C. Hermans, C. Lambert, L. Knoops, M.-C. Vekemans, X. Poire, V. Havelange, L. Michaux, E. Van Den Neste Published in the journal : February 2016 Category : Hematology/Oncology

In keeping with previous years, 2015 was rich in developments and innovations in the field of blood diseases. As regards blood coagulation, the development of an antidote to Pradaxa® represents a major advance. Furthermore, recent studies demonstrated that FXI could be a target of choice for new anticoagulants and that bridging with lowmolecular- weight heparin is no longer required in all patients with atrial fibrillation on vitamin K antagonist therapy prior to invasive procedures. Innovations in hemophilia are dominated by the development of new FVIII and FIX concentrates with prolonged half-lives, in addition to the validation of a bispecific antibody mimicking the function of FVIII within the coagulation cascade. With respect to hematological malignancies, several new therapies are expected to revolutionize the treatment of leukemia and lymphomas in the near future, including potent specific inhibitors and immunotherapies, especially chimeric receptor-expressing T cells. The molecular basis of myelodysplastic syndromes are now better understood. Plenty of new molecules have been developed for the treatment of multiple myeloma, in addition to new staging strategies displaying major therapeutic implications.

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Ch. Beauloye, A. Persu, A.-C. Pouleur, A. Pasquet Published in the journal : February 2016 Category : Cardiology

What are the lessons learned from 2015 in cardiology? In 2015, the European Society of Cardiology published new guidelines. This article sought to review the guidelines' key points as regards bacterial endocarditis and management of non-STEMI acute coronary syndrome. Like each year, numerous pharmacological studies were published. Among these, the Sprint Study certainly represents a milestone in the treatment of hypertension. Moreover, new therapeutic agents are emerging in the field of heart failure, as evidenced by the Paradigm and Socrates studies.

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J.-Fr. Baurain, F. Cornélis, F. Duhoux, Y. Humblet, F. Mazzeo, M. van den Eynde, J.-P. Machiels Published in the journal : February 2016 Category : Oncologie

Cancer management has become multidisciplinary, and major advances have been achieved in medical oncology field over the last years. The year 2015 was marked by a change in the treatment strategies for metastatic prostate cancer, with docetaxel-based chemotherapy being now initiated concurrently with castration. This allows for a 10-month increase in median overall survival in these patients, thereby representing a major breakthrough. Last year, a new kind of targeted agent, olaparib, was also granted reimbursement for the treatment of platinumsensitive ovarian cancer. This inhibitor of PARP, a major protein involved in DNA repair, was shown to significantly increase recurrence-free survival in BRCA-mutated ovarian cancer patients. BRCA is a key protein involved in the second DNA repair mechanism. Lastly, the most impressive oncological advance achieved last year pertained to the introduction in daily practice of the anti-PD1 or PDL1 antibodies. Several studies, conducted mostly in melanoma patients, have shown this immunotherapy to be highly effective, with possible cancer cure for some patients. Administering these antibodies is, however, associated with very specific toxicity features, namely autoimmune toxicity that may be severe or even fatal if not recognized and treated early. All these treatments are available at the King Albert II Cancer Institute.

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M. Buysschaert Published in the journal : September 2015 Category : Diabetes and Nutrition

Numerous papers of clinical and therapeutic interest were published in 2015 in the field of diabetology. This article sought to review key messages emerging from these studies, which contribute to an improved management of diabetic subjects. We focused on the “finality” of international guidelines (ADA, EASD) relating to Type 2 diabetes. Therapeutic innovations with DPP-4 inhibitors and SGLT-2 inhibitors are also discussed, along with cognitive disorders in older diabetic patients. Finally, the association between pediatric Type 1 diabetes and psychiatric disorders is addressed.

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Spondyloarthritis: New insights in the pathophysiology and therapeutics perspectives!

