Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg最新文献_第10页

[Antiphospholipid antibody syndrome]. [抗磷脂抗体综合征]。

Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg Pub Date : 2009-01-01

V Chakoutio, F Ries

{"title":"[Antiphospholipid antibody syndrome].","authors":"V Chakoutio, F Ries","doi":"","DOIUrl":"","url":null,"abstract":"An Antiphospholipid syndrome (APS) was diagnosed in a patient who had massive pulmonary embolisation from a right atrial thrombus. The (APS) is an autoimmune disease defined by the presence in the serum of at least one type of autoantibody known as antiphospholipid antibody (aPL) and the occurrence of at least one clinical feature from a list of potential disease manifestations, the most common of which are venous or arterial thrombosis, recurrent fetal loss and thrombocytopenia. The prevalence of APS in a series of patients from internal medicine is 2 percent. The mean age at diagnosis is 42 years. The pathogenesis of APS associated with clinical manifestations seems to result from a variety of effects of aPL on coagulation pathways,but the exact mechanism of action of aPL on these pathways is not completely understood. The APS can be primary or secondary to a disease. Thrombosis is the most frequent clinical manifestation of APS. It involves many organs, resulting on multiorgan failure: this is the catastrophic APS. The treatment is the same whether the APS is primary or secondary. It is mainly symptomatic and consists in the prevention of thrombosis at short and long-term by using aspirin and/or anticoagulants. Immunomodulating treatment can be offered but its efficiency at long-term is unproven. The mortality varies according to the etiology and the clinical manifestations. The mortality rate is 50 percent in catastrophic APS, despite treatment.","PeriodicalId":72476,"journal":{"name":"Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28232060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Results of the ALEGRIA study in Luxembourg. An epidemiological, observational study to describe symptom impact and control in patients with GERD and an evaluation of the GERD Impact Scale. 卢森堡ALEGRIA研究的结果。一项流行病学观察性研究，描述了反流胃食管反流患者的症状影响和控制，并评估了反流胃食管反流影响量表。

Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg Pub Date : 2009-01-01

R Fritz, N Goodman, V Duquenne, C Taeter

{"title":"Results of the ALEGRIA study in Luxembourg. An epidemiological, observational study to describe symptom impact and control in patients with GERD and an evaluation of the GERD Impact Scale.","authors":"R Fritz, N Goodman, V Duquenne, C Taeter","doi":"","DOIUrl":"","url":null,"abstract":"Background and study aims: The aim of this observational study was to perform the first epidemiology study in a primary care patient population with GERD in the Grand Duchy of Luxembourg and to evaluate the added value of the GERD Impact Scale (GIS) patient questionnaire.Patients and methods: 152 Patients with symptoms of GERD from 20 study centers were included. At visit 1, demographic data including lifestyle factors and the patients' symptoms were recorded. GERD symptoms and their severity, treatment changes and the GIS were all assessed at baseline (visit 1), visit 2 (4-6 weeks) and visit 3 (8-14 weeks). Analyses were performed on an intent-to-treat basis.Results: 142 patients were included in the analysis, which comprised 50% men and 50% women with a mean BMI of 27 kg/m2. Documented lifestyle factors included consumption of caffeine-containing beverages (87% of patients), stress (62%) and alcohol consumption (53%); 44% of patients were smokers or ex-smokers. The median duration of GERD was 2.0 years. Upon inclusion, 46% were receiving, or had received, proton pump inhibitors (PPIs), antacids (44%), H2-receptor antagonists (21%) or no treatment (21%). PPIs were prescribed at the first visit in the majority of cases (94%) with 75% of patients being prescribed esomeprazole with a median daily dose of 40 mg. The GIS score correlated well with the clinician's judgment of symptom severity and was reported to help determine the appropriate treatment and evaluate the patient's response in approximately 80% of patients.Conclusions: In this, the first epidemiological study on GERD patients in the Grand Duchy of Luxembourg, data was obtained as planned. The novel patient questionnaire was judged to be helpful by the physician and data shows that the GIS may have an added value over current assessments.","PeriodicalId":72476,"journal":{"name":"Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28585126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Measurement of ventricular twist by 2D speckle tracking early after acute myocardial infarction. Comparison between anterior and inferior infarction]. 急性心肌梗死后早期二维斑点跟踪测量心室扭转。前、下段梗死的比较[j]。

Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg Pub Date : 2009-01-01

C Blasen, A Codreanu, F Robert, N Meniconi, J Beissel, D R Wagner

{"title":"[Measurement of ventricular twist by 2D speckle tracking early after acute myocardial infarction. Comparison between anterior and inferior infarction].","authors":"C Blasen, A Codreanu, F Robert, N Meniconi, J Beissel, D R Wagner","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Left Ventricular twist (LV twist) is defined as the apical counter-clockwise rotation relative to the clockwise basal rotation. It has been shown that LV twist decreases after myocardial infarction (MI) and that it is well correlated with left ventricular ejection fraction. Most studies have only evaluated anterior wall MI. The aim of our study was to determine whether LV twist is dependent on the infarct territory (anterior vs. inferior) and whether there is a correlation between LV twist and matrix metalloproteinase-9, a marker of LV remodeling.Methods: We measured LV twist using echocardiography with 2D speckle tracking in patients with acute MI and in a control group.Results: We evaluated 27 controls and 35 patients with acute MI, 15 with anterior wall and 20 with inferior wall MI. LV twist was significantly decreased after MI, compared to the control group (10.93 +/- 2.05 vs 15.5 +/- 2.29; p = 0.003). There was no difference between anterior and inferior MI. LV rotation was decreased in the infarct area. We did not observe a correlation between LV twist and MMP-9, or creatine phosphokinase.Conclusion: With this study we confirm that LV twist decreases after acute MI. Moreover, we show that LV apical rotation is mostly decreased after large anterior MI. As apical rotation is important for ejection and aspiration (untwisting), this could be a possible mechanism of LV dysfunction after MI.","PeriodicalId":72476,"journal":{"name":"Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28585251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early decompressive hemicraniectomy in fulminant herpes simplex encephalitis. 暴发性单纯疱疹脑炎早期减压半脑切除术。

Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg Pub Date : 2009-01-01

N Maraite, F Mataigne, V Pieri, T Dang, N J Diederich

引用次数: 0

C-reactive protein to initiate or withhold antibiotics in acute respiratory tract infections in adults, in primary care: review. c反应蛋白与初级保健中成人急性呼吸道感染启动或停用抗生素的关系:综述

Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg Pub Date : 2009-01-01

Siggy Rausch, Maryse Flammang, Nico Haas, Romain Stein, Patrick Tabouring, Serge Delvigne, Danièle Holper, Caroline Jentges, Marion Pieger, Charlotte Lieunard, Catalina Iliescu

{"title":"C-reactive protein to initiate or withhold antibiotics in acute respiratory tract infections in adults, in primary care: review.","authors":"Siggy Rausch, Maryse Flammang, Nico Haas, Romain Stein, Patrick Tabouring, Serge Delvigne, Danièle Holper, Caroline Jentges, Marion Pieger, Charlotte Lieunard, Catalina Iliescu","doi":"","DOIUrl":"","url":null,"abstract":"Background: There is a discrepancy between the incidence of viral pathogens and the frequency of prescribing antibiotics for acute respiratory tract infections (ARTIs). Typically, primary care physicians have few possibilities to order sophisticated laboratory tests to help distinguish viral pathogens from bacterial pathogens. C-Reactive Protein (CRP) measurement could help the primary care physician to discriminate more easily between these two conditions, and should contribute to reducing unnecessary prescribing of antibiotics during the first patient consultation.Methods: A literature review was performed in order to see what is known and tested about CRP measurement in ARTIs in adult patients in the primary care setting, to assist GPs in their decision whether or not to prescribe antibiotics.Results: Out of 54 entered articles reviewed from 109 abstracts, we could identify 8 articles which correspond to our selection criteria. Overall the methodological quality of the studies is heterogeneous. Specificity and sensibility of CRP measurement in ARTIs in adults vary widely from as low as 10% to as high as 99%.Discussion and conclusion: Current literature is insufficient and too heterogeneous to allow conclusions about the value of CRP measurement to support the decision of prescribing antibiotics for ARTIs in adults, in primary care. Most studies tested CRP in view of an aetiological diagnosis of ARTIs, whereas common practice in primary care is oriented pragmatically towards risk management and watchful waiting when 'dangerous' symptoms are absent. We found sufficient evidence that CRP would be a useful biomarker in this perspective, but thorough and rigorous studies are needed to test this hypothesis.","PeriodicalId":72476,"journal":{"name":"Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28232063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Post-traumatic stress disorders in medical practice: diagnostic and therapeutic guidelines in primary care]. [医疗实践中的创伤后应激障碍:初级保健诊断和治疗指南]。

Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg Pub Date : 2009-01-01

Nick Miller, Coralie Lazignac, Fabien Jecker, Marili Zürcher, Cristian Damsa

引用次数: 0

[What can the physician do when faced with the gigantic puzzle of abuse?]. [当医生面对巨大的滥用困惑时该怎么办?]

Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg Pub Date : 2009-01-01

Cornelia Gauthier

引用次数: 0

The athlete's foot: the grey zone behind the ankle. 运动员的脚:脚踝后面的灰色地带。

Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg Pub Date : 2009-01-01

Nicolien van Giffen, Romain Seil, Diederich Pape, Christian Nührenbörger

引用次数: 0

[Analysis of inter-judge concordance for the realization of psychiatric expertise in the use of guidelines]. [法官间一致性对实现精神病学专业知识使用指南的分析]。

Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg Pub Date : 2009-01-01

Cristian Damsa, Eric Adam, Coralie Lazignac, Adriana Mihai, Daniela Stamatoiu

{"title":"[Analysis of inter-judge concordance for the realization of psychiatric expertise in the use of guidelines].","authors":"Cristian Damsa, Eric Adam, Coralie Lazignac, Adriana Mihai, Daniela Stamatoiu","doi":"","DOIUrl":"","url":null,"abstract":"Objectives: The aim of this work is to measure the inter-judge concordance in thirteen psychiatric expertises for invalidity insurance.Method: We analyzed thirteen interdisciplinary (somatic and psychiatric) expertise files, blinded for the patient identity. The patients had a first opinion of a \"classic\" psychiatric expertise and then a second opinion of other experts, from a center specialized for interdisciplinary expertises in Switzerland. The inter-experts' judgments were compared according to the complexity of every file, due to the intervention of four foreign independent experts with regard to the expertise process (France, Belgium, United States, Switzerland, Romania).Results: A satisfactory inter-judge concordance in terms of diagnoses and to incapacities was observed in nine files out of thirteen, with a better consensus for the male patients (chi2 = 4.95; p = 0.026). Divergent opinions seem to be in relation with the lack of explicit expertise guidelines used by the first psychiatric experts. We highlight some general principles issued from guidelines of the Swiss Insurance Psychiatric Society for medical expertise of psychiatric disorders. In our opinion these principles would have been able to improve the inter-judge concordance in the thirteen analyzed expertises.Discussion: In spite of his methodological limits, especially the reduced number of analyzed expertises, this work underlines the interest to use of certain guidelines for the realization of psychiatric expertises in terms of invalidity insurance.Conclusion: The use of guidelines could improve the inter-judge concordance for the realization of psychiatric expertises about invalidity insurance.","PeriodicalId":72476,"journal":{"name":"Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28232061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of acute haemolysis with 2 different multi target thyrosine kinase inhibitors in a patient with renal cancer. 2种不同的多靶点甲状腺氨酸激酶抑制剂治疗肾癌患者急性溶血1例。

Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg Pub Date : 2009-01-01

Guy Berchem, Sigrid Dewilde, Philippe Mahassen

引用次数: 0