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See detailStandardisation of 25(OH)-vitamin D assays: beware of limitations
CAVALIER, Etienne ULg

Conference (2014, June 24)

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See detailURINARY AND SALIVARY CORTISOL IN LIQUID CHROMATOGRAPHY–TANDEM MASS SPECTROMETRY: METHOD VALIDATION AND EXPECTED VALUES DETERMINATION
LE GOFF, Caroline ULg; DELCOUR, Sandra ULg; PEETERS, Stéphanie ULg et al

in Clinical Chemistry & Laboratory Medicine (2014, June), 52(Special Suppl), 1241

BACKGROUND: Cortisol measurement is useful in evaluation of Cushing syndrome, adrenal insufficiency, mineralocorticoid excess and congenital adrenal hyperplasia. We developed a liquid ... [more ▼]

BACKGROUND: Cortisol measurement is useful in evaluation of Cushing syndrome, adrenal insufficiency, mineralocorticoid excess and congenital adrenal hyperplasia. We developed a liquid chromatography–tandem mass spectrometry (LCMS/MS) method for salivary and urinary cortisol and we determined the 95th percentile (p95) for the urinary and salivary cortisol. We compared them to the Mayo Clinic expected values. METHODS: Saliva at 8 am and 11 pm and 24h urine were obtained from 32 healthy (22 female, 34.3±9.3 yo) volunteers. We performed validation with the enoval software (Arlenda, Belgium). For the validation, we used water or urine with spiked known amounts of cortisol for the CORS and CTU respectively. For the CORS, samples were centrifuged, deuterium labelled cortisol was added as internal standard and the protein precipated by acetonitril. The supernatant was evaporated, dissolved in methanol acidified with acetic acid and analyzed by LCMS/MS. For CTU, samples were centrifuged, deuterium labelled cortisol was added as internal standard and diluted by the ammonium acetate and analyzed by LCMS/MS. At the Mayo Clinic, the expected values were 1-7.5 μg/L (7 a.m-9 a.m) and <1 μg/L (11-12 p.m) for CORS and 3.5-45 μg/24h (<18yo) for CTU. RESULTS: For the CTU, the with-in run did not exceed 3% (0.4-3%) and the between-run did not exceed 3.1% (0.4-3.1%) for 1.5-750 μg/L. The limit of quantification was 1.5 μg/L. The linearity was good between 1.5 and 750 μg/L. The recovery is 97.9±2.2% (95%CI for the mean: 92.4-101.1%). For the CORS, the with-in run and between run did not exceed 8% (1.9-8%) for 1.15-8.65 μg/L. The limit of quantification was 1.15 μg/L. The analyse presents a good linearity between 1.15 and 8.65 μg/L. The recovery is 99.9±2.9% (95%CI for the mean: 94.2-108.7%). The p95 for the CTU according to the CLSI C28-A3 was 33 μg/24h, and for the CORS was 5.42 μg/L at 8 am and 0.7 μg/L at 12 pm. CONCLUSIONS: Our developed method in liquid chromatography tandem mass spectrometry was validated for the measurement of urinary and salivary cortisol. Our findings indicate that the proposed analytical methods were suitable for routine purposes and useful in many pathological conditions.The expected values confirm these defined by the Mayo Clinic. [less ▲]

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See detailEvaluation of troponin T on AQT90 Flex and COBAS 8000 as a rule in/out tool in an emergency ward
LE GOFF, Caroline ULg; EVRARD, Séverine ULg; BREVERS, Eric ULg et al

in Clinical Chemistry & Laboratory Medicine (2014, June), 52(Special Suppl), 510

BACKGROUND: Troponin measurement is the gold standard for diagnosis of Acute Myocardial Infarction (AMI). Troponin (highly sensitive (hs), T or I) is measured by immunochemistry instrument or by Point of ... [more ▼]

