References of "SCHEEN, André"
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See detailComment j'explore ... le controle glycemique des patients diabetiques a domicile.
Scheen, André ULiege

in Revue Médicale de Liège (1999), 54(11), 893-7

Self blood glucose monitoring is now a key element in the management of diabetic patients. However, in order to improve overall blood glucose control, self-monitoring should lead to self-management. This ... [more ▼]

Self blood glucose monitoring is now a key element in the management of diabetic patients. However, in order to improve overall blood glucose control, self-monitoring should lead to self-management. This implies that the patient modifies his/her behaviour (diet, exercise, oral antidiabetic agents, insulin doses) to ameliorate the metabolic status according to his/her blood glucose measurements. While the place of home blood glucose monitoring is rather well defined in type 1 diabetes, it remains more controversial in type 2 diabetes. [less ▲]

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See detailLe vieillissement s'accompagne-t-il d'une diminution de la sensibilite a l'insuline? Roles de l'IGF1 et de la dehydroepiandrosterone.
Paolisso, G.; Tagliamonte, M. R.; Rizzo, M. R. et al

in Journées Annuelles de Diabetologie de l'Hôtel-Dieu (1999)

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See detailPharma-clinics. Le medicament du mois. L'aceclofenac (Biofenac).
Scheen, André ULiege

in Revue Médicale de Liège (1999), 54(1), 62-4

Aceclofenac, a phenylacetic acid derivative, is a new nonsteroidal anti-inflammatory drug (NSAID). It is indicated in the symptomatic treatment of pain and inflammatory or degenerative arthropathies ... [more ▼]

Aceclofenac, a phenylacetic acid derivative, is a new nonsteroidal anti-inflammatory drug (NSAID). It is indicated in the symptomatic treatment of pain and inflammatory or degenerative arthropathies: osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, abarticular inflammations, posttrauma or postoperative inflammations. The usual oral dosage of aceclofenac is 100 mg twice daily in adults. Its clinical efficacy seems to be similar to that of other NSAIDs, but its safety profile, especially gastro-intestinal tolerance, appears to be better. Finally, in vitro studies suggested that aceclofenac may exert positive effect on cartilage matrix metabolism. [less ▲]

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See detailL'obesite feminine: souci esthetique ou probleme medical?
Luyckx, Françoise ULiege; Scheen, André ULiege; Lefebvre, Pierre ULiege

in Revue Médicale de Liège (1999), 54(4), 262-7

Women more and more frequently refer to medical doctors for treating weight excess. Even if the primum movens is usually a pure esthetic concern, medical aspects should not be neglected. Indeed, if ... [more ▼]

Women more and more frequently refer to medical doctors for treating weight excess. Even if the primum movens is usually a pure esthetic concern, medical aspects should not be neglected. Indeed, if obesity with gynoid adipose tissue distribution is less deleterious than android obesity from a metabolic point of view, severe obesity is frequently associated with cardiovascular risk factors which may hinder the prognosis of these female patients. Other complications are common in obese women, such as oestrogen-related cancers, osteoarticular problems and psychological disturbances. Various therapeutic approaches are available which permit an encouraging weight loss and a rapid improvement of risk factors. Unfortunately, long-term results are often disappointing, essentially because of the difficulty to follow on the long term a strict diet regimen and practice physical exercise and because of the usual unrealistic expectations of the obese women who consult medical doctors. [less ▲]

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See detailL'etude clinique du mois. Etudes cliniques a long terme (1-2 ans) avec l'orlistat, nouveau medicament pour le traitement de l'obesite.
Scheen, André ULiege

in Revue Médicale de Liège (1999), 54(8), 707-9

Orlistat (Xenical), whose original mechanism of action consists of the selective inhibition of gastrointestinal lipases, has been recently commercialized for the treatment of obesity. Despite its recent ... [more ▼]

Orlistat (Xenical), whose original mechanism of action consists of the selective inhibition of gastrointestinal lipases, has been recently commercialized for the treatment of obesity. Despite its recent launch and when compared to common anorectic agents, it has been much better evaluated in long-term trials carried out according to the rules of Good Clinical Practice. We will summarize the four recently published randomized, placebo-controlled, double-blind clinical trials lasting up to 1 to 2 years and evaluating the effects of orlistat 3 x 120 mg/day in obese patients (BMI > or = 28 kg/m2). [less ▲]

