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See detailComment je previens...un érysipele, ses consequences et ses récidives.
Henry, Frédérique ULiege; Salomon-Neira, M. D.; Letot, Bernard ULiege 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 ULiege; Pierard, Claudine ULiege; Nikkels, Arjen ULiege 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 ... A propos du positionnement des inhibiteurs de la DPP-4 (gliptines) dans le traitement du diabète de type 2
SCHEEN, André ULiege

in Revue Médicale de Liège (2015), 70

Summary : Dipeptidyl peptidase-4 (DPP-4) inhibitors (gliptins) are more and more prominent medications in the management of type 2 diabetes (T2D), with five molecules commercialized and as many fixed-dose ... [more ▼]

Summary : Dipeptidyl peptidase-4 (DPP-4) inhibitors (gliptins) are more and more prominent medications in the management of type 2 diabetes (T2D), with five molecules commercialized and as many fixed-dose combinations with metformin. After failure of metformin monotherapy, gliptins compete with old medications such as sulphonylureas, on the one hand, or with new oral antidiabetic agents such as inhibitors of renal sodium-glucose cotransporters type 2 (SGLT2) (gliflozines), on the other hand. Another alternative is the use of an incretin mimetic (agonist of glucagon-like peptide-1 receptors, to be injected subcutaneously) rather than an incretin enhancer such as a gliptin, before considering insulin therapy. This article analyses the arguments in favour of DPP-4 inhibitors. We will mainly consider the use of gliptins in patients with recently diagnosed T2D, in elderly and frail patients and in those with chronic kidney disease. To illustrate the discussion, we will analyze the results of both interventional and observational studies with vildagliptin. Obviously, these various groups of patients represent a large proportion of T2D population. [less ▲]

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See detailCOMMENT JE TRAITE ... des plaies mineures superficielles.
Hermanns-Le, T.; Nizet, Jean-Luc ULiege; Pierard-Franchimont, Claudine ULiege et al

in Revue Médicale de Liège (2016), 71(3), 116-9

Superficial minor wounds represent frequent events in daily practice. Their evolution is often favourable and without any mishap. However, they possibly evolve to some serious episodes. Normal healing ... [more ▼]

Superficial minor wounds represent frequent events in daily practice. Their evolution is often favourable and without any mishap. However, they possibly evolve to some serious episodes. Normal healing develops in three successive phases. They correspond to the inflammatory, proliferative and remodeling phases, respectively. Their treatments are distinct. The major active agents are cleaning products, antiseptics, corticosteroids and silicone gels. By contrast products claiming some healing properties are disappointing in most cases, and in some instances, they are of no use. [less ▲]

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See detailComment je traite ... en optimisant le blocage du système rénine-angiotensine-aldostérone
SCHLEICH, FLorence ULiege; Krzesinski, Jean-Marie ULiege; Pierard, Luc ULiege 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 ULiege; ZANDONA, Régine; EL-FASSI, Mehdi ULiege et al

in Revue Médicale de Liège (2014), 69

Detailed reference viewed: 163 (59 ULiège)
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See detailComment je traite ... L'ostéoporose sénile
Reginster, Jean-Yves ULiege

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 ULiege; Quatresooz, Pascale ULiege; Pierard, Gérald ULiege

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 ULiege; Humblet-Baron, Stéphanie ULiege; Baron, Frédéric ULiege 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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See detailComment je traite ... la mucite bucco-pharyngee lors d'une radiotherapie cervico-faciale
Piret, Pascal ULiege; Deneufbourg, Jean-Marie ULiege

in Revue Médicale de Liège (2004), 59(3), 120-7

Oral mucositis the major acute effect of head and neck radiotherapy. According to the degree, irradiation may be compromised in dose and overall time with consequences on outcome. Up to now there is no ... [more ▼]

Oral mucositis the major acute effect of head and neck radiotherapy. According to the degree, irradiation may be compromised in dose and overall time with consequences on outcome. Up to now there is no standard accepted protocol. A strict program of local and general hygiene is mandatory. Analgesics are often required. Amifostine acts as a protector of salivary glands GM-CSF and G-CSF stimulate proliferation of mucosal basal cells. Sucralfate plays a barrier role. Camomile plant extract is anti-inflammatory, well tolerated and cheap. Povidone-iodine is better than chlorhexidine as an antiseptic agent. PTA lozenges with polymixin E, tobramycin and amphotericin B showed a marked power of selective microbial decontamination. [less ▲]

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See detailComment je traite ... la paralysie faciale par anastomose hypoglosso-faciale.
Courtmans, I; Born, J D; CARLIER, Alain ULiege et al

in Revue Médicale de Liège (2002), 57(1), 3-6

Thirteen patients underwent a hypoglosso- or a spino-facial nerve anastomosis between 1990 and 1996. Facial palsy was the result of surgery in 12 cases and of radiosurgery in 1 case. The mean interval ... [more ▼]

