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Background: Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in neonatal intensive care units, making it one of the leading causes of neonatal mortality despite the progress of neonatal resuscitation. It is more prevalent in lower gestational age and lower birth weight groups. Objective: To describe the epidemiological, clinical, radiographic, therapeutic features and outcome of patients presenting NEC during hospitalization in a Tunisian Neonatal Resuscitation and Intensive Care Unit. Material & Methods: A retrospective descriptive study of patients presented NEC in our Neonatal Resuscitation and Intensive care unit over a two years period (March 2015 - March 2017). Results: We collected 17 patients, 8 male and 9 female. 14 patients were born prematurely. The median weight at birth was 1500 g with extremes between 1100 g and 1980 g. 9 patients were small for gestational age. The mean Apgar at 5 minutes was 6 ± 3. 6 patients had perinatal asphyxia. 15 patients had received an empiric antibiotic therapy at birth. 16 had an umbilical venous catheter. 3 patients had a maternofoetal infection and 7 patients had a healthcare associated infection. 11 patients required mechanical ventilation at birth with a median duration of 5 days and extremes between 2 and 12 days. 10 patients presented metabolic acidosis. Enteral feeding was started after 72 hours of life: 9 patients were breastfeeding and 7 patients had received an infant formula. Clinically, abdominal distension was noted in 13 cases, feeding residuals in 13 cases, apnea in 10 cases, abdominal tenderness in 8 cases and bradycardia in 4 cases. Symptoms were considered severe in 5 cases with schock. Rectal bleeding was noted in 3 cases. Abdominal X-ray was normal in 10 cases. It showed bowel dilatation in 6 cases, thickening of bowel wall in 3 cases, pneumatosis intestinalis in 2 and free intraperitoneal gas indicative of intestinal perforation in one case. According to the ell's criteria, 10 cases were classified as stage I, 6 as stage II and 1 as stage III. 15 patients underwent broad spectrum antibiotherapy, 12 in absolute diet. Mechanical ventilation was used in 11 cases. Only one patient with intestinal perforation underwent surgery. Evolution was favourable in 13 cases, 4 patients died. Conclusion. NEC represents only 8 to 12% of neonatal infections, but it remains a serious lifethreatening condition for newborns. We illustrate the risk factors of this disease and the different clinical features. Despite advancements in the knowledge and understanding of the pathophysiology of NEC, there is currently no universal prevention measure for this serious and often fatal disease. [ABSTRACT FROM AUTHOR]

Background: Goldenhar syndrome (GS) or oculo-auriculo-vertebral dysplasia is a sporadic rare condition due to a defect in the development of first and second branchial arches. It is characterized by a combination of various anomalies involving face, eyes, ears, vertebrae, heart, and lungs. Antenatal diagnosis is possible by ultrasonography. Its etiology is not fully understood. Objective: To illustrate the variety of clinical features of GS. Materiel and methods: A retrospective descriptive study of the patients diagnosed with GS followed in our Neonatal Resuscitation and Intensive Care Unit over the last 15 years. Results: We have identified four patients with GS during the study period; three males and one female. Antenatal diagnosis was achieved in only one case with indication of medical termination of pregnancy at 26 weeks of gestation. Three patients had various degree of hemifacial microsomia, and one patient presented a left facial paralysis. Two patients had mandibular hypoplasia. Microtia with abnormal implantation of the ears was seen in two cases and the presence of preauricular tags occurred in three cases. One patient had cleft palate. As ocular defects, epibulbar dermoid or dermoid cyst and right anophthalmia in another case were seen. Two patients had vertebral abnormalities: spina bifida aberta with myelo-meningocele in the medullar MRI in one case and dystrophy of dorsal rachis without kyphosis and/or scoliosis in another case. Karyotype, cardiac and renal sonography and brain MRI of the three patients were normal. The morphology ultrasound of the one patient detected a complex cardiopathy motivating medical termination of pregnancy. Conclusion: We illustrate the variation of phenotypic spectrum of Goldenhar syndrome that may make diagnosis difficult. [ABSTRACT FROM AUTHOR]

