Myeloid Sarcoma of the Uterine Cervix as Presentation of Acute Myeloid Leukaemia after Treatment with Low-Dose Radioiodine for Thyroid Cancer: A Case Report and Review of the Literature

The development of acute myeloid leukaemia after low-dose radioiodine therapy and its presentation as a myeloid sarcoma of the uterine cervix are both rare events. We report a case of acute myeloid leukaemia revealed by a myeloid sarcoma of the uterine cervix in a 48-year-old woman, 17 months after receiving a total dose of 100 mCi 131I for papillary thyroid cancer. A strict hematological follow-up of patients treated with any dose of 131I is recommended to accurately detect any hematological complications which might have been underestimated. Unusual presentations, such as chloroma of the uterine cervix, may reveal myeloid malignancy and should be kept in mind

Therapeutic targeting of replicative immortality

One of the hallmarks of malignant cell populations is the ability to undergo continuous proliferation. This property allows clonal lineages to acquire sequential aberrations that can fuel increasingly autonomous growth, invasiveness, and therapeutic resistance. Innate cellular mechanisms have evolved to regulate replicative potential as a hedge against malignant progression. When activated in the absence of normal terminal differentiation cues, these mechanisms can result in a state of persistent cytostasis. This state, termed “senescence,” can be triggered by intrinsic cellular processes such as telomere dysfunction and oncogene expression, and by exogenous factors such as DNA damaging agents or oxidative environments. Despite differences in upstream signaling, senescence often involves convergent interdependent activation of tumor suppressors p53 and p16/pRB, but can be induced, albeit with reduced sensitivity, when these suppressors are compromised. Doses of conventional genotoxic drugs required to achieve cancer cell senescence are often much lower than doses required to achieve outright cell death. Additional therapies, such as those targeting cyclin dependent kinases or components of the PI3K signaling pathway, may induce senescence specifically in cancer cells by circumventing defects in tumor suppressor pathways or exploiting cancer cells’ heightened requirements for telomerase. Such treatments sufficient to induce cancer cell senescence could provide increased patient survival with fewer and less severe side effects than conventional cytotoxic regimens. This positive aspect is countered by important caveats regarding senescence reversibility, genomic instability, and paracrine effects that may increase heterogeneity and adaptive resistance of surviving cancer cells. Nevertheless, agents that effectively disrupt replicative immortality will likely be valuable components of new combinatorial approaches to cancer therapy

First Evidence of Palytoxin and 42-Hydroxy-palytoxin in the Marine Cyanobacterium Trichodesmium

Marine pelagic diazotrophic cyanobacteria of the genus Trichodesmium (Oscillatoriales) are widespread throughout the tropics and subtropics, and are particularly common in the waters of New Caledonia. Blooms of Trichodesmium are suspected to be a potential source of toxins in the ciguatera food chain and were previously reported to contain several types of paralyzing toxins. The toxicity of water-soluble extracts of Trichodesmium spp. were analyzed by mouse bioassay and Neuroblastoma assay and their toxic compounds characterized using liquid chromatography coupled with tandem mass spectrometry techniques. Here, we report the first identification of palytoxin and one of its derivatives, 42-hydroxy-palytoxin, in field samples of Trichodesmium collected in the New Caledonian lagoon. The possible role played by Trichodesmium blooms in the development of clupeotoxism, this human intoxication following the ingestion of plankton-eating fish and classically associated with Ostreopsis blooms, is also discussed

High frequency of central nervous system involvement in transformed Waldenstrom macroglobulinemia

Histologicaltransformation (HT) to diffuse large B-cell lymphoma (DLBCL) is a rare event in Waldenström macroglobulinemia (WM) and is associated with a poor prognosis.1-4 It confers an inferior outcome compared with WM patients without HT.2,3 Most transformed WM patients present with elevated serum lactate dehydrogenase (LDH) levels and extranodal disease.1 Among extranodal sites, the central nervous system (CNS) is one of the most frequently involved sites identified at diagnosis of transformed WM (ranging from 13% to 18%).1,3 However, the prognostic value of CNS involvement is unknown, and the rate of CNS involvement at relapse has not been previously reported in this setting.This work was supported by Cancer Research UK [C355/A26819], FC AECC, and AIRC under the “Accelerator Award Program” [EDITOR] to M.A. and R.G.-S

