Publications of Ulysse GASPARD
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See detail"Je ne suis pas enceinte !" A propos du déni de grossesse...
Grobet, Marie ULiege; CAPELLE, Xavier ULiege; Willems, T et al

in Revue Médicale de Liège (2020), 75

The term «denial of pregnancy», although used in current medical practice since 1970, does not yet have a universal definition. The literature allows to define it as «the non-recognition of a pregnancy ... [more ▼]

The term «denial of pregnancy», although used in current medical practice since 1970, does not yet have a universal definition. The literature allows to define it as «the non-recognition of a pregnancy beyond the first trimester, which can last until delivery and cover it». The changes related to pregnancy are biologically reduced or incorrectly perceived or even ignored. Although often wrongly consi- dered as a rare phenomenon, the literature describes it as having a prevalence of 2 to 3 cases per 1.000 viable deliveries. This case report associated with a short review of the literature aims to optimise the clinician awareness, leading to the diagnosis as well as the potential perinatal consequences linked to this phenomenon. [less ▲]

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See detailUnique Vascular Benefits of Estetrol, a Native Fetal Estrogen with Specific Actions in Tissues (NEST)
Foidart, Jean-Michel ULiege; GASPARD, Ulysse ULiege; Pequeux, Christel ULiege et al

in Diaz Brinton, Roberta; Genazzani, Andrea; Simoncini, Tommaso (Eds.) et al Sex Steroids' Effects on Brain, Heart and Vessels: Volume 6: Frontiers in Gynecological Endocrinology (2019)

Estrogens (E), in combination with oral contraceptives (COCs) and hormone replacement therapy (HRT) drugs used for the relief of climacteric symptoms of menopause, increase the synthesis of clotting ... [more ▼]

Estrogens (E), in combination with oral contraceptives (COCs) and hormone replacement therapy (HRT) drugs used for the relief of climacteric symptoms of menopause, increase the synthesis of clotting factors, decrease the levels of coagulation inhibitors, and increase the risk of venous thromboembolic events (VTE). Ischemic stroke incidence in postmenopausal women during HRT use is also increased and is probably due to a thrombotic event. This suggests that a safer estrogen may reduce stroke and VTE incidence, with lower impact on hemostasis. Estetrol (E4) is a relatively recently described new human-specific E produced exclusively by the fetal liver during pregnancy. This Native (human and natural) E has Selective actions in Tissues (NEST). Nest activities of E4 are the consequence of its unique dual role. It activates the nuclear estrogen receptor alpha (ERα) but antagonizes the membrane ERα in contrast to other E, which activate both types of receptors. Most beneficial effects of E on the vascular system have been ascribed to the activation of the membrane ERα of vascular endothelial cells, including enhancement of nitric oxide (NO) production, vasodilation, and prevention of atherosclerosis, of neointimal proliferation, and of hypertension. In a series of papers reviewed here, the INSERM team in Toulouse has demonstrated, by the combined use of pharmacological tools and of transgenic mice lacking either the nuclear ERα, the membrane ERα, or both, that the nuclear ERα plays a major role in controlling E activities in vessels. E4 is able to elicit the important vasculoprotective actions mediated by estradiol (E2). Furthermore, phase 1 and 2 clinical studies of E4 in a contraceptive indication (in combination with drospirenone) or in postmenopausal women for the relief of climacteric complaints demonstrate that E4 has a minimal impact on hemostasis, coagulation factors, coagulation inhibitors, fibrinolysis, angiotensinogen, triglycerides, and cholesterol. Altogether, preclinical studies and phase 1 and 2 clinical data indicate that E4 could be a new E with a better safety/efficacy profile than other E for women’s healthcare. [less ▲]

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See detailExploring the Interest in and the Usage of the Internet Among Patients Eligible for Osteoporosis Screening.
Slomian, Justine ULiege; Reginster, Jean-Yves ULiege; Gaspard, Ulysse ULiege et al

in Calcified Tissue International (2015), 96

The aim of this study was to evaluate the interest in the Internet and its usage for health-related issues among people eligible for osteoporosis screening. Self-administered questionnaires have been ... [more ▼]

