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See detailL'etude clinique du mois. NAVIGATOR: essai de prevention des complications cardio-vasculaires et du diabete de type 2 par le valsartan et/ou le nateglinide.
Scheen, André ULg

in Revue Médicale de Liège (2010), 65(4), 217-23

NAVIGATOR ("Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research") is a large international placebo-controlled trial that randomised 9,031 individuals at high risk because of impaired ... [more ▼]

NAVIGATOR ("Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research") is a large international placebo-controlled trial that randomised 9,031 individuals at high risk because of impaired glucose tolerance and established cardiovascular disease or cardiovascular risk factors. This trial aimed at investigating whether valsartan (a selective AT1 receptor antagonist) and/or nateglinide (a short-acting insulin-secreting agent) are able to reduce the incidence of type 2 diabetes and cardiovascular events. After a median follow up of 6.5 years, neither valsartan nor nateglinide improved cardiovascular prognosis in the tested population, which already benefited from a protective pharmacotherapy at baseline and a reinforcement of lifestyle modification throughout the trial. Nateglinide did not diminish the risk of new onset diabetes. In contrast, valsartan reduced the incidence of type 2 diabetes by 14%, confirming the potential interest of the blockade of the renin-angiotensin system in this high-risk population. [less ▲]

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See detailEtude clinique du mois. ONTARGET: protection comparable du telmisartan et du ramipril et absence de benefice de la combinaison chez des patients a haut risque vasculaire.
Scheen, André ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2008), 63(4), 213-9

ONTARGET ("ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial") compared the angiotensin converting enzyme inhibitor ramipril (10 mg/day), the angiotensin-receptor blocker ... [more ▼]

ONTARGET ("ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial") compared the angiotensin converting enzyme inhibitor ramipril (10 mg/day), the angiotensin-receptor blocker telmisartan 80 mg/day, and the combination of the two drugs in 25,620 patients with vascular disease or high-risk diabetes. After a median follow up of 56 months, no significant differences were observed between the three groups neither in the primary composite outcome (death from cardiovascular causes, myocardial infarction, stroke, or hospitalization for heart failure), nor in each of its components, total mortality and other secondary outcomes. Telmisartan was equivalent to ramipril (non inferiority criterion), but was better tolerated (less cough and angioedema). The combination of the two drugs in this population (without congestive heart failure and proteinuric nephropathy) did not bring increased benefit (no superiority), but was associated with more adverse events (hypotension, syncope and renal dysfunction). In this population, the choice of the molecule in monotherapy remains optional and the use of a dual blockade is not justified in order to have a better cardiovascular protection. [less ▲]

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

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 detailL'etude clinique du mois. Prevention du diabete de type 2 chez le sujet avec exces ponderal et diminution de la tolerance au glucose: efficacite des mesures hygieno-dietetiques.
Scheen, André ULg

in Revue Médicale de Liège (2001), 56(6), 463-5

The "Finnish Diabetes Prevention Study" is a prospective controlled study recently published in the New England Journal of Medicine which compared the risk of developing type 2 diabetes among 265 high ... [more ▼]

The "Finnish Diabetes Prevention Study" is a prospective controlled study recently published in the New England Journal of Medicine which compared the risk of developing type 2 diabetes among 265 high-risk patients treated by changes in lifestyle to that of 257 matched controlled patients. This intervention trial demonstrated that the risk of type 2 diabetes could be reduced by 58% (p < 0.001) after a mean follow-up of 3.2 years with changes in lifestyle of high-risk overweight subjects with impaired glucose tolerance. [less ▲]

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See detailEtude clinique du mois. Protection secondaire de l'accident vasculaire cerebral par le perindopril: l'etude PROGRESS.
Scheen, André ULg

in Revue Médicale de Liège (2001), 56(11), 792-5

PROGRESS ("Perindopril pROtection aGainst REcurrent Stroke Study") demonstrated that blood-pressure lowering treatment with perindopril, an angiotensin converting enzyme inhibitor (combined with the ... [more ▼]

