L. Meric de Bellefon, M.S. Stoenoiu, Ch. Galant, A. Avramovska, S. Nieuwland Husson, A. Nzeusseu Toukap, B. Lauwerys, F.A. Houssiau, P. DurezPublished in the journal : February 2016Category : 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.
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.
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.”
M. Luyckx, J. Squifflet, J.F. Baurain, D. Bourgonjon, A. Gerday, P. Laurent, C. Pirard, C. Watremez, F. Roelandt, C. Rousseau, M. Berlière, Ch. WynsPublished in the journal : February 2016Category : 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.
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.
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. CornuPublished in the journal : February 2016Category : 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.
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.
ATOZET ® contains two active agents, atorvastatin and ezetimibe, which inhibit the pathways pertaining to hepatic synthesis and intestinal absorption of cholesterol, thereby reducing the LDL levels by 50 to 65%. Each active ingredient has proven its effectiveness to significantly reduce the incidence of cardiovascular disease. From a practical point of view, the reimbursement conditions (INAMI/ RIZIV) for this combination pack have been rightly adjusted to the latest European and Belgian recommendations, allowing patients at very high risk to be optimally treated. The combination 'two in one' is also likely to facilitate therapeutic adherence. ATOZET ® is particularly indicated in secondary prevention, in primary prevention, and in patients with a very high SCORE (≥10%), patients with diabetes, or those with familial hypercholesterolemia whose LDL cholesterol levels remain inadequately controlled by statin monotherapy alone.
N. Feller, J.-B. Le Polain de Waroux, S. Marchandise, C. Barbraud, Ch. ScavéePublished in the journal : September 2015Category : Cardiology
We report two cases of patients receiving inappropriate shocks delivered by an implantable cardioverter-defibrillator (ICD). The device malfunction was related to rapid atrial tachycardia in one patient and defibrillation lead defect in the other. With the expansion of ICD implantation, this inappropriate shock problem has increased gradually over the past years and has thus become a noticeable concern today. Inappropriate shocks usually cause psychological distress in the patient and are associated with increased mortality and morbidity. Furthermore, the majority of lead defects may be detected on ICD control before inappropriate shocks occur. Lead defect problems can hardly ever be resolved conservatively, usually requiring an invasive approach.
Diabetes mellitus is a major health problem for at least two main reasons: the disease's epidemic evolution and the risk of chronic, hyperglycemia-related complications. This article aims at emphasizing the worldwide health problem of (pre)diabetes, while presenting approaches in order to better control the disease and its consequences.