Topographic dermatosis

Caroline Peeters, Alison Coster, Marie Baeck, Dominique Tennstedt, Anne Herman Published in the journal : June 2017 Category : Dermatology

We report the contents of the « PEAU’se dermatologique » meeting of the Cliniques Universitaires Saint-Luc of the 21th of November 2016 concerning the topographic dermatosis. Professor D. Tennstedt, consultant at the department of Dermatology at the Cliniques Universitaires Saint-Luc, presented cases of cheilitis and detailed the contact dermatitis of the lips. Doctors Caroline Peeters and Alison Coster, intern residents of the same department, displayed a set of specific pathologies concerning the ears and the nose, respectively.

Key Words

Contact dermatitis of the lips ; auricular dermatosis ; nasal dermatosis

Read more

Zika virus, fetal and neonatal consequences

Elise Osterheld, Emmanuel Scalais Published in the journal : June 2017 Category : Maladies infectieuses

Zika virus (ZIKV) is a flavivirus transmitted by mosquitoes of the Aedes genus, and whose transplacental transmission is responsible for severe neurologic damage in the fetus and newborn. The current brazilian epidemic already concerns 1.3 billion persons and has already spread to more than 50 countries, making it essential to better understand this virus, in order to establish preventive measures, to guide the care of pregnant women exposed to the ZIKV and to ensure an adequate follow-up of their infected children.

Key Words

Zika virus, congenital damage, microcephaly

Read more

Aging with HIV, new reality, new challenges

Jean-Cyr Yombi, Jean-Christophe Marot Published in the journal : June 2017 Category : Maladies infectieuses

HIV/AIDS has been transformed into a manageable, chronic condition and the life expectancy of patients living with human immunodeficiency virus (HIV) is now comparable to those without the disease. This is mainly due to the emergence of combination antiretroviral (cARV) therapy. This situation poses many new problems and challenges: persistent inflammation leading to immune activation, multi-morbidities, accumulation of toxicity of antiretroviral treatments, ageing and, finally, overloading of health systems especially in low resource countries. In this article we discuss many of these challenges.

Key Words

HIV, ageing, heart, kidney, bone, neurocognitive impairement

Read more

Unexpected bleeding and isolated prolongation of activated partial thromboplastin time: a case report

Quentin Binet, Catherine Lambert, Laurine Sacre, Stéphane Eeckhoudt, Cédric Hermans Published in the journal : June 2017 Category : Hématologie et Dermatologie

The differential diagnosis of isolated prolongation of the activated partial thromboplastin time (aPTT) is vast. An infrequent but severe cause is acquired hemophilia A (AHA) which is due to the spontaneous formation of neutralizing antibodies against endogenous factor VIII. About half the cases are associated with pregnancy, post-partum, auto-immune diseases, malignancies, or adverse drug reactions. Symptoms include severe and unexpected bleeding that may prove life-threatening. We report a case of AHA associated with bullous pemphigoid (BP), a chronic, autoimmune, subepidermal, blistering skin disease. AHA was completely cured and BP well-controlled with a short-term treatment consisting of methylprednisolone and rituximab.

Key Words

Acquired hemophilia, bullous pemphigoid

Read more

Familial hypercholesterolemia : some « tips » to facilite the diagnosis and its treatment

Olivier S. Descamps Published in the journal : May 2017 Category : Internal Medicine

Familial Hypercholesterolemia (HF) affects more than 25,000 Belgians and leads, due to its severely elevated levels of LDL cholesterol since birth, to premature risk of cardiovascular disease. Currently, diagnostic tools, effective treatments and preferential reimbursement give the Belgian doctors the opportunity to achieve the early diagnosis and the intense treatment necessary to stop the dramatic prognosis of this disease.

