References of "Revue Médicale Suisse"
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See detailPrévention quaternaire : agir est-il toujours justifié en médecine de famille ?
Widmer, Daniel; Herzig, Lilly; Jamoulle, Marc ULg

in Revue Médicale Suisse (2014), 10(430), 1052-6

La prévention quaternaire vise à protéger le patient ou la po- pulation de la surmédicalisation. Elle imprègne toute l’activité du médecin de famille par une interrogation tant sur l’utilité de la ... [more ▼]

La prévention quaternaire vise à protéger le patient ou la po- pulation de la surmédicalisation. Elle imprègne toute l’activité du médecin de famille par une interrogation tant sur l’utilité de la prévention primaire que du diagnostic précoce, ou sur les risques de la création de nouvelles entités pathologiques et d’une médecine maximaliste. Le médecin de famille favorise la prévention quaternaire en se centrant sur les priorités du patient et sur les ressources locales d’un système de soins efficace. [less ▲]

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See detailDermatophytes transmis par les animaux domestiques
Monod, M; Fratti, B; Mignon, Bernard ULg et al

in Revue Médicale Suisse (2014), 10

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See detailLeucémie myélomonocytaire chronique : diagnostic et thérapeutique
HAFRAOUI, Kaoutar ULg; DE PRIJCK, Bernard ULg; Beguin, Yves ULg

in Revue Médicale Suisse (2013), 9

Chronic myelomonocytic leukemia (CMML) is a disease typically of the elderly. It is suspected when monocytosis reaches IOOO/fil. It may be associated with «B» symptoms (fever, sweating, and weight loss ... [more ▼]

Chronic myelomonocytic leukemia (CMML) is a disease typically of the elderly. It is suspected when monocytosis reaches IOOO/fil. It may be associated with «B» symptoms (fever, sweating, and weight loss) but also visceral, skin and autoimmune complications. Current treatment strategies aim at reducing the symptoms and have no curative goals. In this context hypomethylating agents have shown a good efficacy. Allogeneic hematopoietic stem cell transplantation (HSCT) remains the only curative option but remains difficult to perform in elderly patients population, even if transplantation with a reduced intensity conditioning has reduced the risks. A new prognostic scoring helps to recognize the patients with poor prognosis and to better selected candidates for the HSCT. [less ▲]

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See detailPrise en charge des prolactinomes
VROONEN, Laurent ULg; Daly, Adrian ULg; Beckers, Albert ULg

in Revue Médicale Suisse (2013), 9

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See detailIntérêt de la chronothérapie dans le traitement de l'hypertension artérielle
VANDERWECKENE, Pauline ULg; ERPICUM, Pauline ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale Suisse (2012), 8(351), 1604-1610

The interest of chronotherapy in the field of arterial hypertension is progressively rising, especially in treated hypertensive patients characterized by a small decrease of their blood pressure during ... [more ▼]

The interest of chronotherapy in the field of arterial hypertension is progressively rising, especially in treated hypertensive patients characterized by a small decrease of their blood pressure during the night, and therefore often presenting a high cardiovascular risk. There are more and more data showing that administration of one antihypertensive drug in the evening (and even aspirin) can improve the blood pressure control during the night and the day/night blood pressure pattern, and so can diminish the level of risk. The role of chronotherapy also emphasizes the interest of 24 h ambulatory blood pressure monitoring in the management of high risk hypertensive patients. [less ▲]

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See detailLes maladies chroniques complexes. Du nouveau paradigme medical au gigantesque defi societal!
SCHEEN, André ULg

in Revue Médicale Suisse (2012), 8(351), 1579-80

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See detailUtilisation des antidiabetiques oraux en cas d'insuffisance renale.
SCHEEN, André ULg

in Revue Médicale Suisse (2012), 8(351), 1614-20

People with chronic kidney disease (CKD) of stages 3-4 (creatinine clearance <50 ml/min) represent 25-30% of type 2 diabetic patients, but the problem is often underrecognized or neglected in clinical ... [more ▼]

