References of "Krzesinski, Jean-Marie"
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See detailIntérêt des tigettes urinaires en médecine du travail
Krzesinski, Jean-Marie ULg

Learning material (2010)

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See detailAu plus bas au mieux?
Krzesinski, Jean-Marie ULg

Conference (2010, February 06)

Réunion éducative annuelle 2010 organisée par le GNFB. Sont passées en revue les principales nouveautés concernant l'hypertension artérielle,en tenant compte de la mise à jour des recommandations de la ... [more ▼]

Réunion éducative annuelle 2010 organisée par le GNFB. Sont passées en revue les principales nouveautés concernant l'hypertension artérielle,en tenant compte de la mise à jour des recommandations de la Société Européenne d'Hypertension parue en octobre 2009.L'hypertension est-elle rare chez l'enfant? Comment la diagnostiquer et la prendre en charge? Quelles sont les causes et les particularités de son traitement? A l'autre extrême, faut-il traiter l'hypertension de la personne âgée, voire très âgée et avec quel objectif? L'adage "the lower ... the better" est-il toujours d'actualité ou faut-il craindre des tensions artérielles trop basses? La courbe en J existe-t-elle et faut-il en tenir compte? Quels sont les progrès récents dans la thérapeutique? Est-il logique d'initier le traitement par une association de 2 molécules chez certains patients? Certaines associations sont-elles préférables à d'autres? Que va nous apporter l'inhibition directe de la rénine? Doit-on s'orienter vers des thérapeutiques non médicamenteuses pour juguler certains cas d'hypertension réfractaire? Enfin, que penser des mesures ambulatoires de PA mais aussi de la rigidité artérielles proposés en première ligne, dès aujourd'hui pour les unes, demain pour les autres. Ces techniques sont-elles suffisamment validées pour être intégrées à notre pratique clinique? Quelle est leur valeur ajoutée pour le patient individuel? Les appareils fournis sont-ils tous fiables? Et la télémétrie? Telles sont quelques-unes des questions auxquelles cette réunion s'efforcera de répondre, tout en laissant une large place à l'interactivité, au partage de nos expériences respectives et aux questions posées. [less ▲]

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See detailLe syndrome cardio-rénal
Krzesinski, Jean-Marie ULg

Conference (2010, January 26)

L’insuffisance cardiaque (IC) et celle frappant les reins (IR) constituent deux pathologies au sommet d’un iceberg, cachant un grand nombre de candidats à ces complications redoutables. Souvent, trois ... [more ▼]

L’insuffisance cardiaque (IC) et celle frappant les reins (IR) constituent deux pathologies au sommet d’un iceberg, cachant un grand nombre de candidats à ces complications redoutables. Souvent, trois facteurs de risque sont retrouvés très précocement dans l’histoire de ces patients, à savoir l’hypertension artérielle, le diabète sucré et le vieillissement. [less ▲]

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See detailL'automesure de la pression artérielle
Saint-Remy, Annie ULg; Krzesinski, Jean-Marie ULg

Scientific conference (2010, January 12)

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See detailQuelle quantité minimale de tissu rénal nécessaire?
Krzesinski, Jean-Marie ULg

Conference (2010, January 11)

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See detailTélémédecine en Néphrologie
Krzesinski, Jean-Marie ULg

Conference (2010, January 05)

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See detailDeterminants of blood pressure control in hypertensive patients seen in third referral centers
Persu, Alexandre; Ngueta, G.; Krzesinski, Jean-Marie ULg et al

in Acta Clinica Belgica (2010, January 02), 65(1), 68

This work was designed to look for the main characteristics of hypertensive patients seen in Academic Centers from Belgium, with special emphasis on factors influencing blood pressure (BP) control.

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See detailEtude de la pression artérielle, rigidité artérielle et neuropathie autonome cardiovasculaire chez les patients diabétiques de type 1
Philips, Jean-Christophe ULg; Xhignesse, Patricia ULg; Marchand, Monique ULg et al

in Vaisseaux, Coeur, Poumons (2010), 15(3), 70-73

Nous avons récemment eu l'honneur de recevoir l'Hypertension Young Investigator Award 2009 adressé par le Comité belge de Lutte contre l'Hypertension et soutenu par la fondation Astra Zeneca. Notre projet ... [more ▼]