Key Words

Familial hypercholesterolemia, cardiovascular diseases, cardiovascular prevention, lipoproteins, LDL cholesterol, genetics, atherosclerosis

Read more

Benefits, risks and indications of COX-2 selective NSAIDS revisited: focus on Celecoxib

Cédric Hermans Published in the journal : May 2017 Category : Actualité thérapeutique

Due to their anti-inflammatory and analgesic properties, induced by the inhibition of cyclooxygenase, NSAIDs are among the most widely prescribed drugs. In order to improve digestive tolerance, NSAIDs selectively targeting cyclooxygenase 2 or selective COX-2 inhibitors (COXIBS) have been developed. Despite their digestive benefits, these molecules have fallen into disfavour following documentation of an increase in cardiovascular events associated with the use of Rofecoxib. Several recent publications detailed in this article demonstrate, however, that among COXIBS, Celecoxib used in low doses has a favorable cardiovascular safety profile associated with excellent digestive tolerance, suggesting that the role of this molecule should be re-evaluated. This article reviews the advantages, modalities and precautions of Celecoxib use. Key Words NSAIDs, COXIBS, cardiovascular risk, Gastrointestinal haemorrhage, Celecoxib

Read more

Are SGLT -2 inhibitors an holistic approach for treating patients with type 2 diabetes? A state of the art after the EMPA-REG OUTCOME Trial

Martin Buysschaert Published in the journal : May 2017 Category : Diabétologie

SGLT-2 inhibitors, when administered to patients with type 2 diabetes, result in an improved glycemic control, which is attributable to the agent’s glucoretic effect, in addition to weight loss and reduced blood pressure. A huge number of controlled studies have demonstrated these effects for empagliflozin (Jardiance®). Moreover, the EMPA-REG OUTCOME TRIAL has also evidenced a clear cardiovascular and renal benefit for Jardiance®. This agent, indeed, reduces the risk of total and cardiovascular mortality respectively by 32% and 38%, and the risk of hospitalization for heart failure by 35%. The risk of nephropathy (incident or deterioration of a preexisting disease) is also reduced by 39%.

The aim of this paper is to propose a state of the art in the field and to discuss the place of Jardiance® in clinical practice, based on scientific data.

Key Words

Type 2 diabetes, empagliflozin, cardiovascular disease, nephropathy, treatment

Read more

Bacteria to treat type 2 diabetes ?

Patrice Cani Published in the journal : May 2017 Category : Congrès UCL de Médecine Générale

Obesity and Type 2 diabetes are both associated with low-grade inflammation. Among the possible pathomechanisms, their link to intestinal bacteria is becoming increasingly convincing. Evidence suggests that gut microbiota plays a key role in triggering inflammation and insulin resistance through various mechanisms, such as the translocation of bacteria or bacterial components that induces metabolic endotoxemia. Certain intestinal bacteria may also be either deleterious or beneficial to glucose homeostasis. Among these, the specific role of Akkermansia muciniphila is currently being investigated.

Key Words

Obesity, diabetes, gut microbiota, Akkermansia muciniphila, inflammation

Read more

Burnout is often misdiagnosed

Published in the journal : May 2017 Category : Congrès UCL de Médecine Générale

In this manuscript we explore how the history of psychiatry shed light on its differential diagnosis.

Key Words

Depressive disorder, panic disorder, burn out

Read more

The non-traumatic shoulder physical examination

Henri Nielens Published in the journal : May 2017 Category : Congrès UCL de Médecine Générale

The non-traumatic shoulder physical examinations starts with a specific history followed by an observation of both shoulders at rest and during anterior elevation and abduction movements that must remain symetrical. Thereafter, the patient must be asked to indicate precisely where the pain is located. Active and passive mobilities are evaluated. In case of a major reduction of both passive and active mobility of the shoulder, which is accompanied by severe pain, the occurrence of an adhesive capsulitis should be suspected. The tendons of the rotator cuff must be evaluated with the traditional specific tests. The impigment tests must also take place, as tendon injuries often go along with subacromial impigment. Finally, palpation of the tendon of the rotator cuff as well as motor testing of the muscles of the shoulder including the serratus anterior will end the physical examination of a non-traumatic painful shoulder.

Key Words

Shoulder examination, mobility, specific tests

Read more