References of "Belaiche, Jacques"
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See detailControverses dans le traitement de l'Helicobacter pylori
Van Kemseke, Catherine ULg; Belaiche, Jacques ULg

in Revue Médicale de Liège (1999), 54(7), 570-5

Helicobacter pylori is a worldwide infection. In gastro-duodenal ulcer disease no doubt remains about the necessity of H. pylori eradication. Controversies subsisting in other pathologies such gastro ... [more ▼]

Helicobacter pylori is a worldwide infection. In gastro-duodenal ulcer disease no doubt remains about the necessity of H. pylori eradication. Controversies subsisting in other pathologies such gastro-esophageal reflux, dyspepsia, gastritis, gastric adenocarcinoma or MALT lymphoma are reviewed. Multiple drug combinations have been proposed to cure the infection. These are discussed in the clinical setting of Belgian practice. [less ▲]

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See detailUse of the Enteroscope for Colo-Ileoscopy: Low Yield in Unexplained Lower Gastrointestinal Bleeding
Belaiche, Jacques ULg; Van Kemseke, Catherine ULg; Louis, Edouard ULg

in Endoscopy (1999), 31(4), 298-301

BACKGROUND AND STUDY AIMS: The small intestine is a potential origin of bleeding in patients with unexplained gastrointestinal tract hemorrhage or iron-deficiency anemia. Most reports on the investigation ... [more ▼]

BACKGROUND AND STUDY AIMS: The small intestine is a potential origin of bleeding in patients with unexplained gastrointestinal tract hemorrhage or iron-deficiency anemia. Most reports on the investigation of these patients describe the use of upper tract enteroscopy. The diagnostic yield of combined upper and lower enteroscopy has not been widely assessed and remains to be clarified. The aim of this study was to assess the benefit of lower gastrointestinal tract enteroscopy in occult digestive bleeding. PATIENTS AND METHODS: Between 1 December 1995 and 15 January 1998, 54 patients with gastrointestinal bleeding of unknown origin were prospectively studied using upper and lower video push enteroscopy (44 for chronic iron-deficiency anemia and 10 for unexplained gastrointestinal tract hemorrhage with no potential site having been identified by other investigations). Examinations were done using a Olympus video enteroscope (SIF-100) under general anesthesia in a one-day clinic. An upper tract examination was done first, directly followed by the lower tract investigation. RESULTS: The upper tract enteroscopy was successful in 53 patients (98%) and retrograde ileoscopy in 21 patients (39%). In 18 (38%) cases the technical failure resulted from the impossibility of intubating the ileocecal valve. A potential source of upper gastrointestinal bleeding was detected in 35% of patients with chronic iron-deficiency anemia and in 20% of those with unexplained gastrointestinal tract hemorrhage. The most common lesion in the small bowel was angiodysplasia (25%). The lower tract video push enteroscopy disclosed 11 lesions in patients with chronic anemia. However the lesions, including two ileocecal valve cancers, were mainly located in the colon and had been missed by previous colonoscopy. No case of ileal lesion was detected in this group of patients. In patients with unexplained gastrointestinal tract hemorrhage, three lesions were detected but only one of these was in the ileum. Associated colonic and jejunal lesions were observed in three patients (5.5%). Overall, the diagnostic yield of lower video push enteroscopy was less than 2%. CONCLUSION: This prospective study has shown that using an enteroscope as a colonoscope in the management of patients with gastrointestinal bleeding of unknown origin is of little help. It might actually be more appropriate to perform a second colonoscopy. This however remains controversial and a prospective study is needed to answer that question. [less ▲]

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See detailBronchial Eosinophilic Infiltration in Crohn's Disease in the Absence of Pulmonary Disease
Louis, Edouard ULg; Louis, Renaud ULg; Shute, J. et al

in Clinical & Experimental Allergy : Journal of the British Society for Allergy & Clinical Immunology (1999), 29(5), 660-6

BACKGROUND: Immunological and functional bronchopulmonary abnormalities may be present in up to two-thirds of patients with Crohn's disease. Having recently described a mild increase in methacholine ... [more ▼]

