Quality of life after high-dose-rate brachytherapy monotherapy for prostate cancer

Purpose There is little information in the literature on health-related quality of life (HRQOL) changes due to high-dose-rate (HDR) brachytherapy monotherapy for prostate cancer. Materials and Methods We conducted a prospective study of HRQOL changes due to HDR brachytherapy monotherapy for low risk or favorable intermediate risk prostate cancer. Sixty-four of 84 (76%) patients who were treated between February 2011 and April 2013 completed 50 questions comprising the Expanded Prostate Cancer Index Composite (EPIC) before treatment and 6 and/or 12 months after treatment. Results Six months after treatment, there was a significant decrease (p<0.05) in EPIC urinary, bowel, and sexual scores, including urinary overall, urinary function, urinary bother, urinary irritative, bowel overall, bowel bother, sexual overall, and sexual bother scores. By one year after treatment, EPIC urinary, bowel, and sexual scores had increased and only the bowel overall and bowel bother scores remained significantly below baseline values. Conclusions HDR brachytherapy monotherapy is well-tolerated in patients with low and favorable intermediate risk prostate cancer. EPIC urinary and sexual domain scores returned to close to baseline 12 months after HDR brachytherapy

Terminologie à utiliser pour l’étude et la prise en charge des échinococcoses : adaptation du consensus international à la langue française

International audienceEchinococcoses are zoonoses affecting accidentally humans and their management requires the involvement of specialists from numerous disciplines. A standardization of the international terminology was published recently by the World Association of Echinococcosis. A multidisciplinary working group was established to propose an adaptation to the French language, taking the main French-speaking areas endemic for echinococcoses into account. The main recommendations are: 1) the use of single names for each disease associated with the different Echinococcus species « échinococcose kystique », « échinococcose alvéolaire » and « échinococcose néotropicale »; 2) the restriction of the use of « hydatique » to the larval stage of the cluster of Echinococcus granulosus sensu lato species; 3) the harmonization of terms used to describe the structure of the cysts; 4) the adaptation of the term used to name the ex-« vésicules filles », that now should be replaced by « kystes filles », to better comply with the international terminology. Concerning the surgical treatment of cystic echinococcosis, the description system and the acronym « AORC » (the same in English and in French for Approach/Abord, Opening/Ouverture, Resection/Résection, and Completeness/Complétude) were adopted. The use of this new terminology is crucial for the coherence between scientific publications and textbooks, and especially for a better understanding of the transmission of these diseases as well as for patients’ management.Les échinococcoses sont des zoonoses touchant les humains de manière accidentelle et leur prise en charge implique l’intervention de spécialistes issus de nombreuses disciplines. Un consensus a récemment été obtenu par l’Association mondiale de l’échinococcose sur la standardisation de la terminologie internationale, en anglais. Un groupe de travail francophone multidisciplinaire a été constitué pour proposer une adaptation spécifique à la langue française, en prenant en compte les principales régions du monde francophone endémiques pour les échinococcoses. Les principaux changements adoptés sont : 1) la dénomination des différentes maladies associées au développement du métacestode des différentes espèces d’échinocoques, « échinococcose kystique », « échinococcose alvéolaire » et « échinococcose néotropicale » ; 2) la restriction de l’usage de l’adjectif « hydatique » au stade larvaire du cluster d’espèces Echinococcus granulosus sensu lato ; 3) l’harmonisation des expressions qui décrivent la structure des kystes ; 4) la mise en cohérence avec la terminologie internationale de la dénomination des ex-« vésicules filles », qui sont désormais appelées « kystes filles ». Concernant le traitement chirurgical de l’échinococcose kystique, le système de description et l’acronyme « AORC », identique en français et en anglais pour Abord/Approach, Ouverture/Opening, Résection/Resection, Complétude/Completeness, ont été retenus. L’adoption de cette nouvelle terminologie est essentielle pour la cohérence des publications et des ouvrages pédagogiques, et surtout pour une meilleure compréhension de la transmission de ces maladies et une meilleure prise en charge des patients

Monkeypox Virus Infection in Humans across 16 Countries - April-June 2022

Background: Before April 2022, monkeypox virus infection in humans was seldom reported outside African regions where it is endemic. Currently, cases are occurring worldwide. Transmission, risk factors, clinical presentation, and outcomes of infection are poorly defined. Methods: We formed an international collaborative group of clinicians who contributed to an international case series to describe the presentation, clinical course, and outcomes of polymerase-chain-reaction.confirmed monkeypox virus infections. Results: We report 528 infections diagnosed between April 27 and June 24, 2022, at 43 sites in 16 countries. Overall, 98% of the persons with infection were gay or bisexual men, 75% were White, and 41% had human immunodeficiency virus infection; the median age was 38 years. Transmission was suspected to have occurred through sexual activity in 95% of the persons with infection. In this case series, 95% of the persons presented with a rash (with 64% having ≤10 lesions), 73% had anogenital lesions, and 41% had mucosal lesions (with 54 having a single genital lesion). Common systemic features preceding the rash included fever (62%), lethargy (41%), myalgia (31%), and headache (27%); lymphadenopathy was also common (reported in 56%). Concomitant sexually transmitted infections were reported in 109 of 377 persons (29%) who were tested. Among the 23 persons with a clear exposure history, the median incubation period was 7 days (range, 3 to 20). Monkeypox virus DNA was detected in 29 of the 32 persons in whom seminal fluid was analyzed. Antiviral treatment was given to 5% of the persons overall, and 70 (13%) were hospitalized; the reasons for hospitalization were pain management, mostly for severe anorectal pain (21 persons); soft-tissue superinfection (18); pharyngitis limiting oral intake (5); eye lesions (2); acute kidney injury (2); myocarditis (2); and infection-control purposes (13). No deaths were reported. Conclusions: In this case series, monkeypox manifested with a variety of dermatologic and systemic clinical findings. The simultaneous identification of cases outside areas where monkeypox has traditionally been endemic highlights the need for rapid identification and diagnosis of cases to contain further community spread