Individual patient data meta-analysis of adjuvant gemcitabine-based chemotherapy for biliary tract cancer: combined analysis of the BCAT and PRODIGE-12 studies.

Background: Although gemcitabine-based chemotherapy is the standard of care for advanced biliary tract cancers (BTCs), adjuvant phase III studies (BCAT in Japan, PRODIGE 12 in France) failed to show benefit, possibly owing to fewer patients (n = 225 and n = 194) compared with the adjuvant capecitabine BILCAP trial (n = 447). We performed a combined analysis of both gemcitabine-based chemotherapy adjuvant studies.

Methods: We performed individual patient data meta-analysis of all patients included in BCAT and PRODIGE 12.

Severe spontaneous epistaxis: retrospective study in a tertiary ENT centre.

Purpose: To investigate the clinical profile and outcomes of different treatment strategies in patients hospitalized for spontaneous severe epistaxis.

Methods: This is a retrospective descriptive study of a case series of patients hospitalized for epistaxis in the University Hospital of Ghent between 2005 and 2012.

Results: 124 patients with, respectively, 132 episodes were included.

Stepwise approach towards adoption of allergen immunotherapy for allergic rhinitis and asthma patients in daily practice in Belgium: a BelSACI-Abeforcal-EUFOREA statement.

Allergic rhinitis (AR) affects 23-30% of the European population with equal prevalence reported in Belgium. Despite guidelines on the correct use of effective treatment, up to 40% of AR patients remain uncontrolled. Allergen immunotherapy (AIT) has been shown to improve the level of control up to 84% of patients being controlled by AIT.

Gemcitabine and Oxaliplatin Chemotherapy or Surveillance in Resected Biliary Tract Cancer (PRODIGE 12-ACCORD 18-UNICANCER GI): A Randomized Phase III Study.

Purpose: No standard adjuvant treatment currently is recommended in localized biliary tract cancer (BTC) after surgical resection. We aimed to assess whether gemcitabine and oxaliplatin chemotherapy (GEMOX) would increase relapse-free survival (RFS) while maintaining health-related quality of life (HRQOL) in patients who undergo resection.

Patients And Methods: We performed a multicenter, open-label, randomized phase III trial in 33 centers.

Longitudinal changes in hearing threshold levels for noise-exposed military personnel.

Purpose: Military personnel are exposed to variable and sometimes very high noise in their professional environment. The aim of this study is to evaluate through a longitudinal study if our hearing conservation program has to be adapted to consider specific interventions for subgroups of our military population still subject to a higher risk of hearing loss.

Methods: We conducted a retrospective longitudinal study in 2015-2016 to describe the evolution of hearing threshold levels of military personnel as measured during periodic audiometric screening over a period of 6 years (2009-2014) after the implementation of our hearing conservation program.

Civilian law: from occupational medicine to occupational event.

Civilian law:from occupational medicine to occupational event. Despite the growing importance of objective measurements, the health effects of many occupational risk factors are currently not fully quantified. Occupational noise, as a widespread risk factor, is illustrative in this regard; there is a strong body of evidence linking it to an important health outcome (hearing loss), but it is less decisively associated with others (such as psychological disorders).

Long-term complications after facial, pharyngeal, laryngeal and tracheal traumas.

Unlabelled: Long-term complications after facial, pharyngeal, laryngeal and tracheal traumas.

Objective: To review and summarize the existing evidence for long-term anatomical and functional complications after pharyngeal, laryngeal and tracheal traumas.

Data Sources: The MEDLINE database and the bibliographies of relevant studies were selected, analysed and appraised prior to December 2015.

At risk populations: from children to the elderly.

Unlabelled: At risk populations:from children to the elderly.

Problems/objectives: When considering emergencies in children and elderly people, the risks and consequences are considerably different. For example, the anatomical differences of children have direct consequences on intubation and airway physiology influences breathing, circulation and neurological outcomes.

Management of burn wounds of the head and neck region.

Management of burn wounds of the head and neck region. Management of the severely burned patient is ery often a challenge, not only due to major disturbances in anatomy and physiological processes, but also because the relatively low incidence of this pathology in both civilian and military practice results in care providers'lack of experience. The purpose of this educational document is to provide doctors confronted with these formidable trauma patients with basic management guidelines as well as some practical tips.

Facing coagulation disorders after acute trauma.

Unlabelled: Facing coagulation disorders after acute trauma.

Problems/objectives: Trauma is the leading cause of mortality for persons between one and 44 years of age, essentially due to bleeding complications.

Methodology: We screened the PubMed, Scopus and Cochrane Library databases, using specific keywords.

Protection of respiratory integrity and haemodynamic stabilization.

Unlabelled: Protection of respiratory integrity and haemodynamic stabilization.

Objectives: To perform an analysis of the protection of respiratory integrity and haemodynamic stabilization based on the literature review and the experiences and perspectives of emergency and ENT specialists.

Methodology: A comprehensive literature search was undertaken through PubMed and MEDLINE, using the following keywords: [protection of the respiratory integrity], [intubation], [hypotension] and [haemodynamic stabilization].

Pre-hospital interventions: introduction to life support systems.

