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See detailComment j'explore...le meli-melo des ichtyoses.
Hermanns-Lê, Trinh ULg; REGINSTER, Marie-Annick ULg; QUATRESOOZ, Pascale ULg et al

in Revue Médicale de Liège (2011), 66(2), 102-8

Ichthyoses are hereditary and sometimes acquired diseases of keratinisation. They are heterogeneous according to their clinical and histopathological presentations, as well as to the nature of their ... [more ▼]

Ichthyoses are hereditary and sometimes acquired diseases of keratinisation. They are heterogeneous according to their clinical and histopathological presentations, as well as to the nature of their molecular and genetic alterations. We present the most frequent types of hereditary ichthyoses. [less ▲]

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See detailComment j'explore...le risque cardio-vasculaire absolu a 10 ans: de Framingham 1998 a SCORE 2003.
Scheen, André ULg

in Revue Médicale de Liège (2004), 59(7-8), 460-6

Prevention of cardiovascular diseases should primarily focus on high-risk individuals. In the absence of atherosclerosis manifestations, such persons may be screened by the calculation of the absolute ... [more ▼]

Prevention of cardiovascular diseases should primarily focus on high-risk individuals. In the absence of atherosclerosis manifestations, such persons may be screened by the calculation of the absolute risk of complications during the next ten years or extrapolated at the age of 60 years. This calculation is based upon the analysis of most important risk factors of atherosclerosis. The mode of calculation that prevailed for many years used the Framingham equation determining the absolute coronary risk (both morbidity and mortality) in the next 10 years: a risk equal or superior to 20% is considered as high and requiring specific intervention. The Third Joint Task Force of European and other Societies on cardiovascular disease prevention in clinical practice recently proposed a new mode of calculation (SCORE) based upon the absolute risk of cardiovascular (and not exclusively coronary) mortality (only fatal events and not morbidity): according to SCORE, the threshold of high risk has been set at a risk equal or superior to 5% in the next 10 years. The present article compares the two modes of calculation with their own advantages and disadvantages. [less ▲]

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See detailComment j'explore...le syndrome metabolique par sa nouvelle definition dite de "consensus".
Scheen, André ULg; Luyckx, Françoise ULg; Lefebvre, Pierre ULg

in Revue Médicale de Liège (2006), 61(1), 48-52

The International Diabetes Federation recently proposed a so-called consensus definition of metabolic syndrome. According to this new definition, a subject has the metabolic syndrome if he/she has ... [more ▼]

The International Diabetes Federation recently proposed a so-called consensus definition of metabolic syndrome. According to this new definition, a subject has the metabolic syndrome if he/she has abdominal obesity (considered as a prerequisite and assessed, in the European population, by a waist circumference > 80 cm in women and > 94 cm in men) and, in addition, at least two other risk factors among 1) elevated fasting triglycerides > or = 150 mg/dl; 2) low HDL cholesterol HDL < 50 mg/dl in women and < 40 mg/dl in men; 3) increased arterial blood pressure > or = 130/ 85 mm Hg; and 4) elevated fasting plasma glucose concentration > or = 100 mg/dl. We will discuss the advantages and limitations of this new definition as well as the consequences of its use on the prevalence of the metabolic syndrome in the Belgian population. [less ▲]

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See detailComment j'explore...Les arteres coronaires en 2007: apports de la tomodensitometrie
Davin, Laurent ULg; Bruyere, P. J.; Lewin, Michel ULg et al

in Revue Médicale de Liège (2007), 62(4), 222-9

Cardiac imaging has always been a challenge because of the continuous movement of the heart. Cardiac computed tomography (CT) has undergone an accelerated progression over the past decade, due to the ... [more ▼]

Cardiac imaging has always been a challenge because of the continuous movement of the heart. Cardiac computed tomography (CT) has undergone an accelerated progression over the past decade, due to the combination of the high-speed rotation of the X-ray tube, the ECG-gating technique and the infra-millimeter spatial resolution. Multidetector CT allows visualisation of the coronary artery lumen and the detection of coronary stenosis after intravenous injection of contrast medium. Studies have demonstrated a high negative predictive value of CT coronary angiography (CTCA). CTCA may be reasonably used for the assessment of symptomatic patients, especially in the setting of equivocal treadmill or functional testing. Also, CTCA allows assessment of coronary bypass graft patency and recognition of aberrant coronary arteries. Limitations in the use of this technique exist: atrial fibrillation and other cardiac arrhythmias remain a contraindication; severe calcifications are the most frequent reason for impaired assessment of coronary arteries. High radiation doses prohibit the use of this test as a screening tool for asymptomatic patients. [less ▲]

