The ecology of health care in a Belgian area.

INTRODUCTION: Focusing on the monthly prevalence of health problems and recourse to different levels of care of the population is an interesting approach to demonstrate the respective roles of different levels of health care. In the present study, the ecology of health care was studied in the region of Liège, Belgium. METHOD: A survey questioning people about their health problems was conducted in 2009 in two communes of the province of Liège. For each health problem, 'health care' was defined as contact with any qualified care provider. For each consultation, three elements were recorded: the profession of the health care provider; the place where the care was provided and the kind of health care received. RESULTS: A total of 537 people were interviewed. The monthly prevalence of people who experienced a health problem during the previous month was 85.1%. The monthly prevalence of people who turned to a health care provider at least once during the month was 62.2%. The proportion of people turning to doctors, primarily local doctors, for a simple consultation was important (49.2%). DISCUSSION: Our results are highly comparable with those of other studies. Recourse to a doctor is high (49%), which probably reflects the broad accessibility of health care in Belgium and maybe its overuse. Additional questions on the current and future organisation of the Belgian health care system are debated.

[Allergens of animal origin]. / Les allergènes d'origine animale.

Dander's Allergy still is an actual problem. In urban population the incidence increase with proliferation of domestic Animals in Houses, when, in rural population, cows and horses sensibilization frequency decrease with present evolution of farming. The newness is represented by the amelioration of knowledge in last years of biochemical nature of Antigens and the identification of major allergens.

[Thoracic actinomycosis. Apropos of 5 cases]. / L'actinomycose thoracique. A propos de 5 observations.

Described for the first time by Bradshaw in 1846, actinomycosis is a rare, slowly progressing disease associated with the development of anaerobic bacteria of the Actinomyces genus. It predominates in males and is actively encouraged by poor buccal and dental hygiene and by overall decline of defence mechanisms. Thoracic lesions constitute 15 to 20% of the cases and seem to be relatively increasing. Apart from fistulization to the skin, physical examination usually does not show much; only the presence of yellow grains suggests the diagnosis. Radiography is often misleading, suggesting tuberculosis or cancer. Ultrasonography and, chiefly, computerized tomography are the best methods to evaluate the extension of the disease to the pleura, the chest wall and the mediastinum. The final diagnosis is more often supplied by pathological examination than by bacteriology, which is frequently negative. Treatment is facilitated by the fact that Actinomyces is sensitive to antibiotics, notably to penicillin which still is the first choice drug. A well-conducted treatment will give satisfactory results, but sequelae of retractile fibrosis may be disabling.