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[International guidelines for the assessment of chronic kidney disease]. [国际慢性肾脏疾病评估指南]。
Revue medicale de Liege Pub Date : 2025-05-01
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}
引用次数: 0
[From clinical practice guidelines to personalized medicine : two guides to be implemented in health care]. 【从临床实践指南到个性化医疗：两份在卫生保健领域实施的指南】。
Revue medicale de Liege Pub Date : 2025-05-01
André Scheen
{"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}
引用次数: 0
[Clinical recommendations for the assessment and rehabilitation of patients with non-specific neck pain]. 【非特异性颈痛患者评估与康复的临床建议】。
Revue medicale de Liege Pub Date : 2025-05-01
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}
引用次数: 0
[Management of anaphylaxis in the emergency department : applying recommendations for good clinical practice]. [急诊科过敏反应的管理：应用良好临床实践的建议]。
Revue medicale de Liege Pub Date : 2025-05-01
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}
引用次数: 0
[European guidelines for the management of atrial fibrillation]. [欧洲房颤治疗指南]。
Revue medicale de Liege Pub Date : 2025-05-01
Caroline Piette, Laurent Davin, Patrizio Lancellotti
{"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}
引用次数: 0
[Management of soft tissue sarcomas : guidelines for the diagnosis and treatment]. 【软组织肉瘤的处理：诊断和治疗指南】。
Revue medicale de Liege Pub Date : 2025-05-01
Maud Neuberg, Emmanuel Decker, Christine Gennigens, Gilles Colin, Charles Pottier, Fréderic Lifrange, William Kurth, Arnaud De Roover
{"title":"[Management of soft tissue sarcomas : guidelines for the diagnosis and treatment].","authors":"Maud Neuberg, Emmanuel Decker, Christine Gennigens, Gilles Colin, Charles Pottier, Fréderic Lifrange, William Kurth, Arnaud De Roover","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Soft tissue sarcomas determine a rare heterogeneous group of tumours. Most important is the initial diagnostic procedure, comprising adequate imaging and a core needle biopsy. Management should be carried out in sarcoma reference centres. This would mean referring all patients with any suspected soft tissue sarcoma. Prior to surgery, a multidisciplinary conference determines its moment and the eventual need of neoadjuvant treatment. The standard surgical procedure is an \"en bloc\" excision. This implies removing the tumour in a single specimen with a rim of normal tissue around it.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"330-333"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304174","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
[Updated recommendations on metabolic dysfunction-associated steatotic liver disease]. [关于代谢功能障碍相关脂肪变性肝病的最新建议]。
Revue medicale de Liege Pub Date : 2025-05-01
Alice Dongier, Jean Delwaide, Édouard Louis, Jean-Philippe Loly
{"title":"[Updated recommendations on metabolic dysfunction-associated steatotic liver disease].","authors":"Alice Dongier, Jean Delwaide, Édouard Louis, Jean-Philippe Loly","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The updated recommendations on metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD) emphasize the importance of early detection and clear terminology. MASLD includes hepatic fat accumulation linked to cardiometabolic factors, while its severe inflammatory form is termed metabolic dysfunction-associated steatohepatitis (MASH). Management follows a structured approach: first, clinicians identify risk factors such as obesity, diabetes, alcohol intake, and abnormal liver enzymes. Risk stratification relies on non-invasive tests (e.g., FIB-4 index or FibroScan®) to distinguish simple steatosis from progressive forms that can advance to cirrhosis and hepatocellular carcinoma. Precise assessment of alcohol consumption is also crucial, as it distinguishes MetALD (a combination of metabolic factors and alcohol use) from ALD (significant alcohol use), ensuring tailored treatment. Therapy priorities include lifestyle modifications (weight reduction, dietary changes, and regular physical activity) along with optimal management of comorbidities (diabetes, dyslipidemia) and targeted surveillance for complications. Pharmacological options, including potential future therapies targeting MASH, may be considered in cases of advanced fibrosis. Ultimately, these recommendations highlight the need for a multidisciplinary approach, combining hepatologists, diabetologists, and other specialists, to effectively identify and manage MASLD/MASH and improve long-term outcomes.</p>","PeriodicalId":94201,"journal":{"name":"Revue medicale de Liege","volume":"80 5-6","pages":"401-409"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304186","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
[Best practice recommendations for rehabilitation of anterior cruciate ligament reconstructions]. [前交叉韧带重建康复的最佳实践建议]。
Revue medicale de Liege Pub Date : 2025-05-01
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}
引用次数: 0
[Evidence-based recommendations : clinicians committed to the essentials but aware of the limits]. [循证建议：临床医生致力于要点，但意识到局限性]。
Revue medicale de Liege Pub Date : 2025-05-01
Gilles Henrard
{"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}
引用次数: 0
[Gap between guidelines and clinical practice : from epidemiological evidence to solutions to remove barriers]. [指南与临床实践之间的差距：从流行病学证据到消除障碍的解决方案]。
Revue medicale de Liege Pub Date : 2025-05-01
André Scheen
{"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}
引用次数: 0
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