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See detailManagement of cancer treatment-induced bone loss in early breast and prostate cancer -- a consensus paper of the Belgian Bone Club.
Body, Jean-Jacques; Bergmann, P.; Boonen, S. et al

in Osteoporosis International (2007), 18(11), 1439-50

Cancer treatment-induced bone loss (CTIBL) is one of the most important side effects of adjuvant antineoplastic treatment in hormone-dependent neoplasms. Chemotherapy, GnRH analogs and tamoxifen can ... [more ▼]

Cancer treatment-induced bone loss (CTIBL) is one of the most important side effects of adjuvant antineoplastic treatment in hormone-dependent neoplasms. Chemotherapy, GnRH analogs and tamoxifen can induce marked bone loss in premenopausal women with early breast cancer. Aromatase inhibitors (AIs) are replacing tamoxifen as the preferred treatment for postmenopausal women. As a class effect, steroidal (exemestane) and non-steroidal (anastrozole and letrozole) AIs increase bone turnover and cause bone loss (4%-5% over 2 years). When compared to tamoxifen, the risk of getting a clinical fracture under AI treatment is increased by 35%-50%. In patients with prostate cancer, androgen deprivation therapy (ADT) increases bone turnover, reduces bone mass (4%-5% per year) and increases the fracture rate depending on the duration of therapy. Zoledronic acid can prevent accelerated bone loss induced by goserelin in premenopausal women, by letrozole in postmenopausal women and by ADT in men. More limited data indicate that weekly alendronate or risedronate could also be effective for preventing CTIBL. Initiation of therapy early, prior to the occurrence of severe osteoporosis, rather than after, may be more effective. Bisphosphonate treatment should be considered in osteoporotic but also in osteopenic patients if other risk factor(s) for fractures are present. [less ▲]

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See detailManagement of cases suffering from atypical myopathy: Interpretations of descriptive, epidemiological and pathophysiological findings. Part 2: Muscular, urinary, respiratory and hepatic care, and inflammatory/ infectious status
Van Galen, Gaby ULg; Votion, Dominique ULg

in Equine Veterinary Education (2013), 25(6), 308-314

Atypical myopathy is highly fatal, but about a quarter of affected horses survive. This highlights the need for provision of supportive treatment for these patients. This review is a practical guideline ... [more ▼]

Atypical myopathy is highly fatal, but about a quarter of affected horses survive. This highlights the need for provision of supportive treatment for these patients. This review is a practical guideline for equine practitioners and includes suggestions for close monitoring of involved organ systems and discusses options of supportive treatment based on current knowledge of the condition. Part 2 covers the muscular, urinary, respiratory and hepatic systems, and the general inflammatory/infectious status of the case. [less ▲]

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See detailManagement of cases suffering from atypical myopathy:Interpretations of descriptive, epidemiological and pathophysiological findings. Part 1: First aid, cardiovascular, nutritional and digestive care
Van Galen, Gaby ULg; Votion, Dominique ULg

in Equine Veterinary Education (2013), 25(5), 264-270

Atypical myopathy is highly fatal, but about a quarter of affected horses survive. This highlights the need for provision of supportive treatment for these cases. This review is a practical guideline for ... [more ▼]

Atypical myopathy is highly fatal, but about a quarter of affected horses survive. This highlights the need for provision of supportive treatment for these cases. This review is a practical guideline for equine practitioners and includes suggestions for close monitoring of involved organ systems and discusses options of supportive treatment based on current knowledge of the condition. [less ▲]

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See detailManagement of Difficult Intubation
Janssens, Marc ULg; Hartstein, Gary ULg

in European Journal of Anaesthesiology (2001), 18(1), 3-12

Appropriate airway management is an essential part of the anaesthetist's role. Difficult intubation, which can now be quantified using the 'Intubation Difficulty Scale', should be anticipated whenever ... [more ▼]

