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See detailRecherche-Développement et transfert des connaissances relatifs à un projet de transport fluvial en Amazonie
Marchal, Jean ULg

in Bulletin des Séances de l’Académie Royale des Sciences d’Outre-Mer = Mededelingen der Zittingen van de Koninklijke Academie voor Overzeese Wetenschappen (2006), n°52

Le projet de « Recherche & Développement » présenté, illustre bien les acquis d’une longue collaboration entre l’Université de Liège et l’Université Centrale de l’Equateur. Une consolidation des résultats ... [more ▼]

Le projet de « Recherche & Développement » présenté, illustre bien les acquis d’une longue collaboration entre l’Université de Liège et l’Université Centrale de l’Equateur. Une consolidation des résultats de tous ces travaux a résidé dans la mise au point d’un programme de formation professionnelle à l’attention des cadres des pays d’Amérique du Sud : ce transfert de connaissances, élément qui renforce la durabilité de cette coopération, et sa méthodologie sont également décrits dans la présente communication. Le projet a pour but d'étudier la faisabilité d'un transport organisé et bien structuré, utilisant les voies navigables de la région du haut Napo afin de lui permettre de relever le défi de développement durable et d'amélioration de la qualité de vie de ses habitants. Ce projet s’inscrit dans un projet plus vaste de développement d’un axe intermodal, utilisant intensivement le mode fluvial, entre l’océan Pacifique et l’océan Atlantique à travers le bassin amazonien [less ▲]

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See detailFEASIBILITY STUDY OF SLUDGE TRANSPORT BY INLAND WATERWAYS
Marchal, Jean ULg; Ndiaye, Alassane-Ballé ULg; Zhang, Zhaomin

in Bulletin de l’Association Internationale Permanente des Congrès de Navigation [Bulletin de l'AIPCN] (2006)

There are significant economic and environmental interests to transport the sludge, which comes from the sewage treatment plants, to the incinerators by inland waterways. Due to the physical and chemical ... [more ▼]

There are significant economic and environmental interests to transport the sludge, which comes from the sewage treatment plants, to the incinerators by inland waterways. Due to the physical and chemical characteristics of the sludge, conventional means of waterway transport meet with the limits and the new technologies should be introduced, especially in the aspects of sludge holding and handling. This paper will introduce briefly the study made for the local communities in the region Walloon (Belgium) to establish such systems of sludge transport by inland waterways. The study covered the handling and holding techniques, the optimal shipping operations, and the socio-economic benefits assessments. [less ▲]

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See detailEffect of atropine-dobutamine stress test on left ventricular echocardio graphic parameters in untrained warmblood horses
Sandersen, Charlotte ULg; Detilleux, Johann ULg; De Moffarts, Brieux et al

in Journal of Veterinary Internal Medicine (2006)

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See detailDéchiffrer Vénus. Renaissance et âge classique
Droixhe, Daniel ULg

in Journal de la Renaissance. IV (2006)

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See detailL'aspirine en prevention primaire des maladies cardio-vasculaires chez le patient diabetique.
Legrand, Delphine ULg; Scheen, André ULg

in Revue Médicale de Liège (2006), 61(10), 682-90

Acetylsalicylic acid (aspirin) is widely used as antiplatelet therapy for the primary and secondary prevention of cardiovascular diseases. However, the effects appear to be different according to the ... [more ▼]

Acetylsalicylic acid (aspirin) is widely used as antiplatelet therapy for the primary and secondary prevention of cardiovascular diseases. However, the effects appear to be different according to the studied population, with a reduction of coronary events in men and, rather, a diminution of strokes in women. Diabetes mellitus markedly increases the risk of cardiovascular diseases, with an especially elevated relative risk among women. We present a detailed analysis of the literature about the efficacy of aspirin in the primary prevention of cardiovascular complications in the diabetic population. Limited available data suggest a lower protection in the diabetic than in the non-diabetic population. A greater aspirin resistance has been suggested in diabetic patents, which might lead to the use of a higher daily dosage of aspirin in diabetic than in non diabetic patients. Whatsoever, aspirin remains the first antiplatelet agent in the diabetic population in all international guidelines of cardiovascular prevention. [less ▲]

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See detailL'étude clinique du mois. L'étude CHARISMA: à la recherche de la meilleure stratégie antiagrégante plaquettaire en prévention cardio-vasculaire.
Scheen, André ULg

in Revue Médicale de Liège (2006), 61(9), 656-61

The CHARISMA ("Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance") trial compared the effects of a dual antiplatelet therapy with clopidogrel plus low dose ... [more ▼]

