Analysis of P-gp genes relative expression associated to ivermectin resistance in Haemonchus contortus larval stages from in vitro cultures (L3 and xL3) and from gerbils (Meriones unguiculatus) (L4) as models of study.

The aim of the study was to compare the relative gene expression of Haemonchus contortus P-glycoprotein genes (Hco-pgp) between fourth (L4), infective (L3), and transitory infective (xL3) larval stages as laboratory models to study ivermectin (IVM) resistance. The H. contortus resistant to IVM (IVMr) and susceptible to IVM (IVMs) strains were used to develop xL3in vitro culture and to infect Meriones unguiculatus (gerbils) to collect L4 stages. Morphometric differences were evaluated from 25 individuals of H. contortus from each strain. Relative gene expression from xL3 and L4 was determined between comparison of IVMr stages and from IVMr vs IVMs stages. Seven Hco-pgp genes (1, 2, 3, 4, 9, 10, and 16) were analysed by RT-qPCR using L3 stage as control group, per strain, and GAPDH and ß-tubulin as constitutive genes. Morphological changes were confirmed between xL3 and L4 developing oral shape, oesophagus, and intestinal tube. In addition, the body length and width showed statistical differences (p < 0.05). The Hco-pgp1, 2, 3, and 4 genes (p < 0.05) were upregulated from 7.1- to 463.82-fold changes between IVMr stages, and Hco-pgp9 (13.12-fold) and Hco-pgp10 (13.56-fold) genes showed differences between L4 and xL3, respectively. The comparative study between IVMr vs IVMs strains associated to xL3 and L4 displayed significant upregulation for most of the Hco-pgp genes among 4.89-188.71 fold-change. In conclusion, these results suggest the use of H. contortus xL3 and L4 as suitable laboratory models to study IVMr associated with Hco-pgp genes to contribute to the understanding of anthelmintic resistance.

Real-world EGFR testing practices for non-small-cell lung cancer by thoracic pathology laboratories across Europe.

BACKGROUND: Testing for epidermal growth factor receptor (EGFR) mutations is an essential recommendation in guidelines for metastatic non-squamous non-small-cell lung cancer, and is considered mandatory in European countries. However, in practice, challenges are often faced when carrying out routine biomarker testing, including access to testing, inadequate tissue samples and long turnaround times (TATs). MATERIALS AND METHODS: To evaluate the real-world EGFR testing practices of European pathology laboratories, an online survey was set up and validated by the Pulmonary Pathology Working Group of the European Society of Pathology and distributed to 64 expert testing laboratories. The retrospective survey focussed on laboratory organisation and daily EGFR testing practice of pathologists and molecular biologists between 2018 and 2021. RESULTS: TATs varied greatly both between and within countries. These discrepancies may be partly due to reflex testing practices, as 20.8% of laboratories carried out EGFR testing only at the request of the clinician. Many laboratories across Europe still favour single-test sequencing as a primary method of EGFR mutation identification; 32.7% indicated that they only used targeted techniques and 45.1% used single-gene testing followed by next-generation sequencing (NGS), depending on the case. Reported testing rates were consistent over time with no significant decrease in the number of EGFR tests carried out in 2020, despite the increased pressure faced by testing facilities during the COVID-19 pandemic. ISO 15189 accreditation was reported by 42.0% of molecular biology laboratories for single-test sequencing, and by 42.3% for NGS. 92.5% of laboratories indicated they regularly participate in an external quality assessment scheme. CONCLUSIONS: These results highlight the strong heterogeneity of EGFR testing that still occurs within thoracic pathology and molecular biology laboratories across Europe. Even among expert testing facilities there is variability in testing capabilities, TAT, reflex testing practice and laboratory accreditation, stressing the need to harmonise reimbursement technologies and decision-making algorithms in Europe.

Encapsulation of bioactive peptides: a strategy to improve the stability, protect the nutraceutical bioactivity and support their food applications.

