References of "SCHEEN, André"
     in
Bookmark and Share    
Peer Reviewed
See detailLa neuropathie diabetique: donnees epidemiologiques et predictives.
Scheen, André ULg

in Diabètes & Métabolism (1998), 24 Suppl 3

Neuropathy is a classical complication of diabetes mellitus, to the same extent as micro- and macroangiopathy. Diabetic neuropathy can be schematically divided into peripheral neuropathy, especially in ... [more ▼]

Neuropathy is a classical complication of diabetes mellitus, to the same extent as micro- and macroangiopathy. Diabetic neuropathy can be schematically divided into peripheral neuropathy, especially in the lower limbs (distal polyneuropathy), and autonomic neuropathy, present in all systems (cardiovascular, gastrointestinal, urogenital and even pulmonary abnormalities). Detection should be based on an oriented anamnesis and a careful physical examination. Complementary exams may be performed in order to confirm the diagnosis and assess the severity of the neuropathy. While the diagnosis of peripheral neuropathy is essentially based on clinical examination, that of autonomic neuropathy has been markedly facilitated by simple standardised tests for early detection of cardiac autonomic neuropathy. Depending on the terminology, the diagnostic criteria and the characteristics of the population, the prevalence of diabetic neuropathy can range from 15 to 100%. However, all studies agree that prevalence is important in both types of diabetes (Type 1 and Type 2), that it increases with age and disease duration, and that it is inversely related to the quality of glycaemic control. Detection of neuropathy is an essential step in the clinical approach to diabetic patients, mainly because of the prognosis linked to such a diagnosis, at both an early and late stage of the disease. Once neuropathy is diagnosed, the physician should provide specific advice to diabetic patients in order to prevent possible dramatic complications. [less ▲]

Detailed reference viewed: 67 (1 ULg)
Peer Reviewed
See detailPharma-Clinics. Essais cliniques medicamenteux: importance et role du medecin generaliste .
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(1), 17-20

Clinical trials are an essential step in the development of a drug. They must be conducted according to strict rules called "Good Clinical Practice" or GCP. GCP requirements aim to guarantee a perfect ... [more ▼]

Clinical trials are an essential step in the development of a drug. They must be conducted according to strict rules called "Good Clinical Practice" or GCP. GCP requirements aim to guarantee a perfect methodology in the planning, realization and interpretation of clinical trials. The latter can be divided in four phases: phase 1 aiming to demonstrate the safety and to investigate the pharmacokinetics/metabolism of the drug in healthy volunteers; phase 2 aiming to study the intrinsic activity (generally versus a placebo) and safety of the compound in a rather small number of (hospitalized) patients; phase 3 aiming to confirm the comparative efficacy (versus a placebo or a reference drug) and safety of the pharmacological agent in a quite large number of (ambulatory) patients; and phase 4 carried out after commercialization, to verify the clinical utility of the drug in conditions of daily practice. Because he/she occupies a crucial position in the recruitment and follow-up of outpatients, the general practitioner should play a more active role in clinical trials, provided that he/she could work in collaboration with academic centers specialized in clinical pharmacology which can help to perform studies in accordance with GCP requirements. [less ▲]

Detailed reference viewed: 54 (2 ULg)
Peer Reviewed
See detailLe syndrome X, a la croisee des maladies metaboliques et cardio-vasculaires.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(1), 29-32

The relationships between metabolic disorders and cardiovascular diseases are very strong. Hypercholesterolaemia and diabetes mellitus, for instance, are well-known risk factors. The multifaceted ... [more ▼]

The relationships between metabolic disorders and cardiovascular diseases are very strong. Hypercholesterolaemia and diabetes mellitus, for instance, are well-known risk factors. The multifaceted metabolic syndrome or syndrome X, originally described by Reaven in 1988, comprises several abnormalities which are associated to insulin resistance and compensatory hyperinsulinaemia. Syndrome X results in an increased vascular risk by at least two mechanisms. On the one hand, it favours atherosclerosis and is associated to angiographic lesions, especially in the coronary arteries. On the other hand, it is associated to endothelial dysfunction which may contribute to myocardial ischaemia even in presence of angiographically normal arteries, a phenomenon named also syndrome X by the cardiologists. Thus, metabolic syndrome X and cardiological syndrome X are very close and syndrome X may be considered as a crossing between metabolic disorders and cardiovascular diseases. [less ▲]

Detailed reference viewed: 26 (0 ULg)
Peer Reviewed
See detailPharma-Clinics. Le medicament du mois. La ranitidine bismuth citrate (Pylorid).
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(1), 41-4

