The 'Survivorship Passport' for childhood cancer survivors

Background: Currently, there are between 300,000 and 500,000 childhood cancer survivors (CCSs) in Europe. A significant proportion is at high risk, and at least 60% of them develop adverse health-related outcomes that can appear several years after treatment completion. Many survivors are unaware of their personal risk, and there seems to be a general lack of information among healthcare providers about pathophysiology and natural history of treatment-related complications. This can generate incorrect or delayed diagnosis and treatments. Method: The Survivorship Passport (SurPass) consists of electronic documents, which summarise the clinical history of the childhood or adolescent cancer survivor. It was developed by paediatric oncologists of the PanCare and SIOPE networks and IT experts of Cineca, together with parents, patients, and survivors' organisations within the European Union–funded European Network for Cancer research in Children and Adolescents. It consists of a template of a web-based, simply written document, translatable in all European languages, to be given to each CCS. The SurPass provides a summary of each survivor's clinical history, with detailed information about the original cancer and of treatments received, together with personalised follow-up and screening recommendations based on guidelines published by the International Guidelines Harmonization Group and PanCareSurFup. Results: The SurPass data schema contains a maximum of 168 variables and uses internationally approved nomenclature, except for radiotherapy fields, where a new classification was defined by radiotherapy experts. The survivor-specific screening recommendations are mainly based on treatment received and are automatically suggested, thanks to built-in algorithms. These may be adapted and further individualised by the treating physician in case of special disease and survivor circumstances. The SurPass was tested at the Istituto Giannina Gaslini, Italy, and received positive feedback. It is now being integrated at the institutional, regional and national level. Conclusions: The SurPass is potentially an essential tool for improved and more harmonised follow-up of CCS. It also has the potential to be a useful tool for empowering CCSs to be responsible for their own well-being and preventing adverse events whenever possible. With sufficient commitment on the European level, this solution should increase the capacity to respond more effectively to the needs of European CCS

The ‘Survivorship Passport’ for childhood cancer survivors

Abstract Background: Currently, there are between 300,000 and 500,000 childhood cancer survivors (CCSs) in Europe. A significant proportion is at high risk, and at least 60% of them develop adverse health-related outcomes that can appear several years after treatment completion. Many survivors are unaware of their personal risk, and there seems to be a general lack of information among healthcare providers about pathophysiology and natural history of treatment-related complications. This can generate incorrect or delayed diagnosis and treatments

Technical tips for safe perforator vessel dissection applicable to all perforator flaps

The introduction of perforator flaps by Koshima and Soeda in 1989 was met with much animosity in the surgical community. The flaps challenged conventional teaching and were often branded as being unsafe. Surgeries using perforator flaps are now routinely practiced all over the world, with increasing emphasis on minimizing donor site morbidity, and perforator flaps are becoming the current gold standard. The simple principles and techniques of perforator dissection can be applied to all perforator flaps, provided the surgeon has an intimate knowledge of the regional anatomy. Thus, virtually any piece of skin can be harvested as long as it incorporates a feeding vessel. This article highlights the essential techniques in planning and raising perforator flaps and the common pitfalls to be avoided

PAPULOSE LYMPHOMATOIDE AMELIOREE PAR PUVA-THERAPIE

SCOPUS: NotDefined.jinfo:eu-repo/semantics/publishe

Effect of Freezing on Stability of a Fortified 5 mg/mL Ticarcillin Ophthalmic Solution

