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To investigate the efficacy and tolerance of systemic treatments for the prevention of HLA-B27-associated acute uveitis (AU) recurrence. Methods Retrospective review of patients with HLA-B27-associated uveitis followed in our tertiary center over a 15-year period. Systemic treatments were prescribed to patients with frequent (more than 2 flares per year) or severe uveitis, according to a step-up strategy Results 101 patients (51.5% of men, 88.1% of white Europeans) with a median age of 37 years. AU was mostly recurrent (68.3%) and associated with spondyloarthritis (60.4%). After a median follow-up duration of 22 months (3-73), 37.6% of the patients have received systemic treatment. 88.5% of the patients have been treated with sulfasalazine (SSZ) for ophthalmologic purposes (23/26). Methotrexate (MTX) and anti-TNFα agents have been initiated for a rheumatologic indication in 81.8% (9/11) and 100% of the patients (13/13), respectively. The annual uveitis relapse rate significantly decreased on SSZ (0.37 recurrences/year versus baseline 2.46 recurrences/year; p<0.001) and MTX (1.54 recurrences/year versus 4.17/year; p = 0.008). Patients under ADA for ophthalmologic purposes (n = 2) did not experience any recurrence. Conclusion We report an open-label strategy to prevent the recurrences of HLA-B27-associated AU. First-line sulfasalazine reduced uveitis relapses. The use of anti-TNFα agents for ophthalmologic purposes was unnecessary with rare exceptions.

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Uterine torsion is a rare life-threatening event that happens at any age or any gestational age. By defi nition, it consists of a rotation of more than 45 degrees around the long axis of the uterus. The reported cases have variable presentations. The uterine torsion can happen without any sequelae either for the fetus or the mother. However, fetal and maternal mortalities were also reported in such a case We hereby, report the case of a 29-year-old female patient, with previous four Normal Vaginal Deliveries, pregnant with twins, presenting at 36 weeks gestation with an irreducible uterine torsion at the third trimester of her pregnancy complicated by maternal and fetal deaths. We concluded that the prognosis is improved as long as the management is done rapidly. More data is needed to know about the genetic predilection and the characteristics of imaging workup for a rapid preoperative diagnosis of this condition.

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and 33.3%; p ¼ 0.9). 23.4% of patients received second line treatment. The two most commonly used regimens were FOLFIRI (36.4%) and Capecitabine (27.3%). FOLFIRI seemed to be more effective than Capecitabine (respectively 66.7% of progression vs 100%, p ¼ 0.5). Only 4.3% of patients received a third line chemotherapy based on capecitabine or FOLFIRI. All patients progressed. The median number of received chemotherapy cycles was 4. 41.9% of our patients developed grade 3-4 toxicity during chemotherapy. There was no treatment-related death. Median overall survival (OS) and progression free survival (PFS) were respectively 6 and 5 months. On univariate analysis, factors associated with poor OS were elevated tumor markers (p ¼ 0.001), hepatic metastases (p ¼ 0.003) and radiologic progression after first line treatment (p ¼ 0.03). Those related with a better survival were receiving first (p<0.001) and second line chemotherapy (p ¼ 0.01) and having a surgery (p ¼ 0.01) even with a palliative intent (p ¼ 0.04). Multivariate analysis demonstrated that the only independent factor positively impacting on survival was receiving chemotherapy (p ¼ 0.01). Conclusion: Metastatic spread of gastric cancer is fatal. This study confirms the survival benefit and manageable toxicity of palliative chemotherapy but survival increase remains poor compared to improvements in other gastrointestinal cancers.