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See detailCephalees explosives, "en coup de tonnerre": faut-il s'inquieter?
DELVAUX, Valérie ULg; vandenheede, michel; Schoenen, Jean ULg

in Revue Médicale de Liège (2000), 55(10), 910914

"Thunderclap" headaches are explosive, extremely intense and sometimes associated with neurological signs or symptoms. As illustrated by the 3 case histories presented here, they are a heterogenous group ... [more ▼]

"Thunderclap" headaches are explosive, extremely intense and sometimes associated with neurological signs or symptoms. As illustrated by the 3 case histories presented here, they are a heterogenous group as far as etiology and prognosis are concerned. They may be symptomatic of an intracranial disorder (subarachnoid hemorrhage, cerebral venous thrombosis, pituitary apoplexia) or idiopathic without any known cause and with a benign, though occasionally recurring, course. They can be spontaneous or triggered by Valsalva maneuvers (cough, exertion, coitus, ...). In certain cases of so-called "idiopathic" thunderclap headache, diffuse, multifocal segmental and reversible vasospasm of cerebral arteries has been found on neuroimaging. As headache characteristics are similar in symptomatic and benign cases, angio-MRI is recommended when CT-scan and CSF examination are normal. [less ▲]

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See detailTatouages. Du rituel a la parure avec leurs complications
Paquet, Philippe ULg; Pierard, Gérald ULg; Nikkels, Arjen ULg et al

in Revue Médicale de Liège (2000), 55(9), 847-849

Tattoos are performed for distinct purposes which range from social rituals to aesthetic aims. They are permanent or transient according to the site of the pigments being located either in the dermis or ... [more ▼]

Tattoos are performed for distinct purposes which range from social rituals to aesthetic aims. They are permanent or transient according to the site of the pigments being located either in the dermis or in the stratum corneum, respectively. Tattoos may be responsible for allergic reactions, infections or psychological distress of the subject who requests to be relieved of it. [less ▲]

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See detailMelatonine. II. Actions physiologiques et therapeutiques
Bruls, E.; Crasson, Marion ULg; Van Reeth, O. et al

in Revue Médicale de Liège (2000), 55(9), 862-70

Melatonin is a hormone mainly secreted by the pineal gland during the dark phase of the light-dark cycle. The most known function of melatonin in mammals is to transmit information concerning light-dark ... [more ▼]

Melatonin is a hormone mainly secreted by the pineal gland during the dark phase of the light-dark cycle. The most known function of melatonin in mammals is to transmit information concerning light-dark cycles playing the role of an active neuroendocrine transducer of environmental information. Given this chronobiologic role of pineal melatonin, it seems to be useful in the management of shift work, jet lag and some sleep disorders. In vitro like in vivo melatonin seems to be effective as an antioxidant and oncostatic agent. Melatonin may provide protection against aging process, degenerative diseases, cancer and play a role also in sexual maturation, reproduction, immune function and psychiatric illness. The administration of melatonin in the jet-lag syndrome is well codified. Further clinical research is needed for a better understanding and definition of other indications, treatment regimens and safety of the hormone. The aim of this paper is to review the current knowledge on its clinical implications. [less ▲]

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See detailTraitement de la maladie de Crohn de l'adulte par anticorps anti-tumor necrosis factor-alpha (TNF alpha)
Belaiche, Jacques ULg; Louis, Edouard ULg

in Revue Médicale de Liège (2000), 55(9), 827-32

Crohn's disease (CD) is a chronic inflammatory disease of the bowel characterized by segmental transmural inflammation and granulomatous changes. TNF alpha is a member of a large family of proteins and ... [more ▼]

