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Revue medicale de Liege最新文献

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[A new era for incretins : from GLP-1 receptor agonists to co-agonists and poly-agonists]. [胰高血糖素的新时代：从 GLP-1 受体激动剂到联合激动剂和多激动剂]。
Revue medicale de Liege Pub Date : 2024-09-01
André Scheen
{"title":"[A new era for incretins : from GLP-1 receptor agonists to co-agonists and poly-agonists].","authors":"André Scheen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Incretin gut hormones, especially glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), raise a huge interest in diabetology. GLP-1 receptor agonists have gained a privileged role in the management of type 2 diabetes (T2D). They improve glucose control without inducing hypoglycaemia, while promoting weight loss. Furthermore, they protect people with T2D against atherosclerotic cardiovascular disease and contribute to reduce the risk of heart failure and chronic kidney disease, two other common complications of T2D. A recent innovation consists in the development of co-agonists that target both GIP and GLP-1 receptors. Whereas the co-infusion of GIP and GLP-1 failed to further reduce hyperglycaemia of T2D compared to GLP-1 single infusion, tirzepatide, an original dual unimolecular biaised GIP/GLP-1 agonist, showed a remarkable improvement of glucose control in the SURPASS programme in patients with T2D. Consequently, it is now commercialized in many countries for the management of T2D. GLP-1/glucagon (GCG) co-agonists and GIP/GLP-1/GCG poly-agonists are currently in development, aiming to benefit from the favourable effects of GCG on energy expenditure and liver lipid metabolism, while mitigating the hyperglycaemic effects of this hormone thanks to balanced effects of GLP-1 and/or GIP. They might occupy in the future an interesting place in the management of obesity and its metabolic complications among which T2D and liver steatosis.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 9","pages":"605-612"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[English Title : Treatment of membranous nephropathy]. [英文标题：Treatment of membranous nephropathy].
Revue medicale de Liege Pub Date : 2024-09-01
Adrien Stoffels, François Jouret, Pauline Erpicum, Antoine Bouquegneau
{"title":"[English Title : Treatment of membranous nephropathy].","authors":"Adrien Stoffels, François Jouret, Pauline Erpicum, Antoine Bouquegneau","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Membranous nephropathy (MN) is a frequent cause of nephrotic syndrome in adults. In recent years, many progresses have been made, both in terms of diagnosis and treatment. For diagnosis, the discovery of new antigens and diseases that may be associated with MN led to the establishment of a new classification of MNs. In terms of treatment, many progresses have also been made with increasingly effective management, particularly with the help of immunosuppressive drugs. However, there are still cases of MN refractory to conventional treatments. Numerous molecules are being developed to manage these refractory MNs. Among them, Obinutuzumab, a type II anti-CD20, allows a more profound depletion of B cells compared to Rituximab classically used in clinical routine. To illustrate this point, we present the case of a patient suffering from MN with anti-THSD7A antibodies in whom a clinical and biological improvement was observed with obinutuzumab, after failure of conventional therapies.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 9","pages":"547-553"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Is there still a place for progesterone receptor modulators in chronic use ?] [黄体酮受体调节剂是否仍可长期使用？］
Revue medicale de Liege Pub Date : 2024-09-01
Camille Ledon, Marie Mawet, Joëlle Desreux, Frédéric Kridelka, Nathalie Chabbert Buffet, Axelle Pintiaux
{"title":"[Is there still a place for progesterone receptor modulators in chronic use ?]","authors":"Camille Ledon, Marie Mawet, Joëlle Desreux, Frédéric Kridelka, Nathalie Chabbert Buffet, Axelle Pintiaux","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Selective progesterone receptor modulators (SPRMs) are synthetic steroid compounds that interact with the progesterone receptor, inducing various agonist, antagonist or mixed responses. First identified with mifepristone, they are now represented by ulipristal acetate (UPA), used for emergency contraception and uterine fibroids. Despite a few rare cases of severe hepatic insufficiency, SPRMs offer advantages in the treatment of uterine fibroids, reducing their volume without the hypoestrogenic side-effects of GnRH agonists, thus preserving patients' bone capital and quality of life. Despite temporary suspension of UPA administrated on a daily basis, research is exploring the potential of SPRMs in the management of endometriosis, adenomyosis and breast cancer. Despite certain concerns, SPRMs offer promising prospects in gynecological pathologies, opening up new therapeutic avenues to improve women's health and quality of life. This article describes the case of a patient with peritoneal leiomyomatosis for whom UPA significantly alleviated symptoms, reduced disease progression and improved quality of life, even allowing a pregnancy.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 9","pages":"554-558"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Bipolar disorders and multiple etiologies : a link with attachment disorders ?] [躁郁症和多重病因：与依恋障碍的联系？］