The CHARISMA ("Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance") trial compared the effects of a dual antiplatelet therapy with clopidogrel plus low dose aspirin with those of a monotherapy with aspirin (75-162 mg/day) on the incidence of cardiovascular events in 15,603 patients at high risk for atherothrombotic events followed for a median of 28 months. The primary efficacy endpoint, a composite of myocardial infarction, stroke, or death from cardiovascular causes, was not significantly different between the two treatment arms. The secondary principal efficacy endpoint, which included all hospitalizations for ischaemic events, was slightly reduced in the group with clopidogrel-aspirin as compared to the group with placebo-aspirin. In a subgroup analysis, among so-called "symptomatico" patients (79 % of the studied population), the dual antiplatelet therapy was associated with a significantly lower incidence of events than aspirin alone, including the primary efficacy end point. On the contrary, in "asymptomatic" patients, such a favourable effect was not observed. Unexpectedly, in this subgroup, a paradoxical increase in the mortality rate was observed with the clopidogrel-aspirin combination. As far as safety was concerned, the risk of severe (difference not significant) and moderate (difference significant) bleeding was higher in patients with the clopidogrel-aspirin combination. In conclusion, acetylsalicylic acid (aspirin) is the first choice drug and the only antiplatelet agent to be used in prvention of cardiovascular disease. In secondary prevention, the addition of clopidogrel may reinforce the cardiovascular protection given by aspirin in "symptomatic" patients, but at the expense of a slightly higher bleeding rate. [less ▲]

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See detailLe diabete de type 1 et la maladie coeliaque.
Mathieu, Sandrine ULg; Stassen, A.; Paquot, Nicolas ULg et al

in Revue Médicale de Liège (2006), 61(9), 637-42

Celiac disease is more prevalent in type 1 diabetic patients than in the general population. The exact reason for this association remains unknown. Two hypotheses are taken into consideration: either a ... [more ▼]

Celiac disease is more prevalent in type 1 diabetic patients than in the general population. The exact reason for this association remains unknown. Two hypotheses are taken into consideration: either a common genetic background or an immune response against Langerhans islets triggered by celiac disease. This review presents recent data about this association and its consequences in clinical practice. [less ▲]

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See detailCoût croissant de l'insulinothérapie en Belgique. De l'analyse critique de la situation a la recherche de solutions pratiques.
Scheen, André ULg

in Revue Médicale de Liège (2006), 61(9), 617-22

Cost related to insulin therapy is markedly increasing in Belgium, as in other Eucopean countries. In the present paper, we will briefly analyze the main reasons for such aa increase, integrate such ... [more ▼]

Cost related to insulin therapy is markedly increasing in Belgium, as in other Eucopean countries. In the present paper, we will briefly analyze the main reasons for such aa increase, integrate such observation withIn the global context of diabetes management and suggest some solutions to provide best care to insulin-treated diabetic patients at a reasonable cost. The rise of the cost of insulin therapy has a multifactorial origin. It mainly results from an increase in the number of diabetic patients, a more intensive management, In both type 1 and type 2 diabetes, and a greater use of more expansive insulin analogues. It is important to analyze the increase of the cost of insulin therapy within the global burden of diabetes melitus. Only a better responsibility of all health care partners, patients, physicians, pharmaceutical companies, public health authorities, could provide solutions allowing diabetic people to profit from best treatments they should receive in order to prevent diabetic complications, by far the main cause of expenses. [less ▲]

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See detailConseils pour une meilleure prescription medicamenteuse.
Scheen, André ULg; Parada, Alberto; Giet, Didier ULg

in Revue Médicale de Liège (2006), 61(5-6), 488-93

The prescription of a pharmacological agent concludes most medical visits. The rational basis of drug prescription by the physician relies on numerous pharmacodynamic, pharmacokinetic, pragmatic and ... [more ▼]

The prescription of a pharmacological agent concludes most medical visits. The rational basis of drug prescription by the physician relies on numerous pharmacodynamic, pharmacokinetic, pragmatic and economic considerations. However, it is a pity to notice that one patient out of two does not strictly follow the pharmacological treatment as it was prescribed. This article analyses some problems of the patient-doctor relationship, which may reduce medication compliance, and provides practical advice for improving such a situation in order to enhance both efficacy and safety of drug prescribing. [less ▲]

