Immune checkpoint inhibitors have revolutionized the treatment of metastatic melanoma, with a survival now reaching several years in some patients. The anti-PD-1 monoclonal antibodies nivolumab and pembrolizumab increase both the quality of life and overall survival of metastatic melanoma patients. They are currently the first-line treatment for metastatic melanoma. However, only 40% of patients respond to anti- PD-1 monotherapy. In the era of personalized medicine, it has become essential to identify those patients who will benefit from these treatments that are, by the way, responsible for rare but serious adverse events. We tested several immunohistochemical markers in order to discriminate between responders and nonresponders.
Melanoma is associated with a high risk of recurrence and new primaries. A lifelong follow-up is thus recommended. This study was aimed at identifying the factors that could influence the patient’s compliance with dermatological and oncological follow-up.
A growing number of hospitals decided to completely abandon latex in order to avoid IgE-mediated allergic reactions (which can lead to anaphylaxis), as was the case for the Saint-Luc University Clinics in December 2010 (a premiere in Belgium). This measure concerns more than 300,000 pairs of sterile gloves per year. Since then, many caregivers who had been working for years without experiencing any allergic reaction developed contact dermatitis with the new gloves. The main allergens involved are vulcanization accelerators.
Bariatric surgery offers rapid and massive weight loss, but can leave the body with a substantial amount of excess skin. Excess skin may have both physical and psychological consequences, including distortions of body image and skin problems, such as irritation. Body contouring performed for cosmetic purposes, or after weight loss, has the potential to improve one’s body image and health-related quality of life (HRQOL). Many studies have shown the interest of measuring this improvement using generic instruments. Unfortunately, these tools were not specifically designed for body contouring surgery, thus highlighting the lack of dedicated PRO instruments for measuring outcomes after body contouring surgery.
Complications following intramedullary nailing (IMN) of tibial shaft fractures are well described in the scientific literature and are feared by surgeons. While risk factors for such complications have not been clearly identified, they could help practitioners to be more vigilant. Surgeons could actually adapt their therapies in patients at risk and thus prevent these harmful consequences for patient and society. In this context, the challenge is to answer a central question: “Is it possible to predict IMN complications after tibial shaft fractures and move towards a preventive approach?”.
Laura Mengeot(1), Elodie Fastré(2), Sandrine Mestre(3,4), Nicole Revencu(1), Raphaël Helaers(2), Gabriela M. Repetto(6), Arie van Haeringen(7), Laurence M. Boon(2,8), Isabelle Quere(3,4), Pascal Brouillard(2), Miikka Vikkula(2)Published in the journal : November 2018Category : Mémoires de Recherche Clinique
Lymphedema is a common disabling condition and the most frequent lymphatic anomaly. It is characterized by chronic tissue swelling mostly located in the limbs. Lymphedema can be primary or secondary (acquired), the primary form resulting from inadequate development or function of the lymphatic system. Currently, germline mutations have been identified in 28 genes. However, these only explain approximately 40% of familial forms and 12% of sporadic forms, thus suggesting that other genes are involved.
Cryoablation and radiofrequency catheter ablation have progressively become a standard of care for treating pediatric arrhythmias. While many studies have demonstrated their efficacy in eliminating the arrhythmia substrate, few have evaluated their impact on quality of life, which is the purpose of this study.
Marie-Laure Oberweis(1), Laurent Houtekie(2), Jacques Louis(3)Published in the journal : November 2018Category : Neurology
Acute disseminated encephalomyelitis is an inflammatory and demyelinating disease of the central nervous system mainly affecting children. In its classical form, it is characterized by the acute or subacute occurrence of multifocal neurological symptoms and encephalopathy secondary to an infection. Although most children have a good prognosis with slow but complete healing, we here describe the case of a 25-month-old girl with a severe form of acute disseminated encephalomyelitis following a primary Epstein-Barr-Virus infection. Her case is particularly unusual, since it was characterized by a rapid and severe extension of the lesions that led to death.
Hypereosinophilic syndrome (HES) is characterized by hypereosinophilia associated with subsequent damage of one or more target organs. HES has various causes, that can be divided into primary (clonal involvement of the myeloid lineage), secondary (polyclonal by interleukin-5 production), and idiopathic. Thanks to technological advances, particularly in genetics, six clinical-biological variants could be defined, thus leading to the emergence of targeted therapies. Imatinib, a tyrosine kinase inhibitor, is used in myeloproliferative HES (M-HES), while other variants are treated in first line by corticosteroids. The development of new agents, such as IL-5 inhibitors (mepolizumab), has allowed sparing corticosteroids and thus avoiding their adverse effects, thereby improving the patients’ quality of life.
Elise Osterheld(1), Lutz Bindl(1), Wolfgang Boehm(1), Leon Bofferding(1), Jean Bottu(1), Christine Geron(1), Sandra Heck(1), Charlotte Pierron(1), Moritz Vogel(1), Linda De Meirleir(2), Geert Martens(2), Luc Regal(2), Emmanuel Scalais(1)Published in the journal : November 2018Category : Hematology/Oncology
Intracellular cobalamin (IC) and its two coenzymes, adenosylcobalamin and methylcobalamin, are necessary for the homeostasis of methylmalonic acid and homocysteine (Hcy). Defects of intracellular cobalamin metabolism are responsible for isolated methylmalonic aciduria (MMA), isolated increased Hcy, or both. MMA occurs when adenosylcobalamin, a cofactor of methylmalonic-CoA mutase, is low, thereby causing elevated MMA and decreased succinyl-CoA. A lack of methylcobalamin, a cofactor for methionine synthase, impairs the transformation of Hcy into methionine, thus leading to increased Hcy and low methionine levels.