Stéphanie Mazzone1, Anne Wintgens2, Valentine d’Aspremont3, Adeline Hanzir4, Estelle Mousset5, Sophie Vanhalewyn6, Emmanuel de Becker7Published in the journal : February 2023Category : Psychiatrie infanto-juvénile
Two clinical aspects are discussed this year for the Child and Adolescent Psychiatry Service of the Cliniques universitaires Saint-Luc. They describe the help and care offers implemented to cope with the increase of mental distress situations of children, adolescents, and their families. The first part concerns the deployment of the reference center for Autism Spectrum Disorder, namely the establishment of an early stimulation group for young children awaiting diagnosis and a “parent training” group after diagnosis. The second part encompasses the consolidation of legal time within the SOS-Children team of the Clinics; where we will show the merits and contributions of this specific function in complex cases of child abuse.
Charlotte Smetcoren, Gimbada Benny Mwenge, Thierry Pieters, Françoise Pirson, Gregory Reychler, Giuseppe Liistro, Sophie Gohy, Antoine Froidure, Charles PilettePublished in the journal : February 2023Category : Pneumology
Respiratory medicine is progressively becoming a personalized care due to a better understanding of the pathophysiological mechanisms underlying the endotypes of pulmonary diseases, either frequent (sleep apnea syndrome, lung cancer, chronic obstructive pulmonary disease, asthma, and allergies) or rarer (interstitial lung diseases, cystic fibrosis), in addition to more generic care benefiting to most patients (e.g., environmental avoidance measures, physical exercise). This article describes those inspiring concepts applied to major respiratory diseases by presenting major advances made in 2022.
Valerie Hox, Caroline Huart, Philippe Rombaux, Caroline de Toeuf, Sandra Schmitz, Alexandre Biermans, William Renwart, Marc Hamoir, Monique Decat, Daniele Desiati, Anaïs GregoirePublished in the journal : February 2023Category : Otorhinolaryngology
During 2022, the ENT department focused on the well-being of the patients in all sub-disciplines of our specialty. First, we were pleased to obtain reimbursement of long-awaited biological products for the treatment of patients with chronic rhinosinusitis with nasal polyps. These new therapies are able to help a significant number of patients whose disease cannot be controlled by standard medical and surgical treatments. Second, we were able to review a series of more than 250 patients who underwent parotidectomy with intraoperative neuromonitoring. We found that preservation of facial nerve function was significantly better compared with previously reported data on parotidectomies without neuromonitoring. Finally, in the field of cochlear implantation for patients with severe hearing loss, we are currently preparing for the future. New techniques have been developed in order to maintain residual hearing during the implant’s insertion into the cochlea, such as robotic surgery and intraoperative electrocochleography. These techniques will allow us to increase the indications for implantation, which will lead to more patients being able to benefit from this life-changing technology.
Vincent Joris, Patrice Finet, Christian RaftopoulosPublished in the journal : February 2023Category : Neurochirurgie
The year 2022 was the year of the acquisition of a neuronavigated robotic arm (Stealth Autoguide from Medtronic) for invasive electroencephalography implantation. As estimated, this robotic arm has allowed us to greatly improve the accuracy of our implantations and ensure better safety for our patients
Guillaume Fernandes, Yassin Akachar, Laura Labriola, Michel Jadoul, Nathalie Demoulin, Johann MorellePublished in the journal : February 2023Category : Nephrology
We discuss the negative results of a randomized controlled trial of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers cessation in G4 or G5 stage chronic kidney disease. We next review the initiation modalities of dapagliflozine and finerenone in chronic kidney disease patients. Lastly, we review the recent therapeutic advances in IgA nephropathy treatment.
We summarize hereafter five topics that caught our attention in 2022, related to anticoagulants and hemophilia. First, we will address rivaroxaban treatment of atrial fibrillation (AF) associated with rheumatic valve disease. We then discuss the role of new anticoagulants targeting Factor XI in both the prevention of AF-related thromboembolic events and recurrent ischemic stroke. With respect to hemophilia, we detail the results of the largest ever conducted gene therapy study in patients with severe Factor VIII (FVIII) deficiency. We conclude with the therapeutic successes of emicizumab, a bispecific antibody mimicking FVIII, which has been shown to be effective in patients with non-severe hemophilia A (Haven 6) and in newborn with severe hemophilia A (Haven 7).
