Unusual appearance of a pendulated gastric tumor : always think of GIST

Objective. To investigate the clinicopathological characteristics of gastrointestinal stromal tumor (GIST) with significant cystic changes and to assess the molecular genetic characteristics. Methods. In a 68-year-old man, a large abdominal tumoral mass was discovered incidentally. Computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of a large cystic lesion with multiple contrast-enhancing septae and papillary projections. No clear connection with any of the surrounding organs was identified. Malignancy could not be excluded, and surgery was indicated. During surgery, the large mass was found to be attached by a narrow stalk to the large curvature of the stomach. Results. The histological features and immunohistiochemical profile of the tumor cells (positivity for CD117 and CD34) were consistent with a gastrointestinal stromal tumor with a high risk of progressive disease according to the Fletcher classification. Diagnosis was confirmed by mutational analysis; this demonstrated mutation in exon 14 of PDGFRA. During the followup of 97 months, the patient had a cancer-free survival. Conclusions. This case demonstrates that gastrointestinal stromal tumors (GISTs) with extensive cystic degeneration should be considered in the differential diagnosis of a cystic abdominal mass

stop Smoking Help: A Need

peer reviewedToday the smoker carries a risk of mortality 70% higher compared to the nonsmoker. In Belgium active smoking is indisputably the most important cause of avoidable death. In 2004 it appears that 27% of the belgian population was smoking. This review describes the comorbidity associated with active tobacco consumption and defines the concepts of dependence and smoking cessation. It also identifies the three factors which determine the success of smoking cessation, i.e. the degree of nicotinic dependence, the presence of anxio-depressive disorders and the importance of the motivation to the stop

La fragmentation des systèmes scolaires nationaux à l’heure de la mondialisation

À l’heure où l’on parle beaucoup de la mondialisation et de la force unificatrice d’organisations internationales telles que l’OCDE, n’est-il pas paradoxal d’avancer l’hypothèse d’une fragmentation des systèmes éducatifs ? Cet article et ce dossier tendent à montrer que non. Ils soutiennent que la fragmentation des systèmes scolaires nationaux – ou les freins aux processus d’unification de ces systèmes – s’expliquent par plusieurs phénomènes mondialisés. Les uns rendent difficiles les compromis nationaux autour de finalités et modèles d’éducation, tandis que d’autres favorisent des réseaux internationaux d’écoles s’écartant du modèle national. Ainsi chaque système scolaire national tend-il aujourd’hui à se fragmenter sur deux axes, l’un lié à la stratification sociale et l’autre à la différenciation des modèles et projets éducatifs. On ne peut actuellement prédire si cette fragmentation va persister et signer la fin des systèmes scolaires nationaux ou si elle débouchera sur la recomposition de systèmes unifiés.At a time when there is much discussion about globalization and the unifying power of international organizations such as the OECD, is it not paradoxical to speculate that education systems are becoming fragmented? This article and dossier show that it is not. They argue that the fragmentation of national school systems – or the obstacles to the processes of unifying these systems – can be explained by several globalized phenomena. Some of these problematize national compromises on educational outcomes and models, while others encourage international networks of schools at a remove from the national model. Thus, each national education system now has a tendency to fragment in two respects, one of which is linked to social stratification and the other to the differentiation of educational models and projects. It is not currently possible to predict whether this fragmentation will endure and mark the end of national school systems or whether it will lead to the reconfiguration of unified systems.En una circunstancia en la que se habla mucho de la mundialización y de la fuerza unificadora de organizaciones internacionales como la OCDE, ¿no resulta paradójico el hecho de avanzar la hipótesis de una fragmentación de los sistemas educativos? Este artículo y, de manera más global, este dosier se proponen demostrar que no. Sostienen que la fragmentación de los sistemas escolares nacionales —o los frenos frente a los procesos de unificación de estos sistemas— se explican por varios fenómenos mundializados. Los unos dificultan los compromisos nacionales en torno a las finalidades y a los modelos educativos mientras que los otros favorecen unas redes internacionales de escuelas que se alejan del modelo nacional. De esta manera, cada sistema escolar nacional está sometido a una fragmentación en dos ejes distintos : el primero está vinculado con la estratificación social y el otro con la diferenciación de modelos y proyectos educativos. No se puede predecir actualmente si esta fragmentación va a persistir y significar el fin de los sistemas educativos nacionales o si desembocará en la recomposición de unos sistemas unificados

Comprendre les différences sportives hommes-femmes pour une approche plus inclusive

editorial reviewedComprendre l'origine de la différence sportive et motrice entre hommes et femmes permet de mieux comprendre pourquoi le paysage sportif actuel est extrêmement genré. Une analyse de la littérature scientifique permet d’éclairer le lecteur sur les différences liées aux particularités biologiques et psychologique de chaque sexe et permet également de casser les stéréotypes qui ont souvent tendances à amplifier les différences initiales. Une approche plus inclusive, répondrait davantage aux besoins de tous. Les modèles de compétition dans le sport doivent également être questionnés afin de faire progresser les pratiques pour tous.5. Gender equalit