In recent decades, bioactive peptides have become an emerging field of interest in the scientific community as well as the food, pharmaceutical, and cosmetics industries. A growing body of research indicates that consumption of bioactive peptides may play a vital role in health through their broad spectrum of bioactivity such as antioxidant, antihypertensive, antimicrobial, anti-inflammatory, immunomodulatory, and anti-proliferative activities. In addition, bioactive peptides can be used as food preservatives due to their antimicrobial and antioxidant activities. However, some factors limit their nutraceutical and commercial applications, including easy chemical degradation (e.g., pH, enzymatic), food matrix interaction, low water-solubility, hygroscopicity, and potential bitter taste. Bearing that in mind, the encapsulation of bioactive peptides in different materials can help overcome these challenges. Studies have demonstrated that encapsulation of bioactive peptides increases their bioactivity, improves their stability, sensory properties, increases solubility, and decreases hygroscopicity. However, there is limited scientific evidence about the bioavailability and food matrix interactions of encapsulated peptides. Besides, the diverse colloidal systems used to encapsulate bioactive peptides have shown stability and good encapsulation efficiency. This review provides an overview of current advances in the encapsulation of bioactive peptides, considering the technology, developments, and innovations in the last lustrum.

Treatment outcome of atypical EGFR mutations in the German National Network Genomic Medicine Lung Cancer (nNGM).

BACKGROUND: Atypical EGFR mutations occur in 10%-30% of non-small-cell lung cancer (NSCLC) patients with EGFR mutations and their sensitivity to classical epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKI) is highly heterogeneous. Patients harboring one group of uncommon, recurrent EGFR mutations (G719X, S768I, L861Q) respond to EGFR-TKI. Exon 20 insertions are mostly insensitive to EGFR-TKI but display sensitivity to exon 20 inhibitors. Clinical outcome data of patients with very rare point and compound mutations upon systemic treatments are still sparse to date. PATIENTS AND METHODS: In this retrospective, multicenter study of the national Network Genomic Medicine (nNGM) in Germany, 856 NSCLC cases with atypical EGFR mutations including co-occurring mutations were reported from 12 centers. Clinical follow-up data after treatment with different EGFR-TKIs, chemotherapy and immune checkpoint inhibitors were available from 260 patients. Response to treatment was analyzed in three major groups: (i) uncommon mutations (G719X, S7681, L861Q and combinations), (ii) exon 20 insertions and (iii) very rare EGFR mutations (very rare single point mutations, compound mutations, exon 18 deletions, exon 19 insertions). RESULTS: Our study comprises the largest thus far reported real-world cohort of very rare EGFR single point and compound mutations treated with different systemic treatments. We validated higher efficacy of EGFR-TKI in comparison to chemotherapy in group 1 (uncommon), while most exon 20 insertions (group 2) were not EGFR-TKI responsive. In addition, we found TKI sensitivity of very rare point mutations (group 3) and of complex EGFR mutations containing exon 19 deletions or L858R mutations independent of the combination partner. Notably, treatment responses in group 3 (very rare) were highly heterogeneous. Co-occurring TP53 mutations exerted a non-significant trend for a detrimental effect on outcome in EGFR-TKI-treated patients in groups 2 and 3 but not in group 1. CONCLUSIONS: Based on our findings, we propose a novel nNGM classification of atypical EGFR mutations.

Opioid use prior to admission for chemotherapy induced febrile neutropenia is associated with increased documented infection, sepsis, and death.

