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See detailComparative Evaluation of Four Detectors in the High-Performance Liquid Chromatographic Analysis of Chiral Nonaromatic Alcohols
Toussaint, B.; Duchateau, A. L.; van der Wal, S. et al

in Journal of Chromatographic Science (2000), 38(10), 450-7

A comparative evaluation of ultraviolet, polarimetric, refractive index, and evaporative light-scattering detection coupled with high-performance liquid chromatography has been developed for the ... [more ▼]

A comparative evaluation of ultraviolet, polarimetric, refractive index, and evaporative light-scattering detection coupled with high-performance liquid chromatography has been developed for the separation and quantitation of the enantiomers of chiral nonaromatic alcohols, some of which are intermediates in the synthesis of chiral drugs. (R,S)-3-tert-butylamino-1,2-propanediol; (R,S)-glycidol; and (R,S)-1-(4-morpholino)-2-octanol are selected as model compounds in order to compare the detection sensitivity and the linearity of the response with the four detectors. Separation of the enantiomers is performed using chiral stationary phases in normal-phase liquid chromatography. A one-day validation is achieved for (S)-3-tert-butylamino-1,2-propanediol with each detector, and limits of quantitation are determined for the three compounds. Advantages and limitations of the four detectors are discussed. [less ▲]

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See detailFracture and Bone Mineral Density in Hemodialysis Patients
Fontaine, M. A.; Albert, Adelin ULg; Dubois, Bernard ULg et al

in Clinical Nephrology (2000), 54(3), 218-26

AIM: The aim of this cross-sectional study was to determine in hemodialysis patients the pattern of low trauma fracture, the ability of dual X-ray absorptiometry (DXA) to discriminate between patients ... [more ▼]

AIM: The aim of this cross-sectional study was to determine in hemodialysis patients the pattern of low trauma fracture, the ability of dual X-ray absorptiometry (DXA) to discriminate between patients with and without fracture, and the magnitude, distribution and mechanism of bone loss. PATIENTS AND METHODS: Eighty-eight patients were studied. Bone mineral density (BMD) was measured by DXA at lumbar spine (LS), femoral neck (FN) and 3 radius sites (UD, MID and 1/3R). In 11 patients (12.5%), 16 fractures occurred and were predominant at the distal forearm and ribs. RESULTS: Patients with fracture had a significatively lower BMD Z-score at LS (-1.34 +/- 1.66 vs -0.42 +/- 1.23), at FN (-1.58 +/- 1.25 vs -0.60 +/- 1.01), at MID radius (-2.59 +/- 1.34 vs -0.93 +/- 1.76) and 1/3 radius (-1.62 +/- 1.60 vs -0.39 +/- 1.32). They also had a longer history of dialysis (113 +/- 64 vs 53 +/- 65 months). Prevalence of osteoporosis varied from 23% at LS to 50% at MID radius. CONCLUSION: Multiple regression analysis showed that there was no influence of gender, age, parathormone status and primary renal disease on BMD. However, at FN, UD, MID and 1/3 radius, a significantly negative correlation was found between length of dialysis and BMD Z-score. By contrast at LS, there was a positive correlation between age at onset of dialysis and BMD Z-score. Despite occurrence of fracture at the fistula forearm, BMD levels were similar in both arms. [less ▲]

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See detailDetermination of the Enantiomers of 3-Tert.-Butylamino-1,2-Propanediol by High-Performance Liquid Chromatography Coupled to Evaporative Light Scattering Detection
Toussaint, B.; Duchateau, A. L.; van der Wal, S. et al

in Journal of Chromatography. A (2000), 890(2), 239-49

A method for the separation and quantitation of the enantiomers of 3-tert.-butylamino-1,2-propanediol by high-performance liquid chromatography and evaporative light scattering detection has been ... [more ▼]

A method for the separation and quantitation of the enantiomers of 3-tert.-butylamino-1,2-propanediol by high-performance liquid chromatography and evaporative light scattering detection has been developed. Separation of the enantiomers was performed in normal-phase liquid chromatography on a Chiralpak AS chiral stationary phase. The influence of the gas nature, gas pressure and temperature of the drift tube of the evaporative light scattering detector on the detection sensitivity was investigated. The method was validated in terms of linearity, limit of quantitation, accuracy and precision. The enantiomeric excess of (S)-3-tert.-butylamino-1,2-propanediol, used for the industrial synthesis of (S)-timolol, was measured from 0 to 94%. [less ▲]

