PCSK9 inhibitors in therapeutic arsenal of cardiovascular risk management

Olivier S. Descamps Published in the journal : October 2018 Category : Actualité thérapeutique

In clinical practice, it may at times prove difficult to attain the recommended LDL cholesterol levels due to either high initial levels or low drug tolerance. The 2003 discovery of a new protein named PCSK9 (proprotein convertase subtilisin/kexine Type 9), involved in the metabolism of LDL particles, led to the development of several monoclonal antibodies that neutralize this protein (evolocumab from Amgen, alirocumab from Sanofi/REGENERON, and bocozicumab from Pfizer). When combined with statins and ezetimibe, these agents cause a highly significant reduction in LDL cholesterol levels, associated with very good safety profiles and tolerance, along with significant benefits in terms of cardiovascular prevention. Therefore, they constitute an additional therapeutic strategy to help patients reach their LDL cholesterol targets, especially those with severely elevated cholesterol levels, as observed in familial hypercholesterolemia cases.

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Affective, relational, and sexual life of people with disabilities: resources to inform and get informed

Virginie Koopmans(1), Marie-Aude Moreau(1), Joëlle Berrewaerts(1), Nathalie Michaux Published in the journal : September 2018 Category : Congrès de médecine sexuelle

This article provides ideas to all health professionals willing to advise people with disabilities about their affective, relational, and sexual life. After presenting the Handicap and Sexuality Resource Center (Namur, Belgium), an institution present throughout the Walloon territory, several resources will be explored (evenings with institutions, educational tools, websites, etc.). Nowadays, this issue is more often taken into consideration. However, existing needs are still far from being met..

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Cancer and sexuality

Marie Nuytten, Laurence Faugeras, Lionel D’Hondt Published in the journal : September 2018 Category : Congrès de médecine sexuelle

Sexual repercussions of cancer and its treatments have long been considered of minor importance. However, the sexual dimension of cancer patients has recently been given particular consideration, resulting in an increased scientific interest and the development of international guidelines. In this paper, we detail the main sexual disorders encountered by both male and female cancer patients. Women are mostly affected by dyspareunia and decreased libido, while erectile dysfunction and decreased libido are predominant in men. These disorders may have a major impact on the couple’s life. We also describe the sexual adverse effects induced by the different cancer treatments and provide some advices and nonpharmacological treatments to manage them.

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How to address sexuality with a couple?

Christine Reynaert(1), Thomas Dubois(1), Marcello Di Gregorio(2), Nathalie Michaux(3) Published in the journal : September 2018 Category : Congrès de médecine sexuelle

Working with the couple is of real interest in many medical situations, and particularly in the field of sexology. This article highlights the benefits of working with the couple, proposes different communication strategies, and comes to the conclusion that working in the relational system of patients is part of medical practice.

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How to address sexuality with a woman during medical consultation?

Nathalie Michaux(1), Maria-Laura Marotta(2), Marcelo Di Gregorio(3), Christine Reynaert(4) Published in the journal : September 2018 Category : Congrès de médecine sexuelle

This article explains in a very concrete way how to approach sexuality with a female patient during a consultation, irrespective of the medical specialty.

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How to address sexuality with a man?

Marcelo Di Gregorio MD1, Francis Lorge MD(1), Christine Reynaert MD(2), Nathalie Michaux MD(3) Published in the journal : September 2018 Category : Congrès de médecine sexuelle

a sexological consultation is a delicate task that requires a specific approach. The first difficulty in managing a sexual problem is to get the issue on the table. Patients visit their physician because of problems concerning sexuality/ sexual activity and their consequences. The question is whether general practitioners prefer to avoid answering these questions or if they are willing to respond actively. If so, to what extent are they able to answer the patient’s question? And would they agree to attend specific training courses and to work in collaboration with specialists within a network system. This work’s aim was to provide tools for acquiring and mastering specific medical knowledge and practical skills regarding male sexual disorders (erectile dysfunction, ejaculation and libido disorders) and to facilitate the acquisition of communication skills for the consultation (doctor / patient relationship). 

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Treatment adherence in cardiovascular prevention : the lipidologist's point of view

Olivier S. Descamps Published in the journal : September 2018 Category : GRAPA

The "sneaky" aspect of the risk associated with high blood cholesterol given its asymptomatic nature before complications arise makes hypolipidemic treatment often problematic for our patients. This is especially so because the side effects that can occur such as myalgia and the polemics diffused through the media by some critics cause worry and doubts in our patients. In this article, we will discuss three of the most frequently encountered problems and how to address them.

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Guselkumab, an effective interleukin-23 inhibitor in the treatment of psoriasis

Caroline Colmant, Pierre-Dominique Ghislain (1) Published in the journal : September 2018 Category : Actualité thérapeutique

Guselkumab is a selective interleukin-23 inhibitor that has been marketed and reimbursed since a few months in Belgium. We conducted a literature review in order to assess the efficacy and safety of guselkumab.

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News from the GRAPA (task force for the prevention of atherothrombosis) 9th GRAPA symposium (3rd March 2018)

Alexandre Persu Published in the journal : September 2018 Category : GRAPA

The news from the GRAPA provide a summary of the presentations made at the 9th GRAPA symposium, with a focus on treatment adherence in the prevention of cardiovascular diseases, mainly in the areas of lipidology, diabetology, and rhythmology. The presentations also addressed related topics, such as therapeutic inertia, therapeutic education, empowerment, and the impact of treatment-related adverse events and media controversies on the initiation and continuation of cardiovascular medications. Finally, arguments for the control of cardiovascular risk factors in the prevention of atrial fibrillation, based on recent medical literature, are also presented. 

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Treatment of hemophilia A: Which role for plasmaderived factor VIII in 2018?

Cédric Hermans Published in the journal : September 2018 Category : Actualité thérapeutique

After thousands of hemophilic patients were infected with HIV and HCV, and thanks to major advances in biotechnology, recombinant factor VIII has emerged as a first-line or reference treatment for most factor VIII-deficient patients (hemophilia A). The development of neutralizing antibodies (inhibitors) is currently the most severe and feared complication in hemophilia A replacement therapy. The respective immunogenicity of plasma and recombinant factor VIII concentrates has been debated for many years, with multiple studies providing contradictory results.

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