Sofosbuvir, velpatasvir and voxilaprevir: a new triple combination for hepatitis C virus treatment. One pill fits all? Is it the end of the road?

The advent of oral direct-acting antiviral agents (DAAs) has dramatically improved the hepatitis C virus (HCV) treatment landscape in the last 4 years, providing cure rates over 95% with a shorter duration of treatment and a very good safety profile. This has enabled access to treatment in nearly all HCV infected patients. The launch of two pangenotypic fixed dose combinations (FDCs) in 2017 made a new step forward in HCV treatment by slightly increasing efficacy and more importantly allowing the treatment of patients without HCV genotyping, and in some cases without fibrosis assessment. However, retreatment of the few DAA failure patients was still an issue for some HCV genotypes. The launch of the triple regimen FDC, sofosbuvir/velpatasvir/voxilaprevir, solves this issue by providing a cure rate over 96% regardless of HCV genotype. In this review, we describe the current HCV treatment landscape and focus on the development of this triple FDC either in treatment-naïve or treatment-experienced patients with previous failure on a DAA regimen

Prevalence of cardiovascular manifestations in patients with hypermobile Ehlers-Danlos syndrome at the University of Miami

Cardiovascular system involvements have been frequently reported in hypermobile Ehlers-Danlos Syndrome (hEDS). Mitral valve prolapse (MVP) and aortic root dilatation are included in the 2017 international classification criteria for hEDS. Different studies have found conflicting results regarding the significance of cardiac involvement in hEDS patients. We conducted a retrospective review of cardiac involvement in patients diagnosed with hEDS based on the 2017 International diagnostic criteria to provide further evidence toward more defined and reliable diagnostic criteria and recommended cardiac surveillance. A total of 75 hEDS patients with at least one diagnostic cardiac evaluation were included in the study. The most common reported cardiovascular complaints were lightheadedness (80.6%), followed by palpitations (77.6%), fainting (44.8%), and chest pain (32.8%). Of the 62 echocardiogram reports, 57 (91.9%) showed trace/trivial to mild valvular insufficiency, and 13 (21%) had additional abnormalities such as grade I diastolic dysfunction, mild aortic sclerosis, and trivial or small pericardial effusion. Of the 60 electrocardiograms (ECG) reports, 39 (65%) were normal, and 21 (35%) reported minor abnormalities or normal variants. Even though many hEDS patients in our cohort experienced cardiac symptoms, the presence of a significant cardiac abnormality was very low

Multi-criterion, automated, high-performance, rapid tool for assessing mucosal visualization quality of still images in small bowel capsule endoscopy

International audienc

Développement et validation d’un algorithme électronique d'évaluation de l'abondance des bulles en vidéocapsule endoscopique du grêle

Prix de la meilleure communication section endoscopieInternational audienceLa vidéocapsule endoscopique (VCE) a révolutionné les modalités d'exploration de l’intestin grêle. La préparation à la VCE consiste en un régime liquide et une purge orale variant entre 1 à 4 litres de poly-éthylène-glycol (PEG) la veille de l’ingestion de la capsule. La totalité de la muqueuse intestinale est visualisée dans plus de 80% des cas. Cependant, au cours de la réalisation d’une VCE, plusieurs facteurs, notamment l’air, la présence de bile et de bulles, un temps de transit trop long et la présence de résidus alimentaires dans l’intestin grêle, influencent la qualité de la visualisation de la muqueuse, le délai d’arrivée au caecum, et donc potentiellement le rendement diagnostique. Plusieurs études ont évalué l'intérêt de l'administration orale d'un agent anti-bulles, le siméthicone, lors de la préparation qui semble améliorer la visualisation de la muqueuse de l’intestin grêle en réduisant la présence de bulles intra luminales couverte de bulles. L’objectif principal de notre étude était de développer et valider un algorithme semi-quantitatif électronique automatisé évaluant l’abondance des bulles couvrant la surface d'images fixes de VCE du grêle

Development and Validation of a Highly Sensitive and Specific Automated Algorithm to Evaluate the Abundance of Bubbles in Small Bowel Capsule Endoscopy

International audienc