BACKGROUND: Troponin measurement is the gold standard for diagnosis of Acute Myocardial Infarction (AMI). Troponin (highly sensitive (hs), T or I) is measured by immunochemistry instrument or by Point of Care (POCT). POCT can be useful in emergency lab or ward for a faster diagnosis of patients with chest pain. Our study compared analytical performance of a POCT AQT90 Flex (Radiometer Medical) (AQT) and TnThs Cobas 8000 (Roche Diagnostics) (Cobas). We also compared the clinical performance of both methods at recommended cut-off (14 ng/L for Cobas and 30 ng/ L for AQT). METHODS: We selected 104 patients (296 samples) (range: 6-13822 ng/L) admitted in the Emergency ward for which at least 1 troponin determination (Cobas 8000) had been re-quested in the past 24 hours according to rule in/out procedure applied by this ward. Samples were then measured with the AQT. Inter-assay CV was maximum 8.6% and 9.6% for Cobas and AQT respectively. The cut-off defined as the 99th percentile for Roche was 14 ng/L and the recommended decision threshold value was 30 ng/L for Radiometer. Retrospective analysis of final diagnostic was obtained for all participants: we considered as “true positive” patients for whom a final diagnostic was ST segment-Elevation Myocardial Infarction (STEMI) or non STEMI (NSTEMI). RESULTS: On the whole range of measure, the 2 methods showed a good correlation (r2=0.98). Regression equation was Cobas = 0.98 AQT + 31 ng/L (95%CI of the intercept: (26.7;37.7) and 95% CI of the slope (0.96;1)). When we stratified, for the values <54 ng/L, the equation became Cobas = 0.52 AQT +1.1 ng/L (95%CI of the intercept: (-4.8;5.5) and 95% CI of the slope (0.39;0.69)). Bland and Altman plot did not show any bias. At admission [2-7 hours], 78 (81%) of admitted patients were finally considered as AMI, sensitivity was 92 % [96%] for Cobas and 78% [91%] for AQT. Specificity was 15% for Cobas (cut-off 14ng/L) or 73% (cut-off 54 ng/L) and 76% for AQT. CONCLUSIONS: Overall, there was a good correlation between the 2 methods. However, using a cut-off of 14 ng/L for Cobas is questionable for a rule in/out procedure in an emergency ward. Using 54 ng/L for Roche and 30 ng/L for AQT would have led to the best discrimination between patients presenting AMI or not. [less ▲]

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See detailSUITABILITY OF 24,25(OH)2 VITAMIN D3 DETERMINATION WITH AN ADAPTED VERSION OF THE CHROMSYSTEMS® MASSCHROM® 25-OH-VITAMIN D3/D2– LC-MS/MS KIT
SCHLECK, Marie-Louise ULg; NETCHACOVITCH, Matthieu ULg; CRINE, Yannick ULg et al

in Clinical Chemistry & Laboratory Medicine (2014, June), 52(Special Suppl), 1235

BACKGROUND: The enzym CYP24A1 catalyses the conversion of 25(OH)D3 in 24,25(OH)2D3. Recently, loss-of-function mutation of CYP24A1 has been identified in idiopathic infantile hypercalcemia (IIH). This ... [more ▼]

