{"title":"[Neonatal screening for cystic fibrosis in the Liège region : first evaluation after 4 years].","authors":"Matthieu Thimmesch, François Boemer, Géraldine Luis, Cécile Libioulle, Vinciane Dideberg, Hedwige Boboli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Since January 2020, neonatal screening for cystic fibrosis (CF-NBS) has been implemented in the Wallonia-Brussels Federation. It's based on the immunoreactive trypsin (IRT1) assay between day 2 and day 4, associated with a 12 CFTR pathogenic variants analysis and with an IRT control on day 21. The aim of this study is to evaluate the performance of our CF-NBS in Liège according to the quality criteria defined by the European Cystic Fibrosis Society's working group on neonatal screening. After four years, 58.762 newborns have been screened. Nineteen children with cystic fibrosis were diagnosed : 14 by NBS, 3 following a meconium ileus, 1 by family history and 1 false negative diagnosed on clinical basis. Furthermore, 39 healthy carriers and 2 uncertain diagnosis (CFSPID) were identified. The sensitivity of CF NBS is 93,3 % (target ≥ 95 %), the positive predictive value (PPV) 17,7 % (target ≥ 30 %). Increasing the TIR1 threshold by 0,1 in 0,1 from P99 to P99,5, would be associated with a lower sensitivity and a non-significant improvement of PPV. A national assessment of CF NBS needs to be carried out.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 10","pages":"664-669"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484645","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}
{"title":"[Cannabis and medicine students : who, how and why ?]","authors":"Anaïs Cornez, Pierre Cole, Samuel Leistedt","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cannabis is the third most commonly used substance by students. The aim of this study is to describe cannabis use among medical students and understand their motivations. It seeks to establish the link between cannabis and higher education, especially in medicine.</p><p><strong>Materials and methods: </strong>202 students from the UMons and ULB universities (Belgium) took part in the study. They completed an anonymous online questionnaire. Their answers were cleaned before analysis.</p><p><strong>Results: </strong>52% of the students declared they had never used cannabis. The time of first use was most often secondary school. Evenings out with friends and improvement falling asleep were the two most common reasons for using cannabis. The participants attributed little benefit to cannabis use in terms of managing their studies. Medical studies may have an impact on cannabis use.</p><p><strong>Conclusion: </strong>The prevalence of cannabis use appears to be higher among medical students than in the general population, yet few measures are in place to raise their awareness. This study aims to open up the debate on cannabis use among students, especially in the medical school.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 10","pages":"639-644"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484640","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}
{"title":"[Health is a serious matter : so let's play ! Part 1 : an overview of «serious gaming» in physical medicine and rehabilitation].","authors":"Philippe Coucke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The lack of physical activity is widespread among our populations affecting all age groups from youngsters to older adults, heavily impacting health in general (physical as well as mental health). The main objective of serious gaming is not simply providing entertainment and fun. It aims at achieving specific health-related goals in an efficient and pleasant way. This article will take stock of the general interest of this approach in physical medicine and rehabilitation, while trying to illustrate the barriers and limits. Even if the concept seems effective, more efforts are required based on scientific sound and rational approaches, using standardized methods, to answer multiple existing and persistent questions.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 10","pages":"670-675"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484642","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}
{"title":"[At the heart of central venous lines : between complications and solutions].","authors":"Alexandre Karoui, Xavier Bertrand","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The placement of central venous catheters is a common procedure in various hospital settings, such as emergency departments, intensive care units, and operating rooms. These catheters are essential for monitoring hemodynamic variables, administering vasoactive amines, and providing nutritional support, crucial functions that cannot be performed by peripheral catheters. However, this invasive procedure is associated with a significant complication rate, exceeding 15 %, which may be sometimes severe, even fatal. In this article, we will present the case of a 34-year-old patient who experienced a mechanical complication following the placement of a central venous line in the right jugular vein. We will discuss the various complications specific to central lines and possible solutions to reduce the risk.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 10","pages":"628-632"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484639","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}
André Scheen, Pierre Delanaye, Patrizio Lancellotti
{"title":"[New outcome studies with injectable semaglutide in different at risk populations].","authors":"André Scheen, Pierre Delanaye, Patrizio Lancellotti","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Injectable semaglutide at a dose of 1 mg once weekly has been shown to be the most efficacious glucagon-like peptide-1 receptor agonist when considering both the improvement in blood glucose control and the reduction in body weight in patients with type 2 diabetes (T2D). After the SUSTAIN-6 study, published in 2016, which demonstrated not only the good safety but also already the cardiovascular (CV) efficacy of semaglutide in patients with T2D and high CV risk, several large placebo-controlled randomised trials have confirmed improved prognosis with semaglutide in different at risk populations : patients with T2D and chronic kidney disease (FLOW trial), subjects with obesity and heart failure with preserved ejection fraction, with or without T2D (STEP-HFpEF trial) and people with overweight or obesity (but without T2D) and a confirmed atheromatous cardiovascular disease (SELECT trial). Studies performed in patients with obesity used a higher dose of 2.4 mg/week. These positive results, based upon major clinically relevant outcomes, extend the therapeutic possibilities with semaglutide among at high risk patients of cardiovascular and/or renal diseases.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 10","pages":"676-682"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484646","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}
Sabrina Chevalier, Didier Moens, Olivier Pirotte, Alexandre Ghuysen, Samuel Stipulante
