References of "Revue Médicale Suisse"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailActivite anticancereuse de la metformine: nouvelles perspectives pour une vieille molecule.
Beck, Emmanuel ULg; Scheen, André ULg

in Revue Médicale Suisse (2010), 6(260), 1601-7

Le diabète de type 2 est associé à un risque accru de cancer, d’autant plus évident qu’on maîtrise mieux la mortalité cardio-vasculaire. Tous les traitements antidiabétiques n’ont pas le même impact sur ... [more ▼]

Le diabète de type 2 est associé à un risque accru de cancer, d’autant plus évident qu’on maîtrise mieux la mortalité cardio-vasculaire. Tous les traitements antidiabétiques n’ont pas le même impact sur le cancer : le risque est accru avec les sulfonylurées et diminué avec la metformine (et les glitazones). De nombreuses études épidémiologiques observationnelles et cas-témoins récentes révèlent qu’un traitement par metformine est associé à une nette réduction de l’incidence de néoplasies et de la mortalité par cancer. Il existe une relation doseréponse et une relation entre la durée préalable du traitement par metformine et l’effet protecteur observé. Les mécanismes invoqués sont l’activation de l’enzyme AMPK et l’inhibition de la voie mTOR. Des études avec la metformine sont en cours en oncologie, notamment dans le cancer du sein. [less ▲]

Detailed reference viewed: 68 (2 ULg)
Full Text
Peer Reviewed
See detailReduction du risque metabolique associe a l'obesite en modulant l'exposition tissulaire au cortisol.
Iovino, Alessandra ULg; Paquot, Nicolas ULg; Scheen, André ULg

in Revue Médicale Suisse (2010), 6(260), 1608-12

The 11-beta-hydroxysteroid dehydrogenase type 1 (11HSD1) enzyme promotes the local conversion from cortisone to cortisol, especially in the liver and the adipose tissue. It may play a role in the ... [more ▼]

The 11-beta-hydroxysteroid dehydrogenase type 1 (11HSD1) enzyme promotes the local conversion from cortisone to cortisol, especially in the liver and the adipose tissue. It may play a role in the pathophysiology of abdominal obesity and the metabolic syndrome, both showing some similarities with the Cushing syndrome. Considering experimental results obtained in rodents, the inhibition of this enzyme could exert favourable metabolic effects, with significant reductions in plasma glucose, insulin resistance and dyslipidaemia. Synthetic inhibitors of 11HSD1 are currently in development with encouraging preliminary results, first in animals, and more recently in humans. Selective inhibitors of 11HSD1 may represent an innovative approach in the pharmacological management of obesity, metabolic syndrome and type 2 diabetes in a near future. [less ▲]

Detailed reference viewed: 42 (5 ULg)
Full Text
Peer Reviewed
See detailApproche multirisque du patient diabetique de type 2: desaccord sur les valeurs cibles suite a l'etude ACCORD.
Scheen, André ULg; Paquot, Nicolas ULg

in Revue Médicale Suisse (2010), 6(260), 1582-7

The ACCORD trial investigated the effects of intensifying the global management of 10,251 type 2 diabetic patients, with established cardiovascular disease or at least two other cardiovascular risk ... [more ▼]

The ACCORD trial investigated the effects of intensifying the global management of 10,251 type 2 diabetic patients, with established cardiovascular disease or at least two other cardiovascular risk factors, on a composite endpoint (non fatal myocardial infarction, stroke and cardiovascular death). The attempt to reduce HbA1c level below 6% was associated with an increased cardiovascular mortality (despite a reduction in non fatal myocardial infarcts); lowering systolic blood pressure below 120 mmHg instead of 140 mmHg did not provide any additional benefit; finally, the control of atherogenic dyslipidaemia, with fenofibrate added to a statin, did not modify the composite endpoint (despite a positive effect in the subgroup of patients with high triglycerides and low HDL cholesterol). These rather disappointing results should be interpreted to provide practical guidelines. [less ▲]

Detailed reference viewed: 48 (2 ULg)
Full Text
Peer Reviewed
See detailSyndromes paranéoplasiques endocriniens: diagnostic et prise en charge.
Valdes Socin, Hernan Gonzalo ULg; Niaourou, V.; Vandeva, S. et al

in Revue Médicale Suisse (2009), 5(214), 1668-74

Paraneoplastic endocrine syndromes define a group of secondary signs and symptoms associated to a neoplasia, independently from the location of the primary tumor or its metastases. Paraneoplastic or ... [more ▼]

