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See detailComment j'explore une masse cervicale chez l'enfant
Costa de Araujo, Pedro ULg; Battisti, Oreste ULg

in Revue Médicale de Liège (2010), 65

The discovery of a cervical mass in a child suggests several possible diagnoses ranging from benign conditions to more severe pathologies, even cancer. Parents often worry and consult a physician when ... [more ▼]

The discovery of a cervical mass in a child suggests several possible diagnoses ranging from benign conditions to more severe pathologies, even cancer. Parents often worry and consult a physician when such a mass fails to regress after a few weeks. Palpation of small and solid lymph nodes is commonplace and generally trivial in children. A detailed clinical history and a careful examination often allow a distinction to be made between a benign and a serious condition. Additional tests are needed in case of doubt or in the prospect of reaching an precise aetiological diagnosis. These exams should be selected according to a decision algorithm. The investigation remains delicate. When the physician is convinced of the benign nature of the lymphadenopathy, there is no real need to identify the aetiology with the greatest precision, especially in acute cases with bilateral nodes that are commonly benign and spontaneously resolve. [less ▲]

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See detailcomment j'explore une otite séromuqueuse chez l'enfant
Dachy, Angélique ULg; LEFEBVRE, Philippe ULg; Battisti, Oreste ULg

in Revue Médicale de Liège (2013), 68

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See detailComment j’explore …Une différence de risque de survenue d’un événement dans les études cliniques
SCHEEN, André ULg; ERNEST, Philippe ULg; JANDRAIN, Bernard ULg

in Revue Médicale de Liège (2012), 67(11), 597-602

Evidence-based medicine often requires the comparison of two therapeutic interventions in controlled clinical trials with the demonstration of a superiority (versus a placebo or an active comparator) or ... [more ▼]

Evidence-based medicine often requires the comparison of two therapeutic interventions in controlled clinical trials with the demonstration of a superiority (versus a placebo or an active comparator) or at least a non-inferiority (versus an active reference) concerning a primary endpoint that has been defined a priori (occurrence of a major clinical event, for instance). The difference in the occurrence of such an event between two treatments may be statistically analyzed by absolute risk reduction, relative risk reduction, hazard ratio or odds ratio. The present article discusses the nuances, sometimes of importance, concerning the significance of these various indices and analyses the cautions to be taken and the pitfalls to be avoided in their interpretation and use in practice. The clinician is, indeed, increasingly confronted to results of clinical trials, but is generally poorly informed regarding the nuances of these various statistical analyses. [less ▲]

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See detailComment j'explore. . . une vascularite du systeme nerveux peripherique
Iserentant, Cynthia ULg; Bouquiaux, Olivier ULg; Deprez, Manuel ULg et al

in Revue Médicale de Liège (2005), 60(10), 805-10

Vasculitic neuropathies require early diagnosis and therapy since their prognosis is potentially severe. The following features are usually suggestive of a vasculitic neuropathy: painful multiple ... [more ▼]

Vasculitic neuropathies require early diagnosis and therapy since their prognosis is potentially severe. The following features are usually suggestive of a vasculitic neuropathy: painful multiple mononeuropathy with an acute/subacute course, signs and symptoms of multisystem involvement (arthritis, asthma, renal and skin involvement), biological evidence of an inflammatory syndrome. In one third of patients however, vasculitic neuropathies present as a polyneuropathy. For other patients, peripheral neuropathy is the presentation mode of a necrotizing vasculitis, in the absence of biological inflammatory syndrome. A combined muscle and nerve biopsy, will usually demonstrate the vasculitic process. Vasculitic neuropathies often have a favourable prognosis when immunosuppressive therapy (corticosteroids and/or cyclophosphamide) is initiated at an early stage. [less ▲]

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See detailComment j'explore. Les alopecies cicatricielles primitives.
FRANCHIMONT, Claudine ULg; PIERARD, Gérald ULg

in Revue Médicale de Liège (2012), 67(1), 44-50

Primary cicatricial alopecias (PCA) result from the inflammatory destruction of the hair follicle, followed by its replacement by a fibrotic streamer. The involvement of multipotent stem cells of the hair ... [more ▼]

Primary cicatricial alopecias (PCA) result from the inflammatory destruction of the hair follicle, followed by its replacement by a fibrotic streamer. The involvement of multipotent stem cells of the hair follicle is possible through a transdifferentiation pathway. The diagnosis relies on clinico-pathologic correlations. PCA are classified as the neutrophilic, lymphocytic and mixed types. Each of these groups gather specific disorders including folliculitis decalvans, dissecting folliculitis of the scalp, erosive pustulosis of the scalp, keloidal acne of the nape, frontal fibrosing alopecia, lichen planopilaris and lupus erythematosus. [less ▲]

