References of "Revue Médicale Suisse"
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See detailInhibiteurs de la pompe à protons et risque d'insuffisance rénale
PAQUOT, Francois ULiege; Krzesinski, Jean-Marie ULiege

in Revue Médicale Suisse (2017)

Regarded as safe and effective for management of upper peptic ulcer disease due to gastric acid secretion, the proton pump inhibitors are among the most commonly prescribed drugs. Their use, however, is ... [more ▼]

Regarded as safe and effective for management of upper peptic ulcer disease due to gastric acid secretion, the proton pump inhibitors are among the most commonly prescribed drugs. Their use, however, is not without concerns. Acute kidney injury, mainly due to acute interstitial nephritis, could happen 1.5 to 2 times more frequently when using these drugs. Moreover, a risk for chronic kidney disease has also be noted with proton pump inhibitor use (1.15 to 1.8 increased risk), although biases may exist due to confounding factors related to the observational nature of the studies. So, caution is required before available results from good prospective randomized studies are available. Renal function should be checked when using these medications and timely cessation should be advised when there is no more clear indication for use. [less ▲]

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See detailProtection cardio-renale par les inhibiteurs des SGLT2 (gliflozines) : d'EMPA-REG OUTCOME a CANVAS.
Scheen, André ULiege; Ernest, Philippe; Jandrain, Bernard

in Revue Médicale Suisse (2017), 13(571), 1421-1426

The cardiovascular (CV) and renal protection reported with empagliflozin in EMPA-REG OUTCOME is now confirmed with canagliflozin in CANVAS in patients with type 2 diabetes and high cardiovascular risk ... [more ▼]

The cardiovascular (CV) and renal protection reported with empagliflozin in EMPA-REG OUTCOME is now confirmed with canagliflozin in CANVAS in patients with type 2 diabetes and high cardiovascular risk: similar and significant reductions in major CV events (-14 vs. -14%), in hospitalisations for heart failure (-35 vs. -33%) and in renal events (-39 vs. -40%). The greater reduction in CV mortality (-38 vs. - 13%) and all-cause mortality (-32 vs. -13%) in EMPA-REG OUTCOME than in CANVAS may be explained by the greater proportion of patients with CV disease (secondary prevention : 99 vs. 65%). In contrast to EMPA-REG OUTCOME, CANVAS did not show an increase in stroke (-10%, NS), but reported a higher rate of fractures and amputations with canagliflozin. Overall, these results support a class effect for the cardiorenal protection by inhibitors of sodium-glucose type 2 (SGLT2) cotransporters. [less ▲]

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See detailInhibiteur de la DPP-4 ou des SGLT2 apres echec de la metformine seule dans le diabete de type 2.
Paquot, Nicolas ULiege; Scheen, André ULiege

in Revue Médicale Suisse (2017), 13(571), 1410-1415

After failure of a monotherapy with metformin, dipeptidyl peptidase-4 inhibitors (gliptins) and sodium-glucose cotransporters type 2 (gliflozins) offer an alternative to the add-on of a sulphonylurea ... [more ▼]

After failure of a monotherapy with metformin, dipeptidyl peptidase-4 inhibitors (gliptins) and sodium-glucose cotransporters type 2 (gliflozins) offer an alternative to the add-on of a sulphonylurea, especially in diabetic patients at risk of hypoglycaemia. The choice between a gliptin and a gliflozin may be guided by the individual patient characteristics : rather a gliptin in a patient without obesity or severe hyperglycaemia, in an elderly patient, with a frailty profile or with renal impairment; rather a gliflozin in an obese patient, with hypertension, hyperuricaemia, antecedents of cardiovascular disease (especially heart failure), without advanced renal insufficiency and with a low risk of urinary/genital infections or events linked to dehydration such as hypotension. [less ▲]

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See detailOptions therapeutiques chez un patient diabetique de type 2 mal controle par une insuline basale.
Scheen, André ULiege; Paquot, Nicolas ULiege

in Revue Médicale Suisse (2017), 13(571), 1416-1420

In a patient with type 2 diabetes not well controlled with a basal insulin - metformin combination, several therapeutic options may be considered: intensifying insulin therapy with different schemes ... [more ▼]

In a patient with type 2 diabetes not well controlled with a basal insulin - metformin combination, several therapeutic options may be considered: intensifying insulin therapy with different schemes (appropriate titration using a more favourable basal insulin analogue, adding one, two or three rapid-acting insulin analogues, shift to two or three premix insulin injections), adding a dipeptidyl peptidase-4 inhibitor (gliptin) or an inhibitor of sodium-glucose cotransporters type 2 (gliflozin), or combining a glucagon-like peptide-1 receptor agonist with basal insulin. The choice should be made according the individual profile and preference of the patient, in a personalized approach, taking into account the advantages and disadvantages of each therapeutic solution. [less ▲]

