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Introduction: Ureterocele is a congenital malformation of the urinary tract, characterized by the cystic dilation of the terminal ureter. Its treatment is indicated in symptomatic patients. Over the years, surgical treatment has evolved from open surgeries to minimally invasive procedures. The aim of this study was to assess the long-term outcomes of a case series involving pediatric patients with ureterocele, who were treated using an endoscopic puncture. Material and methods: A retrospective review was performed of ureterocele patients treated by endoscopic puncture from 2002 to 2021. The primary outcome of the study was relief of the obstruction with a single endoscopic puncture. Results: From 2002 to 2021, a total of 34 patients with 39 ureteroceles underwent treatment using this technique. The mean age at diagnosis was 16 months. Diagnoses was made prenatally through an ultrasound revealing a dilated urinary tract in 17/34 (50 %) of patients and during the assessment of a urinary tract infection in 15/34 (44 %) of patients. A duplex collecting system was observed in 28/34 (82 %) of patients, while bilateral ureteroceles were found in 5/34 (15 %) of patients. A single endoscopic puncture of the ureterocele proved to be successful in 27/34 (79 %) of patients. A second endoscopic puncture was needed in 4/34 (12 %). Only 3/34 (9 %) patients required a surgical intervention. The mean follow-up period was 4 years. Conclusion: The results of our study show that endoscopic puncture of obstructive ureterocele is a procedure with excellent long-term results.

Design and assessment of innovative Mediterranean vegetable cropping systems to manage root-knot nematodes. Description of the subject. A system approach based on co-design and experimental field evaluation of cropping systems (CSs), combining technical and varietal innovations, has been implemented for sustainable management of root-knot nematodes (RKN) in Mediterranean sheltered vegetable systems. Objectives. Cropping systems combining genetic resistance and cultural practices (crop rotations including susceptible, resistant, and non-host plants; intercropping management with nematicidal cover crops or soil solarization) were assessed over a period of 4 years (i) to reduce RKN populations and increase the durability of varietal resistances, (ii) to study the impact of these systems on soil ecology (plant-parasitic and free-living nematode communities), and (iii) to evaluate their acceptability by farmers. Method. Three CS prototypes, resulting from a co-design process with research and development stakeholders, were compared with CSs conventionally implemented in the Mediterranean region. The three prototypes were also evaluated using complementary methods: (i) system experiments in three commercial farms in Southern France; (ii) analytical experiments to decipher the mechanisms of action for some [agroecological??] levers; (iii) surveys to evaluate the acceptability of the prototypes by farmers. Results. All three CSs were found to be effective (90% RKN decrease, protection of partially resistant Solanaceae, no negative effect on non-phytoparasitic nematodes) and sustainable, when application conditions and soil biological equilibrium were favorable (global soil nematofauna diversified and abundant). The acceptability of the three systems depended on the type of farm where they were implemented and the attitude of the farmers towards innovation. Conclusions. These three CSs still need to be improved, in terms of their efficiency, in consultation with participating farmers, by introducing new agroecological levers, as well as innovation costs. Future research will also need to open up to a more comprehensive management of soil health.

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Fundamento: La participación social en salud constituye uno de los principios fundamentales de la reforma sanitaria brasileña. El objetivo de este artículo es analizar los conceptos de participación social en salud de los diferentes agentes sociales y su percepción de obstáculos y facilidades a esta participación. Métodos: Se realizó una investigación cualitativa mediante entrevistas individuales (EI) y grupos focales (GF) a diferentes agentes sociales: 135 usuarios (EI, GF), 14 líderes comunitarios (EI, GF), 12 miembros del Consejo Municipal de Salud (EI), 8 formuladores de políticas (EI) y 37 del personal de salud (EI, GF). Se hizo un análisis narrativo de contenido. Los municipios de Cabo y Camaragibe en el Nordeste de Brasil, constituían el área de estudio. Resultados: Con distintos niveles de elaboración, en todos los grupos de informantes emergieron conceptos de participación individual y colectiva en salud y la mayoría describía también su propia actuación. La participación como acción individual y la idea de utilización de los servicios de salud predominaron en las respuestas de usuarios. En los obstáculos a la participación refirieron factores poblacionales e institucionales: usuarios y líderes mencionaron ambos tipos, mientras que el personal de salud y miembros del CMS hacían mayor hincapié en los primeros. Los formuladores de políticas enfatizan la falta de decisión política. En las facilidades se observó la misma tendencia. Conclusiones: Los conceptos y las dificultades a la participación referidos parecen mostrar las distintas formas de relación entre los diversos agentes sociales y los servicios de salud y señalan hacia un limitado alcance de la política de participación social en salud. Se identifican elementos de mejora.