The aim of this study was to evaluate the interest in the Internet and its usage for health-related issues among people eligible for osteoporosis screening. Self-administered questionnaires have been distributed to subjects who were screened for osteoporosis and to menopausal women. 177 patients have responded to the survey (64.5 +/- 10.1 years, 88.1 % of women). There are 78.5 % of Internet users. Among them, 67.2 % said searching information about their health and 74.5 % said using the Internet for this purpose. All respondents attributed an average score, out of 10, of 5.7 +/- 2.3 regarding the reliability of information that they could find on the Internet. The use of the Internet differs significantly depending on age: those who use the Internet are younger (62.1 +/- 8.91 years) than those who do not use it (73.3 +/- 9.42 years). The socioeconomic status also has an impact on the Internet use: Internet users have a higher education, are more professionally active and have a higher net monthly household income compared to the group of non-users. Even if age and socioeconomic status appear to be determining factors in the use of the Internet for the search of health information in patients eligible for osteoporosis screening, almost 75 % of the study population use the Internet for this purpose. Action to promote health through an Internet platform must therefore take these parameters into account. [less ▲]

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See detailAsymmetric facial skin viscoelasticity during climacteric aging.
Pierard, Gérald ULiege; Hermanns-Lê, Trinh ULiege; Gaspard, Ulysse ULiege et al

in Clinical, Cosmetic and Investigational Dermatology (2014), 7

BACKGROUND: Climacteric skin aging affects certain biophysical characteristics of facial skin. The purpose of the present study was to assess the symmetric involvement of the cheeks in this stage of the ... [more ▼]

BACKGROUND: Climacteric skin aging affects certain biophysical characteristics of facial skin. The purpose of the present study was to assess the symmetric involvement of the cheeks in this stage of the aging process. METHODS: Skin viscoelasticity was compared on both cheeks in premenopausal and post-menopausal women with indoor occupational activities somewhat limiting the influence of chronic sun exposure. Eighty-four healthy women comprising 36 premenopausal women and 48 early post-menopausal women off hormone replacement therapy were enrolled in two groups. The tensile characteristics of both cheeks were tested and compared in each group. A computerized suction device equipped with a 2 mm diameter hollow probe was used to derive viscoelasticity parameters during a five-cycle procedure of 2 seconds each. Skin unfolding, intrinsic distensibility, biological elasticity, and creep extension were measured. RESULTS: Both biological elasticity and creep extension were asymmetric on the cheeks of the post-menopausal women. In contrast, these differences were more discrete in the premenopausal women. CONCLUSION: Facial skin viscoelasticity appeared to be asymmetric following menopause. The possibility of asymmetry should be taken into account in future studies of the effects of hormone replacement therapy and any antiaging procedure on the face in menopausal women. [less ▲]

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See detailRevisiting the cutaneous impact of oral hormone replacement therapy.
PIERARD, Gérald ULiege; Humbert, Philippe; Berardesca, Enzo et al

in BioMed Research International (2013), 2013(971760),

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See detailLe médicament du mois. Zoely®, une association monophasique d’estradiol et d’acétate de nomégestrol
PINTIAUX, Axelle ULiege; Gaspard, Ulysse ULiege; Nisolle, Michelle ULiege

in Revue Médicale de Liège (2012), 67(3), 152-6

SUMMARY : A new combined oral contraceptive called Zoely® has just been marketed in Belgium. It contains nomegestrol acetate, a progestin known for its high contraceptive reliability based on its ... [more ▼]

SUMMARY : A new combined oral contraceptive called Zoely® has just been marketed in Belgium. It contains nomegestrol acetate, a progestin known for its high contraceptive reliability based on its antigonadotropic power and long half-life. This progestin is associated with estradiol and Zoely® is devoid of ethinyl estradiol, which is the usual component of the majority of combined oral contraceptives and is primarily responsible for thrombotic side effects of the pill. The compositon and type of regimen of this new oral contraceptive contribute to its efficacy and excellent clinical tolerance. [less ▲]