Ranitidine bismuth citrate (Pylorid, Glaxo-Wellcome) is a novel salt of ranitidine which provides a unique combination of properties: inhibition of secretion of gastric acid by competitive antagonism of ... [more ▼]

Ranitidine bismuth citrate (Pylorid, Glaxo-Wellcome) is a novel salt of ranitidine which provides a unique combination of properties: inhibition of secretion of gastric acid by competitive antagonism of the action of histamine at the histamine H2-receptor on the gastric parietal cell, mucosal protective effects and anti-Helicobacter pylori action. Ranitidine bismuth citrate provides effective healing and symptom relief, both in duodenal ulcer disease and in gastric ulcer disease. When coprescribed with certain antibiotics (clarithromycin alone or combined with amoxicillin or nitro-imidazole), it heals ulcers, eradicates Helicobacter pylori and prevents recurrence of the disease. Several clinical studies demonstrated that ranitidine bismuth citrate is well-tolerated and has quite similar efficacy as proton pump inhibitors. [less ▲]

Detailed reference viewed: 79 (0 ULg)
Peer Reviewed
See detailPharma-clinics. Le medicament du mois. L'atorvastatine (Lipitor).
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(6), 374-7

Atorvastatin, commercialized by the pharmaceutical companies Parke-Davis and Pfizer under the trade name Lipitor, is a new statin acting as a potent hypolipidaemic drug. By inhibiting HMG-CoA reductase ... [more ▼]

Atorvastatin, commercialized by the pharmaceutical companies Parke-Davis and Pfizer under the trade name Lipitor, is a new statin acting as a potent hypolipidaemic drug. By inhibiting HMG-CoA reductase, the key-enzyme of cellular synthesis of cholesterol, it increases the expression of LDL receptors and promotes the hepatic extraction of circulating LDL. It has a more potent action than other available statins, both on LDL cholesterol and triglyceride levels. Atorvastatin is indicated, after diet failure, in the treatment of primary hypercholesterolaemia or combined hyperlipidaemia. Lipitor is available as tablets of 10 and 20 mg. The usual doses is 10 mg once a day, to be increased up to 20 mg/day if necessary. In rare severe cases, the doses may be increased up to 80 mg/day. [less ▲]

Detailed reference viewed: 84 (0 ULg)
Peer Reviewed
See detailLe cas clinique du mois. Une nephropathie galopante chez un patient diabetique de type 2.
Philips, Jean-Christophe ULg; Scheen, André ULg; Firre, E. et al

in Revue Médicale de Liège (1998), 53(4), 171-4

We report the case of a patient with insulin-requiring type 2 diabetes who exhibited a rapid deterioration of his renal function leading to haemodialysis in a few months. Various diagnosis were considered ... [more ▼]

We report the case of a patient with insulin-requiring type 2 diabetes who exhibited a rapid deterioration of his renal function leading to haemodialysis in a few months. Various diagnosis were considered to explain this rapid deterioration, excluding diabetic nephropathy as major etiology. The exploration, especially renal biopsy, demonstrated the presence of a glomerulonephritis due to the deposition of immune complexes associated to active hepatitis C rather than diabetic glomerulosclerosis. A treatment with interferon-alpha allowed to partially restore renal function, this recovery permitting the interruption of hemodialysis, with a current follow-up of more than 6 months. [less ▲]

Detailed reference viewed: 102 (2 ULg)
Peer Reviewed
See detailPharma-clinics. Le dopage a l'erythropoietine ou l'utilisation detournee des progres therapeutiques.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(8), 499-502

Sport performance depends on the capacity of oxygen transport to the exercising skeletal muscles. Performance may be increased thanks to an haematocrit augmentation, either by training in high altitude ... [more ▼]

Sport performance depends on the capacity of oxygen transport to the exercising skeletal muscles. Performance may be increased thanks to an haematocrit augmentation, either by training in high altitude, using blood transfusions, or injecting erythropoietin (Epo). Since the synthesis of Epo by bioengineering, doping with recombinant human Epo has become popular in sports in general, and in cycling in particular. This new kind of doping might have been responsible for several sudden deaths in young athletes, essentially in racing cyclists. Until now, such a doping is hardly to be detected. However, it should deserve careful consideration from both public health authorities and sports communities in order to stop what could become a real plague. [less ▲]

Detailed reference viewed: 165 (1 ULg)
Peer Reviewed
See detailComment je traite... un patient diabetique de type 2: le projet "DREAM" pour une meilleure collaboration medecin generaliste-medecin specialiste. Diabetes Reinforcement of Adequate Management.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(2), 58-62

