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See detailAngioplastie percutanee coronaire chez le patient diabetique. Partie 2: Espoirs apportes par les protheses endovasculaires.
Warzee, Fabian ULg; Legrand, Victor ULg; Scheen, André ULg

in Revue Médicale de Liège (2004), 59(11), 653-8

Coronary artery revascularization procedures provide less favourable results in diabetic patients than in non-diabetic individuals. Especially, percutaneous coronary angioplasty (PTCA) is associated with ... [more ▼]

Coronary artery revascularization procedures provide less favourable results in diabetic patients than in non-diabetic individuals. Especially, percutaneous coronary angioplasty (PTCA) is associated with a higher rate of restenosis and recurrence of cardiac morbidity and death. In diabetic patients, PTCA should, if possible, be combined with a stent. Bare-stents allow to reduce approximately by half the risk of restenosis, but unfortunately their efficacy decreases as the vessel diameter decreases, a common finding among diabetic patients with angiopathy. ARTS ("Arterial Revascularization Therapy Study") recently showed that diabetic patients have a worse prognosis even when bare-stents are combined with PTCA as compared to non-diabetic subjects and as compared to diabetic patients treated with coronary artery bypass graft. These results open new perspectives in favour of the use of drug-eluting stents containing pharmacological agents capable of preventing restenosis. Such new stents might improve the management of diabetic patients with coronary heart disease. [less ▲]

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See detailAngioplastie percutanee coronaire chez le patient diabetique Partie 1 : echecs relatifs lies a la restenose apres angioplastie simple.
Warzee, Fabian ULg; Legrand, Victor ULg; Scheen, André ULg

in Revue Médicale de Liège (2004), 59(10), 584-90

Diabetes mellitus, essentially type 2 diabetes, is markedly associated with a high risk of cardiovascular diseases, especially coronary artery disease (CAD). Revascularization techniques, first coronary ... [more ▼]

Diabetes mellitus, essentially type 2 diabetes, is markedly associated with a high risk of cardiovascular diseases, especially coronary artery disease (CAD). Revascularization techniques, first coronary artery bypass graft (CABG) and second percutaneous transluminal coronary angioplasty (PTCA), have drastically changed the management of patients with CAD. Unfortunately, overall results of such revascularization procedures are less impressive in diabetic patients than in nondiabetic subjects, because of a worse vascular bed due to a more diffuse disease including small vessels. The diabetic population is indeed characterized by higher rates of both post-CABG thrombosis and post-PTCA restenosis, as compared to the corresponding rates observed in a nondiabetic population. Such vascular complications result in a higher incidence of coronary events leading to greater morbidity and mortality in both the short (weeks-months) and long (years) term. The bad quality of blood glucose control appears to play a crucial role in the risk of restenosis and further complications. The use of endovascular stents, especially new drug-eluting stents reducing the risk of restenosis, may represent a new opportunity for the management of a high-risk population such as diabetic patients. [less ▲]

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See detailRetrait du rofecoxib (Vioxx): a propos de la securite cardiovasculaire des anti-inflammatoires non steroidiens cox-2 selectifs.
Scheen, André ULg

in Revue Médicale de Liège (2004), 59(10), 565-9

Rofecoxib (Vioxx), the first COX-2 selective non-steroidal anti-inflammatory drug (NSAID), was recently withdrawn by Merck Sharp & Dohme. Indeed, both observational studies and randomised clinical trials ... [more ▼]

Rofecoxib (Vioxx), the first COX-2 selective non-steroidal anti-inflammatory drug (NSAID), was recently withdrawn by Merck Sharp & Dohme. Indeed, both observational studies and randomised clinical trials showed that rofecoxib is associated with a significantly increased risk of acute myocardial infarction in patients receiving either high daily dosage (>25 mg/day) or for a long period of time (> 18 months). The precise mechanism responsible for this phenomenon still remains unknown. Currently available data suggest that this adverse effect is not observed with other COX-2 NSAIDs, especially celecoxib for which the information is most abundant. Nevertheless, caution is required because of lack of prospective long-term data, and strict respect of indications and modalities of clinical use of COX-2 NSAIDs is mandatory. Finally, in patients with high cardiovascular risk who should receive a COX-2 selective NSAID, the association with a low dose of acetylsalicylic acid is recommended in order to benefit of a protective antiplatelet effect. [less ▲]

