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See detailComment j'explore ... les troubles de la calcémie
Janssens, Lise; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (1999), 54(9), 764-769

Mechanisms for calcium homeostasis are complex but their understanding is important before investigating the calcium disorders. Hypercalcaemia is often due to hyperparathyroidism or cancers. The ... [more ▼]

Mechanisms for calcium homeostasis are complex but their understanding is important before investigating the calcium disorders. Hypercalcaemia is often due to hyperparathyroidism or cancers. The diagnostis must thus be rapid and a treatment decided in a global approach. Hypocalcaemia, more frequently noted, is often due to a general disorder with hypoalbuminemia or chronic renal failure. [less ▲]

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See detailComment j'explore ... une suspicion de sténose d'artère rénale
Krzesinski, Jean-Marie ULg; Turatzinze, Léopold

in Revue Médicale de Liège (1999), 54(8), 702-704

Renal artery stenosis can present 2 clinical pictures, sometimes associated and potentially treatable, due mainly to atherosclerosis, but also to fibromuscular dysplasia. The first possible presentation ... [more ▼]

Renal artery stenosis can present 2 clinical pictures, sometimes associated and potentially treatable, due mainly to atherosclerosis, but also to fibromuscular dysplasia. The first possible presentation is renovascular hypertension which represents 1% of unselected hypertensive populations. The second possible presentation is ischemic renal disease, which represent 10% of the new indications for dialysis therapy and has a 50% mortality rate at 3 years. To explore this disease, arteriography, the gold standard, must be reserved for confirmation and treatment. Hypertension induced by the stenosis is best approached by captopril renal MAG 3 scintigraphy. Measurement of the stenosis severity can be performed either by duplex ultrasonography, magnetic resonance angiography or spinal CT angiography according to patients'characteristics, local experience and facilities. This disease must be searched in the presence of renal insufficiency of unknown cause or refractory hypertension. [less ▲]

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See detailL'anorexie mentale, une maladie grave specifique de la femme jeune.
Scheen, André ULg

in Revue Médicale de Liège (1999), 54(4), 255-61

Anorexia nervosa is characterized by a triad comprising anorexia, weight loss, and amenorrhoea. It is typically present in adolescent or young adult women and its prevalence appears to increase in our ... [more ▼]

Anorexia nervosa is characterized by a triad comprising anorexia, weight loss, and amenorrhoea. It is typically present in adolescent or young adult women and its prevalence appears to increase in our society. Eating disorders may lead to cachexia and various severe complications. This disease, which appears to be associated to a particular psychological background, is triggered by conflictual relationships, usually within the family. The anorectic patient should be carefully evaluated, as soon as possible, from a somatic, dietetic and psychological point of view. A specific therapeutic approach should be rapidly proposed in a specialized centre, if possible by a multidisciplinary team. The treatment is most often difficult and of long duration. Prognosis remains uncertain in most cases, especially when appropriate care is delayed. [less ▲]

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See detailLe quiproquo de la consommation medicale de la femme.
Gillet, Pierre ULg; Tellier, V.

in Revue Médicale de Liège (1999), 54(4), 214-23

By analysing three different Belgian databases, we could demonstrate that whereas women subjectively declare a higher number of diseases, a worse functional state and a higher trend to use medical ... [more ▼]

By analysing three different Belgian databases, we could demonstrate that whereas women subjectively declare a higher number of diseases, a worse functional state and a higher trend to use medical resources, they are, from an objective point of view, less frequently hospitalized and cause a lower cost, at certain ages, for the Social Security. [less ▲]

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See detailHypertension arterielle et diabete de type 2.
Scheen, André ULg; Estrella, F.; Weekers, Laurent ULg

in Revue Médicale de Liège (1999), 54(10), 789-95

Diabetes mellitus is frequently associated with arterial hypertension and the combination of both entities markedly increases the vascular risk. In type 2 diabetes, hypertension appears very early ... [more ▼]

Diabetes mellitus is frequently associated with arterial hypertension and the combination of both entities markedly increases the vascular risk. In type 2 diabetes, hypertension appears very early, especially in the presence of obesity, is part of the insulin resistance syndrome, and contributes to high cardiovascular morbidity and mortality rates in this population. Appropriate regulation of blood pressure is crucial in order to reduce not only microangiopathy (nephropathy and retinopathy) but also macroangiopathy (coronary heart disease and stroke) in hypertensive type 2 diabetic patients. Target blood pressure values have been decreased in recent years and should be < 130/85 mmHg, and may be even lower according to recent data. The optimal modalities of pharmacological treatment remain controversial, but obviously several medications are required to reach such objectives in most hypertensive patients with type 2 diabetes. [less ▲]

