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See detailManagement of patent foramen ovale in cryptogenic stroke.
Budts, Werner; Legrand, Victor ULg; Peeters, Andre et al

in Acta cardiologica (2012), 67(1), 3-9

There is currently no consensus on the optimal management of cryptogenic stroke in the presence of a patent foramen ovale (PFO). Some physicians do not believe in the added value of PFO closure in ... [more ▼]

There is currently no consensus on the optimal management of cryptogenic stroke in the presence of a patent foramen ovale (PFO). Some physicians do not believe in the added value of PFO closure in cryptogenic stroke, whereas, for others, cryptogenic stroke represents a situation where PFO closure would be the best management. Because of a lack of well-designed randomized trials, guidelines do not provide a clear answer. Therefore, the cardiological and neurovascular societies in Belgium decided to write an attempt at an expert opinion paper. [less ▲]

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See detailThe management of patients with mild hepatitis C
Verslype, C.; Michielsen, P.; Adler, M. et al

in Acta Gastro-Enterologica Belgica (2005), 68(3), 314-318

Infection with the hepatitis C virus (HCV) represents an important public health problem and is a leading cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma. Chronic hepatitis C is a ... [more ▼]

Infection with the hepatitis C virus (HCV) represents an important public health problem and is a leading cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma. Chronic hepatitis C is a heterogeneous disease. Many patients have mild disease at presentation but not all of them will develop advanced liver disease. However, the identification of these patients with mild hepatitis C who will show progressive disease is difficult and is based on histological criteria and the assessment of co-factors (age, alcohol intake, steatosis). In addition, serum transaminases that are persistently normal on several occasions during 18 months may point to a more benign course. Patients with mild hepatitis C should not be excluded "a priori" from the possibility of being treated, as treatment with pegylated interferon and ribavirin is safe and effective in this group. Overall, the decision to initiate therapy should be individualized and based on the severity of the disease by liver biopsy, the potential of serious side effects, the probability of response and the motivation of the patient. [less ▲]

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See detailManagement of patients with Paget's disease: a consensus document of the Belgian Bone Club.
Devogelaer, Jean-Pierre; Bergmann, Pierre; Body, Jean-Jacques et al

in Osteoporosis International (2008), 19(8), 1109-17

Paget's disease of bone (PDB) is a potentially crippling condition. Pain, fracture, spinal stenosis, nerve entrapment, vascular steal syndrome, secondary osteoarthritis, bone deformity, dental problems ... [more ▼]

Paget's disease of bone (PDB) is a potentially crippling condition. Pain, fracture, spinal stenosis, nerve entrapment, vascular steal syndrome, secondary osteoarthritis, bone deformity, dental problems, deafness, excessive bleeding during orthopaedic surgery, rare sarcomatous degeneration, and hypercalcaemia constitute complications that may impair the quality of life. The therapeutic approach varies from symptomatic (analgesics, anti-inflammatory drugs) to more specific drugs such as increasingly potent bisphosphonates. Studies such as the PRISM study should in the future help to determine the superiority or not of aggressive treatment over symptomatic treatment in the prevention of complications. Various oral and/or intravenous (i.v.) bisphosphonates have been tested and are currently on the market. The most recently available nitrogen-containing bisphosphonate, i.v. zoledronic acid, is the most potent therapy available for the treatment of PDB. Its therapeutic efficacy, its long-term effect on biologic activity and its good tolerance currently supports its use as a first-line therapeutic option in patients suffering from PDB. [less ▲]

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See detailThe management of postmenopausal osteoporosis: a position paper of the world health origination collaborating center on public health aspects of rheumatic diseases
Delmas, Pierre D; Khaltaev, N.; Arriagada, M. et al

in Osteoporosis International (2005, March), 16(Suppl.3), 47

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See detailThe Management of Postmenopausal Osteoporosis: A Position Paper of the World Health Origination Collaborating Center on Public Health Aspects of Rheumatic Diseases
Delmas, P. D.; Khaltaev, N.; Arriagada, M. et al

in Journal of Musculoskeletal & Neuronal Interactions (2005), 5(2), 105-9

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See detailManagement of Recipients of Hepatic Allografts Harvested from Donors with Malignancy Diagnosed Shortly after Transplantation
Detry, Olivier ULg; Honore, Pierre ULg; Jacquet, Nicolas et al

in Clinical Transplantation (1998), 12(6), 579-81

Transmission of undiagnosed malignancy with the graft is a dramatic complication of liver transplantation. Alternatives in the management of the recipients of livers, harvested from donors with malignancy ... [more ▼]

