References of "SCHEEN, André"
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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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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 ▲]

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See detailPharma clinics. Comment je traite ... un patient diabetique avec obesite severe.
Scheen, André ULg; Triches, K.; Luyckx, Françoise ULg et al

in Revue Médicale de Liège (1998), 53(7), 386-9

Obesity plays a crucial role in type 2 diabetes pathophysiology and a major weight loss markedly improves glycaemic control. The common failure of classical treatments leads to the use of more aggressive ... [more ▼]

Obesity plays a crucial role in type 2 diabetes pathophysiology and a major weight loss markedly improves glycaemic control. The common failure of classical treatments leads to the use of more aggressive weight-reduction approaches, such as very-low-calorie diets (VLCDs), anti-obesity drugs or even bariatric surgery. VLCDs are very successful in the short-term but rather disappointing in the long-term. Anti-obesity compounds only induce a modest mean weight reduction, even if some patients appear to be better responders. Interestingly, serotoninergic agents increase insulin sensitivity and glycaemic control, independently of weight loss. Bariatric surgery provides the most impressive results. In well-selected subjects, gastroplasty (either vertical ring gastroplasty or adjustable silicone gastric banding) generally induces a considerable weight loss which results in a remarkable and sustained glycaemic control improvement and allows the reduction, or even the suppression, of any antidiabetic treatment. This ultimate solution should not be neglected after failure of medical approaches, provided that the indication is correct, the surgical procedure is performed in a specialized centre and the followup is well organized by a multidisciplinary team. [less ▲]

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See detailPharma-clinics. Comment je traite ... un sujet avec une concentration basse de cholesterol HDL.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(12), 727-31

The decision to treat an individual with low HDL cholesterol level depends on his overall cardiovascular risk profile and the therapeutic strategy is based upon the characteristics of the lipid profile ... [more ▼]

The decision to treat an individual with low HDL cholesterol level depends on his overall cardiovascular risk profile and the therapeutic strategy is based upon the characteristics of the lipid profile (isolated abnormality, associated hypertriglyceridaemia or combined elevation of LDL cholesterol). The treatment must favour diet and exercise, before considering a possible pharmacological approach. Results are usually acceptable with better life habits and appropriate diet when low HDL cholesterol level is associated to hypertriglyceridaemia. From a pharmacological point of view, the best results are obtained with fibrates or nicotinic acid. However, results are often disappointing when low HDL cholesterol level is isolated. [less ▲]

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See detailInfluence of the A-->G (-3826) uncoupling protein-1 gene (UCP1) variant on the dynamics of body weight before and after gastroplasty in morbidly obese subjects.
Luyckx, Françoise ULg; Scheen, André ULg; Proenza, A. M. et al

in International Journal of Obesity & Related Metabolic Disorders (1998), 22(12), 1244-5

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See detailLiver abnormalities in severely obese subjects: effect of drastic weight loss after gastroplasty.
Luyckx, Françoise ULg; Desaive, Claude ULg; Thiry, Albert ULg et al

in International Journal of Obesity & Related Metabolic Disorders (1998), 22(3), 222-6

OBJECTIVE: To examine the factors associated with liver steatosis in severely obese subjects and to test the potential reversibility of fatty liver after weight loss. DESIGN: Retrospective clinical study ... [more ▼]

