C. Colmant, D. Maiter, B.Vandeleene, M. Baeck, L. de MontjoyePublished in the journal : September 2015Category : Dermatology
We here report on the “PEAU’se dermatologique” meeting that took place on October 22, 2015, dedicated to dermatological and endocrine diseases. Professor D. Maiter gave us the clues to optimal corticosteroid use in dermatological practice, from treatment initiation to withdrawal. Next, Professor B. Vandeleene reminded us of the cornerstones of diabetic foot management. Finally, Professor M. Baeck presented several clinical cases of dermatological diseases in the diabetic patient.
CADASIL disease is a rare autosomal dominant hereditary angiopathy, primarily characterized by significant white matter damage on MRI. We have herein described a case of Cadasil disease discovered somewhat fortuitously, owing to its insidious symptom onset and the causal mutation 's strongly suspected transmission to the patient’s son.
On February 16th, a round table was held in Brussels dealing with new oral anticoagulants. On this occasion, Belgian experts exchanged views with Professor Giancarlo Agnelli.
Precocious puberty (PP) is a most common condition encountered in pediatric endocrinology practice. Articles reporting on increasingly early pubertal development have recently been published in the lay press, thus resulting in numerous questions from parents regarding their children's pubertal development. PP can be defined as the onset of secondary sexual characteristics, along with accelerated growth and bone maturation, occurring earlier than usual, e.g., prior to the age of 8 years in girls and 9 in boys. PP etiologies can be divided into gonadotropinreleasing hormone (GnRH)-dependent and GnRH-independent causes. GnRHdependent PP, often referred to as central PP, is usually treated using GnRHagonists.
Direct oral anticoagulants (DoaCs) offer significant benefits for the treatment of nonvalvular atrial fibrillation and venous thromboembolism. these agents are simpler to use than others, as they do not require routine laboratory monitoring and dose adjustment. moreover, DoaCs have been shown to reduce severe bleedings, and especially intracranial bleedings, as compared to vitamin k antagonists. real-life clinical data confirmed these benefits that had previously been shown in randomized clinical trials.
This article describes several advances made in the dyslipidemia and cardiovascular prevention fields. These novelties pertain to the three steps of prevention: prediction including screening for two common, but often ignored, genetic abnormalities, namely familial hypercholesterolemia and elevated lipoprotein(a) levels, planning with the emergence in recommendations of a new target called "non-HDL cholesterol or non-HDL-C" in addition to the conventional "LDL-cholesterol or LDL-C" target, and prescription with the possible option of combining statins with other therapeutic classes.
The mechanism of action of the most commonly prescribed immunosuppressive drugs, as well as their dosage and adverse effects, are highligted in this article, with particular emphasis on toxicity prevention and treatment monitoring by general practitioners.
M Mousny, A RendersPublished in the journal : May 2016Category : Pediatrics
Nowadays, pediatric orthopedics is considered a fully-fledged specialty, which differs from adult orthopedics in terms of both the pathologies encountered and the clinical approach. This article describes the “general” orthopedic clinical evaluation as performed by the authors in their daily practice. A particular emphasis is placed on the clinical aspects that may help general practitioners distinguish the normal from the pathological. Of note is that this article only addresses clinical assessment of walking-age children, in a timely fashion that is believed to progressively favor patient compliance.
Familial hypercholesterolemia (FH ) is one of the most common fatal genetic diseases, affecting over 25,000 Belgians. it is responsible for very high cholesterol levels (> 300mg/dL) from birth, along with an increased risk of early vascular, cardiac, and cerebral complications, such as myocardial infarction and stroke, from the age of 30 years onwards in men and 40 in women. Cardiovascular complications may, however, be prevented by means of early diagnosis and proper treatment, ideally started in childhood.
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.