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See detailComment j'explore... des lésions cutanées chez un toxicomane adepte de la cocaïne ou du crack.
Devillers, Céline ULg; Franchimont, Claudine ULg; Pierard, Gérald ULg et al

in Revue Médicale de Liège (2009), 64

Both cocaine and crack exert sympathetic and prothrombotic effects. The induced lesion may affect the skin, and other organ systems as well. Various types of vasculitis and infectious dermatoses are the ... [more ▼]

Both cocaine and crack exert sympathetic and prothrombotic effects. The induced lesion may affect the skin, and other organ systems as well. Various types of vasculitis and infectious dermatoses are the predominant issues. In addition, tactile and visual hallucinations may occur suggesting insect crawling underneath the skin. [less ▲]

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See detailComment j'explore... la rupture prematuree des membranes foetales par l'examen ultrastructural de la peau.
Hermanns-Lê, Trinh ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2008), 63(7-8), 508-10

The etiology of recurrent preterm premature rupture of fetal membranes (PPROM) is varied. Skin biopsies were performed in women who presented recurrent PPROM of unknown origin, searching for a possible ... [more ▼]

The etiology of recurrent preterm premature rupture of fetal membranes (PPROM) is varied. Skin biopsies were performed in women who presented recurrent PPROM of unknown origin, searching for a possible general expression of a connective tissue disorder. In the majority of cases, ultrastructural abnormalities were found in collagen bundles and fibrils, as well as in elastic fibres. In conclusion, some types of recurrent PPROM are probably the expression of a generalized connective tissue disorder. The genetic alteration remains to be explored. [less ▲]

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See detailComment j'explore... les nodules pulmonaires de types verre depoli et mixte: une nouvelle semiologie tomodensitometrique de l'adenocarcinome pulmonaire.
Couvreur, Thierry ULg; Kerzmann, Arnaud ULg; Radermecker, Marc ULg et al

in Revue Médicale de Liège (2007), 62(7-8), 515-22

Recently a new computed tomography semiology of the pulmonary adenocarcinoma was highlighted. Studies on ground-glass nodule and on mixed nodule showed the relation between these radiological images and ... [more ▼]

Recently a new computed tomography semiology of the pulmonary adenocarcinoma was highlighted. Studies on ground-glass nodule and on mixed nodule showed the relation between these radiological images and the different anatomopathological forms of lung adenocarcinoma. Ground-glass opacity can correspond to precancerous lesions and morphological characteristics of nodules are correlated with the prognosis. The presence of spiculation, pleural retraction and air bronchogram is significantly more important in neoplasic lesions. The presence or the apparition of a solid component inside the nodule or the presence of indentation is highly suggestive of adenocarcinoma. A lesion smaller than 20 mm and persistant after 1 month must be, either followed up, or removed by a limited surgical resection. Lesions larger than 20 mm or associated with a solid component must be treated by conventional surgery. [less ▲]

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See detailComment j'explore... les troubles dystoniques : un guide simple et pratique
Jedidi, Zayd ULg; Scholtes, Félix ULg; Kaschten, Bruno ULg et al

in Revue Médicale de Liège (2009), 64

La rencontre d'une dystonie, que ce soit en tant que symptôme entrant dans un cadre nosologique plus large ou en tant qu’anomalie isolée, n’est pas exceptionnelle en pratique clinique. La dystonie peut se ... [more ▼]

La rencontre d'une dystonie, que ce soit en tant que symptôme entrant dans un cadre nosologique plus large ou en tant qu’anomalie isolée, n’est pas exceptionnelle en pratique clinique. La dystonie peut se produire à tous âges de la vie. Un diagnostic précis est important afin d’optimiser la prise en charge de ces affections souvent chroniques et invalidantes. Les divers examens complémentaires devront inclure la résonance magnétique nucléaire, incontournable dans le diagnostic et le suivi des patients dystoniques. Nous présentons ici un aperçu des troubles dystoniques les plus fréquents et des solutions thérapeutiques appropriées, ainsi qu’une proposition de classification afin d’en simplifier le diagnostic. [less ▲]

