References of "Garweg, Christophe"
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See detailApport des troponines T et I ultrasensibles dans le diabète
LE GOFF, Caroline ULg; LAURENT, Terry ULg; GARWEG, Christophe ULg et al

in Immuno-Analyse & Biologie Spécialisée [=IBS] (2012, February), 27(1), 40

Introduction : Le diabète atteint environ 3% de la population française. Or, cette maladie expose à l'apparition précoce de complications cardiovasculaires. Les troponines de nouvelles générations ... [more ▼]

Introduction : Le diabète atteint environ 3% de la population française. Or, cette maladie expose à l'apparition précoce de complications cardiovasculaires. Les troponines de nouvelles générations hautement sensibles pourraient être un bon outil diagnostic pour mettre en évidence des macroou micro-angiopathies non diagnostiquée chez ces patients. Le but de notre étude était de comparer la performance de la troponine T ultrasensible (hsTnT) (Roche Diagnostic) avec la troponine I ultrasensible (TnI II) (Abbott Diagnostic) chez le sujet diabétique. Matériel et méthodes : Vingt patients diabétiques (âge moyen : 52.6 ± 8.4 ans) ont été sélectionnés sur le critère d’un taux d’hémoglobine glyquée (HbA1c) élevé. Ces sujets ont été comparés à vingt sujets contrôles d’âge moyen : 60.05 ± 2.86 ans. Les patients atteints d’insuffisance rénale et d’affections cardiovasculaires ont été exclus. Les analyses ont été réalisées sur du plasma hépariné lithium. La hsTnT a été dosée par électrochemiluminescence sur le Modular E (Roche Diagnostic). Abbott utilise des microparticules chemiluminescentes pour le dosage de la TnI II sur l’ARCHITECT i. Résultats : Les sujets diabétiques ont un taux plasmatique de hsTnT représenté par les valeurs suivantes [médiane (1er quartile, 3ème quartile)] : 0,007 (0,03 ; 0,018) ng/mL ; alors que les sujets contrôles négatifs présentent les valeurs suivantes : 0,003 (0,003 ; 0,004) ng/mL. La différence de taux de hsTnT observée entre ces 2 populations est statistiquement significative (p = 0,000922). Pour la TnI II, on observe un taux plasmatique de: 0,004 (0,003 ; 0,075) ng/mL chez les sujets diabétiques et 0,002 (0,001 ; 0,005) ng/mL chez les sujets contrôles. La différence de taux de TnI II observée entre ces 2 populations n’est pas statistiquement significative (p > 0,005). Discussion-conclusion : Au décours d’un diabète, il apparait que les taux de hsTnT sont augmentés de façon significative par rapport au groupe des contrôles négatifs. Si les taux hsTnT augmentent chez le diabétique, il semblerait normal qu’il en soit de même pour la TnI II, vu que ces deux marqueurs sont intimement liés. Nous ne l’avons pas observé mais ceci peut être du à la plus faible performance analytique du dosage de la TnI II utilisé. Cette libération de hsTnT dans le sang peut être due aux micro- et macro-angiopathies au niveau des coronaires induites au cours d’un diabète. [less ▲]

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See detailProcalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients.
LAYIOS, Nathalie ULg; LAMBERMONT, Bernard ULg; CANIVET, Jean-Luc ULg et al

in Critical Care Medicine (2012), 40(8), 2304-9

OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled ... [more ▼]

OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled study. SETTING: : Five intensive care units from a tertiary teaching hospital. PATIENTS: : All consecutive adult patients hospitalized for > 48 hrs in the intensive care unit during a 9-month period. INTERVENTIONS: : Procalcitonin serum level was obtained for all consecutive patients suspected of developing infection either on admission or during intensive care unit stay. The use of antibiotics was more or less strongly discouraged or recommended according to the Muller classification. Patients were randomized into two groups: one using the procalcitonin results (procalcitonin group) and one being blinded to the procalcitonin results (control group). The primary end point was the reduction of antibiotic use expressed as a proportion of treatment days and of daily defined dose per 100 intensive care unit days using a procalcitonin-guided approach. Secondary end points included: a posteriori assessment of the accuracy of the infectious diagnosis when using procalcitonin in the intensive care unit and of the diagnostic concordance between the intensive care unit physician and the infectious-disease specialist. MEASUREMENTS AND MAIN RESULTS: : There were 258 patients in the procalcitonin group and 251 patients in the control group. A significantly higher amount of withheld treatment was observed in the procalcitonin group of patients classified by the intensive care unit clinicians as having possible infection. This, however, did not result in a reduction of antibiotic consumption. The treatment days represented 62.6 +/- 34.4% and 57.7 +/- 34.4% of the intensive care unit stays in the procalcitonin and control groups, respectively (p = .11). According to the infectious-disease specialist, 33.8% of the cases in which no infection was confirmed, had a procalcitonin value >1microg/L and 14.9% of the cases with confirmed infection had procalcitonin levels <0.25 microg/L. The ability of procalcitonin to differentiate between certain or probable infection and possible or no infection, upon initiation of antibiotic treatment was low, as confirmed by the receiving operating curve analysis (area under the curve = 0.69). Finally, procalcitonin did not help improve concordance between the diagnostic confidence of the infectious-disease specialist and the ICU physician. CONCLUSIONS: : Procalcitonin measuring for the initiation of antimicrobials did not appear to be helpful in a strategy aiming at decreasing the antibiotic consumption in intensive care unit patients. [less ▲]