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See detailLe medicament du mois. Femoston Low (0,5 mg d'estradiol plus 2,5 mg de dydrogesterone) comme traitement hormonal de substitution a la menopause.
SCHEEN, André ULiege; Gaspard, Ulysse ULiege

in Revue Médicale de Liège (2011), 66(4), 209-14

Femoston Low is a hormone replacement therapy that combines low dosages of steroids, i.e. 0.5 mg of estradiol and 2.5 mg of dydrogesterone. This oral preparation should be taken continuously to treat ... [more ▼]

Femoston Low is a hormone replacement therapy that combines low dosages of steroids, i.e. 0.5 mg of estradiol and 2.5 mg of dydrogesterone. This oral preparation should be taken continuously to treat climacteric symptoms in menopausal women. Femoston Low is in agreement with the recent recommendations for menopausal hormone replacement therapy, which give the preference to low dosage therapy whenever possible. The goals are to potentially minimize the risk of breast cancer, the danger of venous or arterial thrombosis and the glucose and lipid metabolic disturbances. Nevertheless, the preparation should efficaciously oppose to endometrial hyperplasia and yield a high degree of amenorrhea. [less ▲]

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See detailLe cancer du sein en Belgique: pourquoi sommes-nous les premiers en Europe?
DESREUX, Joëlle ULiege; Gaspard, Ulysse ULiege; BLERET, Valerie ULiege et al

in Revue Médicale de Liège (2011), 66(5-6), 231-7

Breast cancer incidence in Belgium is on the top of European countries, with 9.697 new cases in 2008 and 106/100.000 women/year. The explanation of this high incidence in our country is probably the ... [more ▼]

Breast cancer incidence in Belgium is on the top of European countries, with 9.697 new cases in 2008 and 106/100.000 women/year. The explanation of this high incidence in our country is probably the accumulation of risk factors (many of them are linked to lifestyle), and the impact of screening and registration of cases. The relative impact of each of theses factors is less clear because we don't have powerful statistical studies. Belgium is slightly above the European mean for breast cancer mortality, with 19,4/100.000 women/year and an all stages 15-year survival of 75%. Breast cancers are responsible for around 3% of all-cause mortality in Belgian women. This article discusses the causes of this high Belgian incidence and of current decrease of incidence in western countries, and reviews known and less known risk factors of breast cancers, with a special focus on menopause hormonal treatments. [less ▲]

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See detailLe medicament du mois. Ulipristal acetate: une contraception d'urgence etendue a 5 jours par progesterone receptor modulator (Ellaone).
Gaspard, Ulysse ULiege; Kridelka, Frédéric ULiege

in Revue Médicale de Liège (2010), 65(12), 700-5

Emergency contraception is a second chance for prevention of pregnancy after unprotected intercourse. Hormonal emergency contraception with levonorgestrel 1.5 mg, only provides an effective contraception ... [more ▼]

Emergency contraception is a second chance for prevention of pregnancy after unprotected intercourse. Hormonal emergency contraception with levonorgestrel 1.5 mg, only provides an effective contraception from 0 to 72 hours after intercourse with decreasing effectiveness as time elapses. It was accordingly mandatory to develop an alternative approach with a stable contraceptive efficacy and good tolerance for 5 days, knowing additionally that the estimated lifespan of sperm in the female genital tract is about 5 days. In comparative studies bearing on more than 3000 young women, the progesterone receptor modulator (PRM) ulipristal acetate, a progesterone antagonist (taken in a single dose of 30 mg), or levonorgestrel (1.5 mg) were administered. Results indicated that the PRM was as effective as levonorgestrel, or even more, kept a stable efficacy for 120 hours after an unprotected intercourse, and was well tolerated. This establishes ulipristal acetate as the new standard for hormonal emergency contraception. [less ▲]