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See detailInteractions medicamenteuses: de la theorie a la pratique.
Scheen, André ULg

in Revue Médicale de Liège (2006), 61(5-6), 471-82

Pharmacotherapy becomes increasingly complex and therapeutic targets are more and more ambitious for both care and prevention. Therefore, polypharmacy is frequent, which exposes the patient to a high risk ... [more ▼]

Pharmacotherapy becomes increasingly complex and therapeutic targets are more and more ambitious for both care and prevention. Therefore, polypharmacy is frequent, which exposes the patient to a high risk of drug-drug interactions. These are often underestimated although they are responsible for many adverse events that may be serious and even fatal. In the present paper, we will first briefly recall the main cautions in the use of medications as well as the most common conditions favouring the occurrence of harmful drug interactions. Then, we will analyze the various mechanisms leading to drug interactions, emphasizing especially those involving cytochrome P450 enzymatic system and P-glycoprotein. Finally, we will illustrate these theoretical considerations with some examples of drug interactions, among the most dangerous and the most frequent in clinical practice. [less ▲]

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See detailLa place des micronutriments en medecine.
Paquot, Nicolas ULg; Scheen, André ULg

in Revue Médicale de Liège (2006), 61(5-6), 464-70

Adequate micronutrient intake throughout life course is essential for the maintenance of health. Micronutrients are necessary for the maintenance of intermediary metabolism, play a crucial role as co ... [more ▼]

Adequate micronutrient intake throughout life course is essential for the maintenance of health. Micronutrients are necessary for the maintenance of intermediary metabolism, play a crucial role as co-factors or co-enzymes in the activity of virtually all enzymes, and have important functions to neutralise the deleterious effects of oxidant species. Claims have been made for the benefits of micronutrient supplementation. Clinical benefit of a supplementation is obvious in those individuals who are severely depleted and at risk of complications. More recently, the concept of subclinical deficit has been developed, which essentially relies upon biochemical abnormalities the interpretation of which remains doubtful in most instances. Symptomatology related to such subclinical deficit is non specific and the potential advantages of micronutrient supplements remain marginal and largely not well-established. In contrast, provision of excess supplements to individuals who do not need them may be harmful. In the general population, a well-balanced diet supplies an adequate intake of micronutrient. Further research is needed to identify the best markers of micronutrient and antioxidant status, so that at risk patients can be identified and appropriate supplementation provided accordingly. New large-scale trials of different doses of micronutrients, based on precise outcome markers, are required to optimise intakes in different groups of patients as well as in the general population. [less ▲]

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See detailEffets du glimepiride (Amarylle) chez le patient diabétique de type 2: Résultats de l'étude belge RECORD en médecine générale.
Radermecker, Régis ULg; Scheen, André ULg

in Revue Médicale de Liège (2006), 61(5-6), 423-9

Sulfonylureas still have a key place in the treatment of type 2 diabetes, especially those of the last generation. This article describes the results of a post-marketing study (RECORD, Routine Evaluation ... [more ▼]

Sulfonylureas still have a key place in the treatment of type 2 diabetes, especially those of the last generation. This article describes the results of a post-marketing study (RECORD, Routine Evaluation Conducted On Registered Drugs project) focusing on glimepiride (Amarylle). This study investigated the efficacy, safety and tolerance of glimepiride in primary care. It was performed in Belgium and concerned 1.012 patients with type 2 diabetes followed for 6 months by 204 general practitioners. Almost two thirds of recruited patients already received oral glucose-lowering agents whereas one third were naive patients. This open study showed a progressive decrease of fasting blood glucose and glycated haemoglobin (HbA1c) levels with glimepiride (titrated from 1 to 6 mg/day, as needed, with a mean daily dose of 2,6 mg), together with a simultaneous slight reduction in body weight and without any increase of the hypoglycaemic risk. Primary care physicians considered both the efficacy and tolerance of glimepiride as good or very good in more than 90% of cases. The value of such a study is to provide valuable information about glimepiride use in real life, a condition that may differ from strict follow-up imposed in randomised controlled clinical trials. [less ▲]

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See detailQuelle place pour la prevention cardio-vasculaire par statine chez les personnes agees?
Petermans, Jean ULg; Laperche, J.; Scheen, André ULg

in Revue Médicale de Liège (2006), 61(5-6), 386-93

Cardiovascular prevention should only be considered if the treatment reduces the incidence of coronary and cerebrovascular events and death. In elderly people, such treatment should also, and most ... [more ▼]

