Hypokalemic periodic paralysis

Elise Osterheld (1), Julien Mergen (1), Marianne Michel (1), Evelyne Heylen (2) Published in the journal : April 2018 Category : Pediatrics

Hypokalemic periodic paralysis is a rare autosomal dominant disorder, caused by a defect in calcium or sodium channels. Common triggers include intense physical activity, high carbohydrate intake, and stress. These paralysis episodes usually resolve within a few hours to a few days.

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Interview : Michael Bergman, MD, FACP NYU School of Medicine

Martin Buysschaert Published in the journal : April 2018 Category : Ama Contacts

Martin Buysschaert : Could you discuss your journey as a student from the USA to Louvain and then your journey back to the USA to practice medicine? Michael Bergman: I was young at the time, about 22 years old before coming to Louvain after completing four years of College.

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History of the youngest medical specialty : nephrology (Part 2 of 4 parts)

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

During the two centuries running from about 1650 to 1850, two scientific innovations account for key achievements in nephrology : new microscopes, which open the door to extending anatomical knowledge to physical processes, and the emergence of chemistry revealing the composition of stones as well as providing the measurement of albumin and urea levels.

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IgA Nephropathy and Henoch-Schönlein purpura : discussion and consequences of their likely common physiopathology

Marie-Julie Debuf (1), Elise Hennaut (2), Jean-Philippe Stalens (3) Published in the journal : April 2018 Category : Pediatrics

Henoch-Schönlein purpura is a vasculitis characterized by IgA immune deposits in small vessels and involving the skin, digestive tract, renal glomeruli, and joints. IgA nephropathy is a glomerulonephritis that is characterized by mesangial deposits of IgA and is associated with episodes of hematuria and/or proteinuria mainly occurring after respiratory or gastrointestinal infections. Despite some differences regarding the typical age of onset and natural history, a growing number of clinical, histological, and biochemical evidence suggests that these diseases are different clinical expressions of the same pathophysiological process, which could have consequences on their management.

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Attitudes and beliefs of Belgian caregivers concerning low back pain

Amandine Poulain (1), Marijke Leysen (2,3), Nathalie Roussel (2), Anne Berquin (4) Published in the journal : April 2018 Category : Physical and Rehabilitation Medicine

Background: Health care practitioners’ attitudes and beliefs concerning low back pain (LBP) have been reported to influence their patients’ prognosis. No specific information is available concerning Belgian caregivers. Methods: Validated questionnaires were filled in by 98 participants, such as physiotherapists, occupational therapists, and nurses, prior to attending educational programs about LBP. Results: Biomedical attitudes and beliefs are widely prevalent in Belgium, even among participants claiming to understand the guidelines, with median scores on the biomedical and psychosocial scales of the Health Care Providers’ Pain and Impairment Relationship Scale and of the Pain Attitudes and Beliefs Scale for Physiotherapists of 31, 35, and 50, respectively. Discussion: This study highlights the need of continuous education on biopsychosocial management of LBP patients.

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Implantable cardiac devices: contribution of medical imaging

Xavier Hamoir (1), Vincent Hamoir (2), Nathalie Pruvost (2), Jacques Kirsch (1) Published in the journal : April 2018 Category : Cardiologie et Imagerie médicale

This work sought to further clarify the contribution of medical imaging in the follow-up of pacemakers and implantable cardioverter defibrillators. Right after implementing these devices, chest radiography must be performed in order to precisely evaluate the position of the leads and exclude potential complications. These images constitute the basis for early and late surveillance, thereby enabling the detection of anomalies that may explain any clinical symptoms or electric troubles. CT scanner or Doppler ultrasound may assist under certain circumstances.

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Hereditary predisposition to malignant hemopathies

S. Dupriez 1, A. Ferrant 1, M-Ch. Vekemans 1, B. Brichard 2, L. Michaux 3, T. Connerotte 4, E. Van Den Neste 1, Ch. Vermylen 2, L. Knoops 5, C. Graux 6, F. P. Duhoux 7, C. Lambert 1, X. Poiré 1, H. Antoine-Poirel 8 Published in the journal : April 2018 Category : Hématologie et Oncologie médicale

Hereditary hematological malignancies syndromes (HHMS) are still underdiagnosed. Yet, it proves essential to correctly identify these disorders in order to select the most appropriate conditioning regimen before transplantation and exclude an inherited mutation in sibling donors, while ensuring personal and familial counseling. We retrospectively reviewed 252 patients from 117 families with a personal or familial history of multiple cancers, including at least one hematological malignancy. A familial mutation was identified in eight families (GATA2, TERT, FANCA, TP53, PTCH1, BRCA1 and ATM), resulting in specific management and familial screening. This study highlights the necessity of early HHMS diagnosis through a close collaboration between hematologists and geneticists. To finish, we present recommendations to better diagnose and manage HHMS on the basis of our observations and the literature.

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Hyperprolactinemia in daily practice: prolactinomas are not so common

Dominique Maiter Published in the journal : March 2018 Category : Endocrinology

When confronted with patients suffering from moderate hyperprolactinemia (25-100μg/L) in daily practice, multiple causes should be evoked. If the condition is not associated with suggestive symptoms, it is most often caused by other conditions than a prolactinoma. These mainly include transient hyperprolactinemia that is not confirmed by subsequent hormonal testing, macroprolactinemia that must always be systematically ruled out; antidopaminergic or serotoninergic drugs leading to a sustained rise in prolactin concentrations (mainly neuroleptics and antiemetics), and disconnection hyperprolactinemia associated with other lesions of the hypothalamic-pituitary axis disrupting the dopaminergic inhibitory control on basal prolactin secretion. We have herein reviewed the different causes of hyperprolactinemia. Before embarking the patient on a long-term treatment with dopamine agonists, the diagnostic evaluation should always take into consideration these potential causes, in addition to a possible pituitary incidentaloma.

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An update on diagnosis and treatment of adult growth hormone deficiency

Orsalia Alexopoulou, Dominique Maiter Published in the journal : March 2018 Category : Endocrinology

Adult growth hormone deficiency (AGHD) is nowadays recognized as a distinct clinical entity and replacement therapy has become a standard practice. The benefits of GH treatment seem to outweigh its potential risks but issues concerning long term efficacy and safety are still a subject of debate. More research is needed in some key areas and it remains essential to monitor patients by means of longitudinal surveillance studies.

Key Words

Growth Hormone Deficiency, Hypopituitarism, GH deficient adults

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Glycemic self-monitoring: benefit-cost ratio

Vanessa Preumont, Stéphanie Rouhard Published in the journal : March 2018 Category : Diabétologie

The FreeStyle Libre® and Guardian Connect® glucose monitors are currently available in Belgium for patients with Type 1 diabetes and for subjects without residual insulin secretion. The FreeStyle Libre® device was designed to replace the recommended finger-stick glucose monitoring, without any need of calibration. Accuracy is comparable to that pertaining to currently available real-time continuous glucose monitoring. The system can be used in adults, children, and during pregnancy. In randomized trials, its use was reported associated with a reduction in hypoglycemia and, in observational studies, with an improvement in glycated hemoglobin levels. User satisfaction was proven high, with relatively few adverse events. Glucose data can be summarized as ambulatory profile in order to facilitate insulin dose adjustments. Further trials are needed in order to assess the long-term impact on both glycated hemoglobin and quality of life.

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