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See detailLa troponine T ultrasensible : un nouvel outil diagnostic pour le médecin sportif?
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; GARWEG, Christophe ULg et al

in 4ème Congrès commun SFMS & SFTS (2011, September)

Introduction : Le risque d’accidents cardiaques ou de mort subite après effort physique intense est bien connu. Ces évènements indésirables se produisent souvent chez des sujets présentant une maladie ... [more ▼]

Introduction : Le risque d’accidents cardiaques ou de mort subite après effort physique intense est bien connu. Ces évènements indésirables se produisent souvent chez des sujets présentant une maladie coronarienne asymptomatique et ignorée. Néanmoins, vu ce risque, l’American Heart Association recommande de réaliser un screening cardiovasculaire chez les athlètes de tout âge. Dans cette optique, le dosage de marqueurs cardiaques de nouvelle génération, plus sensibles, comme la troponine T ultrasensible (hsTnT) peut certainement apporter des informations très intéressantes par la détection de dommages myocardiques mêmes mineurs. Matériels et méthodes : Des 20 sujets masculins volontaires âgés de 22.36±2.02 années, sédentaires, 8 ont dû être exclus (abandon, malaise à l’effort...). La VO2max a été préalablement déterminée lors d’un test à l’effort sur cycloergomètre une semaine avant le test afin de ne pas interférer avec les résultats de l’effort physique intense (EPI) pour lequel les sujets ont couru sur tapis roulant durant 1 heure à 75% de la VO2max. Quatre échantillons sanguins de 5 ml (tube hépariné-lithium) ont été prélevés : juste avant (T1), directement après (T2), 4 heures après (T3) et 24 heures après l’EPI (T4). Le dosage de hsTnT (Modular de Roche Diagnostic®) est réalisé sur du plasma par une technique d’électrocheminiluminescence. Résultats : Une augmentation statistiquement significative des résultats à T3 (p<0.01) est observée. L’élévation de la hsTnT est progressive pour atteindre un pic maximum à T3 et revenir dans les normes à T4. Le seuil critique de 0.03 ng/mL a été retenu et 75% des sujets présentent un taux supérieur à ce dernier à T3 (moyenne : 0.053 ng/mL), alors que 100% des sujets se trouvent en dessous de ce seuil à T1 (0.0041 ng/mL). Discussion - Conclusions : Ces résultats, extrêmement intéressants, suggèrent que la libération de hsTnT serait due soit à un processus physiologique de remodelage, soit à un processus irréversible de lésions au niveau des cardiomyocytes (nécrose). Il est également possible que cette élévation des troponines soit due à une libération à partir du pool cytosolique mais aussi elle peut être la conséquence de dommages membranaires potentiellement induits par le stress oxydatif. A l’issue de cette étude, nous démontrons que la hsTnT peut être un nouvel outil diagnostic dans le domaine de la cardiologie du sport. [less ▲]

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See detailLe cas clinique du mois. Péricardite purulente chez un patient atteint de sarcoïdose pulmonaire
NYSSEN, Astrid ULg; MELON, Pierre ULg; GARWEG, Christophe ULg et al

in Revue Médicale de Liège (2011)

We report the case of a patient, suffering from pulmonary sarcoidosis, who developed a purulent pericarditis complicated with a cardiac tamponade. The widespread use of antibiotics has progressively ... [more ▼]

We report the case of a patient, suffering from pulmonary sarcoidosis, who developed a purulent pericarditis complicated with a cardiac tamponade. The widespread use of antibiotics has progressively reduced the number of purulent pericarditis. However, it remains a serious disease that has to be rapidly diagnosed to be treated timely. We will review the required tests for the diagnosis and the treatment of this pathology that leads to death otherwise. The link with pulmonary sardoidosis is uncertain. [less ▲]

