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See detailLe point sur l’évaluation de la force des muscles respiratoires
Kellens, Isabelle ULg; Crielaard, Jean-Michel ULg

in Revue Médicale de Liège (in press)

The strength of respiratory muscles is crucial for quality of life, especially for patients with lung or neurological disorders. Several methods can be used to assess them: i.e direct or indirect ... [more ▼]

The strength of respiratory muscles is crucial for quality of life, especially for patients with lung or neurological disorders. Several methods can be used to assess them: i.e direct or indirect, voluntary or involuntary. The conventional spirometry method assesses indirectly the respiratory function by measuring maximum inspiratory and expiratory pressure, which reflects the coordination of all respiratory muscles. Techniques of magnetic and electrical stimulation can detect a specific muscle dysfunction, independently of the patient's motivation, however they are invasive methods as measurements are made in the esophagus and stomach. The voluntary techniques are generally non-invasive and require patient's cooperation. Measures of respiratory muscle strength, coupled to a conventional spirometry, can predict the development of ventilatory support in patients at risk, and may be useful during weaning from mechanical ventilation in intensive care units. [less ▲]

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See detailLe phénotype d’Akhenaton ; revue critique entre canons artistiques et expression pathologique.
JEDIDI, Zayd ULg; JEDIDI, Haroun ULg; LAVEAUX, Elisabeth ULg et al

in Revue Médicale de Liège (in press)

Of all the royal families of ancient or modern fame, few are as iconic as the eighteenth dynasty of pharaohs of the New Kingdom of Egypt, whose opulence and deeds we are still familiar to nearly 3,500 ... [more ▼]

Of all the royal families of ancient or modern fame, few are as iconic as the eighteenth dynasty of pharaohs of the New Kingdom of Egypt, whose opulence and deeds we are still familiar to nearly 3,500 years after their time. Tenth pharaoh of this dynasty and father of Tutankhamun, Akhenaten (Amenhotep/Amenhotep IV) still fascinates Egyptologists and history lovers through the many questions surrounding his atypical rule. One of the most striking aspects of the so-called Amarna period concerns the representations of the pharaoh himself, very confusing compared to the traditional iconography of the New Kingdom. These intriguing portraits of Pharaoh raised a whole lot of medical assumptions, more or less substantiated. We review here the main theories developed throughout history. [less ▲]

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See detailUn neurinome intra-canalaire lombaire
Manto, Florence; HOUET, Elise ULg; LACREMANS, Pierre ULg et al

in Revue Médicale de Liège (2016), 71(6), 269-271

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See detailEndométriose minime et légère: quel impact sur la fertilité?
BRICHANT, Géraldine ULg; AUDEBERT, Alain; NISOLLE, Michelle ULg

in Revue Médicale de Liège (2016), 71(5), 236-241

L’endométriose minime ou légère (stades I/II) est fréquemment identifiée chez les femmes hypofertiles, surtout en cas de stérilité inexpliquée. L’impact de ces lésions sur la fertilité est controversé ... [more ▼]

L’endométriose minime ou légère (stades I/II) est fréquemment identifiée chez les femmes hypofertiles, surtout en cas de stérilité inexpliquée. L’impact de ces lésions sur la fertilité est controversé, certains les considérant comme paraphysiologiques. Elles sont hétérogènes dans leur étendue, leur activité biologique, l’inflammation qui les caractérise ou les adhérences qu’elles peuvent induire. La diminution de la qualité ovocytaire, et de la mobilité des spermatozoïdes ainsi que les altérations endométriales apparaissent comme les mécanismes les plus pertinents pour expliquer l’hypofertilité. La fécondité spontanée des femmes présentant une endométriose minime ou légère est diminuée en comparaison avec celle des femmes pour lesquelles le diagnostic de stérilité inexpliquée a été posé. L’insémination intra-utérine avec stimulation de l’ovulation améliore la fertilité des femmes traitées. L’ablation coelioscopique des lésions endométriosiques améliore de façon modeste la fécondité, conduisant à recommander cette pratique compte tenu de ses faibles risques. La fécondation in vitro (FIV) est le moyen le plus efficace permettant d’obtenir des résultats similaires ou légèrement inférieurs à ceux observés chez les femmes témoins présentant une infertilité tubaire. L’impact des endométrioses minimes et légères sur la fertilité apparaît très probable, au moins pour certaines lésions qui demandent à être identifiées. [less ▲]

