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

Asthma and COPD Are Not Risk Factors for ICU Stay and Death in Case of SARS-CoV2 Infection

BACKGROUND: Asthmatics and patients with chronic obstructive pulmonary disease (COPD) have more severe outcomes with viral infections than people without obstructive disease. OBJECTIVE: To evaluate if obstructive diseases are risk factors for intensive care unit (ICU) stay and death due to coronavirus disease 2019 (COVID19). METHODS: We collected data from the electronic medical record from 596 adult patients hospitalized in University Hospital of Liege between March 18 and April 17, 2020, for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. We classified patients into 3 groups according to the underlying respiratory disease, present before the COVID19 pandemic. RESULTS: Among patients requiring hospitalization for COVID19, asthma and COPD accounted for 9.6% and 7.7%, respectively. The proportions of asthmatics, patients with COPD, and patients without obstructive airway disease hospitalized in the ICU were 17.5%, 19.6%, and 14%, respectively. One-third of patients with COPD died during hospitalization, whereas only 7.0% of asthmatics and 13.6% of patients without airway obstruction died due to SARS-CoV2. The multivariate analysis showed that asthma, COPD, inhaled corticosteroid treatment, and oral corticosteroid treatment were not independent risk factors for ICU admission or death. Male gender (odds ratio [OR]: 1.9; 95% confidence interval [CI]: 1.1-3.2) and obesity (OR: 8.5; 95% CI: 5.1-14.1) were predictors of ICU admission, whereas male gender (OR 1.9; 95% CI: 1.1-3.2), older age (OR: 1.9; 95% CI: 1.6-2.3), cardiopathy (OR: 1.8; 95% CI: 1.1-3.1), and immunosuppressive diseases (OR: 3.6; 95% CI: 1.5-8.4) were independent predictors of death. CONCLUSION: Asthma and COPD are not risk factors for ICU admission and death related to SARS-CoV2 infection

Les troubles factices (quelle place pour la psychiatrie de liaison?)

LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Insights on immunotherapy in pulmonary oncology

peer reviewedImmunotherapy, based on the immune response to tumor cells, gives a new therapeutic hope for lung cancer whose prognosis remains dark. Four molecules are currently available in clinical practice. They were first studied for non-small cell cancers in the second and third line of treatment with a significant improvement in overall survival, then in maintenance treatment and more recently in the front line with a significant response. Their complications, mainly dysimmune adverse effects, are protean but immunotherapy remains better tolerated than chemotherapy. It opens many perspectives but further studies, including biomarkers, are still needed. © 2018 Editions Medecine et Hygiene. All rights reserved

Non small cell lung carcinoma in never-smokers at the Liege University Hospital : a retrospective cohort study, 2017-2018.

editorial reviewedLung cancer is the third most common cancer in Belgium in 2017 and remains the leading cause of cancer death worldwide. There is no longer any doubt that the main cause of lung cancer is smoking. However, the prevalence of lung cancer in never-smokers has been increasing overtime. Moreover, it is now recognized that the lung cancer of non-smoker patients has very distinct characteristics. In this retrospective cohort study (N = 520), we describe the characteristics of non-smoker patients and their non-small cell lung carcinoma and compare them to those of smokers. The patients included in this study were whose with a new diagnostic of lung cancer made at the Liège University Hospital of Liège over 2 years round. Non small cell lung cancer occurring in never-smokers patients is more often seen in young and very old patients, more frequent in female, essentially adenocarcinoma and often associated with mutations. This work confirms that lung cancer in never-smokers shows different features than lung cancer seen in patients with a smoking history.Le cancer pulmonaire est le troisième cancer le plus fréquent en Belgique en 2017 et reste la première cause de décès par cancer dans le monde. Il ne fait plus aucun doute que la cause principale de cancer du poumon est le tabagisme. Il est toutefois apparu, ces dernières décennies, que le pourcentage de patients non fumeurs augmente parmi les patients présentant un cancer du poumon. Par ailleurs, il est dorénavant reconnu que le cancer pulmonaire du patient non fumeur présente des caractéristiques bien distinctes. Dans ce contexte, nous présentons une étude rétrospective reprenant les caractéristiques cliniques et néoplasiques de l’ensemble des patients ayant présenté un carcinome pulmonaire non à petites cellules dans notre institution sur une période de 2 ans (N = 520). Les cancers non à petites cellules observés chez les nonfumeurs sont plus fréquents chez les sujets jeunes ou très âgés, plus fréquents dans le sexe féminin, en très grande majorité des adénocarcinomes, et souvent associés à des mutations. Nous confirmons ainsi qu’il s’agit d’un cancer aux caractéristiques différentes des cancers pulmonaires des patients fumeurs

Long-Term Increase of Kcnn4 Potassium Channel Surface Expression on B Cells in Pemphigus Patients after Rituximab Treatment

