How to better improve the treatment and outcomes of HCV in psychiatric patients: review of a Belgian monocentric psychiatric center.

Introduction: Hepatitis C (HCV) is one of the major worldwide infections with 58 million infected persons in the world. HCV can lead to chronic liver disease, cirrhosis, and cancer. These past few years, clinical progress allowed a curative rate of 95% of the patients. There are still populations in which, treating the disease is more difficult, especially psychiatric patients, when substance abuse, psychiatric disorders are important risks factors for getting HCV. With the WHO organization establishing goals for clinical management and treatment of HCV, it is important to target where the difficulties lie in getting a better treatment program for those populations. Aim: Try to highlight the challenges of treating a certain group of patients compare to the general population. Method: This is a cross sectional monocentric study. 79 patients from a mental facility were included between 2012 and 2022. Inclusion criteria were: >18 years old, an active viral HCV infection. Results: 34.7% of patients with a positive PCR were treated with a significant difference between the closed psychiatric unit and the open one (66.5 vs 22.6%, p<.05). There was an 82.4% eradication rate (Sustained Viral Response at 3 months). There were significantly more schizophrenic disorders in the closed unit and significantly more alcohol abuse in the open one. Conclusion: Treatment of HCV in a psychiatric population is feasible with eradication rate equivalent at those in the general population. Patients with more severe mental illness are better treated in the configuration of a closed psychiatric unit.

Theoretical and experimental study of growth and remodeling in the developing heart.

A theoretical model is presented for growth and remodeling in the developing embryonic heart. The model is a thick-walled tube composed of two layers of orthotropic pseudoelastic material. The analysis includes stress and strain dependent volumetric growth, with changes in material properties specified to reflect the evolving structure of the heart wall. For use in model validation, experimental measurements of ventricular opening angles are reported for 3-4-day old chick embryos under control and pressure overload conditions. Owing to changes in residual stress in the overloaded heart, the opening angle decreased from 31 +/- 10 degrees to -8 +/- 12 degrees (mean +/- SD) within 12 h and then increased slightly. The opening angle at 12 h was significantly less than the control value. With an appropriate choice of parameters, the model yields reasonable agreement with these and other published opening angle data, as well as with temporal changes in lumen radius, wall thickness, epicardial strains, and pressure-volume curves during development before and after birth.

[Management of acute intestinal arterial ischemia]. / Conduite à tenir devant une ischémie artérielle intestinale aiguë.

Acute mesenteric ischemia is an infrequent abdominal emergency. The 90% mortality of this affection is related to a delayed diagnosis. The mesenteric ischemia and the mesenteric infarction are two different pathologic stages characterized by two different treatment and prognosis. Superior mesenteric artery embolism is the most frequent cause of mesenteric ischemia. According a difficult clinical diagnosis and the necessity of an early diagnosis we suggest an aggressive attitude. All the patients presenting risk factors and an abdominal pain must have a mesenteric angiography. The purpose of the angiography is diagnostic and therapeutic. The aim of surgery in case of mesenteric ischemia is to restore a normal vascularisation. In spite of this attitude the prognosis of this affection remain poor.