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See detailLe cas clinique du mois. Carcinome basocellulaire pédicule et pigmenté: une présentation inhabituelle.
Azzam, C.; Arrese Estrada, Jorge ULg; Jacquemin, Denise ULg et al

in Revue Médicale de Liège (2006), 61(9), 614-6

Basal cell carcinomas (BCC) are the most common malignant neoplasms in humans. Clinical misdiagnoses are not uncommon. These cancers are classified according to their histological and clinical ... [more ▼]

Basal cell carcinomas (BCC) are the most common malignant neoplasms in humans. Clinical misdiagnoses are not uncommon. These cancers are classified according to their histological and clinical characteristics which exhibit distinct malignant behaviours. It is important to be aware of the different clinical presentations both for the accurate diagnosis and tumour management. We report the case of a 78-year-old man, who presented an unusual pedunculated and pigmented BCC. This combined aspect is rarely encountered. [less ▲]

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See detailSyndrome DRESS à la sulfasalazine.
Bourguignon, Raphaël; Pierard, Claudine ULg; Paquet, Philippe ULg et al

in Revue Médicale de Liège (2006), 61(9), 643-8

We report a case of drug hypersensibility syndrome (DRESS syndrome) developed one month after initiation of a treatment by sulfasalazine. Due to the severity of the cytolytic hepatic damages as observed ... [more ▼]

We report a case of drug hypersensibility syndrome (DRESS syndrome) developed one month after initiation of a treatment by sulfasalazine. Due to the severity of the cytolytic hepatic damages as observed in this case, we emphasize the importance of suggesting this diagnosis in any patient developing a cutaneous rash and an alteration of the general health status after initiation of a new treatment. The hematologic alterations which represent a key feature for the diagnosis may rash. develop only a few days after the cutaneous rash. [less ▲]

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See detailComment je traite...l'acné de l'adolescent: un algorithme stratégique sans antibiotique.
Xhauflaire, Emmanuelle ULg; Goffin, Véronique ULg; Pierard, Claudine ULg et al

in Revue Médicale de Liège (2006), 61(10), 667-70

Acne is a multifaceted disorder. Its clinical presentation differs according to the age and gender of the subjects. Acne of the adolescent is a frequent disorder. Some topical and oral antibiotics have ... [more ▼]

Acne is a multifaceted disorder. Its clinical presentation differs according to the age and gender of the subjects. Acne of the adolescent is a frequent disorder. Some topical and oral antibiotics have proven their efficacy. However, the risk of bacterial resistance may be a concern for the clinicians and their patients. Hence, a therapeutic strategy without antibiotics merits to be considered. Retinoids have a place of choice in this therapeutic strategy. Benzoyl peroxide and miconazole are also active and valuable agents in this therapeutic algorithm. [less ▲]

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See detailLes dermatoses linéaires.
Thirion, L.; Nikkels, Arjen ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(10), 719-23

Some typical distributions of skin lesions represent a helpful sign for the differential diagnosis in dermatology. Indeed, some dermatoses, affecting the skin, nails or mucosae, display an annular or ... [more ▼]

Some typical distributions of skin lesions represent a helpful sign for the differential diagnosis in dermatology. Indeed, some dermatoses, affecting the skin, nails or mucosae, display an annular or linear disposition. The linear pattern can be explained by several factors. The dermatosis can follow either a nerve traject, vascular or lymphatic vessels, or embryological lines. Exogenous factors, including traumatisms or automutilations, can also contribute to this particular distribution. In this review, the principal linear dermatoses are discussed together with their pathogenesis. [less ▲]

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See detailLe caractère relatif des indicateurs de tendance
Monseur, Christian ULg; Lafontaine, Dominique ULg

in Schweizerische Zeitschrift für Bildungswissenschaften = Rivista Svizzera di Scienze dell' Educazione = Revue Suisse des Sciences de l'Education (2006), 3(28), 353-371

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See detailComment je traite...un patient atteint de mycosis fongoide.
Pierard, Claudine ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(11), 740-6

Primary lymphomas of the skin exhibit singular clinical, histological and prognostic features that are not shared by lymphomas originating from the lymphoid tissues. This review is an update of the ... [more ▼]