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See detailComment j'explore...un dysfonctionnement des muscles respiratoires
Lehance, Cédric ULg; Close, Patricia ULg; Bury, Thierry ULg

in Revue Médicale de Liège (2004), 59(1), 51-5

As for other skeletal muscles, ventilatory muscle performance can be described in terms of strength and endurance. Ventilatory muscle strength is measured, for example, as the maximum inspiratory and ... [more ▼]

As for other skeletal muscles, ventilatory muscle performance can be described in terms of strength and endurance. Ventilatory muscle strength is measured, for example, as the maximum inspiratory and expiratory mouth pressures. It is now a routine procedure in many pulmonary function laboratories. Measurements of ventilatory muscle endurance are more difficult but two general types of tests are used: maximum voluntary ventilation and inspiratory threshold loading. [less ▲]

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See detailComment j'explore...Un patient avec un erytheme palmaire.
Vandenbossche, Géraldine ULg; Pierard, Claudine ULg; Quatresooz, Pascale ULg et al

in Revue Médicale de Liège (2008), 63(2), 101-4

Palmar erythema occurs in a series of physiological and pathological conditions. The first group encompasses hereditary and idiopathic conditions, as well as the time of pregnancy and ageing. The ... [more ▼]

Palmar erythema occurs in a series of physiological and pathological conditions. The first group encompasses hereditary and idiopathic conditions, as well as the time of pregnancy and ageing. The pathological states include some dermatoses as well as hepatic, autoimmune, infectious and paraneoplastic conditions. Medications may also be responsible for palmar erythema, in particular some chemotherapy agents. [less ▲]

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See detailComment j'explore...une chéilite.
Goffin, Véronique ULg; Blaise, G.; Henry, Frédérique ULg et al

in Revue Médicale de Liège (2006), 61(11), 780-2

A cheilitis is an inflammatory disease confined to the lips. Several origins are recognized. Their nature is often different in children and adults. Some are spongiotic due to irritation or allergic ... [more ▼]

A cheilitis is an inflammatory disease confined to the lips. Several origins are recognized. Their nature is often different in children and adults. Some are spongiotic due to irritation or allergic reaction. Other lesions are keratotic and can evolve to leucoplasia and epidermoid carcinoma. [less ▲]

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See detailComment j'explore...une escarre de decubitus.
Devillers, Céline ULg; Franchimont, Claudine ULg; Giet-Lesuisse, M. et al

in Revue Médicale de Liège (2009), 64(10), 535-7

Pressure ulcers represent a major health problem causing both considerable morbidity and a high financial burden for the healthcare system. The geriatric segment of the population at risk of pressure ... [more ▼]

Pressure ulcers represent a major health problem causing both considerable morbidity and a high financial burden for the healthcare system. The geriatric segment of the population at risk of pressure ulcer is progressively increasing. This condition occurs at home, in old people's homes and in hospitals as well. The severity, duration and orientation of forces applied to the skin represent the most important factors responsible for pressure ulcers. Prevention measures are essential to reduce the prevalence of the disease. [less ▲]

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See detailComment j'explore...une mycobactériose cutanée atypique
Henry, Frédérique ULg; Hayette, Marie-Pierre ULg; Melin, Pierrette ULg et al

in Revue Médicale de Liège (2000), 55(12), 1058-1063

Atypical mycobacteriosis affecting the skin are diverse and their treatments are different as well. These diseases show an increasing prevalence. The contamination occurs from the environment while ... [more ▼]

Atypical mycobacteriosis affecting the skin are diverse and their treatments are different as well. These diseases show an increasing prevalence. The contamination occurs from the environment while interhuman transmission does not occur. [less ▲]

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See detailComment j'explore...une pathologie pleurale?
Duysinx, Bernard ULg; Corhay, Jean-Louis ULg; Nguyen Dang, Delphine ULg et al

in Revue Médicale de Liège (2008), 63(10), 615-23

Pleural involvements are common and various respiratory diseases including inflammatory, infectious, occupational, or neoplastic pathological entities...Pleural thickening and pleurisy are usual ... [more ▼]

Pleural involvements are common and various respiratory diseases including inflammatory, infectious, occupational, or neoplastic pathological entities...Pleural thickening and pleurisy are usual radiological presentation. Etiological diagnosis imposes a vast and sometimes difficult exploration and it, especially since the conventional imaging by radiology, ultrasound, scanning and nuclear magnetic resonance has no specific diagnostic criteria for pleural malignancy. The metabolic imaging by positron emission tomography (PET) has been gradually positioned in the decision-making algorithm exploration of the pleural disease due to its excellent sensitivity in the diagnosis of malignant pleurisy (88.8%-100%). The analysis of chemistry, bacteriology and cytology pleural fluid makes a significant contribution to the diagnostic approach. However, although inescapable, thoracocentesis has a diagnostic sensibility not exceeding 62%. Moreover, the sensibility of the pleural blind needle biopsies does not exceed 51%. So, thoracoscopy, more invasive, is often justified to precise pleural disease with a diagnostic sensitivity greater than 95%. Finally, despite the diagnostic arsenal available, over 10% of pleurisies remain unknown etiology. [less ▲]

