The 2003 discovery of a new protein called PCSK9 (proprotein convertase subtilisin/kexin type 9), involved in LDL particle metabolism, resulted in the development of a new class of highly potent cholesterol-lowering agents. Given this context, several monthly or bimonthly subcutaneously administered monoclonal antibodies that inhibit PCSK9 (evolocumab, Amgen; alirocumab, Sanofi/Regeneron; bococizumab, Pfizer) were shown to reduce LDL cholesterol by 45-75%, with a very good tolerance and safety profile. This paved the way for a new therapeutic strategy aimed at helping patients achieve their LDL-cholesterol targets while compensating the statins' limitations of use.
A. DeltourPublished in the journal : May 2016Category : Le Genou
Clinical assessment allows determining the type of technical investigation that will facilitate establishing the diagnosis. It must be performed systematically and be guided by the patient’s history. When well conducted, clinical examination contributes to 90% of the final diagnosis.
A. Hartman, D. Leonard, R. Bachmann, N. Abbes Orabi , Ch. Remue, A. Kartheuser, Au nom du groupe intermétiers Fast-TrackPublished in the journal : May 2016Category : Sortie de l'hôpital
The concept of enhanced recovery, also termed "Fast-Track", was introduced in Denmark in the 1990’s by Henrik Kehlet with the aim to improve post-surgery recovery. This multimodal approach seeks to reduce surgical stress through optimized patient care in the pre-, intra-, and postoperative periods. In light of the most recent literature, this article provides a review of the different enhanced recovery program items that we have been using for the past 10 years in our colorectal surgery unit.
This article focuses on several fundamental links between basic respiratory physiology and clinical medicine practice during consultation, when a patient complaints about symptoms of pulmonary origin or seeks explanations for the proper functioning of his/ her lungs and breathing.
Headache is a common complaint that may be associated with a variety of clinical conditions. Most patients suffer from primary headache, whose diagnosis can be made based on clinical history, with no additional test required. Some patients have secondary headache that may be life-threatening, and further tests must be performed, at times under emergency conditions. Red flags include sudden onset of headache, new-onset headache, headache increasing in frequency and severity, advanced age, and abnormal neurological examination.
Chronic obstructive pulmonary disease (COPD) is a common condition, which is burdened with significant morbidity and mortality. The Global initiative for Obstructive Lung Disease (GOLD) international guidelines have recently proposed a new classification based not only on the degree of airflow limitation, but also on symptoms and risk of exacerbations.
Digital clubbing was first described by Hippocrates over 2500 years ago. This condition may occur as isolated finding or part of the hypertrophic osteoarthropathy syndrome, characterized by periostitis, arthritis, and at times thickening and edema of the skin surrounding the affected joints. Numerous diseases have been associated with this manifestation. In this article, we have reviewed the etiology, pathophysiology, and various theories aimed at explaining the occurrence of digital clubbing.
In February 2016, the World Health Organization (WHO) declared the Zika virus outbreak a global public health emergency. The epidemic is raging in over 30 countries in the Americas, Pacific Islands, and several other regions around the world. The Zika virus belongs to the Flaviviridae family, which also includes the yellow fever, dengue, chikungunya, Japanese encephalitis, and West Nile viruses. It is transmitted by Aedes mosquitoes, especially Aedes aegypti and Aedes albopictus. Other mosquito species such as Anopheles and Culex are also considered potential Zika virus vectors. Symptoms are usually mild to moderate, including fever, bilateral non-purulent conjunctivitis, rash, and arthralgia.
Walking is a set of repetitive cyclical movements in the three planes of space. This complex process involves not only the lower-limb joints, but also the entire body. Walking may be impaired by a variety of musculoskeletal disorders of peripheral/central neurological, muscular, or osteoarticular origin, associated with compensatory mechanisms such as limping.
Chronic low back pain is a common reason for medical consultation, with significant impact on functional and professional status of affected patients. Many treatments are available. One of these, a back school program, is a multidisciplinary approach involving therapeutic education and physical exercise. The variety of potential options to treat chronic low back pain and the difficulty of long-term follow-up were the main reasons leading us to carry out this study. Our back school protocol consists of therapeutic education, along with cognitive-behavioral approach and gradual musclestrengthening exercises. In this article, we have presented our experience with back school and our study results regarding 394 chronic low back pain patients assessed on the short- (end-ofprogram evaluation), medium- (6-month evaluation), and longterm (12-month evaluation). The study's main outcome parameters included the benefits of back school on pain, as well as its impact on quality of life, functional status, and professional status. Our back school protocol yielded significant benefits that were maintained over the mediumand long-term. Furthermore, we observed a high rate of patients returning to work.