Vascular malformations: a new hope due to molecular targeted anti-tumor strategies

Emmanuel Seront, Valérie Dekeuleneer, Julien Coulie, Ann Van Damme, Laurence Boon, Miikka Vikkula Published in the journal : May 2022 Category : Oncologie

Vascular malformations are rare diseases that result from disturbances in the angiogenesis process. These malformations are subdivided into capillary, lymphatic, venous, arteriovenous, and mixed malformations, according to the type of affected vessels. Until a few years ago, therapeutic options were limited to sclerotherapy or surgery, but these latter treatments were only rarely curative in nature or often not feasible. The majority of vascular malformations are caused by inherited or somatic mutations in various genes. Of note is that these mutations are similar to oncogenic mutations detected in cancer conditions, causing hyperactivity of essential signaling pathways, including the MAPK and PI3K/AKT/mTOR cascades. In this article, we have highlighted the role of targeted molecular inhibitors as possible therapies for vascular anomalies via repurposing of anticancer drugs.

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Food anaphylaxis: inventory in a Belgian pneumo-allergology consultation

Aurore De Vriendt1, Françoise Pirson1,2,3,4 Published in the journal : May 2022 Category : Pneumology

Food allergy is a common condition, and anaphylaxis, which is its most severe presentation, potentially fatal. This retrospective study has described the characteristics of patients presenting with food anaphylaxis (Grade >2), who were evaluated at the Allergology Unit of Saint-Luc University Clinics, between 2017 and 2019.

The studied population comprised mainly adults, their mean age being 33.7 years. Anaphylaxis were mainly caused by mandatory allergens. The allergological work-up was chiefly based on a detailed clinical history and demonstration (in vivo or in vitro) of sensibilization, in addition to an oral food challenge in several cases. The most common culprit foods were shellfish and peanuts, both accounting for 38.7% of cases. Intramuscular epinephrine was injected in less than half of anaphylaxis cases. Acute management of food anaphylaxis is thus still inappropriate in regards to international guidelines.

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Antibiotic resistance, chronicle of a neglected emergence

Amel Filali Published in the journal : May 2022 Category : Médecine interne et maladies infectieuses

Antibiotic resistance (ABR) is a phenomenon described since the discovery of the first antibiotics. In the euphoria of the golden age of antibiotics, this central problem remained hidden for a long time. Today, ABR is one of the central public health issues of the 21st century. Indeed, available projections estimate that by 2050, overall 10 million people could die each year from the consequences of ABR. In light of these figures, understanding the complexity of its determinants, as well as the delay in the fight against RBA appears crucial. ABR is a global problem, and it is intrinsically a geopolitical issue at the heart of the major challenges of our time. Understanding it from this perspective would enable us to better control this phenomenon. Antibiotics occupy a unique place among anti-infectives. They are indeed societal drugs that play a very special role in our therapeutic arsenal. Along with vaccination and the development of hygiene, antibiotics constitute one of the cornerstones of modern medicine. Without antibiotics, complex surgery is impossible, as are solid organ transplants, resuscitation, and treatment of oncological patients. What is more, prescribing antibiotics is the responsibility of all doctors, whatever their field of practice, and it may at times be the responsibility of non-physicians. Owing to its ubiquitous nature, the treatment of ABR should be a central concern. This article sought to cover ABR by analyzing both its determinants and the response lines that are emerging.

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The management of distal radius fracture in adults: the identification of “the good treatment for the good patient”

Antoine Vanderlinden, Ghady El Khoury, Maxime Bonnelance, Xavier Libouton, Olivier Barbier Published in the journal : May 2022 Category : Orthopedics

The distal radius fracture is the most commonly encountered condition in the emergency departments (1). Its treatment is primarily aimed to improve pain and restore function (2).

The treatment modality depends on the anato-mical fracture characteristics and on functional demands of the patient, as well. It can vary from simple splinting to a complex surgical intervention.

For high-demanding patients, operative fracture treatment consisting of post-reduction radial shortening >3mm, dorsal tilt >10 degrees, or intraarticular displacement with step off >2mm has proven to be associated with improved radiographic and patient reported outcomes (3). Instead, for patients with limited functional demands, conservative treatment is still the preferred option (3).

This article sought to provide management and follow-up strategies for distal radius fracture in adults.

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Concerning stigmatization, reflections about a case of Percheron’s stroke in psychiatric expertise

Muriel Boven (*), Sylvain Dal (**) Published in the journal : May 2022 Category : Psychiatrie

Given that health is considered “the silence of organs”, let’s open our ears. Following a psychiatric expertise in the emergency room, a dementia post-Percheron’s stroke was diagnosed. In this context, the authors asked themselves whether stigmatization had played a potential role in the difficulty of establishing the diagnosis. The authors thus attempted to highlight its existence, in addition to its link with mental related issues and its consequences, while also providing suggestions for prevention. Understanding this condition is critical to be in a better position to face it and improve the healthcare quality. In this article, the authors have also stressed the importance of a good partnership between psychiatrists and physicians.

