BACKGROUND: Intermediate-risk (IR) Non-Muscle Invasive Bladder Cancer (NMIBC) is associated with a high rate of tumor recurrence. To improve patient outcomes, it is recommended to use adjuvant intravesical therapy, by mitomycin C (MMC) or Bacillus Calmette Guerin (BCG). Gemcitabine (GMC) is a known molecule used in urothelial cancer. We aimed to study the efficacy and safety profile of a gemcitabine solution, compared to mitomycin C, in the treatment of IR NMIBC.
METHODS: In this retrospective study, patients with IR NMIBC treated between 2016 and 2020 were selected from two participating centers using either gemcitabine (center A) as the intravesical chemotherapy regimen or mitomycin C (center B). The primary endpoint was recurrence rate and secondary end points were treatment interruption and its causes.
RESULTS: In our cohort of 102 IR NMIBC patients, 49 patients received GMC and 53 MMC with a median follow-up of 30 months. Overall recurrence rate was 42.1% with 22.4% in the GMC group and 60.3% in the MMC group (P<0.01). This difference was also found in the multifactorial analysis. Course interruption was observed in 14.7% of all patients, primarily attributed to adverse events (46.6%), without difference between groups.
CONCLUSIONS: Adjuvant intravesical gemcitabine in patients with IR NMIBC seems to be an interesting option associated with a lower tumor recurrence rate and a favorable tolerance profile when compared to MMC. Larger scale prospective randomized trials are needed to validate our findings.
METHODS: III.

Patients with cancer are at significantly increased risk of venous thromboembolism (VTE), due both to the impact of malignant disease itself and to the impact of certain anticancer drugs on haemostasis. This is true both for first episode venous thromboembolism and recurrence. The diagnosis and management of VTE recurrence in patients with cancer poses particular challenges, and these are reviewed in the present article, based on a systematic review of the relevant scientific literature published over the last decade. Furthermore, it is uncertain whether diagnostic algorithms for venous thromboembolism, validated principally in untreated non-cancer patients, are also valid in anticoagulated cancer patients: the available data suggests that clinical decision rules and D-dimer testing perform less well in this clinical setting. In patients with cancer, computed tomography pulmonary angiography and venous ultrasound appear to be the most reliable diagnostic tools for diagnosis of pulmonary embolism and deep vein thrombosis respectively. Options for treatment of venous thromboembolism include low molecular weight heparins (at a therapeutic dose or an increased dose), fondaparinux or oral direct factor Xa inhibitors. The choice of treatment should take into account the nature (pulmonary embolism or VTE) and severity of the recurrent event, the associated bleeding risk, the current anticoagulant treatment (type, dose, adherence and possible drug-drug interactions) and cancer progression.

BACKGROUND: Basal cell carcinomas (BCCs) represent 90% of malignant tumors of the eyelids, which can be locally invasive and destructive. The observation of histological safety margins (MHS) allows for the prevention of recurrence while maintaining a fair compromise between aesthetics and functionality. However, to date, there is no consensus or national recommendations concerning the MHS to be observed according to the various histological subtypes of BCCs.
METHODS: Through a retrospective analysis of patient records and corresponding excisional slides, we studied the 6-year recurrence rate of 98 patients who underwent surgery for palpebral BCC.
RESULTS: MHS were mostly absent in the excisional specimens of recurrent BCCs and significantly more narrow than in non-recurrent BCCs, on average over 2mm.
CONCLUSIONS: The results of our study suggest that an average MHS greater than 2mm prevents most recurrences.