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See detailLes determinants du comportement de recours au centre de sante en milieu urbain africain: resultats d'une enquete de menage menee a Kinshasa, Congo
Manzambi Kuwekita, Joseph ULg; Tellier, V.; Bertrand, Françoise ULg et al

in Tropical Medicine & International Health [=TM & IH] (2000), 5(8), 563-70

This study analyses the choice determinants of the population for health centres through a survey of the behaviour of families in a representative sample of 1,000 households in the health districts of ... [more ▼]

This study analyses the choice determinants of the population for health centres through a survey of the behaviour of families in a representative sample of 1,000 households in the health districts of Kinshasa, Congo in 1997. For the most recent episode of illness, the respondents turned to seven types of care: the health centre (37%), private dispensaries (26.5%), self-medication through a pharmacy (23.9%), traditional practitioner (21%), traditional self-medication (16.9%), private outpatients' clinic (16.7%) and a reference hospital (10.4%). Past logistics have shown that patients resort to a health centre rather than another type of care structure (P = 0.05) when looking for quality care, reasonable prices and the availability of varied services. On the other hand, concern about the geographical proximity in relation to the family's residence calls for using the private dispensary. When looking for a doctor or the existence of a 'convention', families are more inclined to choose a private officially recognized outpatients' clinic. Those who had been looking for a solution to a special type of illness opted primarily for a traditional practitioner. In conclusion, the results of this study show that if people choose the care offered by health centres, it is because they judge it to be of good quality. The integrated care offered by the same technician, with a required training, is a major asset in the acceptability of the first line of primary health care in Kinshasa. This study suggests that it would no doubt be beneficial to integrate non-official private care structures into the primary health care system, as far as it is possible for them to achieve a level of quality comparable to that of the health centres. In order that the traditional practitioner might play an important complementary role in the realization of primary health care, even in urban areas, the possibility of promoting sites of communication should be studied. Moreover, considering the weak buying power of the city's inhabitants and the previous existence of tontines out of solidarity, the 'conventions' providing relief of health care costs, under the leadership of the local communities, should be integrated into the organization of the urban health system. [less ▲]

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See detailFrom neurophysiology to genetics: cortical information processing in migraine underlies familial influences--a novel approach
Sandor, P. S.; Afra, J.; Proietti Cecchini, A. P. et al

in Functional Neurology (2000), 15(Suppl 3), 68-72

Migraine patients show impaired cortical information processing between attacks with deficient habituation of pattern-reversal visual evoked potentials (VEP), and strong intensity dependence of auditory ... [more ▼]

Migraine patients show impaired cortical information processing between attacks with deficient habituation of pattern-reversal visual evoked potentials (VEP), and strong intensity dependence of auditory cortical evoked potentials (IDAP). This could be a genetic trait as certain genetic patterns are known for evoked potentials in healthy subjects. VEP-habituation and IDAP were studied in 40 migraine patients, i.e. pairs of 20 parents and their children. We developed a novel approach based on Monte Carlo statistics to selectively assess vertical familial influences. Both groups, parents and children, were characterized by abnormal VEP-habituation and IDAP. However, similarity between related pairs was far more pronounced than similarity between unrelated pairs. Assessed with a novel statistical approach, familial influences proved to be highly significant in determining cortical information processing in migraineurs, thus supporting the important role of genetic factors. [less ▲]

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See detailInfluence of colors on habituation of visual evoked potentials in patients with migraine with aura and in healthy volunteers.
Afra, J; Ambrosini, A; Génicot, Roger ULg et al

in Headache (2000), 40(1), 36-40

OBJECTIVE: To investigate whether colored glasses influence the habituation of visual evoked potentials. BACKGROUND: We have previously shown that during pattern-reversal stimulations lasting 2 minutes ... [more ▼]