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See detailL'etude clinique du mois. La privation chronique de sommeil predispose-t-elle au syndrome plurimetabolique?
Scheen, André ULiege

in Revue Médicale de Liège (1999), 54(11), 898-900

According to a recent experimental study published in the Lancet, sleep debt, frequently imposed by the life habits of industrialized countries, results in profound metabolic (impaired glucose tolerance ... [more ▼]

According to a recent experimental study published in the Lancet, sleep debt, frequently imposed by the life habits of industrialized countries, results in profound metabolic (impaired glucose tolerance) and endocrine (increased sympathetic activity and evening cortisol levels) alterations, which mimic those of normal ageing and may have pathophysiological consequences in the long term. Another study recently published in the International Journal of Obesity demonstrated a significant positive relationship between the duration of shift-work and body mass index or waist to hip ratio, a marker of visceral adiposity. One may thus hypothesize that chronic sleep deprivation could predispose to the metabolic syndrome and increase the cardiovascular risk. [less ▲]

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See detailL'etude clinique du mois. L'etude LIPID: "long-term intervention withpravastatin in ischaemic disease".
Scheen, André ULiege

in Revue Médicale de Liège (1999), 54(1), 2-3

The LIPID study is a placebo-controlled, double-bind, randomized trial, performed in 9014 patients with coronary heart disease and total cholesterol levels of 155 to 271 mg/dl. After a mean follow-up of 6 ... [more ▼]

The LIPID study is a placebo-controlled, double-bind, randomized trial, performed in 9014 patients with coronary heart disease and total cholesterol levels of 155 to 271 mg/dl. After a mean follow-up of 6.1 years, patients receiving pravastatin (40 mg/day) had significantly (p < 0.001) lower death rate from coronary heart disease (24%), lower overall mortality (22%) and lower incidence of all cardiovascular outcomes (20 to 29% depending on the event). Interestingly enough, the reduction in death from coronary heart disease or nonfatal myocardial infarction was observed whatever the initial cholesterol concentration, and already significant if total cholesterol was < 213 mg/dl and LDL cholesterol was < 135 mg/dl. Thus, in secondary prevention, the favourable effect of the statin on the coronary heart disease outcomes is observed even in case of initial cholesterol levels yet considered as "normal". [less ▲]

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See detailL' "epidemie" des maladies metaboliques, un probleme majeur de sante publique.
Scheen, André ULiege

in Revue Médicale de Liège (1999), 54(2), 87-94

The industrialized world is confronted to a real epidemic of metabolic diseases triggered by overeating and sedentarity. Obesity, hypercholesterolaemia, diabetes mellitus and the metabolic syndrome ... [more ▼]

The industrialized world is confronted to a real epidemic of metabolic diseases triggered by overeating and sedentarity. Obesity, hypercholesterolaemia, diabetes mellitus and the metabolic syndrome associated to insulin resistance are well-known cardiovascular risk factors which all contribute to increase both morbidity and mortality, to alter the quality of life and to markedly increase the budget of the social security. Preventive measures should be taken urgently in order to correct such a dangerous trend for the public health. [less ▲]

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See detailPharma-clinics le medicament du mois. Le naratriptan (naramig).
Scheen, André ULiege

in Revue Médicale de Liège (1999), 54(3), 189-91

Naratriptan, launched by Glaxo Wellcome under the trade name Naramig, is a potent and selective agonist of 5-HT1B and 5-HT1D vascular receptors. Available as tablets of 2.5 mg, it is indicated in the ... [more ▼]

Naratriptan, launched by Glaxo Wellcome under the trade name Naramig, is a potent and selective agonist of 5-HT1B and 5-HT1D vascular receptors. Available as tablets of 2.5 mg, it is indicated in the acute treatment of migraine, with or without aura. A single oral dose of 2.5 mg naratriptan is characterized by a satisfactory clinical efficacy (already significant after one hour, maximum after 4 hours and persisting during 24 hours), a reduction by half of the recurrence of the migraine crisis within the 24 hours and an excellent tolerance profile. [less ▲]

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See detailTraitement de l'hyperlipidemie combinee: fibrate ou/et statine?
Scheen, André ULiege

in Revue Médicale de Liège (1999), 54(7), 583-7

Combined hyperlipidaemia, associating hypercholesterolaemia and hypertriglyceridaemia, is a common metabolic disorder with a prevalence of about 1/500. It has a genetic background, but its phenotype is ... [more ▼]