Nous avons récemment eu l'honneur de recevoir l'Hypertension Young Investigator Award 2009 adressé par le Comité belge de Lutte contre l'Hypertension et soutenu par la fondation Astra Zeneca. Notre projet propose d'étudier différents indices cardiovasculaires au sein d'une population constituée de patients diabétiques de type 1. L'étude de la pression artérielle, estimée par différentes méthodes, ainsi que l'estimation de la rigidité artérielle chez ces patients pourraient être utiles afin d'apprécier le statut cardiovasculaire chez ces patients à haut risque. Notre service possède une certaine expérience dans la recherche et l'estimation de la neuropathie autonome cardiovasculaire (NAC) chez les patients diabétiques de type 1. Cette complication du diabète est associée à une morbi-mortalité d'origine cardiovasculaire accrue. Nous allons proposer une batterie de tests classiquement effectués dans le cadre de la recherche d'une NAC (en utilisant la technique du Finapress°). Ceux-ci seront combinés à d'autres explorations réalisées par nos confrères néphrologues (mesure ambulatoire de 24 heures de la pression artéielle ou MAPA et Sphygmocor°). Tous ces examens ont l'avantage d'être non-invasifs et peuvent être réalisés en routine clinique. Le recrutement de cette étude devrait permettre d'inclure une soixantaine de patients diabétiques de type 1 âgés de 20 à 50 ans et dont la durée de diabète varie entre 10 et 30 années. Cette population sera comparée à une cohorte de sujet sains apariés pour l'âge, l'indice de masse corporelle et le sexe. Plusieurs mesures sont effectuées et certains indices pourront être calculés après la réalisation des différents examens. Une comparaison entre les deux cohortes (diabétiques versus non-diabétiques) sera effectuée. L'évolution de certains paramètres au sein de la population diabétique sera aussi analysée (en fonction de l'âge et la durée du diabète par exemple). [less ▲]

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See detailAre the complications of arteriovenous fistulas associated with an abnormal Ankle-Brachial Index in hemodialysis patients?
Xhignesse, Patricia ULg; Saint-Remy, Annie ULg; Dubois, Bernard ULg et al

in Acta Clinica Belgica (2010), 65(1), 65

The peripheral artery disease is frequent among patients undergoing hemodialysis much more than in the general population. The ankle-brachial index (AB!) is a potent tool to screen this pathology. We ... [more ▼]

The peripheral artery disease is frequent among patients undergoing hemodialysis much more than in the general population. The ankle-brachial index (AB!) is a potent tool to screen this pathology. We analysed the relationship between ABI abnormal values and arteriovenous fistulas (AVF) complications such as stenosis and thrombosis among chronically hemodialysis pat ients (HD). [less ▲]

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See detailMDRD or CKD-EPI study equations for estimating prevalence of stage 3 CKD in epidemiological studies: which difference? Is this difference relevant?
Delanaye, Pierre ULg; Cavalier, Etienne ULg; Mariat, C. et al

in BMC Nephrology (2010), 11(8),

Background: Prevalence of stage 3 chronic kidney disease (CKD) is increasing according to the NHANES study. Prevalence has been calculated using the MDRD study equation for estimating glomerular ... [more ▼]

Background: Prevalence of stage 3 chronic kidney disease (CKD) is increasing according to the NHANES study. Prevalence has been calculated using the MDRD study equation for estimating glomerular filtration rate (GFR). Recently, a new estimator based on creatinine, the CKD-EPI equation, has been proposed which is presumed to better perform in normal GFR ranges. The aim of the study was to measure the difference in prevalence of stage 3 CKD in a population using either the MDRD or the CKD-EPI study equations. Methods: CKDscreening is organized in the Province of Liège, Belgium. On a voluntary basis, people aged between 45 and 75 years are invited to be screened. GFR is estimated by the MDRD study equation and by the "new" CKD-EPI equations. Results: The population screened consisted in 1992 people (47% of men). Mean serum creatinine was 0.86 ± 0.20 mg/dl. The prevalence of stage 3 CKD in this population using the MDRD or the CKD-EPI equations was 11.04 and 7.98%, respectively. The prevalence of stage 3 CKD is significantly higher with the MDRD study equation (p <0,0012). Conclusions: Prevalence of stage 3 CKDvaries strongly following the method used for estimating GFR, MDRD or CKDEPI study equations. Such discrepancies are of importance and must be confirmed and explained by additional studies using GFR measured with a reference method. [less ▲]

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See detailReference values of central blood pressure and pulse wave velocity in relation with 24 hours ambulatory blood pressure monitoring in Belgian healthy young subjects
Saint-Remy, Annie ULg; Krzesinski, Jean-Marie ULg

in Acta Clinica Belgica (2010), 65-1

The present study aimed to define reference values of central blood pressure (cBP) and Pulse Wave Velocity (PWV) together with 24H ABPM in healthy normotensive young adults before starring a follow-up of ... [more ▼]