OBJECTIVE: To investigate whether colored glasses influence the habituation of visual evoked potentials. BACKGROUND: We have previously shown that during pattern-reversal stimulations lasting 2 minutes the amplitude of the visual evoked potential increases in migraine with and without aura between attacks, whereas it decreases in healthy volunteers. Red light was found to increase visually evoked EEG fast activity only in children with migraine with aura. Wearing rose-tinted glasses for 4 months decreased attack frequency in parallel with a reduction of the visually evoked EEG fast activity. METHODS: We compared the change in amplitude of the visual evoked potential using five different tinted glasses in 12 patients with migraine with aura and in 10 healthy volunteers. During continuous stimulation at 3.1 Hz, five blocks of 50 responses were sequentially averaged using red, yellow, green, blue, and grey glasses and without glasses in a random order and analyzed in terms of latencies and N1-P1 amplitudes. Amplitude changes were calculated for each block by comparison with the first block in every condition and analyzed statistically using Zerbe's method. RESULTS: In healthy volunteers, the visual evoked potential amplitude increased with red glasses compared to without glasses (P = .05) or with green glasses (P = .03). In patients with migraine with aura, no significant difference was detected using colored glasses. Our findings in healthy volunteers are in line with earlier reports of increased excitability of the human visual cortex when exposed to red light. The lack of such a pattern in patients with migraine with aura suggests that the visual cortex is interictally hypoexcitable rather than hyperexcitable, which is consistent with studies of transcranial magnetic stimulation. [less ▲]

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See detailAssessment of postoperative nausea using a visual analogue scale.
Boogaerts, J G; Vanacker, E; Seidel, Laurence ULg et al

in Acta Anaesthesiologica Scandinavica (2000), 44(4), 470-4

BACKGROUND: Assessment of postoperative nausea intensity is difficult because nausea is a subjective and unpleasant sensation. We propose using the Visual Analogue Scale (VAS) device to increase the ... [more ▼]

BACKGROUND: Assessment of postoperative nausea intensity is difficult because nausea is a subjective and unpleasant sensation. We propose using the Visual Analogue Scale (VAS) device to increase the efficiency and precision in the assessment of nausea. We carried out a pilot study on postoperative patients suffering from nausea to measure the degree of agreement between the VAS scores and those given on a 4-point verbal descriptive scale (VDS). METHODS: Postoperative nausea was evaluated by means of a classical VAS (0-10 cm) device and a 4-point VDS (0=no nausea, 1=mild, 2=moderate, 3=severe) in 128 surgical spontaneously complaining patients. Evaluation was repeated 45 min after rescue medication given if nausea was intractable, lasted more than 10 min or at the request of the patient. Ordinal logistic regression was used to measure the association between VAS and VDS and to determine cut-off points on the VAS. RESULTS: The VAS device was easily understood and used by patients. VAS scores decreased significantly from 5.5+/-2.3 to 1.4+/-1.8 after rescue medication (P=0.002). Application of ordinal logistic regression to pre- and post-medication data combined yielded an agreement of 86% between VAS and VDS and the cut-off points on the VAS were estimated as follows: 0-1 (no nausea), 1+/-4 (mild), 4+/-7 (moderate) and 7+/-10 (severe). CONCLUSION: The VAS method proved to be useful for assessing quantitative nausea intensity and for testing the efficacy of rescue medication. It was found that a cut-off value of 4 on the VAS may be considered as a critical threshold triggering anaesthesiologists or nurses to administer rescue medication. [less ▲]

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See detailComparison of rectal and infrared ear temperatures in older hospital inpatients.
Smitz, Simon ULg; Giagoultsis, T; Dewé, Walthère ULg et al

in Journal of the American Geriatrics Society (2000), 48(1), 63-6

OBJECTIVES: To assess the agreement between infrared emission detection (IRED) ear and rectal temperatures and to determine the validity of IRED ear thermometry in detecting rectal fever. DESIGN ... [more ▼]

