Oncological patients' reactions to COVID-19 pandemic: A single institution prospective study.

peer reviewedBACKGROUND: The spread of the COVID-19 pandemic has led to a rapid reorganization in all human and hospital activities, with impact on cancer patients. AIM: An analysis of cancer patients fears, and awareness of COVID-19 has been done in this study. METHODS AND RESULTS: We analyzed cancer patients' reactions to the pandemic and their perception of oncological care reorganization, through a 12-item survey, proposed at the peak of pandemic and 3 months later. Overall, 237 patients were included in the study. During the peak of pandemic 34.6% of patients were more worried about COVID-19 than cancer versus 26.4% in the post-acute phase (p = .013). Although 49.8% of patients in the acute phase and 42.3% in the post-acute phase considered their risk of death if infected ≥50%, and more than 70% of patients thought to be at higher risk of complications, the majority of them did not consider the possibility to stop or delay their treatment. Patients were more interested in following news about COVID-19 than cancer and they complied with all preventive measures in more than 90% of the cases. CONCLUSIONS: Although cancer patients worried about COVID-19 and evaluated the risk of complication or death due to COVID-19 as extremely high, they were still asking for the best oncological treatment

Chemotherapy of Ovarian Cancer: State of the Art

peer reviewedEpithelial ovarian cancer is frequently diagnosed at advanced-stage disease and chemotherapy is nearly always required. Optimally debulked patients may need adjuvant chemotherapy while, most of the time this chemotherapy will be given to those with advanced-stage disease. Also relapses will be treated differently whether they occur early or late in the course of the disease. This paper reviews medical treatment modalities according to stage based on published data. Maintenance and consolidation treatments are also discussed. Finally a brief insight into new therapeutic tools is also given

Atypical metastasis from a colorectal cancer : the pons is undermined !

peer reviewedBrain metastases occur in 1 to 4 % of patients with colorectal cancer and are unique in 0.5 % of them. Because of their infrequent nature, brain imaging is not recommended in the systematic follow-up of these patients. We report here an exceptional case of a unique brain metastasis in a very unusual position. An 82-year-old patient with a colorectal cancer of the splenic angle that was treated with surgery and adjuvant chemotherapy, developed a series of neurological symptoms over four to six weeks: difficulty swallowing, loss of strength in the four limbs and balance disorders. These symptoms urged the performance of a nuclear magnetic resonance to exclude a central neurological lesion. MRI revealed a nodular tumor of 20 millimeters in the major transverse axis and 17 millimeters in the cerebro-caudal axis, located on the ventral portion of the protuberance. Because of its localization, surgery was not possible and the lesion was treated with Cyberknife radiosurgery. Thanks to the treatment, the lesion decreased in size and the symptoms improved significantly. Despite an initially very poor prognosis in view of the localization of the metastasis, the patient is alive and in excellent general condition more than eight months after the diagnosis of recurrence

«Watch and Wait» strategy in the management of rectal adenocarcinoma

Currently, the standard management of locally advanced adenocarcinoma of the middle and lower rectum consists in first intention of pre-operative radio-chemotherapy. This treatment is then usually followed by rectal surgery with removal of the mesorectum. The local recurrence rate is quite low, but at the cost of a non negligible morbidity (urinary, anal and sexual functional sequelae). This raises the question of a possible sparing of surgery and therefore organ preservation in well selected patients with a complete response after radio-chemotherapy. The Brazilians are pioneers in this field. Already in 2004, their publications suggested that the «Watch and Wait» strategy was safe and effective in patients with a complete clinical response. Other publications have followed and tend to confirm that there is no oncological risk in proposing a «watch and wait» strategy for these well selected patients in complete clinical, endoscopic and iconographic remission on the basis of magnetic resonance imaging (MRI). In these conditions, an attentive surveillance strategy allows to avoid operative morbi-mortality without oncological compromise. Monitoring is therefore multi-modal, clinical and endoscopic, but also based on MRI

Predictors of severe Crohn's disease

peer reviewe

Locally advanced pancreatic adenocarcinoma with biliary compression: need for early drainage

The incidence of pancreatic cancer is increasing, but proportion of resectable cases and survival do not increase. Then, our care strategies have to be optimized. Chemotherapy is the principal treatment of locally advanced pancreatic cancer. When the tumour triggers biliary obstruction, chemotherapy-associated morbidity increases, and biliary drainage becomes crucial. Gold-standard is endoscopic retrograde cholangiography, which could be impossible when duodenum or papilla are involved by the tumour. Other options are percutaneous radiologic drainage, surgical double by-pass or EUS-guided drainage. When EUS-guided procedures are available, they are proposed today as the best options