Appropriate airway management is an essential part of the anaesthetist's role. Difficult intubation, which can now be quantified using the 'Intubation Difficulty Scale', should be anticipated whenever possible. A strategy needs to be developed in order to anticipate problems. The first part of this paper reviews the different factors that contribute to make intubation and/or ventilation difficult. Problems with intubation (or ventilation of the lungs) can be caused by abnormal laryngeal structures (e.g. tumour, stenosis), or by difficulty in seeing the glottis. The clinical history will usually help identify the former problem, while physical examination of the airway is required to reveal either disproportion between the various structures of the airway (e.g. tongue, larynx), and/or difficulties in aligning the oral, pharyngeal, and laryngeal axes. The different techniques used to diagnose these problems are described. The second part of this paper summarizes the algorithms used by the anaesthetist when management of the airway is found difficult. Three situations are considered: (a) anticipated difficult intubation, for which awake fibreoptic intubation would appear to be the technique of choice in the majority of cases, (b) unforeseen difficult intubation in a patient whose lungs can be ventilated; here, various techniques for control of the airway will be briefly described, and (c) both tracheal intubation and lung ventilation are impossible; this is a life-threatening emergency, for which three solutions are proposed. These include use of the laryngeal mask airway, the Combitube, or transtracheal ventilation. These situations will be analysed with the aim of proposing management strategies that always guarantee the safety of the patient. [less ▲]

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See detailManagement of diffuse glioma in children: a retrospective study of 27 cases and review of literature.
Piette, Caroline ULg; Deprez, Manuel ULg; Born, Jacques et al

in Acta Neurologica Belgica (2008), 108(2), 35-43

Gliomas are the most common CNS tumours in children and present either as circumscribed tumours or diffusely infiltrative neoplasms. Diffuse gliomas develop both in the cerebral hemispheres and the ... [more ▼]

Gliomas are the most common CNS tumours in children and present either as circumscribed tumours or diffusely infiltrative neoplasms. Diffuse gliomas develop both in the cerebral hemispheres and the brainstem and have a poor prognosis. Guidelines for the therapy of these tumours are still debated. In this study, we reviewed the clinical features of 27 consecutive patients with diffuse gliomas admitted to the Department of Paediatrics of CHR Citadelle, University of Liege, between 1985 and 2005. We review their clinical presentation, diagnosis, treatment and outcome with reference to the published literature. [less ▲]

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See detailManagement of Electric and Hybrid vehicles
Lilien, Jean-Louis ULg; Yuan, H.

(2003, November)

The battery management system (BMS) is an important feature for electric (EVs) and hybrid (HVs) vehicles. The BMS has close connections with the vehicle control and command and gives access to real time ... [more ▼]

The battery management system (BMS) is an important feature for electric (EVs) and hybrid (HVs) vehicles. The BMS has close connections with the vehicle control and command and gives access to real time power available and remaining autonomy. Such information is dramatic and comprises major inputs of the hybrid vehicle strategy on the road. The BMS is obviously related to battery modeling. Electrochemical modeling would be based on the qualification of the intrinsic chemical reactions and would help to define the parameters of the battery. Generally it is hopeless to use this model in such applications, due to all its complexities [less ▲]

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See detailManagement of Environmental Security Through Organic Agriculture. Contribution of Consumer Behavior
Petrescu, Dacinia Crina; Petrescu-Mag, Ruxandra Malina; Burny, Philippe ULg

in Ozunu, Alexandru (Ed.) The 10th Elsedima International Conference : Book of abstracts “Environmental Legislation, Safety Engineering and Disaster Management”, September 18th-19th, 2014, Cluj-Napoca, Romania : 10th Anniversary (2014)

The paper examines and argues why environmental issues are matters of security, offering conceptual clarifications upon "environmental security". The range of issues considered as "environmental security ... [more ▼]

The paper examines and argues why environmental issues are matters of security, offering conceptual clarifications upon "environmental security". The range of issues considered as "environmental security" subjects are numerous and diverse and one of these is related to food. Food production, storage, distribution and quality have always been linked to environ mental conditions. Food security through organic agriculture contributes to environ mental security. Scientists often point to three factors as responsible for environ mental state - population, technology, and consumption, but consumption seems to get the least attention. We studiad consumer behaviour as source of positive and negative consequences with impact on environmental security. The study case presents the results of a survey targeted on organic food consumers from NW Romania. We found that 73% of subjects believe that organic food helps protecting the environ ment more than conventional food and 60% believe that animal organic food comes from animais that had better life (than conventional ones). We found a statistically significant difference between people who believe humanity faces natural environ ment problems which are very threatening and those who do not concerning the strength of beliefs that organic food helps protecting the environment more than conventional food (p<O.05). We observed a direct, strong relationship between the strength of beliefs that organic food has capacity to preserve existence of traditional products and strength of beliefs that organic food has the capacity to protect natural environ ment [r=.506, p=.OOO]. The paper defends the idea that consumers' beliefs such as those related to nature protection or animal welfare through organic food are valuable instruments that help to strengthen the environ mental security. [less ▲]

