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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 ▲]

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

in Revue de l’Association Belge des Technologues de Laboratoire = Tijdschrift van de Belgische Vereniging van Laboratoriumtechnologen (2006), 33

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See detailComment j'explore... Une valeur élevée de calcitonine?
Rikir, Estelle ULg; Valdes Socin, Hernan Gonzalo ULg; Vroonen, Laurent ULg et al

in Revue Médicale de Liège (2006), 61(3), 195-200

This article describes a case of lung cancer with associated hypercalcitoninemia in a man with a goitre. The case raises the problem of the differential diagnosis between medullary thyroid carcinoma and a ... [more ▼]

This article describes a case of lung cancer with associated hypercalcitoninemia in a man with a goitre. The case raises the problem of the differential diagnosis between medullary thyroid carcinoma and a neuroendocrine neoplasm with ectopic calcitonin secretion. The article first reviews the physiology of calcitonin, then outlines the diagnostic tests that are required to investigate hypercalcitoninemia and finally discusses the interpretation of test results. [less ▲]

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See detailComment j'explore.... L'echographie thoracique: le nouveau stethoscope du pneumologue.
HEINEN, Vincent ULg; DUYSINX, Bernard ULg; CORHAY, Jean-Louis ULg et al

in Revue Médicale de Liège (2012), 67(10), 543-9

We now have access to a large library of publications validating transparietal thoracic echography in various clinical situations. Parietal lesions, including osteolysis, can be detected and biopsied ... [more ▼]

We now have access to a large library of publications validating transparietal thoracic echography in various clinical situations. Parietal lesions, including osteolysis, can be detected and biopsied during the thoracic ultrasound (TUS) examination. To evaluate the parietal extension of lung cancers, TUS has proved superior to tomodensitometry. Pleural effusions can be easily diagnosed and aspirated. Pneumothoraces can be detected using well defined lung artifacts with a high frequency probe. Pleural and peripheral lung nodules can be detected and biopsied with real time visualization; the procedure is safe and accurate. Lung consolidations with a pleural contact can be diagnosed; this is particularly useful for pregnant women. In conclusion, TUS is a precious diagnostic tool for chosen applications, and can help to guide interventional procedures. The portable devices are also very useful for bedridden patients or for out of hospital use. [less ▲]

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See detailComment j'explore.... Une hypertension resistante
Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2002), 57(7), 475-478

Hypertension is a cardiovascular risk factor which needs a good evaluation before treatment. When this latter is decided, the target is to normalize high blood pressure. This requires a complete ... [more ▼]

Hypertension is a cardiovascular risk factor which needs a good evaluation before treatment. When this latter is decided, the target is to normalize high blood pressure. This requires a complete information of the patient; the latter will also receive individualized non pharmacological advices and, also, possibly different antihypertensive drugs. When blood pressure does not normalize, one must check the blood pressure measurement technique, the compliance to treatment and potential pharmacologic interferences. Secondary hypertension is only considered if resistance to therapy cannot be found. It should be remembered that obesity and sleep apnea disorders are responsible of many instances of refractory hypertension. [less ▲]

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See detailComment j'explore.... Une sclérodermie cutanée d'une manière non invasive.
Fraiture, A. L.; Henry, Frédérique ULg; Goffin, Véronique ULg et al

in Revue Médicale de Liège (2002), 57(3), 179-82

There exists several clinical types of scleroderma. Most of them show cutaneous manifestations. Skin involvement may be isolated (morphea) or be part of a multi-organ systemic disease. Objective non ... [more ▼]

There exists several clinical types of scleroderma. Most of them show cutaneous manifestations. Skin involvement may be isolated (morphea) or be part of a multi-organ systemic disease. Objective non-invasive functional methods are useful in order to better assess the severity and evolution of the disease and the effects of treatments. Measurements of the thickness and mechanical properties of the skin as well as the visualization of the cutaneous blood flow prove to be informative. [less ▲]

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See detailComment j'explore....une pathologie d'aspect microscopique cutané apparemment sain.
Quatresooz, Pascale ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2005), 60(2), 117-20

Some dermatologic disorders named "Invisible dermatoses" are defined by obvious clinical signs while histologic alterations remain discrete. This situation may lead to clinico-pathological discrepancies ... [more ▼]

Some dermatologic disorders named "Invisible dermatoses" are defined by obvious clinical signs while histologic alterations remain discrete. This situation may lead to clinico-pathological discrepancies impeding the establishment of a diagnosis. In other cases, the skin looks clinically normal but the histological examination allows to disclose some systemic diseases. Systematic analysis of the skin biopsy complemented by histochemical and immunohistochemical techniques may help reach the diagnosis. [less ▲]

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See detailComment j'explore...la peau par le photodiagnostic utilisant la fluorescence cutanee et son imagerie fonctionnelle.
Szepetiuk, G.; PIERARD-FRANCHIMONT, Claudine ULg; QUATRESOOZ, Pascale ULg et al

in Revue Médicale de Liège (2010), 65(9), 521-6

Under specific light illumination, skin produces peculiar fluorescent aspects. Such property can be used to provide diagnostic arguments or to disclose some peculiar functions of the skin. Some ... [more ▼]

Under specific light illumination, skin produces peculiar fluorescent aspects. Such property can be used to provide diagnostic arguments or to disclose some peculiar functions of the skin. Some superficial infections (erythrasma, tinea versicolor, dermatophytic tinea,..) reveal fluorescence that may be intense. The pilosebaceous follicles enriched in Propionibacterium spp show fluorescence. Such property is lost during some anti-acne treatments. A quenching effect is observed after application of sunscreens. The (pre)neoplastic areas prepared for dynamic phototherapy become fluorescent. Pyranine labeling of the stratum corneum exhibits fluorescence allowing the assessment of the renewal activity of the epidermis. [less ▲]

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See detailComment j'explore...la piste toxique revisitée des sclérodermies.
Quatresooz, Pascale ULg; Paquet, Philippe ULg; Pierard, Claudine ULg et al

in Revue Médicale de Liège (2007), 62(3), 170-4

The name scleroderma is given to a spectrum of diseases which differ clinically and bear different prognostic risks. The origins of the various forms of the disease are unclear. A toxic influence has been ... [more ▼]

The name scleroderma is given to a spectrum of diseases which differ clinically and bear different prognostic risks. The origins of the various forms of the disease are unclear. A toxic influence has been suggested, particularly for the progressive systemic scleroderma. However, the imputability of the suspected chemicals often remains unsettled. [less ▲]

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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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