Transmission of undiagnosed malignancy with the graft is a dramatic complication of liver transplantation. Alternatives in the management of the recipients of livers, harvested from donors with malignancy diagnosed shortly after transplantation, are either early re-transplantation or close follow-up without re-operation. We reported 4 cases of liver recipients whose allografts were harvested from donors who were diagnosed with malignancy shortly after the liver transplantation. One recipient underwent re-transplantation, and the three other allografts were not removed. No recipient developed recurrence in the follow-up. While graft removal may be the only way to avoid tumor recurrence in recipients of liver graft harvested from donor with malignancy, close follow-up without re-operation may also be considered. The risk of tumor transferral may depend on the histopathological aggressiveness and metastatic potential of the donor tumor, and may be low for low-grade, local tumors. This risk should be evaluated by analyzing large series, using databases of Eurotransplant or United Network for Organ Sharing. [less ▲]

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See detailThe management of rectal cancer in Belgium: a survey of our practice
Vanderick, JEAN ULg; BEAUDUIN; DENEUFBOURG et al

in Acta gastro-enterologica belgica (2004), 67(1), 9-13

In 1995, a Peer Review Commission Radiotherapy was installed at the initiative of the Belgian Ministry of Health as part of a larger pilot project on quality assurance. This commission was composed of 14 ... [more ▼]

In 1995, a Peer Review Commission Radiotherapy was installed at the initiative of the Belgian Ministry of Health as part of a larger pilot project on quality assurance. This commission was composed of 14 members, 8 radiation oncologists (appointed by the Belgian Association of Radiation Oncology) and 6 physicists (appointed by the Belgian Association of Hospital Physicists). Peer review is only one of the activities within the Quality control of the medical performance aiming to improve quality in diagnostic and therapeutic procedures. Other activities in Quality assurance are development of standards and guidelines, continuous education and measurements of the treatment process. In 1998, the Peer review Commission Radiotherapy has proposed to make a survey of rectal cancer management including diagnostic procedures and therapeutic approaches. More than 1300 questionnaires were sent to the chairman of the 25 Belgian radiotherapy departments, asking them to have it filled in by the radiation oncologist in charge of rectal cancer treatment in their department and to all the known surgeons from a list provided by the Ministry of Health. The paper reports and discuss the results of this survey. [less ▲]

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See detailManagement of recurrent or persistent stress urinary incontinence after TVT-O by mesh readjustment
De Landsheere, Laurent ULg; Lucot, J. P.; Foidart, Jean-Michel ULg et al

in International Urogynecology Journal & Pelvic Floor Dysfunction (2010), 21(11), 1347-51

Introduction and hypothesis The aim of this study was to evaluate, retrospectively, the place of sub-urethral mesh readjustment when treating recurrent stress urinary incontinence (SUI) after TVT-O ... [more ▼]

Introduction and hypothesis The aim of this study was to evaluate, retrospectively, the place of sub-urethral mesh readjustment when treating recurrent stress urinary incontinence (SUI) after TVT-O. Methods Between August 2006 and August 2008, eight patients had recurrent or persistent SUI. They were treated surgically by tightening the pre-implanted sling. Results Medium delay between first surgery and mesh adjustment was 6 months. One patient needed a second TVT-O for rupture of the pre-implanted mesh during adjustment. Among the seven patients who underwent a mesh readjustment, three were cured, three improved, there was one failure. Mean follow-up was 25 months. Conclusions The sub-urethral mesh readjustment is a simple and safe procedure for patients with recurrent SIU after TVT-O procedure. Success rates are high, surgery minimally invasive but long-term follow-up is needed to evaluate efficiency. [less ▲]

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See detailManagement of root perforations using MTA with or without Er:YAG laser irradiation: An in vitro study
Tielemans, Marc; Saloukas, I.; Heysselaer, D. et al

in International Journal of Dentistry (2012)

The aim of this in vitro study is to compare the microleakage of a root perforation sealed with MTA (mineral trioxide aggregate) (group M) to that sealed with MTA following Er:YAG laser irradiation (group ... [more ▼]

The aim of this in vitro study is to compare the microleakage of a root perforation sealed with MTA (mineral trioxide aggregate) (group M) to that sealed with MTA following Er:YAG laser irradiation (group ML). Forty-two recently extracted human monoroot teeth were used. Two cavities were prepared on each root surface. Randomly, on each root, the exposed dentine of one cavity was irradiated prior to MTA filling using an Er:YAG laser with the following settings: 200 mJ/pulses under an air water spray, 10Hz, pulse duration of 50sec, and 0.7mm beam diameter. All cavities were then sealed with MTA. submitted to thermocycling and immersed in 2 methylene blue dye solution for 12h. The penetration of methylene blue in the microleakage of cavity was observed and recorded. The mean value dye penetration in cavities sealed with MTA following Er:YAG laser irradiation (23.91 14.63 ) was lower than that of unlased cavities sealed only with MTA (25.17 17.53 ). No significant difference was noted. The use of an Er:YAG laser beam for dentinal conditioning prior to MTA filling of perforated roots did not decrease significantly the microleakage of MTA sealing when compared to the conventional use of MTA filling. Copyright © 2012 M. Tielemans et al. [less ▲]