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See detailManagement of familial hypercholesterolemia in children and young adults: Consensus paper developed by a panel of lipidologists, cardiologists, paediatricians, nutritionists, gastroenterologists, general practitioners and a patient organization.
Descamps, O. S.; Tenoutasse, S.; Stephenne, X. et al

in Atherosclerosis (2011), 218(2), 272-80

Since heterozygous familial hypercholesterolemia (HeFH) is a disease that exposes the individual from birth onwards to severe hypercholesterolemia with the development of early cardiovascular disease, a ... [more ▼]

Since heterozygous familial hypercholesterolemia (HeFH) is a disease that exposes the individual from birth onwards to severe hypercholesterolemia with the development of early cardiovascular disease, a clear consensus on the management of this disease in young patients is necessary. In Belgium, a panel of paediatricians, specialists in (adult) lipid management, general practitioners and representatives of the FH patient organization agreed on the following common recommendations. Conclusion: The aim of this consensus statement is to achieve more consistent management in the identification and treatment of children with HeFH in Belgium. [less ▲]

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See detailManagement of Fulminant Hepatic Failure
Detry, Olivier ULg; Honore, Pierre ULg; Meurisse, Michel ULg et al

in Acta Chirurgica Belgica (1998), 98(6), 235-40

Fulminant hepatic failure is an infrequent but dreadful disease, occurring usually in young patients. Despite fulminant hepatic failure is reversible in most of the cases, some patients develop brain ... [more ▼]

Fulminant hepatic failure is an infrequent but dreadful disease, occurring usually in young patients. Despite fulminant hepatic failure is reversible in most of the cases, some patients develop brain edema and intracranial hypertension, which are the most common cause of death in these patients. Liver transplantation significantly improves the prognosis of selected patients in who precise criteria predict a low chance of survival. This review summarizes the modern standard of care of patients with fulminant hepatic failure, with particular underlining of the management of brain oedema and intracranial hypertension. [less ▲]

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See detailManagement of glucocorticoid-induced osteoporosis
Rizzoli, R.; Adachi, J. D.; Cooper, C. et al

in Calcified Tissue International (2012), 91(4), 225-243

This review summarizes the available evidence-based data that form the basis for therapeutic intervention and covers the current status of glucocorticoid-induced osteoporosis (GIOP) management, regulatory ... [more ▼]

This review summarizes the available evidence-based data that form the basis for therapeutic intervention and covers the current status of glucocorticoid-induced osteoporosis (GIOP) management, regulatory requirements, and risk-assessment options. Glucocorticoids are known to cause bone loss and fractures, yet many patients receiving or initiating glucocorticoid therapy are not appropriately evaluated and treated. An European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis workshop was convened to discuss GIOP management and to provide a report by a panel of experts. An expert panel reviewed the available studies that discussed approved therapeutic agents, focusing on randomized and controlled clinical trials reporting on bone mineral density and/or fracture risk of at least 48 weeks' duration. There is no evidence that GIOP and postmenopausal osteoporosis respond differently to treatments. The FRAX algorithm can be adjusted according to glucocorticoid dose. Available antiosteoporotic therapies such as bisphosphonates and teriparatide are efficacious in GIOP management. Several other agents approved for the treatment of postmenopausal osteoporosis may become available for GIOP. It is advised to stop antiosteoporotic treatment after glucocorticoid cessation, unless the patient remains at increased risk of fracture. Calcium and vitamin D supplementation as an osteoporosis-prevention measure is less effective than specific antiosteoporotic treatment. Fracture end-point studies and additional studies investigating specific subpopulations (pediatric, premenopausal, or elderly patients) would strengthen the evidence base and facilitate the development of intervention thresholds and treatment guidelines. © Springer Science+Business Media, LLC 2012. [less ▲]

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See detailManagement of high blood pressure in peripheral arterial disease
Krzesinski, Jean-Marie ULg

in Acta Chirurgica Belgica (2005), 105

Arterial hypertension (HTA) is a promoter of peripheral arterial disease (PAD) in association with other atherosclerotic risk factors factors. Systolic HTA is the most frequently noted form in such ... [more ▼]