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See detailLa polykystose rénale autosomique dominante : comment et pourquoi identifier les patients "rapidement progresseurs" vers l'insuffisance rénale terminale?
bodson, aurélie; MEUNIER, Paul ULg; Krzesinski, Jean-Marie ULg et al

in Revue Médicale de Liège (2016), 71(4), 184-192

Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited disease characterised by the progressive development of multiple and bilateral cysts in kidneys and other organs. Most patients ... [more ▼]

Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited disease characterised by the progressive development of multiple and bilateral cysts in kidneys and other organs. Most patients with ADPKD will develop, sooner or later, end-stage renal disease (ESRD). The morbidity and mortality associated with ESRD prompt physicians to identify early ADPKD patients considered as «rapid progressors», who have the greatest risk to rapidly develop ESRD. The rate of progression can be assessed by clinical - especially with the «predicting renal outcome in polycystic kidney disease score» (PROPKD-Score) -, biological (a decline of the glomerular filtration rate (GFR) of 4,4 - 5,9 ml/min/year and/or the doubling of serum creatinine within a 36-month period), or radiological criteria (total kidney volume (TKV) adjusted for the size > 600 cc/m and/or TKV annual growth rate > 5 %). Nowadays, there is no curative treatment for ADPKD. However, vasopressin-2 receptor antagonists, such as tolvaptan, appear to slow down the growth of renal cysts and the slope of GFR decline. The current management of ADPKD patients is mostly based on correcting the risk factors for progression, i.e. encouraging (over)-hydration, normalizing blood pressure, stimulating smoking cessation. [less ▲]

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See detailVIGNETTE DIAGNOSTIQUE DE L'ETUDIANT. LogBook Numérique : Un carnet de bord réflexif comme outil d'apprentissage en contexte de stage.
Scantamburlo, Gabrielle ULg; Vierset, Viviane; Bonnet, Pierre ULg et al

in Revue Médicale de Liège (2016), 71(4), 210-215

Un LogBook (ou journal de bord) est un outil d’apprentissage et d’accompagnement où sont répertoriées des situations cliniques vécues lors d’un stage. Il joue un rôle essentiel dans la maîtrise des ... [more ▼]

Un LogBook (ou journal de bord) est un outil d’apprentissage et d’accompagnement où sont répertoriées des situations cliniques vécues lors d’un stage. Il joue un rôle essentiel dans la maîtrise des compétences cliniques. Au Centre Hospitalier Universitaire de Liège, nous avons développé un LogBook numérique pour renforcer le guidage des étudiants et favoriser une réflexion vers l’autonomisation. Il apporte des repères utiles aux enseignants cliniciens et aux étudiants. Il est aussi utilisé comme outil de co-évaluation. Ce LogBook a été conçu pour le stage en psychiatrie. Cependant, sa particularité est de pouvoir être adapté à tous les contextes de stage, dans toutes les disciplines, en vue de favoriser une harmonisation cohérente du parcours clinique de l’étudiant, en lien avec les impératifs du cursus donnés par l’Europe. [less ▲]

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See detailLa vignette diagnostique de l’étudiant. L’importance du facteur temps et de la chronologie des événements dans l’anamnèse médicale
SCHEEN, André ULg

in Revue Médicale de Liège (2016), 71

Summary : Medical history taking represents a key step in the diagnostic approach. A structured interview with a special attention to the chronology of events is mandatory. The medical student often fails ... [more ▼]

Summary : Medical history taking represents a key step in the diagnostic approach. A structured interview with a special attention to the chronology of events is mandatory. The medical student often fails to use the information on time in an optimal way. The aim of this article is to draw the attention on a few key elements, especially the age of the patient, the duration of symptoms, the time of occurrence of complaints within the 24h period and, finally, how to interpret the simultaneous or sequential occurrence of two (or more) events. [less ▲]

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See detailLe médicament du mois. Le dulaglutide (Trulicity®) : Nouvel agoniste des récepteurs du Glucagon-Like Peptide-1 en injection hebdomadaire pour traiter le diabète de type 2
SCHEEN, André ULg

in Revue Médicale de Liège (2016), 71

Summary : Dulaglutide (Trulicity®) is a new once-weekly agonist of Glucagon-Like Peptide-1 (GLP-1) receptors indicated in the treatment of type 2 diabetes. Phase III clinical trials in AWARD programme ... [more ▼]