PROGRESS ("Perindopril pROtection aGainst REcurrent Stroke Study") demonstrated that blood-pressure lowering treatment with perindopril, an angiotensin converting enzyme inhibitor (combined with the diuretic agent indapamide when necessary), reduces the risk of stroke by 28% (95% CI: 17-38, p < 0.0001) among patients with a history of stroke or transient ischaemic attack. This protective effect was observed among both hypertensive and non-hypertensive individuals. It was more marked in the patients receiving combined perindopril + indapamide treatment (-43%; 95% CI 30-54) who were those who showed the greatest reduction in arterial blood pressure (-12/5 mm Hg). According to these observations, the authors concluded that treatment with these two agents should now be considered routinely for patients with a history of stroke or transient ischaemic attack, irrespective of their blood pressure. [less ▲]

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See detailEtude clinique du mois. Radio-chimiotherapie et chimiotherapie adjuvante apres resection a visee curative du cancer du pancreas: resultats de l'etude randomisee ESPAC-1
Polus, Marc ULg; Jerusalem, Guy ULg; Sautois, Brieuc ULg et al

in Revue Médicale de Liège (2002), 57(2), 119-22

The prognosis of pancreatic adenocarcinoma remains poor, with a 5-year survival rate lower than 5%. Resection, the gold standard treatment, can be performed in less than 15% of patients. Following surgery ... [more ▼]

The prognosis of pancreatic adenocarcinoma remains poor, with a 5-year survival rate lower than 5%. Resection, the gold standard treatment, can be performed in less than 15% of patients. Following surgery, the median survival is 12 months for the most favourable cancer patients. Adjuvant treatment have attempted to improve results. However, chemotherapy, radiotherapy and multimodal treatments don't have demonstrated a clear advantage in controlled trials. We will discuss results of the current trials in this topic. The randomised trial of the European Study Group for Pancreatic Cancer (ESPAC) recently published in the Lancet revealed a potential benefit of adjuvant chemotherapy. A critical analysis of the publication showed, however, that definitive conclusions of this trial must be interpreted with caution. [less ▲]

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See detailL'etude clinique du mois. REVERSAL et PROVE-iT: confirmation du concept the lower, the better" dans le traitement de l'hypercholesterolemie chez le patient coronarien."
Scheen, André ULg; Kulbertus, Henri ULg

in Revue Médicale de Liège (2004), 59(3), 167-73

Statins, as compared to placebo, have proven their efficacy in reducing cardiovascular events in patients with or without cardiovascular disease and in a large range of cholesterol levels. Two new head-to ... [more ▼]

Statins, as compared to placebo, have proven their efficacy in reducing cardiovascular events in patients with or without cardiovascular disease and in a large range of cholesterol levels. Two new head-to-head randomised trials comparing intensive treatment with atorvastatin 80 mg/day with moderate treatment with pravastatin 40 mg/day were recently completed. The mechanistic "Reversing Atherosclerosis with Aggressive Lipid Lowering" (REVERSAL) trial randomised 502 patients with stable coronary disease. Atorvastatin 80 mg (leading to a mean LDL cholesterol of 79 mg/dl) was superior to pravastatin 40 mg (mean LDL of 110 mg/dl) in terms of limiting the progression of atheroma assessed with the use of intravascular ultrasonography after 18 months of follow up (p = 0.02). These differences may be related to the greater reduction in atherogenic lipoprotein (-46% versus -26%, p < 0.001) and C-reactive protein (-36% versus -5%, p < 0.001) in patients treated with atorvastatin as compared to pravastatin. In the clinical "Pravastatin or Atorvastatin Evaluation and Infection Therapy" (PROVE-IT) trial, 4162 patients with acute coronary syndromes were randomised to either atorvastatin 80 mg or pravastatin 40 mg and followed for a mean of 24 months. Again, atorvastatin (mean LDL of 62 mg/dl) was superior to pravastatin (mean LDL of 95 mg/dl), resulting in a 16% percent lower risk of the primary end point, a composite of major cardiovascular events (p = 0.005). Thus, both REVERSAL and PROVE-IT support the concept "the lower, the better". However, they do not allow to disentangle the independent and interdependent effects of statins on LDL cholesterol and the process of arterial inflammation. What so ever, the results suggest that the target LDL cholesterol level may be lower than recommended in the current guidelines in high-risk patient so that a sea change in the prevention and management of atherosclerotic vascular disease may occur very soon. [less ▲]