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See detailComment je mesure la pression artérielle au cabinet
Krzesinski, Jean-Marie ULg; Saint-Remy, Annie ULg

in Revue Médicale de Liège (2012), 67(9), 492-498

Routinely measuring blood pressure is still performed according to the auscultatory method using recognition of Korotkoff sounds. This usual technique is, however, often mishandled and is thus a source of ... [more ▼]

Routinely measuring blood pressure is still performed according to the auscultatory method using recognition of Korotkoff sounds. This usual technique is, however, often mishandled and is thus a source of error in the estimation of the true blood pressure level. Accuracy of such measure is, however, of paramount importance to be useful in daily medical practice. This methodology paper more specifically written for medical students recalls the essential principles of blood pressure measurement at the medical office, but also at home. [less ▲]

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See detailcomment je prends en charge une arthtite septique d'origine indéterminée chez l'enfant
BIONDOLILLO, Gaetano ULg; CAPRASSE, Philippe; Battisti, Oreste ULg

in Revue Médicale de Liège (2013), 68

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See detailComment je previens ... les maladies cardio-vasculaires par une approche pharmacologique combinee: y a-t-il place pour une polypill"?"
Scheen, André ULg; Lefebvre, Pierre ULg; Kulbertus, Henri ULg

in Revue Médicale de Liège (2003), 58(9), 527-33

In the June 28, 2003 issue of the British Medical Journal, an extensive literature survey based on various large meta-analyses of the efficacy and safety of the reduction of four cardiovascular risk ... [more ▼]

In the June 28, 2003 issue of the British Medical Journal, an extensive literature survey based on various large meta-analyses of the efficacy and safety of the reduction of four cardiovascular risk factors (cholesterol, arterial blood pressure, platelet aggregation, homocysteine) leads to the conclusion that a combined pharmacological intervention should reduce ischaemic heart disease events by 88% and strokes by 80% in at risk individuals. Therefore, a new paradigm is proposed for the prevention of cardiovascular diseases. This new strategy would consist in the systematic prescription to people with a history of heart attack or stroke, those with any form of obliterative atherosclerotic vascular disease or diabetes, and everyone aged 55 and older of a fixed combination of 6 pharmacological agents independently of initial risk factor profile.... Such pharmacological formulation, called "polypill", should contain a statin, three blood pressure lowering drugs (each at half standard dose), aspirin (75 mg/day) and folic acid (0.8 mg/day). We discuss the pros and cons of this new paradigm. However, the efficacy of such "polypill" remains to be demonstrated in a large controlled clinical trial as well as its superiority as compared to a classical approach of cardiovascular prevention based upon the individual optimal correction of each risk factor thanks a dose titration of each pharmacological compound. [less ▲]

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See detailComment je préviens ... par des soins dermo-cosmetiques, l'expression d'une acné qui couve.
Pierard, Gérald ULg; Pierard, Claudine ULg

in Revue Médicale de Liège (2005), 60(9), 741-3

Acne is a disorder affecting the majority of subjects during adolescence that may persist at various grades of severity during adulthood. This disorder may manifest itself at different levels of severity ... [more ▼]

Acne is a disorder affecting the majority of subjects during adolescence that may persist at various grades of severity during adulthood. This disorder may manifest itself at different levels of severity ranging from discrete to severe. The lesions may be sporadic or follow a wild course. The therapeutic strategy depends on these progression characteristics and must fit to each individual patient. This review focuses on the minor but the most frequent types of acne that may benefit from dermocosmetic treatments. [less ▲]

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See detailComment je préviens et je traite : les ulcères de stress
FRAIPONT, V; LAMBERMONT, Bernard ULg; GAST, Pierrette ULg et al

in Revue Médicale de Liège (1998), 53

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See detailComment je previens...l'endocardite infectieuse: une meilleure hygiene bucco-dentaire plutot qu'une antibioprophylaxie systematique?
Morimont, P.; Frippiat, F.; LANCELLOTTI, Patrizio ULg et al

in Revue Médicale de Liège (2008), 63(11), 640-2

Prophylaxis for infective endocarditis has been recommended on the basis of the supposed pathophysiology of the disease, although no randomised clinical trial has confirmed its efficacy. Bacteraemia ... [more ▼]

