[First report in the Liege province (Belgium) of a concomitant aortic and mitral valve surgery via a minimally invasive right latero-thoracic approach]. / Double chirurgie mitrale et aortique par abord mini-invasif latéral thoracique droit : à propos d'une première liégeoise.

Compared to median sternotomy, the potential benefits of minimally invasive single aortic or mitral valve surgery include reduction of blood loss, lower morbidity, and shorter intensive care unit and hospital length of stay. However, there are few reports regarding concomitant aortic and mitral valves minimally invasive surgery via mini-thoracotomy. To the authors knowledge, this is the first report in the Liege area, of a successful minimally invasive right latero-thoracic approach for aortic and mitral valve surgery in a 78-year old woman who presented severe and symptomatic aortic stenosis and mitral insufficiency. In addition to the description of the surgical approach, the authors will summarize the current literature on this approach, as well as the clinical evolution of the patient.

La chirurgie valvulaire isolée, aortique ou mitrale par voie mini-invasive offre de nombreux avantages par rapport à la sternotomie médiane en termes de réduction des pertes sanguines, de diminution de la morbidité et de réduction des durées de séjour aux soins intensifs et hospitalier global. Toutefois, il existe très peu de données dans la littérature sur la chirurgie combinée mitrale et aortique par mini-thoracotomie. à notre connaissance, nous présentons le premier cas de double chirurgie mitrale et aortique réalisée avec succès par abord latéral thoracique droit dans la région liégeoise chez une patiente de 78 ans qui présentait une sténose aortique et une insuffisance mitrale sévères et symptomatiques. En plus d'une description de notre technique chirurgicale, nous résumerons les grandes séries cliniques publiées dans la littérature sur le sujet, ainsi que l'évolution clinique de notre patiente.

[Multidisciplinary management of a giant hepatic hydatidosis]. / Prise en charge multidisciplinaire d'une volumineuse hydatidose hépatique.

Cystic echinococcosis or hydatidosis, is a zoonosis caused by larval stages of Echinococcus granulosus that can be encountered in Belgium in patients originating from endemic countries. The liver is the most commonly affected organ. In this paper, the authors describe the multidisciplinary management of this pathology based on the clinical case of a patient suffering from a 28 cm cystic echinococcosis treated by combination of albendazole and liver resection. Several treatment options are described in the literature although there is currently no clear consensus on the management of this condition.

L'échinococcose cystique, appelée aussi hydatidose, est une zoonose causée par le développement chez l'homme de la larve d'un ténia échinocoque de type Echinococcus granulosus. Il s'agit d'une pathologie cosmopolite qui peut être rencontrée en Belgique chez des patients originaires de pays endémiques et qui atteint, le plus souvent, le foie. Dans cet article, les auteurs discutent la prise en charge multidisciplinaire de cette pathologie en partant du cas d'un patient souffrant d'un kyste échinococcique hépatique de 28 cm traité par albendazole et résection hépatique. Plusieurs options de traitement de l'échinococcose cystique sont décrites dans la littérature bien qu'il n'existe pas, à l'heure actuelle, de consensus clair concernant la prise en charge de cette pathologie.

A nephrotic syndrome of tropical origin: case report and short review of the aetiology.

We present a case of nephrotic syndrome in a 38-year-old man of Ivorian origin. In the search of the cause of his illness an infection with Plasmodium malariae (P. malariae) was diagnosed by serology and by microscopy of a Giemsa thin blood smear which revealed rare gametocytes of P. malariae. Proteinuria significantly diminished within three months after antimalarial treatment. Antibodies against Schistosoma were detected as well. Examination of kidney biopsy revealed a discrete mesangioproliferative glomerulonephritis. This case highlights that a thorough history-taking may be essential and that infectious diseases should be included in the differential diagnostic thinking process when a nephrotic syndrome is diagnosed.

Hepatitis E virus: an underdiagnosed cause of chronic hepatitis in renal transplant recipients.

Hepatitis E virus (HEV) infection can evolve to chronic hepatitis in immunocompromised patients leading to rapidly progressive cirrhosis. Proper diagnosis is therefore important, as reducing immunosuppressive therapy can allow clearance of the virus. We report a case of chronic HEV infection in a renal transplant recipient that went undiagnosed for many years, discuss the therapeutic options, and review the current available literature.

Ethanol production from AFEX-treated forages and agricultural residues.

Lignocellulosic materials derived from forages, namely timothy grass, alfalfa, reed canary grass, and agricultural residues, such as corn stalks and barley straw, were pretreated using ammonia fiber explosion (AFEX) process. The pretreated materials were directly saccharified by cellulolytic enzymes. Sixty to 80% of theoretical yield of sugars were obtained from the pretreated biomasses. Subsequent ethanolic fermentation of the hydrolysates by Pachysolen tannophilus ATCC 32691 resulted in 40-60% of theoretical yield after 24 h, based on the sugars present in the hydrolysates. The uptake of sugars was not complete, indicating a possible inhibitory effect on P. tannophilus during the fermentation of these substrates.