Crohn's disease (CD) is a chronic inflammatory disease of the bowel characterized by segmental transmural inflammation and granulomatous changes. TNF alpha is a member of a large family of proteins and receptors that are involved in immune regulation. It is a proinflammatory and immunoregulatory cytokine synthesized by monocytes, macrophages, and T cells. TNF alpha plays an early central role in the cytokine cascade of the inflammatory process. Recently, chimeric monoclonal antibodies that inhibits TNF alpha have been used in the treatment of Crohn's disease. Infliximab has been the most largely used antibody. It is commercialized in the USA and has recently obtained an European marketing approvement. Infliximab is indicated for the treatment of moderately to severely active CD in patients having an inadequate response to conventional therapy. Clinical trials have demonstrated efficacy when the agent is initiated as a 5 mg/kg single intravenous infusion. In patients with fistulizing CD, administration of 2 subsequent 5 mg/kg doses 2 and 6 weeks after the initial dose appears to be efficacious. Limited clinical data also suggest that infliximab retreatment regimen restores response and maintains remission rates. Infliximab appears to be well tolerated. To date, very little is known about the potential for long-term toxicity with infliximab therapy. [less ▲]

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See detailMelatonine. I. Physiologie de la secretion
Bruls, E.; Crasson, Marion ULg; Legros, Jean-Jacques ULg

in Revue Médicale de Liège (2000), 55(8), 785-92

Melatonin is a hormone mainly secreted by the pineal gland during the dark phase of the light-dark cycle. The best known function of melatonin in mammals is to transmit information concerning light-dark ... [more ▼]

Melatonin is a hormone mainly secreted by the pineal gland during the dark phase of the light-dark cycle. The best known function of melatonin in mammals is to transmit information concerning light-dark cycles playing the role of an active neuroendocrine transducer of environmental information. Although melatonin circadian rhythm is endogenous, based on 25 hour cycles, it is modulated by light-dark cycle. During the day, the light signal is sent to the pineal gland through a special neuronal pathway and inhibits melatonin secretion. During the night, the last neuron of this pathway which is coming from the cervical ganglion superior releases nonadrenalin in the interstitium. Nonadrenalin stimulates melatonin synthesis through cAMP accumulation. Some factors other than light can also influence melatonin levels. Electromagnetic fields, age, male sex, Cushing syndrome, hypogonadotrophic hypogonadism, alcoholism seem to be associated with lower melatonin secretion. Female sex, hypergonadotrophic hypogonadism, sport and fasting seem to be linked to higher melatonin secretion. Some pathologies and drugs can modulate some steps of the neuroanatomic pathway of melatonin synthesis. Stress has no effect. The influence of weight and height is still investigated. Once released, melatonin can act on different organs through specific receptors (retina, supra-chiasmatic nucleus, hypophysis, brain, blood vessels, digestive tract, ovaries). [less ▲]

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See detailLes modifications morphologiques bronchiques dans l'asthme
Cataldo, Didier ULg; Louis, Renaud ULg; Godon, A. et al

in Revue Médicale de Liège (2000), 55(7), 715-20

Asthma is an inflammatory disease of the airways clinically characterised by recurrent bronchial obstructions at least partially reversible. Recent epidemiologic data suggest that asthmatics have an ... [more ▼]

Asthma is an inflammatory disease of the airways clinically characterised by recurrent bronchial obstructions at least partially reversible. Recent epidemiologic data suggest that asthmatics have an increased rate of decrease of their expiratory volumes during life. This irreversible lung function impairment is associated with fundamental structural changes of the bronchial wall in terms of conjunctive tissue and smooth muscle composition. We describe these changes and explore the different mechanisms proposed to explain these structural modifications. We also review their consequences in terms of bronchial physiology and their potential influence on bronchial hyperresponsiveness. [less ▲]

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See detailHydroxyuree et infection par le VIH
Nkoghe, D.; Kola, L.; Leonard, Philippe ULg et al

in Revue Médicale de Liège (2000), 55(7), 721-4

Hydroxyurea is an anticancerous product, used recently in the treatment of HIV-1 infection thanks to its inhibitory action in viral replication, potentialization of the nucleosides activity (particularly ... [more ▼]