Combined hyperlipidaemia, associating hypercholesterolaemia and hypertriglyceridaemia, is a common metabolic disorder with a prevalence of about 1/500. It has a genetic background, but its phenotype is triggered by various predisposing factors such as obesity, type 2 diabetes and alcohol consumption. Combined hyperlipidaemia is undoubtedly associated with an increased cardiovascular risk and thus deserves specific management. After diet failure, the first drug choice remains controversial. Indeed, fibrates are more active on hypertriglyceridaemia while statins are more active on hypercholesterolaemia (LDL subfraction). Both pharmacological classes have their advantages and disadvantages, and there is no prospective study comparing the cardiovascular protective efficacy of these two treatments in patients with such dyslipidemia. Furthermore, monotherapy is generally incapable of normalizing the lipid profile in the presence of severe combined hyperlipidaemia. Ideally, a statin-fibrate combination would be most appropriate in order to act on the two components of such hyperlipidaemia and to benefit of the complementary and additive action of the two pharmacological classes. Such association is still contra-indicated because of the description of some cases of rhabdomyolysis is high risk patients; however, it now deserves much interest and is currently being tested in large prospective studies, especially in the population with type 2 diabetes. [less ▲]

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See detailDysthyroidies et dyslipidemies.
Deschampheleire, M.; Luyckx, Françoise ULiege; Scheen, André ULiege

in Revue Médicale de Liège (1999), 54(9), 746-50

While overt thyroid disturbances, characterized by symptoms and/or clinical signs with abnormal serum levels of thyroid hormones, are generally associated with perturbations in the lipid profile, the ... [more ▼]

While overt thyroid disturbances, characterized by symptoms and/or clinical signs with abnormal serum levels of thyroid hormones, are generally associated with perturbations in the lipid profile, the situation is less clear as far as subclinical thyroid disturbances, defined by isolated abnormalities of thyroid stimulating hormone (TSH) levels, are concerned. In severe hyperthyroidism, a decrease of total cholesterol, LDL cholesterol and apoprotein B concentrations is generally observed. These biological parameters are normalized when appropriate antithyroid treatment is given. In profound hypothyroidism, on the contrary, elevated levels of total and LDL cholesterol levels are observed, which decrease after hormonal replacement. In both cases, the changes in serum levels of HDL cholesterol, triglycerides and lipoprotein (a) are less systematic, both before and after treatment. Lipid abnormalities associated with subclinical thyroid disturbances remain controversial. However, two recent meta-analyses have shown higher LDL cholesterol levels in presence of subclinical hypothyroidism and a significant reduction of such lipid abnormality after administration of thyroxine. Furthermore, they demonstrated a higher prevalence of subclinical hypothyroidism in a population with hypercholesterolaemia when compared to a population with normal cholesterol levels. Finally, a significant reduction in both total and LDL cholesterol concentrations has been reported after administration of thyroxine in a small group of hypercholesterolaemic patients with basal TSH levels in the upper range of normal values. In view of the results of the literature, strategies are proposed to help the clinician in the management of patients with overt or subclinical thyroid disturbances, associated with dyslipidaemia. [less ▲]

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See detailDiabete gestationnel: signification pronostique pour l'enfant.
Geronooz, I.; Scheen, André ULiege; Senterre, Jacques ULiege

in Revue Médicale de Liège (1999), 54(6), 517-21

Gestational diabetes, even if it seems to induce far less foetal complications than classical type 1 or type 2 diabetes mellitus, may be deleterious for the child. We will successively consider the ... [more ▼]

Gestational diabetes, even if it seems to induce far less foetal complications than classical type 1 or type 2 diabetes mellitus, may be deleterious for the child. We will successively consider the complications that could affect the child during gestation, during the neonatal period and during adult life. These consequences for the offspring require optimal screening and management of gestational diabetes mellitus. [less ▲]

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See detailGlucotoxicite et lipotoxicite, deux complices impliques dans le cercle vicieux du diabete de type 2.
Scheen, André ULiege; Paquot, Nicolas ULiege; Lefebvre, Pierre ULiege

in Revue Médicale de Liège (1999), 54(6), 535-8

Type 2 diabetes mellitus is a dynamic disease whose natural history is characterized by a progressive aggravation leading to a progressively severe hyperglycaemia, which generally requires a more complex ... [more ▼]