Arterial hypertension (HTA) is a promoter of peripheral arterial disease (PAD) in association with other atherosclerotic risk factors factors. Systolic HTA is the most frequently noted form in such disease, secondary to marked increase in large artery siffness. The existence of PAD confers on the hypertensive patient a very high cardiovascular (CV) risk, requiring an intensive global therapeutical approach. Treating HTA is one of such beneficial actions. The optimal blood pressure (BP) to be reached is at least < 140/90 mmHg but lower BP should be targeted if possible (< or = 130/80 mmHg). First of all, a modification of the lifestyle and diet should be proposed. But to reach such a low target, different antihypertensive agents must be very often used in association. The inhibitors of the renin-angiotensin system constitute one of the main axis of such drug treatment, after having avoided the pitfall of renal artery stenosis. [less ▲]

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See detailManagement of high turnover osteoporosis with calcitonin
Reginster, Jean-Yves ULg

in Osteoporosis Digest (1995), 3

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See detailManagement of High Turnover Osteoporosis with Calcitonin
Reginster, Jean-Yves ULg

in BONE (1992), 13(Suppl 2), 37-40

Osteoporosis, associated with a high turnover of bone and acute bone loss, occurs in a number of clinical models, such as following prolonged steroid therapy, extremity and spinal immobilisation, and ... [more ▼]

Osteoporosis, associated with a high turnover of bone and acute bone loss, occurs in a number of clinical models, such as following prolonged steroid therapy, extremity and spinal immobilisation, and often is associated with fracture. Confinement to bed and subsequent hypodynamism relating to the pain following a vertebral fracture may activate the process of high bone turnover and acute bone loss. In postmenopausal women, the acute bone loss resulting from such clinical pictures may be superimposed on to the natural course of bone loss occurring in many postmenopausal women. Salmon calcitonin, a potent inhibitor of osteoclast activity, has been shown to prevent bone loss in all clinical models of acute bone loss due to increased bone turnover and osteoclastic resorption. In addition, salmon calcitonin has a potent analgesic effect, thereby causing a reduction in bone pain and improvement in functional capacity. For these reasons, calcitonin remains a first-line therapy in bone loss related to a hyper-resorptive state. [less ▲]

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See detailManagement of hypercalcemia from Parathyroid Carcinoma by immunisation
Betea, Daniela ULg; Bradwell, A. R.; Valdes Socin, Hernan Gonzalo ULg et al

in The Endocrine Society's 84th Annual Meeting - Abstract book (2002)

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See detailManagement of hypercalcemia from Parathyroid Carcinoma by immunisation
Betea, Daniela ULg; Bradwell, A. R.; Valdes Socin, Hernan Gonzalo ULg et al

in 6th European Congress of Endocrinology - Abstract book (2003)

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See detailManagement of hyperlactataemia in bovine medicine
Vandeputte, Sébastien ULg

in Point Vétérinaire (2007), 38(280), 47-51

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See detailManagement of inflammatory bowel disease in pregnancy.
Vermeire, Séverine; Carbonnel, Franck; Coulie, Pierre et al

in Journal of Crohn’s and Colitis [=JCC] (2012), 6(8), 811-23

BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) is a chronic disease affecting mainly young people in their reproductive years. IBD therefore has a major impact on patients' family planning ... [more ▼]

BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) is a chronic disease affecting mainly young people in their reproductive years. IBD therefore has a major impact on patients' family planning decisions. Management of IBD in pregnancy requires a challenging balance between optimal disease control and drug safety considerations. This article aims to provide a framework for clinical decision making in IBD based on review of the literature on pregnancy-related topics. METHODS: Medline searches with search terms 'IBD', 'Crohn's disease' or 'ulcerative colitis' in combination with keywords for the topics fertility, pregnancy, congenital abnormalities and drugs names of drugs used for treatment of IBD. RESULTS: IBD patients have normal fertility, except for women after ileal pouch-anal anastomosis (IPAA) and men under sulfasalazine treatment. Achieving and maintaining disease remission is a key factor for successful pregnancy outcomes in this population, as active disease at conception carries an increased risk of preterm delivery and low birth weight. Clinicians should discuss the need for drug therapy to maintain remission with their patients in order to ensure therapy compliance. Most IBD drugs are compatible with pregnancy, except for methotrexate and thalidomide. If possible, anti-TNF therapy should be stopped by the end of the second trimester and the choice of delivery route should be discussed with the patient. CONCLUSIONS: Disease control prior to conception and throughout pregnancy is the cornerstone of successful pregnancy management in IBD patients. [less ▲]

