Lamine Gakuba Rwema*, Olivier Cornu*, Gérald Delfosse, Sami Ftaita, Louis Debarre, Quentin Vraux, Jean-Emile Dubuc, Emmanuel ThienpontPublished in the journal : September 2024Category : Orthopedics
Anterior cruciate ligament (ACL) injuries are one of the most common ligament injuries in athletes. The primary goal of treatment is to restore stability and function to the knee while preventing secondary lesions. Treatment modalities depend on the anatomic characteristics of the rupture, associated lesions, residual stability, and functional requirements of the patient. Conservative treatment consists of several weeks of physical therapy. A subsequent re-evaluation may still lead to surgical treatment at a later stage.
Although there are a variety of surgical treatments, the most common procedure remains ACL ligamentoplasty with one or more grafts (autografts, allografts).
The aim of this article is to recall the epidemiology, biomechanics, and current management of these lesions, thus allowing a better understanding by general practitioners, orthopedists, and sports physicians.
Mindfulness-based interventions (MBIs) implemented in palliative care (PC) are illustrated here through a case study of a patient suffering from metastatic pancreatic cancer from his admission to the palliative unit until his death, including contact with his family.
Through a review of the literature on the concept of mindfulness and the various interventions that exist and have been used in PC, the article outlines those that were used in this case. Which MBIs have been studied and what benefits have been demonstrated for the caregiver, for the caregiver-patient relationship, and for the patient in a PC setting? The two main MBI formats, group and individual, are explored here through different authors as to their relevance for use.
Chronic lymphocytic leukemia is the most common leukemia subtype, accounting for over one-third of leukemia cases in Belgium. Recent years have seen a significant expansion in the treatment range available to patients and clinicians. Today, we live in an era of targeted therapies and immunotherapies, relegating chemotherapy to very rare situations. These new treatments were shown to offer excellent prospects in terms of progression-free survival and quality of life for patients, but they have also introduced new toxicity profiles that clinicians must manage. This article sought to provide physicians with a condensed update on what they need to know about managing this disease in 2024.
On the occasion of the ECU-UCL educational day on May 25, 2024, the author sought to highlight clinical or paraclinical characteristics that likely guide differential diagnosis, and to briefly discuss common and critical rheumatic disorders.
On the occasion of the ECU-UCL educational day on May 25, 2024, the author sought to predict the evolution of rheumatology by highlighting the decline in current rheumatic semiology, emergence of new diseases (particularly of environmental origin), contributions of network medicine, as well as the emergence of cell therapy.
On the occasion of the ECU-UCL educational day held on May 25, 2024, the author summarized the 2024 therapeutic approach to arthritis, covering both traditional pharmacological treatments and new targeted strategies based on biological agents and JAK kinase inhibitors.
Antinuclear autoantibodies (ANA) are commonly investigated, whereas their interpretation can be challenging, especially when the test is triggered by an unusual clinical presentation. Their detection is often incidental, the difficulty being the finding of a 'positive' result. This article sought to examine the role of ANA tests in clinical practice, along with their significance based on the patient context.
Thomas Paul-Emile KirchgesnerPublished in the journal : July 2024Category : Rheumatology
• Radiography (X-ray) is the medical imaging examination of choice for the initial assessment of bone or joint pathologies of the limbs.
• Ultrasound is an excellent non-irradiating examination for the study of superficial and periarticular soft tissues, including the rotator cuff tendons of the shoulder, extensor apparatus of the knee, and the ligaments, and tendons of the ankle.
• When faced with spinal pain, the prescribing physician should look out for warning signs ("red flags") that will guide the choice of medical imaging examinations.
Nadia Vonêche (1), Julia Riggi (2), Christine Galant (3), Martine Berlière (4), Mieke Van Bockstal (5)Published in the journal : July 2024Category : Hématologie et Oncologie médicale
The incidence of ductal carcinoma in situ (DCIS) has considerably risen since the introduction of organized mammography screening programs in the general population. Currently, all DCIS are treated surgically, though most are believed to be indolent. The difficulty in determining which lesions are at risk of becoming invasive has likely led to overtreatment for many patients as well as confusion about the actual risk of developing invasive disease or dying from breast cancer. This misperception of risk has generated significant psychological stress for patients. In order to improve their quality of life, it is crucial to better understand the development of invasive breast cancers and enhance communication between doctors and patients. Some experts are even questioning the current terminology: Should DCIS still be referred as a form of cancer?
To address these issues, new research focusing on molecular, genetic, and microenvironmental aspects of DCIS progression to invasive breast cancer must be initiated. The identification of reliable biomarkers will likely allow for the development of accurate risk prediction that are models specific to DCIS, paving the way towards therapeutic de-escalation. Additionally, this research is likely to support the creation of communication and decision-support tools with treatments being primarily focused on the patient's needs.
Pituitary adenomas, recently renamed pituitary neuroendocrine tumors (PiNETs) according the new World Health Organization classification published in 2017, are one of the two most common intracranial tumors, with an estimated prevalence of 1 in 1,100 people.
A meticulous endocrine evaluation is the first therapeutic step in their management, aimed at detecting hormonal hypersecretion and anterior hypopituitarism. High-resolution magnetic resonance imaging (MRI) of the pituitary region using a dedicated protocol is then recommended to precisely localize the tumor and determine its extra-sellar extension. Each case is discussed weekly at our multidisciplinary meeting to determine the best therapeutic option for each individual patient.
The first-line treatment is usually transnasal transsphenoidal surgery, except for microprolactinomas that are effectively managed using dopamine agonist medication like cabergoline to control the endocrinopathy. Surgical resection in expert centers allows for elevated levels of hypersecreted hormone to be normalized in 50 to 90% of cases. In the event of failure or recurrence, a second surgery or radiotherapy can be proposed. Some PiNETs, including non-functional microadenomas, only require serial MRI monitoring without treatment.