Impacto de um TLC no comércio entre a Colômbia e a Turquia

El artículo explora las oportunidades de crecimiento, diversificación y competencia del comercio entre Colombia y Turquía, y aquellas que se derivarían con la suscripción de un tratado de libre comercio (TLC). Se calculan cinco indicadores de comercio y política comercial y se utiliza información desagregada del año 2010 para hacer simulaciones de equilibrio parcial y estimar los efectos de comercio, bienestar e ingreso que tendría el eventual acuerdo. Los resultados muestran que una reducción arancelaria produciría un aumento del comercio de 3,7% el primer año, reflejado en importaciones colombianas del sector textil y en exportaciones de banano hacía Turquía; se crearía comercio en términos netos y la desviación de comercio afectaría a la Unión Europea, Estados Unidos y Ecuador; los consumidores colombianos y turcos ganarían en términos de bienestar, y se reduciría más el recaudo tributario de Turquía que el de Colombia.The objective of this article is to explore the opportunities for growth, diversification and competition present in trade between Colombia and Turkey, as well as those specific ones that would result from a free trade agreement. Five indicators are calculated to characterize trade and trade policy. Disaggregated data from 2010 is used to conduct partial equilibrium simulations yielding estimates on trade, welfare and income effects. The results show that a tariff reduction would result in a trade increase of 3.7% during the first year, mostly reflected in Colombian imports of textiles and exports of bananas. There would also be net trade creation effects, and trade diversion would affect the European Union, the United States and Ecuador. Turkish and Colombian consumers would gain in terms of welfare and Turkish tax revenues would fall more than those of Colombia.Este artigo explora as oportunidades de crescimento, diversificação e competência do comércio entre a Colômbia e a Turquia, e aquelas que se derivariam com a subscrição de um tratado de livre comércio (TLC). Calculam-se cinco indicadores de comércio e política comercial e utiliza-se informação desvinculada do ano 2010 para fazer simulações de equilíbrio parcial e estimar os efeitos de comércio, bem-estar e ingresso que teria o eventual acordo. Os resultados mostram que uma redução tarifária produziria um aumento do comércio de 3,7% no primeiro ano, refletido em importações colombianas do setor têxtil e em exportações de banana para a Turquia; se criaria comércio em termos líquidos e o desvio de comércio afetaria a União Europeia, os Estados Unidos e o Equador; os consumidores colombianos e turcos ganhariam em termos de bem-estar e se reduziria mais a arrecadação tributária da Turquia do que a da Colômbia

Interest of confocal endomicroscopy for the management of chronic inflammatory bowel disease

Inflammatory bowel diseases are chronic diseases whose long-term evolution depends on the depth of remission. Their clinical and endoscopic evaluation is imperfect. The development of confocal endomicroscopy allows microscopic images to be obtained in vivo. These microscopic data are correlated with the activity of the disease. They predict a possible relapse of the disease and also predict the response to treatment with a biological agent, which allows to modify the therapy before the relapse or to make a rational choice between the different biological agents before introducing a new treatment

Impacto de um TLC no comércio entre a Colômbia e a Turquia

43 páginasEl artículo explora las oportunidades de crecimiento, diversificación y competencia del comercio entre Colombia y Turquía, y aquellas que se derivarían con la suscripción de un tratado de libre comercio (TLC). Se calculan cinco indicadores de comercio y política comercial y se utiliza información desagregada del año 2010 para hacer simulaciones de equilibrio parcial y estimar los efectos de comercio, bienestar e ingreso que tendría el eventual acuerdo. Los resultados muestran que una reducción arancelaria produciría un aumento del comercio de 3,7% el primer año, reflejado en importaciones colombianas del sector textil y en exportaciones de banano hacía Turquía; se crearía comercio en términos netos y la desviación de comercio afectaría a la Unión Europea, Estados Unidos y Ecuador; los consumidores colombianos y turcos ganarían en términos de bienestar, y se reduciría más el recaudo tributario de Turquía que el de Colombia.The objective of this article is to explore the opportunities for growth, diversification and competition present in trade between Colombia and Turkey, as well as those specific ones that would result from a free trade agreement. Five indicators are calculated to characterize trade and trade policy. Disaggregated data from 2010 is used to conduct partial equilibrium simulations yielding estimates on trade, welfare and income effects. The results show that a tariff reduction would result in a trade increase of 3.7% during the first year, mostly reflected in Colombian imports of textiles and exports of bananas. There would also be net trade creation effects, and trade diversion would affect the European Union, the United States and Ecuador. Turkish and Colombian consumers would gain in terms of welfare and Turkish tax revenues would fall more than those of Colombia