BACKGROUND: The enzym CYP24A1 catalyses the conversion of 25(OH)D3 in 24,25(OH)2D3. Recently, loss-of-function mutation of CYP24A1 has been identified in idiopathic infantile hypercalcemia (IIH). This genetic defect can be highlighted by high 1,25(OH)2D3 and undetectable 24,25(OH)2D3 levels. 24,25(OH)2D3 is also known to interfere with 25(OH)D3 determinations with immunoassays, leading to an overestimation of the 25(OH)D3 concentrations. We adapted the MassChrom kit on the AB SCIEX TQ 5500 in order to systematically provide, next to 25(OH)D3, 25(OH)D2 and C3 epimer, the concentrations of 24,25(OH)2D3. The aim of this study was to evaluate the performance of 24,25(OH)2D3 determination with this modified method. We also wanted to establish the reference value of 24,25(OH)2D3. METHODS: We modified the Chromsystems MassChrom method by adding the 24,25(OH)D3 correspondent transitions and performed a calibration by spiking known amounts of 24.25(OH)2D3. The LOQ was determined with 10 concentration levels of 24,25(OH)2D3. We selected 92 healthy children (40 girls; 2.4±1.51 years) presenting normal calcium levels (2.49±0.13mmol/l) to determine the 95th percentile (p95). RESULTS: The 24,25(OH)2D3 LOQ was 4.7 ng/ml. 85.9% of our subjects were below this LOQ. The p 95 for the 24,25(OH)2D3, according to the CLSI C28-A3, was <6.2 ng/ml. The average serum concentrations (mean±SD) of 25(OH)D3 and 3-epi-25(OH)D3 were 24.48±10.22ng/ml and 2.07±1.86 ng/ml respectively. The 24,25(OH)2D3 levels (r2=0.64) correlated with the 25(OH)D3 levels. CONCLUSIONS: Our adapted method from Chromsystems Vitamin D determination is available to quantify 24,25(OH)2D3. In this context, this method is able to determine high levels of 24,25(OH)2D3 that can possibly cross react with immunoassays. However, as the LOQ was not low enough, we couldn’t establish correct reference value for 24,25(OH)2D3. A derivatization step in the sample preparation would be interesting to improve the sensibility of the method. [less ▲]

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See detailCan we use circulating biomarkers to monitor bone turnover in CKD haemodialysis patients? Hypotheses and facts
DELANAYE, Pierre ULg; Souberbielle, Jean-Claude; Lafage-Proust, Marie-Hélène et al

in Nephrology Dialysis Transplantation (2014), 29(5), 997-1004

Assessing bone turnover is a key diagnostic tool in the global management of chronic kidney disease-mineral and bone disorder (CKD-MBD). Since bone biopsy is invasive and cannot be repeated in clinical ... [more ▼]

Assessing bone turnover is a key diagnostic tool in the global management of chronic kidney disease-mineral and bone disorder (CKD-MBD). Since bone biopsy is invasive and cannot be repeated in clinical practice and because bone histomorphometry is less available due to the lack of specialized laboratories, we will focus on potential biomarkers used to assess and monitor bone turnover. After briefly reviewing the pathophysiology of bone turnover in CKD and haemodialysis patients, we will focus on the strengths and limitations of the now recommended biomarkers, i.e. parathormone and bone-specific alkaline phosphatase. We will consider the clinical and also the biological aspects of the topic and also insist on the use of these biomarkers for the monitoring, and the follow-up of the turnover in haemodialysis subjects. Finally, we will discuss some of the most promising, but still not recommended, emerging biomarkers. [less ▲]

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See detailCan we use circulating biomarkers to monitor bone turnover in CKD haemodialysis patients? Hypotheses and facts
DELANAYE, Pierre ULg; Souberbielle, Jean-Claude; Lafage-Proust, Marie-Hélène et al

in Nephrology Dialysis Transplantation (2014), 29(5), 997-1004

Assessing bone turnover is a key diagnostic tool in the global management of chronic kidney disease-mineral and bone disorder (CKD-MBD). Since bone biopsy is invasive and cannot be repeated in clinical ... [more ▼]

Assessing bone turnover is a key diagnostic tool in the global management of chronic kidney disease-mineral and bone disorder (CKD-MBD). Since bone biopsy is invasive and cannot be repeated in clinical practice and because bone histomorphometry is less available due to the lack of specialized laboratories, we will focus on potential biomarkers used to assess and monitor bone turnover. After briefly reviewing the pathophysiology of bone turnover in CKD and haemodialysis patients, we will focus on the strengths and limitations of the now recommended biomarkers, i.e. parathormone and bone-specific alkaline phosphatase. We will consider the clinical and also the biological aspects of the topic and also insist on the use of these biomarkers for the monitoring, and the follow-up of the turnover in haemodialysis subjects. Finally, we will discuss some of the most promising, but still not recommended, emerging biomarkers. [less ▲]

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See detailVitamin D status of schoolchildren in Northern Algeria, seasonal variations and determinants of vitamin D deficiency
Djennane, M; Lebbah, S; Roux, C et al

in Osteoporosis International (2014), 25(5), 1493-502

Summary There are no published data on the vitamin D status of children living in North Africa. In 435 healthy Algerian children 5–15 years old, we found that vitamin D insufficiency (serum 25 ... [more ▼]