PURPOSE: Cancer patients on chemotherapy are at risk for developing febrile neutropenia and infections. Opioids have been associated with immune suppression and risk of infection. We aimed to investigate opioid use associated with infections and death among cancer patients admitted with febrile neutropenia. METHODS: A total of 481 patients admitted for chemotherapy-induced febrile neutropenia were reviewed. There were 274 patients with opioid prescriptions (OP) within 10 days of hospitalization and 207 patients without opioid prescriptions (NOP) for >1 year of hospitalization. The primary outcomes were microbiologically and clinically documented infection as defined by the International Immunocompromised Host Society (IHS), sepsis by clinician, systemic inflammatory response syndrome (SIRS) criteria, and sequential organ failure assessment (SOFA) score. RESULTS: Documented infection occurred in 192 (70%) of patients with opioids compared to 99 (48%) with non-opioids, p < 0.001. Similar results were observed in sepsis by SOFA score with 173 (63%) opioids versus 92 (44%) non-opioids, p < 0.001, and sepsis by SIRS with 225 (82%) and 115 (56%) respectively, p < 0.001. Multivariable analysis showed opioid use has an increased adjusted odds of documented infection by 7.13 fold (95% CI 3.97-12.78), Sepsis by SOFA by 2.39 fold (95% CI 1.33-4.29), and Sepsis by SIRS by 1.87 fold (95% CI 1.13-3.10). Multivariable analysis for death/hospice showed that opioids had 2.30 fold (95% CI 1.16-4.57) increase in adjusted odds of death/hospice within 30 days of discharge. CONCLUSION: The data supports that patients with prior opioid use is associated with increased odds for infection, sepsis and death than non-opioid users admitted with febrile neutropenia.

Genomic analysis and proteomic response of the chromium-resistant and phenanthrene-degrading strain Streptomyces sp. MC1.

AIM: Chemically disparate toxic organic and/or inorganic molecules produced by anthropogenic activities often hinder the bioremediation process. This research was conducted to understand the capacity of Streptomyces sp. MC1 to remove chemically disparate toxics such as Cr(VI) or phenanthrene. METHODS AND RESULTS: Genomic, metabolic modeling and proteomic approaches were used in this study. Our results demonstrated that Streptomyces sp. MC1 has the genetic determinants to remove Cr(VI) or degrade phenanthrene. Proteomics showed that these genetic determinants were expressed. Metabolic versatility of the strain was confirmed by two metabolic models in complex and minimal media. Interestingly, our results also suggested a connection between the degradation of phenanthrene and synthesis of specialized metabolites. CONCLUSIONS: Streptomyces sp. MC1 has the genetic and physiological potential to remove Cr(VI) or degrade phenanthrene SIGNIFICANCE AND IMPACT OF STUDY: The probability of a microorganism to survive in the presence of different contaminants depends on its genetic potential and the ability to express it. The genetic and proteomic profiles obtained for Streptomyces sp. MC1 can be recommended as model and predict if other Streptomyces strains can be used in bioremediation processes. Our work also hypothesized that intermediates of the phenanthrene degradation serve as precursors for the specialized metabolism.

Benefits of Avène thermal hydrotherapy in chronic skin diseases and dermatological conditions: an overview.

The beneficial effects of Avène Thermal Spring Water (TSW), a low mineral content spring water, on chronic skin diseases have been recognized for more than two centuries. This article provides a brief overview of efficacy and tolerance data for Avène TSW from clinical studies conducted at the Avène Hydrotherapy Center in patients with chronic inflammatory skin diseases or temporary skin injuries. Avène TSW hydrotherapy is effective as adjuvant management for chronic skin diseases and dermatological conditions, relieving subjective and physical symptoms with excellent tolerance.

Therapeutic patient education: the Avène-Les-Bains experience.

Originally developed to improve the management of serious chronic diseases such as diabetes mellitus, obesity, cardiovascular diseases, asthma and as aftercare following oncological treatments, therapeutic patient education (TPE) has been extended to other situations, including chronic dermatoses such as atopic dermatitis, eczema and psoriasis. In this article, we provide a brief overview of the development, implementation and evaluation of TPE at the Avène-Les-Bains Hydrotherapy Center, France.

Cure thermale et séquelles de brûlures: Thermal cures and sequelae of burns.

The sequelae of burns often are complicated by inflammatory and hypertrophic scars. Thermal cures can make a noticeable difference in improving these situations, which can be associated with considerable aesthetic damage and altered function. In this setting the benefits of the anti-inflammatory and antipruritic properties of thermal waters are combined with a high-pressure shower technique - the filiform shower - designed to soften and shape the infiltrated and hypertrophied skin areas. It is important to integrate the thermal cure at an early stage in the management of the condition, always considering it as an adjunct to the other therapeutic options available for the management of post-burn scarring. © 2020 Elsevier Masson SAS. All rights reserved.