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See detailManagement of severe preeclampsia
Brichant, Géraldine ULg; Dewandre, Pierre-Yves ULg; Foidart, Jean-Michel ULg et al

in Acta Clinica Belgica (2010), 65(3), 163-169

Features of severe preeclampsia include severe proteinuric hypertension and symptoms of central nervous system dysfunction, hepatocellular injury, thrombocytopenia, oliguria, pulmonary oedema ... [more ▼]

Features of severe preeclampsia include severe proteinuric hypertension and symptoms of central nervous system dysfunction, hepatocellular injury, thrombocytopenia, oliguria, pulmonary oedema, cerebrovascular accident and severe intrauterine growth restriction. Women with severe preeclampsia must be hospitalized to confirm the diagnosis, to assess the severity of the disease, to monitor the progression of the disease and to try to stabilize the disease. Severe preeclampsia may be managed expectantly, in selected cases. The objective of expectant management in these patients is to improve neonatal outcome. Expectant management is based on antihypertensive treatment and prevention of end organ dysfunction. Antihypertensive treatment improves maternal outcome but has the potential to be deleterious for the foetus. Plasma volume expansion has been suggested for severe preeclampsia but trials failed to show any benefit. Magnesium sulfate is the anticonvulsivant of choice to treat or prevent eclampsia when indicated. Antenatal corticosteroids are recommended in severely preeclamptic women with 26-34 weeks gestation. Timing of delivery is based upon gestational age, severity of preeclampsia, maternal and foetal risks. [less ▲]

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See detailManagement of small woods in Belgium.
Rondeux, Jacques ULg

in Quarterly Journal of Forestry (1991), 85(1), 37-42

In Belgium, forest occupies 20 per cent of the total land area. Private forests account for about 52 per cent; they are generally small (averaging about three ha) and their owners are not accustomed to ... [more ▼]

In Belgium, forest occupies 20 per cent of the total land area. Private forests account for about 52 per cent; they are generally small (averaging about three ha) and their owners are not accustomed to basing their decisions on a management plan. However, some attempts to develop co-operation through forestry associations exist and the regional authorities tend to encourage them. Whatever the details of any possible future legislation may be, the principal aim must be the development and introduction of an extremely simple form of management plan (the so-called 'plan simple de gestion') in exchange for assistance to the private owner. [less ▲]

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See detailThe Management of Social Enterprises
Mertens de Wilmars, Sybille ULg

Conference (2009, October 02)

This presentation describes the ways in which social enterprises are managed in order to successfully combine social mission and economic activities.

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See detailManagement of soils polluted by heavy metals in cultivated areas : which kind of bioremediation ?
Schvartz, Christian; Zu, Yanqun; Douay, Francis et al

Conference (2006)

Within the periurban areas of big cities, soils are often contaminated by heavy metals spread by human activity: atmospheric fallouts due to industry and traffic, recycling of urban wastes (directly or ... [more ▼]

Within the periurban areas of big cities, soils are often contaminated by heavy metals spread by human activity: atmospheric fallouts due to industry and traffic, recycling of urban wastes (directly or after water treatment), fertilizers and pesticides used in agriculture… This is, among others, verified in the surroundings of Kunming (Yunnan, PR China) and Lille (Nord-Pas de Calais, France), areas with high density of population and traditional metallurgical industries. These areas have also intensive agricultural activities characterized by important vegetable productions, and are generally known as the "green belts" of the cities. These cultures, with short vegetative period, need high biodisponibility of nutrients, biodisponibility which may also occur for other unwanted elements existing in the soil, such as heavy metals. For evident human health reasons the quality of the crops must be ensured and their heavy metal content kept as low as possible, at least under the values of relevant legal thresholds. Thus, vegetables are particularly sensitive to the presence of heavy metals in the soils where they are growing. It is therefore necessary to manage these soils in order to preserve public health or, more basically, the income of the farmers, as contaminated vegetables would not be marketable. Thus, for these large areas contaminated by diffuse pollution, bioremediation looks to be appropriate. But the kind of the bioremediation which will be applied has to be adapted to the severity of the soil pollution and to the intended land use. In this project, we have assessed the contents of Pb, Cd, Zn and Cu of soils and vegetables within the Chenggong county (near Kunming), and compared the results to the already known situation of the surroundings of two lead and zinc smelters located close to Lille. Then goals and ways of bioremediation have been discussed and the first steps of implementation experimented. [less ▲]