BACKGROUND: Immunological and functional bronchopulmonary abnormalities may be present in up to two-thirds of patients with Crohn's disease. Having recently described a mild increase in methacholine airways responsiveness in these patients, we investigated whether this physiological abnormality is associated with bronchial inflammation since it has previously been described in asthma. METHODS: Eighteen patients with Crohn's disease and 15 healthy controls matched for age, atopy and smoking habit, were studied. All the subjects underwent a bronchial methacholine challenge (1, 4 and 16 mg/mL) and a sputum induction by inhalation of hypertonic saline (NaCl 4.5%). The sputum samples were analysed for their cellular composition as well as for the levels of several mediators and proteins in the fluid phase, including eosinophil cationic protein (ECP), myeloperoxydase, albumin, alpha2-macroglobulin, interleukin-8 (IL-8), IgA and IL-8/immunoglobulin A complexes. RESULTS: When compared to control subjects, patients with Crohn's disease had significantly higher sputum eosinophil counts (14.5% [0-79.9%] vs 0.2% [0-2.3%]; P < 0. 001) and ECP levels (26.2 microg/L [4-124.2 microg/L] vs 9.8 microg/L [0-94.2 microg/L]; P < 0.05). However, patients with Crohn's disease had no sign of increased plasma exudation as reflected by sputum levels of albumin and alpha2-macroglobulin similar to those seen in control subjects. Furthermore the sputum levels of IL-8, IgA and IL-8/IgA complexes were not significantly different between the two groups. The magnitude of the fall in forced expiratory volume in 1 s after methacholine inhalation was significantly increased in Crohn's disease patients although it did not correlate with the extent of sputum eosinophilia or with the sputum ECP levels. CONCLUSIONS: Crohn's disease patients without any clinical respiratory involvement have airway eosinophilia without local increased plasma exudation. However, bronchial eosinophilia in Crohn's disease per se is not sufficient to induce clinically significant airway hyperresponsiveness, suggesting that other factors than bronchial eosinophilic infiltration are required for the clinical expression of an airway instability. [less ▲]

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See detailTreatment of acute hepatitis C with interferon alpha-2b prevents chronicity.
Delwaide, Jean ULg; Bourgeois, N.; Gerard, Christiane ULg et al

in Hepatology (Baltimore, Md.) (1999), 30(4), 413

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See detailSurveillance d'une maladie de Crohn en rémission de l'adulte
Belaiche, Jacques ULg; Louis, Edouard ULg

in Hépato-Gastro (1999), 6

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See detailMaladie de Crohn. Récidives post-opératoires. Conduite à tenir.
Belaiche, Jacques ULg; Louis, Edouard ULg

in Acta Endoscopica (1999), 29

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See detailTreatment of Inflammatory Bowel Disease with Azathioprine: How to Use It in 1999
Louis, Edouard ULg; Belaiche, Jacques ULg

in Acta Gastro-Enterologica Belgica (1999), 62(4, Oct-Dec), 437-9

Azathioprine and 6-mercaptopurine are effective drugs in the management of steroid dependent and chronic active inflammatory bowel diseases. They are also well tolerated on the long term. However, their ... [more ▼]

Azathioprine and 6-mercaptopurine are effective drugs in the management of steroid dependent and chronic active inflammatory bowel diseases. They are also well tolerated on the long term. However, their use is still hampered by some drawbacks including delay before efficacy, 20-35% of non responders, relapse at withdrawal of the drugs, possible bone marrow toxicity and other side effects. During the last few years, these drawbacks have been challenged by important studies showing that a better knowledge of the metabolism of these drugs may help to improve their use. [less ▲]

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See detailPériartérite noueuse en relation avec une hépatite B
Demolin, G.; Delwaide, Jean ULg; Van Severen, M. et al

in Revue Médicale de Liège (1999), 54(1), 921-924

A 66-year-old man was hospitalized for asthenia, weight loss, fever and chills. A polyarteritis nodosa associated with hepatitis B virus infection in a replicative phase was diagnosed. Etiology ... [more ▼]

