Journal of the Faculty of Medicine and Dentistry of the Université catholique de Louvain (UCL)

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Actualité thérapeutique

Semaglutide (Ozempic®), a new weekly GLP- 1 analogue for the...

Semaglutide is a GLP-1 analogue recently marketed in Belgium for the treatment of hyperglycaemia in patients with type 2 diabetes, by weekly subcutaneous administration. Among GLP-1 receptor agonists, semaglutide, at a maintenance dose of 0.5 or 1.0 mg/week, is currently the most effective compound for reducing chronic hyperglycaemia and body weight, as monotherapy or in combination with other hypoglycaemic medications, including basal insulin. The SUSTAIN 6 study also suggests a clinical benefit at the cardiovascular level. The tolerance and safety of semaglutide are comparable to those of other GLP-1 receptor agonists currently available in Belgium

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ECU-Congrès de médecine générale

General practitioner’s strategy for dealing with the depressed...

The general practitioner is confronted daily with patients with depressive symptoms. The first step is to establish a correct differential diagnosis and a first-line treatment plan. Often, this first treatment will have to be reviewed, modified and complexified, in order to allow the patient to obtain a substantial symptomatic improvement and to arrive at symptomatic remission, which should be the goal of any management. Key Words

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ECU-Congrès de médecine générale

Doctor, I have an ache in my hand

Hand and wrist osteoarticular pain usually results from osteoarthritis-related degenerative alterations. Osteoarthritis has two main causes: age-related spontaneous degeneration and post-traumatic degeneration. Traumas lead to direct osteoarticular lesions or instability secondary to bone deformities and ligamentous lesions. The treatment of primary osteoarthritis, dominated by rhizarthrosis (base of the thumb), is initially conservative, using anti-inflammatory drugs (per os and by local massages) and resting splints. Corticosteroid or hyaluronic acid infiltrations can be used as second-line treatment. Finally, surgical prosthetic or non-prosthetic arthroplasty usually yields good results in more severe cases. In post-traumatic situations, early recognition of instability may allow surgical stabilization to be performed so as to prevent pain and secondary degenerative lesions. Radiography, CT-arthrography and MR-arthrography are the examinations of choice to complete the clinical examination.

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ECU-Congrès de médecine générale

Endometriosis: When should it be considered?

Three steps play a key role when assessing patients with suspected endometriosis.

First step: Patient’s clinical history and symptoms (dysmenorrhea, dyspareunia, dyschesia and chronic pelvic pain). Although there is no evidence of a relationship between patient’s symptoms and the presence and severity of endometriotic lesions, the implemented or proposed medical / surgical treatment depends on the context in which endometriosis is observed.

The second step is the physical examination, including evaluation of the posterior vaginal fornix and of the Douglas pouch, which detects more lesions that are missed on ultrasonography and magnetic resonance imaging.

The third step is imaging. A recent meta-analysis found no difference in the detection of endometriotic lesions between ultrasound and magnetic resonance imaging, but these examinations should be performed by a radiologist with expertise in this field.

To date, the final diagnosis of endometriosis is made by laparoscopy with biopsies of the lesions.

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Dermatology

Dermatology and immuno-allergology

We report on the “PEAU’se dermatologique” meeting held on June 18, 2018, organized by the Dermatology department of the Cliniques universitaires Saint-Luc, which was focused on immuno-allergology. The first part of the meeting, presented by Professor Didier Ebo, Head of the Department of Immunology and Allergology at UZA (Universitair Ziekenhuis Antwerpen), addressed the problem of “Perioperative hypersensitivity reactions”. The second part, presented by Professor Olivier Aerts (UZA), was dedicated to "Atypical aspects of contact dermatitis".

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Médecine et société

Future challenges for academic hospitals

Despite the sustained discussions and consultations of these recent years about hospital networks and the role of different hospitals, still much ambiguity exists as to the role of academic hospitals. This analysis puts innovation in medicine forward as the primary mission of these hospitals. Academic hospitals currently face a multitude of challenges, such as the lack of financial resources for academic missions and the concentration of complex and rare diseases, to only name the most important ones.

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STOPP/START.v2

The tool STOPP / START.v2 allows evaluation of drug treatments prescribed to patients age 65 and older.

 

This tool, designed for all care settings, stimulates thinking and challenging medication taken by patients, especially drugs forcardiovascular and nervous system.

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