Epidermal hamartoma type PENS («papular epidermal nevus with « skyline » basal cell layer»)

Marie Cuvelier (1*), Josette André (2), Didier Bessis (3), Pierre-Paul Roquet-Gravy (1), Audrey Bulinckx (1) Published in the journal : January 2021 Category : Dermatology

PENS hamartoma or “papular epidermal nevus with "skyline" basal cell layer” is a congenital epidermal hamartoma, which is characterized by specific histopathological features. We report a diagnosis of PENS hamartoma that was made in an 18-month-old girl.

Initially described by Torrelo et al. in 2011 (1), PENS hamartoma exhibits particular clinical features consisting of coalescent, verrucous, and light brown polygonal papules (2). The diagnosis is confirmed by histological examination, which, in the majority of cases, shows an alignment of epidermal basal cells and palissadic disposition of nuclei evoking a "skyline". In 2012, the term PENS Syndrome was retained, owing to new clinical descriptions associating light neurological abnormalities with these cutaneous lesions (2). PENS syndrome is a rare neuro-cutaneous syndrome, which involves one or more congenital epidermal hamartomas of PENS type, as well as non-specific neurological abnormalities (1-3). Neurological manifestations begin to occur during the first two years of life (1). A review of the literature identified 27 reported cases of PENS hamartomas (1-12), including some familial cases and other cases associated with neurological abnormalities (PENS syndrome). The physiopathology of PENS hamartoma and PENS syndrome remains unclear, whereas several hypotheses have been advanced (7).

Read more

Autoimmune hemolytic anemia warm antibody type associated with seroconversion for cytomegalovirus infection during pregnancy

Moïra Poncelet (1), Catherine Lambert (2), Pierre Bernard (1) Published in the journal : January 2021 Category : Obstétrique

Autoimmune hemolytic anemia, specifically during pregnancy, is an uncommon hematological disorder, which causes premature destruction of red blood cells. While it may be idiopathic, this disorder may also be secondary to an underlying condition. Whatever its etiology, this disease is associated with high maternal, fetal, and neonatal morbidity, which is due to the transplacental passage of immunoglobulins G (IgG). This highlights the usefulness of diagnosing and managing this pathology, which is a real challenge, given the lack of codified recommendations published in the literature.

Read more

Reflections on the management of antenatal hydronephrosis

Hélène Legrand (1), Nathalie Godefroid (2), Axel Feyaerts (3), Stéphane Thiry (3), David Tuerlinckx (4) Published in the journal : January 2021 Category : Pediatrics

Antenatal hydronephrosis is the most common congenital abnormality. The post-natal management is, however, still controversial, specifically concerning further testing, as well as and benefit of antibiotic prophylaxis. The systematic indication of performing a voiding cystourethrogram for vesicoureteral reflux screening and of prescribing antibiotic prophylaxis for preventing urinary tract infections has been increasingly questioned by recent study data. A less aggressive approach is discussed here, which is essentially based on post-natal ultrasound findings.

We herein propose an algorithm that is based on these study data.

Read more

COVID-19 - Measures seen as useful are better adhered to

Isabelle Aujoulat (1), Bénédicte Scheen (1), Kirsten Vanderplanken (2), Stephan Van den Broucke (3), Joris van Loenhout (2) Published in the journal : January 2021 Category : Santé publique

Since the first case of COVID-19 was detected in December 2019, the world has experienced a pandemic of unprecedented proportions. While the development of vaccines against the disease became high priority, many countries were trying to reduce the impact and the burden on healthcare systems by implementing infection prevention and control measures. These measures are flexible, and can be adapted based on the severity of the outbreak that a country is experiencing at a given moment in time. However, the effectiveness of such measures is for a large part determined by the ability and willingness of the population to adhere to them. For Belgium, which has experienced a high infection rate over the year, there was no clear insight in overall adherence to the measures, reasons for (non)adherence, and subgroups of the population that are less likely to adhere.

This article presents the results of a panel-based internet survey, that addressed a sample of respondents (n=2.008), representative for the adult Belgian population in terms of age, sex, region and socio-economic status. The questionnaire was developed by researchers with backgrounds in social sciences, epidemiology, health promotion and psychology. It was guided by the Protection Motivation Theory. Data were collected in September 2020. The detailed methodological design and results may be consulted through the following link: https://dial.uclouvain.be/pr/boreal/object/boreal:241832.