Toxicités dermatologiques après prise en charge d'un cancer du sein : intérêt d'une cure thermale en soins oncologiques de support: Long lasting cutaneous adverse events after breast cancer and evaluation of hydrotherapy as supportive care.

Dermatological toxicities (affecting the skin, mucous membranes, nails or hair) are frequently associated with cancer treatments. They can represent a real burden for patients, with physical, social and psychological repercussions. These dermatological adverse events can also persist long after the treatment has ended, especially after treatment with cytotoxic chemotherapeutic agents such as taxanes. There is a clear need for the development of suitable supportive care measures to help manage these toxicities. The place of a hydrotherapy treatment in this context remains to be clarified. This article summarizes the main data available on the quality of life, and more specifically the dermatological quality of life, of patients for whom hydrotherapy was proposed after breast cancer. © 2020 Elsevier Masson SAS. All rights reserved.

La cure thermale en dermatologie, mode d'emploi: Use of thermal cures in dermatology.

Thermalism is one of the oldest medical disciplines with a history of thousands of years and whose benefits are well documented. The therapy is based on a program of daily care for a period of three weeks in a thermal station. Hydrotherapy is particularly suitable in dermatology since the thermal water will be in direct contact with the skin lesions. The main indications are eczema, psoriasis, chronic pruritus, and wound healing disorders with new indications emerging, such as for cancer treatment-related side effects and follow-up care after cancer treatment. Thermalism encompasses much more than hydrotherapy, acquiring over the past few years a distinct place in therapeutic education. The therapy, which for a long time has been seen as an alternative to pharmacological treatments, should be positioned as an adjunct treatment for chronic dermatoses, aiming at reducing in the mid and long term the severity of the disease and drug dependence. © 2020 Elsevier Masson SAS. Tous droits réservés.

Evaluation of the intraoperative human papillomavirus test as a marker of early cure at 12 months after electrosurgical excision procedure in women with cervical high-grade squamous intraepithelial lesion: a prospective cohort study.

OBJECTIVE: To evaluate if the intraoperative human papillomavirus (IOP-HPV) test has the same prognostic value as the HPV test performed at 6 months after treatment of high-grade squamous intraepithelial lesion (HSIL) to predict treatment failure. DESIGN: Prospective cohort study. SETTING: Barcelona, Spain. POPULATION: A cohort of 216 women diagnosed with HSIL and treated with loop electrosurgical excision procedure (LEEP). METHODS: After LEEP, an HPV test was performed using the Hybrid Capture 2 system. If this was positive, genotyping was performed with the CLART HPV2 technique. The IOP-HPV test was compared with HPV test at 6 months and with surgical margins. MAIN OUTCOME MEASURE: Treatment failure. RESULTS: Recurrence rate of HSIL was 6%. There was a strong association between a positive IOP-HPV test, a positive 6-month HPV test, positive HPV 16 genotype, positive surgical margins and HSIL recurrence. Sensitivity, specificity, and positive and negative predictive values of the IOP-HPV test were 85.7, 80.8,24.0 and 98.8% and of the HPV test at 6 months were 76.9, 75.8, 17.2 and 98.0%. CONCLUSION: Intraoperative HPV test accurately predicts treatment failure in women with cervical intraepithelial neoplasia grade 2/3. This new approach may allow early identification of patients with recurrent disease, which will not delay the treatment. Genotyping could be useful in detecting high-risk patients. TWEETABLE ABSTRACT: IOP-HPV test accurately predicts treatment failure in women with CIN 2/3.

Targeting M2e to DEC-205 induces an enhanced serum antibody-dependent heterosubtypic protection against influenza A virus infection.

