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Jaspers A, Stringer B, Koch K, Kool N. [Self-harming behavior of patients on a closed psychiatric ward]. Tijdschr Psychiatr 2023; 65:244-247. [PMID: 37323043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Self-harming behavior is a frequent problem seen in patients admitted to a closed ward in a psychiatric hospital. Little is known about prevalence and characteristics of this behavior as well as the preceding triggering factors. AIM To gain insights in the self-harming behavior of patients admitted to a closed ward in a psychiatric hospital. METHOD From September 2019 till January 2021 was gathered information on self-harming incidents and aggressive behavior towards others or objects, of 27 patients admitted to the closed department of the Centre Intensive Treatment (Centrum Intensieve Behandeling). RESULTS 20 of 27 patients examined (74%) showed 470 incidents of self-harming behavior. Head banging (40.9%) and self-harming using straps/ropes (29.7%) occured most. Tension/stress as triggering factor was mentioned most (19.1%). Self-harming behavior occured more during evenings. Besides self-harm, a high degree of aggressive behavior towards others or objects was registered. CONCLUSION This study delivers insights in self-harming behavior of patients admitted to closed psychiatric departments that can be used for prevention and treatment.
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Abstract
Introduction Self-harming behavior is a frequent problem seen at patients admitted to closed wards in psychiatric hospitals. People who self-harm have al higher risk of other forms of aggressive behavior as well. Little is known about prevalence and characteristics of this behavior, the preceding triggering factors and the relation with other aggressive behaviors. Objectives To gain insights in the self-harming behavior of patients admitted to a closed ward in a psychiatric hospital. Methods From September 2019 till January 2021 information on self-harming incidents and aggressive behavior towards others or objects, of 27 patients admitted to the closed department of the Centre Intensive Treatment (Centrum Intensieve Behandeling), has been gathered. The Self-Harm Scale and Social Dysfunction and Agression Scale were used to gather the data. Results Twenty of 27 patients examined (74%) showed self-harming behavior. Head banging (41,9%) and self-harming using straps/ropes (30%) occurred most. Tension/stress as triggering factor was mentioned most (19,1%), followed by reliving (13,5%) and team interaction (11,8%). Self-harming behavior occurred more in evenings then during the rest of the day. No significant difference was found in the degree of aggressive behavior towards others or objects between the group of patients harming themselves and the group that didn’t. Conclusions This study delivers insights in self-harming behavior of patients admitted to closed psychiatric departments that can be used for prevention and treatment. Disclosure No significant relationships.
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Chatelain C, Piette C, Bex A, Bex V, Janin N, Salmon JP, Cabay JE, El Hachemi M, Jaspers A, Ben Mustapha S, Louviaux I. [Medulloblastoma : management of a usually pediatric tumour in a young adult]. Rev Med Liege 2022; 77:153-160. [PMID: 35258863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Medulloblastoma is a cerebellar grade IV tumour according to the WHO classification, mainly seen in children under the age of 15. This cancer can nevertheless occur in adults. We report the case of a 22-year-old patient with a medulloblastoma disseminated in the spine. The patient had a type 1 Arnold-Chiari malformation causing hydrocephalus treated by ventriculoperitoneal shunt. The current condition began with perineal and lower limb hypoesthesia, ataxic gait, erectile dysfunction and urinary incontinence. Subsequently, a predominant paraparesis of the right lower limb appeared. The patient was treated according to the PNET HR+5 protocol combining two courses of conventional chemotherapy followed by two courses of high-dose chemotherapy with autograft recovery. Given the excellent response, a proton therapy was then delivered to the whole cerebrospinal axis with boosts to the primary tumour sites. The case of this young adult patient shows on the one hand an atypical presentation, and on the other hand underlines, in the absence of a specific therapeutic strategy established for adults, the importance of collaboration between the adult and pediatric oncology departments, with management integrating innovations such as proton therapy and molecular typing.