Thirteen patients underwent a hypoglosso- or a spino-facial nerve anastomosis between 1990 and 1996. Facial palsy was the result of surgery in 12 cases and of radiosurgery in 1 case. The mean interval between facial palsy and anastomosis was 12 months. Facial nerve function is determined on the basis of clinical examination according to the classification of House-Brackmann and our own evaluation. According to House, 10 patients are classified grade III and 3 grade IV. Our evaluation defines in 10 grade III, 7 good results and 3 fair results. As far as the good results are concerned, the mean interval between palsy and anastomosis is short (< 3 months). The permanent eating and swallowing dysfunctions are consecutive to multiple cranial nerve deficits. The post-paralysis hemifacial spasm is facilitated by prolongated electric stimulations. [less ▲]

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See detailComment je traite ... Le cancer colorectal: I. Prévention et traitement adjuvant
Bours, Vincent ULiege; Jerusalem, Guy ULiege; Fillet, Georges ULiege

in Revue Médicale de Liège (1998), 53(4), 167-70

Colorectal adenocarcinoma is a major cause of cancer-related morbidity and mortality in Belgium and in other western countries. Prevention implies a modification of alimentation and maybe a chronic uptake ... [more ▼]

Colorectal adenocarcinoma is a major cause of cancer-related morbidity and mortality in Belgium and in other western countries. Prevention implies a modification of alimentation and maybe a chronic uptake of acetylsalicylic acid. Treatment of colorectal cancers is based on surgery and the prognosis is determined by the locoregional or metastatic tumor spread. Complete resection of any Astler Coller stage C colorectal malignant tumor has to be followed by a 5-fluorouracil-based adjuvant chemotherapy. In these protocols, 5-fluorouracil is administered together with folinic acid or levamisole. The administration of an adjuvant chemotherapy could also be considered for stage BII diseases. As rectal cancers are characterized by high local relapse rates, their treatment should associate radiotherapy, given either post-surgery or preferentially pre-surgery, with resection and chemotherapy. Appropriate treatment of colorectal cancers thus requires a concerted multidisciplinary approach. [less ▲]

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See detailComment je traite ... Le choix entre un sulfamide hypoglycémiant et une gliptine pour traiter le diabète de type 2
SCHEEN, André ULiege

in Revue Médicale de Liège (2014), 69(9), 476-484

The pharmacological therapy of hyperglycaemia in type 2 diabetes becomes increasingly complex. After failure of metformin monotherapy, several choices are possible. In clinical practice, the most common ... [more ▼]

The pharmacological therapy of hyperglycaemia in type 2 diabetes becomes increasingly complex. After failure of metformin monotherapy, several choices are possible. In clinical practice, the most common dilemma is to choose between adding a sulphonylurea or adding a dipeptidyl peptidase-4 inhibitor (gliptin). This review analyses the arguments in favour of one or the other pharmacological option, based upon criteria of efficacy, tolerance, safety, easiness of use, use in at risk populations and, last but not least, cost of therapy. In general, a patient-centered approach is recommended with an individualization of the therapy in function of the characteristics of each patient with the aim to obtain the best benefits/risks ratio, at an affordable cost. [less ▲]

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See detailComment je traite ... le myelome multiple refractaire par thalidomide
Scerbo, F.; Matus, G.; Sautois, Brieuc ULiege et al

in Revue Médicale de Liège (2000), 55(11), 970-3

Despite the use of high-dose chemotherapy with autologous hematopoietic stem cell transplantation, multiple myeloma remains largely uncurable. Indeed complete remission rate is about 50% and median ... [more ▼]

Despite the use of high-dose chemotherapy with autologous hematopoietic stem cell transplantation, multiple myeloma remains largely uncurable. Indeed complete remission rate is about 50% and median survival reaches 5 years without plateau. Recently thalidomide has been identified as a promising agent. We report the clinical story of 2 patients with refractory myeloma that we treated successfully with thalidomide. [less ▲]

Detailed reference viewed: 85 (3 ULiège)
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See detailComment je traite ... le pied du sportif et sa pathologie cutanée non mycosique
Goffin, Véronique ULiege; Bourguignon, R.; Fraiture, A. L. et al

in Revue Médicale de Liège (2002), 57(10), 630-6

Skin and nails of the foot of sport practitioners of various disciplines are subjected to the effects of benign but invalidating pathologies. Microtraumatisms are frequently involved. Beside ... [more ▼]

Skin and nails of the foot of sport practitioners of various disciplines are subjected to the effects of benign but invalidating pathologies. Microtraumatisms are frequently involved. Beside dermatomycoses and onychomycoses, a dozen of typical disorders are identified. [less ▲]

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See detailComment je traite ... les troubles de la magnésémie
Guillaume, Thierry; Krzesinski, Jean-Marie ULiege

in Revue Médicale de Liège (2003), 58(7-8), 465-467

Because symptoms associated with hypomagnesia are highly aspecific, this ionic abnormality is rarely searched for although it could be present in as much as 20 % of the population. The mode of correction ... [more ▼]

