References of "Revue medicale de Liege"
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See detailComment j'explore... Un traumatisme du rachis cervical chez l'enfant.
CAJGFINGER, Nathalie ULiege; Jamblin, P.; Gilis, N.

in Revue Medicale de Liege (2018), 73(12), 645-649

Cervical spine injuries are a regular reason for consultation in general practice or pediatric emergencies. In many cases, it is difficult to distinguish between whether or not a radiological assessment ... [more ▼]

Cervical spine injuries are a regular reason for consultation in general practice or pediatric emergencies. In many cases, it is difficult to distinguish between whether or not a radiological assessment is necessary. We propose in this article a management strategy based on clinical scores simple to achieve in order to avoid unnecessary radiological examinations for children. [less ▲]

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See detailAtteintes osseuses des leucemies lymphoblastiques aigues pediatriques : experience monocentrique et revue de la litterature.
Pécheux, Lucie ULiege; FORGET, Patricia ULiege; Geurten, Claire ULiege et al

in Revue medicale de Liege (2018), 73(11), 575-582

Bone pain associated with bone marrow infiltration is often present at diagnosis of pediatric acute lymphoblastic leukemia (ALL). It sometimes signs the presence of pathological fracture, lytic lesions ... [more ▼]

Bone pain associated with bone marrow infiltration is often present at diagnosis of pediatric acute lymphoblastic leukemia (ALL). It sometimes signs the presence of pathological fracture, lytic lesions, arthritis, or osteitis associated to ALL that can delay the diagnosis. During treatment, bone complications (pain, osteopenia, fracture, avascular necrosis, ...) are also reported. In order to describe bone involvement (BI) of pediatric LLA, we reviewed the records of 104 patients followed in our unit. The overall incidence of BI was 67 %. At diagnosis, 50 % of patients had BI and in 19 %, the diagnosis of ALL was delayed. During and after treatment, respectively 28 % and 37 % of patients presented bone complications (pain, fractures, avascular necrosis, osteopenia). Patients with BI had a lower leukocytosis inferior to 10x109/l (p = 0.005) and an ALL of average risk (p = 0.019). 38 % of patients with BI during treatment were over 10 years old and 55 % were girls (vs. 21 % and 38 % in the entire cohort, respectively). Osteoporosis was more severe at diagnosis than during treatment, suggesting the presence of constitutional promoting factors. In our cohort, the majority of BI was resolved at the end of treatment with no long-term sequelae. [less ▲]

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See detailL'image du mois. Signe precoce de pneumonie a l'echographie.
Javillier, Benjamin; Massart, Quentin; CANIVET, Jean-Luc ULiege et al

in Revue medicale de Liege (2018), 73(9), 433-434

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See detailSyndrome d'Asherman. Prise en charge apres curetage suite a une retention placentaire post-natale et revue de la litterature.
Tchente, Nguefack C.; BRICHANT, Géraldine ULiege; Nisolle, Michelle ULiege

in Revue medicale de Liege (2018), 73(10), 508-512

Asherman's syndrome (AS) is a partial or complete obliteration of the uterine cavity after intrauterine trauma. Approximately 90 % of severe AS cases occur after abortion curettage or postpartum curettage ... [more ▼]

Asherman's syndrome (AS) is a partial or complete obliteration of the uterine cavity after intrauterine trauma. Approximately 90 % of severe AS cases occur after abortion curettage or postpartum curettage. Clinical signs and symptoms are abnormalities of the cycle (hypomenorrhoea or amenorrhoea) and fertility disorders. We have reviewed the recent literature on AS following the description of a typical clinical case. The management of AS is not easy. It must be done by experienced surgeons. Realization of several surgeries is sometimes mandatory, with the use of anti-adhesive devices between interventions. Its complex management encourages insistence on the avoidance of its risk factors. [less ▲]

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See detailL'ischemie mesenterique aigue.
KERZMANN, Arnaud ULiege; HAUMANN, Alexandre ULiege; BOESMANS, Evelyne ULiege et al

in Revue Medicale de Liege (2018), 73(5-6), 300-303

Acute mesenteric ischemia is a real life-threatening emergency. Mode of presentation is severe abdominal pain with sudden onset. The etiology is most of the time embolus coming from the heart or ... [more ▼]

Acute mesenteric ischemia is a real life-threatening emergency. Mode of presentation is severe abdominal pain with sudden onset. The etiology is most of the time embolus coming from the heart or thrombosis of atherosclerotic vessel wall concerning the superior mesenteric artery. The best investigation is computed tomography with intravenous contrast media injection. Treatment consists of revascularization by open surgery or endovascular approach. Bowel resection may be necessary, as well as delayed second look surgery. This paper aims to review etiologies and therapeutics options for acute mesenteric ischemia. [less ▲]