Background: Bronchiolitis is a common and serious lung infection among children under the age of two. Its treatment is purely symptomatic or better preventive particularly since certain risk factors of severity have been identified. Objective: To describe the epidemiological, clinical and therapeutic features of neonatal bronchiolitis in a Neonatal Resuscitation and Intensive Care Unit. Materiel and methods: A retrospective descriptive study of patients admitted in our Neonatal Resuscitation and Intensive Care Unit over a one-year period (from April 2016 to March 2017). Results: Our study included 46 patients, 22 male and 24 female. 16 patients were born prematurely (34.8%). 7 patients needed mechanical ventilation at birth (15.2%). The median age at admission was 25 days with minimums and maximums of 6 days and 6 months. 22 patients were exposed to passive smoking (47.8%). Viral contamination was noted in 31 cases (67.4%). 7 patients were exclusively breast-fed. Clinically, 43 patients had coryza and congestion (93.5%). Polypnea was found in 42 cases (91.3%), nasal flaring and retractions in 27 cases (58.7%) and difficulty feeding in 28 cases (60.9%). 12 patients had an oxygen saturation less than 92% with cyanosis (26.1%). 4 patients presented apnea (8.7%). 9 patients had fever at admission (19.6%). Respiratory syncytial virus (RSV) was found in seven nasopharyngeal specimens from the 13 performed. Chest X-ray was performed in 43 patients (93.5%). It was normal in 10 cases (21.7%). It showed hyperinflateed lungs in 20 cases, atelectasis in 12 cases and pneumothorax in one case. Secondary bacterial infection occurred in 17 cases (37%). 10 patients needed mechanical ventilation (21.7%) with a median duration of seven days and extremes between two and 14 days. We used inhaled epinephrine in 38 cases (82.6%), aerosolized corticosteroids in 33 cases (71.7%) and aerosolized anticholinergic agent in 29 cases (63%). Nebulized hypertonic saline was used only in two cases (4.3%). 28 patients benefited from chest physiotherapy (60.9%). Favourable evolution was noted in 43 cases (93.5%). The median length of hospital stay was six days with extremes between one and 27 days. Three patients died: two by acute respiratory distress syndrome (ARDS) and one because of Patau syndrome he had. Conclusion: Bronchiolitis represents a growing public health problem despite prevention companions. Newborns are particularly vulnerable to this disease. Authors focus on the risk factors and outcome of neonatal bronchiolitis. Despite a lack of supporting evidence, many interventions continue to be used excessively, prompting efforts to curb unnecessary testing and treatments. Prevention remains the best treatment. [ABSTRACT FROM AUTHOR]

Introduction: Surgery is the cornerstone treatment for retroperitoneal sarcomas (RPS). However, contraindications for unresectability are not well-documented in the literature., Aim of the Study: This study aims to identify contraindications that prevent surgery for primary RPS in a high-volume sarcoma center., Methods: We retrospectively analyzed all consecutive patients treated for primary RPS at our center from 1995 to 2021., Results: Among the 452 patients treated for primary RPS, 92 (20%) were not offered surgery. The reasons for unresectability were categorized as follows: poor general health or severe comorbidities in 39 patients (42%), preoperative detection of distant metastases in 33 patients (36%), and locally advanced disease in 20 patients (22%). Locally advanced disease included vascular involvement in 14 patients (15%) and vertebral invasion in 6 patients (7%). Among the non-operated patients, 66% received chemotherapy, 16% received radiotherapy, and 5% received combined treatments. The median progression-free survival was 7months, and the median overall survival was 18months. The 1-year overall survival rate was 53%., Conclusion: Contraindications for surgery in patients with primary RPS in a high-volume sarcoma center are not uncommon. The next step should be to differentiate absolute from relative (i.e., preoperative modifiable factors) contraindications., Competing Interests: Disclosure of interest The authors declare that they have no competing interest., (Copyright © 2025. Published by Elsevier Masson SAS.)

Cancer immunotherapy combinations have recently been shown to improve the overall survival of advanced mesotheliomas, especially for patients responding to those treatments. We aimed to characterize the biological correlates of malignant pleural mesotheliomas' primary resistance to immunotherapy and antiangiogenics by testing the combination of pembrolizumab, an anti-PD-1 antibody, and nintedanib, a pan-antiangiogenic tyrosine kinase inhibitor, in the multicenter PEMBIB trial (NCT02856425). Thirty patients with advanced malignant pleural mesothelioma were treated and explored. Unexpectedly, we found that refractory patients were actively recruiting CD3+CD8+ cytotoxic T cells in their tumors through CXCL9 tumor release upon treatment. However, these patients displayed high levels of somatic copy-number alterations in their tumors that correlated with high blood and tumor levels of IL6 and CXCL8. Those proinflammatory cytokines resulted in higher tumor secretion of VEGF and tumor enrichment in regulatory T cells. Advanced mesothelioma should further benefit from stratified combination therapies adapted to their tumor biology., Significance: Sequential explorations of fresh tumor biopsies demonstrated that mesothelioma resistance to anti-PD-1 + antiangiogenics is not due to a lack of tumor T-cell infiltration but rather due to adaptive immunosuppressive pathways by tumors, involving molecules (e.g., IL6, CXCL8, VEGF, and CTLA4) that are amenable to targeted therapies. This article is highlighted in the In This Issue feature, p. 799., (©2023 The Authors; Published by the American Association for Cancer Research.)

The use of immune checkpoint inhibitors (ICIs) has drastically transformed the therapeutic landscape in lung cancer. Special focus has been put on immune-related toxicity; however, infections can also seem during ICI treatment. Although rare, tuberculosis (TB) has been increasingly identified after ICIs, and it seems that the programmed cell death protein 1 and programmed death-ligand 1 pathway is directly involved in its pathophysiology. Here, we describe the case of a patient with advanced NSCLC who developed abdominal TB after 32 months of pembrolizumab and who remains in tumor remission 10 months after discontinuation of this drug. Routine screening for latent TB before ICI treatment is advised, with closer collaboration between infectious disease specialists and oncologists., (© 2022 The Authors.)