Summary There are no published data on the vitamin D status of children living in North Africa. In 435 healthy Algerian children 5–15 years old, we found that vitamin D insufficiency (serum 25-hydroxyvitamin D (25OHD) <50 nmol/L) was frequent, especially in winter. Low vitamin D status was associated with increased parathyroid hormone (PTH) and leg deformation Introduction As there are no published data on the vitamin D status of children living in North Africa, we evaluated the 25OHD concentration of healthy Algerian children at the end of summer and at the end of winter. As secondary objectives, we studied the various determinants of vitamin D status and the PTH-25OHD relationship in these subjects. Methods Four hundred thirty-five children 5–15 years old were examined and had a blood sample in September 2010. Of them, 408 were sampled again in March 2011. Results Median 25OHD concentration in the whole group was 71.4 nmol/L in September and 52.9 nmol/L in March. In September, 58.4, 29.9, and 8.1 % had a 25OHD concentration below 75, 50, and 30 nmol/L respectively. In March, these percentages increased to 65.2, 41.4, and 17.4 % for the 75, 50, and 30 nmol/L threshold, respectively. In multivariate analysis, older age, darker skin phototype, low daily vitamin D and calcium intake, poor socioeconomic status, and short daily sun exposure remained significantly associated with a 25OHD <50 nmol/L at both visits. In 72 (16.6 %) children, genu varum/valgum was present. Compared to the 363 children without leg deformation, they presented more frequently with the risk factors of vitamin D insufficiency. They also had lower 25OHD concentrations and higher PTH and tALP. Serum PTH and 25OHD concentrations were negatively and significantly correlated (r=−0.43; p<0.001) without a 25OHD threshold above which PTH does not decrease anymore. Conclusion Despite a sunny environment, vitamin D insufficiency is frequent in healthy Algerian children. [less ▲]

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See detailIs isokinetic eccentric exercise dangerous for the heart?
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; LAURENT, Terry ULg et al

in Isokinetics & Exercise Science (2014), 22(2), 131-136

BACKGROUND: Very strenuous exercises can be performed on an isokinetic dynamometer in order to evaluate the resistance to fatigue of different muscular groups. Good cardiac function is necessary in order ... [more ▼]

BACKGROUND: Very strenuous exercises can be performed on an isokinetic dynamometer in order to evaluate the resistance to fatigue of different muscular groups. Good cardiac function is necessary in order to perform these very intensive exercises; otherwise an acute myocardial dysfunction could theoretically appear in predisposed patients. OBJECTIVE: Our study aimed to observe the cardiovascular impact of a maximal intense isokinetic eccentric exercise performed by a population of sedentary young men. METHODS: Resting and post-exercise (just after, 3 hours and 24 hours after the exercise) blood samples were taken from 12 young male sedentary healthy subjects. These subjects performed an intense maximal eccentric isokinetic exercise of the quadriceps muscle.We evaluated markers of cardiovascular risk (troponin I, highly sensitive troponin T, NT-proBNP,myoglobin), of inflammation (hsCRP) and of oxidative stress (myeloperoxydase, lipidic peroxides, reduced and oxidized glutathione). RESULTS: The following observations were made: no significant increase in cardiac (NT-proBNP, troponins) or inflammation (hsCRP) biomarkers; a significant increase in myoglobin, myeloperoxidase, lipidic peroxides, oxidised glutathione just after the exercise. CONCLUSIONS: No modification in cardiac biomarkers were observed after the maximal eccentric isokinetic exercise. We were thus able to prove that the exercise could be performed without any risk to cardiac function in young sedentary subjects. However, a significant level of oxidative stress was induced by this exercise. [less ▲]

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See detailEffect of gamma-hydroxybutyrate on keratinocytes proliferation: a preliminary prospective controlled study in severe burn patients.
ROUSSEAU, Anne-Françoise ULg; BARGUES, Laurent; LE BEVER, Hervé et al

in International Journal of Critical Illness and Injury Science (2014), 4(2), 108-113