OBJECTIVES: To assess the agreement between infrared emission detection (IRED) ear and rectal temperatures and to determine the validity of IRED ear thermometry in detecting rectal fever. DESIGN: Prospective, convenience sample, unblinded study. SETTING: An acute geriatric unit (teaching hospital) and a multidisciplinary intensive care unit. PARTICIPANTS: The study included 45 inpatients (26 women and 19 men), aged 78.3+/-6.9 years, admitted over a 4-month period. Twelve of the patients were definitely infected. MEASUREMENTS: Sequential rectal (RT) and ear temperature (ET) measurements were performed using mercury-in-glass and IRED ear thermometers, respectively. IRED ear temperatures were measured at both ears (unadjusted mode), with the highest of six ear temperatures considered the true value. RESULTS: Mean RT (37.39 degrees C +/- 0.52 degrees C) was significantly (P<.001) higher than mean ET (36.89 degrees C +/-0.59 degrees C). A highly significant positive correlation was found between RT and ET (slope = 0.69; 95% CI, 0.52-0.86; P<.001; r = 0.78). The mean bias (mean of the differences) between RT and ET was 0.50 degrees C +/-0.37 degrees C (95% CI, 0.41 degrees C-0.59 degrees C), and the 95% limits of agreement -0.22 degrees C and 1.23 degrees C (95% CI, -0.38 degrees C to 1.39 degrees C). According to the standard criterion (RT > or =37.6 degrees C), 14 patients were febrile. Using an optimum IRED ear fever threshold (37.2 degrees C), the sensitivity and specificity of IRED ear thermometry for predicting rectal fever were 86% and 89%, respectively (positive predictive value, 80%; negative predictive value, 93%). CONCLUSIONS: The degree of agreement between rectal temperature and the highest of six IRED ear temperatures was acceptable. Using an optimal IRED ear fever threshold of 37.2 degrees C (99 degrees F), IRED ear thermometry had acceptable sensitivity and specificity for predicting rectal fever. [less ▲]

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See detailClinical Usefulness of the Mini Nutritional Assessment (Mna) Scale in Geriatric Medicine
Gazzotti, C.; Albert, Adelin ULg; Pepinster, A. et al

in Journal of Nutrition, Health & Aging (The) (2000), 4(3), 176-81

OBJECTIVE: This study was undertaken to estimate the prevalence of malnutrition in elderly patients hospitalized with an acute illness, as well as to assess the clinical usefulness of standardized ... [more ▼]

OBJECTIVE: This study was undertaken to estimate the prevalence of malnutrition in elderly patients hospitalized with an acute illness, as well as to assess the clinical usefulness of standardized nutritional assessment upon admission by means of the MNA scale. Design: A prospective study. Setting: A large size regional university hospital. Subjects: There were 175 patients (113 women and 62 men) with a mean age of 79.7 + 8.5 years admitted for an acute problem. Death occurred in 11 patients (6.3%). METHODS: Upon admission, demographic (age, gender, origin) and medical (disease, drugs) data were recorded for each patient; the MNA questionnaire (score: 0-30) was administered and Katz score (7-28) calculated. At hospital discharge, data included Katz score, outcome (death/survival), and destination. RESULTS: The mean MNA score was 20.5 + 5.1 and the prevalence of severe malnutrition (MNA <17) was 21.7%. Further, 48.6% of elderly were at risk of malnutrition (MNA between 17 and 24). There was no association between MNA and age or gender, but underweight was a sign of low MNA values (P <.001). MNA scores were inversely related to Katz scores at both admission and hospital discharge (P <.001). Patients originating from nursing homes had a poorer nutritional status than those living at home (MNA: 18.4 against 22.3, P <.001). The number of drugs taken per patient (5.2 + 2.8) was found to be correlated with MNA (P =.049). MNA scores were on average significantly higher (P <.001) in survivors (20.9) than in nonsurvivors (14.1). CONCLUSIONS: The study clearly demonstrates the high prevalence of malnutrition and the clinical usefulness of the MNA scale in geriatric medicine. The MNA score upon admission reflects the patient's nutritional condition, degree of autonomy (Katz score), living conditions and current treatment. It is also predictive of patient's outcome (death or survival). [less ▲]

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See detailA four-parameter index of marrow dysplasia has predictive value for survival in myelodysplastic syndromes.
Tassin, Françoise ULg; Dewé, Walthère ULg; Schaaf, Nicole ULg et al

in Leukemia & Lymphoma (2000), 36(5-6), 485-96

Marrow dysplasia is a major characteristic of patients with myelodysplastic syndrome (MDS), along with marrow blastosis, cytopenia and cytogenetic anomalies. However, the impact of the degree of marrow ... [more ▼]