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See detailHemochromatose et diabete.
Thielen, Vinciane ULg; Paquot, Nicolas ULg; Scheen, André ULg

in Revue Médicale de Liège (2004), 59(1), 29-31

Nowadays, haemochromatosis is often diagnosed when the patient is monosymptomatic. Diabetes is frequently the first expression of the disease. So, it is important to know the clinical and biologic ... [more ▼]

Nowadays, haemochromatosis is often diagnosed when the patient is monosymptomatic. Diabetes is frequently the first expression of the disease. So, it is important to know the clinical and biologic characteristics to evoke diagnosis as early as possible. Uncommon presentations request systematic screening. [less ▲]

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See detailRenin-angiotensin system inhibition prevents type 2 diabetes mellitus. Part 2. Overview of physiological and biochemical mechanisms.
Scheen, André ULg

in Diabètes & Métabolism (2004), 30(6), 498-505

The inhibition of the renin-angiotensin system (RAS) with either angiotensin converting enzyme inhibitors (ACEIs) or AT1 angiotensin receptor blockers (ARBs) consistently and significantly reduces the ... [more ▼]

The inhibition of the renin-angiotensin system (RAS) with either angiotensin converting enzyme inhibitors (ACEIs) or AT1 angiotensin receptor blockers (ARBs) consistently and significantly reduces the incidence of type 2 diabetes in patients with hypertension or congestive heart failure. The mechanisms underlying this protective effect appear to be complex and may involve an improvement of both insulin sensitivity and insulin secretion. These two effects may result, at least in part, from the well known effects of these pharmacological agents on the vascular system on the one hand, on the ionic balance on the other hand. Indeed, the vasodilation induced by ACEIs or ARBs could improve the blood circulation in skeletal muscles, thus favouring peripheral insulin action, but also in the pancreas, thus promoting insulin secretion. Preserving cellular potassium and magnesium pools by blocking the aldosterone effects could also improve both cellular insulin action and insulin secretion. However, besides these classical effects, new mechanisms have been recently suggested. A direct effect of the inhibition of angiotensin and/or of the enhancement of bradykinin on various steps of the insulin cascade signalling has been described as well an increase in GLUT4 glucose transporters after RAS inhibition. Furthermore, it has been demonstrated that angiotensin II inhibits adipogenic differentiation of human adipocytes via A1 receptors and, therefore, it has been hypothesised that RAS blockade may prevent diabetes by promoting the recruitment and differentiation of adipocytes. Finally, some lipophilic ARBs appear to induce PPAR-gamma activity in the adipose tissue. Hence, the protection against type 2 diabetes observed after RAS inhibition may be partially linked to a thiazolidinedione-like effect. In conclusion, numerous physiological and biochemical mechanisms could explain the protective effect of RAS inhibition against the development of type 2 diabetes in individuals with arterial hypertension or congestive heart failure. What might be the main mechanism in the overall protection effect of ACEIs or ARBs remains an open question. [less ▲]

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See detailRenin-angiotensin system inhibition prevents type 2 diabetes mellitus. Part 1. A meta-analysis of randomised clinical trials.
Scheen, André ULg

in Diabètes & Métabolism (2004), 30(6), 487-96

Most individuals with arterial hypertension or congestive heart failure are insulin-resistant and at a higher risk of developing type 2 diabetes (T2DM). The inhibition of the renin-angiotensin system (RAS ... [more ▼]