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See detailManagement of low back pain and the working environment
Mairiaux, Philippe ULg

in PREMUS 2010, Book of Abstracts (2010)

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See detailManagement of low back pain by occupational health physicians - the belgian guidelines
Mairiaux, Philippe ULg; Mazina, D. ULg

in Proceedings ICOH 2009 (2009, March)

Introduction With the support of the Belgian Health Care Knowledge Centre (KCE), a systematic review of the EBM literature concerning the management of low back pain (LBP) patients in the occupational ... [more ▼]

Introduction With the support of the Belgian Health Care Knowledge Centre (KCE), a systematic review of the EBM literature concerning the management of low back pain (LBP) patients in the occupational health (OH) context has been undertaken in order to issue good practices recommendations for occupational physicians (OP). Methods The guidelines development proceeded in three steps. First, an electronic search was performed to retrieve relevant guidelines and systematic reviews (SR) from 8 international databases. The identified guidelines were appraised using the AGREE method, while SR’s were appraised using the Cochrane Collaboration grid: 7 guidelines and 27 SR’s were selected. A draft of the intended Belgian guidelines was then validated by a group of Belgian OH experts. In a third step, the guidelines were adapted in a more practical format, thanks to a working group involving OP’s coming from 12 OH services and medical advisors (MA) from the sickness funds. Results Two documents have been published with the support of the Belgian Ministry of Labor. The guidelines document (50 p) summarizes the scientific evidence according to the OP main missions : background information to be given to employers and employees, evidence-based prevention policies to promote in the enterprises. As regard the health surveillance of workers, the guidelines consider three situations: periodic health surveillance, spontaneous examinations at the worker request, and return to work examinations after long duration sick leaves. Secondly, a management guide (19 p) is intended for employers and trade unions representatives. Discussion From a health care policy point of view, this study highlighted the major roles of the occupational physician and of the sickness funds medical adviser and stressed the need to better define those roles if decision makers want to tackle the low back pain problem and the economic consequences of the related sick leave. [less ▲]

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See detailManagement of metabolic syndrome and associated cardiovascular risk factors.
De Flines, Jenny ULg; Scheen, André ULg

in Acta Gastro-Enterologica Belgica (2010), 73(2), 261-6

Patients with metabolic syndrome have a 1.5- to 3-fold increase in the risk of coronary heart disease and stroke. The association between metabolic syndrome and cardiovascular diseases raises important ... [more ▼]

Patients with metabolic syndrome have a 1.5- to 3-fold increase in the risk of coronary heart disease and stroke. The association between metabolic syndrome and cardiovascular diseases raises important questions about the underlying pathological processes, especially for designing targeted therapeutic interventions. Cardiovascular risk reduction in individuals with metabolic syndrome should include at least three levels of interventions: 1) control of obesity, unhealthy diet and lack of physical activity; 2) control of the individual components of metabolic syndrome, especially atherogenic dyslipidaemia, hypertension, dysglycaemia and prothrombotic state; and 3) control of insulin resistance, a defect closely linked to metabolic syndrome. Metabolic syndrome generally precedes and is often associated with type 2 diabetes. Because of this intimate relationship, appropriate management of metabolic syndrome should be able to prevent the progression from impaired glucose tolerance to frank diabetes and thus to prevent type 2 diabetes, another important cardiovascular risk factor. The importance of prevention of diabetes in high-risk individuals (such as people with metabolic syndrome are) is highlighted by the substantial and worldwide increase in the prevalence of type 2 diabetes in recent years. Owing to the complex pathophysiology and phenotypic expression of metabolic syndrome, lifestyle changes are crucial as they are able to positively and simultaneously influence almost all components of the syndrome. If such measures are not sufficient or not adequately followed, a pharmacological intervention may be considered. However, no official guidelines are available yet concerning the pharmacological management of individuals with metabolic syndrome. [less ▲]

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