The Management of Immigration Related Cultural Diversity in Federal Countries
in Fédéralisme - Régionalisme (2015), 15Detailed reference viewed: 24 (4 ULg)
Management of inflammatory bowel disease in pregnancy.
; ; 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 ▲]Detailed reference viewed: 53 (7 ULg)
Management of low back pain and the working environment
in PREMUS 2010, Book of Abstracts (2010)Detailed reference viewed: 24 (4 ULg)
Management of low back pain by occupational health physicians - the belgian guidelines
Mairiaux, Philippe ; Mazina, D.
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 ▲]Detailed reference viewed: 60 (2 ULg)
Management of metabolic syndrome and associated cardiovascular risk factors.
De Flines, Jenny ; Scheen, André
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 ▲]Detailed reference viewed: 64 (5 ULg)
MANAGEMENT OF MICROBIAL COMMUNITIES ON THE BASIS OF SINGLE CELL TECHNOLOGIES: APPLICATION TO CELLULOSE DEGRADATION AND BIOFILM FORMATION
Doctoral thesis (2016)Detailed reference viewed: 18 (6 ULg)
Management of Microsporum canis feline dermatophytosis: illustration with a clinical case in a persian cat
; ; et al
Conference (2000)Detailed reference viewed: 20 (6 ULg)
Management of multiple valve disease.
; ; et al
in Heart (British Cardiac Society) (2011), 97(4), 272-7
Multivalvular heart disease is not an uncommon situation, but the paucity of data for each specific situation does not allow the proposal of a standardised, evidence-based management strategy. This paper ... [more ▼]
Multivalvular heart disease is not an uncommon situation, but the paucity of data for each specific situation does not allow the proposal of a standardised, evidence-based management strategy. This paper aims at reviewing the available evidence on the management of multivalvular disease, taking into account the interactions between different valve lesions, the diagnostic pitfalls and the strategies that should be considered in the presence of multiple valvular disease. [less ▲]Detailed reference viewed: 11 (0 ULg)
Management of myiasis: current status and future prospects
; ; et al
in Veterinary Parasitology (2004), 125(1-févr Sp. Iss. SI), 93-104
The management of myiasis in livestock has been an example of the success of modem chemical approaches for parasite control, yet in some cases remains extremely intractable, requiring the development of ... [more ▼]
The management of myiasis in livestock has been an example of the success of modem chemical approaches for parasite control, yet in some cases remains extremely intractable, requiring the development of novel strategies. In addition, the growing and urgent need to develop integrated strategies that enhance the sustainability of livestock production systems drives the search for new techniques [see Int. J. Parasitol. 29 (1999) 7]. The following summary represents a synthesis of a symposium presented at the 19th International Conference of the World Association for the Advancement of Veterinary Parasitology, New Orleans, USA, 10-14 August 2003. The coverage began with a review of the need for more subtle economic analysis of the impact of myiasis based on the use of the sterile insect technique (SIT) for control of bovine hypodermosis in North America. This was followed by a review of the status of chemical control with particular emphasis on the macrocyclic lactones. The outcome of the use of these compounds in a regulated control program for eradication of bovine hypodermosis in EU was surveyed. Similarly, the success of the screwworm eradication program, using the sterile insect technique has shown how effective this approach can be given the appropriate target. Several aspects of the development of newer approaches were surveyed in discussion of newer chemical control products, development of vaccines, use of host genetics, use of predictive simulation modelling and trapping for monitoring and control and the development of new diagnostic approaches for occult infestations. Finally, use of the latest molecular tools for identification of larvae causing myiasis and their use for the identification of species coming from different and distant geographical areas to colonize regions where they have been eradicated was reviewed. [less ▲]Detailed reference viewed: 60 (7 ULg)
Management of night-only electricity meters
Master's dissertation (2014)
In this Master’s thesis, the influence of PhotoVoltaic (PV) panels on the distribution network is explained and related available solutions are also mentioned. We focus on a solution which consists of ... [more ▼]
In this Master’s thesis, the influence of PhotoVoltaic (PV) panels on the distribution network is explained and related available solutions are also mentioned. We focus on a solution which consists of optimally using flexible loads. We consider a price signal with two settings: off- peak tariff and on-peak tariff. Some suitable loads are connected to specific electricity meters, called ‘night-only meters,’ which allow the consumption of power only in off-peak periods. We describe the meters’ characteristics and the suitable loads. We also discuss the aspects related to the practical implementation. Historically, off-peak periods were located during the night and on-peak periods during the day. Changing the assignment of off-peak periods is an easy method for distribution system operators to access to the flexibility of small consumers. This solution can be implemented quickly as the infrastructure needed already exists. We propose a mixed-integer linear model to assign optimally the off-peak hours so as to maximize a social welfare. This welfare gathers together the cost of electricity, the financial losses due to energy curtailments of PV installations and the loads’ wellbeing. Our model considers automatic tripping of inverters and constraints of the electrical distribution networks. We target night-only meters, but an extension to dual-hourly meters is also presented. The results compare the application of the classical pattern against the optimal one for summer and winter days, the influence of the available variable power for a summer day, and the use of a monthly-optimal pattern against the classical one for a summer month. The new disposition of off-peak hours can reduce by 50% the PV energy curtailed in the summer, and can also help reducing the power flow going through the High-Voltage (HV)/Medium-Voltage (MV) transformer. The document ends by a cost analysis comparing the homes’ money gains in two main cases: classical pattern and monthly-optimal one, for a summer month. For each case, the Distribution System Operator (DSO) either refunds curtailments or not. Four different types of homes are considered: with or without night-only meters, with or without PV. This analysis allows to know rapidly who earns money and who looses money by getting plausible values of electricity bills. [less ▲]Detailed reference viewed: 58 (11 ULg)
Management of non-insulin-dependent diabetes mellitus.