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See detailProtection cardiovasculaire du patient diabetique de type 2 : d'EMPA-REG OUTCOME a LEADER.
Scheen, André ULiege; Wallemacq, Caroline; Jandrain, Bernard et al

in Revue Médicale Suisse (2016), 12(527), 1370-1375

Two clinical trials demonstrate the superiority versus a placebo of two antidiabetic drugs in patients with type 2 diabetes and high cardiovascular risk. Empagliflozin, an inhibitor of sodium-glucose type ... [more ▼]

Two clinical trials demonstrate the superiority versus a placebo of two antidiabetic drugs in patients with type 2 diabetes and high cardiovascular risk. Empagliflozin, an inhibitor of sodium-glucose type 2 (SGLT2) cotransporters, in EMPA-REG OUTCOME, and liraglutide, an agonist of glucagon-like peptide-1 (GLP-1) receptors, in LEADER, showed a significant reduction in major cardiovascular events (- 14 and - 13 %, respectively), cardiovascular mortality (- 38 and - 22 %, respectively) and all-cause mortality (- 32 and - 15 %, respectively). A lower progression of kidney disease and less renal events were also reported. The underlying protective mechanisms remain controverted as the discussion whether the benefits are specific to each medication or could be extended to other molecules of these two pharmacological classes. [less ▲]

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See detailEfficacite de trois techniques de chirurgie bariatrique chez des sujets obeses diabetiques de type 2.
Bessemans, Severine; Scheen, André ULiege

in Revue Médicale Suisse (2016), 12(527), 1378-1382

This retrospective work compares the efficacy of three procedures of bariatric surgery in obese patients with type 2 diabetes : gastric bypass (n = 22), sleeve gastrectomy (n = 18) and Magenstrasse & Mill ... [more ▼]

This retrospective work compares the efficacy of three procedures of bariatric surgery in obese patients with type 2 diabetes : gastric bypass (n = 22), sleeve gastrectomy (n = 18) and Magenstrasse & Mill gastroplasty (also known as reversible sleeve (n = 19). The three interventions result in a remarkable weight loss after one year, a better glycaemic control, with often a remission of diabetes, a reduction of blood pressure and an improvement of lipid profile, allowing an interruption or a dose reduction of concomitant medications. Overall, classical sleeve provides almost similar results as gastric bypass and appears slightly better than reversible sleeve. These results deserve confirmation in studies with more patients followed for a longer term. [less ▲]

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See detailCombinaison gliptine-gliflozine dans le traitement du diabete de type 2.
Scheen, André ULiege; Paquot, Nicolas ULiege

in Revue Médicale Suisse (2016), 12(527), 1384-1388

Type 2 diabetes (T2D) is a complex disease with multiple defects, which generally require a combination of several pharmacological approaches to control hyperglycaemia. Combining a dipeptidyl peptidase-4 ... [more ▼]

Type 2 diabetes (T2D) is a complex disease with multiple defects, which generally require a combination of several pharmacological approaches to control hyperglycaemia. Combining a dipeptidyl peptidase-4 inhibitor (DPP-4i) and a sodium-glucose cotransporter type 2 inhibitor (SGT2i) appears to be an attractive approach because the two drugs exert different and potentially complementary glucose-lowering effects. Dual therapy (initial combination or stepwise approach) is more potent than either monotherapy in patients treated with diet and exercise or already treated with metformin. Combining the two pharmacological options is safe and does not induce hypoglycaemia. Two fixed-dose combinations (FDCs) are already available (saxagliptin-dapagliflozin and linagliptin-empagliflozin) and others are in current development. [less ▲]

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See detailPrise en charge actuelle du lymphome de la zone marginale
Bonnet, Christophe ULiege; LEJEUNE, Marie ULiege; VAN KEMSEKE, Catherine ULiege et al

in Revue Médicale Suisse (2015), 11

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See detailThermoplastie bronchique : une réelle avancée dans le traitement de l'asthme
HEINEN, Vincent ULiege; SCHLEICH, FLorence ULiege; DUYSINX, Bernard ULiege et al

in Revue Médicale Suisse (2014), 10(439), 1544-1548

New treatments are needed to improve the care of severe asthmatic patients. Bronchial thermoplasty aims to lessen the airway smooth muscles via the heating of bronchial walls by radiofrequency. The ... [more ▼]