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See detailCardiac troponins and natriuretic peptides in runners: useful for cardiac risk screening ?
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Fillet, Marianne ULg et al

in British Journal of Sports Medicine (2014, April), 48(7), 173

Background Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. Objective Our aim was to compare ... [more ▼]

Background Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. Objective Our aim was to compare cTnT and NT-proBNP levels before and after the stress tests, in sportive subjects. Design Prospective, cohort study. Setting Amateur marathon runners and ultrarunners. Patients 28 subjects (26 men, 42.5±11 yrs) were enrolled. Interventions Subjects ran the Maasmarathon (42.195 kilometers) and 33 subjects (33 men, 45.7±9.3 yrs) ran the Ultratour of Liège (Belgium; 67 km). All subjects gave their informed consent. We took blood sample before (T0), just after (T1) and 3 hours after the race (T3). Main outcome measurements cTnT concentrations were measured by high sensitive methods (hsTnT, Roche Diagnostics) on heparin plasma. The NT-proBNP was also determined with the kit Roche on heparin plasma. All statistical analyses were performed using Medcalc version 8.1 for Windows. P-value <.01 was regarded as statistically significant. Results A significant difference between hsTnT concentrations at T0 and T1 (P<.001), and between T0 and T3 (P<.001) for NT-proBNP have been observed, but not between T1 and T3. This observation appeared only after a strenuous exercise. However, up to now this type of exercise is not reproducible easily in a laboratory. Moreover, nobody knows if these observations would have cardiac consequences at long terms. Conclusion Measurement of cardiac troponins by high sensitive methods allows detecting significant release of biomarkers from the heart during exercise. The value of NT-proBNP are also significant but less than TnThs. We think that the TnThs could be an interesting tool in the future to help sport medicine to detect risk of developing a cardiac problem in the future or a sudden death. [less ▲]

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See detailTwo biomarkers for the screening of cardiac risk among runners ?
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Fillet, Marianne ULg et al

in British Journal of Sports Medicine (2014, April), 48(7), 174

Background Heart-type fatty acid-binding protein (H-FABP) is a low molecular weight protein involved in the intracellular uptake and buffering of long chain fatty in the myocardium. Troponin T is a ... [more ▼]

Background Heart-type fatty acid-binding protein (H-FABP) is a low molecular weight protein involved in the intracellular uptake and buffering of long chain fatty in the myocardium. Troponin T is a component of the contractile apparatus of the striated musculature. Both are early markers for acute coronary syndrome. Objective The aim of our study was to compare the results obtained with the H-FABP and the highly sensitive cardiac troponins (hsTnT) and to test their cardiospecificity in healthy runners. Design Prospective, cohort study. Setting Amateur marathon runners. Patients 23 runners (marathon) were enrolled. Interventions We drowned blood samples at three times: just before (T0), just after (T1), and three hours after the end of the race (T3). Main outcome measurements H-FABP and hs-TnT were performed according to the manufacturer's instructions. A linear regression was calculated to observe if there is any correlation between the two biomarkers. Values above the 95th percentile for H-FABP (2.5 ng/mL) and the 99th percentile for hsTnT (14 ng/L) were considered as positive. Results At T0, none of the subjects were positive for hsTnT but 35% were positive for H-FABP; at T1, 83% for hsTnT and 100% for H-FABP; at T3, 83% for hsTnT and 96% for H-FABP. At T0, the regression equation was H-FABP T0=3.9454–0.1001×hsTnT T0; at T1: H-FABP T1=51.838–1.7026×hsTnT T1; at T3: H-FABP T3=47.977–1.6193×hsTnT T3. No correlation was observed between the 2 biomarkers. Conclusion We observed a significant increase of H-FABP and hsTnT in runners. These markers are independent to each other. These values could biologically correspond to a heart ischemia. These biomarkers could be helpful for the screening of cardiac risk among runners. [less ▲]