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See detailLe cas clinique du mois. Diagnostic et traitement du kyste adventitiel de l'artere poplitee.
Zeaiter, R.; SAKALIHASAN, Natzi ULg; VAN DAMME, Hendrik ULg et al

in Revue Médicale de Liège (1999), 54(6), 514-6

The authors report the case of a 66-year-old patient with unilateral intermittent claudication, in whom no evidence of intravascular occlusive disease was found. Surgical approach revealed an ... [more ▼]

The authors report the case of a 66-year-old patient with unilateral intermittent claudication, in whom no evidence of intravascular occlusive disease was found. Surgical approach revealed an intraparietal cystic adventitial disease of the popliteal artery. An excision of the affected segment and bypass grafting with the internal saphenous vein was done. [less ▲]

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See detailLe cas clinique du mois. Rupture couverte d'un anevrysme infectieux post-typhique de l'aorte abdominale sous-renale.
SCHILS, Fabian ULg; SAKALIHASAN, Natzi ULg; Sente, J. M. et al

in Revue Médicale de Liège (1999), 54(10), 786-8

Mycotic aneurysms are uncommon but remain one of the most challenging clinical problems for the vascular surgeon. They are associated with high morbidity and mortality, and the clinical signs and symptoms ... [more ▼]

Mycotic aneurysms are uncommon but remain one of the most challenging clinical problems for the vascular surgeon. They are associated with high morbidity and mortality, and the clinical signs and symptoms are non specific. We report here the case of an abdominal aorta mycotic aneurysm due to salmonellosis treated by insertion of an arterial homograft. [less ▲]

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See detailLes adolescents qui abusent sexuellement des enfants
Malchair, Alain ULg

in Revue Médicale de Liège (1999), 54(6), 527-534

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See detailPériartérite noueuse en relation avec une hépatite B
Demolin, G.; Delwaide, Jean ULg; Van Severen, M. et al

in Revue Médicale de Liège (1999), 54(1), 921-924

A 66-year-old man was hospitalized for asthenia, weight loss, fever and chills. A polyarteritis nodosa associated with hepatitis B virus infection in a replicative phase was diagnosed. Etiology ... [more ▼]

A 66-year-old man was hospitalized for asthenia, weight loss, fever and chills. A polyarteritis nodosa associated with hepatitis B virus infection in a replicative phase was diagnosed. Etiology, physiopathology, and clinical characteristics of hepatitis B virus-related polyarteritis nodosa will be reviewed, as well as the effectiveness of therapy combining corticosteroids, interferon alpha and plasma exchanges. [less ▲]

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See detailL'incontinence urinaire chez la femme agee.
Fillet, Marc ULg; Bonnet, Pierre ULg; de Leval, Jean ULg

in Revue Médicale de Liège (1999), 54(4), 341-8

Physical, psychological and economical consequences of urinary incontinence of the elderly woman are underestimated. It often results in depression, social isolation and early institutionalisation. It is ... [more ▼]

Physical, psychological and economical consequences of urinary incontinence of the elderly woman are underestimated. It often results in depression, social isolation and early institutionalisation. It is often the key factor that determines the decision of institutionalisation, which represent the most important part of the total cost of urinary incontinence. This problem is too often neglected and deserves considerable attention. [less ▲]

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See detailLe diabete gestationnel: definition, depistage et traitement.
Geronooz, I.; Scheen, André ULg; Foidart, Jacqueline ULg

in Revue Médicale de Liège (1999), 54(5), 429-33

Defined as glucose intolerance with onset or first recognition during pregnancy, gestational diabetes mellitus represents in fact an heterogeneous clinical entity which may concern 1 to 4% of all pregnant ... [more ▼]

Defined as glucose intolerance with onset or first recognition during pregnancy, gestational diabetes mellitus represents in fact an heterogeneous clinical entity which may concern 1 to 4% of all pregnant women in our country. Its adverse effects on the mother and her child, the need for a universal screening and the mode of screening are still controversial. Screening may be made either by a first test with a 50 g oral glucose load (the so-called O'Sullivan test), confirmed if positive by a 100 g oral glucose tolerance test (OGTT), or at first glance by a 75 g OGTT performed between the 24th and 28th weeks of gestation. The treatment of gestational diabetes is based on diet. In case of diet failure to obtain good glucose control, insulin therapy should be proposed. [less ▲]