The ectodomain of the influenza A virus (IAV) M2 protein (M2e) is highly conserved, and it represents a promising candidate for the development of an "universal vaccine". However, the low immunogenicity associated to M2e in a natural infection or in response to seasonal vaccines has led to explore new approaches to enhance it. In recent years, it has become clear that targeting antigens to dendritic cells (DC) is an efficient way to enhance immune responses against pathogens. In this work, the M2e peptide was chemically cross-linked to a monoclonal antibody (mAb) specific for DEC-205 (α-DEC-205:M2e), present on DC. BALB/c mice were inoculated subcutaneously (s.c.) three times with the conjugate equivalent to 1 µg of M2e, in the presence of polyinosinic-polycytidylic acid (poly I:C) as adjuvant. As controls, other groups of mice were inoculated under the same conditions with M2e cross-linked to an isotype control mAb (isotype:M2e), 5 µg of free M2e peptide, ovalbumin (OVA) cross-linked to the α-DEC-205 mAb (α-DEC-205:OVA) or poly I:C alone. Immunization with α-DEC-205-M2e induced high levels of serum antibodies (Abs) compared to isotype:M2e or to free M2e peptide, and in all cases IgG1 was predominant over IgG2a Abs. Furthermore, immunization with the α-DEC-205:M2e conjugate did not prevent morbidity, but it induced up to 76% protection against a heterosubtypic IAV lethal challenge. Contrasting with the 20 to 40% protection induced by isotype:M2e or by free M2e peptide. The protection induced by α-DEC-205:M2e conjugate was dependent on non-neutralizing serum Abs and independent of effector CD4+ T cells. These results show that targeting M2e to DEC-205 is a very effective alternative to induce strong heterosubtypic protection against an IAV infection.

Standardizing electrocardiographic and arterial pressure parameters in creole horses of the Bogotá Savannah / Estandarización de parámetros electrocardiográficos y presión arterial en caballos criollos de la Sabana de Bogotá

ABSTRACT Background: Cardiovascular parameters may vary between breeds and physiological stages, hindering the cardiovascular evaluation in horses. Objective: Standardize electrocardiographic (ECG) and arterial pressure (AP) parameters in creole horses from the Bogota Savannah. Methods: 100 male and female horses were evaluated, divided into four groups (n=25 each) according to age: group 1 (G1), between 6 months and 1 year old; group 2 (G2), between 1 and 4 years old; group 3 (G3), between 4 and 10 years old; and group 4 (G4), over 10 years old. Bipolar, unipolar and precordial leads in ECG, as well as systolic AP (SAP), mean AP (MAP), and diastolic AP (DAP) were evaluated in all groups. Results: 99 animals showed sinus rhythm, among which one female from G2 and one from G4 exhibited left fascicles anterior block; a female from G3 had sinus arrhythmia and one female from G2 evidenced 3 premature ventricular complexes. The presence of a unique and positive P wave, a QRS complex of the QR type and a biphasic T wave, were the most common in all groups. A significant decrease in the cardiac axis was observed in G1 when compared to the other groups. The G1 group showed a significant increase in heart rate, SAP, MAP and DAP values. Conclusions: Taking into account the environmental conditions and how the investigation was developed, it is possible to conclude that creole horses from the Bogotá Savannah differ in their cardiovascular parameters in relation to age.

RESUMEN Antecedentes: Los parámetros cardiovasculares en los caballos pueden variar entre razas y etapas fisiológicas, lo que dificulta la evaluación cardiaca. Objetivo: Estandarizar parámetros electrocardiográficos (ECG) y de presión arterial (PA) en caballos criollos de la Sabana de Bogotá. Métodos: Fueron estudiados 100 caballos entre machos y hembras divididos en cuatro grupos de acuerdo con su edad (n=25): grupo 1 (G1), entre 6 meses y 1 año de edad; grupo 2 (G2), entre 1 y 4 años; grupo 3 (G3), entre 4 y 10 años, y grupo 4 (G4), mayores de 10 años. Se evaluaron derivaciones bipolares, unipolares y precordiales en ECG, así como en PA Sistólica (PAS), PA Media (PAM), y PA Diastólica (PAD) en todos los grupos. Resultados: 99 animales mostraron ritmo sinusal, entre los cuales se observó bloqueo anterior del fascículo izquierdo en una hembra del G2 y en una del G4; a su vez, una hembra del G3 presentó arritmia sinusal y en una del G2 se evidenciaron tres complejos ventriculares prematuros. La presencia de una onda P única y positiva, complejo QRS tipo QR y onda T bifásica fueron los más observados en todos los grupos. Una disminución significativa del eje cardiaco se observó en el G1 cuando se comparó con los demás grupos; además, el G1 presentó aumento significativo en valores de frecuencia cardiaca, PAS, PAM y PAD. Conclusiones: Teniendo en cuenta las condiciones del medio y la forma en que la investigación se ejecutó, es posible concluir que los parámetros cardiovasculares de caballos criollos de la Sabana de Bogotá difieren con relación a su edad.