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Ventrolateral lumbar disk herniation as an unusual presentation

Olivier Raskin, Ludovic Kaminski Published in the journal : May 2022 Category : Chirurgie orthopédique et traumatologie

Acute lumbar pain is a common reason for patients attending primary care practices, with most of it being benign in nature.

One of its most frequent cause is a lumbar disk herniation, which can manifest itself only as a lower back pain, though it is usually associated with sciatica.

We have described herein a case of ventrolateral lumbar disk herniation crushing the psoas muscle origin, with a radiating pain that was not caused by nerve root compression. Nevertheless, like most cases of lumbar disk herniation, the pain improved with the passage of time and completely resolved within a few weeks, without any surgical procedure.

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Antenatal diagnosis of Miller-Dieker syndrome, ultrasound screening and differential diagnosis

Marta Merola Martinez1, Anne Guillaume2, Jean-Paul Hermand3, Maia Delaine4, Didier Van Wymersch5 Published in the journal : April 2022 Category : Clinical Report

We herein describe the antenatal diagnosis of Miller-Dieker syndrome. Ultrasound is the primary means of screening for Miller-Dieker syndrome. However, early presentations of the disease vary widely. With this case report, we want to emphasize facial dysmorphism, and namely retrognathism, as an important feature that can raise suspicion of the diagnosis, especially when associated with ventriculomegaly and intrauterine growth restriction.

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Guillain-Barré and severe myositis induced by hepatitis E virus: case report and literature review

Ewelina Uscilowska (a), Marie De Vos (b), Catherine Thiran (c), Ilisei Dragos (d) Published in the journal : April 2022 Category : Clinical Report

Hepatitis E virus (HEV), which is spread all over the world, is nowadays among the most common causes of viral hepatitis, mainly affecting developing countries. Nevertheless, over the last 10 years, there has been a resurgence of viral hepatitis cases in developed countries. In most cases, HEV infection has been rather benign, but it can at times be complicated by extra-hepatic manifestations, neurological ones being the most common. Based on a clinical case report, we have describe the atypical evolution of HEV infection, which was complicated by Guillain Barré syndrome and myositis.

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COVID-19-induced urological pathologies, a review of the literature based on an observation of Peyronie's disease

Nathan Wirtzfeld*, Gwenola Mambour**, Bertrand Tombal***, Annabelle Stainier*, Roland Vaesen*, Frédéric Leduc* Published in the journal : April 2022 Category : Clinical Report

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by the SARS-CoV-2. This coronavirus proves able to invade endothelial cells, thereby causing systemic inflammation and a blood hypercoagulable state. This systematic review of the literature reports on the various urological disorders observed in the course of COVID-19, starting from a case of Peyronie's disease. Only one case of post-COVID-19 Peyronie's disease has been described in the literature so far. Peyronie's disease should be considered as a possible sequela of COVID-19, and healthcare professionals should inquire about a possible COVID-19 history in patients with Peyronie's disease.

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Comparison of a rapid antigen test versus polymerase chain reaction for detecting respiratory syncytial virus, influenza A/B virus, and adenovirus in children

Claire Sommelette (1), Marc Bourgeois (2), David Tuerlinckx (3) Published in the journal : April 2022 Category : Pediatrics

Viruses are a common cause of respiratory infections in children. This study sought to compare the performance of a rapid antigen test versus the polymerase chain reaction (PCR) method for detecting three viruses (respiratory syncytial virus [RSV], adenovirus [ADV], and influenza A/B ([INF A/B]). We herein report the results of a prospective study conducted as part of the Sciensano (Institute of Public Health in Belgium) acute respiratory infection (ARI) surveillance. Between October 2018 and April 2019, 140 nasopharyngeal cell samples were collected from 135 children hospitalized for ARI at the University Hospital Dinant Godinne (Belgium). The rapid antigen test came back positive for 71/140 (50.7%) samples, while PCR came back positive for at least one virus for 123/140 (87.8%) samples. We determined the sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of the rapid test compared to the RT-qPCR (PCR), which is used as the gold standard. The results for the rapid antigen test were as follows: Se 80.3%, Sp 100%, PPV 100%, and NPV 85% for RSV; Se 6.25%, Sp 99%, PPV 66.7%, and NPV 78.1% for ADV; Se 87.5%, Sp 98.4%, PPV 87.5%, and NPV 98.4% for INF.

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