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See detailComment j'explore... Revue des principaux auto-anticorps
Le Goff, Caroline ULg; Kaux, Jean-François ULg; Chapelle, Jean-Paul ULg et al

in Revue Médicale de Liège (2008), 63(1), 43-9

Auto-immune diseases represent the 3rd cause of morbidity after cardiovascular and oncologic diseases. They often occur in young subjects. Their presence is not synonymous of disease and must be ... [more ▼]

Auto-immune diseases represent the 3rd cause of morbidity after cardiovascular and oncologic diseases. They often occur in young subjects. Their presence is not synonymous of disease and must be associated to clinical signs to be pathological. However, their discovery can require a complement of investigations and the possibility of a follow-up because some auto-antibodies are predictive of disease. This paper is concerned with the main autoantibodies that can be picked out at the laboratory of immunology. Some technical explanations and INAMI rules are explained too. [less ▲]

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See detailComment j'explore... un lymphome T cutane. Nouveaux horizons.
Quatresooz, Pascale ULg; Pierard, Claudine ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2008), 63(4), 208-12

Although cutaneous T cell lymphomas remain rare, their incidence seems progressively on the rise. The main diagnostic criteria are issued from the clinico-pathological confrontation. Other methods help ... [more ▼]

Although cutaneous T cell lymphomas remain rare, their incidence seems progressively on the rise. The main diagnostic criteria are issued from the clinico-pathological confrontation. Other methods help support the diagnosis and establish a prognosis. [less ▲]

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See detailComment j'explore... un syndrome polyuropolydipsique insipide
Schleich, FLorence ULg; Krzesinski, Jean-Marie ULg; Legros, Jean-Jacques ULg

in Revue Médicale de Liège (2004), 59(11), 664-668

The finding of a polyuropolydispsic syndrome should prompt a complete biological investigation of its etiology. If polyuria can be a minor sign as in psychiatric disorder, it can also be the first ... [more ▼]

The finding of a polyuropolydispsic syndrome should prompt a complete biological investigation of its etiology. If polyuria can be a minor sign as in psychiatric disorder, it can also be the first manifestation of diabetes mellitus but also central diabetes insipidus, the latter linked to cerebral tumors, metastases in the hypothalamus, granulomatous disease, but also nephrogenic diabetes insipidus such as chronic renal disease or autoimmune disease. Intracellular dehydration is the major risk in case of a polyuropolydipsic syndrome. Prognosis depends on the capacity to maintain water balance through an intact thirst mechanism. After a brief review of the majority of causes of diabetes insipidus, we propose a diagnosis algorithm to easily make the diagnosis. [less ▲]

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See detailComment j'explore... Une anemie (1e partie).
Beguin, Yves ULg

in Revue Médicale de Liège (1995), 50(10), 443-4

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See detailComment j'explore... Une arythmie ventriculaire chez le sportif
Tombeux, C.; MELON, Pierre ULg; Close, P. et al

in Revue Médicale de Liège (2011), 66(1), 30-33

How I explore : ventricular arrhythmhmias in athletes <br />SUMMARY : Documented ventricular tachyarrhythmias or related symptoms need meticulous cardiac investigations. The mechanism of ventricular ... [more ▼]

How I explore : ventricular arrhythmhmias in athletes <br />SUMMARY : Documented ventricular tachyarrhythmias or related symptoms need meticulous cardiac investigations. The mechanism of ventricular arrhythmia must be defined. The prognosis is related to underlying cardiac electrical or structural disorders. In the absence of cardiovascular abnormalities, the prognosis is good. No disqualification to competitive activity is required in most cases. Assessment of the risk of sudden death remains a continuing challenge in athletes. This article reviews the diagnostic and therapeutic approaches of ventricular arrhythmias encountered in trained athletes. [less ▲]

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See detailComment j'explore... une dermatose hypochromique ou achromique.
Devillers, C.; Szepetiuk, Grégory ULg; Pierard, Claudine ULg et al

in Revue Médicale de Liège (2010), 65(2), 109-12

Some skin disorders typically share in common a hypochromic or achromic aspect. The diagnostic approach relies on a directed evaluation of the medical history and a careful clinical examination. In ... [more ▼]

Some skin disorders typically share in common a hypochromic or achromic aspect. The diagnostic approach relies on a directed evaluation of the medical history and a careful clinical examination. In addition, the cyanoacrylate skin surface biopsy helps establish the diagnosis. [less ▲]

