Background: Mechanisms underlying overeating-induced obesity in postmenopausal woman include functional lack of 17β-estradiol dysregulating dopamine D2 receptors, thereby inducing food addiction, glucose craving or alcohol dependence through reward circuitry. This study aimed at further understanding 17β-estradiol and dopamine D2 receptors interferences in the etiology of woman obesity. Method: Seventy-two Wistar female rats weighing 200 -205 g, individually-housed, were divided into non-ovariectomized control (C = 6 groups) and ovariectomized rats (OVX = 6 groups) which were concurrently subjected to the following treatments: Non-drug-treated (DMSO vehicle), 17β-estradiol (E2, 5 µg/kg, s.c.), sulpiride (SUL, 20 mg/kg, i.p.), bromocriptine (BR, 0.1 mg/kg, i.p.), E2 + SUL or E2 + BR, designating the 6 constitutive groups of either control or ovariectomy. Within each experimental group, consumption of different solutions (10% alcohol, 10% sucrose and water) as well as food intake and body weight were daily measured, for 10 consecutive days. Results: This study indicated that D2S was a specific inducer of alcohol and food intakes, but reduced sugar consumption. In addition, 17β-estradiol regulated the body weight set point, modulating D2S functions towards increased food intake at lower weights and decreased food intake at higher weights. D2S met the slow genomic actions induced by 17β-estradiol. Conversely, D2L inhibited alcohol and food intakes, but induced specifically sugar consumption, thereby regulating blood glucose levels and promoting energy expenditure in reducing body weight. Indeed, 17β-estradiol exerted a tonic inhibition on D2L which was released by OVX, exacerbating sugar intake and increasing body weight. D2L mediated the rapid metabolic effects of that activation of the mostly expressed presynaptically D2S-class autoreceptors decreased dopamine release stimulating food intake, whereas activation of the predominantly postsynaptic isoform D2L receptors increased dopamine activity inhibiting food intake. Our studies indicated that 17β-estradiol acted on the two types of D2 receptors showing opposite functions to equilibrate energy intake vs. expenditure for weight set point regulation. Our data also supported biochemical findings reporting that 17β-estradiol induced D2 genes transcriptional regulation, thereby involving both types of D2 receptors in the etiology of obesity. The combined dysregulated effects of D2L and D2S receptors, as 17β-estradiol was lacking, would be causal factors underlying the etiology of obesity.
A relatively rare congenital malformation, hematocolpos is the progressive accumulation of menstrual blood in the vaginal cavity at puberty. It is often the consequence of a hymen imperforation. It is clinically manifested by cyclic pelvic pain and primary amenorrhea and, more rarely, by a pelvic mass syndrome. The diagnosis is primarily clinical. Ultrasound and magnetic resonance imaging (MRI) are additional tests to confirm hematolcolpos and exclude other associated genitourinary malformations. Treatment consists of a hymenotomy to drain the hematocolpos. The age of discovery of hematocolpos varies from 13 to 14 years. We report a case of hematocolpos secondary to hymenal imperforation diagnosed in a 17-year-old girl with periodic pelvic pain, primary amenorrhea and a pelvic mass. A first ultrasound trap had evoked a large ovarian cyst but the repeat pelvic ultrasound in our hospital confirmed the diagnosis of hematocolpos.
Introduction: A child is defined as “any human being under the age of 18, unless majority is reached earlier due to the legislation applicable to them. In reality, initial care is also found in multipurpose or adult emergency departments. In France (Seine-Saint-Denis), out of 390 children rescued by the Emergency Medical Assistance Service (SAMU) in 2004, 77% of child deaths were medicalized by the Regional Emergency Medical Service (SMUR). all-rounders of the department. As a result, at the hospital in Mali, many children are referred to the emergency department, while there is no pediatrician in the SAU and the technical platform is not well suited to their care,hence the objective of this work.. Methods and Materials: We conducted a prospective, longitudinal study over a period of 12 months from January 1, 2019 to December 31, 2019 at the emergency department of the hospital in Mali. The study involved patients aged zero (0) to fifteen (15) years The parameters studied were socio- demographic and clinical variables Results: During the study period, we collected 458 children aged 0 to 15 out of 6517 visits to the service, i.e. a frequency of 8.12%. The age group of 10 to 15 years was the most representative with 39% of cases. The male sex represented 58% of cases with a sex ratio of 1.36. The patients were uneducated in 10% of the cases, the workers represented 28.8% among the fathers and 54.8% of the mothers were housewives. Children belonging to families with more than three children accounted for 50.9% of cases and 39.5% of patients lived outside Bamako, the capital. Our study shows that 53.9% of patients were admitted between 8 a.m. and 4 p.m., 54.8% of patients came to the service by taxi, vehicle or motorbike and admissions by referral/evacuation represented 60.3% of case. AVP accounted for 48.7% of cases After the initial examination on admission, 36% of patients were classified as category three according to the Clinical Classification of Emergency Patients (CCMU3). Conclusion: The grounds for recourse of children from 0 to 15 years old to the general-purpose SAU of the Hospital of Mali are multiple. Accidents remain the most frequent reason for recourse in the service.
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