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See detailLe cas clinique du mois. Fusariose disseminee chez un patient immunodeprime
Quatresooz, Pascale ULg; Meiers, I.; Arrese, J. E. et al

in Revue Médicale de Liège (2000), 55(11), 974-6

Fusarium spp are ubiquitous soil saprophytes and occasional plant pathogens. Fusariosis in humans is usually limited to superficial mycoses. We report the case of a disseminated fungal infection due to ... [more ▼]

Fusarium spp are ubiquitous soil saprophytes and occasional plant pathogens. Fusariosis in humans is usually limited to superficial mycoses. We report the case of a disseminated fungal infection due to Fusarium spp in an immunosuppressed patient suffering from acute lymphoblastic leukemia. This report and review of the recent literature suggest that Fusarium spp are emerging fungal pathogens in immunosuppressed patients. [less ▲]

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See detailL'image du mois. Histiocytome fibreux malin
Delanaye, Pierre ULg; Heymans, Olivier; Boverie, Jacques ULg

in Revue Médicale de Liège (2000), 55(11), 969

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See detailLes fibroses pulmonaires idiopathiques: nouvelle classification histopathologique et aspects cliniques
Blaise, Pierre ULg; Louis, Renaud ULg; Bartsch, Pierre ULg

in Revue Médicale de Liège (2000), 55(11), 986-90

Idiopathic pulmonary fibrosis (IPF) comprises different interstitial lung diseases of unknown origin. They are classified into four groups based on pathologic criteria: UIP, DIP, AIP and NSIP. This ... [more ▼]

Idiopathic pulmonary fibrosis (IPF) comprises different interstitial lung diseases of unknown origin. They are classified into four groups based on pathologic criteria: UIP, DIP, AIP and NSIP. This classification helps in terms of prognosis and treatment. In addition to history, physical examination and common investigations (chest X ray, pulmonary function testing), a bronchoalveolar lavage (BAL), a high-resolution CT scan and ideally a open-lung biopsy are needed to establish a precise diagnosis. The patients are usually treated by immunosuppressive agents, and mainly by corticoids. However, in UIP, lung transplantation is the only way to improve survival. [less ▲]

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See detailComment j'explore ... une bouche brulante
Claessens, N.; Pierard-Franchimont, Claudine ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2000), 55(11), 1011-4

Burning mouth is a symptom typical for the oral mucosa. In contrast, pruritus is absent at this site. The situation which is the reverse on the skin can be explained by microanatomical differences in the ... [more ▼]

Burning mouth is a symptom typical for the oral mucosa. In contrast, pruritus is absent at this site. The situation which is the reverse on the skin can be explained by microanatomical differences in the sensorial innervation and by a different balance between neuromediators. Burning mouth sensation calls for the search of a series of diseases. However, it is most often a monosymptomatic expression of a minimal lichenoid stomatitis. [less ▲]

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See detailLe cas clinique du mois. A propos d'une presentation inhabituelle de syndrome cave superieur
Monami, Catherine; Martinez, Christophe ULg; Ghuysen, Alexandre ULg et al

in Revue Médicale de Liège (2000), 55(10), 905-9

We report the case of a 48-year-old man who was admitted to our emergency department because of a superior vena caval syndrome from which the symptoms occurred only during exercise. His past history ... [more ▼]

We report the case of a 48-year-old man who was admitted to our emergency department because of a superior vena caval syndrome from which the symptoms occurred only during exercise. His past history included an episode of lower limb deep venous thrombosis. Because an atrio-ventricular partial block was fortuitously evidenced, the patient was submitted to a pacemaker insertion. A few years later, the patient suffered from rapid dyspnea on exercise, associated with facial cyanosis and systemic hypotension. The exploration by phlebography evidenced that the inferior vena cava was completely obstructed. Therefore the venous return from the lower part of the body to right heart was obtained through hypertrophy of the vena azygos. In addition, the presence of cardiac pacing electrodes induced a stenosis at the level of the superior vena cava, just before its entrance into the right atrium. Such a venous network accounted for the occurrence of a chronic superior vena caval syndrome associated with peripheral arterial hypotension during exercise. Treatment consisted of a superior vena caval percutaneous transluminal balloon angioplasty followed by a Wallstent insertion. This procedure led to a correction of all hemodynamic abnormalities responsible for reported pathophysiological limitations to stress. [less ▲]

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See detailObésité et hypertension artérielle: de la physiopathologie au traitement
Geronooz, Isabelle; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2000), 55(10), 921-928

Obesity constitutes a problem of major concern in our industrialized countries. Overweight is frequently associated with hypertension (50% of hypertensive subjects are obese and the prevalence of ... [more ▼]

Obesity constitutes a problem of major concern in our industrialized countries. Overweight is frequently associated with hypertension (50% of hypertensive subjects are obese and the prevalence of hypertension in obese patients is twice that of the normal population). Both pathologies are major cardiovascular risk factors. This review aims at a better understanding of the relationship between hypertension and overweight and at giving to the clinicians simple and consistent guidelines to treat these two medical entities. [less ▲]

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See detailLa chirurgie du thymus, normal, involue ou tumoral
Limet, Raymond ULg; Rogister, Bernard ULg

in Revue Médicale de Liège (2000), 55(10), 940-4

Thymoma is the most frequently resected mediastinal tumor. Its malignancy is related more to macroscopical findings than to microscopical analysis. All thymomas should be resected, in order to prevent ... [more ▼]

Thymoma is the most frequently resected mediastinal tumor. Its malignancy is related more to macroscopical findings than to microscopical analysis. All thymomas should be resected, in order to prevent malignant degeneration. Furthermore, for the treatment of myasthenia, several centers recommend resection of the thymus, either tumoral (thymoma) or atrophied. Although the role of surgery in this regard is controversial, all authors unanimously stress that complete resection of all thymic remnants is essential to achieve adequate results. [less ▲]

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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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