The results which are summarised hereafter were presented on Decembre 17th, 2020 in a webinar organised by Fondation Louvain, who supported study: https://uclouvain.be/fr/chercher/fondation-louvain/webinaires.html.

Read more

Insulinotherapy in 2021

Martin Buysschaert, Vanessa Preumont, Dominique Maiter Published in the journal : January 2021 Category : Diabétologie

The aim of this paper is to propose a current state of the art in the field of insulin treatment. We describe human insulin and analogs available in Belgium, as well as the current recommendations in terms of insulin strategies in type 1 and type 2 diabetes.

Read more

The therapeutic potential of molecular scissors: perspectives of the 2020 Nobel Prize in chemistry

Nathalie Lannoy, Cédric Hermans Published in the journal : November 2020 Category : Prix Nobel

The 2020 Nobel Prize in chemistry was jointly awarded to two geneticists Emmanuelle Charpentier and Jennifer Doudna for their having developed the "Crispr-Cas9 molecular scissors". This real innovation pertaining to the molecular biology field is principally able to easily, quickly, and inexpensively edit the genome of any cell. Its use in all fields of life allows for scientific, medical, agronomic, and industrial applications both for better and worse.

Read more

Anesthesia without opioids: May this be useful in Sub-Saharan countries?

Published in the journal : November 2020 Category : Clinical Report

The systematic use of opioids has made us lose sight of their significant adverse effects, including respiratory distress, hyperalgesia, as well as postoperative nausea and vomiting. Sub-Saharan African countries are currently facing the issue of post-interventional surveillance, with post-operative respiratory problems being rather common. Similarly, these countries experience difficulties in managing pain, nausea, and vomiting. At times, opioid ruptures may occur, which may lead to postponing surgical procedures, in a context where access to surgery is already a obstacle. The opioid-free anesthesia could be an interesting alternative for these countries, especially when using accessible drugs with simple protocols. Therefore, anesthesiologists from these countries should focus their interest on such anesthesia techniques, in the aim to better define their place in their daily practice and share their potential benefits in a limited-resource setting.

Read more

Use and abuse of tissue fillers in the field of urology

Walther Brochier, Greet Swinnen, Peter De Wil, Sam Ward Published in the journal : November 2020 Category : Clinical Report

The injection of tissue fillers for esthetic purposes is considered a decade-old practice. In our urological practice, we are now seeing an increasing number of patients that have purposefully injected such fillers in order to increase penile girth. Nevertheless, particularly when done in non-professional settings or using low-quality products, this may lead to severe complications. These complications are mostly caused by the injections of silicone, which is a non-resorbable filler, unlike hyaluronic acid or autologous fat.

We present herein the case report of a 37-year-old man treated in our department for preputial pain and swelling following silicone self-injections. We then continue with a literature review on the topic.

Read more

Multiple resistance to anti-platelets agents

Silvio Wallemacq1A, Mohamed Ben Yedder1A, Patrick Timmermans1A, Jérémie Gras2A, Vincent Haufroid2B, Benjamin Hennart2C, Cédric Hermans3B Published in the journal : November 2020 Category : Clinical Report

Dual antiplatelet therapy consisting of aspirin in combination with clopidogrel, ticagrelor, or prasugrel is considered the standard of care for preventing stent thrombosis following percutaneous coronary angioplasty. However, adverse cardiovascular events may still occur despite such biotherapy. This can be explained by resistance to antiplatelet agents, with clopidogrel resistance the most widely studied so far. Some cases of resistance to other antiplatelet agents like prasugrel and ticagrelor have recently been reported. While laboratory tests have been developed to assess the degree of platelet inhibition under treatment, their clinical usefulness remains controversial. We herein report the case of a patient with a resistance to different antiplatelet agents.

Read more

Chronic hepatitis C, a disease that is prone to be eradicated owing to your collaboration: perspectives of the 2020 Nobel Prize in medicine

Yves Horsmans Published in the journal : November 2020 Category : Prix Nobel

The 2020 Nobel Prize in medicine was jointly awarded to three experts for their contribution to the discovery of the hepatitis C virus. This discovery has enabled us to better understand the epidemiology of the virus, as well as its mode of contamination and mode of reproduction, which has eventually resulted in the development of direct anti-viral agents. These medications are so powerful that the World Health Organization (WHO) has now included the objective of HCV eradication on their agenda.

Read more