Paraneoplastic endocrine syndromes define a group of secondary signs and symptoms associated to a neoplasia, independently from the location of the primary tumor or its metastases. Paraneoplastic or ectopic endocrine syndromes usually result from aberrant hormone precursors or hormone-like substances by tumours. Knowledge of paraneoplastic endocrine complications is important both for the early diagnosis of neoplasia and the prognosis of the patient. In this review we discuss almost all reported paraneoplastic endocrine syndromes. We analyze their prevalence, etiology, laboratory diagnosis and treatment. [less ▲]

Detailed reference viewed: 65 (2 ULg)
Full Text
Peer Reviewed
See detailTrouble obsessionnel-compulsif (TOC).
Debabeche, Cécile ULg; Muselle, Alice ULg; Servais, Sophie ULg et al

in Revue Médicale Suisse (2009), 5(214), 1659-62

Obsessive compulsive disorder (OCD) is a frequent and disabling psychic illness. Along psychiatric history, several etiological models have been successively hypothesized to explain the obsessive ... [more ▼]

Obsessive compulsive disorder (OCD) is a frequent and disabling psychic illness. Along psychiatric history, several etiological models have been successively hypothesized to explain the obsessive compulsive symptoms from a psychological, behavioural or biological point of view. This review aims at presenting OCD etiological models as well as describing OCD clinical and therapeutic aspects. [less ▲]

Detailed reference viewed: 204 (23 ULg)
Full Text
Peer Reviewed
See detailTraitements actuels du lymphome folliculaire
Bonnet, Christophe ULg; Beguin, Yves ULg; De Prijck, Bernard ULg et al

in Revue Médicale Suisse (2009), 5

After diffuse large B-cell lymphoma, follicular lymphoma is the most frequent non-Hodgkin's lymphoma. It remains incurable, except for localized diseases. Advanced disease has to be treated only in the ... [more ▼]

After diffuse large B-cell lymphoma, follicular lymphoma is the most frequent non-Hodgkin's lymphoma. It remains incurable, except for localized diseases. Advanced disease has to be treated only in the presence of clinical and/or biology aggressiveness. These patients should be treated by rituximab (Mab-Thera) associated to polychemotherapy comprising cyclophosphamide, vincristine and prednisone. After this therapy, the benefit of rituximab in maintenance has to be confirmed. Autologous stem cell transplantation is also an interesting option. The other therapeutic options comprise radio-immunotherapy with 90Y ibritumomab tiuxetan (Zevalin) and bortezomib (Velcade). [less ▲]

Detailed reference viewed: 444 (5 ULg)
Full Text
Peer Reviewed
See detailQuel avenir pour les essais de prevention cardiovasculaire?
Scheen, André ULg

in Revue Médicale Suisse (2009), 5(214), 1635-6

Detailed reference viewed: 17 (1 ULg)
Full Text
Peer Reviewed
See detailTraitement de la maladie de Parkinson en 2009.
MAERTENS DE NOORDHOUT, Alain ULg

in Revue Médicale Suisse (2009), 5(214), 1650-5

The cause of Parkinson's disease remains unknown and no cure or prevention exists so far. Levodopa remains by far the most potent symptomatic therapy, but induces side-effects such as motor fluctuations ... [more ▼]

The cause of Parkinson's disease remains unknown and no cure or prevention exists so far. Levodopa remains by far the most potent symptomatic therapy, but induces side-effects such as motor fluctuations and abnormal movements, which can somewhat be counterbalanced by optimizing levodopa plasma levels or acting at receptors level with long half-life dopamine agonists. In severe cases, functional surgery with deep brain stimulation can be offered. Some non-dopaminergic symptoms like dementia, freezing, postural instability or dysautonomia do not respond to dopaminergic drugs and need special care. [less ▲]

Detailed reference viewed: 44 (12 ULg)
Full Text
Peer Reviewed
See detailIndications cliniques de la radiotherapie metabolique dans les lymphomes
Witvrouw, Nancy ULg; De Prijck, Bernard ULg; Hustinx, Roland ULg

in Revue Médicale Suisse (2008), 4(168), 1818-22

In their later stages low grade lymphoma are incurable. These lymphomas being radio-sensitive, a treatment of metabolic radioimmunotherapy, using monoclonal antibodies (anti-CD20) as the carrier has been ... [more ▼]

