Publications by authors named "S Moret"

110 Publications

Glue mesh fixation in laparoscopic sacrocolpopexy: results at 3 years' follow-up.

Int Urogynecol J 2021 Mar 20. Epub 2021 Mar 20.

Centre Hospitalier Lyon Sud, Service de Chirurgie Gynécologique, Chemin du Grand Revoyet, 69495, Pierre Bénite, France.

Introduction And Hypothesis: We assessed 3-year anatomic and functional results using synthetic glue to fix mesh in laparoscopic sacrocolpopexy.

Methods: Prospective multicenter cohort study in three academic urogynecology departments. Seventy consecutive patients with stage ≥ 3 POP-Q (Pelvic Organ Prolapse Quantification) anterior and/or apical prolapse underwent laparoscopic sacrocolpopexy using synthetic surgical glue to fix anterior and posterior meshes to the vagina. Patients were followed up at 1, 2 and 3 years. Primary outcome was anterior and apical anatomic success (POP-Q stage ≤ 1) at 3 years. Secondary outcomes comprised functional results (international quality of life and sexuality scales), mesh-related morbidity and urinary incontinence at 3 years.

Results: Mean age was 56.7 ± 1.2 years. Mean follow-up was 43 months. Anterior compartment anatomic success rate was 87% at 2 years (Ba, -2.4 cm; p < 0.0001) and 86.5% at 3 years (Ba, -2.3 cm; p < 0.0001); apical success was 96.3% at 2 years (C, -6.8 cm; p < 0.0001) and 97.3% at 3 years (C, -6.5 cm; p < 0.0001). All quality-of-life scores improved significantly and lastingly at 3 years: PFDI-20, PFIQ-7 and PISQ-12, respectively, p < 0.0001, p < 0.0001 and p = 0.01. There was one case of vaginal mesh exposure at 3 years (2.8%) and five of mesh shrinkage at 1 year (7.8%), none at 2 years and two at 3 years (5.4%). Urinary incontinence rate was 29.7% at 1 year, 14.8% at 2 years and 11.1% at 3 years.

Conclusion: Vaginal mesh adhesive in laparoscopic sacrocolpopexy remained effective at 3 years, with excellent tolerance and no specific complications. Anatomic and functional results were good and enduring in terms of both anterior and apical correction.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
March 2021

[Impact of the healthcare pathway on the rate of obstetrical interventions in small for gestational age fetuses (IATROPAG Study)].

Gynecol Obstet Fertil Senol 2021 Mar 4. Epub 2021 Mar 4.

Hospices Civils de Lyon, Département de gynécologie obstétrique, Hôpital Femme Mère Enfant, Centre Hospitalo-Universitaire, 59, boulevard Pinel, 69500 Bron, France; Université de Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, 69008 Lyon, France. Electronic address:

Background: While previous studies have demonstrated an improvement in implementation of clinical practices and an improved neonatal prognosis when growth restricted fetuses were followed within a standardized healthcare pathway, the objective of this study was to assess the prevalence of obstetric interventions in small-for-gestational-age (SGA) fetuses followed within a standardized care pathway compared to a traditional care pathway.

Methods: We conducted a retrospective study between 2015 and 2017, in a type III maternity hospital in Lyon, in a population of SGA fetuses, considered as such in case of antenatal diagnosis of fetal weight<10th percentile but>3rd centile without umbilical Doppler abnormality during antenatal surveillance and without ultrasound argument suggesting intrauterine growth retardation (IUGR). We collected the gestational age at diagnosis, obstetrical events and prevention of preterm delivery (antenatal corticosteroids), gestation age at birth, the method of delivery (spontaneous or induced), indication of induction, the method of birth (spontaneous, instrumental extraction or caesarean section), and the immediate neonatal outcome including cord pH, Apgar score at 5minutes, birth weight and fetal sex. After diagnosis, the choice of the pathway was left to the practitioner depending on their habit, their ability to manage the follow-up and their organizational constraints.

Results: Over the study period, and after exclusion of IUGR, 96 SGA were followed up in the traditional pathway and 106 SGA were followed up in the standardized pathway P=0.75. The traditional pathway showed in multivariate analysis a higher prevalence of antenatal corticosteroid therapy for SGA (16,6%) between 2015 and 2017 with OR 7.3 95% CI [1.41-38.43] when compared to the standardized pathway (3,7%). Similarly, the traditional pathway proposes a higher prevalence of induction of labor (54,1%) than the standardized pathway (33,9%) between 2015 and 2017 with OR 3.19 95% CI [1.70-7.80]. The "a posteriori" post-hoc power of the study is 82.9%.

Conclusion: This study confirms the absence of excessive obstetrical intervention in the SGA population when followed in a standardized healthcare pathway. The latter would reduce unnecessary obstetrical interventions while respecting the intrinsic neonatal prognosis of small for gestational age fetuses.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
March 2021

A Review on the Occurrence and Analytical Determination of PAHs in Olive Oils.

Foods 2021 Feb 3;10(2). Epub 2021 Feb 3.

Department of Agri-Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy.