Type 2 diabetes mellitus is a dynamic disease whose natural history is characterized by a progressive aggravation leading to a progressively severe hyperglycaemia, which generally requires a more complex therapy as time progresses. Such an evolution results from a vicious circle where both glucotoxicity and lipotoxicity contribute to reduce insulin secretion and the action of insulin on cell glucose metabolism. These new concepts are able to modify the strategies of prevention and treatment of type 2 diabetes. [less ▲]

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See detailComment j'explore ... un sujet avec un exces ponderal ou une obesite.
Scheen, André ULiege; Luyckx, Françoise ULiege

in Revue Médicale de Liège (1999), 54(6), 553-6

The evaluation of an obese subject aims at better understanding the disease, its causes and consequences, in order to optimize its management. Schematically, this task can be done in three successive ... [more ▼]

The evaluation of an obese subject aims at better understanding the disease, its causes and consequences, in order to optimize its management. Schematically, this task can be done in three successive steps. First, it is necessary to analyse data from the past, by asking about family and personal history. Then, the present data should be carefully analysed, especially the severity of overweight, its type of distribution and the importance of associated complications. Finally, it is mandatory to project these data into the future, in order to assess the final prognosis of the obese patient allowing a better definition of the goals and the therapeutical strategies. [less ▲]

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See detailL'etude clinique du mois. Prevention des accidents vasculaires cerebraux chez les patients avec fibrillation auriculaire.
Scheen, André ULiege

in Revue Médicale de Liège (1999), 54(6), 561-3

A recent analysis of the literature, published in the 19 May issue of the JAMA, once again demonstrates the efficacy of warfarin, and its superiority on aspirin, in preventing stroke in patients with ... [more ▼]

A recent analysis of the literature, published in the 19 May issue of the JAMA, once again demonstrates the efficacy of warfarin, and its superiority on aspirin, in preventing stroke in patients with atrial fibrillation, at least in subjects at highest risk. However, a feasibility study, published in the 15 May issue of the British Medical Journal, points to the difficulties of implementing guidelines from evidence-based medicine in general practice, essentially because of the reluctance of the physician and/or the patient when the constraints, risks and even advantages of antithrombotic treatment are taken into account. [less ▲]

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See detailLa non-observance therapeutique: probleme majeur pour la prevention des maladies cardio-vasculaires.
Scheen, André ULiege

in Revue Médicale de Liège (1999), 54(12), 914-20

The prevention of cardiovascular diseases relies upon the correction of risk factors and, more particularly, the optimal management of various metabolic abnormalities such as obesity, dyslipidaemias ... [more ▼]

The prevention of cardiovascular diseases relies upon the correction of risk factors and, more particularly, the optimal management of various metabolic abnormalities such as obesity, dyslipidaemias, diabetes mellitus and arterial hypertension. Such an approach first requires the adherence to life-style habits (healthy diet, physical activity and no smoking) and, in case of failure, the use of lipid-lowering drugs, antidiabetic agents and/or antihypertensive medications. Sometimes, a monotherapy may be sufficient but, in most cases, a drug combination is mandatory because of the need to reach tight therapeutic targets and of the presence of a polypathology, especially within the frame of the metabolic syndrome. Unfortunately, all surveys indicate that therapeutic compliance to non-pharmacological advice and even to drug prescriptions is far from being excellent. Such a non-compliance limits the efficacy of the prevention strategies and contributes to markedly increase the cost of metabolic diseases and associated complications. [less ▲]

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See detailLa diabete de type 2: approaches diagnostiques, objectifs glycemiques et strategies therapeutiques.
Scheen, André ULiege; Paquot, Nicolas ULiege

in Revue Médicale de Liège (1999), 54(8), 659-66

Type 2 diabetes is a prevalent disease, with high morbidity and mortality rates, which is usually managed by general practitioners. We will discuss the new diagnostic approaches, the glycaemic goals and ... [more ▼]

Type 2 diabetes is a prevalent disease, with high morbidity and mortality rates, which is usually managed by general practitioners. We will discuss the new diagnostic approaches, the glycaemic goals and the therapeutic strategies which may contribute to improve both adequate management and prognosis of diabetic patients with type 2 diabetes. As far as possible, the management should be both individualized and integrated, not only focused on blood glucose control but also on the correction of other vascular risk factors frequently associated with diabetes (mainly arterial hypertension and dyslipidaemias). Obviously, the reduction of the incidence and severity of microangiopathy and macroangiopathy diabetic complications would require a tight collaboration between general practitioners and specialized physicians. [less ▲]

