Revue medicale de Liege最新文献

Osteoarthritis, a degenerative disorder of the osteoarticular system, leads to progressive cartilage deterioration, resulting in pain and functional impairment. Its clinical presentation is heterogeneous, reflecting a diversity of phenotypes and molecular profiles. Risk factors include advanced age, female sex, obesity and joint trauma. Among emerging therapeutic strategies, mesenchymal stem cells (MSCs) offer promising prospects. These cells, derived from bone marrow, adipose tissue, and umbilical tissues, exhibit regenerative and immunomodulatory properties. In parallel, MSC-derived exosomes, which carry regenerative bioactive factors, represent another avenue of innovation, though their clinical application still requires further validation.

Ischemic heart disease, the main clinical expression of atherosclerotic cardiovascular disease, remains a leading global health challenge. While coronary angiography is the gold standard for anatomical assessment, it has limitations in determining the functional relevance of coronary lesions. Invasive physiological techniques - such as Fractional Flow Reserve (FFR) and its resting equivalents (iFR, RFR) - enable an objective hemodynamic evaluation, particularly useful in intermediate or multivessel diseases. Emerging imaging-derived tools, including QFR and FFRCT, offer less invasive alternatives that may play an increasing role in the upstream decision-making process. This article provides a practical overview of the available modalities, their physiological rationale, and their integration into interventional practice.

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This study explores the clinical presentation, neurobiological basis and therapeutic approaches of attention deficit hyperactivity disorder (ADHD) through the case of an adult who had not previously been diagnosed. Since childhood, the patient presented with symptoms suggestive of mixed ADHD, combining inattention, agitation, impulsivity and addictive comorbidity. Clinical and neuropsychological assessment has documented a typical picture. Recent data from the literature, particularly on the dysregulation of mesocortical and mesolimbic dopaminergic pathways, shed light on the underlying mechanisms. An integrated pharmacological and non-pharmacological treatment plan is proposed, tailored to the specific needs of the adult patient.

The diagnosis of rare movement disorders remains a major challenge in neurology due to their phenotypic diversity and genetic heterogeneity. Recent advances in high-throughput sequencing make it possible to identify new causative variants, while high-resolution MRI (7T) refine the analysis of associated brain abnormalities. The combination of rigorous clinical phenotyping, state-of-the-art genetic tools, and innovative brain imaging is currently redefining the diagnostic approach, paving the way for earlier and better targeted management of these disorders.

Optic neuritis is an inflammation of the optic nerve most often caused by autoimmune or systemic disease. The diagnostic management is transdisciplinary. The clinical approach should be global first and then system-oriented. It determines the choice of additional investigations whose purpose is the characterization of the type and the cause of the optic neuritis. The exploration initially involves neuroimaging techniques, visual electrophysiology and biological analyses. Optical coherence tomography is of considerable interest in specifying the differential diagnosis. Diagnostic accuracy influences the treatment and prognosis of this condition.

Langerhans cell histiocytosis is a rare disorder characterized by clonal proliferation of Langerhans cells. We report the case of a 40-year-old active smoker who was initially treated for a right pleural mesothelioma with chemo-immunotherapy, bullectomy with talc pleurodesis, and subsequent pleuropneumonectomy due to extensive pleuro-pulmonary involvement. During an oncological reassessment, multiple nodular lesions were detected in the contralateral lung parenchyma and were initially suspected to be metastatic. However, histological analysis of bronchoalveolar lavage and transbronchial biopsies revealed pulmonary Langerhans cell histiocytosis (formerly known as eosinophilic granuloma or histiocytosis X). This case highlights the importance of differential diagnosis in post-treatment oncologic follow-up, particularly in smokers.

Pediatric pulmonary abscess, a rare complication of pulmonary infection or congenital malformation, is characterized by parenchymal necrosis and purulent cavitation. Diagnosis is established through thoracic imaging and microbiological investigations, whereas treatment is mainly based on prolonged antimicrobial therapy, with percutaneous drainage or surgical intervention considered in cases of therapeutic failure. Prognosis is generally favorable but requires follow-up to detect possible sequelae or an underlying pulmonary malformation.