New treatments are needed to improve the care of severe asthmatic patients. Bronchial thermoplasty aims to lessen the airway smooth muscles via the heating of bronchial walls by radiofrequency. The preliminary studies showed a good tolerance and some good efficacy. Randomized controlled trials have been undertaken on moderate to severe asthmatic patients, demonstrating an improvement in quality of life, rate of severe exacerbations and unscheduled medical visits. The main side-effects consist of asthma exacerbations, atelectasis and infections. Bronchial thermoplasty is an innovative treatment with good efficacy and acceptable tolerance for moderate to severe asthmatic patients. More studies are needed to better understand its mechanism of action and more clearly delineate the precise indications of this innovative technique. [less ▲]

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See detailIntérêt des cellules stromales mésenchymateuses en transplantation d’organes solides
Delens, Loic ULiege; Jouret, François ULiege; DETRY, Olivier ULiege et al

in Revue Médicale Suisse (2014), 10

Solid organ transplantation (SOT) currently represents the best therapeutic option in end-stage diseases caused by the irrevocable functional loss of an organ. Still, SOT is associated with immunological ... [more ▼]

Solid organ transplantation (SOT) currently represents the best therapeutic option in end-stage diseases caused by the irrevocable functional loss of an organ. Still, SOT is associated with immunological and non-immunological injuries, whose severity impacts on early functional recovery and long-term survival of the transplant. Current research focuses on the identification of innovative approaches to 1) attenuate ischemia/reperfusion-induced damage, 2) accelerate processes of tissue repair, and 3) induce in fine graft tolerance. Encouraging observations from both preclinical studies and clinical trials suggest that the administration of mesenchymal stromal cells at the time of SOT might be beneficial, as a result of theirs immunomodulatory, anti-inflammatory and regenerative properties. [less ▲]

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See detailPrévention quaternaire : agir est-il toujours justifié en médecine de famille ?
Widmer, Daniel; Herzig, Lilly; Jamoulle, Marc ULiege

in Revue Médicale Suisse (2014), 10(430), 1052-6

La prévention quaternaire vise à protéger le patient ou la po- pulation de la surmédicalisation. Elle imprègne toute l’activité du médecin de famille par une interrogation tant sur l’utilité de la ... [more ▼]

La prévention quaternaire vise à protéger le patient ou la po- pulation de la surmédicalisation. Elle imprègne toute l’activité du médecin de famille par une interrogation tant sur l’utilité de la prévention primaire que du diagnostic précoce, ou sur les risques de la création de nouvelles entités pathologiques et d’une médecine maximaliste. Le médecin de famille favorise la prévention quaternaire en se centrant sur les priorités du patient et sur les ressources locales d’un système de soins efficace. [less ▲]

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See detailDermatophytes transmis par les animaux domestiques
Monod, M; Fratti, B; Mignon, Bernard ULiege et al

in Revue Médicale Suisse (2014), 10

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See detailThe management of systemic lupus erythematosus with biological therapies
MALAISE, Olivier ULiege; VON FRENCKELL, Christian ULiege; ANDRE, Béatrice ULiege et al

in Revue Médicale Suisse (2013), 9(395), 1507-11

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See detailLeucémie myélomonocytaire chronique : diagnostic et thérapeutique
HAFRAOUI, Kaoutar ULiege; DE PRIJCK, Bernard ULiege; Beguin, Yves ULiege

in Revue Médicale Suisse (2013), 9

Chronic myelomonocytic leukemia (CMML) is a disease typically of the elderly. It is suspected when monocytosis reaches IOOO/fil. It may be associated with «B» symptoms (fever, sweating, and weight loss ... [more ▼]

Chronic myelomonocytic leukemia (CMML) is a disease typically of the elderly. It is suspected when monocytosis reaches IOOO/fil. It may be associated with «B» symptoms (fever, sweating, and weight loss) but also visceral, skin and autoimmune complications. Current treatment strategies aim at reducing the symptoms and have no curative goals. In this context hypomethylating agents have shown a good efficacy. Allogeneic hematopoietic stem cell transplantation (HSCT) remains the only curative option but remains difficult to perform in elderly patients population, even if transplantation with a reduced intensity conditioning has reduced the risks. A new prognostic scoring helps to recognize the patients with poor prognosis and to better selected candidates for the HSCT. [less ▲]