Cardiovascular prevention should only be considered if the treatment reduces the incidence of coronary and cerebrovascular events and death. In elderly people, such treatment should also, and most importantly, help maintain a good quality of life, without increasing the risk of iatrogenic side-effects. These key-elements should be kept in mind when prescription of a statin is envisaged in the old (> 70 years) and especially the very old (> 80 years) individual. Randomised controlled trials in people above 70 years are rather rare. In the field of cardiovascular prevention, two studies provide information, on post-hoc analysis of the Heart Protection Study (HPS) with simvastatin and the PROSPER trial with pravastatin. The protection observed in the general population of HPS was also present in the subgroup of subjects aged above 70, both for coronary and cardiovascular events. The difference was less impressive in PROSPER, without any significant difference as far as the incidence of stroke was concerned. None of these two prospective trials provide specific data on individuals above 80. Interestingly, some experimental and epidemiological observations suggested that statins may prevent Alzheimer disease. However, the data from HPS and PROSPER are not convincing in this respect. Thus, results from new ongoing trials should be awaited, especially in patients with mild to moderate Alzheimer disease. Finally, it is noteworthy that low serum cholesterol level can be used as a marker of poor nutrition in very old people. Such condition is rather common, especially among institutionalised subjects, and is usually associated with a higher risk of morbidity and mortality. [less ▲]

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See detailASTEROID: regression de l'atherosclerose coronaire avec la rosuvastatine 'a une dose maximale de 40 mg par jour.
Scheen, André ULg

in Revue Médicale de Liège (2006), 61(4), 267-72

ASTEROID is a prospective, open-label blinded end-points trial aiming to assess whether very intensive statin therapy with rosuvastatin 40 mg/day could regress coronary atherosclerosis as determined by ... [more ▼]

ASTEROID is a prospective, open-label blinded end-points trial aiming to assess whether very intensive statin therapy with rosuvastatin 40 mg/day could regress coronary atherosclerosis as determined by intravascular ultrasound (IVUS). This multinational study included 507 patients, among whom 349 had evaluable serial IVUS examinations at 24 months. Rosuvastatin decreased LDL cholesterol level from 130 mg/dl to 61 mg/dl (- 53.2%) and increased HDL cholesterol from 43 to 49 mg/dl (+ 14.7%). The three prespecified IVUS efficacy parameters were positively altered by rosuvastatin, demonstrating regression of coronary atherosclerosis : the mean change in percent atheroma volume (- 0.98%), the change in atheroma volume in the most diseased 10-mm subsegment me (- 6.1 mm3) and the change in total atheroma volume (- 6.8%) were all significant (p < 0,001). Adverse events were infrequent and similar to other statin trials. The present study demonstrates that a 2-year treatment with a high dose of rosuvastatin 40 mg/day is able to induce significant regression of coronary atherosclerosis as determined by IVU imaging. Further ongoing studies in the GALAXY clinical investigation programme should now demonstrate that rosuvastatin, the most potent statin to reduce LDL and increase HDL cholesterol, is also able to diminish the incidence of clinical outcomes, cardiovascular events in general and major coronary events in particular. [less ▲]

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See detailLes criteres de jugement dans les essais cliniques: reflexions a propos d'etudes recentes de prevention cardio-vasculaire.
Scheen, André ULg

in Revue Médicale de Liège (2006), 61(4), 260-6

The comparison of two therapeutic interventions requires the use of endpoints in randomized clinical trials, which supports evidence-based medicine. It is preferable to consider hard endpoints, such as ... [more ▼]

The comparison of two therapeutic interventions requires the use of endpoints in randomized clinical trials, which supports evidence-based medicine. It is preferable to consider hard endpoints, such as major clinical events and mortality rather than biological or surrogate endpoints. In large cardiovascular prevention trials, it is now well accepted to analyze primary and secondary endpoints as well as to use combined clinical endpoints. Such composite endpoints offer the advantage of increasing the number of events, but have the disadvantage of diluting the therapeutic effect and of exposing to possible bias. We discuss this crucial issue at the light of controversial results from a few recent important cardiovascular prevention trials. [less ▲]

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See detailInnover par l'EBM: glossaire initiatique aux recherches cliniques.
Pierard, Gérald ULg; Scheen, André ULg

in Revue Médicale de Liège (2006), 61(3), 190-4

We present a glossary of terms frequently used in medico-scientific studies.