ABSTRACT Background and Objective: Degradation of ticarcillin limits its shelf life under certain storage conditions. This study was undertaken to determine the stability of 5 mg/mL ticarcillin ophthalmic solution in 0.9% sodium chloride in frozen and unfrozen preparations.Methods: Ticarcillin ophthalmic solutions were prepared in 0.9% sodium chloride. One set of samples was frozen (–20°C) for 9 weeks, thawed at room temperature, and stored for 15 days at either 4°C or room temperature (25°C), with or without protection from light. Another set of samples was stored, without freezing, for 15 days at either 4°C or room temperature (25°C), with or without protection from light. Physical and chemical analysis of the samples included visual inspection, determination of pH and osmolarity, reverse-phase liquid chromatographic analysis of the ticarcillin concentration (with ultraviolet light detection at 240 nm), and analysis of microbial growth. The stored solutions were opened twice a day to reproduce conditions of use after dispensing.Results: Ticarcillin ophthalmic solutions (5 mg/mL) were physically stable during the study period, and there was no evidence of microbial growth. The samples that had not been previously frozen retained more than 90% of their initial ticarcillin concentration (with 95% confidence) for 7 days at 4°C and for 3 days at room temperature with or without protection from light. Samples that had been frozen for 9 weeks also retained more than 90% of their initial concentration (with 95% confidence) after thawing, for 6 days at 4°C and for 3 days at room temperature with or without protection from light.Conclusions: Ticarcillin ophthalmic solutions can be made up in advance and stored frozen, without affecting the expiry date. The thawed solutions should be used within 3 days if stored at room temperature or 6 days if stored at 4°C. Freezing allows chemical and microbiological testing to be completed before use, if necessary.RÉSUMÉ Historique et objectif : La dégradation de la ticarcilline limite la durée de conservation de celle-ci dans certaines conditions d’entreposage. Cette étude a été menée pour déterminer la stabilité de préparations gelées et non gelées de solutions ophtalmiques de ticarcilline disodique à 5 mg/mL dans du chlorure de sodium à 0,9 %.Méthodes : Les solutions de ticarcilline disodique ont été préparées dans du chlorure de sodium à 0,9 %. Une série d’échantillons ont été congelés (–20 °C) pendant 9 semaines, décongelés à la température ambiante, puis entreposés pendant 15 jours à 4 °C ou à la température ambiante (25 °C), à l’abri ou non de la lumière. Une autre série d’échantillons ont été entreposés, sans être congelés, pendant 15 jours à 4 °C ou à la température ambiante (25 °C), à l’abri ou non de la lumière. L’analyse physique et chimique des échantillons a compris une inspection visuelle, une détermination du pH et de l’osmolarité, une analyse de la concentration en ticarcilline disodique au moyen d’une épreuve par chromatographie liquide en phase inverse (avec détection ultraviolette à 240 nm) ainsi qu’une analyse de croissance microbienne. Les solutions ainsi entreposées ont été ouvertes deux fois par jour afin de reproduire les conditions d’utilisation après leur distribution.Résultats : Les solutions ophtalmiques de ticarcilline (5 mg/mL) sont demeurées physiquement stables durant la période de l’étude, et on n’a observé aucun signe de contamination microbienne. Les échantillons qui n’avaient pas été congelés ont conservé plus de 90 % de leur concentration initiale de ticarcilline (intervalle de confiance à 95 %) pendant 7 jours à 4 °C et pendant 3 jours à la température ambiante, à l’abri ou non de la lumière. Les échantillons qui avaient été congelés pendant 9 semaines ont conservé également plus de 90 % de leur concentration initiale (intervalle de confiance à 95 %) une fois décongelés, pendant 6 jours à 4 °C et pendant 3 jours à la température ambiante, à l’abri ou non de la lumière.Conclusions : Les solutions ophtalmiques de ticarcilline peuvent être préparées à l’avance et congelées, sans que cela n’affecte leur durée de conservation. Une fois décongelées, les solutions doivent être utilisées dans les 3 jours si elles sont conservées à la température ambiante ou pendant 6 jours si elles sont conservées à 4 °C. La congélation permet de compléter les épreuves chimiques et microbiologiques avant l’utilisation, au besoin

DNA double strand breaks induced by low dose mammography X-rays in breast tissue: A pilot study