International audienc

How I manage... Malignant pleural mesothelioma in 2019

peer reviewedMalignant pleural mesothelioma is a rare disease originating from mesothelial cells of the pleura and is related to asbestos exposure. The tumor is generally extended at the time of diagnosis and the treatment consists of a systemic palliative therapy. Radical approach is limited to very selected patients and is performed in expert centers but without validated schema. Radiotherapy alone is mainly used in palliative intent. Platinum-based chemotherapy in association with pemetrexed is the frontline standard of care and provides a 12-month overall survival. The addition of bevacizumab, an antiangiogenic drug, shows an improvement in median survival. To date, there is no second-line treatment approved for this disease and therefore inclusion in trials is recommended. Currently, various studies are investigating target therapy, immunotherapy and intrapleural perioperative treatment

0133: The Log Book as a new tool for the secondary prevention of coronary artery disease

International audienceIntroductionThe Log book (LB) project was created by a multidisciplinary team of healthcare professionals from a regional care network and aimed to improve secondary prevention (SP) after acute myocardial infarction (MI) in Cote d’Or. LB includes information and advices for increasing self management of risk factors by the patient.MethodsA prospective interventional study on 469 patients hospitalised for an acute MI in the 2 Intensive Coronary Care unit of Côte d’Or (CHU Dijon and Clinique de Fontaine les Dijon) in 2012 and surviving at 1 year follow-up (FU). LB was randomly given at the time of their hospitalisation by the nursing team, also providing oral advices on risk factors management and CV health self care. Patients who received LB (LB+) were compared with patients without LB (LB-).ResultsPatients from LB+ group (n=307(65%)) were younger (57 vs 63y, p<0.001)) and less frequently women (16 vs 32%, p<0.001), diabetic (17 vs 30%, p<0.001) or with prior CAD (7 vs 15%, p=0.008) than patients without LB (LB- group, n=162(35%)). After matching patients LB+ with LB- based on age, sex, diabetes and GRACE risk score (n=127 in each group), baseline characteristics, were similar in the 2 groups. At 1 year FU, there was a trend for more frequent visits to the cardiologist in the LB+ group (2±1 vs 1±1, p=0.056) and cardiac rehabilitation program was more often performed in LB+ patients (69 vs 54%, p=0.015). Moreover, weight loss in obese patients and smoke withdrawal rates also showed a trend for improvement in LB+ patients (respectively 71 vs 59%, p=0.311 and 69 vs 53%, p=0.109). Finally, patients with LB showed a trend toward a lower rate of combined outcomes including recurrent MI, hospitalisation for heart failure and unscheduled PCI than in the LB- group (3 vs 7%, p=0.155).ConclusionThese preliminary data of our ongoing regional study suggest the efficacy of LB as a support for CV risk factor self management. In addition, our study provides encouraging data on the potential clinical benefits of this pioneer tool for SP

Neuroendocrine neoplasms : a new era to the top of multidisciplinarity !

editorial reviewedNeuroendocrine neoplasms are histologically defined by a common neuroendocrine cellular phenotype. These are still considered as rare tumours even though their incidence is increasing. Heterogeneity is everywhere whether in the localization of the primitive cancer, the clinical presentation, the histological classification, the prognosis, as well as in therapeutic options, which clearly justifies specialized multidisciplinary care. Heterogeneity and scarcity explain the still fragmented nature of knowledge in this domain. Thanks to an increase in incidence, a desire for standardization of classification as well as the arrival of major therapeutic advances, such as vectorized internal radiotherapy, the future of neuroendocrine neoplasia seems more than promising and exciting. In our daily clinical practice at CHU Liège, we hope to bring our stone to the building by listing as many cases as possible in national and/or international databases, by centralizing therapeutic discussions within specific multidisciplinary concertations and by participating in multicenter study protocols.Les néoplasies neuroendocrines sont définies histologiquement par un phénotype cellulaire neuroendocrine commun. Ces néoplasies sont toujours considérées comme des tumeurs rares, bien que leur incidence soit en constante augmentation. L’hétérogénéité est omniprésente, que ce soit dans la localisation du cancer primitif, la présentation clinique, la classification histologique, le pronostic ainsi que dans les diverses options thérapeutiques, justifiant impérativement une prise en charge pluridisciplinaire spécialisée. Cette hétérogénéité et cette rareté expliquent que les connaissances soient parcellaires. Grâce à une majoration d’incidence, une volonté d’uniformisation de classification ainsi que l’arrivée d’avancées thérapeutiques majeures, telles que la radiothérapie interne vectorisée, l’avenir des néoplasies neuroendocrines semble plus que prometteur et palpitant. En pratique clinique quotidienne au CHU de Liège, nous espérons apporter notre pierre à l’édifice en recensant un maximum de cas dans des bases de données nationales et/ou internationales, en centralisant les discussions thérapeutiques au sein de concertations multidisciplinaires dédiées et en participant à des protocoles d’études cliniques multicentriques