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous environmental and processing contaminants, which may contaminate vegetable oils due to atmospheric fall-out or bad production practices. Due to their carcinogenic and toxic effects, surveillance schemes and mitigation strategies are needed to monitor human exposure to PAHs. In particular, due to the lipophilic nature of these substances, edible oils may present unsafe levels of these compounds. Among these, olive oil, and in particular extra virgin olive oil, is a high-value commodity, also known for its health benefits. Therefore, the occurrence of contaminants in this product is not only of health concern but also causes economic and image damage. In this review, an overview of the occurrence of PAHs in all categories of olive oil is provided, as well as a description of the official methods available and the analytical developments in the last 10 years.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
February 2021

On-Line HP(LC)-GC-FID Determination of Hydrocarbon Contaminants in Fresh and Packaged Fish and Fish Products.

J AOAC Int 2021 May;104(2):267-273

Department of Agricultural, Food, Environmental, and Animal Sciences, University of Udine, Italy.

Background: Fish products can be contaminated with mineral oil hydrocarbons (MOH), mainly as a result of environmental contamination (wild fish) or contaminated feeds (farmed fish). Packaged products may also be contaminated with polyolefin oligomeric hydrocarbons (POH), which, depending on the packaging, storage condition, matrix composition, and fat content, may migrate relatively easily from the packaging to the food.

Objective: A rapid, solvent-sparing method for determining hydrocarbon contaminants in fish products was developed, validated, and applied to farmed and wild fish products (both fresh and packaged samples, stored under different conditions).

Method: Microwave-assisted saponification (MAS) was used in combination with on-line LC-GC-flame ionization detection (FID).

Results: The proposed method showed quantitative recovery, good repeatability, and high sensitivity. Farmed salmon had variable mineral oil saturated hydrocarbon contamination (from 0.5 to 4.3 mg/kg), accompanied by mineral oil aromatic hydrocarbons (maximum 1.4 mg/kg), while wild salmons had no detectable contamination. Samples of one farmed salmon and a swordfish, both sliced and packed under vacuum, resulted contaminated with POH migrated from the packaging. POH migration was also evident in a ready-to-eat meal.

Conclusions: The proposed method showed good performance characteristics in terms of recovery, repeatability, and LOQ. Fatty fish products are more prone to contamination with hydrocarbon contaminants.

Highlights: MAS allows for rapid and efficient sample preparation. An LC-GC-FID method for MOH/POH determination in fish products was validated. Fish products may be contaminated with variable amounts of hydrocarbon contaminants.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
May 2021

Standardized healthcare pathway in intrauterine growth restriction and minimum evidence-based care.

J Gynecol Obstet Hum Reprod 2021 Jan 19;50(1):101998. Epub 2020 Nov 19.

Hospices Civils de Lyon, Department of Obstetrics and Gynecology, Femme Mère Enfant Hospital, University Hospital Center, 59 Boulevard Pinel, 69500, Bron, France; University of Lyon, University Claude Bernard Lyon 1, University of Saint-Étienne, HESPER EA 7425, F-69008 Lyon, F-42023, Saint-Etienne, France. Electronic address:

Introduction: Fetal growth restricted fetuses are less likely to receive evidence-based care; a previous work demonstrated an improvement in neonatal prognosis when fetuses with intrauterine growth restriction (IUGR) received minimum evidence based-care.

Objective: The objective of the study was to evaluate the impact of a standardized healthcare pathway on the implementation of the recommended clinical practice in the antenatal management of IUGR fetuses, in comparison to a traditional pathway. The quality of the implementation of practice has been defined whether or not minimum evidence-based care (MEC), defined according to the recommendations of the French college of gynecologists and obstetricians (CNGOF), has been implemented.

Study Design: From a historical cohort of 31,052 children, born at the Femme Mère Enfant Hospital (Lyon, France) between January 1st, 2011 and December 31st, 2017, we selected the population of IUGR fetuses. We compared the rate of MEC between the IUGR fetuses followed-up in the traditional healthcare pathway versus the IUGR fetuses followed-up in a standardized healthcare pathway between 2015 and 2017.

Results: A total of 245 IUGR were tracked between 2015 and 2017. Over this period, 120 fetuses were followed within the traditional pathway and 125 within the IUGR pathway. The standardized pathway resulted in a higher rate of MEC (86,4%) when compared to IUGR fetuses followed-up in the traditional pathway (27,5% (OR* 20 (95 % CI 10.0-39.7). Among early-onset IUGR: 31 % received MEC in the traditional pathway versus 83 % in the standardized pathway (p<0.001). Among late-onset IUGR: 22 % received MEC in the traditional pathway versus 92 % in the standardized pathway (p<0.001). The provided care in the standardized pathway resulted in an increase of complete antenatal corticosteroid therapy (92,8 %) when compared to the traditional pathway (50.0 %; p<0.001) and a reduction of the rate of caesarean sections before labor for non-reassuring fetal heart rate (15 %) when compared to the traditional pathway (41.3 % p=0.007).

Conclusion: The standardized pathway improves the implementation of the local recommendations in the management of early- and late-onset IUGR. This study is the first to suggest a standardized care pathway in prenatal medicine. A medico-economic study could estimate the health care savings that such a pathway would provide by allowing a medical management in accordance with the recommendations.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
January 2021