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Affiliation(s)
| | - C Piette
- Service d'Hémato-Oncologie pédiatrique, CHR Citadelle-CHU Liège, Belgique
| | - A Bex
- Service de Neurochirurgie, CHR Citadelle, Liège, Belgique
| | - V Bex
- Service de Neurochirurgie, CHR Citadelle, Liège, Belgique
| | - N Janin
- Service d'Oncologie, CHR Citadelle, Liège, Belgique
| | - J P Salmon
- Service d'Oncologie, CHR Citadelle, Liège, Belgique
| | - J E Cabay
- Service de Radiologie, CHR Citadelle, Liège, Belgique
| | - M El Hachemi
- Service de Radiologie, CHR Citadelle, Liège, Belgique
| | - A Jaspers
- Service d'Hématologie clinique, CHU Liège, site CHR Citadelle, Belgique
| | | | - I Louviaux
- Service d'Oncologie, CHR Citadelle, Liège, Belgique
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De Voeght A, Jaspers A, Beguin Y, Baron F, De Prijck B. [Overview of the general management of acute leukemia for adults]. Rev Med Liege 2021; 76:470-475. [PMID: 34080382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Acute leukemias are a heterogeneous group of malignant hemopathies which are subdivided according to the cytological orientation of the pathological blast cell into lymphoblastic (ALL) and myeloblastic (AML) acute leukemias. Recent advances in the biological and genetic understanding of these diseases have led to improved treatments. Specific chemotherapy treatment or so-called «targeted» treatments, advances in bone marrow transplantation and better supportive care have gradually improved the prognosis. This review, focused on the adult patient, aims to describe recent progress in terms of diagnosis, prognostic markers and therapy.
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Affiliation(s)
| | - A Jaspers
- Service d'Hématologie, CHU Liège, Belgique
| | - Y Beguin
- Service d'Hématologie, CHU Liège, Belgique
| | - F Baron
- Service d'Hématologie, CHU Liège, Belgique
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Van Severen C, Jaspers A, Weber T, Gustin M. [Hemophagocytic lymphohistiocytosis on Epstein-Barr Virus reactivation]. Rev Med Liege 2020; 75:512-517. [PMID: 32779901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We describe the case of a 43-years-old female patient admitted in the emergency department for impairment of general condition and dyspnea. This patient is on immunosuppressive medication for Behçet's disease and will develop a lymphoma and hemophagocytic lymphohistiocytosis following Epstein-Barr virus (EBV) reactivation. This clinical case introduces a brief literature review about hemophagocytic lymphohistiocytosis (HLH).
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Affiliation(s)
- C Van Severen
- Service de Pneumo-Oncologie, CHR de la Citadelle, Liège, Belgique
| | - A Jaspers
- Service d'Hématologie clinique, CHR de la Citadelle, Liège, Belgique
| | - T Weber
- Service de Pneumo-Oncologie, CHR de la Citadelle, Liège, Belgique
| | - M Gustin
- Service de Pneumo-Oncologie, CHR de la Citadelle, Liège, Belgique
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Ossenkoppele GJ, Breems DA, Stuessi G, van Norden Y, Bargetzi M, Biemond BJ, A von dem Borne P, Chalandon Y, Cloos J, Deeren D, Fehr M, Gjertsen B, Graux C, Huls G, Janssen JJJW, Jaspers A, Jongen-Lavrencic M, de Jongh E, Klein SK, van der Klift M, van Marwijk Kooy M, Maertens J, Michaux L, van der Poel MWM, van Rhenen A, Tick L, Valk P, Vekemans MC, van der Velden WJFM, de Weerdt O, Pabst T, Manz M, Löwenberg B. Lenalidomide added to standard intensive treatment for older patients with AML and high-risk MDS. Leukemia 2020; 34:1751-1759. [PMID: 32020044 DOI: 10.1038/s41375-020-0725-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/24/2019] [Accepted: 01/22/2020] [Indexed: 11/09/2022]
Abstract
More effective treatment modalities are urgently needed in patients with acute myeloid leukemia (AML) of older age. We hypothesized that adding lenalidomide to intensive standard chemotherapy might improve their outcome. After establishing a safe lenalidomide, dose elderly patients with AML were randomly assigned in this randomized Phase 2 study (n = 222) to receive standard chemotherapy ("3 + 7") with or without lenalidomide at a dose of 20 mg/day 1-21. In the second cycle, patients received cytarabine 1000 mg/m2 twice daily on days 1-6 with or without lenalidomide (20 mg/day 1-21). The CR/CRi rates in the two arms were not different (69 vs. 66%). Event-free survival (EFS) at 36 months was 19% for the standard arm versus 21% for the lenalidomide arm and overall survival (OS) 35% vs. 30%, respectively. The frequencies and grade of adverse events were not significantly different between the treatment arms. Cardiovascular toxicities were rare and equally distributed between the arms. The results of the present study show that the addition of lenalidomide to standard remission induction chemotherapy does not improve the therapeutic outcome of older AML patients. This trial is registered as number NTR2294 in The NederlandsTrial Register (www.trialregister.nl).