Primary lymphomas of the skin exhibit singular clinical, histological and prognostic features that are not shared by lymphomas originating from the lymphoid tissues. This review is an update of the current concepts about the diagnosis and treatment of mycosis fungoides, the most frequent entity among the primary cutaneous lymphomas. [less ▲]

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See detailComment j'explore ... un patient atteint de mélanome: actualisation d'un algorithme.
Pierard, Claudine ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(12), 837-43

Cutaneous melanoma is a cancer affecting an ever growing proportion of young adults. Currently, the best approach for a prolonged remission or cure relies on early detection of the primary neoplasm and of ... [more ▼]

Cutaneous melanoma is a cancer affecting an ever growing proportion of young adults. Currently, the best approach for a prolonged remission or cure relies on early detection of the primary neoplasm and of its first possible metastases. Some therapies can bring much hope at this stage of the disease. The early detection of lymph node metastases is therefore essential in the global management strategy. The excision and the microscopic examination of the sentinel lymph node are important in this evaluation. Echography of the draining lymph nodes is a non invasive procedure which may also prove to be informative. PET-scan brings additional information, particularly when the dissemination risk is beyond the first group of lymph nodes. [less ▲]

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See detailSkin capacitance imaging for the dermatologists
Pierard, Gérald ULg

in European Dermatology Review (2006), 1

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See detailRecherche-Développement et transfert des connaissances relatifs à un projet de transport fluvial en Amazonie
Marchal, Jean ULg

in Bulletin des Séances de l’Académie Royale des Sciences d’Outre-Mer = Mededelingen der Zittingen van de Koninklijke Academie voor Overzeese Wetenschappen (2006), n°52

Le projet de « Recherche & Développement » présenté, illustre bien les acquis d’une longue collaboration entre l’Université de Liège et l’Université Centrale de l’Equateur. Une consolidation des résultats ... [more ▼]

Le projet de « Recherche & Développement » présenté, illustre bien les acquis d’une longue collaboration entre l’Université de Liège et l’Université Centrale de l’Equateur. Une consolidation des résultats de tous ces travaux a résidé dans la mise au point d’un programme de formation professionnelle à l’attention des cadres des pays d’Amérique du Sud : ce transfert de connaissances, élément qui renforce la durabilité de cette coopération, et sa méthodologie sont également décrits dans la présente communication. Le projet a pour but d'étudier la faisabilité d'un transport organisé et bien structuré, utilisant les voies navigables de la région du haut Napo afin de lui permettre de relever le défi de développement durable et d'amélioration de la qualité de vie de ses habitants. Ce projet s’inscrit dans un projet plus vaste de développement d’un axe intermodal, utilisant intensivement le mode fluvial, entre l’océan Pacifique et l’océan Atlantique à travers le bassin amazonien [less ▲]

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See detailFEASIBILITY STUDY OF SLUDGE TRANSPORT BY INLAND WATERWAYS
Marchal, Jean ULg; Ndiaye, Alassane-Ballé ULg; Zhang, Zhaomin

in Bulletin de l’Association Internationale Permanente des Congrès de Navigation [Bulletin de l'AIPCN] (2006)

There are significant economic and environmental interests to transport the sludge, which comes from the sewage treatment plants, to the incinerators by inland waterways. Due to the physical and chemical ... [more ▼]

There are significant economic and environmental interests to transport the sludge, which comes from the sewage treatment plants, to the incinerators by inland waterways. Due to the physical and chemical characteristics of the sludge, conventional means of waterway transport meet with the limits and the new technologies should be introduced, especially in the aspects of sludge holding and handling. This paper will introduce briefly the study made for the local communities in the region Walloon (Belgium) to establish such systems of sludge transport by inland waterways. The study covered the handling and holding techniques, the optimal shipping operations, and the socio-economic benefits assessments. [less ▲]

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See detailEffect of atropine-dobutamine stress test on left ventricular echocardio graphic parameters in untrained warmblood horses
Sandersen, Charlotte ULg; Detilleux, Johann ULg; De Moffarts, Brieux et al

in Journal of Veterinary Internal Medicine (2006)

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See detailDéchiffrer Vénus. Renaissance et âge classique
Droixhe, Daniel ULg

in Journal de la Renaissance. IV (2006)