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See detailSyncope aux Urgences: Diagnostic differentiel et stratification du risque.
Marechal, P.; Scheen, André ULiege; Lancellotti, Patrizio ULiege

in Revue Medicale de Liege (2018), 73(5-6), 237-242

Syncope is one of the most common reasons of emergency admission and hospitalisation. Management of syncope remains challenging for the medical staff as there are a multitude of possible etiologies ... [more ▼]

Syncope is one of the most common reasons of emergency admission and hospitalisation. Management of syncope remains challenging for the medical staff as there are a multitude of possible etiologies ranging from benign to potentially life-threatening causes. Historically, 30-40% of patients presenting for syncope are hospitalized for further exploration, resulting in a significant cost to health care. The purpose of this article is to clarify the etiologies of syncope and to stratify their risk for a better managment. [less ▲]

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See detailVignette diagnostique de l'etudiant. Exploration d'un syndrome de malabsorption digestive.
DE FLINES, Jenny ULiege; Louis, Edouard ULiege; Paquot, Nicolas ULiege

in Revue Medicale de Liege (2018), 73(10), 526-532

Malabsorption syndrome is a complex clinical entity that needs to be carefully explored. Patients present frequently chronic diarrhoea associated with weight loss. These symptoms affect patient's quality ... [more ▼]

Malabsorption syndrome is a complex clinical entity that needs to be carefully explored. Patients present frequently chronic diarrhoea associated with weight loss. These symptoms affect patient's quality of life. The assessment of this syndrome requires a detailed anamnesis, a careful clinical exam, the use of biological measurements in both blood and faeces, and, if necessary, other more complex investigations including radionuclide tests. It is important to find the right pathogenesis in order to start effective treatments if possible. First, there are classical bowel pathologies like celiac disease and rarely Crohn disease. Second, biliopancreatic pathologies may also result in a malabsorption syndrome. Of note, this syndrome is very common after abdominal surgery like intestinal resection following mesenteric ischemia, biliopancreatic and gastric surgery. We will use a clinical case of malabsorption after an abdominal surgery to illustrate how to explore these patients who are suffering from malabsorption. [less ▲]

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See detailLa metformine revisitee : moins de restrictions et davantage d'indications.
Scheen, André ULiege; Lefèbvre, Pierre ULiege; Paquot, Nicolas ULiege

in Revue Medicale de Liege (2018), 73(11), 544-549

While commercialized since over 60 years, metformin is still the first-line drug recommended for the management of type 2 diabetes and is thus today the first glucose-lowering agent used worldwide ... [more ▼]

While commercialized since over 60 years, metformin is still the first-line drug recommended for the management of type 2 diabetes and is thus today the first glucose-lowering agent used worldwide. Despite this long experience, metformin retains its mysteries, especially regarding the underlying mechanisms responsible for its antidiabetic activity and other potential beneficial effects. During the last years, some contra-indications of metformin use have been at least partially withdrawn while new indications have been recognized. Furthermore, interesting prospects have been reported in important, although unexpected, medical areas such as cancer and neurodegenerative diseases. However, promising results in animal studies and observational human studies have now to be confirmed in well conducted randomized controlled trials. [less ▲]

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See detailComment je traite ... un echec de la pharmacotherapie.
Scheen, André ULiege

in Revue Medicale de Liege (2018), 73(10), 488-491

Drug therapy failure may occur with any medical intervention. It is badly accepted by both the physician and the patient. Drug failure may be attributed to the physician, the patient, the medication or ... [more ▼]

Drug therapy failure may occur with any medical intervention. It is badly accepted by both the physician and the patient. Drug failure may be attributed to the physician, the patient, the medication or the severity of the disease itself. Once drug failure is confirmed, causes should rapidly be identified in order to find a solution because several ones may often be offered. [less ▲]

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See detailLe medicament du mois. Combinaison en proportion fixe insuline basale degludec-liraglutide (Xultophy(R)).
Scheen, André ULiege; Mathieu, Chantal

in Revue Medicale de Liege (2018), 73(10), 526-532

Xultophy(R) (IDegLira) is a fixed ratio combination of basal insulin degludec and glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide. Insulin degludec is characterized by an original mode of ... [more ▼]

