Pierre Delanaye, François Jouret, Étienne Cavalier
{"title":"[International guidelines for the assessment of chronic kidney disease].","authors":"Pierre Delanaye, François Jouret, Étienne Cavalier","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The new KDIGO («Kidney Disease Improving Global Outcomes») 2024 guidelines on chronic kidney disease (CKD) provide significant updates. They reaffirm the importance of the glomerular filtration rate (GFR) and of the urine albumin-to-creatinine ratio (ACR) for diagnosing and classifying CKD. CKD is defined by a GFR < 60 mL/min/1.73 m² and/or ACR > 30 mg/g and/or persistent renal abnormalities for at least three months. The main innovation is the preferential use of equations combining creatinine and cystatin C to estimate GFR, although cystatin C assay may not always be available or reimbursed. The guidelines also recommend the EKFC («European Kidney Function Consortium») equations, particularly suited to Europe and applicable to all age groups. ACR remains a key indicator for assessing the risk of CKD progression and the response to nephroprotective treatments. The use of the «Kidney Failure Risk Equation» is encouraged to estimate the risk of kidney failure and guide clinical decisions.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"369-375"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304172","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}
{"title":"[From clinical practice guidelines to personalized medicine : two guides to be implemented in health care].","authors":"André Scheen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>/.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"265-267"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304166","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}
Stéphanie Grosdent, Marc Vanderthommen, Jean-François Kaux, Marco Tomasella, Christophe Demoulin
{"title":"[Clinical recommendations for the assessment and rehabilitation of patients with non-specific neck pain].","authors":"Stéphanie Grosdent, Marc Vanderthommen, Jean-François Kaux, Marco Tomasella, Christophe Demoulin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Non-specific neck pain is a common musculo-skeletal disorder that persists and/or causes significant functional disability in some patients. The recommended first-line conservative treatment requires an individualised assessment and management approach using a biopsychosocial model. Current guidelines emphasise a combination of patient education (with particular attention to psychosocial factors) and tailored exercise, combined with manual techniques as appropriate. Patient adherence, supported by a therapeutic alliance, shared decision-making, individualised care and realistic goals, is essential to maximise long-term benefits.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"436-441"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304161","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}
Antoine Perot, Aurore Ancion, Meryl Paquay, Alexandre Ghuysen
{"title":"[Management of anaphylaxis in the emergency department : applying recommendations for good clinical practice].","authors":"Antoine Perot, Aurore Ancion, Meryl Paquay, Alexandre Ghuysen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Allergic reactions are a common cause of emergency department admissions. The most serious class is anaphylaxis, which can be graded according to its severity and its impact on different organs. It is primarily caused by the release of various chemical mediators into the body following contact with an allergen. Treatment must be initiated as quickly as possible to achieve a satisfactory outcome. It mainly consists of intramuscular (IM) epinephrine and inhalated beta2-agonists. Some intravenous (IV) crystalloids may be given in case of hypotension. According to the latest guidelines, other treatments are not appropriate in the initial approach of the acute phase. Close monitoring should be carried out depending on the initial severity of the anaphylactic reaction. Specialized follow-up in allergology should be initiated, and a prescription for an epinephrine auto-injector should be given to the patient discharged from hospital.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"339-347"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304173","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}
{"title":"[European guidelines for the management of atrial fibrillation].","authors":"Caroline Piette, Laurent Davin, Patrizio Lancellotti","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The new 2024 recommendations of the European Society of Cardiology (ESC) on atrial fibrillation bring several updates compared to those from 2020. They emphasize the importance of ablation and the management of comorbidities associated with this arrhythmia. In recent years, there has also been a significant rise in connected devices for cardiac rhythm monitoring and a strengthened focus on comprehensive patient care. This article provides a summary of the key recommendations.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"348-353"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304164","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}
François Delvaux, Jean-François Kaux, Christophe Daniel, Christophe Lepièce, Benjamin Lewandowski, Jean-Louis Croisier