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See detailL'etude clinique du mois. L'etude IDEAL comparant simvastatine 20-40 mg versus atorvastatine 80 mg en prevention apres un infarctus du myocarde: entre deux idees de l'ideal.
Scheen, André ULg

in Revue Médicale de Liège (2006), 61(1), 53-9

The IDEAL ("Incremental Decrease in End Points Through Aggressive Lipid Lowering") study compared the effects of two strategies of lipid lowering on the risk of cardiovascular disease among patients with ... [more ▼]

The IDEAL ("Incremental Decrease in End Points Through Aggressive Lipid Lowering") study compared the effects of two strategies of lipid lowering on the risk of cardiovascular disease among patients with a previous myocardial infarction. In this prospective, randomized, open-label, blinded end-point evaluation trial, patients were randomly assigned to receive a high dose of atorvastatin (80 mg/day; n = 4439), or an usual dose of simvastatin (20 mg/day, titrated up to 40 mg/day if necessary; n = 4449). During treatment, mean LDL cholesterol levels were 104 mg/dl in the simvastatin group and 81 mg/dl in the atorvastatin group (p < 0.001). After a median follow-up of 4.8 years, no significant difference was observed in the primary outcome of major coronary events (defined as coronary death, confirmed nonfatal acute myocardial infarction, or cardiac arrest with resuscitation), but the risk of other composite secondary end points (i.e., major cardiovascular events, all cardiovascular events, all coronary events) was statistically reduced in the atorvastatin group compared to the simvastatin group. There were no differences in cardiovascular or all-cause mortality between the two groups. In conclusion, patients with myocardial infarction may benefit from intensive lowering of LDL cholesterol without an increase in noncardiovascular mortality or other serious adverse reactions. [less ▲]

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See detailComment j'explore...le syndrome metabolique par sa nouvelle definition dite de "consensus".
Scheen, André ULg; Luyckx, Françoise ULg; Lefebvre, Pierre ULg

in Revue Médicale de Liège (2006), 61(1), 48-52

The International Diabetes Federation recently proposed a so-called consensus definition of metabolic syndrome. According to this new definition, a subject has the metabolic syndrome if he/she has ... [more ▼]

The International Diabetes Federation recently proposed a so-called consensus definition of metabolic syndrome. According to this new definition, a subject has the metabolic syndrome if he/she has abdominal obesity (considered as a prerequisite and assessed, in the European population, by a waist circumference > 80 cm in women and > 94 cm in men) and, in addition, at least two other risk factors among 1) elevated fasting triglycerides > or = 150 mg/dl; 2) low HDL cholesterol HDL < 50 mg/dl in women and < 40 mg/dl in men; 3) increased arterial blood pressure > or = 130/ 85 mm Hg; and 4) elevated fasting plasma glucose concentration > or = 100 mg/dl. We will discuss the advantages and limitations of this new definition as well as the consequences of its use on the prevalence of the metabolic syndrome in the Belgian population. [less ▲]

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See detailL'évolution des QCM
Leclercq, Dieudonné ULg

in Figari, Gérard; Mottiez-Lopez, Lucie (Eds.) Recherches sur l'évaluation en Education (2006)

The history of one century of evolution of MC questions is described via a grid of 8 quality criteria or validities : ETIC PRAD (Ecological, Theoretical, Informative, Consequential, Predictive, Reliable ... [more ▼]

The history of one century of evolution of MC questions is described via a grid of 8 quality criteria or validities : ETIC PRAD (Ecological, Theoretical, Informative, Consequential, Predictive, Reliable, Acceptable, Deontological. [less ▲]

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See detailThe triple Consistency Illustrated by e-tivities to Help Understand National and International Policies in e-learning
Kovertaite, Vilma Ruta; Leclercq, Dieudonné ULg

in Revue Internationale des Technologies en Pédagogie Universitaire (2006), 3(1-2), 1-7

Les auteurs décrivent la conception et l’utilisation d’e-tivités, mot forgé pour designer des activités menées dans le cadre d’un cours à distance appelé « Politique nationale et internationale dans ... [more ▼]

Les auteurs décrivent la conception et l’utilisation d’e-tivités, mot forgé pour designer des activités menées dans le cadre d’un cours à distance appelé « Politique nationale et internationale dans l’enseignement ouvert et à distance », lui-même inclus dans un diplôme de maîtrise intitulé « Technologie de l’Information en Enseignement à Distance ». L’article se concentre sur la triple concordance entre les objectifs, les méthodes et le système d’évaluation, et sur la représentation de cette triple concordance. [less ▲]

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