Revue médicale de Liège
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Revue médicale de Liège · May 2006
Review Case Reports[Patent foramen ovale and migraine, a fortuitus association or a causal relationship?].
Epidemiologic studies have shown a clear comorbidity between migraine with aura and a patent foramen ovale (PFO). Under the age of 55, migraine with aura is a risk factor for ischemic stroke and a proportion of the latter is due to a PFO. It remains to be determined whether PFO is causally related to migraine attacks, or is a fortuitous association due to common genetic factors. ⋯ Several retrospective and uncontrolled studies suggest that percutaneous closure of a PFO for stroke or decompression illness in divers reduces frequency of migraine attacks with, but also without aura. Multicentric, prospective and controlled trials of this intervention in migraineurs are underway or in preparation. As long as their results are not known, there is no rationale for proposing PFO closure for migraine.
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Revue médicale de Liège · Jul 2005
Case Reports[Clinical case of the month. Twiddler's syndrome: report of a case].
The Twiddler's syndrome is characterized by the migration of pacemaker's leads due to rotation of the pulse generator. In our case, ventricular leads coiled in the upper side of the right atrium with stimulation of pectoralis major muscle during left decubitus lateralis position.
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Maturity-onset diabetes of the young (MODY) is a monogenic subtype of diabetes mellitus characterized by a young onset of type 2 diabetes, some abnormalities of the beta-cell function and an autosomal dominant inheritance with high penetrance. MODY types represent less than 5% of all cases of type 2 diabetes. ⋯ Among the two most frequent forms, MODY 2 (mutation of the glucokinase gene) has a benign clinical evolution whereas MODY 3 (mutation of HNF-1alpha gene) has a much more severe evolution. The recognition of the MODY diabetes is important in clinical practice and may lead to the discovery of new more specific molecular therapeutic targets.
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Revue médicale de Liège · May 2005
Review[Metabolic emergencies related to diabetes mellitus: ketoacidosis and hyperosmolar state].
Diabetic ketoacidosis and hyperglycaemic hyperosmolar state are relatively frequent metabolic emergencies. Such entities complicate type 1 and type 2 diabetes mellitus, respectively. ⋯ Prognosis of such complications remains generally severe. Management is based on insulin infusion, fluid resuscitation as well as concomitant compensation for electrolytes losses.
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Compartment syndrome is defined as an increased intracompartmental pressure within inelastic fascia which surround muscular compartments. That pathology can be either acute or chronic. The acute situation is generally a medical emergency. ⋯ If pressures reach the critical threshold (30 mm Hg) and remain high five minutes after exercise, compartment syndrome is present. Treatment is nearly exclusively surgical. It consists in an fasciotomy allowing a complete recovery and a return to sport activities.