Hydroxyurea is an anticancerous product, used recently in the treatment of HIV-1 infection thanks to its inhibitory action in viral replication, potentialization of the nucleosides activity (particularly ddI or didanosine) and its cytostatic properties on CD4 and CD8 lymphocytes. Many studies showed its efficiency, as further drug, in initial regimen of a tritherapy (containing ddI) and salvage therapy. The dosage of 500 mg bid seems tolerated well by adults, and 20 mg/kg by children. Long-term tolerance remains unknown. With ddI, it could be proposed in developing countries. [less ▲]

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See detailIl y a 250 ans paraissait "l'Homme machine". La Mettrie (1709-1753). Les origines du materialisme medical
Limet, Raymond ULg

in Revue Médicale de Liège (2000), 55(7), 740-4

Some 250 years ago, the publication of "L'Homme machine" established the fact that human body and brain functioning was to be approached by human study just as like as physics or chemistry.

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See detailLe systeme IGF: synthese et donnees recentes
Winkler, Rose ULg; Pasleau, Françoise ULg; Boussif, N. et al

in Revue Médicale de Liège (2000), 55(7), 725-39

We are entitled to state that our knowledge about the IGF system has literally exploded in the last years. Having been considered for some time merely as trophic and mitogenic factors, the IGFs now appear ... [more ▼]

We are entitled to state that our knowledge about the IGF system has literally exploded in the last years. Having been considered for some time merely as trophic and mitogenic factors, the IGFs now appear as molecules essential for the differentiation of many cell types, and even more so, as powerful protective agents for the nervous and the cardiovascular systems. However, these properties so beneficial in normal physiological conditions, are subverted by the cancerous cells who use them to extend their life span and resist therapy. The IGFs did not live up to expectations in the treatment of diabetes; however, today their capacity to improve the condition of patients suffering from severe neurological, renal or muscle diseases is tested. The IGF system might also be targetted by the anticancer treatments. In the following paper we have briefly summarized our knowledge on the IGF system, and presented in more detail the recent data. [less ▲]

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See detailOrientations diagnostiques chez le voyageur au retour d'un pays exotique
Pierard, Gérald ULg

in Revue Médicale de Liège (2000), 55(6), 490-1

On a medical ground, a traveller returning from an exotic country may suffer from three main categories of diseases: fever, diarrhoea and unusual dermatosis. The present review is a synoptic aid at the ... [more ▼]

On a medical ground, a traveller returning from an exotic country may suffer from three main categories of diseases: fever, diarrhoea and unusual dermatosis. The present review is a synoptic aid at the diagnosis. [less ▲]

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See detailLa malaria: du diagnostic au traitement curatif
Delanaye, Pierre ULg; Nkoghe, D.; Demonty, Jean ULg

in Revue Médicale de Liège (2000), 55(6), 510-5

Malaria is a parasitic disease, with variable severity, provoked by the Plasmodium. It is present in tropical zones. The diagnosis is evoked by a fever occurring in a subject coming from a zone at risk ... [more ▼]

Malaria is a parasitic disease, with variable severity, provoked by the Plasmodium. It is present in tropical zones. The diagnosis is evoked by a fever occurring in a subject coming from a zone at risk, and is confirmed by microbiology. Considering the high prevalence of resistance to chloroquine, the treatment rests on quinine (or its derivatives) associated (or not) with an antibiotic. The severe forms of malaria, due to Plasmodium falciparum, are responsible for a high mortality rate. It requires urgent hospital management is required. Criteria defining this form deserve to be perfectly known. [less ▲]

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See detailStratégies de prévention contre la malaria
Delanaye, Pierre ULg; Nkoghe, Dieudonné; Demonty, Jean ULg

in Revue Médicale de Liège (2000), 55(6), 505-9

In the absence of an efficacious vaccine, malaria prophylaxis remains important for the traveller in endemic areas. In addition to classical measures to protect against malaria vectors, chemoprophylaxis ... [more ▼]

In the absence of an efficacious vaccine, malaria prophylaxis remains important for the traveller in endemic areas. In addition to classical measures to protect against malaria vectors, chemoprophylaxis should be selected according to the geographic area. Besides a chemoprophylaxis scheme for the traveller, prevention modalities in pregnant women and in the general population living in an endemic area will also be briefly described. [less ▲]

