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Dermience M.,University of Liege | Lognay G.,University of Liege | Mathieu F.,Kashin Beck Disease Fund Asbl Vzw | Goyens P.,Kashin Beck Disease Fund Asbl Vzw | Goyens P.,Free Universities of Brussels
Journal of Trace Elements in Medicine and Biology | Year: 2015

The human skeleton, made of 206 bones, plays vital roles including supporting the body, protecting organs, enabling movement, and storing minerals. Bones are made of organic structures, intimately connected with an inorganic matrix produced by bone cells. Many elements are ubiquitous in our environment, and many impact bone metabolism. Most elements have antagonistic actions depending on concentration. Indeed, some elements are essential, others are deleterious, and many can be both. Several pathways mediate effects of element deficiencies or excesses on bone metabolism. This paper aims to identify all elements that impact bone health and explore the mechanisms by which they act. To date, this is the first time that the effects of thirty minerals on bone metabolism have been summarized. © 2015 Elsevier GmbH. Source

Antoine C.,Free Universities of Brussels | Ameye L.,Free Universities of Brussels | Paesmans M.,Free Universities of Brussels | Rozenberg S.,Free Universities of Brussels
Maturitas | Year: 2012

Background: Several studies reported a decrease in breast cancer (BC) incidence, subsequent to the decrease in hormone replacement therapy (HRT) use. Aim: Although Belgium has one of the highest incidences of BC in Europe and one of the highest rates of HRT use, we were unable, in a previous study, to observe a significant association between BC incidence and HRT changes. In this updated report we added the BC data from incidence years 2007 and 2008. Material and method: We used European standardized incidence rates for invasive BC in the age class 50-69 years for Flanders (1999-2008), Brussels and Wallonia (2004-2008), obtained from IMS Health HRT sales data (1997-2008) for Brussels, Flanders and Wallonia. The association between BC incidence and HRT use was analyzed using generalized estimating equations (GEE) in order to take into consideration the dependency between the subsequent data points. Results: There was a significant association between the invasive BC incidence rate and estimated rate of HRT users in the previous year: p-value < 0.001. Conclusion: Although this study is hampered by a number of limitations, these data support the idea that the drop in BC incidence can be partly attributed to the decrease in HRT use. Since HRT remains the most used medication for climacteric symptoms, we encourage the creation of a prospective registry in Europe, collecting detailed data in various European countries, in order to assess the adjusted increase in BC risk associated with HRT, which may be population and regimen dependent. © 2012 Elsevier Ireland Ltd. All rights reserved. Source

Antoine C.,Free Universities of Brussels | Ameye L.,Free Universities of Brussels | Paesmans M.,Free Universities of Brussels | Rozenberg S.,Free Universities of Brussels
Maturitas | Year: 2014

Introduction Women affected by breast cancer (BC) will often go through menopause at an earlier age and display more frequent and severe symptoms than women who have a natural menopause. The safety of hormone replacement therapy (HRT) and vaginal estrogens for BC survivors has been debated over time and remains unclear. Non hormonal therapies such as antidepressants, gabapentine and clonidine may be useful for those patients but there are few data about their safety. Aim This retrospective study analyses the use by BC patients of treatments known to alleviate climacteric symptoms. Material and method Post-menopausal Estrogen Receptors positive (ER+) BC patients, aged 45-69, were identified as having bought, at least once, an aromatase inhibitor (AI) or tamoxifen between the years 2000 and 2012 through a pharmaceutical databank in Belgium. Among them, we defined users of a climacteric treatment those who bought, at least once, HRT, vaginal topical estrogens, antidepressants, clonidine and gabapentine. Results We identified 2530 BC patients. Among them, 45% were buying a treatment known to alleviate menopausal symptoms. The majority of these treatments were non-HRT therapies. HRT and vaginal estrogens were seldom bought (respectively 1.1% and 6%), but 3% bought vaginal estrogens while buying AI. About 9.2% of tamoxifen users patients bought antidepressants implicated in tamoxifen metabolism at the same time as tamoxifen. Conclusions Most BC patients follow current guidelines contra-indicating the use of HRT after BC, they use non hormonal therapies. In some cases they use unfortunately antidepressants that may alter the metabolism of tamoxifen. © 2014 Elsevier Ireland Ltd. Source

Antoine C.,Free Universities of Brussels | Ameye L.,Free Universities of Brussels | Moreau M.,Free Universities of Brussels | Paesmans M.,Free Universities of Brussels | Rozenberg S.,Free Universities of Brussels
Climacteric | Year: 2011

Background Recent randomized studies concluded that an increased risk of breast cancer is associated with hormone replacement therapy (HRT). Since then, HRT use has decreased in many countries. Several studies have reported a subsequent decrease in breast cancer incidence. Aim As Belgium has one of the highest incidences of breast cancer in Europe and has a high rate of HRT use, with differences between regions, we assessed the evolution of breast cancer incidence and HRT sales per region and per regimen. Materials and methods Breast cancer incidence rates (provided by the Belgian Cancer Registry) and HRT sales data (provided by IMS Health®) were analyzed by region, age class and HRT regimens. We also calculated the correlation between breast cancer incidence and HRT sales. Results Breast cancer incidence decreased from 2003 onwards in Flanders, Brussels and Wallonia, especially in the age group 5069 years. In the same three regions, HRT use decreased by half from 2002 onwards. Greater decreases were observed for estrogens combined with androgenic progestins, estrogens only and estrogens prescribed with a separate progestin. The correlation between breast cancer incidence rates and HRT sales in the previous year was 0.55 (p=0.04), but, when adjusted for the number of women in the age class 4069 years in each region, the correlation was no longer statistically significant (r=0.39, p=0.17). Conclusion Although many arguments support the hypothesis that the drop in breast cancer incidence can be partly explained by the decrease in HRT use, we were unable to find a strong association between the two in Belgium. © 2011 International Menopause Society. Source

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