Most individuals with arterial hypertension or congestive heart failure are insulin-resistant and at a higher risk of developing type 2 diabetes (T2DM). The inhibition of the renin-angiotensin system (RAS), using an angiotensin converting enzyme inhibitor (ACEI) or a selective angiotensin receptor AT1 blocker (ARB), may exert favourable metabolic effects capable of preventing T2DM in high risk individuals. We performed a meta-analysis of randomised clinical trials (RCTs) assessing the effects of RAS inhibition on the incidence of new cases of T2DM in patients with arterial hypertension or congestive heart failure. Ten RCTs with cardiovascular prognosis as primary endpoints analysed the incidence of T2DM as secondary endpoints or as post-hoc analysis after a mean follow-up of 1 to 6 years: five with an ACEI and five with an ARB, compared with a placebo (n=4) or a reference drug (beta-blocker or diuretic: n=5; amlodipine: n=2). Eight RCTs concerned hypertensive patients: STOP Hypertension-2 (lisinopril or enalapril vs beta-blocker or diuretic), CAPPP (captopril vs thiazide or beta-blocker), HOPE (ramipril vs placebo), ALLHAT (lisinopril vs chlorthalidone and lisinopril vs amlodipine), LIFE (losartan vs atenolol), SCOPE (candesartan vs placebo), ALPINE (candesartan vs placebo) and VALUE (valsartan vs amlodipine). Two RCTs concerned patients with congestive heart failure: SOLVD (enalapril vs placebo) and CHARM-overall programme (candesartan vs placebo). Overall, 2 675 new cases of T2DM (7.40%) were observed in the group of 36 167 patients receiving a treatment with ACEI or ARA as compared with 3 842 events (9.63%) in the group of 39 902 control patients. A mean weighed relative risk reduction of new T2DM of 22% (95% CI: 18, 26; p<0.00001) was observed after RAS inhibition. The beneficial effect was similar with ACEIs and with ARBs as well as in patients with hypertension and in those with heart failure, and was also present whatever the comparator (placebo or beta-blockers/diuretics or amlodipine). The number needed-to-treat to avoid one new case of T2DM averaged 45 patients over 4-5 years. In conclusion, RAS inhibition consistently and significantly reduces the incidence of T2DM in individuals with arterial hypertension or with congestive heart failure. Considering the pandemic of T2DM, such pharmacological approach deserves further attention among the strategies aiming at preventing T2DM. [less ▲]

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See detailDrug-eluting stents: meta-analysis in diabetic patients.
Scheen, André ULg; Warzee, Fabian ULg; Legrand, Victor ULg

in European heart journal (2004), 25(23), 2167-82168-9

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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 detailPathophysiology of insulin secretion.
Scheen, André ULg

in Annales d'Endocrinologie (2004), 65(1), 29-36

Defects in pancreatic islet beta-cell function play a major role in the development of diabetes mellitus. Type 1 diabetes is caused by a more or less rapid destruction of pancreatic beta cells, and the ... [more ▼]

Defects in pancreatic islet beta-cell function play a major role in the development of diabetes mellitus. Type 1 diabetes is caused by a more or less rapid destruction of pancreatic beta cells, and the autoimmune process begins years before the beta-cell destruction becomes complete, thereby providing a window of opportunity for intervention. During the preclinical period and early after diagnosis, much of the insulin deficiency may be the result of functional inhibition of insulin secretion that may be at least partially and transiently reversible. Type 2 diabetes is characterized by a progressive loss of beta-cell function throughout the course of the disease. The pattern of loss is an initial (probably of genetic origin) defect in acute or first-phase insulin secretion, followed by a decreasing maximal capacity of insulin secretion. Last, a defective steady-state and basal insulin secretion develops, leading to almost complete beta-cell failure requiring insulin treatment. Because of the reciprocal relation between insulin secretion and insulin sensitivity, valid representation of beta-cell function requires interpretation of insulin responses in the context of the prevailing degree of insulin sensitivity. This appropriate approach highlights defects in insulin secretion at the various stages of the natural history of type 2 diabetes and already present in individuals at risk to develop the disease. To date none of the available therapies can stop the progressive beta-cell defect and the progression of the metabolic disorder. The better understanding of the pathophysiology of the disease should lead to the development of new strategies to preserve beta-cell function in both type 1 and type 2 diabetes mellitus. [less ▲]

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See detailIntact cross-talk between insulin secretion and insulin action after postgastroplasty recovery of ideal body weight in severely obese patients.
Letiexhe, Michel ULg; Desaive, Claude ULg; Lefebvre, Pierre ULg et al

in International Journal of Obesity & Related Metabolic Disorders (2004), 28(6), 821-3

Most reports investigating the hormonal and metabolic effects of bariatric surgery studied obese subjects after partial weight loss only. Nevertheless, all studies showed significant improvements of ... [more ▼]