Accoutumance à l'eau : 25 ans de pratique et d'expérience avec le CEReKi

Le diaporama présente de manière synthétique l'approche de l'accoutumance à l'eau recommandée par le CEREKI ainsi que les résultats d'études montrant son efficacité

MODIFYING PHYSICAL ENVIRONMENT TO BE APPROPRIATE FOR CHILDREN

peer reviewedOur experience confirms that adapting physical environments is critical for providing appropriate physical activity for 3 to 8 years old children.. Moreover, the pedagogy has to favour success, discovery and a fun environment. This work illustrates what can be achieved and provides clear guidance for developing centres to support the promotion of physical activity in early childhood

Actes du 5ème colloque Guy Namurois : le sport au féminin : sport de demain !

Les conférences du matin aborderont à tour de rôle les particularités historiques, physiologiques et psychologiques du sport au féminin. Les tables rondes de l’après-midi seront l’occasion d’entendre la voix des femmes sportives de haut niveau, « entraîneures », dirigeantes, arbitres, dans un monde souvent très masculin. Est-ce plus difficile d’émerger et d’être reconnue en tant que femme ? Qu’est-ce qui doit être amélioré ? Les modèles de pratique sportive répondent-ils aux préférences des femmes ? En conclusion de la journée, un débat final abordera les combats féministes qui feront progresser le sport et la société

Transfer of Communication Skills to the Workplace during Clinical Rounds : Impact of a Program for Residents

peer reviewe

Factors associated with self-perceived burden to the primary caregiver in older patients with hematologic malignancies: an exploratory study

Objective: Although cancer patients frequently experience self-perceived burden to others, this perception has not been enough studied. The aim of this study was to investigate the prevalence of selfperceived burden to the primary caregiver (SPB-PC) and associated factors in an older patient population with hematologic malignancies at the time of chemotherapy initiation. Methods: In total, 166 consecutive patients with hematologic malignancies aged ≥65 years were recruited at the time of chemotherapy initiation. Patients’ SPB-PC was assessed using a 100-mm visual analogue scale (VAS). Characteristics potentially associated with SPB-PC, including sociodemographic and medical characteristics, physical functioning status (Karnofsky performance score, activities of daily living (ADL)/instrumental ADL), symptoms (fatigue, pain, nausea, quality of life), psychological distress (Hospital Anxiety and Depression Scale (HADS)), perceived cognitive function (Functional Assessment of Cancer Therapy Cognitive (FACT-Cog) Scale), and patients’/primary caregivers’ personal relationship characteristics (family tie, support), were assessed. Results: Thirty-five percent of patients reported moderate to severe SPB-PC (VAS ≥ 50 mm). Patients’ SPB-PC was associated with lower Karnofsky performance (β = 0.135, p = 0.058) and ADL (β = 0.148, p = 0.037) scores, and higher HADS (β = 0.283, p<0.001) and FACT-Cog perceived cognitive impairments subscale (β = 0.211, p = 0.004) scores. The proportion of explained variance was 23.5%. Conclusions: Health care professionals should be aware that about one third of older cancer patients experience moderate to severe SPB-PC at the time of chemotherapy initiation. They should adapt their support of patients who report such a feeling

Positive Effects of Vitamin D Supplementation in Patients Hospitalized for COVID-19: A Randomized, Double-Blind, Placebo-Controlled Trial

peer reviewedRetrospective studies showed a relationship between vitamin D status and COVID-19 severity and mortality, with an inverse relation between SARS-CoV-2 positivity and circulating calcifediol levels. The objective of this pilot study was to investigate the effect of vitamin D supplementation on the length of hospital stay and clinical improvement in patients with vitamin D deficiency hospitalized with COVID-19. The study was randomized, double blind and placebo controlled. A total of 50 subjects were enrolled and received, in addition to the best available COVID therapy, either vitamin D (25,000 IU per day over 4 consecutive days, followed by 25,000 IU per week up to 6 weeks) or placebo. The length of hospital stay decreased significantly in the vitamin D group compared to the placebo group (4 days vs. 8 days; p = 0.003). At Day 7, a significantly lower percentage of patients were still hospitalized in the vitamin D group compared to the placebo group (19% vs. 54%; p = 0.0161), and none of the patients treated with vitamin D were hospitalized after 21 days compared to 14% of the patients treated with placebo. Vitamin D significantly reduced the duration of supplemental oxygen among the patients who needed it (4 days vs. 7 days in the placebo group; p = 0.012) and significantly improved the clinical recovery of the patients, as assessed by the WHO scale (p = 0.0048). In conclusion, this study demonstrated that the clinical outcome of COVID-19 patients requiring hospitalization was improved by administration of vitamin D