Un outil d’aide au dimensionnement, à la planification et à la visualisation d’un programme opératoire

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Une tentative d'unification et de résolution des problèmes de modélisation et d'optimisation dans les systèmes hospitaliers . Application au nouvel hôpital Estaing

The objective of this thesis is to study simulation and decision-making tools for the management and the supervision of the hospital systems (technical support center, care units, emergency departments...). These questions remain crucial and have been the object of research studies in laboratories for a few years now. Today, predictive methods are commonly used as inspired by the practice of industrial systems. Therefore, reactive methods appear essential to allow for a real-time follow-up of the systems. The subject of this research is an attempt to create models of the various types of flow (patient, staff, equipment...), and their interactions, together with the definition and evaluation of related performance indicators. The purpose is to study the hospital systems class and to suggest a methodology of simulation and decision-making aid for management and supervision. These questions are studied within the framework of the NHE project (New Estaing Hospital) in the city of Clermont-Ferrand. The main concern focuses on the design of generic models of the various classes of systems, but also on the definition of performance indicators and the design and implementation of decision-making tools for hospital managers (Directors, department heads, doctors, health executives...).L'objectif de cette thèse est d'étudier les problèmes de simulation et d'aide à la décision pour la gestion et le pilotage des systèmes hospitaliers (plateaux médico-techniques, unité de soins, services d' urgence ...). Cette problématique est très importante et fait l'objet depuis quelques années de travaux de recherche dans des laboratoires. A l'heure actuelle, les approches proposées sont des approches prédictives et s'inspirent des méthodes mises en oeuvre dans les systèmes industriels. Il apparaît indispensable de proposer des approches réactives permettant un suivi quasiment en temps réel des systèmes. Le sujet proposé concerne la modélisation des différents types de flux (patients, personnels, matériels, ...) et de leurs interactions et l'évaluation d'indicateurs de performance à définir. Il s'agit donc d'étudier la classe (le domaine) des systèmes et de proposer une méthodologie de simulation et d'aide à la décision pour la gestion et le pilotage. Cette problématique est étudiée dans le cadre du projet NHE (Nouvel hôpital Estaing) à Clermont-Ferrand et s'intéresse plus particulièrement à la conception de modèles génériques des différentes classes de systèmes, à la définition d'indicateurs de performance et à la conception et mise en oeuvre d'outils d'aide à la décision pour les managers hospitaliers (directeur, chef de servive, médecin, cadre de santé ...

Du féodalisme établissement au pilotage de territoire,de nouveaux boulevards à explorer pour les sciences de gestion

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Une tentative d'unification et de résolution des problèmes de modélisation et d'optimisation dans les systèmes hospitaliers (Application au nouvel hôpital Estaing)

L'objectif de cette thèse est d'étudier les problèmes de simulation et d'aide à la décision pour la gestion et le pilotage des systèmes hospitaliers (plateaux médico-techniques, unité de soins, services d' urgence ...). Cette problématique est très importante et fait l'objet depuis quelques années de travaux de recherche dans des laboratoires. A l'heure actuelle, les approches proposées sont des approches prédictives et s'inspirent des méthodes mises en oeuvre dans les systèmes industriels. Il apparaît indispensable de proposer des approches réactives permettant un suivi quasiment en temps réel des systèmes. Le sujet proposé concerne la modélisation des différents types de flux (patients, personnels, matériels, ...) et de leurs interactions et l'évaluation d'indicateurs de performance à définir. Il s'agit donc d'étudier la classe (le domaine) des systèmes et de proposer une méthodologie de simulation et d'aide à la décision pour la gestion et le pilotage. Cette problématique est étudiée dans le cadre du projet NHE (Nouvel hôpital Estaing) à Clermont-Ferrand et s'intéresse plus particulièrement à la conception de modèles génériques des différentes classes de systèmes, à la définition d'indicateurs de performance et à la conception et mise en oeuvre d'outils d'aide à la décision pour les managers hospitaliers (directeur, chef de servive, médecin, cadre de santé ...)CLERMONT FD-BCIU Sci.et Tech. (630142101) / SudocSudocFranceF

Un outil d’aide au dimensionnement, à la planification et à la visualisation d’un programme opératoire

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