RESUMEN
Langerhans cell histiocytosis is a non-malignant proliferative disease of unknown etiology that can affect one or more organs. This is a rare disease, 1 to 2/100,000, affecting mainly children with a male predominance. The osseous lesions are the most frequent (60 to 90%). There is however no consensus treatment for the management of these sites. We report the cases of two patients successfully treated with radiotherapy after primary chemotherapy, at doses of 15 Gy in ten sessions of 1.5 Gy for one patient and 18 Gy in ten fractions of 1.8 Gy for the other. Single or multifocal bone Langerhans cell histiocytosis without visceral involvement is a benign, self-limiting affection in most cases. Some bone lesions could be treated by radiotherapy alone. But the high variability of doses currently given in the literature does not allow determining the lowest effective dose limiting the risk of secondary neoplasia or impaired growth in children, in whom lower doses of 6 to 8 Gy are recommended. The decision of radiotherapy must be weighed against the risk of the disease. Caution should be the rule in this non-malignant tumour pathology.
Asunto(s)
Enfermedades Óseas/radioterapia , Histiocitosis de Células de Langerhans/radioterapia , Radioterapia Conformacional , Corticoesteroides/uso terapéutico , Adulto , Enfermedades Óseas/tratamiento farmacológico , Terapia Combinada , Fraccionamiento de la Dosis de Radiación , Histiocitosis de Células de Langerhans/tratamiento farmacológico , Humanos , Ilion/patología , Masculino , Mandíbula/patología , Enfermedades Mandibulares/tratamiento farmacológico , Enfermedades Mandibulares/radioterapia , Persona de Mediana Edad , Osteólisis/etiología , Hueso Parietal/patología , Riesgo , Enfermedades de la Columna Vertebral/tratamiento farmacológico , Enfermedades de la Columna Vertebral/radioterapia , Esternón/patología , Vinblastina/uso terapéuticoRESUMEN
The standard regimen for the treatment of chronic hepatitis C virus (HCV) is peginterferon alpha-2a or -2b associated with ribavirine. The recommended duration of treatment for genotype 2 HCV infection is 24 weeks. However, the relatively poor drug tolerance often leads to a reduction or a discontinuation of the treatment. Here, we report two female patients who discontinued antiviral therapy after less than 6 weeks for intolerance and who experienced a sustained virological response. A treatment of 3 to 5 weeks may be enough for genotype 2 HCV eradication. However, there is not sufficient evidence in 2009 to recommend a reduced treatment duration.
Asunto(s)
Hepatitis C Crónica/tratamiento farmacológico , Antivirales/uso terapéutico , ADN Viral/análisis , Femenino , Hepatitis C Crónica/genética , Humanos , Interferón alfa-2 , Interferón-alfa/uso terapéutico , Cumplimiento de la Medicación , Persona de Mediana Edad , Polietilenglicoles/uso terapéutico , Proteínas Recombinantes , Ribavirina/uso terapéuticoRESUMEN
PURPOSE: Medical meetings give the opportunity to present oral communications or posters to the attending participants. However, the peer-reviewed publication of a full article allows to reach a wide readership. KEY POINTS: The survey that was performed on the oral communications and posters presented at the 43rd meeting of the French National Society of Internal Medicine, December 2000, showed that amongst the 303 selected podium presentations and posters, only 82 (27%) were published during the five following years. Podium presentations were more likely to be published than posters (36% versus 22%). CONCLUSION: Many oral communications and posters that are presented in medical meeting are not followed by the publication of a peer-reviewed full article despite the modern means of communication. However, this issue is of paramount importance as beyond the legitimate personal satisfaction of a publication, the scientific and academic recognition are the ground of medical career achievement for many physicians.