{"title":"[Best practice recommendations for rehabilitation of anterior cruciate ligament reconstructions].","authors":"François Delvaux, Jean-François Kaux, Christophe Daniel, Christophe Lepièce, Benjamin Lewandowski, Jean-Louis Croisier","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rupture of the anterior cruciate ligament (ACL) is a frequent and particularly severe injury that occurs mainly in contact team sports or skiing. Reconstruction of the ruptured ACL is often realized and must be followed by an optimal rehabilitation to restore the knee's active stability during daily activities and sports. This rehabilitation is based on an individualised approach, the ultimate aim of which is to ensure a return to sporting performance while minimising the risk of recurrence. The patient will first of all optimises his/her chances of success by undergoing high-quality pre-operative rehabilitation. After surgery, there will be three main phases, each with its own objectives and resources. The transition from one phase to the next will be based on precise criteria, enabling the constraints to be adapted as closely as possible to the patient's progress. Ultimately, the return to unrestricted sport will also be based on a set of objective criteria and decided on a multidisciplinary basis.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"442-447"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304158","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}
{"title":"[Evidence-based recommendations : clinicians committed to the essentials but aware of the limits].","authors":"Gilles Henrard","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The «Evidence-Based Medicine» (EBM) approach was born at the end of the last century in the English-speaking world. This article will briefly recall its essential contributions and reaffirm the importance of taking scientific data into account to support decisions. It will also describe the armful drifts observed in practice and the intrinsic limits of the approach. It will then discuss how the practice of EBM, from the consideration of the best available scientific data to the strict application of recommendations, can resonate with different ways of managing uncertainty. Finally, it will argue in favour of an «Evidence Based Practice» (EBP) approach that strengthens the critical skills of clinicians and targets share decision-making with patients.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"284-287"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304165","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}
{"title":"[Gap between guidelines and clinical practice : from epidemiological evidence to solutions to remove barriers].","authors":"André Scheen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Good clinical practice guidelines are intended to facilitate and improve patient care. However, it is clear that recommended targets are not reached among numerous patients in real life. It is the case for the control of cardiovascular risk factors such as hypercholesterolaemia, arterial hypertension and type 2 diabetes, both in primary and secondary prevention. Barriers are multiple and concern all field actors : prescribing doctors, patients regarding their medications, health care system and pharmaceutical industry. Identifying barriers and proposing solutions should help narrow the gap between guidelines and clinical practice.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"275-283"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304167","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}
{"title":"[New recommendations from the European Society of Cardiology on chronic coronary syndromes].","authors":"Laurent Davin, Maud Carapelluci, Caroline Piette, Raluca Elena Dulgheru, Patrizio Lancellotti","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chronic coronary syndromes are a major public health issue worldwide, characterized by a high prevalence and significant clinical consequences in terms of cardiovascular morbidity and mortality. The management of these syndromes has made considerable progress in recent decades, due in particular to the development of more effective diagnostic strategies, innovative therapeutic interventions and better targeted preventive measures. The European Society of Cardiology takes stock of the subject in its latest recommendations in 2024.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"354-362"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304177","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}
{"title":"[Belgian recommendation bodies related to medical practice : impact on public health].","authors":"Régis Radermecker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The article presents the main recommendation bodies in Belgium: the Superior Health Council (CSS), the KCE (Federal Health Care Knowledge Centre), the CBIP (Belgian Centre for Pharmacotherapeutic Information), and the FAMHP (Federal Agency for Medicines and Health Products). The CSS advises the government on public health issues, while the KCE conducts studies to improve healthcare quality. The CBIP focuses on the use of medications, providing practical recommendations to healthcare professionals, and the FAMHP regulates medicines and medical devices to ensure their safety and efficacy. Together, these bodies play a crucial role in strengthening the Belgian healthcare system.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"271-274"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304157","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}