[Residual ankle instability in patients with syndesmosis lesions without fracture treated with situational screws]. / Inestabilidad residual de tobillo en pacientes con lesión de la sindesmosis sin fractura tratados con tornillos situacionales.

INTRODUCTION: The lesion of the distal tibiofibular syndesmosis is commonly accompanied by the fracture of the maleollus either medial or lateral, rarely, the syndesmosis can be injured without there being a fracture of any of the bone structures that make up the ankle, accounting for about 1% of all injuries. Being very rare, they are not diagnosed at the acute event, and are usually treated as a simple sprained ankle. MATERIAL AND METHODS: Series of cases with ankle fractureless syndesmosis lesion, treated with situational double screw placement, deferred support and implant removal at two months. After six months of initial surgery, the Cumberland ankle instability (CAIT) test is applied which measures the degree of ankle instability. RESULTS: For one year, 4 cases of fractureless synosmosis lesions were found out of a total of 349 surgical cases treated in the hospital, exclusively in male patients, all under the age of 40. Six months after surgery, CAIT was applied, encountering residual instability in 100% of treated cases. DISCUSSION: This result is unencouraging and makes us reconsider the treatment established to improve the final stability of the ankle.

INTRODUCCIÓN: La lesión de la sindesmosis tibioperonea se presenta por lo regular acompañada de la fractura de los maléolos ya sea medial o lateral, muy rara vez la sindesmosis puede lesionarse sin que exista una fractura de alguna de las estructuras óseas que conforman el tobillo, representa alrededor de 1% de todas las lesiones. Al ser muy raras, no se diagnostican en el evento agudo y suelen tratarse como un simple esguince de tobillo. MATERIAL Y MÉTODOS: Serie de casos con lesión de la sindesmosis sin fractura de tobillo, tratadas con colocación de doble tornillo situacional, apoyo diferido y retiro de los implantes a los dos meses. Posteriormente, a los seis meses de la cirugía inicial se aplica el test de inestabilidad de tobillo de Cumberland (CAIT), el cual cuenta con nueve reactivos donde se mide el grado de inestabilidad del tobillo. RESULTADOS: Durante un año se detectaron cuatro casos de lesión de la sindesmosis sin fractura de un total de 349 casos quirúrgicos tratados en el hospital, exclusivamente en pacientes masculinos, todos ellos menores de 40 años. Seis meses después de la cirugía se aplicó el CAIT encontrando una inestabilidad residual en 100% de los casos tratados, algunos en mayor medida que los demás. DISCUSIÓN: Este resultado es poco alentador y nos hace reconsiderar el tratamiento establecido para mejorar la estabilidad final del tobillo.

Enhancement of VP6 immunogenicity and protective efficacy against rotavirus by VP2 in a genetic immunization.