Type 2 diabetes is an important public health problem because of its high prevalence and morbidity rate which both are associated with a considerable social and human cost. The general practitioner should ... [more ▼]

Type 2 diabetes is an important public health problem because of its high prevalence and morbidity rate which both are associated with a considerable social and human cost. The general practitioner should play a central role in the management of patients with type 2 diabetes and try to meet the therapeutic objectives. Main goals include reinforcement of early diagnosis, by a better screening of individuals at risk for type 2 diabetes, achievement of a good glycaemic control, through an optimized antidiabetic treatment, correction of associated risk factors as well as detection and treatment of disease complications. DREAM ("Diabetes Reinforcement of Adequate Management") is a pilot project which started in Liege area end 1997 for at least 2 years. It aims at improving the management of type 2 diabetic patients through a better free collaboration between general practitioners and diabetologists and the adhesion to an optimized therapeutic strategy. This ambitious project benefits from the valuable support of three pharmaceutical companies. [less ▲]

Detailed reference viewed: 62 (1 ULg)
Peer Reviewed
See detailPharmaco-economie des medicaments hypolipidemiants: analyse des facteurs influencant le rapport cout/efficacite.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(5), 270-5

The demonstration that stains reduce the risk of cardiovascular diseases, in both secondary and primary prevention trials, led to the recent publication of sophisticated pharmaco-economical studies. A lot ... [more ▼]

The demonstration that stains reduce the risk of cardiovascular diseases, in both secondary and primary prevention trials, led to the recent publication of sophisticated pharmaco-economical studies. A lot of factors may influence the cost-effectiveness ratio of the pharmacological intervention, especially the mode of calculation of various costs, the initial level of cardiovascular risk of the patients and the medico-economical particularities of each country. What so ever, available studies appear to justify the use of statins in secondary prevention, i.e. in coronary patients, even those with only a moderate hypercholesterolaemia, and, in primary prevention, i.e in hypercholesterolaemia individuals with obvious high risk of cardiovascular disease. [less ▲]

Detailed reference viewed: 46 (5 ULg)
Peer Reviewed
See detailActualites therapeutiques 1997-1998 (1). Seconde partie.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(9), 518-23

The most important drugs registered and/or launched in Belgium during the last year in the various disciplines of internal medicine will be briefly described. The originality of each molecule as well as ... [more ▼]

The most important drugs registered and/or launched in Belgium during the last year in the various disciplines of internal medicine will be briefly described. The originality of each molecule as well as its modalities of appropriate use in clinical practice will be stressed. This second part is devoted to drugs acting on infectious, rheumatoid, immunologic, oncologic and urogenital diseases. [less ▲]

Detailed reference viewed: 8 (1 ULg)
Peer Reviewed
See detailPharmaco-economie du diabete de type 2.
Scheen, André ULg; Lefebvre, Pierre ULg

in Revue Médicale de Liège (1998), 53(5), 285-9

Type 2 diabetes has long been considered as a benign disease, whereas it is in fact associated with an enormous socio-economic cost. The major part of the burden of diabetes results from the management of ... [more ▼]

Type 2 diabetes has long been considered as a benign disease, whereas it is in fact associated with an enormous socio-economic cost. The major part of the burden of diabetes results from the management of complications (both direct and indirect costs), rather than from the various components of the antihyperglycaemic treatment itself. Solutions include a better prevention of the disease, an earlier diagnosis among individuals at risk, and an optimized management of diabetes, particularly in primary care settings, in order to avoid or retard the development of severe micro- or macroangiopathic complications which are particularly expensive. [less ▲]

Detailed reference viewed: 105 (7 ULg)
Peer Reviewed
See detailActualites therapeutiques 1997-1998 (1). Premiere partie.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(8), 459-66

The most important drugs registered and/or launched in Belgium during the last year in the various disciplines of internal medicine will be briefly described. The originality of each molecule as well as ... [more ▼]

The most important drugs registered and/or launched in Belgium during the last year in the various disciplines of internal medicine will be briefly described. The originality of each molecule as well as its modalities of appropriate use in clinical practice will be stressed. This first part is devoted to drugs acting on cardiovascular, respiratory, digestive and neurologic diseases. [less ▲]

Detailed reference viewed: 12 (0 ULg)
Peer Reviewed
See detailComment j'explore... une hypertriglyceridemie.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(2), 103-5

The strategy for the diagnosis of hypertriglyceridaemia comprises three successive steps. First, the physician should confirm the biological abnormality by at least one additional blood sample taken after ... [more ▼]