Revue medicale de Liege Pub Date : 2024-09-01
Jean-Benoît Désert, Jean-Marc Triffaux
{"title":"[Bipolar disorders and multiple etiologies : a link with attachment disorders ?]","authors":"Jean-Benoît Désert, Jean-Marc Triffaux","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Bipolar disorders (BD) bring together different forms of mood disorders, characterized by the occurrence of depressive, manic, hypomanic and/or mixed episodes. They are recognized as the seventh cause of disability per year of life among 15 to 44 year old people by the World Health Organization (WHO). It is therefore a frequently encountered pathology. On the etiological level, the avenues currently accepted concerning BD are multiple, yet they still remain at the hypothesis stage. Each of these avenues therefore has therapeutic potential. It therefore seems interesting to address the different major hypotheses existing to date on the etiological level. We will first describe BD from historical, nosological and epidemiological points of view. We will then develop the genetic etiological aspects and the neural aspects through brain imaging research. Finally, we will propose a reflection on the specific relational etiology and the avenues of research that result from it.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 9","pages":"598-604"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Therapeutic vignette : treatment of pulmonary embolism]. [治疗小故事：肺栓塞的治疗]。
Revue medicale de Liege Pub Date : 2024-09-01
Charline Longle, Sébastien Robinet, Bernard Lambermont
{"title":"[Therapeutic vignette : treatment of pulmonary embolism].","authors":"Charline Longle, Sébastien Robinet, Bernard Lambermont","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pulmonary embolism is a manifestation of venous thromboembolic disease, characterized by thrombus formation within the pulmonary arteries. Symptoms and clinical signs are numerous and nonspecific. Diagnosis relies on medical imaging (thoracic CT angiography or ventilation/perfusion scintigraphy). This disease requires prompt management to reduce morbidity and mortality. Treatment strategies include anticoagulation, systemic or catheter-guided thrombolysis, mechanical thrombectomy or surgery. In our institution, we have a multidisciplinary team, called PERT (Pulmonary Embolism Response Team), responsible for guiding the management of pulmonary embolism and for facilitating the access to those emerging endovascular techniques.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 9","pages":"613-618"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Advanced heart failure : what are the prospects for patients ?] [晚期心力衰竭：患者前景如何？］
Revue medicale de Liege Pub Date : 2024-09-01
Mai-Linh Nguyen-Trung, Arnaud Ancion, Sophie Ribeiro Coelho, Patrizio Lancellotti
{"title":"[Advanced heart failure : what are the prospects for patients ?]","authors":"Mai-Linh Nguyen-Trung, Arnaud Ancion, Sophie Ribeiro Coelho, Patrizio Lancellotti","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Heart failure (HF) is a major public health problem in our country and in most developed countries. Despite advances in the diagnosis and management of this condition and numerous therapeutic innovations, many patients with chronic HF progress inexorably to advanced HF, characterized by persistent symptoms despite maximal treatment. The prognosis for this condition is poor. However, mechanical circulatory support and heart transplantation, when considered in suitable candidates, are likely to improve the quality of life and life expectancy of these patients. In this context, timely referral to referral centers for the management of advanced HF is crucial. This article reminds the definition of advanced HF, details its specific management and specifies the criteria and timing for appropriate referral.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 9","pages":"559-566"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Anti-MOG antibody spectrum disease with annular-enhancing brain lesions in an immunocompetent child]. [一名免疫功能正常儿童的抗 MOG 抗体谱系病伴有环状增强的脑损伤]。
Revue medicale de Liege Pub Date : 2024-07-01
Zohour Lamtiri Laarif, Christophe Barrea