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See detailPrise en charge des prolactinomes
VROONEN, Laurent ULiege; Daly, Adrian ULiege; Beckers, Albert ULiege

in Revue Médicale Suisse (2013), 9

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See detailIntérêt de la chronothérapie dans le traitement de l'hypertension artérielle
VANDERWECKENE, Pauline ULiege; ERPICUM, Pauline ULiege; Krzesinski, Jean-Marie ULiege

in Revue Médicale Suisse (2012), 8(351), 1604-1610

The interest of chronotherapy in the field of arterial hypertension is progressively rising, especially in treated hypertensive patients characterized by a small decrease of their blood pressure during ... [more ▼]

The interest of chronotherapy in the field of arterial hypertension is progressively rising, especially in treated hypertensive patients characterized by a small decrease of their blood pressure during the night, and therefore often presenting a high cardiovascular risk. There are more and more data showing that administration of one antihypertensive drug in the evening (and even aspirin) can improve the blood pressure control during the night and the day/night blood pressure pattern, and so can diminish the level of risk. The role of chronotherapy also emphasizes the interest of 24 h ambulatory blood pressure monitoring in the management of high risk hypertensive patients. [less ▲]

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See detailLes maladies chroniques complexes. Du nouveau paradigme medical au gigantesque defi societal!
SCHEEN, André ULiege

in Revue Médicale Suisse (2012), 8(351), 1579-80

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See detailPrise en charge du lymphome B diffus à grandes cellules en 2012
Bonnet, Christophe ULiege; DE PRIJCK, Bernard ULiege; LEJEUNE, Marie ULiege et al

in Revue Médicale Suisse (2012), 8

Diffuse Large B Cells Lymphoma (DLBCLI is the mast comman non-Hodgkin Iymphoma and comprises a large numberof different entities with different clinico-pathological characteristics. The role of positron ... [more ▼]

Diffuse Large B Cells Lymphoma (DLBCLI is the mast comman non-Hodgkin Iymphoma and comprises a large numberof different entities with different clinico-pathological characteristics. The role of positron emission tomography is essential dudog the Ini tial staging and post treatment assessment, and potentially at early or mid-treatmentevaluation of response. First-line therapy comprises immuno-chemotherapy with rituximab and different cytotox ic agents that differforcomponents, dosages and frequency of administration taking worldwlderecognized pre-treatment prognostic variables into account. After relapse, peripheral blood stem cells transplantation remains the only chance of cu re. This review attempts to summarize the current state of our knowledge by highlighting the leads pursued to further improve current therapeutic results. [less ▲]

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See detailY a-t-il encore une place pour la double inhibition du système rénine-angiotensine en 2012?
Krzesinski, Jean-Marie ULiege; Scheen, André ULiege

in Revue Médicale Suisse (2012), 8(351), 1598-1603

The blockade of the renin-angiotensin system (RAS) improves the prognosis of patients with complications related to diabetes, hypertension or, in general, atherosclerosis. Several observational studies ... [more ▼]

The blockade of the renin-angiotensin system (RAS) improves the prognosis of patients with complications related to diabetes, hypertension or, in general, atherosclerosis. Several observational studies have suggested the use of a dual blockade of the RAS to benefit from a better cardiorenal protection. However, recent randomized controlled studies failed to demonstrate that a dual blockade exert a better protection than single blockade, but showed a higher risk for renal complications and hyperkalemia. To decrease the residual risk, other opportunities may be recommended such as reinforcement of low salt diet, use of supraphysiological dose of a monotherapy inhibiting the RAS (perhaps prescribed at the evening) or addition of an aldosterone antagonist. However, all these approaches, as dual therapy, may also increase the risk of hypotension and renal insufficiency and thus require to be used under strict medical supervision. [less ▲]

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See detailChirurgie metabolique: une place croissante dans le traitement du diabete.
De Flines, J.; Franck, M.; Rorive, M. et al

in Revue Médicale Suisse (2012), 8(351), 1621-41626-7

Bariatric surgery becomes more and more important in the management of the obese patient with type 2 diabetes, especially in case of failure of medical approaches. Metabolic improvement results not only ... [more ▼]

Bariatric surgery becomes more and more important in the management of the obese patient with type 2 diabetes, especially in case of failure of medical approaches. Metabolic improvement results not only from weight loss and the subsequent reduction in insulin resistance, but also from modifications of digestive hormones (especially incretins) that contribute to promote insulin secretion. This new paradigm, moving from bariatric surgery to metabolic surgery, opens new perspectives. The present article briefly describes innovative surgical techniques focusing on endocrine and metabolic improvement rather than on weight loss, the preliminary results of metabolic surgery in patients with type 2 diabetes and a body mass index <35 kg/m2 and, finally, some data regarding the surgical management of obese patients with type I diabetes not well treated with classical medical means. [less ▲]

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