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See detailAnesthesie generale versus anesthesie perimedullaire.
Murayi, P.; Joris, Jean ULg; Lamy, Maurice ULg

in Revue Médicale de Liège (1999), 54(7), 588-92

Perimedullary anesthetic techniques (epidural or spinal anesthesia), by themselves or combined with general anesthesia offer several advantages in the postoperative period when compared with general ... [more ▼]

Perimedullary anesthetic techniques (epidural or spinal anesthesia), by themselves or combined with general anesthesia offer several advantages in the postoperative period when compared with general anesthesia alone. The incidence of postoperative respiratory and cardiovascular complications is decreased. The physiologic stress reaction, with its associated hypercoagulable state and immune depression, is attenuated. Finally, the resumption of gastrointestinal function is hastened. These benefits of central neural blockade are noted most clearly when the techniques are used for several days postoperatively, most often by catheter based epidural analgesia. The use of local anesthetic agents in the analgesic mixture would appear to be important. This is likely because these substances inhibit the sympathetic nervous system and spinal reflex axes. The role of this inhibition in the advantages of perimedullary techniques is probably important. It is important to note that inhibition of the sympathatetic nervous system can be associated with indesirable consequences in certain patients. These techniques must therefore be used cautiously, and patients who benefit from them must receive careful surveillance. [less ▲]

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See detailLes anomalies congenitales des vaisseaux de la base du coeur: "ring" et "sling" vasculaires. A propos d'un cas
Radermecker, M. A.; Massin, M.; Grenade, Thierry ULg et al

in Revue Médicale de Liège (1999), 54(10), 823-8

We present a case of double aortic arch corrected by surgical interruption and full mobilization of the trachea and the esophagus. The vascular malformations of the supraaortic trunks, which form more or ... [more ▼]

We present a case of double aortic arch corrected by surgical interruption and full mobilization of the trachea and the esophagus. The vascular malformations of the supraaortic trunks, which form more or less complete vascular rings encircling the esophagus and the trachea, are reviewed. The different presentations of double aortic arch, aberrant subclavian arteries, and abnormal development of the pulmonary arteries are discussed. [less ▲]

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See detailL'observance therapeutique.
Scheen, André ULg

in Revue Médicale de Liège (1999), 54(11), 854-8

Compliance is defined as the extent to which a patient's behaviour coincides with medical or health advice. Medication compliance seems to be rather low as 30 to 60% of no or poor adherence to medical ... [more ▼]

Compliance is defined as the extent to which a patient's behaviour coincides with medical or health advice. Medication compliance seems to be rather low as 30 to 60% of no or poor adherence to medical recommendation have been reported. Numerous factors may influence medication compliance among which patient's characteristics, disease particularities, drug treatment modalities or physician's attitudes. The consequences of medication non-compliance may not only be dangerous for patient's health, but also dramatically increase the financial cost for public health services. Thus, all energies should be devoted to improve drug compliance, including treatment optimization and simplification, patient's information and education, use of practical means that facilitate adherence to medical recommendation, the patient being responsible for his/her treatment. [less ▲]

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See detailLes mélanomes cutanés, un spectre de cancers émergents chez la femme en région wallonne
Pierard-Franchimont, Claudine ULg; Arrese Estrada, Jorge ULg; Cornil, F. et al

in Revue Médicale de Liège (1999), 54(5), 495-499

The Mosan Study Group of Pigmented Neoplasms was founded about 15 years ago. It has collected more than 20.000 cutaneous malignancies including melanoms and basal and squamous cell carcinomas. The ... [more ▼]

The Mosan Study Group of Pigmented Neoplasms was founded about 15 years ago. It has collected more than 20.000 cutaneous malignancies including melanoms and basal and squamous cell carcinomas. The incidence of these cancers in on the rise in Wallonia. In particular, malignant melanoms represent a spectrum of emerging cancers characterized by a proteiform biological outcome. They mostly affect young women. The major risk factor appears to be iterative and unwise ultraviolet exposures. The prevention of malenomas is basically founded on such a dogma and accordingly relies on sunscreens. However, controversies about their beneficial effects are rife and fueled by axiomas and contradictory sophisms. At the exception of surgery, the therapeutic options for the diverse types of melanomas do not yet fulfill the scope of evidence-based medicine. [less ▲]