Marrow dysplasia is a major characteristic of patients with myelodysplastic syndrome (MDS), along with marrow blastosis, cytopenia and cytogenetic anomalies. However, the impact of the degree of marrow dysplasia on survival has not been fully assessed. In this retrospective analysis of 111 patients selected according to the IPSS criteria of MDS diagnosis, the presence or absence of 21 dysplasia characteristics recognizable in bone marrow smears stained by the May-Grunwald-Giemsa method was correlated with patient survival. Using Cox proportional hazards regression analysis, megaloblastosis (MEGALO), neutrophil agranularity (AGRAN) and hypogranularity (HYPOGRAN) were highly significant predictors (p < 0.005), and Pelger-Huet anomaly (PELGHUET) a significant predictor (p = 0.05), of patient survival. The regression analysis yielded a dysplasia-based risk index (DI) where DI = 1.26 MEGALO + 0.82 AGRAN - 1.08 HYPOGRAN + 0.45 PELGHUET. The two subgroups of 60 and 47 patients with DI < or = 0 and > 0 showed highly significant differences in median survivals (2.6 vs 1.1 yrs; p <0.0001). Multivariate analysis further showed that DI offered additional predictive power that was independent of that provided by the IPSS (p=0.002 and 0.001 respectively). Analysis of survival curves stratified for IPSS and DI showed that the additional predictive power offered by inclusion of the DI essentially concerned the IPSS low/INT-1 risk categories. Further stratification for age did not improve survival prediction. The data indicate that a set of 4 dysplasia parameters can offer some prediction for survival of MDS patients in addition to that provided by the IPSS. Further multicenter studies should aim at including some form of evaluation of the degree of dysplasia in prognostic systems. [less ▲]

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See detailTropisetron in the prevention of postoperative nausea and vomiting.
Boogaerts, J G; Bardiau, Françoise ULg; Seidel, Laurence ULg et al

in Journal of Clinical Anesthesia (2000), 12(5), 402-8

STUDY OBJECTIVES: To evaluate the efficacy of tropisetron, a selective 5-HT(3) receptor antagonist, in preventing nausea and vomiting in high-risk inpatients undergoing various surgical procedures. DESIGN ... [more ▼]

STUDY OBJECTIVES: To evaluate the efficacy of tropisetron, a selective 5-HT(3) receptor antagonist, in preventing nausea and vomiting in high-risk inpatients undergoing various surgical procedures. DESIGN: Prospective, open, nonrandomized, observational, interventional study. SETTING: Postanesthesia care unit, and surgical wards of the University Hospital Center, Charleroi. PATIENTS: A total of 1,132 elective surgical inpatients (>15 years of age) in two separate surveys. The first prospective survey covered all surgical adult inpatients (n = 671) after various surgical procedures over a 3-month period. A new 3-month survey was performed to assess the effectiveness of the preventive measure and included another 461 patients. INTERVENTIONS: Risk factors associated with nausea and vomiting were recorded in the first survey and used to establish an antiemetic policy. This consisted in the administration of tropisetron 2 mg intravenously after anesthesia induction, if two patient-related risk factors associated with high-risk surgery and general anesthesia were present. MEASUREMENTS AND MAIN RESULTS: Nausea frequency and intensity, assessed every 4 hours using a visual analog scale (VAS), frequency and times of vomiting episodes and the need for rescue medication were recorded for 72 hours postoperatively. Nausea was experienced by 18.8% and vomiting by 9.8% of the patients in the first survey (211 high risk-patients of 671). In the second survey, 137 patients of 461, considered at high-risk received prophylactic tropisetron. The proportion of patients having nausea decreased to 11.1% (p,178 0.01) and vomiting episodes to 2.8% (p < 0.001). Twenty-six of the tropisetron-treated patients (19%) suffered subsequent postoperative nausea and vomiting (PONV). Patient satisfaction with tropisetron was high. CONCLUSION: Prophylactic tropisetron can reduce the incidence of PONV in selected high-risk inpatients undergoing various types of surgical procedures. [less ▲]

