While in Flanders and in Brussels the prevalence is comparable to that in other Western European countries, in Wallonia it is markedly lower. Transsexualism in Wallonia appears to be socially less acceptable: persons suffering from gender dysphoria in that part of Belgium encounter more problems accessing gender clinics and receiving treatment.

In differentiated tissues, such as muscle and brain, increased adenosine monophosphate (AMP) levels stimulate glycolytic flux rates. In the breast cancer cell line MCF-7, which characteristically has a constantly high glycolytic flux rate, AMP induces a strong inhibition of glycolysis. The human breast cancer cell line MDA-MB-453, on the other hand, is characterized by a more differentiated metabolic phenotype. MDA-MB-453 cells have a lower glycolytic flux rate and higher pyruvate consumption than MCF-7 cells. In addition, they have an active glycerol 3-phosphate shuttle. AMP inhibits cell proliferation as well as NAD and NADH synthesis in both MCF-7 and MDA-MB-453 cells. However, in MDA-MB-453 cells glycolysis is slightly activated by AMP. This disparate response of glycolytic flux rate to AMP treatment is presumably caused by the fact that the reduced NAD and NADH levels in AMP-treated MDA-MB-453 cells reduce lactate dehydrogenase but not cytosolic glycerol-3-phosphate dehydrogenase reaction. Due to the different enzymatic complement in MCF-7 cells, proliferation is inhibited under glucose starvation, whereas MDA-MB-453 cells grow under these conditions. The inhibition of cell proliferation correlates with a reduction in glycolytic carbon flow to synthetic processes and a decrease in phosphotyrosine content of several proteins in both cell lines.Both proliferating cells and tumor cells maintain a high glycolytic rate even under aerobic conditions, a process referred to as aerobic glycolysis. Observations on aerobic glycolysis in tumor cells prompted Warburg (1) to postulate an altered respiratory function leading to an increased glycolytic capacity and a high rate of lactate formation from glucose in the presence of oxygen. Data from former reports suggest that there are many factors contributing to the origin of aerobic glycolysis (2). The altered control of glycolysis by expression of certain isoenzymes is one important factor (2-12). Furthermore, the glycerol 3-phosphate shuttle and the malate-aspartate shuttle are altered in such a way that transport of cytosolic hydrogen into the mitochondria is reduced, requiring tumor cells to reoxidize NADH cytosolically by lactate dehydrogenase (13-15). Additionally, oxidation of pyruvate is reduced in favor of glutamine oxidation (16 -25). Due to the expression of the mitochondrial, NAD-dependent malate decarboxylase, malate is converted to pyruvate and lactate (22)(23)(24). The conversion of glutamine to lactate is called, in analogy to glycolysis, glutaminolysis (25). In tumor cells the glycolytic capacity can be so great that all of the cell's energy requirements are derived from glycolysis (2, 26). Therefore, high glycolytic activity ensures the survival and the migration of tumor cells in hypoxic areas (2,26,27). The main role of the glutaminolytic pathway is the generation of energy (2, 25). However, a high glycolytic rate is not always linked to cell proliferation or tumor formation. There are several cell lines that are able to grow in a medium with 5 mM gala...

BackgroundEven though virtual reality (VR) is more and more considered for its power of distraction in different medical contexts, the optimal conditions for its use still have to be determined in order to design interfaces adapted to therapeutic support in oncology.ObjectiveThe objective of this study was to examine the benefits of VR using two immersion methods (i.e., one participatory, one contemplative) and comparing them with each other in a population of women with breast cancer who have undergone breast surgery, during scar massage sessions.MethodsIn a physiotherapy center, each patient participated in four experimental conditions in a random order: two sessions used virtual immersion (i.e., one participatory and one contemplative), one session proposed musical listening and the fourth one was a standard session care. The impact of the level of patient involvement in the virtual world was apprehended through the evaluation of the feeling of presence; the estimation of elapsed time of the physiotherapy sessions and particular attention was paid to the evaluation of patient emotional state.ResultsOur study showed an increase in positive emotions (i.e., joy and happiness) and a decrease in anxiety regardless which support methods were offered. Participatory VR created a feeling of more intense spatial presence.ConclusionOur results highlight the importance of the context in which VR should be offered. The presence of the practitioner and his interactions with the patient can provide a context just as favorable in reducing anxiety as the emotional regulation tools used (VR, music). The use of technological tools should be favored when the practitioner is unavailable during the treatment phase or, even, in order to reduce the monotonous nature of repetitive therapeutic sessions.

The aim of this study is to examine the impact of haematological cancers on quality of life (QoL). A review of the international literature was conducted from the databases ‘PsycInfo' and 'Medline' using the keywords: 'haematological cancer', 'quality of life', 'physical', 'psychological', 'social', 'vocational', 'professional', 'economic', 'cognitive', and 'sexual'. Twenty-one reliable studies were analysed. Among these studies, 12 showed that haematological cancer altered overall QoL, 8 papers found a deterioration of physical dimension, 8 papers reported on functional and role dimensions, 11 papers reported on the psychological component and 9 on the social component. Moreover, one study and two manuscripts, respectively, reported deteriorated sexual and cognitive dimensions. Our review demonstrates that the different dimensions of QoL are deteriorated by haematological malignancies and, probably, by the side effects of treatment.