J.-Fr. Baurain, F. Cornélis, F. Duhoux, Y. Humblet, F. Mazzeo, M. van den Eynde, J.-P. MachielsPublished in the journal : February 2016Category : 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.
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.
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.
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. VandenplasPublished in the journal : February 2016Category : 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.
R. Bachmann, D. Léonard, N. Abbes Orabi, Ch. Remue, A. KartheuserPublished in the journal : February 2016Category : 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.
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.
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.