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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 ▲]

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See detailA propos de la prevention et du traitement des maladies cardiovasculaires.
Scheen, André ULg

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

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See detailSpondylodiscite compliquée d'un abcès du psoas
Leclercq, P.; Loly, Catherine ULg; Giot, Jean-Baptiste ULg et al

in Revue Médicale Suisse (2007), 3(101), 620-621

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See detailLes incretinomimetiques et incretinopotentiateurs dans le traitement du diabete de type 2.
Scheen, André ULg; Radermecker, Régis ULg; Philips, Jean-Christophe ULg et al

in Revue Médicale Suisse (2007), 3(122), 18841886-8

Glucagon-like peptide-1 (GLP-1) is a gut hormone secreted in response to a meal ingestion, which is rapidly degraded by a specific enzyme, dipeptidylpeptidase-4 (DPP-4). It enhances insulin secretion in a ... [more ▼]

Glucagon-like peptide-1 (GLP-1) is a gut hormone secreted in response to a meal ingestion, which is rapidly degraded by a specific enzyme, dipeptidylpeptidase-4 (DPP-4). It enhances insulin secretion in a glucose-dependent manner, inhibits glucagon secretion, retards gastric emptying,... Two pharmacological approaches have been developed to increase the abnormally low GLP-1 levels in type 2 diabetic patients: either to subcutaneously inject an agent closed to GLP-1 (exenatide), which is partially resistant to the action of DPP-4, either to orally administer a selective DPP-4 inhibitor (sitagliptin,...). These new drugs offer improved blood glucose control of type 2 diabetic patients, without inducing hypoglycaemia and with favourable effects on body weight. [less ▲]

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See detailLa prescription médicamenteuse chez la personne âgée: que devons-nous savoir?
Wotquenne, Pol ULg; Petermans, Jean ULg; Scheen, André ULg

in Revue Médicale Suisse (2006), 2(76), 1878-801882-3

Because of the increasing longevity of the population, a growing number of very old people are exposed to medications. Drug therapy in this population is difficult because of our lack of knowledge. The ... [more ▼]

Because of the increasing longevity of the population, a growing number of very old people are exposed to medications. Drug therapy in this population is difficult because of our lack of knowledge. The number of drugs administered is generally high and the prescription is often inappropriate. Changes in body composition, malnutrition and renal failure can cause drug accumulation and toxicity. However, hepatic metabolism via cytochrome P450 does not seem to be markedly influenced by oldness. Iatrogenic pathology is frequent in the elderly and may lead to hospitalisation and reduction in quality of life. Specific education of the medical care team should be promoted in order to tackle this important problem of public health. [less ▲]

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See detailLe rimonabant ameliore le profit de risque cardio-metabolique chez le sujet obese ou en surpoids: synthese des etudes "RIO".
Scheen, André ULg; Van Gaal, L. G.; Despres, J. P. et al

in Revue Médicale Suisse (2006), 2(76), 1916-23

RIO (Rimonabant In Obesity and related disorders) is a large phase 3 programme (>6600 patients) evaluating the efficacy and safety of rimonabant (5 or 20 mg/day), a CBI receptor antagonist of ... [more ▼]

RIO (Rimonabant In Obesity and related disorders) is a large phase 3 programme (>6600 patients) evaluating the efficacy and safety of rimonabant (5 or 20 mg/day), a CBI receptor antagonist of endocannabinoid system, in obese or overweight patients with or without comorbidities (RIO-Europe and RIO-North America), with untreated dyslipidaemia (RIO-Lipids) or with type 2 diabetes treated with metformin or sulfonylurea (RIO-Diabetes). Compared to placebo, rimonabant 20 mg/day consistently increases weight loss, reduces waist circumference, increases HDL cholesterol, lowers triglyceride levels, diminishes insulin resistance, and reduces the prevalence of metabolic syndrome. Almost half of the metabolic effects, including adiponectin increase, occur beyond weight loss, suggesting a direct peripheral effect of rimonabant. [less ▲]

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See detailPrevention cardiovasculaire par l'aspirine chez le patient diabetique: que nous apprend la medecine factuelle?
Legrand, Delphine ULg; Scheen, André ULg

in Revue Médicale Suisse (2006), 2(76), 1904-8

Diabetes mellitus markedly increases the risk of cardiovascular diseases, with an especially elevated relative risk among women. Aspirin prescription is mandatory in secondary prevention, even if the ... [more ▼]

Diabetes mellitus markedly increases the risk of cardiovascular diseases, with an especially elevated relative risk among women. Aspirin prescription is mandatory in secondary prevention, even if the protection by aspirin appears less efficacious in diabetic than in non-diabetic patients. In primary prevention, available data are paradoxically rather scarce, but also suggest a less effective prevention when diabetes is present. Aspirin remains the first antiplatelet agent in the diabetic population in all international guidelines of cardiovascular prevention although a higher daily dose may be proposed in this subgroup of patients (160-300 mg rather than 75-100 mg). [less ▲]