Lefebvre, Pierre ; Scheen, André
in Drugs (1992), 44 Suppl 3
The initial management of non-insulin-dependent diabetes mellitus (NIDDM) should include patient education, dietary counselling and, when feasible, individualised physical activity. It is only when such ... [more ▼]
The initial management of non-insulin-dependent diabetes mellitus (NIDDM) should include patient education, dietary counselling and, when feasible, individualised physical activity. It is only when such measures fail that drug therapy should be considered. Dietary management of NIDDM includes a restriction in calories, and these should be appropriately distributed as carbohydrates, lipids and proteins. Supplementation of the diet with soluble fibre and supplementation with magnesium salts if hypomagnesaemia is demonstrated, is recommended. However, supplementation with fish oils or with fish oil-derived omega-3 fatty acids is not currently recommended. Oral drug therapies used in NIDDM include sulphonylurea derivatives, which are a first-line treatment in patients who are not grossly obese, metformin, which is the treatment of choice for obese patients, and alpha-glucosidase inhibitors such as acarbose, which are used mainly to reduce postprandial blood glucose peaks. These types of drugs can be used alone or in combination. Insulin therapy may be required to achieve adequate control of blood glucose levels in some patients. In several instances, it is suggested that insulin therapy be combined with sulphonylureas (essentially when residual insulin secretion is present), with metformin, or with alpha-glucosidase inhibitors. The treatment of disorders associated with NIDDM, such as obesity, hypertension or hyperlipidaemia, requires particular attention in diabetic patients, since some drugs can adversely affect glycaemic control. Oral drugs for the treatment of NIDDM include sulphonylurea derivatives used in first-line treatment in patients who are not grossly obese, metformin, which is often the treatment of choice for obese patients and, more recently, the alpha-glucosidase inhibitors, such as acarbose, which are effective in reducing the postprandial rise in blood glucose. [less ▲]Detailed reference viewed: 95 (1 ULg)
MANAGEMENT OF NON-SMALL CELL LUNG CANCER
; ; et al
in Revue Médicale de Liège (2015), 70(9), 432-441Detailed reference viewed: 16 (0 ULg)
Management of osteoporosis after multi-risks assessment in French postmenopausal women
Tancredi, Annalisa ; ; et al
in Osteoporosis International (2005, March), 16(Suppl.3), 108Detailed reference viewed: 7 (0 ULg)
Management of osteoporosis in the elderly.
; Bruyère, Olivier ; et al
in Current Medical Research & Opinion (2009), 25(10), 2373-2387
ABSTRACT Background: Osteoporosis is predominantly a condition of the elderly, and the median age for hip fracture in women is approximately 83 years. Osteoporotic fracture risk is multifactorial, and ... [more ▼]
ABSTRACT Background: Osteoporosis is predominantly a condition of the elderly, and the median age for hip fracture in women is approximately 83 years. Osteoporotic fracture risk is multifactorial, and often involves the balance between bone strength and propensity for falling. Objective: To present an overview of the available evidence, located primarily by Medline searches up to April, 2009, for the different management strategies aimed at reducing the risk of falls and osteoporotic fractures in the elderly. Results: Frailty is an independent predictor of falls, hip fractures, hospitalisation, disability and death in the elderly that is receiving increasing attention. Non-pharmacological strategies to reduce fall risk can prevent osteoporotic fractures. Exercise programmes, especially those involving high doses of exercise and incorporating balance training, have been shown to be effective. Many older people, especially the very elderly and those living in care institutions, have vitamin D inadequacy. In appropriate patients and given in sufficient doses, vitamin D and calcium supplementation is effective in reducing both falls and osteoporotic fractures, including hip fractures. Specific anti-osteoporosis drugs are underused, even in those most at risk of osteoporotic fracture. The evidence base for the efficacy of most such drugs in the elderly is incomplete, particularly with regard to nonvertebral and hip fractures. The evidence base is perhaps most complete for the relatively recently introduced drug, strontium ranelate. Non-adherence to treatment is a substantial problem, and may be exacerbated by the requirements for safe oral administration of bisphosphonates. Conclusion: Evidence-based strategies are available for reducing osteoporotic fracture risk in the elderly, and include exercise training, vitamin D and calcium supplementation, and use of evidence-based anti-osteoporotic drugs. A positive and determined approach to optimising the use of such strategies could reduce the burden of osteoporotic fractures in this high-risk group. [less ▲]Detailed reference viewed: 89 (6 ULg)
Management of osteoporosis of the oldest old.