A 66-year-old man was hospitalized for asthenia, weight loss, fever and chills. A polyarteritis nodosa associated with hepatitis B virus infection in a replicative phase was diagnosed. Etiology, physiopathology, and clinical characteristics of hepatitis B virus-related polyarteritis nodosa will be reviewed, as well as the effectiveness of therapy combining corticosteroids, interferon alpha and plasma exchanges. [less ▲]

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See detailDecreased Corticosensitivity in Quiescent Crohn's Disease: An Ex Vivo Study Using Whole Blood Cell Cultures
Franchimont, Denis; Louis, Edouard ULg; Dupont, Pierre et al

in Digestive Diseases & Sciences (1999), 44(6), 1208-15

Corticosensitivity influences the degree and the duration of an inflammatory reaction by altering target cell responses to endogenous and/or exogenous glucocorticoids. Indeed, different clinical responses ... [more ▼]

Corticosensitivity influences the degree and the duration of an inflammatory reaction by altering target cell responses to endogenous and/or exogenous glucocorticoids. Indeed, different clinical responses to glucocorticoids have been observed among patients with Crohn's disease, suggesting different degrees of corticosensitivity in these subjects. The purpose of this study was to compare the corticosensitivity of patients with quiescent Crohn's disease to that of healthy subjects (HS). Nineteen patients with quiescent Crohn's disease and 14 HS were studied; all patients were steroid-free for at least six months; 7 of the 19 were corticosteroid-dependent (CSD) and treated with nonglucocorticoid immunosuppressants at the time of the study. Corticosensitivity was measured by the inhibition of LPS-induced cytokine secretion in whole blood cell cultures treated with increasing concentrations (10(-9) to 10(-6) M) of dexamethasone. Tumor-necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-1 beta (IL-1 beta) were measured using specific immunoassays. Crohn's disease patients had a markedly decreased dexamethasone-mediated inhibition of TNF-alpha (P < 0.01), IL-6 (P < 0.001), and IL-1 beta (P < 0.01) compared to healthy subjects, with a shift of the dexamethasone dose-response curve to the right. No significant differences in the basal and LPS-stimulated secretion of the three cytokines were observed between CSD and non-CSD patients, and both subgroups of patients had similar degrees of dexamethasone-mediated cytokine inhibition. We conclude that patients with Crohn's disease have a significant decrease in the corticosensitivity of their leukocytes. This may be related to a specific genetic/constitutional background and/or could be acquired, due to inflammation-related endocrine and/or immune factors. [less ▲]

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See detailLa transmission du virus de l’hépatite C en milieu hospitalier
Delwaide, Jean ULg; Gerard, Christiane ULg; Belaiche, Jacques ULg et al

in Médecine et Hygiène (1999), 57

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See detailHepatitis C virus transmission following invasive medical procedures
Delwaide, Jean ULg; Gerard, Christiane ULg; Vaira, Dolorès ULg et al

in Journal of Internal Medicine (1999), 245(1), 107-108

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See detailCorticosensitivity in whole blood cell cultures in Crohn's disease and healthy subjects
Franchimont, Denis; Louis, Edouard ULg; Geenen, Vincent ULg et al

in Digestive Diseases & Sciences (1999), 44

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See detailPrevalence of hepatitis G virus in a haemodialysis unit
Lamproye, Anne ULg; Delwaide, Jean ULg; Vaira, Dolorès ULg et al

in Acta Gastro-Enterologica Belgica (1999), 62(1), 13-15

Background : Recently, a novel blood-borne virus has been identified and named hepatitis G virus. Transfusion is the main route of transmission. It is known that patients on maintenance dialysis are more ... [more ▼]

