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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 arthrite septique d'origine indéterminée chez l'enfant
BIONDOLILLO, Gaetano ULg; CAPRASSE, Philippe; Battisti, Oreste ULg

in Revue Médicale de Liège (2014), 69(1), 7-11

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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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See detailComment je traite ... en optimisant le blocage du système rénine-angiotensine-aldostérone
SCHLEICH, FLorence ULg; Krzesinski, Jean-Marie ULg; Pierard, Luc ULg et al

in Revue Médicale de Liège (2008), 63

The blockade of the renin-angiotensin-aldosterone system (RAAS) has been shown to be useful, or even mandatory, in the management of arterial hypertension, congestive heart failure, post-myocardial ... [more ▼]

The blockade of the renin-angiotensin-aldosterone system (RAAS) has been shown to be useful, or even mandatory, in the management of arterial hypertension, congestive heart failure, post-myocardial infarction and nephropathy with albuminuria, due to diabetes or not. Such blockade can be obtained with an angiotensin converting enzyme inhibitor, a specific antagonist of angiotensin II AT1 receptors and/or recently a direct inhibitor of renin such as aliskiren. Various studies have demonstrated the advantage of optimising RAAS blockade in order to benefit of the best cardiorenal protection. The present article describes the various modalities to optimize the RAAS blockade, either by using a maximal dosage of a monotherapy, or by choosing a double inhibition of RAAS. New prospects for the RAAS blockade will be also briefly considered. [less ▲]

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See detailCOMMENT JE TRAITE ... L’arrêt cardio-respiratoire extrahospitalier : la fenêtre du centraliste 112
STIPULANTE, Samuel ULg; ZANDONA, Régine; EL-FASSI, Mehdi ULg et al

in Revue Médicale de Liège (2014), 69

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See detailComment je traite ... L'ostéoporose sénile
Reginster, Jean-Yves ULg

in Revue Médicale de Liège (1997), 52(4), 267-9

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See detailComment je traite ... la dermatite atopique par le pimecrolimus topique (Elidel). Le paradigme émergent des inhibiteurs de la calcineurine.
Pierard, Claudine ULg; Quatresooz, Pascale ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2005), 60(3), 136-40

Topical calcineurin inhibitors, also called topical immunomodulators or downregulators, represent an innovative class of non-steroidal anti-inflammatory agents. Pimecrolimus 1% cream (Elidel) is one ... [more ▼]

Topical calcineurin inhibitors, also called topical immunomodulators or downregulators, represent an innovative class of non-steroidal anti-inflammatory agents. Pimecrolimus 1% cream (Elidel) is one representative drug available for the treatment of atopic dermatitis. Unlike topical steroids, this drug does not affect collagen synthesis and does not alter the dendritic cell functions and the barrier function of the skin. [less ▲]

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See detailComment je traite ... la leucemie myeloide chronique (LMC).
Hafraoui, Kaoutar ULg; Humblet-Baron, Stéphanie ULg; Baron, Frédéric ULg et al

in Revue Médicale de Liège (2003), 58(1), 7-12

This review article describes the identification of the tyrosine kinase BCR/ABL as the hallmark of chronic myeloid leukemias (CML) as well as the development of a specific inhibitor of this tyrosine ... [more ▼]

This review article describes the identification of the tyrosine kinase BCR/ABL as the hallmark of chronic myeloid leukemias (CML) as well as the development of a specific inhibitor of this tyrosine kinase, the STI571 (Glivec, imatinib mesylate). The authors discuss the results of a phase I and three phase II trials reporting the efficacy of STI571 as treatment for CML patients and propose two simplified algorithms that may help to guide decision-making for the individual patient. [less ▲]

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