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See detailL'aspirine en prevention primaire des maladies cardio-vasculaires chez le patient diabetique.
Legrand, Delphine ULg; Scheen, André ULg

in Revue Médicale de Liège (2006), 61(10), 682-90

Acetylsalicylic acid (aspirin) is widely used as antiplatelet therapy for the primary and secondary prevention of cardiovascular diseases. However, the effects appear to be different according to the ... [more ▼]

Acetylsalicylic acid (aspirin) is widely used as antiplatelet therapy for the primary and secondary prevention of cardiovascular diseases. However, the effects appear to be different according to the studied population, with a reduction of coronary events in men and, rather, a diminution of strokes in women. Diabetes mellitus markedly increases the risk of cardiovascular diseases, with an especially elevated relative risk among women. We present a detailed analysis of the literature about the efficacy of aspirin in the primary prevention of cardiovascular complications in the diabetic population. Limited available data suggest a lower protection in the diabetic than in the non-diabetic population. A greater aspirin resistance has been suggested in diabetic patents, which might lead to the use of a higher daily dosage of aspirin in diabetic than in non diabetic patients. Whatsoever, aspirin remains the first antiplatelet agent in the diabetic population in all international guidelines of cardiovascular prevention. [less ▲]

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See detailL'étude clinique du mois. L'étude CHARISMA: à la recherche de la meilleure stratégie antiagrégante plaquettaire en prévention cardio-vasculaire.
Scheen, André ULg

in Revue Médicale de Liège (2006), 61(9), 656-61

The CHARISMA ("Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance") trial compared the effects of a dual antiplatelet therapy with clopidogrel plus low dose ... [more ▼]

The CHARISMA ("Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance") trial compared the effects of a dual antiplatelet therapy with clopidogrel plus low dose aspirin with those of a monotherapy with aspirin (75-162 mg/day) on the incidence of cardiovascular events in 15,603 patients at high risk for atherothrombotic events followed for a median of 28 months. The primary efficacy endpoint, a composite of myocardial infarction, stroke, or death from cardiovascular causes, was not significantly different between the two treatment arms. The secondary principal efficacy endpoint, which included all hospitalizations for ischaemic events, was slightly reduced in the group with clopidogrel-aspirin as compared to the group with placebo-aspirin. In a subgroup analysis, among so-called "symptomatico" patients (79 % of the studied population), the dual antiplatelet therapy was associated with a significantly lower incidence of events than aspirin alone, including the primary efficacy end point. On the contrary, in "asymptomatic" patients, such a favourable effect was not observed. Unexpectedly, in this subgroup, a paradoxical increase in the mortality rate was observed with the clopidogrel-aspirin combination. As far as safety was concerned, the risk of severe (difference not significant) and moderate (difference significant) bleeding was higher in patients with the clopidogrel-aspirin combination. In conclusion, acetylsalicylic acid (aspirin) is the first choice drug and the only antiplatelet agent to be used in prvention of cardiovascular disease. In secondary prevention, the addition of clopidogrel may reinforce the cardiovascular protection given by aspirin in "symptomatic" patients, but at the expense of a slightly higher bleeding rate. [less ▲]

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See detailLe diabete de type 1 et la maladie coeliaque.
Mathieu, Sandrine ULg; Stassen, A.; Paquot, Nicolas ULg et al

in Revue Médicale de Liège (2006), 61(9), 637-42

Celiac disease is more prevalent in type 1 diabetic patients than in the general population. The exact reason for this association remains unknown. Two hypotheses are taken into consideration: either a ... [more ▼]

Celiac disease is more prevalent in type 1 diabetic patients than in the general population. The exact reason for this association remains unknown. Two hypotheses are taken into consideration: either a common genetic background or an immune response against Langerhans islets triggered by celiac disease. This review presents recent data about this association and its consequences in clinical practice. [less ▲]

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See detailCoût croissant de l'insulinothérapie en Belgique. De l'analyse critique de la situation a la recherche de solutions pratiques.
Scheen, André ULg

in Revue Médicale de Liège (2006), 61(9), 617-22

Cost related to insulin therapy is markedly increasing in Belgium, as in other Eucopean countries. In the present paper, we will briefly analyze the main reasons for such aa increase, integrate such ... [more ▼]