Because symptoms associated with hypomagnesia are highly aspecific, this ionic abnormality is rarely searched for although it could be present in as much as 20 % of the population. The mode of correction (oral or intravenous) depends on the etiology, severity and clinical consequences of hypomagnesemia. Significant hypermagnesemia only occurs in the presence of renal insufficiency and/or acute excess administration, mainly by the intravenous route. If interruption of administration does not suffice, renal dialysis might become necessary to quickly correct the magnesemium serum levels. [less ▲]

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See detailComment je traite ... les varicosités par sclérothérapie
Mostinckx, S.; Dezfoulian, Bita ULiege; Richert, Bertrand ULiege et al

in Revue Médicale de Liège (2005), 60(2), 77-80

Sclerotherapy is a technique for the treatment of varicosities, vascular ectasia, and sometimes, leg varicose veins. This method is aesthetic and in some cases therapeutics and uses sclerosing agents ... [more ▼]

Sclerotherapy is a technique for the treatment of varicosities, vascular ectasia, and sometimes, leg varicose veins. This method is aesthetic and in some cases therapeutics and uses sclerosing agents, electrocoagulation and exceptionally LASER. These relatively simple methods are safe and efficient if they are applied with a rigorous procedure by well trained physicians. [less ▲]

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See detailComment je traite ... par hormonotherapie des patientes developpant des complications thrombo-emboliques lors du traitement d'un cancer du sein par tamoxifene
Pelerin, D.; Silvestre, R. M.; Jerusalem, Guy ULiege et al

in Revue Médicale de Liège (2002), 57(12), 755-6

Thromboembolic complications are well known side effects of treatment with tamoxifen in patients with breast cancer. The authors review the pathophysiology and the risk factors that increase the ... [more ▼]

Thromboembolic complications are well known side effects of treatment with tamoxifen in patients with breast cancer. The authors review the pathophysiology and the risk factors that increase the probability to develop these complications. The most appropriate treatment is discussed. [less ▲]

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See detailComment je traite ... par metformine un patient diabetique avec insuffisance renale moderee.
SCHEEN, André ULiege

in Revue Médicale de Liège (2013), 68(4), 190-5

Numerous patients with type 2 diabetes have renal impairment, especially in the elderly population. Metformin, the first choice oral glucose-lowering agent, is classically contraindicated in case of ... [more ▼]

Numerous patients with type 2 diabetes have renal impairment, especially in the elderly population. Metformin, the first choice oral glucose-lowering agent, is classically contraindicated in case of chronic kidney disease of stages 3-5 (creatinine clearance < 60 ml/min/1.73 m2), because of a risk of accumulation of the biguanide that may lead to lactic acidosis. Hence numerous patients with some degree of renal impairment are being treated with metformin in clinical practice, apparently without any harm. In contrast, several observational studies have shown that they may clinically benefit from this therapy, including with a significant reduction of all-cause mortality when compared to patients not receiving metformin. Thus, an increasing number of physicians plea for revisiting the official criteria of contraindication to the use of metformin in case of renal insufficiency. The present paper discusses this controversy and insists upon the mandatory cautions to be taken when using metformin in a diabetic patient with moderate (stage 3) chronic kidney disease (metformin being contraindicated in case of severe renal impairment - stages 4-5). [less ▲]

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See detailCOMMENT JE TRAITE ... Point de vue critique sur l'approche actuelle du cancer du pancreas localisé
VAN DAELE, Daniel ULiege; Martinive, Philippe ULiege; Loly, C. et al

in Revue medicale de Liege (2015), 70(11), 540-5

Surgical resection followed by chemotherapy is the actual standard of care for localized, deemed resectable, pancreatic ductal adenocarcinoma. Despite a better selection of surgical candidates and the ... [more ▼]

Surgical resection followed by chemotherapy is the actual standard of care for localized, deemed resectable, pancreatic ductal adenocarcinoma. Despite a better selection of surgical candidates and the actual performance of expert teams, the proportion of patients with a prolonged survival has not been ameliorated during the last three decades. The morphological determinants of resectability are the subject of limitations. In the future, only a better understanding of the biological process, an earlier diagnosis of purely localized disease and more efficient systemic therapies may lead to a better prognosis. Meanwhile, taking into account the prognostic factors associated with a lower chance of cure is currently a matter of debate. The optimal therapeutic sequence, being a surgery-first or a neoadjuvant approach is controversial. The theoretical advantages of preoperative chemotherapy eventually associated with chemo-radiation are demonstrated in other tumours and applicable to pancreatic cancer without any excess of operative mortality, early progression rates and, on the contrary with positive survival data. The completion rates of multi-modal therapy are in favour of the preoperative approach, which also gives the opportunity to select the best candidates for surgical resection. [less ▲]

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