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See detailEvaluation of frequency and type of errors detected by a computerized record and verify system during radiation treatment
Barthelemy, Nicole ULg; Sabatier, Jacques; Dewé, Walthère ULg et al

in Radiotherapy & Oncology (1999), 53(2), 149-54

Background: Computerized record and verify systems (RVS) have been introduced to improve the precision of radiation treatment delivery. These systems prevent the delivery of ionizing radiations when the ... [more ▼]

Background: Computerized record and verify systems (RVS) have been introduced to improve the precision of radiation treatment delivery. These systems prevent the delivery of ionizing radiations when the settings of the treatment machine do not match the intended parameters within some maximal authorized deviation. Purpose: To assess the potential alteration of the frequency of errors associated with the use of RVS during radiation treatment delivery. Materials and methods: The software of the RVS was altered in order to record the settings actually used for radiation treatment delivery whereas the verification function was suppressed. At the end of the study period, the settings used during daily administration of radiation treatment were compared to the parameters recorded in the RVS using the computer. They were also compared with the planned ones written in the patient treatment chart. Results: Out of the 147 476 parameters examined during the study period, 678 (0.46%) were set erroneously. At least one error occurred in 628 (3.22%) of the 19 512 treated fields. An erroneous parameter was introduced in the RVS memory in 22 (1.17%) of the 1885 fields. Conclusions: RVS has the potential to improve precision of radiation treatment delivery by detecting a significant number of setting errors. However, excessive confidence in RVS could lead to repeated errors as there is a potential for the entry of erroneous parameters into the RVS memory. [less ▲]

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See detailEffectiveness of an acute pain service inception in a general hospital
Bardiau, Françoise ULg; Braeckman, M.M.; SEIDEL, Laurence ULg et al

in Journal of Clinical Anesthesia (1999), 11(7), 583-589

STUDY OBJECTIVES: To assess the effects of an Acute Pain Service (APS) inception on postoperative pain management in a general teaching hospital using pain indicators as performance measures. DESIGN: Open ... [more ▼]

STUDY OBJECTIVES: To assess the effects of an Acute Pain Service (APS) inception on postoperative pain management in a general teaching hospital using pain indicators as performance measures. DESIGN: Open, prospective, nonrandomized, observational study. SETTING: Postanesthesia Care Unit, surgical wards of University Hospital Center of Charleroi. PATIENTS: 1304 patients in the pre-APS inception phase and 671 patients after its implemention who have undergone various types of surgery (orthopedics, gynecology, urology, neurosurgery, stomatology, ear, nose, and throat, ophthalmic, abdominal, vascular-thoracic, plastic, and maxillofacial). INTERVENTIONS: An APS, nurse-based, anesthesiologist-supervised model was devised, based on the concept that postoperative pain relief can be greatly improved by providing in-service training for surgical nursing staff and optimal use of systemic analgesics. MEASUREMENTS AND MAIN RESULTS: Postoperative pain was assessed using a visual analog scale (VAS) every 4 hours for 72 hours in the two phases. Analgesic consumption was registered at the same time. Time-related VAS scores were summarized using several pain indicators. There was an overall improvement in the pain scores after APS inception. The differences were most pronounced, around 50%, in patients undergoing vascular, maxillofacial, gynecologic, and urologic surgeries, and stomatology. Regular administration of paracetamol and nonsteroidal antiinflammatory drugs decreased morphine consumption in the second phase. CONCLUSION: This study validates the benefits of a formal APS, using continuous monitoring of rest pain intensity and analgesic consumption in the postoperative period. Results not only support previous research findings but also offer outcome-based tools to evaluate current practices as compared with desired outcomes. [less ▲]

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See detailFamilial influences on cortical evoked potentials in migraine.
Sandor, P S; Afra, J; Proietti-Cecchini, A et al

in Neuroreport (1999), 10(6), 1235-8

Cortical information processing in migraine patients is impaired between attacks, showing deficient habituation of pattern-reversal visual evoked potentials (VEP), and strong intensity dependence of ... [more ▼]