Breast tissue is very sensitive to ionizing radiation due to the presence of reproductive hormones, including estrogen. In the present pilot study, the efficiency of mammography X-rays to induce DNA double strand breaks (DSB) in mammary epithelial cells was investigated. For this, freshly resected healthy breast tissue was irradiated with 30 kV mammography X-rays in the dose range 0-500 mGy (2, 4, 10, 20, 40, 100 and 500 mGy). Breast specimens were also irradiated with identical doses of Co-60 -rays as a radiation quality standard. With the H2AX-foci assay, the number of DNA DSB induced by radiation were quantified in the mammary epithelial cells present in breast tissue. Results indicated that foci induced by 30 kV X-rays and -rays followed a biphasic linear dose-response. For 30 kV X-rays, the slope in the low dose region (0-20 mGy) was 8.71 times steeper compared with the slope in the higher dose region (20-500 mGy). Furthermore, compared with -rays, 30 kV X-rays were also more effective in inducing H2AX-foci. This resulted in a relative biological effectiveness (RBE) value of 1.82 in the low dose range. In the higher dose range, an RBE close to 1 was obtained. In conclusion, the results indicated the existence of a low dose hypersensitive response for DSB induction in the dose range representative for mammography screening, which is probably caused by the bystander effect. This could affect the radiation risk calculations for women participating in mammography screening

Meeting report of the 1st^{st} SIOP Europe Course in Paediatric Oncology: Maasmechelen, Belgium, April 6–9, 2022 – The participants’ view and experience

More than 35,000 children are diagnosed with cancer and treated in Europe each year. With the 1$^{st}$ SIOP Europe Course in Paediatric Oncology, the European Society for Paediatric Oncology (SIOP Europe) aimed to equip aspiring physicians to become leaders within a pan-European network and ensure state-of-the-art treatment for children across Europe. Fifty participants from 24 countries and 37 centres were enrolled on the course. With a virtual and a face-to-face meeting complete, we herewith report on the course concept, application process and first meetings of this 3-year educational program

Application of a new molecular technique for the genetic evaluation of products of conception

Objectives: Karyotyping is a well-established method of investigating the genetic content of product of conceptions (POCs). Because of the high rate of culture failure and maternal cell contamination, failed results or 46,XX findings are often obtained. Different molecular approaches that are not culture dependent have been proposed to circumvent these limits. On the basis of the robust experience previously obtained with bacterial artificial chromosomes (BACs)-on-Beads™ (BoBs™), we evaluated the same technology that we had used for the analysis of prenatal samples on POCs. Method: KaryoLite™ BoBs™ includes 91 beads, each of which is conjugated with a composite of multiple neighboring BACs according to the hg19 assembly. It quantifies proximal and terminal regions of each chromosome arm. The study included 376 samples. Results: The failure rate was 2%, and reproducibility >99%; false-positive and false-negative rates wer

Care of adolescents and young adults with cancer in Asia: Results of an ESMO/SIOPE/SIOP Asia survey

© Author (s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ on behalf of the European Society for Medical Oncology. Adolescents and young adults (AYAs) with cancer require dedicated management encompassing both adult and paediatric cancer services. Following a European survey, the European Society for Medical Oncology, the European Society for Paediatric Oncology and the Asian continental branch of International Society of Paediatric Oncology undertook a similar survey to assess AYA cancer care across Asia. Methods A link to the online survey was sent to healthcare professionals (HCPs) in Asia interested in AYA cancer care. Questions covered the demographics and training of HCPs, their understanding of AYA definition, availability and access to specialised AYA services, the support and advice offered during and after treatment, and factors of treatment non-compliance. Results We received 268 responses from 22 Asian countries. There was a striking variation in the definition of AYA (median lower age 15 years, median higher age 29 years). The majority of the respondents (78%) did not have access to specialised cancer services and 73% were not aware of any research initiatives for AYA. Over two-thirds (69%) had the option to refer their patients for psychological and/or nutritional support and most advised their patients on a healthy lifestyle. Even so, 46% did not ask about smokeless tobacco habits and only half referred smokers to a smoking cessation service. Furthermore, 29% did not promote human papillomavirus vaccination for girls and 17% did not promote hepatitis B virus vaccination for high-risk individuals. In terms of funding, 69% reported governmental insurance coverage, although 65% reported that patients self-paid, at least partially. Almost half (47%) reported treatment non-compliance or abandonment as an issue, attributed to financial and family problems (72%), loss of follow-up (74%) and seeking of alternative treatments (77%). Conclusions Lack of access to and suboptimal delivery of AYA-specialised cancer care services across Asia pose major challenges and require specific interventions