People with chronic kidney disease (CKD) of stages 3-4 (creatinine clearance <50 ml/min) represent 25-30% of type 2 diabetic patients, but the problem is often underrecognized or neglected in clinical practice. However, most of oral antidiabetic agents have limitations in case of renal impairment, either because they require a dose adjustment, or because they are contra-indicated for safety reasons. It is the case for metformin (risk of lactic acidosis) and for most sulfonylureas (risk of hypoglycaemia). New antidiabetic agents are better tolerated in case of CKD. However, the daily dose of dipeptidyl peptidase-4 inhibitors should be adjusted (except for linagliptin). Concerning new inhibitors of renal SGLT2 cotransporters, they have a reduced efficacy and their safety remains to be demonstrated in presence of CKD. [less ▲]

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See detailChirurgie metabolique: une place croissante dans le traitement du diabete.
De Flines, J.; Franck, M.; Rorive, M. et al

in Revue Médicale Suisse (2012), 8(351), 1621-41626-7

Bariatric surgery becomes more and more important in the management of the obese patient with type 2 diabetes, especially in case of failure of medical approaches. Metabolic improvement results not only ... [more ▼]

Bariatric surgery becomes more and more important in the management of the obese patient with type 2 diabetes, especially in case of failure of medical approaches. Metabolic improvement results not only from weight loss and the subsequent reduction in insulin resistance, but also from modifications of digestive hormones (especially incretins) that contribute to promote insulin secretion. This new paradigm, moving from bariatric surgery to metabolic surgery, opens new perspectives. The present article briefly describes innovative surgical techniques focusing on endocrine and metabolic improvement rather than on weight loss, the preliminary results of metabolic surgery in patients with type 2 diabetes and a body mass index <35 kg/m2 and, finally, some data regarding the surgical management of obese patients with type I diabetes not well treated with classical medical means. [less ▲]

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See detailY a-t-il encore une place pour la double inhibition du système rénine-angiotensine en 2012?
Krzesinski, Jean-Marie ULg; Scheen, André ULg

in Revue Médicale Suisse (2012), 8(351), 1598-1603

The blockade of the renin-angiotensin system (RAS) improves the prognosis of patients with complications related to diabetes, hypertension or, in general, atherosclerosis. Several observational studies ... [more ▼]

The blockade of the renin-angiotensin system (RAS) improves the prognosis of patients with complications related to diabetes, hypertension or, in general, atherosclerosis. Several observational studies have suggested the use of a dual blockade of the RAS to benefit from a better cardiorenal protection. However, recent randomized controlled studies failed to demonstrate that a dual blockade exert a better protection than single blockade, but showed a higher risk for renal complications and hyperkalemia. To decrease the residual risk, other opportunities may be recommended such as reinforcement of low salt diet, use of supraphysiological dose of a monotherapy inhibiting the RAS (perhaps prescribed at the evening) or addition of an aldosterone antagonist. However, all these approaches, as dual therapy, may also increase the risk of hypotension and renal insufficiency and thus require to be used under strict medical supervision. [less ▲]

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See detailPrise en charge du lymphome B diffus à grandes cellules en 2012
Bonnet, Christophe ULg; DE PRIJCK, Bernard ULg; LEJEUNE, Marie ULg et al

in Revue Médicale Suisse (2012), 8

Diffuse Large B Cells Lymphoma (DLBCLI is the mast comman non-Hodgkin Iymphoma and comprises a large numberof different entities with different clinico-pathological characteristics. The role of positron ... [more ▼]

Diffuse Large B Cells Lymphoma (DLBCLI is the mast comman non-Hodgkin Iymphoma and comprises a large numberof different entities with different clinico-pathological characteristics. The role of positron emission tomography is essential dudog the Ini tial staging and post treatment assessment, and potentially at early or mid-treatmentevaluation of response. First-line therapy comprises immuno-chemotherapy with rituximab and different cytotox ic agents that differforcomponents, dosages and frequency of administration taking worldwlderecognized pre-treatment prognostic variables into account. After relapse, peripheral blood stem cells transplantation remains the only chance of cu re. This review attempts to summarize the current state of our knowledge by highlighting the leads pursued to further improve current therapeutic results. [less ▲]