Summary : Dulaglutide (Trulicity®) is a new once-weekly agonist of Glucagon-Like Peptide-1 (GLP-1) receptors indicated in the treatment of type 2 diabetes. Phase III clinical trials in AWARD programme demonstrated the efficacy and safety of dulaglutide in patients with type 2 diabetes treated by diet and exercise, metformin, a combination of metformin and a sulfonylurea or metformin and pioglitazone or even by supplements of prandial insulin. In the AWARD programme, dulaglutide (subcutaneous 0.75 or 1.5 mg once weekly) exerted a greater glucose-lowering activity than metformin, sitagliptin, exenatide or insulin glargine, and was non-inferior to liraglutide 1.8 mg once daily. Dulaglutide is currently reimbursed in Belgium after failure of and in combination with a dual oral therapy with metformin and a sulfonylurea or metformin and pioglitazone. [less ▲]

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See detailLE CAS CLINIQUE DU MOIS. Granulomatose sarcoidose-like chez les patients traites par anti-TNFalpha.
Petrovici, Andreea; Kaiser, Marie; Louis, Renaud ULg et al

in Revue Médicale de Liège (2016), 71(3), 124-8

Over recent years, anti-TNFalpha have been used to treat rheumatoid arthritis. The principal secondary effect of anti-TNFalpha is tuberculosis infections. Another paradoxical effect, previously less well ... [more ▼]

Over recent years, anti-TNFalpha have been used to treat rheumatoid arthritis. The principal secondary effect of anti-TNFalpha is tuberculosis infections. Another paradoxical effect, previously less well understood, is the development of sarcoid-like granulomatous reactions. We report the case of a 36 year old woman who had been treated for 9 years with anti-TNF alpha. She developed a pulmonary sarcoid-like gra-nulomatosis, complication that is rare but not exceptional in patients treated with TNF-blockers. Discontinuation of anti TNF usually led to recovery. It has been suggested that these reactions mainly occur with etanercept, but this requires further confirmation. [less ▲]

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See detailCOMMENT J'EXPLORE... LA BIPOLARITE EN PEDOPSYCHIATRIE : UNE SEMIOLOGIE DIMENSIONNELLE
SCHOLL, Jean-Marc ULg

in Revue Médicale de Liège (2016), 71(2), 94-100

Despite its high frequency, bipolarity in childhood is little understood and is often diagnosed only after several years of development, and this during a time when the child’s psychosocial future is at ... [more ▼]

Despite its high frequency, bipolarity in childhood is little understood and is often diagnosed only after several years of development, and this during a time when the child’s psychosocial future is at stake. A proper diagnosis requires recognition of accurate clinical signs. It is therefore essential to furnish clinicians with precise semiological markers. This paper presents a dimensional semiology for use in anamnesis and in clinical observation of the child. These clinical signs enable the identification of a bipolar manic temperament in the child and/or the identification of various different forms of childhood bipolar and depressive disorder. The relevant differential diagnoses and comorbidities are also presented. [less ▲]

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See detailLe médicament du mois. Insuline glargine 300 U/mL (Toujeo®)
SCHEEN, André ULg

in Revue Médicale de Liège (2016), 71

Summary : This article presents a new formulation of insulin glargine concentrated at 300 U/mL (Gla-300). It is commercialized under the trade name of Toujeo® in an optimized pre-filled SoloStar™ pen for ... [more ▼]

Summary : This article presents a new formulation of insulin glargine concentrated at 300 U/mL (Gla-300). It is commercialized under the trade name of Toujeo® in an optimized pre-filled SoloStar™ pen for the treatment of type 1 and type 2 diabetes in adults. Besides a threefold higher concentration compared to the classical insulin Lantus® (100 U/mL or Gla-100), both pharmacokinetic and pharmacodynamic profiles of Gla-300 are flatter and longer (more than 24 hours) and have a lesser intra-/inter-variability, which makes them more reproducible. Overall, Toujeo® offers the same hypoglycaemic efficacy and the same safety profile when compared with Lantus®. However, a lower risk of hypoglycaemia, especially at night, a slightly smaller weight gain and a better flexibility in the time of injection have been reported. The two insulin formulations are not bioequivalent and the daily insulin requirement is slightly higher with insulin Gla-300 than with insulin Gla-100. The shift from an already available basal insulin towards Toujeo® may require a dose adjustment and a reinforcement of blood glucose monitoring. [less ▲]

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See detailPremière consultation de contraception chez les adolescentes
BELIARD, Aude ULg

in Revue Médicale de Liège (2016), 71(1), 28-33

Adequate contraception prescription is mandatory for teenagers to avoid any unwanted pregnancy. Counselling and description of side effect improve compliance. Use of condom is important to avoid sexually ... [more ▼]