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See detailLe médicament du mois. Nouvelle contraception orale combinée au valerate d'estradiol et au dienogest (Qlaira).
Gaspard, Ulysse ULiege; PINTIAUX, Axelle ULiege; Kridelka, Frédéric ULiege

in Revue Médicale de Liège (2010), 65(12), 706-13

In combined oral contraception (OC), a drastic reduction of both ethinylestradiol and androgenic progestins mostly derived from 19 NOR testosterone, allowed to moderately reduce the adverse impact of ... [more ▼]

In combined oral contraception (OC), a drastic reduction of both ethinylestradiol and androgenic progestins mostly derived from 19 NOR testosterone, allowed to moderately reduce the adverse impact of classical combined pills on metabolism and circulation (both arterial and venous). However, the marked hepatic action of ethinylestradiol, even in small dosages, lessens the expected risk reduction. For the first time, an OC has been developed, which contains estradiol valerate (with reduced hepatic action because of lack of a 17alpha ethinyl group) with dienogest, a 19 NOR testosterone-derived nonandrogenic progestin, which powerfully inhibits endometrial proliferation. Thanks to a dynamic modulation of estrogen and progestin doses (26 active days + 2 placebo days), an adequate contraceptive effectiveness, a good cycle control and drug tolerance are achieved, similar to those obtained with a classical low-dose OC. Recent data indicate that this new combination reduces the usually observed metabolic impact. An adequate cycle control (with 20% amenorrhea) is achieved for the first time with estradiol valerate + progestin,, in opposition with prior catastrophic results with other formulations containing 17beta-estradiol. A second combination containing estradiol + nomegestrol acetate (monophasic, 24 active days + 4 placebo days) is under study and seems also to yield promising results. Of course, in-depth study of metabolic and vascular effects of these new combinations is mandatory - and ongoing. [less ▲]

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See detailDysfonction sexuelle féminine et androgénothérapie à la ménopause
DELCOMINETTE, Sarah ULiege; GASPARD, Ulysse ULiege

in Revue Médicale de Liège (2008), 63

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See detailPrediction of maternal predisposition to preeclampsia
Emonts, Patrick ULiege; Seaksan, S.; Seidel, Laurence ULiege et al

in Hypertension in Pregnancy (2008), 27(3), 237-45

Objective: To derive a prediction index based on the most salient patient history, laboratory, and clinical parameters for identifying women at high risk for developing preeclampsia (PE). Methods ... [more ▼]

Objective: To derive a prediction index based on the most salient patient history, laboratory, and clinical parameters for identifying women at high risk for developing preeclampsia (PE). Methods: Nonpregnant women with a history of PE (n = 101) were compared with nonpregnant parous women with a history of one or more successful normotensive pregnancies (n = 50) but with comparable age, gestation, and parity profiles. The parameters included a medical examination (demographics, patient history, family history, and clinical and obstetrical findings), laboratory investigations (hemostasis, coagulation, and vitamins), and morphological and functional tests (cardiovascular and renal functions). Stepwise logistic regression analysis was applied to develop a three-step PE prediction index based on the most discriminant parameters. Results: Patients with and without PE differed significantly (p < 0.05) with respect to 1) maternal history of chronic hypertension, body mass index, and blood pressure; 2) APTT, PT, activated factor VIII, homocystein, free protein S and vitamin B1; and 3) relative plasma volume. Based on these three sets of parameters, a three-step PE prediction index was developed. The likelihood ratio of a positive index score was equal to 3.4, 7.3, and 8.8, respectively. Thus, assuming a PE prevalence (or prior probability) of 5%, a patient's chances of developing PE when presenting with a positive score on the three-step prediction index were 15%, 28%, and 32%, respectively. Discussion: In the absence of welldefined pre-pregnancy screening guidelines for PE, the present study attempts to proceed in a stepwise fashion by looking at medical examination data first, requesting, if necessary, specific hemostasis and coagulation tests next, and finally measuring the relative plasma volume for confirmatory purposes. This approach offers a satisfactory positive predictive value and cost efficiency ratio. [less ▲]