; ; et al
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (2014), 25
This consensus article reviews the diagnosis and treatment of osteoporosis in geriatric populations. Specifically, it reviews the risk assessment and intervention thresholds, the impact of nutritional ... [more ▼]
This consensus article reviews the diagnosis and treatment of osteoporosis in geriatric populations. Specifically, it reviews the risk assessment and intervention thresholds, the impact of nutritional deficiencies, fall prevention strategies, pharmacological treatments and their safety considerations, the risks of sub-optimal treatment adherence and strategies for its improvement. INTRODUCTION: This consensus article reviews the therapeutic strategies and management options for the treatment of osteoporosis of the oldest old. This vulnerable segment (persons over 80 years of age) stands to gain substantially from effective anti-osteoporosis treatment, but the under-prescription of these treatments is frequent. METHODS: This report is the result of an ESCEO (European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis) expert working group, which explores some of the reasons for this and presents the arguments to counter these beliefs. The risk assessment of older individuals is briefly reviewed along with the differences between some intervention guidelines. The current evidence on the impact of nutritional deficiencies (i.e. calcium, protein and vitamin D) is presented, as are strategies to prevent falls. One possible reason for the under-prescription of pharmacological treatments for osteoporosis in the oldest old is the perception that anti-fracture efficacy requires long-term treatment. However, a review of the data shows convincing anti-fracture efficacy already by 12 months. RESULTS: The safety profiles of these pharmacological agents are generally satisfactory in this patient segment provided a few precautions are followed. CONCLUSION: These patients should be considered for particular consultation/follow-up procedures in the effort to convince on the benefits of treatment and to allay fears of adverse drug reactions, since poor adherence is a major problem for the success of a strategy for osteoporosis and limits cost-effectiveness. [less ▲]Detailed reference viewed: 14 (6 ULg)
Management of patent foramen ovale in cryptogenic stroke.
; Legrand, Victor ; 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 ▲]Detailed reference viewed: 29 (0 ULg)
The management of patients with mild hepatitis C
; ; 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 ▲]Detailed reference viewed: 13 (1 ULg)
Management of patients with Paget's disease: a consensus document of the Belgian Bone Club.
; ; 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 ▲]Detailed reference viewed: 19 (0 ULg)
Management of pelvic organ prolapse in French-speaking Belgium: the EPILAPSUS study.
DE LANDSHEERE, Laurent ; ; et al
in Gynecological Surgery (2016), 13(3), 165-172
Management of pelvic organ prolapse (POP) may be conducted by abdominal (laparotomy or laparoscopy) or vaginal approach, with or without mesh repair, mainly depending on the surgeon’s expertise. The aim ... [more ▼]
Management of pelvic organ prolapse (POP) may be conducted by abdominal (laparotomy or laparoscopy) or vaginal approach, with or without mesh repair, mainly depending on the surgeon’s expertise. The aim of this study was to determine the trends in surgical management of POP in French-speaking Belgium. The GGOLFB Gynecologic surgery working group initiated a registry of the patients surgically treated for POP from eight centers in French-speaking Belgium. In this prospective multicentric study, conducted between June 2010 and January 2013, we analyzed the clinical and surgical data, the postoperative results at 4 months, the intra and postoperative complications, and reoperation rates. A total of 394 patients were registered in the database. Surgical POP repair was performed vaginally in 83.5 % of the patients, with prosthetic material in 70.2 % of the cases. In case of abdominal procedure, surgery was mainly (93.5 %) performed by laparoscopic sacrocolpopexy. The most common intraoperative complications were severe bleeding (2.3 %), bladder (2 %), and bowel (0.2 %) injuries. At 4 months, the total reoperation rate was 11.3 %. The anatomical success rate (POP-Q < 2) was 87.5 % with 2.1 % of reoperation for recurrence. Mesh exposure was observed in 9.8 % of the cases. Surgery for stress urinary incontinence (SUI) was reported in 5.1 % of the patients. The analysis of the current urogynecological practice in French-speaking Belgium shows that vaginal mesh repair is the preferential approach used for management of POP in the participating centers. The creation of a national database will help to evaluate the global trends in prolapse surgery and the potential impact of the FDA notification in the management of POP in Belgium. [less ▲]Detailed reference viewed: 13 (1 ULg)
The Management of Postmenopausal Osteoporosis: A Position Paper of the World Health Origination Collaborating Center on Public Health Aspects of Rheumatic Diseases
; ; et al
in Journal of Musculoskeletal & Neuronal Interactions (2005), 5(2), 105-9Detailed reference viewed: 17 (0 ULg)