In their later stages low grade lymphoma are incurable. These lymphomas being radio-sensitive, a treatment of metabolic radioimmunotherapy, using monoclonal antibodies (anti-CD20) as the carrier has been developed. The aim of this treatment is to use these antibodies to target radiation to tumor tissues while limiting toxicity to normal cells. Ibritumomab tiuxetan (Zevalin) is currently prescribed for patients with relapsed or refractory low-grade follicular lymphoma after rituximab treatment. This outpatient treatment has a high level of overall response rate including complete response and that for a long period. The side effects are essentially hematological and reversible. In the near future many more indications should become apparent and Zevalin should become an important tool in the B-cell lymphoma (low and high grade). [less ▲]

Detailed reference viewed: 72 (4 ULg)
Full Text
Peer Reviewed
See detailEndoprotheses coronaires pharmaco-actives chez les patients diabetiques.
Nyssen, Astrid; Legrand, Victor ULg; Scheen, André ULg

in Revue Médicale Suisse (2008), 4(168), 1806-10

In diabetic patients, the use of drug-eluting stents (paclitaxel-PES or sirolimus-SES) reduces the risk of restenosis as compared to bare-metal stents. However, the risk of (very) late thrombosis is ... [more ▼]

In diabetic patients, the use of drug-eluting stents (paclitaxel-PES or sirolimus-SES) reduces the risk of restenosis as compared to bare-metal stents. However, the risk of (very) late thrombosis is higher with drug-eluting stents than with bare-metal stents. All together, the incidence of major cardiovascular events is reduced with drug-eluting stents, mainly resulting from a diminution of revascularisation procedures rather than from a reduction in myocardial infarcts or cardiovascular deaths. Attempts to compare SES and PES gave discordant results in both randomised trials and registries. Efficacious antiplatelet therapy in the long run is mandatory in all diabetic patients treated with drug-eluting stents. [less ▲]

Detailed reference viewed: 35 (10 ULg)
Full Text
Peer Reviewed
See detailQuelle place pour une double ou triple inhibition du systeme renine-angiotensine-aldosterone ?
Legrand, Delphine ULg; Krzesinski, Jean-Marie ULg; Scheen, André ULg

in Revue Médicale Suisse (2008), 4(168), 1792-7

The blockade of the renin-angiotensin-aldosterone system (RAAS) is helpful in the management of arterial hypertension, congestive heart failure, post-myocardial infarction and diabetic nephropathy. Such ... [more ▼]

The blockade of the renin-angiotensin-aldosterone system (RAAS) is helpful in the management of arterial hypertension, congestive heart failure, post-myocardial infarction and diabetic nephropathy. Such blockade can be obtained with an angiotensin converting enzyme inhibitor, a specific antagonist of angiotensin II AT1 receptors, an aldosterone receptor antagonist and/or a direct inhibitor of renin such as aliskiren. Various studies have demonstrated that a dual or even triple RAAS inhibition may offer a better cardiorenal protection, in refractory congestive heart failure and in nephropathy with proteinuria. However, in the ONTARGET study, the dual inhibition with ramipril plus telmisartan did not provide any additional benefit compared to ramipril alone in high-risk cardiovascular patients, but showed a worse tolerance profile. [less ▲]

Detailed reference viewed: 55 (9 ULg)
Full Text
Peer Reviewed
See detailSyphilis en 2008: controverses et attitudes pratiques.
Frippiat, Frédéric ULg; GIOT, Jean-Baptiste ULg; Chandrikakumari, Kavitha et al

in Revue Médicale Suisse (2008), 4(168), 1823-7

Rising incidence rate of syphilis is observed in economically advanced countries, particularly among homosexual men and subpopulation with low socioeconomic status. The various clinical presentations are ... [more ▼]