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See detailThe Third/Second Generation PTH Assay Ratio as a Marker for Parathyroid Carcinoma: Evaluation Using an Automated Platform
CAVALIER, Etienne ULg; BETEA, Daniela ULg; SCHLECK, Marie-Louise ULg et al

in Journal of Clinical Endocrinology and Metabolism (2014), 99(3), 453-7

Background: Parathyroid carcinoma (PCa) is rare and often difficult to differentiate initially from benign disease. Because PCa oversecretes amino PTH that is detected by third-generation but not by ... [more ▼]

Background: Parathyroid carcinoma (PCa) is rare and often difficult to differentiate initially from benign disease. Because PCa oversecretes amino PTH that is detected by third-generation but not by second-generation PTH assays, the normal generation PTH ( 1) is inverted in PCa (ie, 1). Objective: The objective of the investigation was to study the utility and advantages of automated generation PTH ratio measurements using the Liaison XL platform over existing manual techniques. Setting: The study was conducted at a tertiary-referral academic center. Design: This was a retrospective laboratory study. Subjects: Eleven patients with advanced PCa (mean age 56.0 y). The controls were patients with 1°-hyperparathyroidism (n 144;meanage 53.8 y), renal transplantation (n 41;meanage 50.6 y), hemodialysis (n 80; mean age 65.2 y), and healthy elderly subjects (n 40; mean age 72.6 y). Results: The median (interquartile range) generation PTH ratio was 1.16 (1.10 –1.38) in the PCa group, which was significantly higher than the control groups: 0.74 (hemodialysis, 0.71–0.75), 0.77 (renal transplant, 0.73–0.79), 0.80 (healthy elderly, 0.74–0.83), and 0.76 (1°-hyperparathyroidism, 0.74–0.78). An inverted -generation PTH ratio ( 1) was seen in 9 of 11 PCa patients (81.8%) and in 7 of 305 controls (2.3%), 3 of 80 hemodialysis (3.8%), and 4 of 144 1°-hyperparathyroidism patients (2.8%). Of four PCa patients who had a normal PTH ratio with the manual method, two had an inverted -generation PTH ratio with the automated method. Conclusions: Study of the -generation PTH ratio in large patient populations should be feasible using a mainstream automated platform like the Liaison XL. The current study confirms the utility of the inverted -generation PTH ratio as a marker of PCa (sensitivity: 81.8%; specificity: 97.3%). [less ▲]

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See detailThe Third/Second Generation PTH Assay Ratio as a Marker for Parathyroid Carcinoma: Evaluation Using an Automated Platform
CAVALIER, Etienne ULg; BETEA, Daniela ULg; SCHLECK, Marie-Louise ULg et al

in Journal of Clinical Endocrinology and Metabolism (2014), 99(3), 453-7

Background: Parathyroid carcinoma (PCa) is rare and often difficult to differentiate initially from benign disease. Because PCa oversecretes amino PTH that is detected by third-generation but not by ... [more ▼]

Background: Parathyroid carcinoma (PCa) is rare and often difficult to differentiate initially from benign disease. Because PCa oversecretes amino PTH that is detected by third-generation but not by second-generation PTH assays, the normal generation PTH ( 1) is inverted in PCa (ie, 1). Objective: The objective of the investigation was to study the utility and advantages of automated generation PTH ratio measurements using the Liaison XL platform over existing manual techniques. Setting: The study was conducted at a tertiary-referral academic center. Design: This was a retrospective laboratory study. Subjects: Eleven patients with advanced PCa (mean age 56.0 y). The controls were patients with 1°-hyperparathyroidism (n 144;meanage 53.8 y), renal transplantation (n 41;meanage 50.6 y), hemodialysis (n 80; mean age 65.2 y), and healthy elderly subjects (n 40; mean age 72.6 y). Results: The median (interquartile range) generation PTH ratio was 1.16 (1.10 –1.38) in the PCa group, which was significantly higher than the control groups: 0.74 (hemodialysis, 0.71–0.75), 0.77 (renal transplant, 0.73–0.79), 0.80 (healthy elderly, 0.74–0.83), and 0.76 (1°-hyperparathyroidism, 0.74–0.78). An inverted -generation PTH ratio ( 1) was seen in 9 of 11 PCa patients (81.8%) and in 7 of 305 controls (2.3%), 3 of 80 hemodialysis (3.8%), and 4 of 144 1°-hyperparathyroidism patients (2.8%). Of four PCa patients who had a normal PTH ratio with the manual method, two had an inverted -generation PTH ratio with the automated method. Conclusions: Study of the -generation PTH ratio in large patient populations should be feasible using a mainstream automated platform like the Liaison XL. The current study confirms the utility of the inverted -generation PTH ratio as a marker of PCa (sensitivity: 81.8%; specificity: 97.3%). [less ▲]