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See detailHypo- et hypertension intracrânienne bénigne
DELVAUX, Valérie ULg; DIOH, Alioune ULg; Schoenen, Jean ULg

in Revue Médicale de Liège (1999), 54(8), 671-676

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See detailHystéroscopie opératoire ou hystérectomie dans le traitement des lésions utérines bénignes. Que choisir en 1998?
Herman, Philippe ULg; Gaspard, Ulysse ULg; Foidart, Jean-Michel ULg

in Revue Médicale de Liège (1998), 53(12), 756-61

In the past, the treatment of benign uterine lesions required, in many instances, a hysterectomy. These days, most cases can be successfully treated by hysteroscopy. To be reliable, this technique must ... [more ▼]

In the past, the treatment of benign uterine lesions required, in many instances, a hysterectomy. These days, most cases can be successfully treated by hysteroscopy. To be reliable, this technique must lead to a significant reduction in the number of hysterectomies performed for benign uterine lesions. The electroresection technique is preferred to that using the Nd-YAG laser because of its lower cost and its equivalent efficacy. By using the uterine perfusion pump device, the risk of resorption syndrome can be reduced to its minimum. Submucosal myomas < 1 cm, benign endometrial hyperplasia and adenomyosis are the commonest benign lesions treated. Dysfunctional uterine bleeding can also be treated by an endometrectomy. A preoperative workup includes a transvaginal ultrasound and a biopsy. This ensures that only benign lesions that are accessible to a hysteroscopy will be submitted to this technique and that no cases of endometrial cancer or atypical hyperplasia would be ignored. This study presents 270 cases of operative hysteroscopy with a follow-up to 4 years. 82.8% of myomatous lesions were treated with success. The results for patients with benign endometrial polyps or benign endometrial hyperplasia are also excellent with only 4.6% and 5.6% rate of secondary surgery respectively. Adenomyosis does not appear to be a good indication for hysteroscopy as only 37% of patients did not need a definitive hysterectomy. Rates of operative complications (post-operative bleeding, uterine perforation, resorption syndrome and difficulty of access) are acceptable and get less frequent as the surgeon experience increases. [less ▲]

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See detailTransplantation hépatique: expérience et résultats du programme de l'Université de Liège
Honore, Pierre ULg; Detry, Olivier ULg; Meurisse, Michel ULg et al

in Revue Médicale de Liège (1998), 53(12), 735-7

The orthotopic liver transplantation (OLT) program of the University of Liege was initiated in 1986. Between 1986 and December 1998, 150 adult OLT have been performed in our institution, including 18 ... [more ▼]

The orthotopic liver transplantation (OLT) program of the University of Liege was initiated in 1986. Between 1986 and December 1998, 150 adult OLT have been performed in our institution, including 18 liver retransplantations, 1 combined heart and liver transplantation and 3 combined liver and kidney transplantations. The aim of this study was to report the last 3 years of our experience. From January 1996 to November 1998, we performed 50 OLT on 49 patients. Three were retransplantations and two were combined liver and kidney transplantations. Fourty-three patients were transplanted for chronic liver disease and 6 for acute or subacute hepatopathy. Mean waiting time on the list was 4 weeks. Immunosuppression was based on triple therapy (cyclosporin A/tacrolimus, steroids, azathioprine), with steroid and azathioprine withdrawal in most of the patients after 3 months. In the chronic liver disease group, operative (< 30 days) survival was 95% (peroperative myocardial infarction in 2 patients). In the acute liver disease group, postoperative survival was 66%. No perioperative death occurred in 1997 and 1998. Actuarial one year survival was 87%. In our experience, OLT has become a safe procedure. [less ▲]

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See detailA propos des prothèses mammaires. L'examen senologique conventionnel
Lifrange, Eric ULg; Colin, Claude ULg

in Revue Médicale de Liège (1998), 53(12), 746-9

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See detailSuivi du patient traité par amiodarone
LANCELLOTTI, Patrizio ULg; Melon, Pierre ULg; Kulbertus, Henri ULg

in Revue Médicale de Liège (1998), 53(12), 762-5

Amiodarone is a highly effective antiarrhythmic agent. Its iodine content and tissue accumulation are however responsible for various side effects. In this article, we review the various amiodarone ... [more ▼]

Amiodarone is a highly effective antiarrhythmic agent. Its iodine content and tissue accumulation are however responsible for various side effects. In this article, we review the various amiodarone related side effects and propose a monitoring chart for patients treated by this specific agent. [less ▲]

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