[Management of dysmenorrhea]

Dysmenorrhea is one of the most common reasons for consultation in gynecology. The social and economic burdens are important. Dysmenorrhea may therefore be considered as a major public health issue. Its management is not yet optimal as dysmenorrhea still affects the quality of life of many patients. Primary dysmenorrhea, with no underlying organic cause, results from myometrial hyper contractility, arteriolar vasoconstriction, and tissue hypoxia. Secondary dysmenorrhea may involve the pathophysiological mechanisms of primary dysmenorrhea, but is mainly the expression of an underlying gynecological pathology. Although the pathophysiology of primary dysmenorrhea is well established, studies are now focusing on treatments to improve the management of these patients, who are often young. Nonsteroidal anti-inflammatory drugs and oral contraception remain the recommended firstline drugs, but their effectiveness can be enhanced by complementary therapy such as local heat application or regular exercise. Studies on other unconventional complementary therapies, such as ginger consumption, are very encouraging and need to be reinforced to incorporate recommendations for the management of primary dysmenorrhea.

Spontaneous intergluteal cleft endometriosis

Endometriosis is a condition where hormonal-responsive endometrial tissue grows outside the uterus usually within the pelvic cavity. Extra-abdominal endometriosis is less common and may involves the skin. Subcutaneous endometriosis is rare. We report the first case of spontaneous intergluteal cleft endometriosis revealed by pain and bleeding during menstruation.

Plastic surgery for breast conservation therapy: how to define the volume of the tumor bed for the boost?

PURPOSE

To describe the procedure of definition of the boost volume using pre- and post-operative computed tomography (CT) and surgical clips in the tumor bed after oncoplastic surgical procedure.

PATIENTS AND METHODS

Thirty-one consecutive breast cancer patients who underwent simple lumpectomy or oncoplastic surgery were studied. All of them underwent pre- and post-operative CT scan in treatment position to evaluate the planning target volume (PTV) boost volume and define the primary tumor (gross tumor volume (GTV)) and tumor bed zones (CTV), with an overall margin of 5 mm in lateral and 10 mm in craniocaudal directions, corresponding to localization and setup uncertainties.

RESULTS

Thirteem patients underwent simple lumpectomy and 18 oncoplastic surgery. The volumetric analysis showed that the intersection between GTV and CTV clips was significantly higher in patients with three and more clips (28.4% vs 3.14%; p < 0.001). In the case of patients with oncoplastic surgery, more than three clips were needed to define the tumor bed volume with accuracy. The number of clips was directly related to the exact definition of the boost volume.

CONCLUSIONS

The use of more than three clips allows better definition of the PTV boost volume after oncoplastic surgical procedure.

Electric field gradient calculations in paramagnetic compounds using the PAW approach. Application to ²³Na NMR in layered vanadium phosphates

This article presents ab initio calculations of electric field gradient (EFG) parameters as a tool for the structural characterization of paramagnetic crystalline compounds. Previously reported ²³Na NMR parameters of vanadium + IV containing vanado-phosphate compounds were computed within density functional theory using both cluster and fully periodic approaches. Quadrupolar parameter values measured by ²³Na NMR experiments were reproduced with a level of accuracy comparable to that achievable in diamagnetic compounds and allowed the assignment of observed ²³Na NMR signals. This work demonstrates the utility of the periodic planewave pseudopotential + PAW approach for the calculation of EFG parameters in paramagnetic compounds.

New mercury vanadium phosphate hydrate Hg(4)(-)(x)()O(1-)(y)()((VO)(PO(4))(2).H(2)O with unprecedented tetrahedral oxo-cluster [Hg( approximately )(4)O( approximately )(5)]

The new mercury vanadium phosphate hydrate Hg(4)(-)(x)()O(1)(-)(y)()(VO)(PO(4))(2).H(2)O has been synthesized under hydrothermal conditions. X-ray investigations led to orthorhombic symmetry, space group P2(1)2(1)2(1) (No. 19), a = 6.3632(2) A, b = 12.4155(5) A, c = 14.2292(6) A, Z = 4. The crystal structure was solved and refined from single-crystal diffractometer data to residuals R[F(2) > 2sigmaF(2)] = 0.039, R(w)(F(2)) = 0.055. The VPO framework consists of infinite one-dimensional [VO(PO(4))(2)]( infinity ) chains with corner-connected VO(6) octahedra and PO(4) tetrahedra. The chains run along the [100] direction and are held together by the unprecedented tetrahedral cationic units [Hg(4)(-)(x)()O(1)(-)(y)()](4+). Presence of Hg-Hg bonding contacts is proved from theoretical calculations.