The strategy for the diagnosis of hypertriglyceridaemia comprises three successive steps. First, the physician should confirm the biological abnormality by at least one additional blood sample taken after an overnight fast; recent data, however, suggest that postprandial hypertriglyceridaemia may also represent a cardiovascular risk factor. Second, the phenotype of hypertriglyceridaemia should be considered as either isolated high triglyceride levels or hypertriglyceridaemia combined with hypercholesterolemia may be present; the combination of hypertriglyceridaemia with a low HDL cholesterol concentration or its association with the metabolic or insulin resistance syndrome should also be investigated. Third, all should be done in order to find the etiology of the hypertriglyceridaemia (by determining its genetic or nutritional origin, by excluding possible underlying pathologies, by looking for drugs able to increase serum triglyceride levels). These various steps should help the physician to take the final decision of treating one particular patient as well as to chose the most appropriate, nutritional or pharmacological, treatment. [less ▲]

Detailed reference viewed: 56 (1 ULg)
Peer Reviewed
See detailPharma-clinics. Le medicament du mois. L'alendronate (Fosamax).
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(4), 220-2

Alendronate (Fosamax, Merck Sharp & Dohme) is an aminobisphosphonate which inhibits bone turnover by suppressing the activity of osteoclasts without increasing the risk of osteomalacia. Alendronate is ... [more ▼]

Alendronate (Fosamax, Merck Sharp & Dohme) is an aminobisphosphonate which inhibits bone turnover by suppressing the activity of osteoclasts without increasing the risk of osteomalacia. Alendronate is highly effective at preventing bone loss associated to absence of endogenous estrogen and induces a sustained increase in bone mass. Fosamax is indicated and reimbursed in the treatment of osteoporosis in postmenopausal women, with either an history of bone fracture confirmed by X-ray exam or obvious osteoporosis assessed by bone mineral density measurement. The recommended dosage is 10 mg once daily, continuously. The drug should be absorbed after an overnight fast to improve its bioavailability and with a big glass of plain water to reduce the risk of oesophageal ulcerations. Large randomized controlled trials for up to 3 years have demonstrated that alendronate is able to reduce the risk and rate of occurrence of vertebral and nonvertebral fractures in postmenopausal women. [less ▲]

Detailed reference viewed: 56 (7 ULg)
Peer Reviewed
See detailImplications virales dans l'etiopathogenie du diabete de type 1: donnees actuelles.
Radermecker, Régis ULg; Scheen, André ULg; Letiexhe, Michel ULg et al

in Revue Médicale de Liège (1998), 53(10), 597-602

Type 1 diabetes mellitus results from autoimmune destruction of pancreatic beta cells. After having described genetic, immunological and metabolic factors, some researchers have hypothezised that ... [more ▼]

Type 1 diabetes mellitus results from autoimmune destruction of pancreatic beta cells. After having described genetic, immunological and metabolic factors, some researchers have hypothezised that environmental factors might trigger the autoimmune process. Based on epidemiological, anatomoclinical and animal studies, they suggest a role for virus infections. [less ▲]

Detailed reference viewed: 50 (4 ULg)
Peer Reviewed
See detailPharma clinics. Comment je traite.... Certaines maladies metaboliques grace a une intervention pharmacologique ciblee sur l'intestin.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(11), 646-50

Besides the classical dietary regimen, it is possible to use specific pharmacological approaches, targeted at the intestine, in order to treat some metabolic disorders. Three approaches will be described ... [more ▼]

Besides the classical dietary regimen, it is possible to use specific pharmacological approaches, targeted at the intestine, in order to treat some metabolic disorders. Three approaches will be described: anionic resins for treating hypercholesterolaemia, alpha-glucosidase inhibitors for treating diabetes mellitus and reactive hypoglycaemia, and intestinal lipase inhibitors for treating obesity. All these drugs are based on original concepts, but their clinical use is often limited by the occurrence of digestive side-effects. The latter may generally be reduced by progressive and individual titration of the dosage of each drug and/or by following an appropriate diet. [less ▲]

Detailed reference viewed: 21 (1 ULg)
Peer Reviewed
See detailPharma-clinics. Le medicament du mois. Premelle (oestrogenes conjugues + medroxyprogesterone).
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(10), 638-40

Premelle, commercialised by Wyeth-Lederle, is a combination of conjugated estrogens 0.625 mg and medroxyprogesterone acetate 5 mg which is indicated in the treatment of menopause-associated problems ... [more ▼]