Background : Recently, a novel blood-borne virus has been identified and named hepatitis G virus. Transfusion is the main route of transmission. It is known that patients on maintenance dialysis are more susceptible to infections with parenterally-transmitted viruses than the general population. The aim of the present study was to determine the prevalence of hepatitis G infection in a Belgian dialysis unit. Methods: The entire population of our dialysis unit (82 patients) was tested for the presence of hepatitis G virus (HGV) by reverse transcriptase polymerase chain reaction. History of transfusion or renal transplantation coinfections with hepatitis B and C viruses, and serum aminotransferase levels were also tested. Results: Thirteen patients (16%) were found positive for HGV-RNA. Among these patients, 69.2% were infected by the G virus alone, 15.4% were coinfected with B virus, and 15.4% with C virus. All but one patient had a history of transfusion. Ten of the thirteen infected patients (77%) had normal aminotransferase (< 30 UI/l). Three patients had elevated aminotransferase levels (23%); one was coinfected with B virus, one with C virus, and the last one had a diabetes-induced fatty liver infiltration. No liver biopsies were performed. Conclusions :It is concluded that infection with C virus is common among dialyzed patients. This high rate of infection could be related to previous transfusions, but may as well be due to nosocomial transmission. In our series, at least one patient has been contaminated by another road than transplantation or transfusion. Finally, it does not appear clearly that chronic infection with hepatitis G virus induces Liver disease, as defined by elevated aminotransferase level. [less ▲]

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See detailClinical Pattern of Corticosteroid Dependent Crohn's Disease
Franchimont, D. P.; Louis, Edouard ULg; Croes, F. et al

in European Journal of Gastroenterology & Hepatology (1998), 10(10), 821-5

OBJECTIVES: Corticosteroid dependency in Crohn's disease (CD) is characterized by the need for chronic use of corticosteroids to maintain clinical remission. Several definitions have been used. Depending ... [more ▼]

OBJECTIVES: Corticosteroid dependency in Crohn's disease (CD) is characterized by the need for chronic use of corticosteroids to maintain clinical remission. Several definitions have been used. Depending on the definition, 10-30% of the patients are considered as corticosteroid dependent. The aim of the study was to define a clinical pattern of corticosteroid dependent CD patients. PATIENTS AND METHODS: Epidemiological and clinical characteristics were retrospectively compared between 20 corticosteroid dependent CD patients and 248 non-corticosteroid dependent CD patients by using univariate and multivariate analyses. Corticosteroid dependency was defined either by two successive relapses during the 2 months after discontinuing glucocorticoids (n=5) or by two successive relapses at dose tapering, after successful treatment of a flare-up by using glucocorticoids (n=15). RESULTS: Corticosteroid dependent CD patients were younger at diagnosis (P < 0.001), and were characterized by a higher frequency of colonic location (P< 0.05), but lower frequency of ileal location (P < 0.01), and higher ano-perineal location (P < 0.05). They were also more frequently smokers (P< 0.05) and users of contraceptive pills (P< 0.01). The inflammatory type of the disease was increased (P < 0.01), while the fibrostenotic type was decreased (P < 0.001) in corticosteroid dependent CD patients. By multivariate analysis, a smoking habit (P < 0.01), a colonic location (P < 0.05), a non-fibrostenotic type (P< 0.05) and a younger age at diagnosis (P< 0.05) were shown to be independently associated with corticosteroid dependency. CONCLUSIONS: This study suggests a clinical pattern associated with corticosteroid dependency. Whether this clinical pattern is simply associated with the dependency, or whether a primary decrease of corticosensitivity produces this clinical pattern, is not known. Further prospective studies will have to determine whether the presence of these clinical characteristics is predictive of corticosteroid dependency and whether this prediction will be useful for the management of this condition. [less ▲]

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See detailEffects of Dexamethasone on the Profile of Cytokine Secretion in Human Whole Blood Cell Cultures
Franchimont, Denis; Louis, Edouard ULg; Dewé, Walthère ULg et al

in Regulatory Peptides (1998), 73(1), 59-65

EXPERIMENTAL OBJECTIVES: The interaction between the endocrine and immune systems is a very intriguing area. Endogenous glucocorticoids, as end-effectors of the hypothalamo-pituitary-adrenal axis, inhibit ... [more ▼]