Pre-hospital interventions: introduction to life support systems. Crucial decisions in pre-hospital emergency care are often made; therefore, a tactical emergency medical support team (TEMS) should maintain the capacity to capture the situation instantaneously and in all circumstances. However, low exposure to severe trauma cases can be a weakness for emergency specialists, which makes pre-hospital assessment more difficult.

First-line attitudes in acute medicine.

First-line attitudes in acute medicine. The often complex problems of the trauma and/or severely ill patient present many challenges to front-line emergency staff. Multiple injuries and/or systems of the body involved require careful and timely prioritization and intervention.

Recruitment and activation of circulating neutrophils after sinus surgery.

Objective: After failure of pharmacological treatment, sinus surgery is the recommended alternative treatment for chronic sinusitis with or without nasal polyps. During post-operative healing, adequate local neutrophil activation plays an important role in the repair process. This pilot study aimed to systematically explore the participation of circulating neutrophils in early-phase wound repair of the nasal and paranasal mucosa after sinus surgery, with a special focus on neutrophil recruitment and activation patterns.

Remodeling and Repair in Rhinosinusitis.

Remodeling refers to the development of specific but potentially irreversible structural changes in tissue. Caucasian eosinophilic chronic rhinosinusitis (CRS) with polyps associated or not with cystic fibrosis was discriminated by edema from CRS without nasal polyps, characterized by extensive fibrotic fields. However, changes in epithelial and extracellular matrix structures are common findings in all types of chronic inflammatory diseases of upper airways, but rarely specific and highly variable in extend.

Landscape and climatic characteristics associated with human alveolar echinococcosis in France, 1982 to 2007.

Human alveolar echinococcosis (AE) is a severe hepatic disease caused by Echinococcus multilocularis. In France, the definitive and intermediate hosts of E. multilocularis (foxes and rodents, respectively) have a broader geographical distribution than that of human AE.

[Why, when and how to monitor new oral anticoagulants].

Several direct oral anticoagulants (DOACs) are now widely used in the prevention and treatment of thromboembolic events. Unlike vitamin K antagonists, DOACs exhibit predictable pharmacokinetics and pharmacodynamics. DOACs are to be administered at fixed doses without routine coagulation monitoring.

Immunohistochemical studies of wound healing after monopolar electrocautery and ultrasound submucosal inferior nasal turbinate reduction in sheep.

Background: Extracellular matrix (ECM) proteins such as fibronectin and collagen III, enzymes such as matrix metalloproteinases and macrophages have been demonstrated to intervene in nasal and paranasal sinuses wound healing.

Aim Of The Study: To compare concentration of ECM proteins, enzymes and the recruitment of macrophages during wound repair after monopolar electrocautery in contrast with ultrasound submucosal surgical tissue reduction of inferior nasal turbinate (INT) tested in sheep.

Materials And Methods: Prospective controlled study in sheep.

Populations at risk for alveolar echinococcosis, France.

During 1982-2007, alveolar echinococcosis (AE) was diagnosed in 407 patients in France, a country previously known to register half of all European patients. To better define high-risk groups in France, we conducted a national registry-based study to identify areas where persons were at risk and spatial clusters of cases. We interviewed 180 AE patients about their way of life and compared responses to those of 517 controls.

Specific medical and surgical treatment for chronic inflammatory diseases in children.

Treatment for chronic inflammatory conditions in children should take into account the specific pathophysiological and clinical processes underlying these disorders. These guidelines provide a framework for both the medical and surgical treatment of chronic inflammatory diseases such as otitis media, allergic rhinitis and chronic rhinosinusitis, chronic inflammation of tonsils and adenoids, and laryngitis. In addition, the role of vaccinations and immunomodulatory therapies is discussed.

Biological conditions affecting chronic inflammation in upper airways in children.

Problems/objectives: A child's immune system cannot depend on a memory-type immune response and it also induces cytokine responses less efficiently. Biological conditions like allergy or cystic fibrosis, immune deficiency or gastrooesophageal reflux can induce and maintain background inflammation in children's upper airways, making newborns and children more susceptible to upper airway infections and inflammations. This paper will describe in brief how allergy, cystic fibrosis, immune deficiency, nasal and paranasal anatomical variants, and gastro-oesophageal reflux (GOR) can affect the immune and inflammatory responses in upper airways and how they could interfere with immunity development and maturation in children.

Chronic inflammation of upper airways in children: basic principles.

Problems/objectives: A child's immune system has to initiate the immune response from scratch and cannot depend on a memory-type of immune response. Moreover, the immune system in newborns is also less efficient in inducing cytokine responses. In consequence, newborns and children are more susceptible to upper-airway infections and inflammation than adults.

Different aspects of respiration: relationships between the upper and lower respiratory tracts, and the middle ear cleft, nasal versus oral breathing.

This paper outlines the normal functioning of the child's upper airway: defending the lower airway by means of air conditioning, filtration, initiation of inflammatory reactions or immune responses. We investigate the hypothetical mechanisms that explain the influence of, and interrelations between, mouth breathing and obstructive sleep apnoea on craniofacial development. We advise orthodontic diagnosis and/or intervention at a young age.