A. Nzeusseu Toukap Published in the journal : February 2016 Category : Rheumatology

Spondyloarthritis (Spa) is a chronic immune-mediated inflammatory disease characterized by skeletal involvement (axial, an peripheral or both), at times associated with extra-articular manifestations (skin, gut, or eye). This heterogenic rheumatic disease may cause structural and functional impairments, in addition to a decrease in patients' quality of life. A better understanding of the disease's pathophysiology has led to new encouraging therapeutics strategies for managing this disease.

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T. Pieters, P. Collard, C. Dahlqvist, J.P. d’Odemont, A. Froidure, S. Gohy, G. Liistro, E. Marchand, G.B. Mwenge, C. Pilette, G. Reychler, O. Vandenplas Published in the journal : February 2016 Category : Pneumology

In the field of pneumology, the year 2015 was once again rich in new developments, of which we provide a non-exhaustive list in this article. They concern pathophysiological mechanisms especially in sleep apnea, in addition to diagnostic and curative features. The diagnostic advances include the new reference values for spirometry, the contribution of cryobiopsy to the diagnosis of diffuse interstitial lung diseases, the assessment of bronchiectasis in adults, etc. Regarding treatments, we have chosen to focus on the advances in drug and non-drug management of asthma, idiopathic pulmonary fibrosis, emphysema, and bronchial cancer.

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Synovial biopsy: an essential tool for guiding rheumatoid arthritis treatment?

L. Meric de Bellefon, M.S. Stoenoiu, Ch. Galant, A. Avramovska, S. Nieuwland Husson, A. Nzeusseu Toukap, B. Lauwerys, F.A. Houssiau, P. Durez Published in the journal : February 2016 Category : Rheumatology

Over the last years, the management of rheumatoid arthritis (RA) has been largely improved owing to the introduction of biologicals. These agents have been developed based on a better understanding of the disease pathophysiology. In the next years, the histopathological and molecular features of the synovial tissue will likely help clinicians better define RA treatment strategies.

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O. Lebecque, V. Godding, P. Lebecque Published in the journal : February 2016 Category : Pneumologie pédiatrique

Your money or your life? - Kalydeco®: a milestone towards the “cure” of cystic fibrosis From February 1st 2016 on, Ivacaftor (KALYDECO™) will be reimbursed in Belgium for the treatment of cystic fibrosis (CF) in patients aged 6 years and older carrying at least one of nine well characterized gating (Class III) cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations, which account for approximately 3% of Belgian CF patients. In most of these patients, this very expensive oral drug (248,000 €/year) substantially improves lung function, lowers sweat chloride levels, and improves body weight by targeting the primary defect, thus representing a fundamental shift in the way the disease is managed. However, clinicians should be aware of the drug's potential for numerous drug interactions.

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The child and adolescent psychiatry department: 2015 highlights

E. de Becker, N. Chatelle, P. Kinoo, E. Mousset, A. Wintgens Published in the journal : February 2016 Category : Psychiatrie infanto-juvénile

In 2015, the child and adolescent psychiatry department initiated measures aimed to comply with the guidelines that have been produced as part of the mental health care reform initiated by the federal and regional authorities (setting up of networks, of a mobile crisis team, etc.). At the Saint-Luc hospital, three interesting initiatives should be worth mentioning. The SOS-CHILDREN team has opened a space pertaining to the "repair" of the parent-child relationship, for the event of documented child abuse instances requiring the child’s placement. Besides, the KaPP team has proposed a therapeutic strategy designed to deal with parental refusal of medical treatment deemed necessary by healthcare professionals. Lastly, the CRA team has developed a tool for assisting both parents and child after the diagnosis of autism has been made by setting up a social skills training group.”

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M. Luyckx, J. Squifflet, J.F. Baurain, D. Bourgonjon, A. Gerday, P. Laurent, C. Pirard, C. Watremez, F. Roelandt, C. Rousseau, M. Berlière, Ch. Wyns Published in the journal : February 2016 Category : Gynecology and Obstetrics

The gynecology-andrology department presents several major innovations developed in 2015. Advances have been achieved in the fields of both treatment strategies, as illustrated by the implementation of the sentinel node technique for pelvic cancers, and of quality of life during patient care, especially via using hypnosis while treating benign and malignant breast diseases or in reproductive medicine.

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