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Overall, 9 of 11 relapses were successfully treated with canakinumab treatment intensification or re-introduction. At last visit, 18% of patients were off treatment due to remission and 26% due to disease activity. Canakinumab had a significant corticosteroid sparing effect allowing weaning in 21 of 41 cases. Infections (20%, severe 4%) and leucopenia (6%) led to treatment cessation in one patient.

High rates of sustained remission were observed in this, largest so far, real-life cohort of adult patients with refractory Still's disease treated with canakinumab.

High rates of sustained remission were observed in this, largest so far, real-life cohort of adult patients with refractory Still's disease treated with canakinumab.

Considering the role of metabolic diseases in osteoarthritis (OA), we investigated whether biomarkers of adipose tissue dysfunction could be associated with OA-related pain.

We cross-sectionally analyzed patients with knee and/or hip OA at inclusion in the KHOALA cohort. We used visual analogic scale (VAS) for pain, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) pain subscores. At inclusion, we measured ultra-sensitive CRP (usCRP), leptin and adiponectin for calculation of leptinadiponectin ratio (LAR), a marker of adipose tissue dysfunction associated with central adiposity, high-molecular-weight adiponectin, visfatin and apolipoproteins. SNDX-5613 Univariate and multivariable analyses using stepwise linear regression models were performed to search for correlation between pain assessments and these biomarkers, with systematic adjustment on age.

In 596 women with hip and/or knee OA, multivariable analyses indicated that higher pain intensity was associated with higher LAR (VAS pain β=0.49; p=0.0001, OAKHQOL pain β=-0.46; p=0.0002, WOMAC pain β=0.30; p=0.001) in the whole group as well as in hip or knee OA patients considered separately. Pain intensity correlated also with usCRP level (VAS pain β= 0.27; p=0.02, OAKHQOL pain β =-0.30; p=0.01) and Kellgren-Lawrence score. In 267 men, no correlation between biomarkers and pain was found.

Serum LAR and usCRP level are associated with pain level, independently of radiographic structural severity in women with hip and/or knee OA, emphasizing the role of adipose tissue dysfunction and of meta-inflammation in pain experience in the female population.

Serum LAR and usCRP level are associated with pain level, independently of radiographic structural severity in women with hip and/or knee OA, emphasizing the role of adipose tissue dysfunction and of meta-inflammation in pain experience in the female population.A 55-year-old-man underwent laparoscopic sigmoidectomy for sigmoid colon cancer. Preoperative barium enema showed a slightly medial displacement of the descending colon, and the sigmoid colon was quite long. The operative findings showed that the descending colon was not fused with the retroperitoneum and shifted to the midline and the left colon adhered to the small mesentery and right pelvic wall. Thus, a diagnosis of persistent descending mesocolon (PDM) was made. The left colon, sigmoid colon, and superior rectal arteries often branch radially from the inferior mesenteric artery. The sigmoid mesentery shortens, and the inferior mesenteric vein is often close to the marginal vessels. By understanding the anatomical feature of PDM and devising surgical techniques, laparoscopic sigmoidectomy for sigmoid colon cancer with PDM could be performed without compromising its curative effect and safety.

Orbital metastases from solid cancers are infrequent or underestimated, since they represent only 1-13% of tumors of the orbit. They are even less frequent in breast cancer and are rarely diagnosed. We report a case of an early diagnosed orbital metastasis from breast cancer to an extra ocular muscle.

We report the case of a 33-year-old female patient who presented, following the diagnosis of her breast cancer, headache, a progressive decrease in visual acuity of the right eye and diplopia. Brain imaging revealed a tissue process at the expense of the internal rectus muscle, which biopsy pointed to a secondary lesion of breast cancer.

Extraocular muscles are rarely infiltrated by metastasis from distant sites. They are mostly asymptomatic and suggest a systematic spread of the disease. The treatment is generally palliative and the prognosis is generally poor.

Orbital metastases from breast cancer are certainly rare but are associated with significant morbidity. In order to make a precise diagnosis and offer an appropriate treatment, healthcare professionals must remain vigilant in the face of any ophthalmological symptoms.

Orbital metastases from breast cancer are certainly rare but are associated with significant morbidity. In order to make a precise diagnosis and offer an appropriate treatment, healthcare professionals must remain vigilant in the face of any ophthalmological symptoms.

Peripheral venous cannulation is the most common procedure, often performed by junior colleagues. Despite its benign nature, it is associated with extravascular infiltration, thrombophlebitis, hematoma, catheter-associated bloodstream infections, trauma to surrounding structures, including tendon and nerve injures, hematoma formation and air embolism. Fracture of a peripheral intravenous cannula in situ is a rare, potentially serious complication that is underreported. More importantly, the etiology and prevention of this complication are not widely known by those performing cannulation. This case report will increase awareness and knowledge on intravenous peripheral cannula fracture to improve peripheral intravenous cannulation safety.

In this case report, we describe a fracture of a size 18 G plastic peripheral intravenous cannula (Neovac-Neomedic) in situ in a 76-year-old hypertensive male managed at Aga Khan Hospital Dar es salaam, Tanzania. The cannula's fracture was noticed 24 h later during the cannding the guide needle's reinsertion may result in cannula fracture, allows safer cannulation practices by the clinician and adequate counseling of the patient before the procedure.

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