The present study aimed to define reference values of central blood pressure (cBP) and Pulse Wave Velocity (PWV) together with 24H ABPM in healthy normotensive young adults before starring a follow-up of their CV profile modifications over time. [less ▲]

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See detailAre ACE-inhibitors or ARB's still needed for cardiovascular prevention in high risk patients? Insights from PRoFESS and TRANSCEND
Van Mieghem, W.; Billiouw, J.-M.; Brohet, C. et al

in Acta Clinica Belgica (2010), 65-2

The HOPE and EUROPA clinical studies have shown that treatment with the angiotensin-converting enzyme (ACE) inhibitors, ramipril and perindopril, may reduce the occurence of major cardiovascular events in ... [more ▼]

The HOPE and EUROPA clinical studies have shown that treatment with the angiotensin-converting enzyme (ACE) inhibitors, ramipril and perindopril, may reduce the occurence of major cardiovascular events in patients with proven atherosclerotic disease. The recently published results of the PRoFESS and TRANSCEND trials completed the much needed information concerning the use of an angiotensin receptor blocker for patients at high risk of cardiovascular events. PRoFESS compared a therapy of telmisartan 80 mg daily with placebo in patients with a recent ischemic stroke. The difference in the primary outcome of first recurrent stroke was not statistically significant between telmisartan and placebo. The secondary outcome of major cardiovascular events showed a relative risk reduction (RRR) of 7% in favour of telmsartan. This tended to be significant (p=0.06) despite a rather short follow-up period of only 28 months. In TRANSCEND 5,926 patients at high risk for cardiovascular events were randomized to a treatment with telmisartan 80 mg daily or placebo for a mean duration of follow-up of 56 months. The primary composite outcome of cardiovascular death, myocardial infarction, stroke or hospitalization for heart failure showed a non-significant 8% RRR in favour of the telmisartan treated patients. The main secondary outcome of cardiovascular death and myocardial infarction or stroke as used in the HOPE trial showed a non-significant RRR of 13% in favour of telmisartan treated patients (p=0,068 adjusted for multiplicity of comparisons). In comparing the Kaplan-Meier curves for the endpoint of major cardiovascular events used in HOPE, EUROPA, TRANSCEND and PRoFESS, the trends are similar. Results of most of th recently published trials have been neutral. This could partly be explained by major improvements in the optimal background therapy of the patients included. Nevertheless, the results of PRoFESS and TRANSCEND do not contradict the results from previous studies with the ACE inhibitors ramipril and perindopril and the ARB telmisartan. [less ▲]

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See detailLa néphropathie tubulo-interstitielle aiguë: une cause rare d’insuffisance rénale aiguë
Bouquegneau, A.; Longton, J.; Bovy, Christophe ULg et al

in Revue Médicale de Liège (2010), 65(7-8), 459-463

We report the case of an acute renal failure due to an acute interstitial nephropathy (ATIN) induced by non steroidal anti-inflammatory drugs (NSAID). Even though this pathology is a rare cause of acute ... [more ▼]

We report the case of an acute renal failure due to an acute interstitial nephropathy (ATIN) induced by non steroidal anti-inflammatory drugs (NSAID). Even though this pathology is a rare cause of acute renal failure, it still requires special attention in view of the fact that it induces a high risk of acute morbidity but it also can evolve into chronic renal failure. Its differential diagnosis with other causes of acute renal failure becomes essential because of the different therapeutic care. In this article, we are going to briefly sum up the reasoning to adopt in order to diagnose an acute renal failure. [less ▲]

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See detailL’image du mois. Localisation rénale d’un lymphome
Dispas, Hélène; Delperdange, Mélanie; Meunier, Paul ULg et al

in Revue Médicale de Liège (2010), 65(7-8), 427-429

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See detailInertie thérapeutique en hypertension artérielle: pourquoi et comment combattre cette attitude?
Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2010), 65(5-6), 273-277

Therapeutic inertia, i.e. the absence of introduction of an antihypertensive treatment or on adjustment of its intensity by the medical doctor if the blood pressure is elevated or the goal not reached, is ... [more ▼]