Xultophy(R) (IDegLira) is a fixed ratio combination of basal insulin degludec and glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide. Insulin degludec is characterized by an original mode of prolonged and continuous insulin diffusion after its subcutaneous injection. Thereby, it has a very long half-life, around 25 hours, and a better reproducibility from both a pharmacokinetic and pharmacodynamic point of view, with less hypoglycaemia, especially at night. Liraglutide is a well-known once-daily GLP-1 receptor agonist that showed a cardiovascular and renal protection in patients with type 2 diabetes at high cardiovascular risk. Both molecules exert complementary antihyperglycaemic effects, which allows a better glucose control, both in the fasting and postprandial states. IDegLira is more effective than another basal insulin regimen in reaching individualized glycated haemoglobin target, with a lower daily dose of insulin. It has a better tolerance profile, with a more favourable effect on body weight and less hypoglycaemia compared with a basal insulin and less gastrointestinal adverse effects when compared with liraglutide alone. Xultophy(R) is presented as a prefilled pen and is indicated in the management of type 2 diabetes not well controlled with basal insulin. The dose of IDegLira is progressively uptitrated, starting from 16 dose steps up to a maximum of 50 dose steps per day (corresponding to 50 IU insulin degludec and 1.8 mg liraglutide). [less ▲]

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See detailVignette diagnostique de l'étudiant. Oedème des membres inférieurs chez un patient diabétique de type 2 (2018)
Scheen, André ULiege; Paquot, Nicolas ULiege; Lancellotti, Patrizio ULiege et al

in Revue Medicale de Liege (2018), 73(2), 101-106

Differential diagnosis of lower limb oedema is a common exercise in clinical practice. Taking the example of a patient presenting with such clinical picture in the pre-sence of type 2 diabetes and ... [more ▼]

Differential diagnosis of lower limb oedema is a common exercise in clinical practice. Taking the example of a patient presenting with such clinical picture in the pre-sence of type 2 diabetes and arterial hypertension with coronary heart disease and chronic kidney disease as comorbidities, we discuss here the respective contributions of congestive heart failure, renal impairment (and possibly nephrotic syndrome) and liver disease in the development of lower limb oedema. The focus is made on a careful patient history and a meticulous clinical examination, two crucial steps that should allow prescribing well selected simple complementary procedures and rapidly make the final diagnosis. © 2018 Revue Medicale de Liege. All rights reserved. [less ▲]

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See detailUne petite histoire de la syphilis. La maladie a travers l'art et l'artiste.
Jedidi, H; Laverdeur, C; DEPIERREUX, Frédérique ULiege et al

in Revue Medicale de Liege (2018), 73(7-8), 363-369

Considering its strong symbolic connotations and its rich history, syphilis could be regarded as the perfect example of venerian disease. It could also be seen as a representative disease of the whole ... [more ▼]

Considering its strong symbolic connotations and its rich history, syphilis could be regarded as the perfect example of venerian disease. It could also be seen as a representative disease of the whole medical history and the evolution of both medical ways of thinking and curing. In this work we will briefly discuss the history of the syphilitic disease and try to show how this condition has affected the life and works of some of the most famous artists of the 19th century. Moreover, we shall try to evoke the complex relationship between art and pathology. [less ▲]

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See detailDe l'atherosclerose a l'atherothrombose: D'une pathologie chronique silencieuse a un accident aigu critique.
Scheen, André ULiege

in Revue Medicale de Liege (2018), 73(5-6), 224-228

Cardiovascular disease still represents, together with cancer, a major cause of morbidity and mortality. Atherosclerosis is a silent progressive process, which can start in early life and usually ... [more ▼]

Cardiovascular disease still represents, together with cancer, a major cause of morbidity and mortality. Atherosclerosis is a silent progressive process, which can start in early life and usually progresses with advancing age. Besides genetic predisposition, atherosclerosis is accelerated by the presence of several modifiable risk factors such as smoking, dyslipidaemia, arterial hypertension and diabetes mellitus. Asymptomatic atherosclerosis may lead to an acute event, mostly due to plaque rupture and secondary thrombosis. If the thrombus is occlusive, according to the artery where it occurs, the acute complication involves most often an acute coronary event or an ischaemic stroke. Major cardiovascular events (MACEs) represent the primary outcome in a majority of clinical trials. Some populations, as patients with type 2 diabetes, are especially prone to these complications due to atherothrombosis linked to subclinical accelerated atherosclerosis. In most cases, an emergency intervention is mandatory to avoid premature death or irreversible sequelae. [less ▲]

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See detailMoxifloxacine et transillumination irienne : cas clinique.
Broens, A.; COLLIGNON, Nathalie ULiege

in Revue Medicale de Liege (2016), 71(7-8), 321-323

Bilateral Acute Iris Transillumination (BAIT) is a new clinical entity characterized by acute onset of pigment dispersion in the anterior chamber and angle, depigmentation of the iris stroma and permanent ... [more ▼]