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See detailReactions indesirables au contact d'organismes marins
Letot, Bernard ULg; Kharfi, M.; Mandojana, R. et al

in Revue Médicale de Liège (2000), 55(6), 531-7

The contact of some marine organisms with the skin may prove to be traumatic and sometimes very dangerous. Some coelenterates, fishes, urchins, sea snakes, cephalopods, molluscs and other sea organisms ... [more ▼]

The contact of some marine organisms with the skin may prove to be traumatic and sometimes very dangerous. Some coelenterates, fishes, urchins, sea snakes, cephalopods, molluscs and other sea organisms are responsible for dermatological lesions, associated or not with toxic or allergic reactions exhibiting systemic effects. [less ▲]

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See detailConsensus clinique de l'approche raisonnee des troubles erectiles chez un patient cardio-vasculaire
Andrianne, Robert ULg; D'Orio, Vincenzo ULg

in Revue Médicale de Liège (2000), 55(5), 454-8

The most common physical risk factors for erectile dysfunction (ED) are atherosclerosis, heart disease, hypertension and diabetes. Since accessibility to easy and efficacy drug for ED therapy, GPs are ... [more ▼]

The most common physical risk factors for erectile dysfunction (ED) are atherosclerosis, heart disease, hypertension and diabetes. Since accessibility to easy and efficacy drug for ED therapy, GPs are increasingly at the front line in the management of ED and are often best-placed to discuss this problem with cardiovascular male patients. This consensus aims to provide practical advice on the management of ED in patients with diagnosed cardiovascular disease and also addresses the assessment of the cardiovascular risk in restoring sexual activity in these patients. A risk assessment algorithm has been drawn up to aid clinicians in deciding the level of cardiovascular risk that would be associated with a return of sexual activity as well as criteria for referral to specialists for further cardiac evaluation. Treatment options are briefly reviewed and follow-up process identified. [less ▲]

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See detailTraitement adjuvant du cancer du sein: meta-analyse et recommandations therapeutiques
Jerusalem, Guy ULg; Bours, Vincent ULg; Fillet, Georges ULg

in Revue Médicale de Liège (2000), 55(5), 356-9

Adjuvant chemotherapy and hormonotherapy have a major impact on relapse-free and overall survival of patients with early-stage breast cancer. Providing effective medical care for these patients is an ... [more ▼]

Adjuvant chemotherapy and hormonotherapy have a major impact on relapse-free and overall survival of patients with early-stage breast cancer. Providing effective medical care for these patients is an important public health issue. We reviewed the results of the meta-analysis performed by the "Early Breast Cancer Trialists' Cooperative Group". We summarize the recommendations and guidelines proposed by the International Consensus Panel during the St Gallen Conference, 1998. We discussed also the methodology used by the "Federation National des Centres de Lutte Contre le Cancer" in France to establish guidelines for the adjuvant treatment of breast cancer. Faster development and validation of effective treatments will only be possible if participation in clinical trials become more acceptable to the public as well as to the medical community. [less ▲]

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See detailApproche factuelle du traitement de l'herpes genital
Nikkels, Arjen ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2000), 55(5), 430-437

Genital herpes is a sexually transmitted disease. After the primary infection, the virus establishes a life-long latency in the sacral dorsal root ganglia. Recurrences may occur at an unpredictable rate ... [more ▼]

Genital herpes is a sexually transmitted disease. After the primary infection, the virus establishes a life-long latency in the sacral dorsal root ganglia. Recurrences may occur at an unpredictable rate. The clinical signs are not always easy to recognize and viral identification techniques may be helpful such as immunohistochemistry and in situ hybridization on Tzanck smears and muco-cutaneous biopsies. The treatment of genital herpes can follow one of three strategies using antiviral drugs, non-specific immunomodulators, and vaccination. The new oral antiviral drugs decrease the severity of clinical manifestations without, however, providing a definitive cure. In this article recent knowledge about the clinical aspects, differential diagnosis, diagnostic methods, treatment options and management is reviewed. [less ▲]

