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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INNOVATIONS IN PEDIATRIC PNEUMOGRAPHY, WHAT TO RETAIN FROM 2015?

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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Colorectal surgery in the robotic era

R. Bachmann, D. Léonard, N. Abbes Orabi, Ch. Remue, A. Kartheuser Published in the journal : February 2016 Category : Chirurgie colorectale

The year 2015 has been marked by the initiation of robotic-assisted colorectal surgery at the Cliniques universitaires Saint-Luc. Robotic surgery is a new surgical technology, which attempts to overcome the technical limitations of laparoscopic surgery. Contrary to the rectilinear and rigid instruments used in classical laparoscopy, the robot’s arms and instruments allow for intuitive movements that perfectly mimic those of the surgeon’s wrist and hand. Along with the 3D magnified vision of the operating field and filtering of physiological tremor, these features in addition to others are key to the precision and safety of minimally invasive surgery.

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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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INNOVATIONS IN GYNECOLOGY, WHAT TO RETAIN FROM 2015?

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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Novelties and innovations in physical medicine: What are the lessons learned from the year 2015?

S. Salazar Gajardo, T. Lejeune, S. Fizaine, I. de Biourge, G. Caty Published in the journal : February 2016 Category : Physical and Rehabilitation Medicine

In physical medicine and rehabilitation, the year 2015 was notably marked by the continued implementation of exercise medicine in Belgium, in addition to the publication of additional evidence and supplementary information regarding the usefulness of supervised exercise in the prevention and therapeutic management of chronic diseases. In addition, recent randomized controlled trials have been instrumental in supporting the need that physical exercise be integrated in the global management of cancer patients.

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2015 innovations in orthopedic surgery and traumatology

N. Irda, D. Putineanu, K. Tribak, X. Libouton, O. Barbier, M. Van Cauter, J.-E. Dubuc, E. Thienpont, J.-C. Yombi, Th. Schubert, L. Kaminski, M. Mousny, P.-L. Docquier, X. Banse, Ch. Delloye, O. Cornu Published in the journal : February 2016 Category : Chirurgie orthopédique et traumatologie

Orthopedic surgery has been driven by technological advances for several years, thereby facilitating joint replacements while helping restore joint function and patient autonomy. New prostheses regularly emerge. They provide solutions to the problems posed by current joint replacements and render new joint replacements foreseeable, as is the case for the ankle and wrist.

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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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INNOVATIONS IN DERMATOLOGY, WHAT TO RETAIN FROM 2015?

M. Baeck, A. Herman, V. Dekeuleneer, A.-C. Deswysen, P.-D. Ghislain, B. Leroy, L. de Montjoye, I. Tromme Published in the journal : February 2016 Category : Dermatology

2015 was an important year in dermatology, especially in the therapeutic area. New treatments are available for chronic urticaria, psoriasis and angiofibromas of the face in the tubrous sclerosis complex context. In dermato-oncology, treatments of advanced cases of basal cell carcinomas and metastatic melanomas have significally improved. Finally, methylisothiazolinone remains a major allergen, responsible for contact allergy epidemic and for which it is urgent to establish a limitation of its use at European level.

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