Rising incidence rate of syphilis is observed in economically advanced countries, particularly among homosexual men and subpopulation with low socioeconomic status. The various clinical presentations are divided into early and late stages, including neurosyphilis. The latter can occur during any stage of the disease, leading to the question "when to perform lumbar puncture", particularly in HIV positive patients. Penicillin continues to be the first-line therapy for all stages of syphilis. An alternative treatment should be considered as an exemption, after advice from a specialist. All patients require prolonged clinical and serological follow-up after treatment to rule out relapse or re-infection. The diagnosis of syphilis is an opportunity to search and treat other sexually transmitted diseases in patients and their sexual partner(s). [less ▲]

Detailed reference viewed: 84 (8 ULg)
Full Text
Peer Reviewed
See detailInhibition des recepteurs CB1 et metabolisme du glucose: rimonabant dans le diabete de type 2.
Scheen, André ULg; Paquot, Nicolas ULg; Van Gaal, Luc F

in Revue Médicale Suisse (2008), 4(168), 1812-7

Endocannabinoid system is overactivated in individuals with abdominal obesity. CBI receptors, first individualized in the brain, are also expressed in the adipocyte, the skeletal muscle, the liver, the ... [more ▼]

Endocannabinoid system is overactivated in individuals with abdominal obesity. CBI receptors, first individualized in the brain, are also expressed in the adipocyte, the skeletal muscle, the liver, the gut, and the pancreas. Their blockade improves glucose tolerance and lipid profile, thanks increased insulin sensitivity and adiponectin levels. Rimonabant, a selective antagonist of CBI receptors, improves glucose control in patients with type 2 diabetes, treated with diet alone, metformin, sulfonylurea or insulin, while it also reduces body weight and other risk factors. Ongoing studies aim at further demonstrating the potential of rimonabant in the management of type 2 diabetes, in the prevention of type 2 diabetes and in the protection against cardiovascular complications in (diabetic) patients with abdominal obesity. [less ▲]

Detailed reference viewed: 51 (2 ULg)
Full Text
Peer Reviewed
See detailImpact thérapeutique du dépistage de l’ischémie myocardique silencieuse chez le sujet diabétique de type 2
Wallemacq, Caroline ULg; Scheen, André ULg

in Revue Médicale Suisse (2008), 168(4), 1800-1804

Coronary artery disease is the major cause of mortality of type 2 diabetic subjects. Its early diagnosis to prevent progression and clinical events has intuitive appeal. Somehow, rationale for screening ... [more ▼]

Coronary artery disease is the major cause of mortality of type 2 diabetic subjects. Its early diagnosis to prevent progression and clinical events has intuitive appeal. Somehow, rationale for screening has not been clearly established. Screening should not modify the medical therapy because diabetic subjects have to be treated in a secondary prevention strategy. We have no data from randomized trials concerning a better outcome after revascularization in this specific population. The question how to select the high risk population to be screened has no response by now. SPECT and stress echocardiography seem valuable for screening but not for risk stratification. A large randomized clinical trial is required to confirm the cost-utility ratio of such a screening. [less ▲]

Detailed reference viewed: 121 (4 ULg)
Full Text
Peer Reviewed
See detailUtilité du mycophénolate mofétil en pathologie rénale en dehors de la transplantation
Parotte, Marie-Christine ULg; Bovy, Christophe ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale Suisse (2007), 3

Glomerular diseases remain frequent causes of end-stage renal failure. Immunosuppressive drugs in association with corticosteroids induce remission of proteinuria and stabilize renal function, as well as ... [more ▼]

Glomerular diseases remain frequent causes of end-stage renal failure. Immunosuppressive drugs in association with corticosteroids induce remission of proteinuria and stabilize renal function, as well as prevent relapses, but are responsible for severe portential side-effects: infections, secondary malignancies, sterility and alopecia, and even nephrotoxicity. Mycophenolate mofetil (MMF), a well-known drug in transplantation, presents interesting characteristics potentially useful in the teatment of glomerulopathies. Moreover, its side-effect profile is safer. The present review of literature suggests that MMF is efficient for the treatment of glomerular disease, even if the results of the different studies remain limited and require further confirmation. [less ▲]

Detailed reference viewed: 76 (3 ULg)
Full Text
See detailPrise en charge du cancer pulmonaire non a petites cellules
Bosquee, Léon ULg; Frusch, Nicolas ULg; Louis, Renaud ULg

in Revue Médicale Suisse (2007), 3(122), 1890-5

Surgery, chemotherapy, radiotherapy and "biological" treatment are differently used in the treatment of non small cell lung cancer. Surgery is the cornerstone of the stages I-II treatment; chemotherapy is ... [more ▼]