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See detailDiabete sucre et decompensation cardiaque: specificites ethiopathogeniques et therapeutiques.
De Flines, Jenny ULg; Scheen, André ULg

in Revue Médicale Suisse (2006), 2(76), 1893-61898-900

Diabetes mellitus increases by 2.5 to 5 the relative risk of congestive heart failure. Besides the classical risk factors of congestive heart failure such as obesity, arterial hypertension and coronary ... [more ▼]

Diabetes mellitus increases by 2.5 to 5 the relative risk of congestive heart failure. Besides the classical risk factors of congestive heart failure such as obesity, arterial hypertension and coronary artery disease that are frequently associated to type 2 diabetes, a diabetic cardiomyopathy plays also a role. This specific complication is related to metabolic factors and oxidative stress, leading to muscular cell apoptosis and fibrosis. The management of a diabetic patient with congestive heart failure has several specificities not only concerning the treatment of cardiac insufficiency but most importantly concerning antidiabetic therapy. The relationship between glitazones, peripheral oedema and risk of congestive heart failure is currently raising much interest and controversies. [less ▲]

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See detailControverses a propos des criteres de jugement dans les essais cliniques de prevention cardiovasculaire.
Scheen, André ULg

in Revue Médicale Suisse (2006), 2(76), 1875-6

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See detailDistinction entre patients bons synthetiseurs et bons absorbeurs pour optimiser le traitement hypo- cholesterolemiant.
Radermecker, Régis ULg; Scheen, André ULg

in Revue Médicale Suisse (2006), 2(76), 1910-5

The inhibition of cholesterol synthesis by a statin enhances intestinal absorption of both cholesterol and various phytosterols. The atherogenic role of phytosterols, well proven in hypersitosterolemia ... [more ▼]

The inhibition of cholesterol synthesis by a statin enhances intestinal absorption of both cholesterol and various phytosterols. The atherogenic role of phytosterols, well proven in hypersitosterolemia, is now suspected in patients with premature coronary artery disease. The cholestanol/cholesterol ratio can be used as a marker of intestinal cholesterol absorption. Individuals with elevated ratio ("high absorbers") have less favourable cholesterol-lowering response and cardiovascular protection with statin therapy as compared to individuals with low ratio ("high synthesizers"). They may benefit of an adjunct therapy with phytostanols or ezetimibe, both being capable to reduce plasma concentrations of cholesterol and of phytosterols. [less ▲]

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See detailObservance et persistance: impact sur l'efficience des traitements de l'osteoporose
Reginster, Jean-Yves ULg; Rabenda, Véronique ULg

in Revue Médicale Suisse (2005), 1(35), 2278-81

Low adherence to therapies has been repeatedly described as a major determinant of poor clinical outcomes in chronic disorders. Bisphosphonates, the most widely prescribed drugs in this field, have been ... [more ▼]

Low adherence to therapies has been repeatedly described as a major determinant of poor clinical outcomes in chronic disorders. Bisphosphonates, the most widely prescribed drugs in this field, have been linked to a 12-month persistence lower than 40%. The situation is improved when using the weekly formulation compared to the daily intake of the drug. Low compliance results in lesser increase in bone mineral density and decreased anti-fracture efficacy. New medications, currently developed for the management of osteoporosis, will be user-friendly, allowing to an improvement of compliance and persistence. [less ▲]

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See detailLe tiotropium: une nouvelle option therapeutique dans la bronchopneumopathie chronique obstructive
Corhay, Jean-Louis ULg; Louis, Renaud ULg

in Revue Médicale Suisse (2005), 1(30), 1967-1972

Tiotropium is a long-acting anticholinergic bronchodilator, inhaled only once a day, which produces relaxation of airway smooth muscle through antagonism of acetylcholine at M3-muscarinic receptors. Its ... [more ▼]

Tiotropium is a long-acting anticholinergic bronchodilator, inhaled only once a day, which produces relaxation of airway smooth muscle through antagonism of acetylcholine at M3-muscarinic receptors. Its duration of action is at least 24 h with once daily administration of tiotropium. Several studies have shown its efficacy and its good tolerance in the treatment of patients who are suffering from moderate to very severe chronic obstructive pulmonary disease (COPD). Tiotropium improves spirometric measurements and quality of life, and reduces dyspnea and exacerbation rate in COPD patients. [less ▲]

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See detailNouveautés dans la prise en charge médicale des anomalies du bilan phosphocalcique chez le patient hémodialysé
Van Overmeire, Lionel ULg; Delanaye, Pierre ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale Suisse (2005), 1(30), 1960-5

Bone metabolism is very frequently disturbed in end stage renal failure hemodialyzed, with secondary hyperparathyroidism development but also serious potential cardiovascular consequences. New treatments ... [more ▼]

Bone metabolism is very frequently disturbed in end stage renal failure hemodialyzed, with secondary hyperparathyroidism development but also serious potential cardiovascular consequences. New treatments will be available very soon in Europe such as new phosphate binders, vitamin D2 analogues or calcimimetics to fight against such medical diseases, with the hope of less risk for vascular complications. The real place of such new medical opportunities needs to be determined. Moreover, studies with morbidity and mortality end-points are waited before estimating the real importance of these new therapeutic tools. [less ▲]