Most reports investigating the hormonal and metabolic effects of bariatric surgery studied obese subjects after partial weight loss only. Nevertheless, all studies showed significant improvements of insulin secretion, action, clearance and inhibition of its own secretion, although the parallel kinetics of all these changes remained questionable. Using the intravenous glucose tolerance test, we demonstrated a full normalization of insulin secretion, action on glucose metabolism and clearance in eight obese women who recovered and maintained ideal body weight following gastroplasty. Reciprocal changes were observed between postglucose acute insulin secretion and insulin-mediated glucose disposal so that the so-called disposition index (product of these two variables) remained unchanged after vs before gastroplasty in those individuals with normal glucose tolerance. These favourable results should encourage obtaining a drastic and sustained weight loss in patients with severe obesity at risk of developing type II diabetes. [less ▲]

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See detailLa gestion des spécificités linguistiques et culturelles dans les évaluations internationales de la lecture
Baye, Ariane ULg

in Politiques d'Education et de Formation : Analyses et Comparaisons Internationales (2004), 11

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See detailThe effects of aging on location-based and distance-based processes in memory for time
Bastin, Christine ULg; Van der Linden, Martial ULg; Michel, Anne-Pascale et al

in Acta Psychologica (2004), 116

Retrieving when an event occurred may depend on an estimation of the age of the event (distance-based processes) or on strategic reconstruction processes based on contextual information associated with ... [more ▼]

Retrieving when an event occurred may depend on an estimation of the age of the event (distance-based processes) or on strategic reconstruction processes based on contextual information associated with the event (location-based processes). Young and older participants performed a list discrimination task that has been designed to dissociate the contribution of both types of processes. An adapted Remember/Know/Guess procedure [Can. J. Exp. Psychol. 50 (1996) 114] was developed to evaluate the processes used by the participants to recognize the stimuli and retrieve their list of occurrence. The results showed that aging disrupts location- based processes more than distance-based processes. In addition, a limitation of speed of processing and working-memory capacities was the main predictor of age-related differences on location-based processes, whereas working-memory capacities mediated partly age differences on distance-based processes. [less ▲]

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See detailA projective approach to handle 3D spatial data
Billen, Roland ULg

in Proceedings of GIS Research UK 2004 (2004)

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See detailEtude des caractéristiques projectives des objets spatiaux et de leurs relations
Billen, Roland ULg; Clementini, Eliseo

in Revue Internationale de Géomatique (2004), 14(2), 145-165

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See detailIntroducing a reasoning system based on ternary projective relationships
Billen, Roland ULg; Clementini, Eliseo

in Fisher, Peter (Ed.) Developments in Spatial Data Handling (2004)

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See detailA model for ternary projective relations between regions
Billen, Roland ULg; Clementini, Eliseo

in Lecture Notes in Computer Science (2004)

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See detailElaboration d’une typologie hydro-géomorphologique de cours d’eau dans l’Euregio Meuse-Rhin
Hallot, Eric ULg; Schmitt, L.; Mols, J. et al

in Mosella - XXIX, 3-4 (2004)

This paper shows the first results of a method of river hydro-geomorphological typology applied on the Euregio Maas-Rhine. This is based on non factorial multivariate analysis (clusters) of only ... [more ▼]

This paper shows the first results of a method of river hydro-geomorphological typology applied on the Euregio Maas-Rhine. This is based on non factorial multivariate analysis (clusters) of only quantitative data automatically extracted from DEM or obtained by field measurements with a simplified protocol. The regional differentiation of variables allows the automatic characterization of rivers especially with the specific stream power. [less ▲]

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See detailProposition d’une méthode de typologie hydro-géomorphologique des cours d’eau et tes sur un sous-bassin du Rhône (Bassin de l’Yzeron).
Schmitt, Laurent; Valette, L.; Valin, K. et al

in MOSELLA, XXIX (3-4) (2004)

Proposal of a method of hydro-geomorphological typology of rivers and test of a sub-basin of the Rhône River (Yzeron basin). The paper proposes a hydro-geomorphological typology method of watercourses ... [more ▼]

Proposal of a method of hydro-geomorphological typology of rivers and test of a sub-basin of the Rhône River (Yzeron basin). The paper proposes a hydro-geomorphological typology method of watercourses that might potentially be used in western Europe. The method was tested in the Yzeron basin (France). Field data were collected and analysed by multivariate statistics. Statistical results were consistent with the results of the typology model. Some recommendations are also made for the future development of automatic methods of characterization-sectorization of rivers. [less ▲]

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