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

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

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See detailThe management of temporal constraints in naturalistic decision making: The case of anesthesia
De Keyser, Véronique ULg; Nyssen, Anne-Sophie ULg

in Klein, G.; Salas, E. (Eds.) Linking expertise and naturalistic decision making (2001)

Explores weather temporal expertise can be acquired using simulators. This chapter addressed that issue and focuses on three types of competence: dynamic diagnosis, anticipation and planification, and ... [more ▼]

Explores weather temporal expertise can be acquired using simulators. This chapter addressed that issue and focuses on three types of competence: dynamic diagnosis, anticipation and planification, and synchronization. All of them are important for situativeness and rely on duration, order, and temporal perspectives. All of them are potential sources of errors and accidents. The domain covered by this chapter is anesthesia. [less ▲]

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See detailManagement of the metabolic syndrome.
Scheen, André ULg

in Minerva Endocrinologica (2004), 29(2), 31-45

The metabolic syndrome (MetS) is strongly associated with insulin resistance and consists of a constellation of factors that raise the risk for cardiovascular diseases and diabetes mellitus. Therefore ... [more ▼]

The metabolic syndrome (MetS) is strongly associated with insulin resistance and consists of a constellation of factors that raise the risk for cardiovascular diseases and diabetes mellitus. Therefore, the primary goals of treating MetS are prevention of type 2 diabetes and cardiovascular events. Three levels of intervention may be considered for individuals with MetS : 1) management of underlying risk conditions by controlling weight excess, enhancing regular physical exercise and promoting healthy diet; 2) management of individual risk factors such as dyslipidaemia, hypertension, hyperglycaemia and prothrombotic state; and 3) targeting insulin resistance by using specific insulin sensitizers such as thiazolidinediones. The most important therapeutic intervention effective in subjects with MetS should focus on modest weight reduction and regular leisure-time physical activities. Although lifestyle modification is the first-line therapy, drug therapy may be necessary in many patients to achieve recommended goals regarding lipid profile, blood pressure and blood glucose control. Rather than to use a magic bullet that might fully reverse the underlying cause of the syndrome, one appealing alternative would be to use a so-called "polypill" targeting each of the components of MetS. However, such a polypill should ideally contain numerous molecules that all have shown a potential interest for the management of MetS such as metformin, acarbose, a thiazolidinedione, a statin, a fibrate, an inhibitor of the renin-angiotensin system, aspirin. The growing prevalence and high-risk nature of MetS highlights the need to identify individuals with this condition and to treat them with an aggressive multitargeted approach. [less ▲]

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See detailManagement of the unstable cervical spine: elective versus emergent cases.
Bonhomme, Vincent ULg; Hans, Pol ULg

in Current Opinion in Anaesthesiology (2009), 22(5), 579-85

PURPOSE OF REVIEW: The present review focuses on similarities and discrepancies in the management of emergent and elective unstable cervical spine (C-spine) patients. RECENT FINDINGS: During mobilization ... [more ▼]

PURPOSE OF REVIEW: The present review focuses on similarities and discrepancies in the management of emergent and elective unstable cervical spine (C-spine) patients. RECENT FINDINGS: During mobilization, lifting is superior to rolling in limiting spine movements. Before prone position surgery, the transfer of the patient on a rotating table is preferable to rolling. In trauma patients, helical computed tomography (CT) with sagittal reconstruction is the first choice for clearing the C-spine. In those patients, airway compromise may be related to hidden cervical edema or hematoma. Several devices can be of help in performing safe tracheal intubation in patients with limited neck movements, but awake fiberoptic intubation remains the safest procedure. The muscle relaxant antagonist sugammadex can improve safety for rapid sequence induction. It can rapidly reverse profound steroid-based neuromuscular blockade and allows avoidance of succinylcholine in this indication. Propofol anesthesia better prevents coughing upon emergence than inhaled anesthesia. Neuroprotection in cord-damaged patients is disappointing, and the controversy on the efficacy of high-dose methylprednisolone is not closed. Nevertheless, maintenance of homeostasis remains the cornerstone of neuroprotection. SUMMARY: Subtle details differentiate the management of emergent and elective unstable C-spine patients. In both situations, the presence or the absence of a neurological insult governs the therapeutic strategy. [less ▲]

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See detailManagement of ventilatory supports in adult respiratory distress syndrome (ARDS)
Lamy, Maurice ULg

in Akutes progressives lungenversagen. Acute respiratory failure (1978)

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