This case series describes the clinical course of ocular and non-ocular squamous cell carinoma (SCC) in the Haflinger horse and is intended to raise awareness of the high recurrence rate and tendency to metastasize. Eight Haflingers with histologically confirmed SCC were included, five ocular and three non-ocular, who were presented at the Institut Suisse de Médecine Équine (ISME) Bern between July 2015 and January 2022. The ocular SCC cases were all presented because of an apparent mass, which in most cases was post-treatment recurrence. The occurrence of recurrences was observed between 3 weeks and 16 years after initial therapy. Four of five Haflingers with ocular SCC had an enucleation, three of which were clinically normal at the time of the completion of this study, one case was euthanized due to confirmed metastases and one due to lameness. The result of enucleations for therapy of ocular SCC was good if no metastases occurred. Of the three non-ocular SCC cases, only one case, a penile SCC, had an apparent mass. Therapy was initiated in this case, while the other two cases were euthanized shortly after diagnosis due to the poor prognosis of SCC in the appropriate locations (maxillary sinus, mandible). Metastases occurred three and two years after removal of the primary tumor in ocular SCC in the scapula, liver and lungs and in non-ocular SCC from the penis to the nostrils. Since a postmortem pathological examination was not carried out on all Haflingers, further metastases cannot be ruled out. Haflingers with SCC should be monitored by a veterinarian over the long term, as recurrences and/or metastases can still occur years later.
Diese Fallserie beschreibt den klinischen Verlauf des okulären und nicht-okulären Plattenepithelkarzinoms (SCC) beim Haflinger und soll für die hohe Rezidivrate und Metastasierungstendenz sensibilisieren. Eingeschlossen wurden acht Haflinger mit histologisch bestätigtem SCC, davon fünf okuläre und drei nicht-okuläre, die zwischen Juli 2015 und Januar 2022 an der Pferdeklinik Institut Suisse de Médecine Équine (ISME) Bern vorgestellt wurden. Die okulären SCC wurden alle aufgrund einer augenscheinlichen Masse vorgestellt, bei der es sich in den meisten Fällen um ein Rezidiv nach bereits erfolgter Behandlung handelte. Das Auftreten von Rezidiven wurde zwischen 3 Wochen und 16 Jahren nach initialer Therapie beobachtet. Bei vier von fünf Haflingern mit okulärem SCC wurde eine Enukleation des Augapfels vorgenommen, davon sind drei zum Zeitpunkt des Abschlusses dieser Studie klinisch unauffällig, ein Fall wurde aufgrund bestätigter Metastasen und einer aufgrund von Lahmheit euthanasiert. Das Resultat der Enukleationen zur Therapie der okulären SCC war gut, solange keine Metastasen auftraten. Von den drei nicht-okulären SCC-Fällen wies nur ein Fall, ein SCC am Penis, eine augenscheinliche Masse auf. In diesem Fall wurde eine Therapie eingeleitet, während die beiden anderen Fälle aufgrund der schlechten Prognose von SCC in den entsprechenden Lokalisationen (Sinus maxillaris, Mandibula) kurz nach der Diagnosestellung euthanasiert wurden. Metastasen traten drei bzw. zwei Jahre nach Entfernung des Primärtumors bei einem okulären SCC in Scapula, Leber und Lunge und bei einem nicht-okulären SCC vom Penis in den Bereich der Nüstern auf. Da nicht bei allen Haflingern eine postmortale pathologische Untersuchung durchgeführt wurde, können weitere Metastasen nicht ausgeschlossen werden. Haflinger mit SCC sollten unbedingt langfristig tierärztlich überwacht werden, da auch nach Jahren noch Rezidive und/oder Metastasen auftreten können.
Cette série de cas décrit l’évolution clinique des carcinomes épidermoïdes (CE) oculaires et non oculaires chez le cheval Haflinger et vise à faire prendre conscience du taux de récidive élevé et de la tendance à la formation de métastases. Huit Haflinger avec un CE confirmé histologiquement, cinq oculaires et trois non-oculaires, qui ont été présentés à l’Institut Suisse de Médecine Équine (ISME) Berne entre juillet 2015 et janvier 2022, ont été inclus. Les cas de CE oculaires ont tous été présentés en raison d’une masse apparente, qui dans la plupart des cas était une récidive post-traitement. La survenue des récidives a été observée entre 3 semaines et 16 ans après le traitement initial. Quatre des cinq Haflinger atteints de CE oculaire ont subi une énucléation, dont trois étaient cliniquement normaux au moment de l’achèvement de l’étude, un cas ayant été euthanasié en raison de métastases confirmées et un autre en raison d’une boiterie. Le résultat des énucléations pour la thérapie du CE oculaire était bon s’il n’y avait pas de métastases. Sur les trois cas de CE non oculaires, seul un cas, un CE pénien, présentait une masse apparente. Le traitement a été initié dans ce cas, tandis que les deux autres cas ont été euthanasiés peu de temps après le diagnostic en raison du mauvais pronostic des CE dans les localisations constatées (sinus maxillaire, mandibule). Des métastases sont apparues trois et deux ans après l’ablation de la tumeur primaire dans le cas du CE oculaire, au niveau de l’omoplate, du foie et des poumons et, dans un cas de CE non oculaire, celui du pénis, aux narines. Étant donné que tous les Haflinger n’ont pas fait l’objet d’un examen pathologique post-mortem, on ne peut exclure la possibilité d’autres métastases. Les Haflinger atteints de CE doivent être suivis à long terme par un vétérinaire, car des récidives et/ou des métastases peuvent encore survenir des années plus tard.
Questa serie di casi descrive l’andamento clinico dei carcinomi a cellule squamose (SCC) oculari e non oculari nel cavallo di razza Avelignese e ha lo scopo di sensibilizzare riguardo all’alta frequenza di recidive e alla propensione alla metastatizzazione. Sono stati inclusi otto Avelignesi con SCC confermati istologicamente, di cui cinque oculari e tre non oculari, che sono stati presentati presso l’Istitut Suisse de Médecine Équine (ISME) di Berna tra luglio 2015 e gennaio 2022. I casi di SCC oculare sono stati tutti presentati a causa di una massa apparente, che nella maggior parte dei casi era una recidiva post-trattamento. La comparsa delle recidive è stata osservata tra 3 settimane e 16 anni dopo la terapia iniziale. Quattro dei cinque Avelignesi affetti da SCC oculare sono stati sottoposti ad enucleazione, tre dei quali erano clinicamente normali al momento della conclusione di questo studio, un caso è stato eutanasizzato a causa di metastasi confermate e uno a causa di zoppia. Il risultato dell’enucleazione come terapia per il SCC oculare è stato positivo se vi erano metastasi. Dei tre casi di SCC non oculare, solo un caso, un SCC penieno, presentava una massa apparente. La terapia è stata avviata in questo caso, mentre gli altri due casi sono stati eutanasizzati poco dopo la diagnosi a causa della scarsa prognosi del SCC dovuta alla loro localizzazione (seno mascellare e mandibola). Le metastasi sono comparse due e tre anni dopo l’asportazione del tumore primario nel SCC oculare nella scapola, nel fegato e nei polmoni, e nel SCC non oculare nel pene e nell’area delle narici. Poiché non è stata effettuata un’analisi patologica post mortem su tutti gli Avelignesi, ulteriori metastasi non possono essere escluse. Gli Avelignesi affetti da SCC dovrebbero essere monitorati a lungo termine da un veterinario, poiché le recidive e/o le metastasi possono ancora verificarsi dopo anni.