{"title":"[Optimizing prehospital intervention times for extrahospital emergencies : experience of a Belgian air emergency service].","authors":"Sabrina Chevalier, Didier Moens, Olivier Pirotte, Alexandre Ghuysen, Samuel Stipulante","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>the efficacy of helicopter medical transport in terms of prehospital time savings, compared to ground transport, remains a topic of debate in the management of extrahospital emergencies. This study aims to assess the temporal impact of using the air emergency service in Belgian rural context.</p><p><strong>Methods: </strong>We retrospectively analyzed the interventions of the Bra-sur-Lienne emergency medical helicopter service from 2015 to 2023. The study included five target conditions: acute myocardial infarction, traumatic brain injury, coma, cardiopulmonary arrest, and severe polytrauma. Prehospital intervention times, actual for helicopter and simulated for ground transport, were compared using the Wilcoxon rank-sum test.</p><p><strong>Results: </strong>The study encompassed 255 myocardial infarction cases, 404 traumatic brain injuries, 129 comas, 297 cardiopulmonary arrests, and 680 severe polytraumas. The results demonstrate a significant prehospital time saving with helicopter transport (p < 0.0001), highlighting its effectiveness in reducing intervention delay.</p><p><strong>Conclusion: </strong>Helicopter transport emerges as a preferred option to optimize prehospital intervention times in Belgian rural areas, particularly for critical pathologies over long distances. Its deployment should be considered an essential link in the chain of survival in extrahospital emergencies.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 10","pages":"633-638"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484647","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}
Youness Khaoulani, Margaux Mestdag, Simon Lacroix, Éric Deflandre
{"title":"[Carotid endarterectomy : General versus local anesthesia, which is the best ?]","authors":"Youness Khaoulani, Margaux Mestdag, Simon Lacroix, Éric Deflandre","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article explores two anesthetic strategies for carotid endarterectomy: cervical plexus block and general anesthesia. Regional anesthesia is increasingly favoured for its ability to enable continuous neurological monitoring and maintain hemodynamic stability. General anesthesia remains essential for certain patients, offering comfort, optimal control of physiological conditions, and extended cerebral protection. We also discuss pathophysiological considerations, crucial elements for understanding patient responses to these techniques. The development of ultrasound-guided cervical plexus block emerges as a promising alternative to general anesthesia, enhancing the options available for safer and more effective anesthetic management. However, an individualized approach remains crucial to optimize clinical outcomes. This approach is part of the concept of «personalized medicine», in which contemporary anesthesia must necessarily be adapted to the specific needs of each individual.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 10","pages":"645-651"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484641","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}
{"title":"[Race against sudden death : the benefits of pre-participation cardiovascular screening].","authors":"Camille Mathieu, Julien Tridetti, Cynthia Barbraud, Liliana Stefan, Jean-Manuel Herzet, Pierre Troisfontaines","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sudden death (SD) in young, apparently healthy athletes under 35 is an underestimated public health problem in Belgium. This is dramatically illustrated by the case of a 28-year old ultra-trail runner who suffered cardiac arrest during training, revealing an unrecognized cardiomyopathy. This highlights the importance of pre-participation cardiovascular screening in identifying such hidden conditions. The variety of causes of SD, mainly of cardiac origin, underlines the complexity of screening and the need to tailor it to the specific risks of each individual. The central issue in screening is the relevance of the resting 12-lead electrocardiogram (ECG). While some countries have adopted it with positive results, others continue to debate its systematic inclusion. Sudden death affects not only professional athletes, but also amateurs, who are often less medically monitored. The aim of cardiovascular screening is twofold: to identify young people at risk, while not unnecessarily limiting access to sport for those with no cardiac pathology. The effectiveness of the ECG is well recognized, but the implementation of such systematic screening in Belgium must take into account certain practical aspects.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 9","pages":"567-574"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305225","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}
{"title":"[The computerized medical record. From lost illusions to the hope of renewal].","authors":"Philippe Coucke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although the principle of recording and transmitting patient data is not new, the computerized medical record used in today's practice of care still does not meet the needs. We can easily - and often rightly - cast shame on the designers of those medical records and on administrators of our care institutions, but we as caregivers do need to share responsibility. If we really intend to use multiple sources of data wisely, in order to increase global health status at the individual level or for a population, we need to understand clearly the multiple dimensions of data and therefore acquire a real data culture. The revival of the medical record, for too long a source of disillusionment and burnout, is within reach especially as technical solutions appear to automate and facilitate our work of recording data in the field.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 9","pages":"588-597"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305227","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}
{"title":"[Sodium depletion assessed by the urinary sodium/creatinine ratio in monitoring cystic fibrosis patients].","authors":"Matthieu Thimmesch, Olivier Pollé, Hedwige Boboli, Matthieu Boulay, Olivia Bauraind","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As a result of excessive salt loss, cystic fibrosis patients are at risk of dehydration, especially in hot weather. The urinary sodium/creatinine ratio is an easy and noninvasive tool for assessing whether dietary salt intake is adequate, whatever the patient's age. Recently, new reference values have been established, adapted to the patient's age. The objectives of this study are to investigate the impact of these new standards on the diagnosis of inadequate sodium intake and the variation in this ratio as a function of body mass index (BMI), outdoor temperature and the use of modulator therapy of CFTR protein. The present study included 40 patients and 335 urine samples. Adapting the urinary sodium/creatinine ratio with the new reference values reduced the number of patients with sodium deficiency by 11.8%. However, there were no significant differences in BMI, lung function or outdoor temperature between the sodium deficient and non-deficient groups. The CFTR modulator-treated group had a better mean urinary sodium/creatinine ratio compared with the group without modulators (p = 0.01), However, larger-scale studies are needed to provide a definitive answer to this question.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"79 9","pages":"575-580"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305226","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}