Sarah Bailly1,2, Eric Van Den Neste1, Stefan N. Constantinescu1,2,3,4Published in the journal : February 2023Category : Hematology/Oncology
The specific characteristics of the CD19 cell marker make it an ideal therapeutic target in the treatment of B-cell lymphoma. Several molecules targeting CD19 have recently been made available, or are currently being developed, and show promising results for this therapeutic indication. This seems to be particularly true in the management of relapsing or refractory diffuse large B-cell lymphoma, as demonstrated by the results of the different studies described in this article. The choice of the right molecule and the best sequence for these treatments is still to be defined.
Géraldine Dahlqvist 1, Bénédicte Delire 1, Olivier Dewit 1, Nicolas Lanthier 1,2, Hubert Piessevaux 1Published in the journal : February 2023Category : Hépato-Gastro-Entérologie
The year 2022 was rich in lessons and saw the issuance of many recommendations in hepatology. Indeed, animal and human studies have shown that hepatic steatosis is closely linked to insulin resistance, justifying not only to search for diabetes in patients suffering from hepatic steatosis but also to evaluate the severity of the possible hepatic impairment in diabetic patients. In addition, new recommendations (Baveno VII) were published in 2022 and propose threshold values for hepatic elastometry for the screening of clinically significant portal hypertension in compensated advanced chronic liver disease and its treatment with non-cardioselective beta blockers to prevent the first episode of cirrhotic decompensation. In January 2022, the American Association for the Study of Liver Diseases also published guidelines for the palliative management of patients with decompensated cirrhosis in whom liver transplantation is not indicated. In the area of inflammatory bowel diseases, two new drugs have been added to the therapeutic arsenal for ulcerative colitis in Belgium in 2022: filgotinib and ozanimod. In addition, the first randomized controlled study of comBIOtherapy was carried out: the “VEGA” study. This is the first randomized study to focus on the combination of biologicals in the field of digestive inflammatory diseases. On the other hand, the “SPARE” study investigated a treatment tapering strategy, particularly in patients with Crohn’s disease. Finally, a group of Belgian experts met several times during the years 2021 and 2022 to establish Belgian recommendations for the management of irritable bowel syndrome. The product of this comprehensive work was published in April 2022.
Axel De Greef, M.D., Marie Baeck, M.D., Ph.D.Published in the journal : February 2023Category : Dermatology
The emergence of Janus kinase inhibitors (JAKi) in the medical dermatology arsenal has enabled a considerable advancement in the management of several inflammatory skin diseases, such as atopic dermatitis or autoimmune diseases like alopecia areata or vitiligo. JAKi’s broad action profile in terms of cytokine blockade, which has been associated with beneficial therapeutic effects, nonetheless requires a certain degree of precaution with respect to the safety profile of this drug class. This article sought to review the latest safety data on JAKi. As shown herein, it is essential to distinguish the risk in keeping with the populations treated and the pathologies targeted by these molecules. Yet, caution is still required in elderly patients, in those with cardiovascular risk factors including active or past smoking, as well as those with a previous cancer.
Xavier Libouton*, Othmane Miri*, Randy Buzisa Mbuku*, Anaelle Mottet*, Julie Manon, Robin Evrard, Hervé Poilvache, Solange de Wouters, Karim Tribak, Dan Putineanu, Maïte Van Cauter, Vincent Druez, Jean-Emile Dubuc, Jean-Cyr Yombi, Nadia Irda, Ludovic KamiPublished in the journal : February 2023Category : Chirurgie orthopédique et traumatologie
The limitation of financial means in health care compels us to justify our choices by bringing the proof of a real improvement for the patient, reflected by his/her ability to quickly reintegrate the economic circuit and resume an active social life, or by developing less invasive techniques that shorten the period of incapacity or reduce the complications to which the patient is exposed. The Department of Orthopedic Surgery and Traumatology has chosen to highlight different approaches in this context: the usefulness of a functional evaluation in hand surgery in terms of objectifying the benefit of different therapeutic modalities, the still early prospects of phage therapy in infections of orthopedic implants by multidrug-resistant bacteria avoiding the need for major surgical interventions, and two biological and bio-technological approaches to successfully treat fracture healing defects, without exposing the patient to the complications of autologous bone harvesting.