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See detailThe Third/Second Generation PTH Assay Ratio as a Marker for Parathyroid Carcinoma: Evaluation Using an Automated Platform
CAVALIER, Etienne ULg; BETEA, Daniela ULg; SCHLECK, Marie-Louise ULg et al

in Journal of Clinical Endocrinology and Metabolism (2014), 99(3), 453-7

Background: Parathyroid carcinoma (PCa) is rare and often difficult to differentiate initially from benign disease. Because PCa oversecretes amino PTH that is detected by third-generation but not by ... [more ▼]

Background: Parathyroid carcinoma (PCa) is rare and often difficult to differentiate initially from benign disease. Because PCa oversecretes amino PTH that is detected by third-generation but not by second-generation PTH assays, the normal generation PTH ( 1) is inverted in PCa (ie, 1). Objective: The objective of the investigation was to study the utility and advantages of automated generation PTH ratio measurements using the Liaison XL platform over existing manual techniques. Setting: The study was conducted at a tertiary-referral academic center. Design: This was a retrospective laboratory study. Subjects: Eleven patients with advanced PCa (mean age 56.0 y). The controls were patients with 1°-hyperparathyroidism (n 144;meanage 53.8 y), renal transplantation (n 41;meanage 50.6 y), hemodialysis (n 80; mean age 65.2 y), and healthy elderly subjects (n 40; mean age 72.6 y). Results: The median (interquartile range) generation PTH ratio was 1.16 (1.10 –1.38) in the PCa group, which was significantly higher than the control groups: 0.74 (hemodialysis, 0.71–0.75), 0.77 (renal transplant, 0.73–0.79), 0.80 (healthy elderly, 0.74–0.83), and 0.76 (1°-hyperparathyroidism, 0.74–0.78). An inverted -generation PTH ratio ( 1) was seen in 9 of 11 PCa patients (81.8%) and in 7 of 305 controls (2.3%), 3 of 80 hemodialysis (3.8%), and 4 of 144 1°-hyperparathyroidism patients (2.8%). Of four PCa patients who had a normal PTH ratio with the manual method, two had an inverted -generation PTH ratio with the automated method. Conclusions: Study of the -generation PTH ratio in large patient populations should be feasible using a mainstream automated platform like the Liaison XL. The current study confirms the utility of the inverted -generation PTH ratio as a marker of PCa (sensitivity: 81.8%; specificity: 97.3%). [less ▲]

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See detailThe Third/Second Generation PTH Assay Ratio as a Marker for Parathyroid Carcinoma: Evaluation Using an Automated Platform
CAVALIER, Etienne ULg; BETEA, Daniela ULg; SCHLECK, Marie-Louise ULg et al

in Journal of Clinical Endocrinology and Metabolism (2014), 99(3), 453-7

Background: Parathyroid carcinoma (PCa) is rare and often difficult to differentiate initially from benign disease. Because PCa oversecretes amino PTH that is detected by third-generation but not by ... [more ▼]