Prophylaxis for infective endocarditis has been recommended on the basis of the supposed pathophysiology of the disease, although no randomised clinical trial has confirmed its efficacy. Bacteraemia resulting from daily activities is much more likely to cause infective endocarditis than bacteraemia associated with invasive medical procedures. As a result, recommendations for antibiotic prophylaxis tend now to be severely restricted. [less ▲]

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See detailComment je previens...le zona par la vaccination.
Nikkels, Arjen ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2007), 62(1), 44-7

Herpes zoster (HZ) results from reactivation of the varicella-zoster virus (VZV), which remains latent in the dorsal root ganglia after varicella. HZ predominantly affects people over 50 years of age ... [more ▼]

Herpes zoster (HZ) results from reactivation of the varicella-zoster virus (VZV), which remains latent in the dorsal root ganglia after varicella. HZ predominantly affects people over 50 years of age without gender distinction, and its incidence increases with age. The most feared complication of HZ is the zoster-associated pains (ZAP), which encompasses the prodromal, concomitant and post-zoster persistent pains. The latter neuralgias are particularly invalidating and notoriously difficult, or even impossible to abate with current therapies. Until now, the best ZAP prevention was achieved by antiviral treatment given during the earliest phase of the eruption. This treatment certainly reduces the duration and intensity of ZAP, but exerts little influence on post-zoster persistent pains. A vaccination boosting the specific anti-VZV immunity in order to decrease the HZ incidence and post-zoster pains appears promising. A recent study performed on 38.546 immunocompetent patients aged over 60 years assessed the efficacy of a single injection of an anti-zoster vaccine (Zostavax). The incidence of HZ and post-zoster pain was decreased by 50% and 66%, respectively. Vaccination could be considered as a valuable option to alleviate the feared complications of HZ. [less ▲]

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See detailComment je préviens...les cancers cutanés: entre information et syndrome "telly belly".
Pierard, Claudine ULg; Henry, Frédérique ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2004), 59(1), 5-7

During the past decades, the incidence of skin cancers has been on the rise in Wallonia as in other regions of similar latitude in the rest of the world. Awareness of the population to the dangers of sun ... [more ▼]

During the past decades, the incidence of skin cancers has been on the rise in Wallonia as in other regions of similar latitude in the rest of the world. Awareness of the population to the dangers of sun exposure and to the benefit of early cancer diagnosis is of the upmost importance and undisputed. The impact of the information delivered by the media and of the actions initiated by physicians is heterogeneous. The positive and unquestionable aspect is hampered if the population at risk is not properly targeted. It is also reduced if the problem understanding creates a surge in telly-belly syndrome. [less ▲]

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See detailComment je previens...un érysipele, ses consequences et ses récidives.
Henry, Frédérique ULg; Salomon-Neira, M. D.; Letot, Bernard ULg et al

in Revue Médicale de Liège (2004), 59(7-8), 423-5

Erysipelas is a serious infection of the skin. In case of delay in initiating adequate antibiotic treatment, complications, sometimes dismal, can supervene. In addition, erysipelas shows a tendancy to ... [more ▼]

Erysipelas is a serious infection of the skin. In case of delay in initiating adequate antibiotic treatment, complications, sometimes dismal, can supervene. In addition, erysipelas shows a tendancy to recurrences. The prevention of an episode of erysipelas calls for correct personal hygiene and adequate use of topical antiseptics in case of skin effraction, even when minimal. When erysipelas is established, a rapidly initiated antibiotic treatment for a prolonged period prevents streptococcal gangrene complications. Elastic contention of any leg edema from venous or lymphatic origin and prophylactic antisepsis of discrete wounds help in preventing erysipelas recurrences. [less ▲]

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See detailComment je previens...une exacerbation de la dermatite atopique.
Xhauflaire, Emmanuelle ULg; Pierard, Claudine ULg; Nikkels, Arjen ULg et al

in Revue Médicale de Liège (2006), 61(7-8), 600-3

Atopic dermatitis is under the influence of series of environmental factors. The contact with unsuited cleaning agents and rough textiles can exacerbate pruritus and inflammation. Preventive and adjuvant ... [more ▼]

Atopic dermatitis is under the influence of series of environmental factors. The contact with unsuited cleaning agents and rough textiles can exacerbate pruritus and inflammation. Preventive and adjuvant measures can thus help the care procedures of the disease. Appropriate hygiene measures and the use of emollients are particularly helpful. Clothing measures are also in place. Undergarments and pyjamas made of knitted natural silk are available. Other measures, sometimes corresponding to anecdotal claims--antihistamines, thermal cures, unconventional medicine, probiotics, chinese herbals, essential fatty acids--have not proven their preventive efficacy in atopic dermatitis. [less ▲]

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