Bilateral Acute Iris Transillumination (BAIT) is a new clinical entity characterized by acute onset of pigment dispersion in the anterior chamber and angle, depigmentation of the iris stroma and permanent iris transillumination, masquerading as uveitis. An association with oral moxifloxacin is reported in some articles. We describe one case of bilateral acute iris transillumination, following the use of systemic moxifloxacin. [less ▲]

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See detailGlaucome aigu bilateral par fermeture de l'angle, secondaire a la prise de topiramate.
Beaudry, O.; Goncette, V.; COLLIGNON, Nathalie ULiege

in Revue Medicale de Liege (2016), 71(11), 509-512

Topiramate (TPM) is a drug used in migraine prophylaxis. It is involved in the bilateral angle-closure glaucoma due to idiosyncratic response. This side effect is rare but can lead to irreversible vision ... [more ▼]

Topiramate (TPM) is a drug used in migraine prophylaxis. It is involved in the bilateral angle-closure glaucoma due to idiosyncratic response. This side effect is rare but can lead to irreversible vision loss if it is not recognized in time and if it is not managed immediately by an ophthalmologist. [less ▲]

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See detailCombinaison fixe atorvastatine-ezetimibe (Atozet(R)).
Scheen, André ULiege

in Revue Médicale de Liège (2016), 71(1), 47-52

Cardiovascular prevention in subjects at high or very high risk requires a drastic reduction in LDL cholesterol according to the concept "the lower, the better". The combination of an inhibitor of ... [more ▼]

Cardiovascular prevention in subjects at high or very high risk requires a drastic reduction in LDL cholesterol according to the concept "the lower, the better". The combination of an inhibitor of cholesterol synthesis and a selective inhibitor of intestinal absorption results in a complementary and synergistic LDL-lowering activity. Besides a first fixed combination ezetimibe-simvastatin (Inegy(R)), a new fixed combination is presented, Atozet(R) that combines atorvastatin and ezetimibe. Because atorvastatin is more potent than simvastatin, this novel fixed combination should facilitate reaching therapeutic goals in terms of LDL cholesterol amongst patients with severe hypercholesterolaemia and/or at high or very high cardiovascular risk. [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, Catherine ULiege et al

in Revue Médicale de Liège (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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See detailMédecine personnalisée : Nouveaux défis pour le praticien
Scheen, Andre ULiege

in Revue Médicale de Liège (2015), 70(5-6), 242-6

The clinician has to cope with new advances in medicine. Traditional medicine, which is based upon pathophysiological reasoning and clinical experience, has been reinforced by evidence-based medicine ... [more ▼]

The clinician has to cope with new advances in medicine. Traditional medicine, which is based upon pathophysiological reasoning and clinical experience, has been reinforced by evidence-based medicine, which relies on levels of evidence provided by controlled clinical trials carried out on cohorts of patients. Since a few years, personalized medicine has been put at the forefront. A therapy tailored to every patient, if possible characterized by biomarkers, among which, since the achievement of the whole human genome sequencing, an increasing number of genetic markers. Personalized medicine should be used as a complement of traditional and evidence-based medicine. Physicians should progressively integrate this new strategy in their therapeutic approach. Hence, clinicians have to face new challenges as far as scientific knowledge, practical applications and physician-patient relationship are concerned. [less ▲]

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See detailQuels médecins pour quelle médecine?
Scheen, André ULiege

in Revue Médicale de Liège (2015), 70(1), 1-4

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See detailBIOPSIE DES LESIONS SUSPECTES CHEZ LES PATIENTS AYANT PRESENTE UN CANCER DU SEIN.
Colin, P.-E.; Schroeder, H.; Gonne, E. et al

in Revue Médicale de Liège (2015), 70(11), 563-8

Discordances between hormone receptors and HER2 status in primary and metastatic breast cancer have been reported by several studies. In this context, systematic biopsies could be clinically relevant in ... [more ▼]

Discordances between hormone receptors and HER2 status in primary and metastatic breast cancer have been reported by several studies. In this context, systematic biopsies could be clinically relevant in breast cancer to confirm the biological characteristics of a suspicious lesion. In this article, illustrated by 2 case reports and based on a recent review on this topic, we discuss the clinical significance of receptor discordances and possible diagnosis of a secondary primary tumor. The role of these biopsies for the identification of new therapeutic targets is also envisaged as well as underlying mechanisms for receptors' modification like tumoral heterogeneity, clonal selection and technical artifacts. [less ▲]

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