Revue médicale de Liège
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Revue médicale de Liège · Oct 2002
Review[Efficacy and safety of acetaminophen-codeine in the treatment of pain].
The treatment of acute or chronic pain of variable intensity and origin, is efficiently achieved by the association of paracetamol and codeine. At a dose of 1000 mg paracetamol and 60 mg of codeine, this association is considered one of the most efficient as compared to other analgesics of level II in the OMS classification, like tramadol.
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Revue médicale de Liège · Aug 2002
Review[Clinical study of the month. Benefit/risk balance of postmenopausal estrogen-progestin treatment in peril in the Women's Health Initiative study: practical attitude of the clinician].
The Women's Health Initiative (WHI) is sponsored by the NIH. The study focuses on risk and benefits of strategies that could potentially reduce the incidence of heart disease, breast and colon cancer, and fractures in postmenopausal women. One arm of the study, a double-blind, placebo-controlled trial, looking at the effects of continuous combined estrogen-progestin regimen was stopped prematurely based on health risks which exceeded health benefits. ⋯ We should leave to the patient the final decision whether or not to continue the treatment. It is presently impossible to decide whether other estroprogestin associations, other administration routes and other molecules such as estradiol, natural progesterone or other progestins, SERMS and Tibolone could have an impact very different from that of the estroprogestin combination used in the WHI study. It is the duty of every physician to decide, from the complex epidemiological data obtained in the aged women (63-68 years) with a high cardiovascular risk in the WHI study, if it is possible or not in each individual case to recommend the initiation or pursue of an hormone replacement therapy.
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Revue médicale de Liège · Jul 2002
Review[Arterial revascularization with free tissue transfer for salvage of ischemic limbs with extensive tissue loss: an alternative to amputation].
Severe limb ischemia is a common problem encountered in medical practice. Aggressive attempts at revascularization have extended the limits of limb salvage. ⋯ Microvascular free tissue transfer combined with arterial revascularization allows healing of these wounds and limb preservation. This combined approach is the ultimate alternative to amputation.
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Revue médicale de Liège · May 2002
Review[Anti-vitamins K and oral surgery: the end of their prohibition?].
In patients under oral anticoagulation therapy, the risk of haemorrhage following surgery must be balanced with the risk of thrombo-embolism induced by its discontinuation. Dental surgery is usually safe. Indirect anticoagulation may be continued provided rigorous surgical techniques and careful local hemostasis are applied.
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Revue médicale de Liège · Feb 2002
[Clinical study of the month. Adjuvant radio-chemotherapy and chemotherapy following curative resection of pancreatic cancer: results of the randomized trial ESPAC-1].
The prognosis of pancreatic adenocarcinoma remains poor, with a 5-year survival rate lower than 5%. Resection, the gold standard treatment, can be performed in less than 15% of patients. Following surgery, the median survival is 12 months for the most favourable cancer patients. ⋯ We will discuss results of the current trials in this topic. The randomised trial of the European Study Group for Pancreatic Cancer (ESPAC) recently published in the Lancet revealed a potential benefit of adjuvant chemotherapy. A critical analysis of the publication showed, however, that definitive conclusions of this trial must be interpreted with caution.