History of the youngest medical specialty : (Part 3 of 4 parts)

Yves Pirson Published in the journal : November 2018 Category : Ama Contacts

Between the half of the 19th and the half of the 20th centuries, Richard Bright’s successors have a profound problem classifying diseases leading to uremia. The advent of immunology around the onset of the 20th century sheds new light on this issue, with the identification of immune-complex and antibody mediated disorders.

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Liver transplantation for hepatocellular carcinoma: role of immunosuppression and rejection treatment in cancer recurrence - results of a multicenter study

Maxime Foguenne, Samuele Iesari, Jan Lerut Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Liver transplantation (LT) was initially dedicated to the treatment of cirrhosis. Nowadays, it is playing an increasingly important role in the treatment of hepatocellular carcinoma (HCC). Surgery, in the form of partial or total (i.e., transplantation) liver resection, represents the only curative treatment of HCC. It is important to keep in mind that a patient affected by HCC has in fact two diseases: the cancer itself and the underlying cirrhosis. LT thus represents a very interesting approach that treats both of them, but is really challenging.

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Glucocorticoid withdrawal in an incident cohort of lupus nephritis patients

Séverine Wautier, Farah Tamirou, Séverine Nieuwland-Husson, Frédéric Houssiau Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Nephritis is one the most frequent and severe manifestation of systemic lupus erythematosus. Treatment of lupus nephritis (LN) is based on the use of glucocorticoids (GC) and other immunosuppressants on the one hand, and on optimal renal protection on the other hand. The objective is to induce renal remission while avoiding cumulative damages. In this respect, chronic GC use is associated with many severe adverse events leading to increased morbidity. A prompt stop and withdrawal of GC is therefore of paramount importance.

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Machine learning applied to imaging: validation of the radiomics approach in a population of non-small-cell lung cancer patients treated by (chemo-)radiotherapy at the Cliniques universitaires Saint-Luc

Madeleine Scrivener Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

An increasing number of advances have been achieved in the field of medical imaging, namely the conversion of standardof- care images into mineable data. Radiomics refers to the high-throughput extraction of quantitative image features from medical images (watch the video on https://youtu.be/ Tq980GEVP0Y and visit www.radiomics.world). These image features can be divided into four groups depending on the tumor characteristic they describe: tumor intensity, tumor shape, tumor texture, or wavelets. This study consisted in a radiomics analysis of 18’026 features extracted from standard-of-care, pretreatment, 4D computed tomography (CT) images from a cohort of 44 non-small-cell lung cancer (NSCLC) patients treated with chemoradiotherapy at the Cliniques Universitaires St-Luc. A radiomics signature was created using machine learning algorithms in order to preselect a small group of radiomics features based on their correlation with the studied endpoint (survival, histological types, etc.). The signature was created by analyzing the features of a patient cohort, and its robustness was then tested and validated on an external independent dataset.

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Rapid objective assessment of contrast sensitivity and visual acuity with sweep visual evoked potentials and an extended electrode array*

Coralie Hemptinne(1), Joan Liu-Shuang(2), Demet Yuksel(1,3), Bruno Rossion(2,4) Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Sweep visual evoked potentials (sVEPs) provide an implicit, objective, and sensitive evaluation of low-level visual functions such as visual acuity and contrast sensitivity. For practical and traditional reasons, sVEPs in ophthalmologic examinations have usually been recorded over a single or a limited number of electrodes over the medial occipital region. Here we examined whether a higher density of recording electrodes improves the estimation of individual low-level visual thresholds with sVEPS, and to which extent such testing could be streamlined for clinical application.

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Characterization of inter- and intrafamilial variability in autosomal dominant polycystic kidney disease

Henry Gaspard Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Autosomal dominant polycystic disease (ADPKD) is the most common inherited renal disease, accounting for 5 to 10% of patients requiring renal replacement therapy. ADPKD is characterized by the development of multiple cysts in both kidneys, leading to end-stage renal disease (ESRD) before the age of 60 years in approximately half of patients. This multisystem disorder can potentially affect the liver, pancreas, heart, and intracerebral arteries. ADPKD is a genetically heterogeneous disease caused by mutations in the PKD1 and PKD2 genes.

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Endoscopic management of postoperative pancreatic fistula

Gabriela Gujda, Catherine Hubert, Tom Moreels, Julie Navez, Enrique Perez Cuadrado-Robles, Pierre-Henri Deprez Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Postoperative pancreatic fistula (POPF) is one of the most prevalent clinically relevant complications following partial pancreatic resection. Endoscopic approaches have proven successful, but the literature regarding the best route of drainage is scarce. Our study was aimed at comparing the efficacy and safety of transpapillary (endoscopic retrograde cholangiopancreatography [ERCP]-based) and transmural (endoscopic ultrasound [EUS]-guided) endoscopic treatment of POPF occurring after distal pancreatectomy.

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Liver regeneration and the role of hepatic progenitor cells in alcoholic steatohepatitis

Adrienne Lejeune(1,2), Peter Stärkel(1,2), Alexandre Louvet(3), Axel Hittelet(4), Céline Bazille(5), Boris Bastens(6), Hans Orlent(7), Luc Lasser(8), Xavier Dekoninck(9), Sergio Negrin Dastis(10), Jean Delwaide(11), Anja Geerts(12), et al. Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

The role of liver progenitor cells (LPCs), which are known as severity markers in chronic liver diseases, remains poorly understood, as is the impact of macrophages on liver regeneration. We aimed to characterize these cell populations in severe alcoholic steatohepatitis (ASH) and determine whether their activation could be considered as a good prognostic factor.

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Evaluation of the screening strategy for gestational diabetes at the Saint-Luc University Clinics “Maternal and fetal complications”: a retrospective analysis of 1,018 patients

Jeanne Cuvelier Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Gestational diabetes is a much debated condition in the medical world, and many studies carried out recently yielded divergent results as to the utility of the new screening criteria issued by the International Association of Diabetes and Pregnancy Study Group (IADSPG). The prevalence of diabetes has significantly increased over the past few years. This study’s aim was to clarify whether treating patients with "mild" gestational diabetes is beneficial.

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Overlap syndrome and primary sclerosing cholangitis in childhood and adolescence: response to antibiotics and related changes in gut microflora and bile acid profile

Pauline Sambon(1,2), Amandine Everard(3,4), Xavier Stephenne(1,2), Françoise Smets(1,2), Isabelle Scheers(1,2), Mina Komuta(5,6), Giulio G. Muccioli(7), Patrice D. Cani(3,4), Etienne Sokal(1,2) Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

The concurrent occurrence of autoimmune hepatitis (AIH) and primary sclerosing cholangitis (PSC) is referred to as AIH/PSC overlap syndrome or autoimmune sclerosing cholangitis (ASC) in children. Though not evidence-based, it is standard practice to treat the AIH component with corticosteroids (CS) and azathioprine, and the PSC component with ursodeoxycholic acid (UDCA). Antibiotics (AB) are increasingly being reported to have favorable effects in PSC, but their role in ASC is poorly evaluated. We retrospectively investigated the response to oral ABs as initial or rescue therapy in ASC children. A historical control group included ASC patients receiving the recommended treatment. We prospectively analyzed the gut microbiota and serum bile acid (BA) profile before and after AB therapy in children with either ASC or PSC alone, and evaluated whether changes in gut microbiota and/or BAs correlated with the therapeutic response. 

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