Therapeutic inertia, i.e. the absence of introduction of an antihypertensive treatment or on adjustment of its intensity by the medical doctor if the blood pressure is elevated or the goal not reached, is frequent and does play a role in the insufficient control of blood presure in the hypertensive population. The responsibility of the medical doctor is high in this respect. A strict medical approach is required, step by step, to correct this lack of reaction. [less ▲]

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See detailL'observance thérapeutique en transplantation d'organe - L'exemple de la greffe de rein
Milicevic, Martina ULg; Grosch, Stéphanie ULg; Weekers, Laurent ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 386-390

A successful transplantation implies that immunosuppressive drugs will have to be taken during the whole patient’s life. Poor drug compliance is a multifactorial problem, that is particularly dangerous in ... [more ▼]

A successful transplantation implies that immunosuppressive drugs will have to be taken during the whole patient’s life. Poor drug compliance is a multifactorial problem, that is particularly dangerous in organ transplantation as it can lead to loss of graft function and return to dialysis treatment. The medical doctor must stimulate the patient’s adherence to the strict therapeutic drug protocol. The patient must also be reminded at each medical consultation of the importance of such rigorous drug intake. This bad (or non) compliance is particularly well demonstrated a long time after transplantation. The medical staff, all the health participants, but also the family members must continuously fight against non compliance, which is inherent to any chronic disease. [less ▲]

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See detailImportance de la mauvaise adhésion au traitement antihypertenseur
Krzesinski, Jean-Marie ULg; Krzesinski, François ULg

in Revue Médicale de Liège (2010), 65(5-6), 278-284

S’il est unanimement admis que le traitement de l’hypertension artérielle améliore le pronostic cardiovasculaire des patients qui en sont atteints, force est de constater que la moitié des patients ... [more ▼]

S’il est unanimement admis que le traitement de l’hypertension artérielle améliore le pronostic cardiovasculaire des patients qui en sont atteints, force est de constater que la moitié des patients traités n’ont pas leur pression artérielle normalisée. Un des facteurs responsables de ce relatif échec est la mauvaise adhésion au traitement (non médicamenteux et pharmacologique). Ce problème d’observance est multifactoriel. Interviennent le patient, sa maladie, son traitement et l’environnement thérapeutique où la relation médecin-malade joue un grand rôle. Pour améliorer l’observance, comme d’ailleurs la persistance du traitement, il faut d’abord y penser. Le dialogue avec le patient sur l’observance doit être mené à chaque consultation. Une excellente relation médecin-patient, une éducation sur l’hypertension, ses risques et les moyens d’éviter les complications, le choix de schémas de traitement bien tolérés, simplifiés et introduits progressivement, la recherche et la limitation des effets secondaires générés, le partenariat de la famille et du pharmacien dans la prise en charge, la stimulation de l’automesure de la pression artérielle par le patient sont autant de pistes importantes pour améliorer ce paramètre. Ceci permettrait, à coup sûr, de réduire les complications cardiovasculaires liées à l’hypertension et le coût pour la société. [less ▲]

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See detailReference values of central blood pressure and pulse wave velocity in relations with 24 hours ambulatory blood pressure monitoring in Belgian normotensive young subjects
Saint-Remy, Annie ULg; Krzesinski, Jean-Marie ULg

in Journal of Hypertension (2010), 28

The present study aimed to define reference values of central blood pressure (cBP) and Pulse Wave Velocity (PWV) together with 24H APPM in healththy normotensive young adults before starting a follow-up ... [more ▼]

The present study aimed to define reference values of central blood pressure (cBP) and Pulse Wave Velocity (PWV) together with 24H APPM in healththy normotensive young adults before starting a follow-up of their CV profile modifications over time. [less ▲]

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See detailLa vignette thérapeutiqu de l'étudiant Diagnostic différentiel étiologique des oedmes
Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2010), 65(11), 655-661

Oedema is a frequent disorder and the easily detectable consequence of an increase of fluid located in the interstitial tissue. It could be localized or generalized and related either to a primary ... [more ▼]

Oedema is a frequent disorder and the easily detectable consequence of an increase of fluid located in the interstitial tissue. It could be localized or generalized and related either to a primary disturbance of hemodynamics at the capillary level, due to a modification of the Starling’s law components with secondary water and saline retention, or to a primary retention of salt and water linked to a kidney abnormality. Generalized forms are pitting oedema, most often painless, white, bilateral and symmetric, distributed at the lower part of the body (localisation according to the gravitation law). They are different in their characteristics from localized oedema or lymphoedema which are tough. We propose a diagnostic approach based on medical history, clinical examination which allows a confident medical diagnosis and so an adapted therapy. [less ▲]

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