Effect 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.

BACKGROUND: 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 Liégeoise 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 microM 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/l). 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) and gamma-tocopherol (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.

[Should the BCG vaccine still be recommended?]. / Doit-on encore recommander le vaccin BCG?

The BCG vaccine has demonstrated its efficacy to protect young children from severe extrapulmonary forms of tuberculosis. Nevertheless, the immunity induced by the vaccine disappears in adults and cannot be boosted by readministration of BCG. Adverse effects of BCG are rare, but potentially dangerous (i.e. disseminated vaccinal infections) and they justify the fact that BCG should not be administered anymore in Western European countries where the incidence of pediatric tuberculous meningitis is very low. The vaccine is still recommanded for children living in countries with high tuberculosis prevalence and for resident children leaving Belgium for these countries.

[Some Websites frequently used in general practice]. / Dix sites Internet d'usage fréquent en médecine générale.

Internet use is booming worldwide. The general practitioner can find on the Web a significant help for his research of information, as well as for his medical practice and the administrative management of his office. The proportion of general practitioners who make use of Internet in their professional life is constantly increasing, but their major difficulty remains to know where to quickly find the reliable information. The purpose of this paper is to describe ten Websites of particular interest in general practice.

[Evaluation of tetanus vaccine coverage in rural society]. / Evaluation de la couverture vaccinale anti-tétanique en milieu rural.

The Liège University Department of General Practice and the Association of the General Practitioners of Sprimont (Belgian municipality) have jointly drawn up a study protocol named "Evaluation of anti-tetanus cover in rural society". The aim of this epidemiological search program was to answer the 2 following questions: What is the status of anti-tetanus cover among the rural population, according to age, sex and social classes? Is vaccine protection influenced by leisure activities (sport practice, gardening and animal farming at a small scale)? We received 790 answers out of 960 forms sent in a at random selected population (82.3%). A sampling classification has been done by the general practitioners, who have determined 3 categories of patients: unprotected patients (no vaccination for the last 10 years), patients in the process of vaccination, protected patients. Protected patients represent 51.8% of the population. Surprisingly enough, more than 45% of that rural population are not protected. This study clearly shows that two factors highly influence the vaccination cover against tetanus: age (elderly are less protected) and sex (women are always less protected than men). It also emerges from our analysis that the nature of the population's professional activities does not influence the protection rate. In contrast, leisure activities seem to have a favourable impact on the vaccination rate, sport leading to a better protection for both sexes. It is also true in the case of gardening practice, frequent in rural environment. We must then be careful to reach optimal vaccination among a population with an increasing life expectancy, therefore with more and more elderly people, and we must be careful with vaccination among females, presently less protected. The role of the family doctor is paramount to carry out that mission.

[Post-Doc (post-graduate training for medical doctors in Europe). The use of the Internet in the continuing education of general practice physicians: a European project of multimedia continuing medical education. The University of Aachen, Maastricht, Catholic University Leuven and the Central University Limburg (Diepenbeek) and EUREGIONET]. / Post doc (post graduate training for medical doctors in Europe). L'utilisation d'Internet dans la formation continue des médecins généralistes: un projet européen de formation médicale continue (FMC) multimedia. Universités de Aachen, Maastricht, la Katholieke Universiteit Leuven et l'Universitair Centrum Limburg (Diepenbeek) et EUREGIONET.

The continuing formation of the General Practitioners (GP) must stay in stride with the rapid evolution of society, technology, science and needs of the population. The Web allows on-line a rapid access to a pertinent and practical information whenever needed. PostDoc is a joint venture of the Universities of Aachen, Maastricht, Leuven and Diepenbeek. The Department of general medicine is associated with the Service of Technology of Education in this project. The interactivity of an Internet Website introduces a cooperative dimension in the work of the GP's centred on formation and discussion of problems encountered. This tool allows each GP to contribute to clinical cases and information.