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See detailEtude clinique du mois. Rôle néphroprotecteur des antagonistes du récepteur de l'angiotensine II (ARA) dans le diabète de type 2: résultats des études IDNT et RENAAL
Weekers, Laurent ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2001), 56(10), 723-726

Nephropathy associated with type 2 diabetes mellitus is a rising cause of end-stage renal disease and is a major public health problem. If blocking of the renin angiotensin system has a well established ... [more ▼]

Nephropathy associated with type 2 diabetes mellitus is a rising cause of end-stage renal disease and is a major public health problem. If blocking of the renin angiotensin system has a well established nephroprotective effect in type 1 diabetic nephropathy, this remained to be shown for type 2 diabetes. Two large outcome trials using angiotensin II receptor antagonists (ARA's) in proteinuric chronic renal impairment and hypertensive type 2 diabetic patients have now closed this gap: the Irbesartan Diabetic Nephropathy Trial (IDNT) and the Reduction of Endpoints in NIDDM with Angiotensin II Antagonist Losartan (RENAAL) trial. Both trials showed a significant reduction in the primary pre-specified end-point of death, or worsening of renal function (doubling of serum creatinine) or the development of end-stage renal disease. This effect goes beyond the reduction in blood pressure and makes of ARA's one of the important tools in the treatment of type 2 diabetic nephropathy. [less ▲]

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See detailL'etude clinique du mois. Toxicite de l'hyperglycemie en soins intensifs et effets benefiques d'une insulinotherapie optimisee.
Scheen, André ULg

in Revue Médicale de Liège (2001), 56(12), 859-61

A large Belgian, prospective, controlled study was performed in 1.548 critically ill patients (83% without history of diabetes) hospitalised in a surgical intensive care unit. On admission, patients were ... [more ▼]

A large Belgian, prospective, controlled study was performed in 1.548 critically ill patients (83% without history of diabetes) hospitalised in a surgical intensive care unit. On admission, patients were randomly assigned to receive intensive intravenous insulin therapy (maintenance of blood glucose at a level between 80 and 110 mg/dl) or conventional treatment (infusion of insulin only if the blood glucose level exceeded 215 mg/dl and maintenance of glucose at a level between 180 and 200 mg/dl). Intensive insulin therapy reduced morbidity and mortality by 40%. These remarkable results should influence further therapeutical attitudes in intensive care units and open new perspectives for the management of critically ill patients. [less ▲]

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See detailL'etude clinique du mois. Treating to New Targets": plaidoyer pour une valeur cible de cholesterol LDL egale ou inferieure a 75 mg/dl chez tout patient coronarien."
Scheen, André ULg

in Revue Médicale de Liège (2005), 60(4), 264-7

The "Treating to New Targets" (TNT) trial compared atorvastatin 80 mg (aiming at reducing LDL cholesterol < or = 75 mg/dl) and atorvastatin 10 mg (LDL < or = 100 mg/dl as target) in 10,001 patients with ... [more ▼]

The "Treating to New Targets" (TNT) trial compared atorvastatin 80 mg (aiming at reducing LDL cholesterol < or = 75 mg/dl) and atorvastatin 10 mg (LDL < or = 100 mg/dl as target) in 10,001 patients with stable coronary heart disease followed up for 5 years. A reduction of major cardiovascular events of 22% was observed in the atorvastatin 80 mg group as compared to the atorvastatin 10 mg group (hazard ratio: 0.78; 95 % interval of confidence: 0.69-0.89; p < 0.001). Such clinical efficacy was obtained while a good drug safety profile was maintained. Total mortality was not significantly different between the two groups. However, and remarkably, cardiovascular death was not the first cause of death anymore in this atorvastatin-treated population. The results of TNT in patients with stable coronary heart disease thus confirm the results of PROVE-IT in patients with acute coronary syndrome. These two randomised controlled trials should encourage considering a LDL cholesterol level of 75 mg/dl (rather than 100 mg/dl) as a new target in any patient with coronary heart disease. [less ▲]