Management of recurrent Dupuytren\'s disease of the little finger is challenging. Various treatment modalities have been proposed: external fixation, local skin flap, dermofasciectomy, or even amputation. An alternative surgical technique was introduced by Honecker et al. in 2016 and refined by Raimbeau et al. in 2019, consisting in resection of the middle phalanx and shortening arthrodesis. We modified the technique by combining arthrodesis with a limited fasciectomy of the abductor and/or pretendinous cord in the fifth ray to improve cosmetic and functional outcomes.
Patients with severe recurrent Dupuytren\'s disease of the little finger (Tubiana stage III/IV) were treated with proximodistal interphalangeal arthrodesis, combined with limited fasciectomy. Range of motion was assessed preoperatively and postoperatively. QuickDASH and a VAS were assessed to determine overall function and pain respectively. Radiographic evaluation was made at 6 and 12 weeks postoperatively.
Thirteen patients were eligible for inclusion. Mean age was 69 years (range 49-87). Radiographic consolidation was obtained at a mean 58 days (range 27-97). Full extension of the metacarpophalangeal joint was achieved in 11 patients and full adduction in 12. Mean active flexion was 94° (range 90-100). QuickDASH scores decreased from 18 to 12 after surgery. Pain scores were low and unchanged.
By combining proximodistal interphalangeal arthrodesis with limited fasciectomy through a volar approach, finger extension improved, and fixed abduction was also treated. The combined volar and dorsal approach did not induce vascular impairment or other complications.

