[Screening for the risk of childhood overweight and obesity]. / Dépister le risque de surpoids et d'obésité infantiles.

Childhood overweight and obesity have become a public health issue due to the many associated complications that cause morbidity and a major cost to society. About half of obese children will remain obese as adults, and this risk increases sharply if obesity persists into adolescence. The "first 1000 days" period from conception to two years of age is a pivotal period for long-term metabolic risk. During this period of vulnerability, several maternal and obstetric risk factors have been identified to be associated with overweight and childhood obesity. The identification of children at risk of developing obesity should allow preventive actions, based on the support of families in the establishment of healthy behaviours from an early age.

RÉSUMÉ DÉPISTER LE RISQUE DE SURPOIDS ET D'OBÉSITÉ INFANTILES. Le surpoids et l'obésité infantiles sont devenus un enjeu de santé publique en raison des nombreuses complications associées qui engendrent une morbidité et un coût majeur pour la société. Environ la moitié des enfants obèses le resteront à l'âge adulte et ce risque augmente fortement si l'obésité persiste à l'adolescence. La période des « 1 000 premiers jours ¼ allant de la conception aux 2 ans de l'enfant est une période charnière pour le risque métabolique à long terme. Pendant cette période de vulnérabilité, plusieurs facteurs de risque maternels et obstétricaux ont été identifiés comme étant associés au surpoids et à l'obésité infantile. Le repérage des enfants à risque de développer une obésité devrait permettre des actions de prévention, basées sur l'accompagnement des familles dans la mise en place de comportements favorables à la santé dès le plus jeune âge.

Immunotherapy for LELC: Case Report and a Focused Review.

Lymphoepithelioma-like carcinoma of the lung (LELC) is a rare, Epstein-Barr virus-associated tumor. LELC occurs mostly in young, Asian nonsmokers. A few hundred cases have been reported, mostly from retrospective Asian studies. Optimal treatment has not been clearly established. Treatment options are based on surgery for early stage and on cisplatin-based chemotherapy as first-line therapy for metastatic disease. Prognosis may seem better than for other types of non-small-cell lung cancer, but it remains poor in advanced disease, with a median survival of 24 months, and new treatments options are still warranted. Immunotherapies are now key players in the treatment of non-small-cell lung cancer. However, few data are available for this rare histologic subgroup. We have reviewed the available data on LELC with a focus on the first few cases reported with a response to a programmed cell death 1 inhibitor.

A successful compartmental approach for the treatment of breast cancer brain metastases.

BACKGROUND: Brain metastases are challenging daily practice in oncology and remain a compartmental problem since most anti-cancer drugs do not cross the blood-brain barrier at relevant pharmacological concentrations. METHODS: In a young woman with HER2-overexpressing breast cancer resistant to standard treatments, at the time of brain metastases progression, a ventricular reservoir was implanted for intrathecal drug injections and detailed pharmacokinetic studies. RESULTS: A first association of intrathecal trastuzumab with intravenous cisplatin was offered to the patient. For trastuzumab, the mean cerebrospinal fluid trough concentration of 53.4 mg/L reached relevant levels, enabling the stabilization of the metastases. Adding intravenous cisplatin was not beneficial, since the cerebrospinal fluid exposure was almost undetectable under 0.08 mg/L. We then offered the patient an intrathecal combination of trastuzumab and methotrexate, because of their in vitro synergic cytotoxicity. The cerebrospinal fluid peak of methotrexate was 1037 µmol/L at 2 h, and the concentrations remained above the theoretical therapeutic concentration. After 2 months of this drug combination, we obtained an excellent response on the brain metastases. CONCLUSION: Our preliminary study supports the interest of a compartmental approach through a direct administration of drugs into the cerebrospinal fluid for the treatment of breast cancer brain metastases.

[Lung cancer treatment in elderly patients]. / Traitement du cancer bronchique du sujet âgé.

The treatment of an elderly patient with a bronchial carcinoma is a daily challenge for the physician, because of the high incidence of lung carcinoma and a population getting older. The treatment has to be adapted, after geriatric assessment and evaluation of comorbidities, iatrogenic complications being more frequent and more severe in these patients. At the opposite, these patients are to often under-treated. This article will update the therapeutic strategy for non-small cell and small-cell lung carcinoma in the elderly.

Tumor lysis associated with sudden onset of syndrome of inappropriate antidiuretic hormone secretion.

Syndrome of inappropriate antidiuretic hormone secretion is frequent in small-cell lung carcinomas. We report on a case of syndrome of inappropriate antidiuretic hormone secretion after each of the first 2 cycles of chemotherapy for small-cell lung cancer. The association with chemotherapy-induced tumor lysis is proposed, particularly based on the course of antidiuretic hormone levels, and a review of the literature is presented. Syndrome of inappropriate antidiuretic hormone secretion can occur during tumor lysis syndrome.

[Non-metastatic intrahepatic cholestasis associated with bronchial adenocarcinoma]. / Cholestase intra-hépatique non métastatique associée à un adénocarcinome bronchique.

In 1961, Stauffer first described a syndrome characterized by nonmetastatic intrahepatic cholestasis associated with undifferentiated renal adenocarcinoma. Since that time, this syndrome has been associated with other tumor diseases. We describe here a patient with lung adenocarcinoma which led to paraneoplastic cholestasis. We discuss the diagnosis and review the literature, emphasizing the pathophysiology of Stauffer's syndrome.