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See detailInhibiteurs du cotransporteur du glucose SGLT rénal pour traiter le diabète de type 2
SCHEEN, André ULg; RADERMECKER, Régis ULg; ERNEST, Philippe ULg et al

in Revue Médicale Suisse (2011), 7(306), 1621-1629

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See detailHypophosphatémie et ostéomalacie oncogénique
Van der Rest, Catherine; CAVALIER, Etienne ULg; COLSON, Laurent ULg et al

in Revue Médicale Suisse (2011), 7

In this article, we will discuss about hypophosphatemia due to tumor-induced osteomalacia. This disease is characterized by severe muscular and articular tenderness inducing profound walking limitation ... [more ▼]

In this article, we will discuss about hypophosphatemia due to tumor-induced osteomalacia. This disease is characterized by severe muscular and articular tenderness inducing profound walking limitation. Clinical chemistry results show severe hypophosphatemia due to hyperphosphaturia. Fibroblast growth factor 23 (FGG-23) is abnormally high. Physiological role of FGF-23 is examined. We also consider the pathophysiology of tumor induced osteomalacia, the use of different investigations to localize the tumor and therapies available to treat this rare disease. [less ▲]

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See detailPrise en charge actuelle des syndromes myélodysplasiques
CAERS, Jo ULg; BONNET, Christophe ULg; GRAUX, Carlos et al

in Revue Médicale Suisse (2011), 7

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See detailDiabete de type 2 et medicaments anti-inflammatoires: nouvelles perspectives therapeutiques?
Esser, Nathalie ULg; Paquot, Nicolas ULg; SCHEEN, André ULg

in Revue Médicale Suisse (2011), 7(306), 1614-81620

It is now well accepted that a chronic, low-grade inflammation is observed in abdominal obesity, insulin resistance and type 2 diabetes mellitus, and that pro-inflammatory cytokines and oxidative stress ... [more ▼]

It is now well accepted that a chronic, low-grade inflammation is observed in abdominal obesity, insulin resistance and type 2 diabetes mellitus, and that pro-inflammatory cytokines and oxidative stress play a role in the pathogenesis of type 2 diabetes. These new findings raise the question of whether antiinflammatory strategies may have a place in the prevention and treatment of type 2 diabetes. This review article describes the results obtained in studies on patients with metabolic syndrome or type 2 diabetes aiming to test the metabolic effect of anti-inflammatory (salicylates, antagonists of interleukine-1, antagonists of tumor necrosis factor-alpha) and anti-oxydants (succinobucol) drugs. [less ▲]

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See detailLymphome du manteau : prise en charge 2011
Bonnet, Christophe ULg; CAERS, Jo ULg; DE PRIJCK, Bernard ULg et al

in Revue Médicale Suisse (2011), 7

Le lymphome du manteau (LM) représente 6% des lymphomes non hodgkiniens (LNH). Le diagnostic repose sur l'immunophénotypage et la démonstration de la présence de la location entre les chromosomes 11 et 14 ... [more ▼]

Le lymphome du manteau (LM) représente 6% des lymphomes non hodgkiniens (LNH). Le diagnostic repose sur l'immunophénotypage et la démonstration de la présence de la location entre les chromosomes 11 et 14, avec surexpression de la cycline D1. Le traitement de première ligne du sujet jeune associe trois cures de R-CHOP21 alternées avec trois cures de R-DHAP21, suivies d'une autogreffe conditionnée par irradiation corporelle totale, cyclophosphamide et aracytine. Le sujet de plus de 65 ans peut bénéficier de huit cures de R-CHOP21. L'intérêt du traitement de maintenance est en cours d'évaluation. L'allogreffe de cellules souches hématopoïétiques offre une chance de guérison aux patients en rechute en bon état général. Les traitements ciblés permettront une amélioration du pronostic de cette maladie. [less ▲]

