The news from the GRAPA provide a summary of the presentations made at the 9th GRAPA symposium, with a focus on treatment adherence in the prevention of cardiovascular diseases, mainly in the areas of lipidology, diabetology, and rhythmology. The presentations also addressed related topics, such as therapeutic inertia, therapeutic education, empowerment, and the impact of treatment-related adverse events and media controversies on the initiation and continuation of cardiovascular medications. Finally, arguments for the control of cardiovascular risk factors in the prevention of atrial fibrillation, based on recent medical literature, are also presented.
After thousands of hemophilic patients were infected with HIV and HCV, and thanks to major advances in biotechnology, recombinant factor VIII has emerged as a first-line or reference treatment for most factor VIII-deficient patients (hemophilia A). The development of neutralizing antibodies (inhibitors) is currently the most severe and feared complication in hemophilia A replacement therapy. The respective immunogenicity of plasma and recombinant factor VIII concentrates has been debated for many years, with multiple studies providing contradictory results.
Xultophy® is a new combination product consisting of basal insulin (degludec) and a GLP-1 agonist (liraglutide). In this article, we analyzed recent literature in order to find out its potential advantages in general and compared to basal insulin in particular, as well as to clarify its role in the therapeutic management of insulinrequiring type 2 diabetes.
Kevin Ackenine(1), Samuele Iesari1, (2), Maxime Foguenne(1), Chantal De Reyck(1), Eliano Bonaccorsi Riani(1), Olga Ciccarelli(1), Laurent Coubeau(1), Quirino Lai(3), Mina Komuta(4), Pierre Gianello(5), Jan Lerut(1)Published in the journal : July 2018Category : Mémoires de Recherche Clinique
The efficacy of anti-lymphocyte serum (ALS) induction remains inconclusive in liver transplantation (LT) due to poorly designed trials.
Valentine Hermans(1), Thierry Detaille(1), Astrid Haenecour(1), Emilien Derycke(1), Laurent Houtekie(1), Raymond Reding(2), Stéphan Clément de Cléty(1)Published in the journal : July 2018Category : Mémoires de Recherche Clinique
Pediatric acute liver failure (PALF) is a rare yet severe condition characterized by rapidly progressing hepatic dysfunction and multisystem organ failure (MOF) syndrome in previously healthy children. It poses several clinical challenges to physicians, one of them being the identification of the children who won’t recover without liver transplantation (LT).
Martin Caluwaerts(1), Diego Castanares-Zapatero(1), Pierre-François Laterre(1), Philippe Hantson(1)Published in the journal : July 2018Category : Mémoires de Recherche Clinique
Acute mesenteric ischemia (AMI) is a frequent cause of acute abdomen in the elderly, which is commonly encountered in the intensive care unit (ICU). AMI has a high mortality rate of between 60 and 80%, as well as a high morbidity rate among survivors. One of the reasons for this poor prognosis is the lack of accurate diagnostic tools for the clinician, with a delayed diagnosis as the main consequence. The characteristics of AMI diagnosed in the ICU often differ from those found in the general population, which results in a real diagnostic challenge. In the ICU, the interpretation of clinical, biological, and radiological signs of AMI proves more difficult. Furthermore, the poor prognosis is also accounted for by the numerous comorbidities of intensive care patients.
Given the aging population and increasing prevalence of degenerative diseases of the spine, neurosurgeons need to perform more lumbar fusions with pedicle screw fixations. As these interventions are currently carried out percutaneously, surgeons are dependent on intraoperative imaging to replace the anatomical landmarks found in open procedures. In our institution, we recently acquired a neuronavigation system based on intraoperative 3D fluoroscopy.
Autosomal dominant polycystic kidney disease (ADPKD), caused by PKD1 or PKD2 mutations, is the most common inherited kidney disease. Intracranial aneurysms (ICA) and mitral valve prolapses are well-known vascular complications in ADPKD patients. Other reported vascular manifestations include thoracic aortic aneurysms and dissections (TAAD) and cardiomyopathies (CMP).
Mélissa Salavrakos(1), Hubert Piessevaux(1), Mina Komuta(2), Nicolas Lanthier(3), Peter Stärkel(3)Published in the journal : July 2018Category : Mémoires de Recherche Clinique
Transient elastography (TE), or Fibroscan®, has been validated for the diagnosis and staging of liver fibrosis in chronic hepatitis C, but there is no clear consensus on the optimal TE cut-off values in alcoholic liver disease (ALD). The objectives of the study were: (a) to evaluate the cut-off values reported in the literature and determine new ones for the diagnosis of fibrosis in alcoholic patients; (b) to investigate the impact of 2 weeks of abstinence on TE results; (c) to evaluate the diagnostic accuracy of TE for detecting clinically significant portal hypertension; (d) to evaluate the accuracy of non-invasive blood tests (AST-Platelet Ratio Index [APRI], Forns index, Fibrosis-4 [FIB-4]); (e) to study the potential histological (steatosis, alcoholic hepatitis, perisinusoidal fibrosis) and biochemical (transaminases and cholestasis) confounding factors leading to misclassification by TE.
Shabneez Kautbally(1), Pierre Deprez(1), Michel Hermans(2), Tom Moreels(3), Tarik Aouattah(3), Enrique Perez-Cuadrado-Robles(3)Published in the journal : July 2018Category : Mémoires de Recherche Clinique
Studies reporting on pancreatic function after endoscopic treatment of chronic pancreatitis are scarce. This study was aimed at prospectively investigating the evolution of pancreatic endocrine and exocrine function in patients who underwent endoscopic treatment using endocrine function parameters and fecal tests for exocrine function.