Hidradenitis suppurativa/acne inversa

Laura Nobile1, Marie Baeck1 Published in the journal : May 2018 Category : Congrès UCL de Médecine Générale

Hidradenitis suppurativa/acne inversa is a multifactorial chronic inflammatory skin desease. This affection is characterized by reccurent nodules that rupture and lead to sinus tracts. To date, no evidence-based treatement guidelines has been proposed. However a multidiscipinary approach is recommanded.

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Surgical modalities and indications in hip pathologies

Olivier Cornu, Maite Van Cauter, Christine Detrembleur, Jean-Emile Dubuc Published in the journal : May 2018 Category : Congrès UCL de Médecine Générale

Whereas surgical repair of severe bone or tendon traumas must be undertaken as soon as possible so as to prevent significant functional deficit, hip surgery is only performed in symptomatic patients, after considering its potential benefit in preventing osteoarthritis and the need for joint replacement. Prosthetic joint replacement provides good results, but it should not be performed too early in order not to disappoint the patient and expose him to subsequent surgical revision.

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Clara Selves Published in the journal : May 2018 Category : Congrès UCL de Médecine Générale

Greater trochanteric pain syndrome is a degenerative disorder of the tendons surrounding the greater trochanter, trochanteric bursitis may or may not be present. Sometimes referred to as the "false sciatica", pain may radiate to the knee, but has a mechanic clinical presentation. History taking and clinical examination are key to the diagnosis, revealing painful palpation of the peritrochanteric region. Paraclinical exams should be reserved to unusual clinical presentations.

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Clinical examination of the hip

Henri Nielens Published in the journal : May 2018 Category : Congrès UCL de Médecine Générale

Hip examination traditionally includes history taking, as well as an assessment of the patient’s gait pattern and joint mobility. If the patient is unable to stand following a trauma or a fall, a deformity (shortening, rotation of the lower limb) must be searched for, as it may indicate a fracture. Common tendinopathies must also be searched for through palpation, especially at the greater trochanter that is a common painful site in older overweight female patients.

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Published in the journal : May 2018 Category : Congrès UCL de Médecine Générale

Infection with the human immunodeficiency virus (HIV) remains a public health concern worldwide. Young adults are the most affected by the pandemic, with 40% of new cases concerning people from the 15-24 year age group, which also is the most sexually active. There are four prevention strategies of HIV infection. One of them is post-exposure prophylaxis (PEP) by the administration of antiretroviral therapy, which can be used in post-coital situation for exposed patients. The probability of HIV transmission depends on the type of exposure, infectivity level of the source, and susceptibility of the exposed person. The risk of acquiring HIV after an exposure incident can be calculated by multiplying the risk that the source person is HIV-positive by the risk of exposure. Prophylaxis is recommended when the risk of transmission is greater than 1/1,000 and must be considered when the risk is between 1/1,000 and 1/10,000. When this risk is below 1/10,000, prophylaxis is not recommended. All cases need to be evaluated on an individual basis. Most recent guidelines recommend two nucleoside reverse transcriptase inhibitors (NRTI) associated with either an integrase inhibitor (INI) or a boosted protease inhibitor (PI/r). The treatment should be initiated as soon as possible after exposure, preferably within 24 h or, at the latest, within 72 h. The treatment duration is 28 days. HIV serology is performed at Day 0, Week 8 and Week 12 using a 4th generation blood test. Counselling on HIV prevention should be provided during the follow-up.

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Treating HIV in 2018: what the general practitioner should know

Jean-Cyr Yombi Published in the journal : May 2018 Category : Congrès UCL de Médecine Générale

Many prevention and treatment efforts have been made since the outbreak of the human immunodeficiency virus (HIV) epidemic. It is estimated that by June 2017, 20.9 million people had access to antiretroviral therapy. Due to the efficacy of new antiretroviral therapies, HIV-infected patients have an almost normal life expectancy. HIV has become a chronic disease requiring long-term treatment, which poses new problems such as comorbidities, the accumulation of antiretroviral treatment toxicities and finally, ageing.

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Bariatric surgery: follow-up in general medicine

Benoit Navez(1), Jean-Paul Thissen (2,3) Published in the journal : May 2018 Category : Congrès UCL de Médecine Générale

The recognition of bariatric surgery as a legitimate component of the treatment of obesity and its comorbidities has led to a clear increase in the number of these procedures. It is essential to know the main principles of postoperative follow-up of these patients so as to ensure success and minimize the risks. Indeed, bariatric surgery imposes a modification of eating behavior and exposes the patient to certain complications and nutritional deficiencies. Their nature depends on the type of surgery, which can be either purely restrictive (sleeve gastrectomy) or mixed, i.e. restrictive and malabsorptive (gastric bypass). While surgical complications most often occur early, nutritional deficiencies commonly appear later. In case of associated comorbidities, the follow-up has to be intensified in order to adapt the drug treatment. Pregnancy can only be considered after stabilization of weight and correction of nutritional deficiencies.

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Cytomegalovirus infection associated with portal vein thrombosis and thrombocytopenia: a case report

Gianfranco Di Prinzio (1), Phung Nguyen Ung (2), Anne-Sophie Valschaerts (2), Olivier Borgniet (2) Published in the journal : April 2018 Category : Internal Medicine

We here present the case of portal vein thrombosis in a patient exhibiting symptoms of cytomegalovirus infection, confirmed by serology and polymerase chain reaction (PCR) and complicated by thrombocytopenia. The literature reveals growing evidence that human CMV likely plays a role in thrombotic disorders. However, only 11 cases of CMV-induced visceral venous thrombosis have been described so far. On the other hand, thrombocytopenia is a well-known complication of CMV infection. The patient was successfully treated using high-dose immunoglobulins by intravenous route

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Biological treatments and dermatology

Caroline Colmant, Pierre-Dominique Ghislain, Marie Baeck, Laurence de Montjoye (1) Published in the journal : April 2018 Category : Dermatology

Light was also shed on biosimilars. Doctor Pierre-Dominique Ghislain shared his clinical experience and provided practical guidelines for using biological treatments in dermatology. Lastly, several unusual indications of biological treatments have been illustrated based on clinical cases from the dermatology department of the Cliniques universitaires Saint-Luc, Brussels, Belgium.

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Rare and serious complications related to granulomatosis with polyangiitis

Published in the journal : April 2018 Category : Internal Medicine

Granulomatosis with polyangiitis is a rare systemic vasculitis with significant morbidity and mortality. The diagnosis is based on the association of clinical signs, such as involvement of upper and lower respiratory tract, as well as of the kidney, along with the presence of specific antibodies (ANCA anti-PR3), and confirmation of histopathological biopsy specimen. Although the current treatment of the disease has resulted in significantly reduced mortality, morbidity remains very high, which is linked to both the disease itself and the undesirable effects of immunosuppressive therapy.

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