Adequate contraception prescription is mandatory for teenagers to avoid any unwanted pregnancy. Counselling and description of side effect improve compliance. Use of condom is important to avoid sexually transmitted infections. Combined estroprogestin contraception has multiple non-contraceptive benefits, e.g. dysmenorrhea improvement. Familial and personal history is needed before contraception prescription. Further consultation 3 months later has to be planned to evaluate compliance, side effects and to adapt contraception if needed. [less ▲]

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See detailLE CAS CLINIQUE DU MOIS Thrombose veineuse ovarienne gauche et extension à la veine rénale
JEAN, FLORENCE; CLAUDOT, A.; ISTACE, B. et al

in Revue Médicale de Liège (2016), 71(1), 17-21

Ovarian vein thrombosis is a rare, but potentially serious postpartum complication. In 80 % of the cases, it occurs on the right side and in less than 6 % on the left side; it is bilateral in 14 % of ... [more ▼]

Ovarian vein thrombosis is a rare, but potentially serious postpartum complication. In 80 % of the cases, it occurs on the right side and in less than 6 % on the left side; it is bilateral in 14 % of cases. The usual clinical features include abdominal pain, fever and leucocytosis. However, the diagnosis is often complicated by other non specific signs and symptoms. Ovarian vein thrombosis may cause sepsis, pulmonary thromboembolism, and thrombosis of the inferior vena cava and the renal vein. The diagnosis can be established by CT scan or nuclear magnetic resonance imaging, which has a high sensitivity and specificity. Treatment for the ovarian vein thrombosis includes antibiotics and anticoagulation. The complications can sometimes be surgically managed. Prompt diagnosis and treatment can decrease the morbidity and the mortality. Nowadays, the fatal issue is rare as the appropriate treatment is quickly instaured. [less ▲]

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See detailComment je traite... la sténose aortique asymptomatique
MEURICE, Caroline ULg; DULGHERU, Raluca Elena ULg; PIERARD, Luc ULg

in Revue Médicale de Liège (2016), (71), 6-10

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See detailComment je traite ....... Le delirium chez le patient âgé
CHRISTELBACH, Sophie ULg; ALLEPAERTS, Sophie ULg; PETERMANS, Jean ULg

in Revue Médicale de Liège (2016)

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See detailHyperuricémie et risque potentiel de pathologie cardiovasculiare et rénale
Schils, Raphaël ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2016)

Besides the well accepted need to treat hyperuricemia associated with gout, some large observational studies and small prospective therapeutic trials have suggested that treating asymptomatic ... [more ▼]

Besides the well accepted need to treat hyperuricemia associated with gout, some large observational studies and small prospective therapeutic trials have suggested that treating asymptomatic hyperuricemia, especially by xanthine oxidase inhibition, the enzyme producing uric acid, could be beneficial for cardiovascular and renal risk prevention. This article discusses the literature about this promising approach, which, however, requests prospective validation. [less ▲]

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See detailUne présentation rare de craniosténose associée à un crâne lacunaire
Vaessen, françois; Thimmesch, Mathieu; BORN, Jacques et al

in Revue Médicale de Liège (2016), 71(3), 120-123

A rare case of lacunar skull deformity associated with craniosynostosis Summary : The lacunar skull is a radiologic description characterised by the presence of lacunae in the cranial vault. Its ... [more ▼]

A rare case of lacunar skull deformity associated with craniosynostosis Summary : The lacunar skull is a radiologic description characterised by the presence of lacunae in the cranial vault. Its physiopathology remains up to now poorly understood; it is mostly associated with neural tube defects. The association of a lacunar skull with a craniosynostosis has rarely been described in the literature. The case of a 9-month-old patient presenting a multisutural craniosynostosis with a lacunar skull is reported in this article. The surgical treatment allowed to remodel the skull and to hope for a spontaneous regression of the lacunae. [less ▲]

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See detailApport du cathétérisme cardiaque dans le diagnostic et le traitement de la maladie coronarienne avant 40 ans
MEURICE, Caroline; LEGRAND, Victor ULg; PIERARD, Luc ULg

in Revue Médicale de Liège (2016), 71(3), 129-136

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See detailComment j'explore le malaise du nourrisson
Zambelli, Laura ULg; Battisti, Oreste ULg

in Revue Médicale de Liège (2016), 71

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