Revue médicale de Liège
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Currently, the demand for intensive care (ICU) exceeds supply leading to refuse admission of patients who are judged to be too ill or too well to benefit form ICU. The refusal is justified either by the lack of benefit for the individual patient or on the basis of the "distributive justice" ("triage") concept. ⋯ Nurses and doctors appreciation of futility and quality of live are frequently unreliable. Each ICU should develop admission and discharge policies and procedures, in accordance with a team representing medicine, nursing and hospital administration.
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Revue médicale de Liège · Nov 2004
[Interheart: nine risk factors predict nine out of ten myocardial infarctions].
INTERHEART is a standardised case-control study of acute myocardial infarction in 52 countries representing every inhabited continent. 15152 cases and 14820 controls were enrolled. Collectively, 9 factors accounted for 90% of myocardial infarctions in men and 94% in women. These factors were 6 risk factors (dyslipidaemia characterized by high apoB/apoA1 ratio, smoking, hypertension, diabetes mellitus, abdominal obesity and stressful psychosocial factors) and 3 protective factors (daily consumption of fruits and vegetables, regular alcohol consumption, and regular physical activity). These findings suggest that interventions targeting these 9 factors have the potential to prevent most premature cases of myocardial infarction and that these strategies should be implemented worldwide.
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Revue médicale de Liège · Oct 2004
[Indications for epidural steroids in back pain and in radiculopathy].
Back pain is very frequent in western countries and it represents a very high social cost. The treatment is based on five modalities: medication, physiotherapy, invasive technics, rehabilitation programs and psycho-social approaches. Several treatments may be proposed simultaneously and introduced gradually. ⋯ The initial treatment of back pain is medical. This pathology is multifactorial and the relief of symptoms is often incomplete. The patient should be urged to feel responsible for and involved in his treatment.
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Diaper dermatitis is a frequent condition. Several clinical types are distinguished. The most frequent type results from increased fragility of the newborn buttock skin when covered by diapers. ⋯ Adequate preventive and curative measures can combat diaper dermatitis with confidence. A miconazole paste allows to improve the tribological properties of the interface between diapers and the skin. It also abates the impact of Candida albicans in the pathogenesis of the skin disorder.