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See detailComment j'explore ... une suspicion de cancer broncho-pulmonaire par tomographie a émission de positrons
Bury, Thierry ULg; Paulus, Patrick; Weber, Thierry et al

in Revue Médicale de Liège (1996), 51(4), 317-9

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See detailComment j'explore ... une suspicion de sténose d'artère rénale
Krzesinski, Jean-Marie ULg; Turatzinze, Léopold

in Revue Médicale de Liège (1999), 54(8), 702-704

Renal artery stenosis can present 2 clinical pictures, sometimes associated and potentially treatable, due mainly to atherosclerosis, but also to fibromuscular dysplasia. The first possible presentation ... [more ▼]

Renal artery stenosis can present 2 clinical pictures, sometimes associated and potentially treatable, due mainly to atherosclerosis, but also to fibromuscular dysplasia. The first possible presentation is renovascular hypertension which represents 1% of unselected hypertensive populations. The second possible presentation is ischemic renal disease, which represent 10% of the new indications for dialysis therapy and has a 50% mortality rate at 3 years. To explore this disease, arteriography, the gold standard, must be reserved for confirmation and treatment. Hypertension induced by the stenosis is best approached by captopril renal MAG 3 scintigraphy. Measurement of the stenosis severity can be performed either by duplex ultrasonography, magnetic resonance angiography or spinal CT angiography according to patients'characteristics, local experience and facilities. This disease must be searched in the presence of renal insufficiency of unknown cause or refractory hypertension. [less ▲]

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See detailComment j'explore ... une tache noire au cours de la grossesse. Une tache parfois difficile pour le clinicien.
Uhoda, I.; Pierard, Claudine ULg; Arrese Estrada, Jorge ULg et al

in Revue Médicale de Liège (2003), 58(12), 766-9

Cancers rarely coexist with pregnancy. Cutaneous melanoma, however, is one of the most frequently encountered neoplasms during pregnancy. Gestation may also be a period during which the aspect of some ... [more ▼]

Cancers rarely coexist with pregnancy. Cutaneous melanoma, however, is one of the most frequently encountered neoplasms during pregnancy. Gestation may also be a period during which the aspect of some melanocytic naevi can change eventhough the tumor remains benign. Distinction between a benign and a malignant lesion may then be a dilemma. Clinical morphometry, dermoscopy, skin surface biopsy, conventional histology and immunohistochemistry are valuable means that can be used to secure maximum diagnostic confidence. [less ▲]

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See detailComment j'explore ... Votre patient se plaint d’une perte de cheveux Contribution de la biopsie cutanée dans le diagnostic des alopécies non cicatricielles
Pierard-Franchimont, Claudine ULg; Pierard, Gérald ULg

in Revue medicale de Liege (2014), 69(12), 686-91

The diagnosis of most alopecia problems is based on the clinical history and a well conducted clinical examination. The additional contributions of dermoscopy, trichoscopy and trichogram are helpful ... [more ▼]

The diagnosis of most alopecia problems is based on the clinical history and a well conducted clinical examination. The additional contributions of dermoscopy, trichoscopy and trichogram are helpful. However, a scalp biopsy is occasionally necessary to establish the correct diagnosis. The main noncicatricial alopecias are represented by androgenetic alopecia, alopecia areata, trichotillomania, traction and pressure alopecia, temporal triangular alopecia, ageing alopecia, loose anagen syndrome, telogen effluvium and anagen effluvium. [less ▲]

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See detailComment j'explore certains cas difficiles de meningite tuberculeuse
Lemaire, Roger ULg; al Azba, S.; Brumioul, Danielle ULg et al

in Revue Médicale de Liège (2001), 56(3), 181-185

To formally document the presence of the bacillus of Koch in meninges still remains difficult and depends on many variables. We report two cases where the diagnosis proved difficult. The presentation of ... [more ▼]

To formally document the presence of the bacillus of Koch in meninges still remains difficult and depends on many variables. We report two cases where the diagnosis proved difficult. The presentation of tuberculous meningitis can take several aspects. Mantoux reaction is frequently negative. The BK cultures, which demonstrate the diagnosis, depend on the volume of CSF and on the importance of BK dissemination. It, unfortunately, remains difficult to make the diagnosis of tuberculous meningitis even though this pathology can have extremely deleterious consequences. [less ▲]

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See detailCOMMENT J’EXPLORE ET TRAITE UNE THROMBOSE VEINEUSE RÉNALE NÉONATALE : à propos d’un cas
Tribolet, S.; DRESSE, Marie-Françoise ULg; Lombet, J. et al

in Revue Médicale de Liège (2014), 69(4), 169-174

Neonatal renal vein thrombosis is a rare condition. The present case is rather unfrequent and particularly educative since it shows the complete diagnostic triad including hematuria, flank mass and ... [more ▼]

Neonatal renal vein thrombosis is a rare condition. The present case is rather unfrequent and particularly educative since it shows the complete diagnostic triad including hematuria, flank mass and thrombocytopenia. The diagnosis relies on the demonstration, by Doppler ultrasound, of an obstructed renal venous bed. The investigation is completed by a platelet count and the determination of the prothrombin time, of the activated partial thromboplastin time as well as of the concentration of fibrinogen. The screening also includes the search for a possible etiology, such as a deficiency in coagulation proteins, the presence of antiphospholipid antibodies or of a genetic mutation of one of the coagulation factors. Since there exist no evidence based guidelines for the management of the disease, we will discuss the diagnosis and treatment in relation with the published literature. [less ▲]

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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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See detailComment j'explore les hypoglycémies chez l'enfant : à propos de deux cas
HARVENGT, Julie ULg; DEBRAY, François-Guillaume ULg; LEBRETHON, Marie-Christine ULg et al

in Revue Médicale de Liège (2011), 66(12), 631-635

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See detailComment j'explore un patient hypertendu
Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (1995), 50(2), 91-92

Des examens complémentaires consitituent une étape importante de la prise en charge d'un patient hypertendu. Du bilan de base simple, peu coûteux et à appliquer à tous, aux examens paracliniques les plus ... [more ▼]

Des examens complémentaires consitituent une étape importante de la prise en charge d'un patient hypertendu. Du bilan de base simple, peu coûteux et à appliquer à tous, aux examens paracliniques les plus sophistiqués, la prescription nécessite cependant une personnalisation. II n'y a en effet pas une hypertension à explorer, mais des hypertendus, fort différents entre eux. Les examens à recommander vont cerner l'état actuel cardiaque, artériel et rénal ainsi que le profil de risque cardiovasculaire. Ils vont aussi rechercher une cause à l'élévation de pression si la clinique, l'anamnèse et quelques examens de laboratoire le suggèrent. [less ▲]

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See detailComment j'explore une atteinte des nerfs crâniens ?
WANG, François-Charles ULg; LOZZA, Alessandro

Conference (2012)

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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 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 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 ▲]

Detailed reference viewed: 96 (6 ULg)