EXPERIMENTAL OBJECTIVES: The interaction between the endocrine and immune systems is a very intriguing area. Endogenous glucocorticoids, as end-effectors of the hypothalamo-pituitary-adrenal axis, inhibit the immune and inflammatory responses and are used as immunosuppressive drugs in many inflammatory, autoimmune and allergic diseases. The aims of this study were to investigate the effects of dexamethasone on the profile of cytokine secretion in whole blood cell cultures from healthy subjects and to analyse the gender-related sensitivity to dexamethasone on each cytokine secretion. RESULTS: There was a significant inhibition by dexamethasone (from 1 to 100 nM) on the secretion of monokines (IL-1beta, IL-6, IL-8 and TNF alpha) and lymphokines (IL-2, IL-4, IL-10 and IFN gamma), either after LPS or PHA stimulation (P < 0.01). Interleukin 4 and IL-10 were less inhibited than IFN gamma (P < 0.05 at 1 nM, P < 0.01 at 10 nM and P < 0.001 from 100 nM to 10 microM). No gender difference was observed in the rate of inhibition of the secretion of each cytokine. CONCLUSION: This study shows that the inhibition of cytokine secretion by dexamethasone is more marked on Th1-type cytokines than on Th2-type cytokines. These data support the idea that glucocorticoids may induce a shift from the Th1 to Th2 profile of cytokine secretion. [less ▲]

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See detailCorticosteroid Treatment in Active Crohn's Disease
Belaiche, Jacques ULg; Louis, Edouard ULg

in Acta Gastro-Enterologica Belgica (1998), 61(2, Apr-Jun), 153-7

Despite recent improvements in the management of Crohn's disease, steroids are still the most efficacious treatment in flare ups of the disease. However they have significant side effects and are only ... [more ▼]

Despite recent improvements in the management of Crohn's disease, steroids are still the most efficacious treatment in flare ups of the disease. However they have significant side effects and are only effective in the short term. There is no consensus regarding initial dose or duration of corticotherapy. With 1 mg/Kg a day of oral prednisolone given for 3 to 7 weeks, 92% of the patients achieve clinical remission. Topical acting oral corticosteroids such as budesonide seem to represent an important therapeutic advance due to their better tolerance. The promising results of budesonide in mild and moderate flare ups need to be confirmed and its indication in severe disease beside high dose prednisolone has to be clarified. [less ▲]

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See detailNouveaux traitements immunomodulateurs dans la maladie de Crohn
Louis, Edouard ULg; Belaiche, Jacques ULg

in Médecine et Hygiène (1998), 56

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See detailTumour necrosis factor (TNF) gene polymorphism influences TNF-alpha production in lipopolysaccharide (LPS)-stimulated whole blood cell culture in healthy humans.
Louis, Edouard ULg; Franchimont, D.; Piron, Anne ULg et al

in Clinical & Experimental Immunology (1998), 113(3), 401-406

TNF-alpha is involved in infectious and immuno-inflammatory diseases. Different individuals may have different capacities for TNF-alpha production. This might determine a predisposition to develop some ... [more ▼]

TNF-alpha is involved in infectious and immuno-inflammatory diseases. Different individuals may have different capacities for TNF-alpha production. This might determine a predisposition to develop some complications or phenotypes of these diseases. The aims of our study were to assess the inter-individual variability of TNF-alpha production and to correlate this variability to a single base pair polymorphism located at position -308 in TNF gene. We studied 62 healthy individuals. TNF-alpha production after LPS stimulation was evaluated using a whole blood cell culture model. The TNF gene polymorphism was studied by an allele-specific polymerase chain reaction. Other cytokines produced in the culture, soluble CD14 concentrations and expression of CD14 on blood cells were also measured. Among the 62 individuals, 57 were successfully genotyped. There were 41 TNF1 homozygotes and 16 TNF1/TNF2 heterozygotes. TNF-alpha production after LPS stimulation of whole blood cell culture was higher among TNF2 carriers than among TNFI homozygotes (929pg/ml (480-1473pg/ml) versus 521 pg/ ml (178-1307 pg/ml); P<0.05). This difference was even more significant after correction of TNF-alpha production for CD14 expression on blood cells. In conclusion, the single base pair polymorphism at position -308 in the TNF gene may influence TNF-alpha production in healthy individuals. [less ▲]

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See detailTransmission du virus de l'hépatite C par examens médicaux invasifs
DELWAIDE, Jean ULg; Gerard, Christiane ULg; Vaira, Dolorès ULg et al

in Gastroentérologie Clinique et Biologique (1998), 22(2), 172

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