BACKGROUND: Darrier-Ferrand dermatofibrosarcoma (DFSC) is the most common cutaneous sarcoma. It generally affects subjects with an average age of 40 years, without gender or race predominance. It is a tumour characterised by a slow evolution and local aggressiveness. The reasons for consultation are pain, pruritus or rapidly progressive evolution. There are no specific imaging studies for this tumour. The diagnosis of certainty is based on immunohistochemistry with positive CD34 labelling. Treatment is surgical based on wide excision.
METHODS: This is an observation of a patient operated in our department for the initial diagnosis of cutaneous leiomyosarcoma of the right flank that rapidly increased in volume to 10cm in six months. A large fasciocutaneous excision was performed. The postoperative course was simple.
CONCLUSIONS: In our patient, this lesion occurred on an old burn scar. This notion of skin trauma preceding the appearance of DFSC is reported in 10 to 20% of cases. The rapid increase in volume was the reason for consultation. The diagnosis of DFSC could only be made on definitive analysis of the surgical specimen, which showed positive immunostaining for CD34. The occurrence of metastases, although rare, confers a survival of no more than two years. The prognostic factors depend on the quality of the surgical excision, the presence of metastases and certain locations (head, neck), which make the surgery particularly mutilating. Only long-term monitoring attests to definitive cure, given the frequency of recurrence.
CONCLUSIONS: DFSC is a rare and slowly evolving tumour. Wide surgical excision should be attempted in most cases. In inoperable cases, the use of targeted therapies (IMATINIB) has led to complete cures in some cases.

BACKGROUND: Non-muscle-infiltrating cancers (NMIBC) represent 75% of bladder tumors. The objective of our study is to report a single-center experience of the efficacy and tolerability of HIVEC on intermediate- and high-risk NMIBC in adjuvant therapy.
METHODS: Between December 2016 and October 2020, patients with intermediate-risk or high-risk NMIBC were included. They were all treated with HIVEC as an adjuvant therapy to bladder resection. Efficacy was assessed by endoscopic follow-up and tolerance by a standardized questionnaire.
RESULTS: A total of 50 patients were included. The median age was 70years (34-88). The median follow-up time was 31 months (4-48). Forty-nine patients had cystoscopy as part of the follow-up. Nine recurred. One patient progressed to Cis. The 24-month recurrence-free survival was 86.6%. There were no severe adverse events (grade 3 or 4). The ratio of delivered instillations to planned instillations was 93%.
CONCLUSIONS: HIVEC with the COMBAT system is well tolerated in adjuvant treatment. However, it is not better than standard treatments, especially for intermediate-risk NMIBC. While waiting for recommendations, it cannot be proposed as an alternative to standard treatment.
METHODS:

OBJECTIVE: To evaluate surgical outcomes (recurrence rate, aesthetics and symptoms) of pterygium surgery with two different amniotic membrane preservation approaches - lyophilized (LAM) and cryopreserved (CAM).
METHODS: Primary pterygium patients were randomized to either LAM or CAM surgery. Demographic data, ocular surface disease index (OSDI), aesthetic grading (1 to 4), recurrences and complications were recorded over a 6-month follow-up period.
RESULTS: Twenty-nine patients were recruited. Recurrence at month 6 was detected in 11 cases (37.9%) and was more prevalent with CAM grafts, without reaching statistical significance (P=0.196). Aesthetic outcome grading showed no differences between LAM and CAM at month 6 (P=0.124). Aesthetic results were mostly unsatisfactory (grade 3 and 4) without statistical differences between groups (P=0.514). Baseline OSDI was similar in both groups (P=0.888), and it significantly decreased by the last follow-up visit (P<0.001) for both the LAM and CAM groups. This decrease did not significantly differ between amniotic membrane preservation approach surgery groups (P=0.714).
CONCLUSIONS: LAM might be considered a legitimate alternative to CAM, showing no inferiority in outcomes, since clinical and aesthetic outcomes were similar for both groups.

While the perpetrators of incestuous assaults are found in families from all social, cultural and professional categories, the vast majority of them have common characteristics. Linda Tromeleue, a psychologist and family therapist, works in the prison integration and probation service, particularly with incestuous paedocriminals who have been tried and sentenced. She describes their personality traits and the process established to carry out their transgressive acts, often for years.

BACKGROUND: The Level of Service/Case Management Inventory (LS/CMI) is one of the best-known recidivism risk instruments. In France, this scale is rarely used because no study had yet been carried out to confirm its psychometric properties on samples of French offenders. The aim of this study was to test the psychometric properties of the LS/CMI on samples of violent French prisoners.
METHODS: The Level of Service/Case Management Inventory, the BARR-2002R, Historical Clinic Risk-Scale 20 and the Risk for Sexual Violence Protocol were administered to 128 violent offenders.
UNASSIGNED: The results showed good internal consistency, reliability and convergent validity of the LS/CMI. Assault, robbery and sexual assault were correlated with the LS/CMI. All of these results are discussed and analysed using the international reference literature.
CONCLUSIONS: Confirmation of the psychometric properties of the LS/CMI among French offenders to allow it to be used to assess the risk of recidivism of offenders.