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Affiliation(s)
- G J Ossenkoppele
- Amsterdam University Medical Cente, location VUMC, Amsterdam, Netherlands.
| | | | - G Stuessi
- Bellinzona-IOSI, Bellinzona, Switzerland
| | - Y van Norden
- HOVON Data Center, Erasmus MC- Department of Hematology, Rotterdam, The Netherlands
| | - M Bargetzi
- Aarau- Kantonsspital, Aarau, Switzerland
| | - B J Biemond
- Amsterdam University Medical Center, location AMC, Amsterdam, Netherlands
| | | | - Y Chalandon
- University Hospital and University of Geneva, Genève, Switzerland
| | - J Cloos
- Amsterdam University Medical Cente, location VUMC, Amsterdam, Netherlands
| | - D Deeren
- Roeselare-AZ Delta, Roeselare, Belgium
| | - M Fehr
- St Gallen-Kantonnsspital, St. Gallen, Switzerland
| | - B Gjertsen
- Haukeland University Hospital, Bergen (N), Norway
| | - C Graux
- Yvoir-MontGodinne, Yvoir, Belgium
| | - G Huls
- University Medical Center, Groningen, Netherlands
| | - J J J W Janssen
- Amsterdam University Medical Cente, location VUMC, Amsterdam, Netherlands
| | - A Jaspers
- Hôpital Citadelle, Liège (B), Belgium
| | | | | | - S K Klein
- Meander Medical Center, Amersfoort, Netherlands
| | | | | | - J Maertens
- Hospital Gasthuisberg, Leuven (B), Belgium
| | - L Michaux
- Center for Human Genetics, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | | | | | - L Tick
- MaximaMC Eindhoven, Eindhoven, Netherlands
| | - P Valk
- Hôpital Citadelle, Liège (B), Belgium
| | | | | | - O de Weerdt
- St Antonius Hospital, Nieuwegein, Netherlands
| | - T Pabst
- Department of Oncology, University Hospital, Inselspital and University of Bern, Bern, Switzerland
| | - M Manz
- University Hospital, Zurich, Switzerland
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Jaspers A, Baron F, Bonnet C, De Prijck B, Fassotte MF, Beguin Y. [Mantle cell lymphoma]. Rev Med Liege 2010; 65:171-176. [PMID: 20499817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Mantle cell lymphoma comprises 3 to 10% of non-Hodgkin's lymphomas. Cyclin D1 expression due to t(11 ;14) (q13 ;32) is considered as a hallmark of this lymphoma and plays a pivotal role in the pathophysiology of lymphoma transformation. Median age at diagnosis ranges from 60 to 70 years, and diagnosis is often made at an advanced stage with widespread lymphadenopathy and extranodular (particularly bone marrow and gastrointestinal) infiltration. First line treatment consists of combination chemotherapy followed with autologous hematopoietic cell transplantation (HCT) in younger patients, while allogeneic HCT following non-myeloablative conditioning might have a role in patients relapsing after autologous HCT.
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van Gent R, Kater AP, Otto SA, Jaspers A, Borghans JAM, Vrisekoop N, Ackermans MAT, Ruiter AFC, Wittebol S, Eldering E, van Oers MHJ, Tesselaar K, Kersten MJ, Miedema F. In vivo dynamics of stable chronic lymphocytic leukemia inversely correlate with somatic hypermutation levels and suggest no major leukemic turnover in bone marrow. Cancer Res 2009; 68:10137-44. [PMID: 19074880 DOI: 10.1158/0008-5472.can-08-2325] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although accumulating evidence indicates that chronic lymphocytic leukemia (CLL) is a disease with appreciable cell dynamics, it remains uncertain whether this also applies to patients with stable disease. In this study, (2)H(2)O was administered to a clinically homogeneous cohort of nine stable, untreated CLL patients. CLL dynamics in blood and bone marrow were determined and compared with normal B-cell dynamics in blood from five healthy individuals who underwent a similar (2)H(2)O labeling protocol. Average CLL turnover rates (0.08-0.35% of the clone per day) were approximately 2-fold lower than average B-cell turnover rates from healthy individuals (0.34-0.89%), whereas the rate at which labeled CLL cells in blood disappeared (0.00-0.39% of B cells per day) was approximately 10-fold lower compared with labeled B cells from healthy individuals (1.57-4.24% per day). Leukemic cell turnover variables inversely correlated with the level of somatic hypermutation of the CLL clone (IgVH mutations). Although CLL cells in bone marrow had a higher level of label enrichment than CLL cells in blood, no difference between proliferation rates and proapoptotic and antiapoptotic profiles of CLL cells from these compartments was observed. These data suggest that, in stable disease, there is a biological relationship between the degree of somatic hypermutation of the CLL clone and its dynamics in vivo. Furthermore, in contrast to lymph nodes, the bone marrow does not seem to be a major CLL proliferation site.
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MESH Headings
- Apoptosis/genetics
- Bone Marrow/pathology
- Child, Preschool
- Female
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Variable Region/genetics
- Infant
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Mutation
- RNA, Neoplasm/genetics
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Affiliation(s)
- Rogier van Gent
- Department of Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
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