{"title":"[Anti-MOG antibody spectrum disease with annular-enhancing brain lesions in an immunocompetent child].","authors":"Zohour Lamtiri Laarif, Christophe Barrea","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a rare diagnosis of ring-enhanced brain lesions. We describe a case of a 4-year-old immunocompetent girl presenting with a subacute alteration of her general condition and a walking disorder a few weeks after her return from a trip to Bangladesh. The etiological work-up revealed ring-enhanced brain lesions on magnetic resonance imaging (MRI). A wide range of etiologies, including infectious, tumoral and inflammatory causes, were considered. Given the clinical and radiological suspicion of neurocysticerosis, the patient was initially treated with corticosteroids and various infectious serologies were carried out, with negative results. Following a rapidly favourable clinical course on corticosteroids alone, further biological investigations revealed the presence of anti-MOG antibodies in both serum and cerebrospinal fluid, suggesting MOGAD (myelin oligodendrocyte glycoprotein antibody-associated disease). This case report highlights the complexity of diagnosing ring-enhanced brain lesions. It also draws attention to MOGAD in immunocompetent patients as a rare but possible etiology, to be systematically investigated in the presence of this type of lesion. Indeed, consideration of inflammatory and autoimmune causes is crucial for accurate diagnosis, enabling earlier targeted treatment.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 7-8","pages":"497-502"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Upper gastro-intestinal tumour stenosis treated by a new endoscopic approach]. [采用新的内窥镜方法治疗上消化道肿瘤狭窄]。
Revue medicale de Liege Pub Date : 2024-07-01
Thanh-Hien Trieu, Patrick Yengue, Hélène Vandenbulcke, Maxence Lefebvre
{"title":"[Upper gastro-intestinal tumour stenosis treated by a new endoscopic approach].","authors":"Thanh-Hien Trieu, Patrick Yengue, Hélène Vandenbulcke, Maxence Lefebvre","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Gastric outlet obstruction (GOO) is a mechanical obstruction of the distal stomach or proximal duodenum. Surgical gastro-jejunostomy and self-expanding metal duodenal stents were the conventional treatments for GOO. In recent years, a new treatment option emerged using echo-guided endoscopic gastroenterostomy (EUS-GE). It appears to be a safe and effective technique with a clinical success rate of 85-90 % and a side effect rate of less than 18 %. Compared to metal duodenal prostheses, the risk of recurrence of GOO and of re-intervention is lower with EUS-GE. The rate of side effects also appears to be lower than with the surgical technique, with a shorter length of hospital stay. Randomised studies comparing these different techniques are still needed to determine a new treatment algorithm for GOO. We report a case of successful EUS-GE performed at our institution.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 7-8","pages":"538-542"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Post-traumatic stroke due to fat embolism]. [脂肪栓塞导致的创伤后中风]。
Revue medicale de Liege Pub Date : 2024-07-01
Marion Paquay, Pierre Goffin, Michelle Yerna, Pascal Marchetti
{"title":"[Post-traumatic stroke due to fat embolism].","authors":"Marion Paquay, Pierre Goffin, Michelle Yerna, Pascal Marchetti","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fat embolism syndrome mainly occurs following trauma to the long bones or pelvis. Non-traumatic causes are rarer. Its incidence varies greatly and depends on the number of fractures involved. Two physiopathological theories, one mechanical and the other biochemical, attempt to explain this still poorly understood phenomenon. The complete form of the syndrome results in a combination of pulmonary involvement, neurological disorders and a petechial rash. Given the polymorphism of signs and symptoms, Fat embolism syndrome remains a diagnosis of exclusion. Regarding treatment, the therapeutic strategy combines treatment of the causative process with conservative measures.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 7-8","pages":"507-510"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Wernicke encephalopathy : a neuro-ophthalmological side effect of bariatric surgery]. [韦尼克脑病：减肥手术的神经眼科副作用]。
Revue medicale de Liege Pub Date : 2024-07-01
Solène Kairis, Cécile Andris, Jean-Marie Rakic
{"title":"[Wernicke encephalopathy : a neuro-ophthalmological side effect of bariatric surgery].","authors":"Solène Kairis, Cécile Andris, Jean-Marie Rakic","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Due to an increase in the worldwide prevalence of obesity and the efficiency of bariatric surgery, this procedure is more often performed. Besides its benefits, it has also disadvantages and may be the cause of nutritional deficiencies. Thiamin deficiency is particularly important to diagnose and to treat early as it can lead to major sequelae and even to death. Wernicke's encephalopathy is the most frequent presentation associating confusion, ataxia, ophtalmoplegia and nystagmus. The full triad is not usually observed, which may lead to sub-diagnosis of this affection. The diagnosis is clinical, biological and radiologic thanks to the brain MRI. Intravenous thiamin supplementation therapy must be administered as fast as possible in order to avoid long-term damages. In the ophthalmological field, the potential sequelae are ophthalmoplegia, nystagmus and optic neuropathy. Therapeutics for nystagmus are pharmacological, surgical and/or optical. We illustrate this condition with a case report of an 18-year-old man developing Wernicke's encephalopathy as early as six weeks after a sleeve gastrectomy.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 7-8","pages":"492-496"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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