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See detailComment j'explore... une fièvre d'origine indéterminée chez le patient adulte ?
VERTENOEIL, Gaëlle ULg; SERVAIS, Sophie ULg; Beguin, Yves ULg

in Revue Médicale de Liège (2012), 67(7-8), 391-397

Fever of unknown origin (FUO), with more than 200 potential causes, can represent a real diagnostic challenge.For the work-up of FUO, the first step is to pay attention to each element revealed by a ... [more ▼]

Fever of unknown origin (FUO), with more than 200 potential causes, can represent a real diagnostic challenge.For the work-up of FUO, the first step is to pay attention to each element revealed by a detailed history, a complete physical examination and by some basic diagnostic tests. These elements may constitute some clues that can guide the physician for the prescription of further appropriate diagnostic examinations and procedures. If there is no real specific clues,a pet-scan seems to be useful for the work-up of FUO. [less ▲]

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See detailComment j'explore... une hypertriglyceridemie.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(2), 103-5

The strategy for the diagnosis of hypertriglyceridaemia comprises three successive steps. First, the physician should confirm the biological abnormality by at least one additional blood sample taken after ... [more ▼]

The strategy for the diagnosis of hypertriglyceridaemia comprises three successive steps. First, the physician should confirm the biological abnormality by at least one additional blood sample taken after an overnight fast; recent data, however, suggest that postprandial hypertriglyceridaemia may also represent a cardiovascular risk factor. Second, the phenotype of hypertriglyceridaemia should be considered as either isolated high triglyceride levels or hypertriglyceridaemia combined with hypercholesterolemia may be present; the combination of hypertriglyceridaemia with a low HDL cholesterol concentration or its association with the metabolic or insulin resistance syndrome should also be investigated. Third, all should be done in order to find the etiology of the hypertriglyceridaemia (by determining its genetic or nutritional origin, by excluding possible underlying pathologies, by looking for drugs able to increase serum triglyceride levels). These various steps should help the physician to take the final decision of treating one particular patient as well as to chose the most appropriate, nutritional or pharmacological, treatment. [less ▲]

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See detailComment j'explore... une insuffisance cardiaque chronique
ANCION, Arnaud ULg; NELLESSEN, Eric ULg; Lancellotti, Patrizio ULg et al

in Revue Médicale de Liège (2011)

Heart failure is defined by precise criteria associating clinical signs and cardiac abnormalities. The exploration for signs and symptoms must be associated with the systematic realization of an ... [more ▼]

Heart failure is defined by precise criteria associating clinical signs and cardiac abnormalities. The exploration for signs and symptoms must be associated with the systematic realization of an electrocardiogram, a chest X-ray and an echocardiogram to rapidly obtain the diagnosis and direct the patient to an adapted complementary clarification. Other additional tests are available (catheterization, nuclear cardiology imaging,...). The purpose is to confirm the diagnosis, to determine the aetiology and to identify factors of poor prognosis. [less ▲]

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See detailComment j'explore... une metastase cutanee. Qui es-tu, d'ou viens-tu?
Quatresooz, Pascale ULg; Pierard, Claudine ULg; Rorive, Andrée ULg et al

in Revue Médicale de Liège (2008), 63(9), 559-63

Cutaneous metastases may accompany up to 3 to 10% of all malignancies. They are usually identified after diagnosing the primary neoplasm. However, their disclosure can be synchronous, or the metastasis ... [more ▼]

Cutaneous metastases may accompany up to 3 to 10% of all malignancies. They are usually identified after diagnosing the primary neoplasm. However, their disclosure can be synchronous, or the metastasis may be the initial finding qualified as "precocious". The identification of the primary neoplasm sometimes proves to be difficult. Gender of the patient, the aspect and distribution of the metastases, as well as the histological and immunohistological examinations help establishing the diagnosis. The prognosis of the metastatic disease is often poor. [less ▲]

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See detailComment j'explore... une perte de cheveux chez un patient cancéreux.
Pierard, Claudine ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2004), 59(9), 525-9

Increased hair loss followed, in some instances by an acute focal or total alopecia, can develop in some cancer patients. The surgical stress or procedure, radiotherapy and some chemotherapy regimens can ... [more ▼]

Increased hair loss followed, in some instances by an acute focal or total alopecia, can develop in some cancer patients. The surgical stress or procedure, radiotherapy and some chemotherapy regimens can be responsible for these disturbing events. The alopecia is transient or permanent according to its origin. Diverse diagnostic and prognostic methods are available for assessing alopecias. The trichogram is a rewarding one. [less ▲]

Detailed reference viewed: 62 (1 ULg)