Cortical information processing in migraine patients is impaired between attacks, showing deficient habituation of pattern-reversal visual evoked potentials (VEP), and strong intensity dependence of auditory cortical evoked potentials (IDAP). This could be a genetic trait as certain genetic patterns are known for evoked potentials in healthy subjects. We investigated VEP habituation and IDAP in 20 pairs of migraineurs made up of parents and their children. Using a Monte-Carlo statistical method, we selectively assessed vertical familial influences. VEP habituation and IDAP were abnormal in both parents and children. However, similarity was far more pronounced between related pairs than between unrelated pairs. Familial influences are highly significant in determinants of cortical information processing in migraineurs, hence supporting the important role of genetic factors. [less ▲]

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See detailLimited clinical utility of a self-evaluating risk assessment scale for postmenopausal osteoporosis: lack of predictive value of lifestyle-related factors
Goemaere, S; Zegels, Brigitte ULg; Toye, K et al

in Calcified Tissue International (1999), 65(5), 354-358

The aim of this study was to assess the efficiency of a self-administered questionnaire to identify subjects with postmenopausal osteoporosis in the setting of first line medical care. A sample of 300 ... [more ▼]

The aim of this study was to assess the efficiency of a self-administered questionnaire to identify subjects with postmenopausal osteoporosis in the setting of first line medical care. A sample of 300 postmenopausal women completed the questionnaire based on 18 items. Bone mineral density at the lumbar spine (BMD-L), total hip (BMD-H), and femoral neck (BMD-N) was used as objective criterion for evaluation. The mean risk score was 8.2 +/- 3.21. BMD was correlated with total risk score: r = -0.32 for BMD-L, -0.36 for BMD-N, and -0.43 for BMD-H. Cutoff points for the risk score (equal likelihood points) according to a T-score threshold of -2.5 were 8.6 for BMD-L and BMD-N and 9.3 for BMD-H; specificity and sensitivity was 62% and 62%, respectively, for BMD-L, 65% and 62% for BMD-N, and 75% and 63% for BMD-H. Stepwise multiple regression analysis of the questionnaire items in relation to BMD showed higher correlation coefficients for models including individual items rather than the overall risk score. Items concerning low weight, older age, and wrist fracture after 50 years of age were always selected as significant determinants of BMD (R = 0.43-0.55). Hormonal replacement therapy was also an important determinant. Lifestyle-related items did not contribute significantly. In conclusion, the diagnostic performance of the 18-item self-administered questionnaire was poorer than a shortened questionnaire omitting lifestyle factors. The clinical utility of a questionnaire should ultimately be evaluated in the specific optic of a chosen global strategy for prevention of osteoporotic fractures. [less ▲]

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See detailPubertal Growth as a Determinant of Adult Height in Boys with Constitutional Delay of Growth and Puberty
Rensonnet, Claudie ULg; Kanen, F.; Coremans, C. et al

in Hormone Research (1999), 51(5), 223-9

In boys with constitutional delay of growth and puberty, adult height may be inconsistent with parental (target) height. We aimed at studying which period of growth was important to account for adult ... [more ▼]

In boys with constitutional delay of growth and puberty, adult height may be inconsistent with parental (target) height. We aimed at studying which period of growth was important to account for adult height being above or below target height. In this retrospective study, adult height measured after 20 years in 39 patients was compared with target height and height data obtained at about 6 and 12 years of age and at diagnosis of delayed puberty (mean 14.6 years). Twenty-eight patients were untreated while 11 received testosterone enanthate (50 or 100 mg/month for 6 months). The growth data from both groups were pooled since they were not different. On average, the adult height standard deviation score (-0. 6 +/- 0.8, mean +/- SD) was similar to target height (-0.5 +/- 0.6). There were, however, marked individual differences since adult height varied between 1.7 SD (11 cm) below target height and 1.4 SD (9.5 cm) above target height. Multiple regression analysis showed that the most significant determinant of the difference between adult height and target height was height catch up during puberty (p < 0.002). We conclude that the magnitude of height catch up during puberty is a significant determinant of adult height in boys with constitutional delay of growth and puberty. Thus, optimizing pubertal growth may be a relevant therapeutic aim for adult height in boys with short stature and delayed puberty. Copyrightz1999S. KargerAG,Basel [less ▲]

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