Background: Parathyroid carcinoma (PCa) is rare and often difficult to differentiate initially from benign disease. Because PCa oversecretes amino PTH that is detected by third-generation but not by second-generation PTH assays, the normal generation PTH ( 1) is inverted in PCa (ie, 1). Objective: The objective of the investigation was to study the utility and advantages of automated generation PTH ratio measurements using the Liaison XL platform over existing manual techniques. Setting: The study was conducted at a tertiary-referral academic center. Design: This was a retrospective laboratory study. Subjects: Eleven patients with advanced PCa (mean age 56.0 y). The controls were patients with 1°-hyperparathyroidism (n 144;meanage 53.8 y), renal transplantation (n 41;meanage 50.6 y), hemodialysis (n 80; mean age 65.2 y), and healthy elderly subjects (n 40; mean age 72.6 y). Results: The median (interquartile range) generation PTH ratio was 1.16 (1.10 –1.38) in the PCa group, which was significantly higher than the control groups: 0.74 (hemodialysis, 0.71–0.75), 0.77 (renal transplant, 0.73–0.79), 0.80 (healthy elderly, 0.74–0.83), and 0.76 (1°-hyperparathyroidism, 0.74–0.78). An inverted -generation PTH ratio ( 1) was seen in 9 of 11 PCa patients (81.8%) and in 7 of 305 controls (2.3%), 3 of 80 hemodialysis (3.8%), and 4 of 144 1°-hyperparathyroidism patients (2.8%). Of four PCa patients who had a normal PTH ratio with the manual method, two had an inverted -generation PTH ratio with the automated method. Conclusions: Study of the -generation PTH ratio in large patient populations should be feasible using a mainstream automated platform like the Liaison XL. The current study confirms the utility of the inverted -generation PTH ratio as a marker of PCa (sensitivity: 81.8%; specificity: 97.3%). [less ▲]

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See detailAt which level of vitamin D should we aim?
CAVALIER, Etienne ULg

Conference (2014, January 18)

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See detailDetection of decreased glomerular filtration rate in intensive care units: serum cystatin C versus serum creatinine
DELANAYE, Pierre ULg; CAVALIER, Etienne ULg; Morel, Jérôme et al

in BMC Nephrology (2014), 15(9), 1471-2369

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See detailEnzymatic creatinine assays allowestimation of glomerular filtration rate in stages 1 and 2 chronic kidney disease using CKD-EPI equation
Kuster, Nils; Cristol, Jean-Paul; CAVALIER, Etienne ULg et al

in Clinica Chimica Acta (2014), 428

The National Kidney Disease Education Program group demonstrated that MDRD equation is sensitive to creatinine measurement error, particularly at higher glomerular filtration rates. Thus, MDRD-based eGFR ... [more ▼]

The National Kidney Disease Education Program group demonstrated that MDRD equation is sensitive to creatinine measurement error, particularly at higher glomerular filtration rates. Thus, MDRD-based eGFR above 60 mL/min/1.73 m2 should not be reported numerically. However, little is known about the impact of analytical error on CKD-EPI-based estimates. This study aimed at assessing the impact of analytical characteristics (bias and imprecision) of 12 enzymatic and 4 compensated Jaffe previously characterized creatinine assays on MDRD and CKD-EPI eGFR. In a simulation study, the impact of analytical error was assessed on a hospital population of 24 084 patients. Ability using each assay to correctly classify patients according to chronic kidney disease (CKD) stages was evaluated. For eGFR between 60 and 90 mL/min/1.73 m2, both equations were sensitive to analytical error. Compensated Jaffe assays displayed high bias in this range and led to poorer sensitivity/specificity for classification according to CKD stages than enzymatic assays. As compared to MDRD equation, CKD-EPI equation decreases impact of analytical error in creatinine measurement above 90 mL/min/1.73 m2. Compensated Jaffe creatinine assays lead to important errors in eGFR and should be avoided. Accurate enzymatic assays allow estimation of eGFR until 90 mL/min/1.73 m2 with MDRD and 120 mL/min/1.73 m2 with CKD-EPI equation. [less ▲]

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See detailEvaluation du nombre de résidents en maison de retraite médicalisée bénéficiant d'une supplémentation en vitamine D
Buckinx, Fanny ULg; Reginster, Jean-Yves ULg; Cavalier, Etienne ULg et al

in Cahiers de l'Année Gérontologique (Les) (2014), 2(23), 207-63

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