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See detailReflux gastro-oesophagien de l'adulte: diagnostic et traitement
Louis, Edouard ULg; Belaiche, Jacques ULg

in Revue Médicale de Liège (2000), 55(5), 341-4

Gastro-oesophageal reflux is a frequent problem affecting up to one third of the Belgian adult population. It is most often a benign non evolutive disease. It is however frequently chronic, with a ... [more ▼]

Gastro-oesophageal reflux is a frequent problem affecting up to one third of the Belgian adult population. It is most often a benign non evolutive disease. It is however frequently chronic, with a significant negative impact on quality of life. The diagnostic and therapeutic management must be adapted to each individual case. In the majority of cases, the purpose of therapy is the control of symptoms and, in a small number of cases with severe oesophagitis the aim is a complete and persistent healing of lesions. A Franco-Belgian consensus meeting on diagnostic and therapeutic management of gastro-oesophageal reflux disease in adults was recently held. Guidelines have been proposed. The aim of the present paper is to highlight the main principles of these guidelines and to comment on their adjustment to current belgian medical practice. [less ▲]

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See detailRecommandations en matiere de traitement du cancer rectal
Gast, Pierrette ULg; Bours, Vincent ULg; Detroz, Bernard ULg et al

in Revue Médicale de Liège (2000), 55(5), 350-5

Curative resection of primary tumor and metastases is the only way to obtain a prolonged survival. Several additional treatments are under evaluation; some are already routinely proposed, in order to ... [more ▼]

Curative resection of primary tumor and metastases is the only way to obtain a prolonged survival. Several additional treatments are under evaluation; some are already routinely proposed, in order to reduce the tumor size and to allow surgery, to reduce the recurrence rate, and to give a better survival in case of unresectable metastases. Even in case of unresectable metastases, resection of the primary tumor should be envisaged, as quality of life with an evolving rectal tumor is very poor. [less ▲]

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See detailRecommandations dans la prise en charge de l'Helicobacter pylori: point de vue recent de la Societe nationale francaise de Gastroenterologie
Van Kemseke, Catherine ULg; Belaiche, Jacques ULg

in Revue Médicale de Liège (2000), 55(5), 345-9

Guidelines for management of Helicobacter pylori are in constant evolution since its discovery in 1982 by Marshall and Warren. This article presents and comments recent guidelines developed under the ... [more ▼]

Guidelines for management of Helicobacter pylori are in constant evolution since its discovery in 1982 by Marshall and Warren. This article presents and comments recent guidelines developed under the auspices of the "Societe Nationale Francaise de Gastroenterologie". [less ▲]

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See detailLe Problem-Based Learning, description d'une pedagogie conduisant a la medecine factuelle
Chalon, Patrice ULg; Delvenne, Catherine ULg; Pasleau, Françoise ULg

in Revue Médicale de Liège (2000), 55(4), 233-8

Problem-Based Learning is an educational method which uses health care scenarios to provide a context for learning and to elaborate knowledge through discussion. Additional expectations are to stimulate ... [more ▼]

Problem-Based Learning is an educational method which uses health care scenarios to provide a context for learning and to elaborate knowledge through discussion. Additional expectations are to stimulate critical thinking and problem-solving skills, and to develop clinical reasoning taking into account the patient's psychosocial environment and preferences, the economic requirements as well as the best evidence from biomedical research. Appearing at the end of the 60's, it has been adopted by 10% of medical schools world-wide. PBL follows the same rules as Evidence-Based Medicine but is student-centered and provides the information-seeking skills necessary for self-directed life long learning. In this short article, we review the theoretical basis and process of PBL, emphasizing the teacher-student relationship and discussing the suggested advantages and disadvantages of this curriculum. Students in PBL programs make greater use of self-selected references and online searching. From this point of view, PBL strengthens the role of health libraries in medical education, and prepares the future physician for Evidence-Based Medicine. [less ▲]

Detailed reference viewed: 38 (5 ULg)