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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How to track and register gastrointestinal endoscopy-related adverse events?

Francesca Chiara Della Casa Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Gastrointestinal endoscopic procedures have evolved significantly in the last 50 years, thereby revolutionizing the diagnosis and treatment of gastroenterological diseases. Although using the body’s natural openings to access the region of interest skillfully bypasses disruption of superficial tissues or muscular planes, endoscopy remains an invasive technical procedure, which is thus associated with risks and complications. As a part of every quality program in medicine, tracking adverse events represents a quality indicator, which has been widely accepted as a monitoring measure. This study’s aim was to elaborate a practical system for reporting the endoscopic procedure-associated adverse events occurring in the department of gastroenterology of the Saint-Luc University Hospital.

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Prevalence of pituitary insufficiency in patients with nonfunctioning pituitary macroadenoma and evolution following neurosurgical treatment: a study of 150 patients

Valérie Everard Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Non-functioning pituitary macroadenomas (NFPA) are supracentimetric adenomas whose main symptoms (visual impairment, pituitary insufficiency, headaches) are caused by the compression of adjacent anatomical structures. NFPA are mostly treated by transsphenoidal tumor resection in order to correct or avoid symptoms caused by mass effects. Limited data are available regarding the evolution of pituitary functions following surgery.

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Predictors of response to new immunomodulatory therapies in melanoma

Alexia Degraeuwe(1) Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Immune checkpoint inhibitors have revolutionized the treatment of metastatic melanoma, with a survival now reaching several years in some patients. The anti-PD-1 monoclonal antibodies nivolumab and pembrolizumab increase both the quality of life and overall survival of metastatic melanoma patients. They are currently the first-line treatment for metastatic melanoma. However, only 40% of patients respond to anti- PD-1 monotherapy. In the era of personalized medicine, it has become essential to identify those patients who will benefit from these treatments that are, by the way, responsible for rare but serious adverse events. We tested several immunohistochemical markers in order to discriminate between responders and nonresponders.

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Study of compliance with follow-up in melanoma patients

Laura Baumel, Aline Van Maanen, David Ogez, Isabelle Tromme Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Melanoma is associated with a high risk of recurrence and new primaries. A lifelong follow-up is thus recommended. This study was aimed at identifying the factors that could influence the patient’s compliance with dermatological and oncological follow-up.

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Allergic contact dermatitis to synthetic rubber gloves in caregivers

Guillaume Dejonckheere Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

A growing number of hospitals decided to completely abandon latex in order to avoid IgE-mediated allergic reactions (which can lead to anaphylaxis), as was the case for the Saint-Luc University Clinics in December 2010 (a premiere in Belgium). This measure concerns more than 300,000 pairs of sterile gloves per year. Since then, many caregivers who had been working for years without experiencing any allergic reaction developed contact dermatitis with the new gloves. The main allergens involved are vulcanization accelerators.

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Translation into French, linguistic and cultural validation of a new PRO instrument: the BODY-Q – description of the process and use in a clinical project

Perle Rillon Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Bariatric surgery offers rapid and massive weight loss, but can leave the body with a substantial amount of excess skin. Excess skin may have both physical and psychological consequences, including distortions of body image and skin problems, such as irritation. Body contouring performed for cosmetic purposes, or after weight loss, has the potential to improve one’s body image and health-related quality of life (HRQOL). Many studies have shown the interest of measuring this improvement using generic instruments. Unfortunately, these tools were not specifically designed for body contouring surgery, thus highlighting the lack of dedicated PRO instruments for measuring outcomes after body contouring surgery.

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Assessment of tibial diaphyseal fracture treatment by intramedullary nailing and identification of risk factors for complications

Julie Manon(1) Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Complications following intramedullary nailing (IMN) of tibial shaft fractures are well described in the scientific literature and are feared by surgeons. While risk factors for such complications have not been clearly identified, they could help practitioners to be more vigilant. Surgeons could actually adapt their therapies in patients at risk and thus prevent these harmful consequences for patient and society. In this context, the challenge is to answer a central question: “Is it possible to predict IMN complications after tibial shaft fractures and move towards a preventive approach?”.

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Primary lymphedema and HGF mutation: Phenotypic analysis in 11 patients with primary lymphedema associated with HGF mutation and literature review

Laura Mengeot(1), Elodie Fastré(2), Sandrine Mestre(3,4), Nicole Revencu(1), Raphaël Helaers(2), Gabriela M. Repetto(6), Arie van Haeringen(7), Laurence M. Boon(2,8), Isabelle Quere(3,4), Pascal Brouillard(2), Miikka Vikkula(2) Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Lymphedema is a common disabling condition and the most frequent lymphatic anomaly. It is characterized by chronic tissue swelling mostly located in the limbs. Lymphedema can be primary or secondary (acquired), the primary form resulting from inadequate development or function of the lymphatic system. Currently, germline mutations have been identified in 28 genes. However, these only explain approximately 40% of familial forms and 12% of sporadic forms, thus suggesting that other genes are involved.

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Quality of life of pediatric patients before and after cardiac arrhythmia ablation

Laura Peter(1), Maria Cecilia Gonzalez(2) Published in the journal : November 2018 Category : Mémoires de Recherche Clinique

Cryoablation and radiofrequency catheter ablation have progressively become a standard of care for treating pediatric arrhythmias. While many studies have demonstrated their efficacy in eliminating the arrhythmia substrate, few have evaluated their impact on quality of life, which is the purpose of this study.

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