Bacteria to treat type 2 diabetes ?

Patrice Cani Published in the journal : May 2017 Category : Congrès UCL de Médecine Générale

Obesity and Type 2 diabetes are both associated with low-grade inflammation. Among the possible pathomechanisms, their link to intestinal bacteria is becoming increasingly convincing. Evidence suggests that gut microbiota plays a key role in triggering inflammation and insulin resistance through various mechanisms, such as the translocation of bacteria or bacterial components that induces metabolic endotoxemia. Certain intestinal bacteria may also be either deleterious or beneficial to glucose homeostasis. Among these, the specific role of Akkermansia muciniphila is currently being investigated.

Key Words

Obesity, diabetes, gut microbiota, Akkermansia muciniphila, inflammation

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Burnout is often misdiagnosed

Published in the journal : May 2017 Category : Congrès UCL de Médecine Générale

In this manuscript we explore how the history of psychiatry shed light on its differential diagnosis.

Key Words

Depressive disorder, panic disorder, burn out

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The non-traumatic shoulder physical examination

Henri Nielens Published in the journal : May 2017 Category : Congrès UCL de Médecine Générale

The non-traumatic shoulder physical examinations starts with a specific history followed by an observation of both shoulders at rest and during anterior elevation and abduction movements that must remain symetrical. Thereafter, the patient must be asked to indicate precisely where the pain is located. Active and passive mobilities are evaluated. In case of a major reduction of both passive and active mobility of the shoulder, which is accompanied by severe pain, the occurrence of an adhesive capsulitis should be suspected. The tendons of the rotator cuff must be evaluated with the traditional specific tests. The impigment tests must also take place, as tendon injuries often go along with subacromial impigment. Finally, palpation of the tendon of the rotator cuff as well as motor testing of the muscles of the shoulder including the serratus anterior will end the physical examination of a non-traumatic painful shoulder.

Key Words

Shoulder examination, mobility, specific tests

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Current medical therapies of breast cancer

François Duhoux Published in the journal : May 2017 Category : Congrès UCL de Médecine Générale

CDK4/6 inhibitors are a new standard of care in the management of metastatic breast cancer patients. In the early setting, the use of genomic tests will better define the patients who will benefit the most from adjuvant chemotherapy.

Key Words

Breast cancer, CDK4/6 inhibitors, genomic tests

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Hereditary breast cancer: role of the general practitioners

Anne De Leener Published in the journal : May 2017 Category : Congrès UCL de Médecine Générale

Breast cancer occurs in 12% of the female population. If in most of the case this affection is sporadic, heredity plays a role in 10-15% of the cases. In certain personal of familial situations, a genetic analysis can be proposed to the patients after genetic counselling. When a germline mutation is found in a family, a predictive genetic testing can be proposed to “at risk” relatives to take preventive measures. General practitioners, caretaker of the familial history, plays an important role in the follow-up and support, as in the information’s transmission in the family.

Key Words

Breast, Cancer, heredity, syndrome, HBOC

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Atypical back pain as a manifestation of granulomatosis with polyangiitis (GPA)

Alexandre Jacquerie ¹, Elodie Georges¹, Charlotte Van Ende², Gabriela Migali², Benoit Ghaye³, Michel Lambert¹ Published in the journal : April 2017 Category : Internal Medicine

We report the case of a 43-year-old woman presenting with atypical back pain caused by a tumor-like paraspinal mass. This turned out be a rare presentation of granulomatosis with polyangiitis (GPA) or Wegener's disease.

Key Words

Back pain, tumor-like mass, thoracic spine lesion, GPA

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Melanoma diagnosis and treatment

Laurine Sacré (1), Isabelle Tromme (1), Jean-François Baurain (2), Benoit Lengelé (3), Marie Baeck (1) Published in the journal : April 2017 Category : Dermatology

We report here on the "PEAU’se dermatologique" meeting, held on January 16, 2016, focusing on melanoma diagnosis and new treatments. Doctor I. Tromme presented her thesis results concerning melanoma detection by means of optical and digital dermoscopy. Professor JF. Baurain provided us with a better understanding of new systemic therapies for metastatic melanomas. Lastly, Professor B. Lengelé shared with us his experience in electrochemotherapy for managing primary or metastatic cutaneous tumors.

Key Words

Melanoma, optical and digital dermoscopy, targeted therapy, elcetrochemotherapy

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When heart failure reveals itself as bronchiolitis

Georges de Bilderling (1), Claire Geurten (1), Jean Evrard (1), François Kanen (1), Laurent Houtekie (2), Alain Poncelet (3), Karlien Carbonez (4), Stéphane Moniotte (4) Published in the journal : April 2017 Category : Pediatrics

A 2-month-old baby is admitted to our unit for bronchiolitis. Due to the infant's prolonged symptoms with predominant feeding difficulties and because of a heart murmur noted on auscultation, cardiac ultrasound is performed, resulting in the diagnosis of ALCAPA syndrome (Anomalous Left Coronary Artery from Pulmonary Artery). ALCAPA is a rare but severe cardiac malformation, with early diagnosis and treatment being key to a good prognosis. Bronchiolitis can provoke heart failure, whereas clinical features of heart failure may mimic bronchiolitis. This clinical case underlines the need for performing a complete clinical examination, along with oriented diagnostic investigations, when confronted with a baby suffering from a respiratory condition whose severity or evolution appears unusual.

Key Words

ALCAPA, coronary malformation, cardiac failure, bronchiolitis, infant

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Unusual complication of Osler-Weber-Rendu disease

Edeline Kaze (1), François D’heygere (2) Published in the journal : April 2017 Category : Rare Diseases

The combined syndrome of juvenile polyposis / inherited hemorrhagic telangiectasia (JD-HHT Syndrome) is rare, caused by mutations in the MADH4 gene. Affected individuals exhibit the clinical manifestations of both pathologies and are at increased risk of gastrointestinal cancer (1).

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Comparative study of collagenase injections versus fasciectomy in Dupuytren's contracture: a 1-year follow-up

Alexandre Hupez (a-b), M.D., Christine Detrembleur (c), Ph.D, Fernand Van Innis (a), M.D., Serge Troussel (a), M.D., Xavier Libouton (b-c), M.D, Ph.D., Thierry Lequint (a), M.D. Published in the journal : April 2017 Category : Orthopedics

This study sought to evaluate the use of collagenase injections for Dupuytren's contracture (19 compared to fasciectomy, with 19 patients assessed in each group. We measured loss of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint extension at baseline and 12 months post-injection, along with its impact on patients' daily life, pain, and satisfaction. Whereas there was no significant between-group difference observed for loss of MCP joint extension, PIP joint extension proved lower for the surgical group compared to the injection group. The injection group exhibited significant improvements in terms of pain, daily activities, and satisfaction regarding the MCP joints, with no between-group differences observed for the PIP joints.

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