise testing (CPET) is used to assess perioperative risk in surgical patients. While previous studies have looked at short-term outcomes, this paper explores the ability of CPET to predict 5 yr survival after major surgery. METHODS: Over a period (1996-2009), 1725 patients referred for CPET subsequently underwent major surgery. Breath-by-breath data derived during each patient's CPET was processed using customized software to extract variables likely to impact on survival. Initial analysis examined the predictive power of single variables. Subsequently, Bayesian model averaging (BMA) was used to construct a multivariate model defining the association between CPET data and 5 yr survival. RESULTS: Six hundred and sixteen (36%) of the study patients died. Single variables were not significantly associated with 5 yr postoperative survival. BMA indicated the following major predictors of 5 yr survival: patient gender; type of surgery, and forced vital capacity. Four variables derived at the patient's anaerobic threshold were weaker predictors. These were end-tidal oxygen concentration, respiratory exchange ratio, oxygen consumption per unit body weight, and oxygen consumption per heart beat. The resulting model was then used to divide patients into low-, medium-, or high-risk categories, and 5 yr survival for each category was 87.8; 75.8, and 53.8% respectively. Survival was independent of patient age. CONCLUSIONS: Multivariate analysis and model generation techniques can be applied to CPET data to predict 5 yr survival after major surgery more accurately than is possible with single variable analysis.

[Female cosmetic genital surgery: point-counterpoint]. / Que penser de la génitoplastie cosmétique féminine aujourd'hui ?

Cosmetic genitoplasty interventions, and especially reduction nymphoplasties, now seem to attract more and more patients, mainly among the younger who are more influenced by widely publicized pornographic than by anatomic reality they hardly suspect. However, they must be informed and warned against the trivialization of a still young surgery, insufficiently justified validated and supervised, especially on the psychological level, and with many unresolved ethical issues.

Cardiac complications and mortality rates in diabetic patients following non-cardiac surgery in an Australian teaching hospital.

This retrospective study of diabetic patients undergoing non-cardiac surgery has identified that a greater number of patients are at risk of cardiac complications and death in the perioperative period than had previously been suggested. As well as insulin-dependent diabetic patients and patients with elevated creatinine (> 178 micromol/l) as previously found, our study suggests that non-insulin-dependent diabetic patients and patients with creatinine > 120 micromol/l are also at increased risk of cardiac complications and death following non-cardiac surgery. This increases by a factor of six those diabetic patients at risk of perioperative complications from non-cardiac surgery and also increases the number of patients with renal failure similarly at risk. The study confirms similar risks of cardiac complications and death to other recently published data and suggests ongoing comparisons will contribute to quality assurance activities in anaesthesia and surgery.

[Couple, ways of couples coping, and erectile dysfunction]. / Couple, conjugalité et dysfonction érectile.

Erectile Dysfunction (ED) is extremely common in men. Erection problems will usually produce a significant psychological and emotional reaction in most men, and their partners. Both are likely to face a drop in sexual quality of life and challenges to their intimate relationship as couples' sexual activities are curtailed by the loss of erectile function. If successful and effective management is to occur, any discussion of treatment should include the couple. ED is a couple's problem and therefore it requires a couple's solution. The quality of relationship is to be improved by couple-centred understanding and solutions.

Hybridization in the section Mentha (Lamiaceae) inferred from AFLP markers.

The amplified fragment length polymorphism (AFLP) method was used to evaluate genetic diversity and to assess genetic relationships within the section Mentha in order to clarify the taxonomy of several interspecific mint hybrids with molecular markers. To this end, genetic diversity of 62 Mentha accessions from different geographic origins, representing five species and three hybrids, was assessed. Three EcoRI/MseI AFLP primer combinations generated an average of 40 AFLP markers per primer combination, ranging in size from 50 to 500 base pairs (bp). The percentage of markers polymorphic ranged from 50% to 60% across all accessions studied. According to phenetic and cladistic analysis, the 62 mint accessions were grouped into two major clusters. Principal coordinates analysis separated species into well-defined groups, and clear relationships between species and hybrids could be described. Our AFLP analysis supports taxonomic classification established among Mentha species by conventional (morphological, cytological, and chemical) methods. It allows the assessment of phenetic relationships between species and the hybrids M. spicata and M. × piperita, largely cultivated all over the world for their menthol source, and provides new insights into the subdivision of M. spicata, based for the first time on molecular markers.