Creativity and construction of professional identity:reflections and practices in paediatric onco-haematology

This article illustrates the clinical practice of psycho-oncology in a paediatric onco-haematology department by young psychologists.To begin with,we look at the role of the psychologist in a somatic department.Creativity in clinical work and the modulation of medical temporality.The aim here is to discuss the construction of the professional identity in relation to the construction of the therapeutic alliance with patients.Specifically,we will look at the relationship with creativity,which is necessary to support children and adolescents in their existential questioning.This work of creativity in the therapeutic alliance will be illustrated using two clinical cases that are particularly representative of clinical work centred on the relationship with finitude.

Pazopanib-induced posterior reversible encephalopathy syndrome with possible syndrome of inappropriate secretion of antidiuretic hormone: an incidental or pathophysiological association?

Introduction:Pazopanib is an oral protein kinase inhibitor(PKI)that targets vascular endothelial growth factor(VEGF)receptors,fibroblastic growth factor receptors,platelet-derived growth factor receptors,and stem cell factor that inhibits VEGF-induced cellular proliferation.Pazopanib is approved for use in advanced renal cell carcinoma and subtypes of advanced soft-tissue sarcoma(Deguchi et al.,2018).Major adverse drug reactions of pazopanib include hypertension,high-grade hyponatremia and posterior reversible encephalopathy syndrome(PRES)(Berardi et al.,2016;Deguchi et al.,2018).In clinical trials,few investigations have been conducted to determine the aetiology of PKI-associated hyponatremia,the mechanism remains therefore unknown.Only rare cases of PKI-induced syndrome of inappropriate secretion of antidiuretic hormone(SIADH)(Largeau et al.,2019),and none with pazopanib,have been reported.PRES is a clinical and radiological entity where a bilateral white matter oedema,occurring predominantly in the posterior occipital and parietal lobes,is associated with several neurologic symptoms.Interestingly,a recent review suggests that SIADH could be a symptom of PRES(Largeau et al.,2019).To our knowledge,this is the first case published where pazopanib-induced PRES occurs contemporaneously with possible SIADH.

Intracranial Meningiomas among Intracranial Tumors in the Neurosurgical Unit of Sylvanus Olympio Teaching Hospital

Objective: To describe the pattern of intracranial tumors in Sylvanus Olympio teaching hospital of Lomé (Togo). Method: We conducted a retrospective and descriptive study between November 2017 and December 2019. Data were obtained from the clinical records of patients with intracranial tumors treated in our neurosurgery unit, and histology obtained. Patients without a definitive histological diagnosis were excluded. Results: 53 patients were operated and had a histological diagnosis in the period of the study. The mean age at diagnosis was 32 ± 27.1 years. The majority of tumors were seen in adults at 88.7% with age range between 23 - 75 years and a mean age of 40 ± 10.5 years. Meningioma was the commonest intracranial tumor in adults (47.2%) and more seen in females. The histological type of meningioma is meningotheliomatous in our study. In children, principal tumors were medulloblastoma and ependymoma (11.3%). Conclusion: Meningioma is the most common intracranial tumor in adults, while embryonal tumors (medulloblastoma and ependymoma) are the most frequent in children in our environment.