OBJECTIVE: To examine the factors associated with liver steatosis in severely obese subjects and to test the potential reversibility of fatty liver after weight loss. DESIGN: Retrospective clinical study. SUBJECT: 528 obese patients before bariatric surgery and 69 obese subjects of the initial cohort evaluated before and 27+/-15 months after gastroplasty. MEASUREMENTS: Fatty deposition (scored as mild, moderate or severe) and inflammatory changes were evaluated in liver biopsies; clinical (body mass index (BMI), age, gender, duration of obesity) and biological (glucose, triglycerides, liver enzymes) parameters were related to histological findings. RESULTS: 74% of the 528 biopsies showed fatty change, estimated as mild in 41% of cases, moderate in 32% and severe in 27%. The prevalence of steatosis was significantly higher in men than in women (91% vs 70%, P = 0.001) and in patients with impaired glucose tolerance or type 2 diabetes compared with nondiabetics (89% vs 69% P = 0.001). The severity of the steatosis was associated with BMI (P = 0.002) but not with the duration of obesity or the age of the patient. When compared with patients without fatty change, those with liver steatosis had significantly higher fasting plasma glucose (5.5 mmol/l vs 5.1 mmol/l, P = 0.007) and triglycerides (1.8 mmol/l vs 1.3 mmol/l, P = 0.002). Mean serum liver enzyme activities (alkaline phosphatase, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl-transpeptidase (gammaGT) were significantly (P < 0.001) increased in patients with fatty change but remained within laboratory reference values. In the 69 patients who have been evaluated after a marked weight reduction (-32+/-19kg), 45% of the biopsies were considered as normal (vs 13% before, P < 0.001) while pure fatty change was still observed in 38% of the patients (vs 83% before, P = 0.001). However, the severity of the steatosis was significantly (P < 0.001) reduced (mild: 62% vs 21%; moderate: 23% vs 37%; severe: 15% vs 42%). In addition, a significant increase of hepatitis was observed in 26% of the biopsies (vs 14% before, P < 0.05). CONCLUSIONS: Liver steatosis in obese subjects is associated with men, diabetic status, BMI, higher fasting glucose and hypertriglyceridaemia. Postgastroplasty weight loss reduces liver steatosis, but seems to increase the incidence of inflammatory lobular hepatitis. [less ▲]

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See detailIA-2-autoantibodies complement GAD65-autoantibodies in new-onset IDDM patients and help predict impending diabetes in their siblings. The Belgian Diabetes Registry.
Gorus, F. K.; Goubert, P.; Semakula, C. et al

in Diabetologia (1997), 40(1), 95-9

IA-2 has been identified as an autoantigen that is recognized by immunoglobulins from insulin-dependent diabetic (IDDM) patients. Using a liquid phase radiobinding assay, we performed an IA-2-autoantibody ... [more ▼]

IA-2 has been identified as an autoantigen that is recognized by immunoglobulins from insulin-dependent diabetic (IDDM) patients. Using a liquid phase radiobinding assay, we performed an IA-2-autoantibody (IA-2-Ab) assay in 474 IDDM patients and 482 non-diabetic control subjects aged 0-3 years. IA-2-Ab were detected in 58% of the patients and 0.8% of control subjects. Their prevalence in patients was lower than that of islet cell autoantibodies (ICA; 73%) or glutamic acid decarboxylase (M(r) 65 kDa)-autoantibodies (GAD65-Ab; 82%) but higher than that of insulin autoantibodies (IAA; 42%). IA-2-Ab were more frequent in patients under age 20 years (70%) than between 20 and 40 years (45%; p < 0.001). In the whole IDDM group, 92% of patients were positive for at least one of the three molecular assays, which is higher than the positivity for the ICA assay (73%). Only 1% was negative in the molecular assays and positive in the ICA assay. IA-2-Ab levels were positively correlated with ICA titres (p < 0.001) and HLA DQ A1*0301-DQ B1*0.02 (p < 0.003) by multivariate analysis. In a group of 481 non-diabetic siblings (age 0-39 years) of IDDM patients only 7 were IA-2-Ab positive (1.5%). All seven were under age 20 years and positive for at least two other autoantibodies and for DQ A1*0301-DQB1*0302. Four of these seven developed IDDM during the 6-70-month follow-up period. The positive predictive value of IA-2-Ab (57%) was higher than that of ICA, GAD65-Ab or IAA alone, or in combination (< or = 20%) but these calculations are restricted by the relatively short observation period and the small number of cases. The only IA-2-Ab-negative case of pre-diabetes was also negative for IAA and GAD65-Ab, while it was strongly positive for ICA. In conclusion, IA-2-Ab show a high diagnostic specificity for IDDM and are predictive markers of impending diabetes in siblings of patients. In combination with other molecular antibody assays they may replace ICA testing in future. Our data also indicate that other autoantibodies than IA-2-Ab, GAD65-Ab and IAA contribute to ICA. [less ▲]

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See detailA propos de quelques utilisations non conventionnelles de la metformine
SCHEEN, André ULg; PAQUOT, Nicolas ULg; LETIEXHE, Michel ULg et al

in Médecine et Hygiène (1997), 55

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