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See detailEffect of different contraceptive methods on the oxidative stress status in women aged 40-48 years from the ELAN study in the province of Liege, Belgium
Pincemail, Joël ULiege; Vanbelle, Sophie ULiege; Gaspard, Ulysse ULiege et al

in Human Reproduction (2007), 22(8), 2335-2343

Oxidative stress is associated with the development of several disorders including cardiovascular disease and cancer. Among conditions known to influence oxidative stress, the use of oral contraception ... [more ▼]

Oxidative stress is associated with the development of several disorders including cardiovascular disease and cancer. Among conditions known to influence oxidative stress, the use of oral contraception (OC) in women has been a matter of ongoing discussion. METHODS: A total of 897 eligible and healthy volunteers were recruited from among the patients of 50 general practitioners participating in the ELAN study (Etude Liegeoise sur les ANtioxydants). A subsample consisting of 209 women aged 40-48 years was studied for a comprehensive oxidative stress status (OSS), including the analysis of antioxidants, trace elements and three markers of oxidative damage to lipids. Among 209 subsample, 49 (23%) were OC users (OCU), 119 (57%) non-contraception users (NCU) and 41 (20%) were intrauterine (hormonal and copper) devices users (IUD). RESULTS: After adjustment for smoking, systolic and diastolic blood pressure and BMI (or waist circumference), a marked and significant increase in lipid peroxides was observed among OCU women when compared with NCU and IUD users. A cut-off value of 660 mu M in lipid peroxides allowed the discrimination of OCU from the two other groups. In contrast, no difference was observed in the plasma concentration of both oxidized low-density lipoprotein (LDL) and their related antibodies. The increased level in lipid peroxides was strongly related to higher concentrations of copper (r < 0.84; P < 0.0001, cut-off value 1.2 mg/1). When compared with NCU and IUD users, plasma antioxidant defences were significantly altered in OCU women as shown by lower levels of beta-carotene (decrease of 39%; P < 0.01) andytocopherol (decrease by 22%; P < 0.01). In contrast, higher concentrations of selenium (increased by 11.8%; P < 0.01) were observed in OCU women. Blood concentrations of vitamin C, alpha-tocopherol and zinc were unaffected by OC use. CONCLUSIONS: The intake of OC significantly increases the lipid peroxidation in women aged 40-48 years. This may represent a potential cardiovascular risk factor for these women. [less ▲]

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See detailPeut-on sortir de l'embrouillamini relatif aux contraceptifs oraux et aux cancers cutanés?
Pierard, Gérald ULiege; Pierard, Claudine ULiege; Quatresooz, Pascale ULiege et al

in Revue Médicale de Liège (2007), 62(5-6), 463-6

Skin contains various hormonal receptors, particularly those for estrogens, progesterone and androgens. Steroid hormones of oral contraceptives affect the skin, in particular the control of the cell cycle ... [more ▼]

Skin contains various hormonal receptors, particularly those for estrogens, progesterone and androgens. Steroid hormones of oral contraceptives affect the skin, in particular the control of the cell cycle, DNA replication, apoptosis and other cellular functions. Some estrogen-responsive pathways have the potential to promote tumor development. The question of whether oral contraceptives increase the risk for the development of skin cancer, particularly melanoma, remains an area of concern. There is some evidence that steroid hormones present in oral contraceptives do not significantly increase the risk of developing skin cancer when estrogen exposure is not excessive. [less ▲]

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See detailActualites therapeutiques en gynecologie: pathologies organiques
HERMAN, Philippe ULiege; Lifrange, Eric ULiege; Nisolle, Michelle ULiege et al

in Revue Médicale de Liège (2007), 62(5-6, May-Jun), 414-22

Over the last ten years, progress in evidence-based medicine coupled with technological and surgical breakthroughs have deeply changed the management of our patients. Uterine bleeding is the first cause ... [more ▼]