Surgery, chemotherapy, radiotherapy and "biological" treatment are differently used in the treatment of non small cell lung cancer. Surgery is the cornerstone of the stages I-II treatment; chemotherapy is dominant in the treatment of metastatic stage, but is more and more used in earlier stages. A large discussion is still open for advanced non metastatic stages, even if the association of the 3 major modalities is extensively studied. We discuss our position in this setting. [less ▲]

Detailed reference viewed: 122 (5 ULg)
Full Text
Peer Reviewed
See detailNouveautes dans la prise en charge des valvulopathies du coeur gauche
Davin, Laurent ULg; Pierard, L.A.; Lancellotti, Patrizio ULg

in Revue Médicale Suisse (2007), 3(122), 1870-5

In the last years, the management of left valvular disease has considerably evolved. The American guidelines of 1998 were recently reviewed. Since this year, we have European guidelines which are ... [more ▼]

In the last years, the management of left valvular disease has considerably evolved. The American guidelines of 1998 were recently reviewed. Since this year, we have European guidelines which are different in some points. The place of exercise testing in risk stratification of asymptomatic valvular disease is increasing and helps to make earlier decision regarding the need for surgery. [less ▲]

Detailed reference viewed: 4 (2 ULg)
Full Text
Peer Reviewed
See detailGlitazones et insuffisance cardiaque: resultats des etudes PROactive, ADOPT, DREAM et RECORD.
De Flines, Jenny ULg; Scheen, André ULg

in Revue Médicale Suisse (2007), 3(122), 18761878-83

Thiazolidinediones (TZDs) are used as insulin sensitizers in the treatment of type 2 diabetes, but are associated with an increased risk of congestive heart failure (CHF). The odds ratio of ICC was 1.43 ... [more ▼]

Thiazolidinediones (TZDs) are used as insulin sensitizers in the treatment of type 2 diabetes, but are associated with an increased risk of congestive heart failure (CHF). The odds ratio of ICC was 1.43 (pioglitazone vs placebo) in diabetic patients with high cardiovascular risk in the PROactive trial while it averaged 1.22 (rosiglitazone vs metformin) and 2.20 (rosiglitazone vs metformin) in the ADOPT study. In the interim analysis of the ongoing RECORD trial, the odds ratio averaged 2.15 (rosiglitazone vs metformin or sulfonylureas). In four real life registries, the relative risk of CHF with TZDs varied between 1.06 and 1.76 (between 1.10 and 1.44 combined with insulin) as compared to a treatment without TZDs. Such higher CHF risk should be appreciated according to the potential benefits of glitazones in the management of type 2 diabetes. [less ▲]

Detailed reference viewed: 50 (0 ULg)
Full Text
Peer Reviewed
See detailExiste-t-il une "memoire therapeutique" en prevention cardiovasculaire?
Scheen, André ULg

in Revue Médicale Suisse (2007), 3(122), 1864-61868-9

The prevention of type 2 diabetes and of cardiovascular diseases is a major public health objective. Obviously life-style changes play a major role in this strategy. The Finnish Prevention Study recently ... [more ▼]

The prevention of type 2 diabetes and of cardiovascular diseases is a major public health objective. Obviously life-style changes play a major role in this strategy. The Finnish Prevention Study recently demonstrated that the remarkable diabetes prevention observed after a 4-year lifestyle intervention is maintained after a further 3-year period of follow-up without prolongation of the active intervention. Such a reminiscent effect may also be observed in the prevention of cardiovascular diseases with various pharmacological interventions: an ACE inhibitor (HOPE), a statin (4S), a fibrate (Helsinki Heart Study) or an intensive insulin therapy in type I diabetic patients (DCCT-EDIC). These intriguing results argue for a long-term memory of previous therapeutic interventions in cardiovascular prevention. [less ▲]

Detailed reference viewed: 40 (2 ULg)
Full Text
Peer Reviewed
See detailA propos de la prevention et du traitement des maladies cardiovasculaires.
Scheen, André ULg

in Revue Médicale Suisse (2007), 3(122), 1859-60

Detailed reference viewed: 8 (0 ULg)