Cost related to insulin therapy is markedly increasing in Belgium, as in other Eucopean countries. In the present paper, we will briefly analyze the main reasons for such aa increase, integrate such observation withIn the global context of diabetes management and suggest some solutions to provide best care to insulin-treated diabetic patients at a reasonable cost. The rise of the cost of insulin therapy has a multifactorial origin. It mainly results from an increase in the number of diabetic patients, a more intensive management, In both type 1 and type 2 diabetes, and a greater use of more expansive insulin analogues. It is important to analyze the increase of the cost of insulin therapy within the global burden of diabetes melitus. Only a better responsibility of all health care partners, patients, physicians, pharmaceutical companies, public health authorities, could provide solutions allowing diabetic people to profit from best treatments they should receive in order to prevent diabetic complications, by far the main cause of expenses. [less ▲]

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See detailConseils pour une meilleure prescription medicamenteuse.
Scheen, André ULg; Parada, Alberto; Giet, Didier ULg

in Revue Médicale de Liège (2006), 61(5-6), 488-93

The prescription of a pharmacological agent concludes most medical visits. The rational basis of drug prescription by the physician relies on numerous pharmacodynamic, pharmacokinetic, pragmatic and ... [more ▼]

The prescription of a pharmacological agent concludes most medical visits. The rational basis of drug prescription by the physician relies on numerous pharmacodynamic, pharmacokinetic, pragmatic and economic considerations. However, it is a pity to notice that one patient out of two does not strictly follow the pharmacological treatment as it was prescribed. This article analyses some problems of the patient-doctor relationship, which may reduce medication compliance, and provides practical advice for improving such a situation in order to enhance both efficacy and safety of drug prescribing. [less ▲]

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See detailInteractions medicamenteuses: de la theorie a la pratique.
Scheen, André ULg

in Revue Médicale de Liège (2006), 61(5-6), 471-82

Pharmacotherapy becomes increasingly complex and therapeutic targets are more and more ambitious for both care and prevention. Therefore, polypharmacy is frequent, which exposes the patient to a high risk ... [more ▼]

Pharmacotherapy becomes increasingly complex and therapeutic targets are more and more ambitious for both care and prevention. Therefore, polypharmacy is frequent, which exposes the patient to a high risk of drug-drug interactions. These are often underestimated although they are responsible for many adverse events that may be serious and even fatal. In the present paper, we will first briefly recall the main cautions in the use of medications as well as the most common conditions favouring the occurrence of harmful drug interactions. Then, we will analyze the various mechanisms leading to drug interactions, emphasizing especially those involving cytochrome P450 enzymatic system and P-glycoprotein. Finally, we will illustrate these theoretical considerations with some examples of drug interactions, among the most dangerous and the most frequent in clinical practice. [less ▲]

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See detailLa place des micronutriments en medecine.
Paquot, Nicolas ULg; Scheen, André ULg

in Revue Médicale de Liège (2006), 61(5-6), 464-70

Adequate micronutrient intake throughout life course is essential for the maintenance of health. Micronutrients are necessary for the maintenance of intermediary metabolism, play a crucial role as co ... [more ▼]

Adequate micronutrient intake throughout life course is essential for the maintenance of health. Micronutrients are necessary for the maintenance of intermediary metabolism, play a crucial role as co-factors or co-enzymes in the activity of virtually all enzymes, and have important functions to neutralise the deleterious effects of oxidant species. Claims have been made for the benefits of micronutrient supplementation. Clinical benefit of a supplementation is obvious in those individuals who are severely depleted and at risk of complications. More recently, the concept of subclinical deficit has been developed, which essentially relies upon biochemical abnormalities the interpretation of which remains doubtful in most instances. Symptomatology related to such subclinical deficit is non specific and the potential advantages of micronutrient supplements remain marginal and largely not well-established. In contrast, provision of excess supplements to individuals who do not need them may be harmful. In the general population, a well-balanced diet supplies an adequate intake of micronutrient. Further research is needed to identify the best markers of micronutrient and antioxidant status, so that at risk patients can be identified and appropriate supplementation provided accordingly. New large-scale trials of different doses of micronutrients, based on precise outcome markers, are required to optimise intakes in different groups of patients as well as in the general population. [less ▲]

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