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See detailL'etude clinique du mois. United Kingdom Prospective Diabetes Study: 10 ans plus tard.
Scheen, André ULg; Paquot, Nicolas ULg; Lefebvre, Pierre ULg

in Revue Médicale de Liège (2008), 63(10), 624-9

A 10-year post-trial monitoring of patients with newly diagnosed type 2 diabetes randomised in the "United Kingdom Prospective Diabetes Study" (UKPDS) demonstrated a continued reduction in microvascular ... [more ▼]

A 10-year post-trial monitoring of patients with newly diagnosed type 2 diabetes randomised in the "United Kingdom Prospective Diabetes Study" (UKPDS) demonstrated a continued reduction in microvascular risk (-24%, p = 0.001) and emergent risk reductions for myocardial infarction (-15%, p = 0.01) and death from any cause (-13%, p = 0.007), despite an early loss of glycaemic differences ("legacy effect"). A continued benefit after metformin therapy was evident during the ten-year post-trial follow-up among overweight patients (-33%, p = 0.005 for myocardial infarction and -27%, p = 0.002 for death from any cause). In contrast, the benefits of previously improved blood pressure control were not sustained when between-groups differences in blood pressure were lost during follow-up, except for a reduced risk for peripheral vascular disease. These observations are strong arguments in favour of an early optimisation of blood glucose control and of a sustained control of blood pressure in patients with type 2 diabetes. [less ▲]

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See detailEtude clinique et anatomopathologique de l’infection expérimentale de lapins E.O.P.S. par 5 souches virales amyxomateuses
Marlier, Didier ULg; Cassart, Dominique ULg; Boucraut-Baralon, Corinne et al

in Proceedings of the 7èmes Journées de la Recherche Cunicole (1998, May 13)

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See detailEtude clinique et anatomopathologique de l'infection expérimentale de lapins par une souche virale amyxomateuse isolée en Belgique
Marlier, Didier ULg; Coignoul, Freddy ULg; Boucraut-Baralon, Corine et al

in Annales de Médecine Vétérinaire (1997), 141

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See detailEtude clinique et biologique de la fonction hypophyso-gonanique dans les prolactinomes.
Beckers, Albert ULg; Stevenaert, Achille ULg; Hennen, G. et al

in Acta Clinica Belgica (1985)

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See detailEtude comparative de cinq techniques de préparation plaquettaire (Platelet-Rich Plasma)
Kaux, Jean-François ULg; Le Goff, Caroline ULg; Seidel, Laurence ULg et al

in Pathologie Biologie (2011), 59

Aim of the study: Injections of platelet-rich plasma (PRP) constitute a new therapeutic for treating chronic tendinopathies. The injection being carried out in the tendon, the volume of PRP should thus be ... [more ▼]

Aim of the study: Injections of platelet-rich plasma (PRP) constitute a new therapeutic for treating chronic tendinopathies. The injection being carried out in the tendon, the volume of PRP should thus be minimal (to decrease the intra-tendinous pressure and to minimize pain). This PRP should also have a raised platelet count. The quantity of released growth factors could be related to the system of preparation employed. We thus carried out a comparative study of 5 techniques of preparation of PRP described in the literature. Patients and methods: Samples of venous blood were taken among 5 patients in order to compare 5 techniques of preparation of PRP: University Hospital of Liège technique, Curasan® PRP Kit, Plateltex®, GPS® and RegenLab®. Results: The various techniques make it possible to obtain more important platelet concentration than in blood, with variable volumes (0,3 mL to 6 mL). The number of platelets/microlitre appears higher with Plateltex® and obtains smallest volume of PRP. The other techniques also give small volumes excepted for the GPS® II. The number of collected platelets with this technique appears thus higher. The best collect efficiency is obtained with RegenLab®. Conclusion: The technique Plateltex® makes it possible to collect the highest concentration of platelets in the smallest volume available. [less ▲]

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See detailEtude comparative de deux modes de révélation des cultures de toxoplasme en culture cellulaire
Hayette, Marie-Pierre ULg; Elies, Rosen; Chetaille, Eric et al

Poster (1994, June)

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