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See detail"The lower, the better": pas d'accord sur le rapport benefices/risques apres "ACCORD".
SCHEEN, André ULg

in Revue Médicale Suisse (2011), 7(306), 1603-4

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See detailActualités thérapeutiques dans la cardiomyopathie hypertrophique.
Moonen, Marie ULg; Pierard, Luc ULg

in Revue Médicale Suisse (2010), 6(260), 1591-4

The management of patients with hypertrophic cardiomyopathy has largely evolved over the past two decades. One important finding is that medical treatment appears under used. Invasive procedure are ... [more ▼]

The management of patients with hypertrophic cardiomyopathy has largely evolved over the past two decades. One important finding is that medical treatment appears under used. Invasive procedure are reserved to patients with obstructive hypertrophic cardiomyopathy who remain symptomatic despite optimal medical treatment. Indications for implantable cardiac defibrillator are still debated. A global and multidisciplinary approach of the patient and of his family is mandatory. [less ▲]

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See detailQuelle cible tensionnelle idéale pour nos patients hypertendus en 2010?
Krzesinski, Jean-Marie ULg; Saint-Remy, Annie ULg

in Revue Médicale Suisse (2010), 6

Les directives du traitement de l'hypertension artérielle de 2007 ont été rediscutées en 2009. Quelle que soit la pathologie associée à l'hypertension artérielle, la cible à atteindre est : 130 à 139 mmHg ... [more ▼]

Les directives du traitement de l'hypertension artérielle de 2007 ont été rediscutées en 2009. Quelle que soit la pathologie associée à l'hypertension artérielle, la cible à atteindre est : 130 à 139 mmHg pour la systolique et 80 à 85 mmHg pour la diastolique. Si le patient peut tolérer une pression plus basse, on ne freinera pas l’abaissement de pression. Beaucoup de questions restent cependant encore sans réelles réponses quant à des cibles plus basses en fonction de l’âge et de situations pathologiques individuelles. Le choix des agents antihypertenseurs devient primordial lors d’un risque cardiovasculaire majeur. Il convient toujours d’appliquer des règles hygiéno-diététiques à l’ensemble de la population hypertendue et d’agir sur tous les facteurs de risque associés. [less ▲]

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See detailEducation therapeutique et mesure continue de la glycemie chez le patient diabetique insulino-traite.
Thielen, Vinciane ULg; Radermecker, Régis ULg; Renard, Eric et al

in Revue Médicale Suisse (2010), 6(260), 1596-600

L’efficacité d’un programme éducationnel fondé sur l’utilisation d’une mesure continue du glucose avec un affichage en temps réel a été évaluée chez des patients diabétiques de type 1 (système couplé à ... [more ▼]

L’efficacité d’un programme éducationnel fondé sur l’utilisation d’une mesure continue du glucose avec un affichage en temps réel a été évaluée chez des patients diabétiques de type 1 (système couplé à une pompe à insuline externe - Paradigm Real Time®) et chez des patients diabétiques de type 2 mal contrôlés sous insuline (système Guardian RT® une semaine par mois pendant 3 mois versus automesure classique). Ces deux essais pilote montrent une diminution du taux d’hémoglobine glyquée (HbA1c) avec le « glucose sensor », avec moins d’hypoglycémies symptomatiques. Malgré certaines difficultés techniques (surtout chez les diabétiques de type 2), l’approche représente un outil intéressant d’éducation thérapeutique. Ces résultats prometteurs plaident pour des études de plus grande envergure chez des patients diabétiques bien sélectionnés. [less ▲]

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See detailA propos de l'inertie et de la non-observance therapeutiques.
Scheen, André ULg

in Revue Médicale Suisse (2010), 6(260), 1571-2

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