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See detailMedical aspects of obesity.
Scheen, André ULiege; Luyckx, Françoise ULiege

in Acta Chirurgica Belgica (1999), 99(3), 135-9

Obesity poses a serious health hazard and its treatment is often disappointing. Major advances have been made during recent years in the understanding of body weight regulation, with the discovery of ... [more ▼]

Obesity poses a serious health hazard and its treatment is often disappointing. Major advances have been made during recent years in the understanding of body weight regulation, with the discovery of leptin, a protein produced by adipocytes and acting on the central nervous system to reduce food intake, and that of beta-3 adrenergic receptors and uncoupling proteins which contribute to stimulate energy expenditure. Numerous metabolic complications are associated with abdominal obesity and most of them, such as diabetes mellitus, dyslipidaemias and arterial hypertension, appear to be linked to insulin resistance and may be part of the socalled metabolic syndrome or syndrome X. While very-low-calorie diets are usually effective in the short-term, they cannot, in the long-term and for most patients, solve the problem of severe obesity. Pharmacological antiobesity treatment may include drugs that reduce food intake, drugs that increase energy expenditure and drugs that affect nutrient partitioning or metabolism. All of these pharmacological approaches have potential efficacy, but unfortunately serious limitations. This is also the case of mechanical means, such as intragastric balloons. Consequently, bariatric surgery may be considered as a valuable alternative therapy in well-selected patients with morbid obesity refractory to classical treatments. In conclusion, obesity is a chronic disease and should be treated as such with reasonable expectations. [less ▲]

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See detailComment apprecier chez l'homme l'action de l'insuline en recherche et en pratique.
Scheen, André ULiege

in Annales d'Endocrinologie (1999), 60(3), 179-87

Various methods have been proposed to assess insulin action in vivo, from the most complex to the simplest. All methods are based on the comparison of plasma concentrations of glucose and insulin, but can ... [more ▼]

Various methods have been proposed to assess insulin action in vivo, from the most complex to the simplest. All methods are based on the comparison of plasma concentrations of glucose and insulin, but can be differentiated by some important characteristics: evaluation in the basal state, after administration of exogenous insulin or after stimulation of insulin secretion; measurement in conditions of normo, hyper- or hypoglycaemia; and assessment using or not a modeling approach. For research purpose, the most informative techniques, such as the "euglycaemic hyperinsulinaemic clamp" or the intravenous glucose tolerance test combined with the minimal model approach, should be preferred. Easier tests may be used as alternative approaches, such as the fixed insulin-glucose infusion or the continuous infusion of glucose with model assessment (CIGMA). In daily practice, the clinician can often use simpler indices, such as fasting insulin concentrations, eventually analysed in comparison with corresponding glucose levels using the HOMA method. The only easy to perform dynamic maneuver is the short insulin tolerance test, but it is subject to several criticisms. As every approach for measuring insulin action has its own advantages and disadvantages, the selection essentially depends on studied populations (diabetic or not), primary objectives and, most importantly, available means. [less ▲]

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See detailInterets et limites de la diete proteique chez le patient obese diabetique de type 2.
Scheen, André ULiege

in Annales d'Endocrinologie (1999), 60(6), 443-50

Weight excess plays a major role in the pathophysiology of type 2 diabetes but only a minority of patients succeed in following a restrictive calorie diet in the long-term, able to reduce body weight and ... [more ▼]

Weight excess plays a major role in the pathophysiology of type 2 diabetes but only a minority of patients succeed in following a restrictive calorie diet in the long-term, able to reduce body weight and maintain normoglycaemia. Very low-calorie diets such as protein diets rapidly reduce plasma glucose levels by various mechanisms, among which a significant improvement of hepatic and muscular insulin sensitivity and a partial recovery of insulin secretion. The rapidity of the hypoglycaemic action suggests that calorie restriction plays a more important role than weight loss itself. The lowering of plasma glucose levels imposes an early reduction in the doses of antidiabetic agents to avoid hypoglycaemia. Well-balanced protein diets are well tolerated, provided that they are restricted to a few weeks. The most important limitation of the protein diet is the risk of weight regain afterwards and such situation requires the maintenance of an hypocaloric diet in the long-term. Ideally, the protein diet should be integrated in a global approach including treatment of obesity, type 2 diabetes and frequently associated other risk factors. [less ▲]

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