Over the last ten years, progress in evidence-based medicine coupled with technological and surgical breakthroughs have deeply changed the management of our patients. Uterine bleeding is the first cause of gynaecological consultation and the intrauterine progestin delivery system as well as new hysteroscopic procedures have optimized the therapeutic approach to this problem. Introduction of magnetic resonance imaging and interventional procedures have improved breast disease diagnosis and management; likewise sentinel node localization, introduction of aromatase and growth factors inhibitors, new radiotherapy procedures and pharmacogenomics, have helped to ameliorate breast cancer treatment. Pelvic surgery has been switching more and more towards laparoscopic procedures not only in the field of benign lesions (eg endometriosis), of surgery of prolapse and incontinence with new prosthetic materials, but also for an improved management of gynaecological cancers. [less ▲]

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See detailSkin climacteric aging and hormone replacement therapy.
Quatresooz, Pascale ULiege; Pierard, Claudine ULiege; Gaspard, Ulysse ULiege et al

in Journal of Cosmetic Dermatology (2006), 5(1), 3-8

A gender perspective is indispensable for a full understanding of aging. Menopause is a turning point in women's lives. In addition to the effects of chronological aging, sunlight exposure, and other ... [more ▼]

A gender perspective is indispensable for a full understanding of aging. Menopause is a turning point in women's lives. In addition to the effects of chronological aging, sunlight exposure, and other environmental and endogenous stimuli, the climacteric appears to exert some dramatic consequences on skin biology and aspect. The epidermis may become xerotic and exhibit altered functions. The dermis thins out and its elasticity decreases in concert with the decline in bone mass. The skin microcirculation is impaired. These aspects are some of the better worked-out changes of the climacteric, which in turn seem to be stabilized or in part reversible with hormone replacement therapy (HRT). The HRT effect on menopause consequences on hair growth and sebum production is less impressive. This review summarizes some important impacts of the climacteric on skin, and highlights the benefits of HRT that may influence cosmetic dermatology. [less ▲]

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See detailLa peau et le temps de la menopause.
Thirion, Laurence; Franchimont, Claudine ULiege; Arrese Estrada, Jorge ULiege et al

in Revue Médicale de Liège (2006), 61(3), 159-62

The estrogen deficit occurring at menopause manifests itself under various modalities in the diverse organs and their functions. Skin does not escape this global involutive process. In addition to the ... [more ▼]

The estrogen deficit occurring at menopause manifests itself under various modalities in the diverse organs and their functions. Skin does not escape this global involutive process. In addition to the effects of chronological ageing, sunlight exposure and other environmental and endogenous stimuli, the climacteric appears to exert some dramatic consequences on skin biology and aspect. The epidermis, its adnexae and the dermis are altered by this process. The epidermis may become xerotic and exhibits altered functions. The dermis thins out and its elasticity decreases in concert with the decline in bone mass. The skin microcirculation is impaired. These aspects are some of the better-worked out skin climacteric changes of which in turn seem to be stabilized or in part reversible with hormone replacement therapy (HRT). [less ▲]

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See detailLe cas clinique du mois. Remplacement de l'aorte ascendante et conservation de la valve aortique: operation de David
RADERMECKER, Marc ULiege; Pierard, Luc ULiege; GASPARD, Ulysse ULiege et al

in Revue Médicale de Liège (2005), 60(3), 141-3

We report the case of an ascending aortic aneurysm involving the aortic root, with a functionally competent bicuspid aortic valve, treated by the David's operation. This operation allows to fix the aortic ... [more ▼]

We report the case of an ascending aortic aneurysm involving the aortic root, with a functionally competent bicuspid aortic valve, treated by the David's operation. This operation allows to fix the aortic root pathology, whilst preserving the native aortic valve. The technical aspects, surgical indications, and potential benefits of this operation are reviewed. [less ▲]

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