Acceptability of Elderly Cancer Patients and Tolerance to COVID-19 Vaccination in the Brittany Region<br/>L’acceptabilité du Patient Âgé Porteur de Cancer et la Tolérance à la Vaccination Anti-COVID-19 dans la Région Bretagne

Context: Since January 2021, vaccination for COVID-19 has been made possible in France for people aged 75 and over. Patients suffering from a cancer disease are part of a group at risk to develop severe complications to COVID-19. Method: The « Unité de coordination en Onco-Gériatrie région Bretagne » (the Brittany This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Coordinating Unit in Onco-Geriatrics) has wished to set up an inquest about the acceptability and the tolerance to COVID-19 vaccination by old-aged patients suffering from cancer in the Brittany region. Results: The study has been carried out between May 1, 2021 and August 31, 2021 in 7 Breton centers. 50 patients have been included in the study with an average age of 84 (72-93). At the time of inclusion, 43 patients had already been vaccinated (80% having had 2 injections and 8% only one). Among them, 86% have declared they had had a very good tolerance to the first injection of the vaccine, and 90% to the second injection. 12% of the patients had not been vaccinated. Conclusion: Overall, in our study, old-aged patients suffering from cancer haven’t been reluctant to the antiCOVID-19 vaccination and have shown a very good tolerance to these vaccines. However, seen the profile of these patients and the period of inclusion, the number of patients showing a complete vaccinal outline should have been more consistent, indeed even total.

RÉSUMÉ
Contexte: Depuis le 25 janvier 2021, la vaccination de la COVID-19 a pu être réalisée en France auprès des personnes âgées de 75 ans et plus. Les patients souffrant d’une maladie cancéreuse font partie des groupes à risque de développer des complications sévères à la COVID-19. Méthode: L’Unité de Coordination en Onco-Gériatrie région Bretagne a souhaité mettre en place une enquête sur l’acceptabilité du patient âgé porteur de cancer et sur la tolérance à la vaccination anti-COVID 19 dans la région Bretagne. Résultats: L’étude a été réalisée entre le 1^er mai 2021 et le 31 août 2021 dans 7 centres bretons. 50 patients ont été inclus avec un âge médian de 84 ans (72–93). 43 patients au moment de l’inclusion avaient été vaccinés (80% ayant eu 2 injections et 8% une seule injection). Parmi eux, 86% ont déclaré avoir eu une très bonne tolérance à la première injection du vaccin et 90 % à la seconde injection. 12% des patients n’étaient pas vaccinés. Conclusion: Globalement, dans notre étude, les patients âgés porteurs de cancer ne présentaient pas de réticence à lavaccination anti-COVID19 et ont eu une très bonne tolérance à ces vaccins. Cependant, au vu du profil de ces patients et de la période d’inclusion, le nombre de patients présentant un schéma vaccinal complet aurait pu être plus conséquent.     

Secondary nocturnal enuresis related to central diabetes insipidus as an early manifestation of intracranial germinomatous germ cell tumors in a series of male youngsters

Nocturnal enuresis is a common symptom in children. It is usually attributed to benign causes and diagnostic evaluation is not carried out. We report three male young patients initially presenting with short stature and nocturnal enuresis, related to diabetes insipidus, caused by intracranial germinomatous germ cell tumors. In all three cases, water deprivation tests confirmed diabetes insipidus. Extensive endocrinological investigation also showed further hormone deficiencies. Magnetic resonance imaging of the brain revealed the presence of a central nervous system lesion and histology confirmed the final diagnosis. Surgery, radiation with or without chemotherapy was conducted and the patients were treated with hormone replacement therapies. The patients after a long follow-up were free of disease. We present these cases to alert clinicians to bear in mind that the presence of an intracranial germinomatous germ cell tumor should at least be considered in a child presenting with bed wetting, especially if additional symptoms and signs, including late onset puberty and growth delay or morning hypernatremia, may coexist.     

Circulating endothelial microparticles: a new marker of vascular injury

Cell activation or apoptosis leads to plasma membrane blebbing and microparticles (MPs) release. MPs are submicron membrane vesicles expressing a panel of oxidized phospholipids and proteins specific of the cells they originate from. Exposure of negatively charged phospholipids and tissue factor confers a procoagulant potential to MPs. Increases in plasma MPs levels, particularly those of endothelial origin, reflects cellular injury and appears now as a surrogate marker of vascular dysfunction. MPs are also biologically active and stimulate pro-inflammatory responses in target cells. Thus, MPs can promote a prothrombogenic and pro-inflammatory vicious circle leading to vascular dysfunction. A better understanding of MPs composition, as well as their effects and the mechanisms leading to their clearance will likely open new therapeutic approaches in the treatment and the prognosis of cardiovascular diseases.     

Hémangiome épithélioïde du calcaneus

Résumé: L’hémangiome épithélioïde des os est une tumeur vasculaire bénigne survenant très rarement dans les os du pied. Nous rapportons le cas d’un hémangiome épithélioïde du calcaneus gauche d’un homme de 65 ans. La présentation clinique, radiologique, scanographique, IRM et histologique de la tumeur est donnée. Les radiographies et le scanner objectivaient une lésion ostéolytique bien définie avec une condensation périphérique dans le calcaneus. L’IRM précisait que le centre liquidien était réhaussé par l’injection de gadolinium alors que la portion périphérique était de signal graisseux. L’analyse histologique nous montrait qu’il s’agissait d’un hémangiome épithélioïde osseux. L’exérèse chirurgicale en est le meilleur traitement mais le pronostic reste incertain avec toujours la crainte d’avoir méconnu un contingent malin au sein de la tumeur. Des récidives ont été rapportées après chirurgie et un suivi à long terme est nécessaire. La meilleure connaissance de cette tumeur pourrait permettre d’en améliorer le diagnostic et le traitement.     

Rupture of hepatic focal nodular hyperplasia. About two cases

The diagnostics of focal nodular hyperplasia is reached through the use of imaging. When the diagnostic is certain, surgical abstention is the rule. Nevertheless, we were confronted with two cases of a rare complication; that of intraperitoneal rupture. In this situation, we suggest to first do an arteriography to control the bleeding, then to perform surgery when the patient has reached hemodynamic stability. Spontaneous rupture as a complication of benign nodular hyperplasia remains a rare event and only five cases were reported in litterature.