Premelle, commercialised by Wyeth-Lederle, is a combination of conjugated estrogens 0.625 mg and medroxyprogesterone acetate 5 mg which is indicated in the treatment of menopause-associated problems, among which vasomotor symptoms, atrophic vaginitis and/or urethritis, and in the prevention and treatment of post-menopausal osteoporosis. It is presented in two formulations, Premelle cyclic 5 and Premelle 5. The former, in which the progestagen is only given during the last 14 out of 28 days of the treatment cycle, is accompanied by regular bleeding and thus preferably indicated during perimenopause whereas the latter, in which the progestagen is given continuously and results in amenorrhea, is mostly indicated after menopause in order to improve long-term compliance. [less ▲]

Detailed reference viewed: 49 (1 ULg)
Peer Reviewed
See detailComment j'explore ... un sujet avec une concentration basse de cholesterol HDL.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(11), 711-4

A decrease in plasma HDL cholesterol concentration is considered as a major cardiovascular risk factor and is a prevalent lipid abnormality among patients with coronary heart disease. This condition is ... [more ▼]

A decrease in plasma HDL cholesterol concentration is considered as a major cardiovascular risk factor and is a prevalent lipid abnormality among patients with coronary heart disease. This condition is most often observed in the presence of hypertriglyceridaemia, generally linked to the insulin resistance syndrome, but may also be associated to elevated LDL cholesterol level or even be present alone (hypoalphalipoproteinaemia). The decision to treat a patient with low HDL level depends on the individual overall cardiovascular risk which should be evaluated as carefully as possible. The investigation should look for causes which may favour this metabolic condition, such as bad life habits or possible pharmacological interferences. [less ▲]

Detailed reference viewed: 11 (0 ULg)
Peer Reviewed
See detailPharma-clinics. Le medicament du mois. Le formoterol (Oxis Turbohaler).
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(11), 715-8

Formoterol, commercialized by Astra under the trade name Oxis, is a new potent and selective agonist of beta-2 adrenergic receptors, which is used with a specific device (Turbohaler) allowing effective ... [more ▼]

Formoterol, commercialized by Astra under the trade name Oxis, is a new potent and selective agonist of beta-2 adrenergic receptors, which is used with a specific device (Turbohaler) allowing effective inhalation. Bronchodilatation occurs rapidly, within 1-3 minutes after inhalation, and lasts about 12 hours after the administration of a unique dose. Oxis Turbohaler is indicated to reduce symptoms associated with bronchial obstruction in asthmatic patients when the control of asthma is not achieved with inhaled corticoid therapy. It is not indicated for the treatment of acute crisis. It is presented as powder vials for inhalation (4.5 or 9 micrograms per dose). The usual dose in adults is 1-2 inhalations 1-2 times per day, in the morning and/or in the evening (bedtime administration should be recommended in case of nocturnal asthma). There is not enough data for treating children. The lowest dose allowing adequate control of asthma should be selected for chronic treatment. [less ▲]

Detailed reference viewed: 41 (0 ULg)
Peer Reviewed
See detailInfo-congres. Les lecons de la "United Kingdom Prospective Diabetes Study".
Scheen, André ULg; Lefebvre, Pierre ULg

in Revue Médicale de Liège (1998), 53(9), 576-8

The United Kingdom Prospective Diabetes Study (UKPDS) is the largest study ever performed in the field of diabetes. It has been carried on in more than 5000 patients with newly diagnosed type 2 diabetes ... [more ▼]

The United Kingdom Prospective Diabetes Study (UKPDS) is the largest study ever performed in the field of diabetes. It has been carried on in more than 5000 patients with newly diagnosed type 2 diabetes and followed during almost 15 years. The main goals of the study were to investigate the effects of improving blood glucose and/or blood pressure control on diabetic complications, and to compare the advantages and inconvenients of the most important pharmacological approaches. The results of the UKPDS have been presented at the last Congress of the European Association for the Study of Diabetes (EASD) in Barcelona, September 10-11, 1998. They essentially showed that improving blood glucose or arterial blood pressure control allows to significantly reduce the incidence of complications associated to diabetes. Best results were observed in individuals in whom treatments of both hyperglycemia and hypertension were intensified. For each risk factor, no threshold has been found so that every reduction in blood glucose or arterial pressure is accompanied by a nearly linear diminution in the incidence of diabetic complications. The type of pharmacological treatment appears to have a less prominent influence, even if metformin appears to exert the most favourable effects in the group of obese patients with type 2 diabetes. [less ▲]

Detailed reference viewed: 21 (0 ULg)