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See detailImmunotherapie du cancer par minigreffe de cellules souches hematopoietiques.
Willems, Evelyne ULg; Baron, Frédéric ULg; Vanstraelen, Gaëtan et al

in Revue Médicale Suisse (2005), 1(30), 1973-7

Allogeneic hematopoietic stem cell transplantation (HSCT) is used for the treatment of selected haematological malignancies. Its curative potential is based on two different mechanisms, i.e. the ... [more ▼]

Allogeneic hematopoietic stem cell transplantation (HSCT) is used for the treatment of selected haematological malignancies. Its curative potential is based on two different mechanisms, i.e. the conditioning regimen and the graft-versus-host immunologic reactions. However, because of its toxicity, it is restricted to younger and fitter patients. These observations led several groups to set up new (less toxic) transplant protocols. These transplants are called nonmyeloablative HSCT or minitransplants. These are feasible with a relatively low transplant-related mortality even in patients up to 70 years. In addition, strong anti-tumor responses are observed in several haematological malignancies. [less ▲]

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See detailQuelles indications pour les statines hormis le traitement de l'hypercholesterolemie?
Scheen, André ULg; Sadzot, Bernard ULg

in Revue Médicale Suisse (2005), 1(30), 19541956-9

Statins are essential drugs for the prevention of coronary and cerebral vascular complications. Besides their specific cholesterol-lowering effect, these agents exert various pleiotropic effects, which ... [more ▼]

Statins are essential drugs for the prevention of coronary and cerebral vascular complications. Besides their specific cholesterol-lowering effect, these agents exert various pleiotropic effects, which probably contribute to the cardiovascular protection, but may also play a favourable effect in various other pathologies. Some recent data suggested that statins may play a positive effect in the prevention of Alzheimer disease and colorectal cancer. In contrast, after some initial hope, recent observations in the field of osteoporosis prevention provided discordant and finally rather disappointing results. New prospective studies are mandatory before accepting such new potential indications of statins. [less ▲]

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See detailTriple therapie orale dans le diabete de type 2.
Scheen, André ULg

in Revue Médicale Suisse (2005), 1(30), 19421944-61948

Type 2 diabetes has a complex pathophysiology, combining a defect of insulin secretion by the pancreas, an increased glucose production by the liver and a reduced insulin-mediated glucose uptake by the ... [more ▼]

Type 2 diabetes has a complex pathophysiology, combining a defect of insulin secretion by the pancreas, an increased glucose production by the liver and a reduced insulin-mediated glucose uptake by the skeletal muscle. Each of these abnormalities can be partially reversed by a specific drug, an agent promoting insulin secretion (sulphonylurea or glinide), metformin and a thiazolidinedione (glitazone), respectively. Therefore, a triple oral therapy, targeting simultaneously the three main metabolic abnormalities of type 2 diabetes, deserves special attention. Recent clinical trials have shown both the efficacy and safety of this triple oral therapy. However, its precise place remains to be better specified in the overall management of type 2 diabetes. [less ▲]

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See detailDe la plus-value therapeutique au surcout d'un nouveau medicament: a propos d'un hiatus croissant.
Scheen, André ULg

in Revue Médicale Suisse (2005), 1(30), 1931-2

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See detailTraitement du cancer du sein chez la personne âgée
Gillain, Sophie ULg; Gennigens, Christine ULg; Sautois, Brieuc ULg et al

in Revue Médicale Suisse (2004), 62

Le cancer du sein représente chez la personne âgée une pathologie fréquente. Le choix du traitement dépend de l'âge physiologique, des pathologies et comorbidités associées ainsi que du niveau de vie et d ... [more ▼]

Le cancer du sein représente chez la personne âgée une pathologie fréquente. Le choix du traitement dépend de l'âge physiologique, des pathologies et comorbidités associées ainsi que du niveau de vie et d'autonomie. De plus, selon les facteurs histopronostiques (récepteurs aux oestrogènes et à la progestérone, la surexpression du cerb-B2) on décidera éventuellement du schéma thérapeutique le plus approprié. Chez la personne âgée, la chirurgie (mastectomie ou tumorectomie), la radiothérapie et l'hormonothérapie trouvent leur place. Au-delà de 70 ans, la place de la chimiothérapie est incertaine. En effet, les patientes de plus de 70 ans sont sous-représentées dans les études randomisées. [less ▲]

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See detailTraitement moléculaire du cancer: le STI571, un inhibiteur des tyrosines kinases
Humblet-Baron, Stéphanie ULg; Baron, Frédéric ULg; Pirson, Laurence ULg et al

in Revue Médicale Suisse (2002), 60(598), 1504-1508

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See detailoncologie gastro-intestinale
Frei, A.; Coucke, Philippe ULg; Felley, C. et al

in Revue Médicale Suisse (1999), 760

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