VP2/VP6 virus like particles (VLPs) are very effective in inducing protection against the rotavirus infection in animal models. Individually, VP6 can also induce protection. However, there is no information about the immunogenicity of VP2. The aim of this work was to evaluate the efficacy of DNA vaccines codifying for VP2 or VP6, alone or combined, to induce protection against the rotavirus infection. Murine rotavirus VP2 and VP6 genes were cloned into the pcDNA3 vector. Adult BALB/c mice were inoculated three times by intramuscular (i.m.) injections with 100 or 200µg of pcDNA3-VP2 or pcDNA3-VP6 alone or co-administered with 100µg of pcDNA3-VP2/100µg of pcDNA3-VP6. Two weeks after the last inoculation, mice were challenged with the wild type murine rotavirus strain epizootic diarrhea of infant mice (EDIMwt). We found that both plasmids, pcDNA3-VP2 and pcDNA3-VP6, were able to induce rotavirus-specific serum antibodies, but not intestinal rotavirus-specific IgA; only 200µg of pcDNA3-VP6 induced 35% protection against the infection. A similar level of protection was found when mice were co-administered with 100µg of pcDNA3-VP2/100µg of pcDNA3-VP6 (1:1 ratio). However, the best protection (up to 58%) occurred when mice were inoculated with 10µg of pcDNA3-VP2/100µg of pcDNA3-VP6 (1:10 ratio). These results indicate that the DNA plasmid expressing VP6 is a better vaccine candidate that the one expressing VP2. However, when co-expressed, VP2 potentiates the immunogenicity and protective efficacy of VP6.

Efficacy of a global supportive skin care programme with hydrotherapy after non-metastatic breast cancer treatment: A randomised, controlled study.

This study investigated the efficacy of post-treatment hydrotherapy as supportive care for management of persistent/long-lasting dermatologic adverse events (dAEs) induced in breast cancer survivors by adjuvant therapy, and its impact on quality of life (QoL). Patients in complete remission after standardised (neo)adjuvant chemotherapy, surgery and radiotherapy combination treatment for infiltrating HR+/HER2-breast carcinoma were enrolled in this randomised, multicentre controlled study 1-5 weeks after completing radiotherapy. The control group (CG, n = 33) received best supportive care and the treatment group (HG, n = 35) received 3-weeks of specific hydrotherapy. The primary criterion was change in QoL (QLQ-BR23) after hydrotherapy. Clinical grading of dAEs, cancer-related QoL (QLQ-C30), dermatologic QoL (DLQI) and general psychological well-being (PGWBI) were assessed. Significant dAEs were found at inclusion in both groups (n = 261). Most items showed significantly greater improvement in the HG versus CG group: QLQ-BR23 (breast [p = .0001] and arm symptoms [p = .0015], systemic therapy side effects [p = .0044], body image [p = .0139]), some dAE grading, DLQI (p = .0002) and PGWBI (p = .0028). Xerosis (88% of patients at inclusion) completely healed in all HG patients. Specific hydrotherapy is an effective supportive care for highly prevalent and long-lasting dAEs occurring after early breast cancer treatment, including chemotherapy, and leads to improved QoL and dermatologic toxicities.

Eau thermale d'Avène et dermatite atopique: Avène's thermal water and atopic dermatitis.

Atopic dermatitis (AD) is the most frequent disease treated at the Avène hydrotherapy center. Children represent a large part of the population due to the high prevalence of AD in early childhood. Avène thermal spring water (ATSW) has been known for its therapeutic effects since the middle of the 18th century. It has been greatly studied over the last decades, with a comprehensive fundamental, pharmaco-clinical and clinical approach. Cohort studies using the Scoring Atopic Dermatitis (SCORAD) clinical score and the Dermatology Life Quality Index (DLQI) or the Children's Dermatology Life Quality Index [CDLQI]) quality of life scores, allowed to confirm the clinical results obtained from the previous studies. These results were corroborated by clinical trials conducted in atopic patients outside the Avène hydrotherapy center, allowing to demonstrate the specific effect of the ATSW. Pharmacological and pharmaco-clinical studies evidenced several effects that could explain the healing effect of ATSW: effect on histamine release, anti-inflammatory effects on standardized models, immuno-modulation of some cytokines involved in DA physiopathology (interferon [INF], interleukin 2 and 4 [IL-2, IL-4]), improvement of keratinocyte differentiation, effect on the skin microbioma by promoting the development of a diversified non-pathogenic flora. In addition, an original microorganism, Aquaphilus dolomiae, never described in another medium, has very recently been identified in the ATSW. Aquaphilus dolomiae is responsible for significant pharmacological activities on inflammation, pruritus and enhancement of innate immunity. This set of works confirms the medical significance of the hydrotherapy which should be considered as a complementary care in the sometimes difficult management of AD.