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See detailLa Vignette diagnostique de l'étudiant: Critères électrocardiographiques d’une tachycardie ventriculaire
GARWEG, Christophe ULg; BOLOGNE, Jean-Christophe ULg; MELON, Pierre ULg et al

in Revue Médicale de Liège (2011)

Recording of a regular wide QRS tachycardia is often source of panic and anxiety for the young clinician who has to make the differential diagnosis between ventricular tachycardia and supraventricular ... [more ▼]

Recording of a regular wide QRS tachycardia is often source of panic and anxiety for the young clinician who has to make the differential diagnosis between ventricular tachycardia and supraventricular tachycardia with aberration associated with fundamentally different vital prognosis. Most of the time, a rigorous approach and a systematic analysis of the electrocardiogram associated with clinical examination allow to obtain the correct diagnosis. [less ▲]

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See detailAssessment of high sensitive troponin T and I immunoassays in patients with acute chest
Le Goff, Caroline ULg; Garweg, Christophe ULg; Laurent, Terry et al

in Clinical Chemistry (2010, July), 56(S6), 127

Introduction: Cardiac troponin I and T are specific markers of myocardial injury that are widely used for the diagnosis of acute coronary syndrome (ACS). In acute chest pain without ST-segment elevation ... [more ▼]

Introduction: Cardiac troponin I and T are specific markers of myocardial injury that are widely used for the diagnosis of acute coronary syndrome (ACS). In acute chest pain without ST-segment elevation, they are used to differentiate unstable angina from non ST-segment elevation myocardial infarction (NSTEMI). Recently, troponin assays with higher analytical sensitivities became available to enable the detection of minor myocardial damage and identify individuals at higher risk for ACS. As a result of its high tissue-specificity, cardiac troponin T and I are cardio-specific, highly sensitive markers for myocardial damage. The aim of this study was to evaluate the new higher sensitive troponin (T and I) in patients with stable angina and acute chest pain without ST-segment elevation. Methods: Sixty subjects (mean age : 65.5± 11 years), were included: 20 healthy controls, 20 patients with stable angina, 9 with unstable angina (troponin-) and 18 patients with NSTEMI myocardial infarction (troponin+). The protocol was approved by the ethic committee of the University of Liège (Belgium). High sensitive troponin T (hsTnT) determination was realized on heparin plasma by electrochemiluminescence immunoassay on Modular E (Roche Diagnostic). Troponin I II (TnI II) is a chemiluminescent microparticle immunoassay for the quantitative determination of cardiac troponin-I in heparine plasma on the ARCHITECT i System (Abbott Diagnostic). The lower detection limit of these assays was 0.005μg/L for hsTnT and 0.01μg/L for TnI II. Stastistical analysis was performed using t test. P value <0.05 was considered significant. Results: HsTNT levels were 0.003(0.003, 0.004) [median baseline (1st, 3rd quartile)]ng/ml in controls, 0.0075 (0.00475, 0.014) ng/ml in stable angina, 0.011(0.006, 0.012) ng/ml in unstable angina and 0.3715 (0.1795, 1.00725) ng/ml in NSTEMI ACS. TnI II levels were 0 (0, 0.001) ng/ml in controls and in patients with stable angina, 0.07 (0.005, 0.014) ng/ml in unstable angina and 1.4475 (0.0407, 2.656) ng/ml in NSTEMI. HsTNT and TnI II levels were significantly increased in NSTEMI as compared to control subjects, patients with stable and unstable angina. TnI II levels were also increased in unstable angina as compared to controls. Conclusion: In our population, TnI II was more sensitive than hsTNT to detect minor myocardial damage in patients with unstable angina as compared to controls. Therefore, future studies will have to determine whether TnI II might contribute to better risk stratification and treatment strategy in this group of patients. [less ▲]

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See detailDoes echocardiographic stress test induced release of hsTnT and TnI II?
Le Goff, Caroline ULg; Laurent, Terry; Garweg, Christophe ULg et al

in Clinical Chemistry (2010, July), 56(S6), 128

Background: Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury. In this study, cTnT and cTnI were measured by new commercially available high-sensitive ... [more ▼]

Background: Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury. In this study, cTnT and cTnI were measured by new commercially available high-sensitive methods in patients undergoing brief exercise- or pharmacologicinduced stress. Our aim was to compare cTnT and cTnI levels before and after the stress tests, in the patients with or without reversible ischemia. Materials and Methods: Fifty patients (28 men and 22 women) underwent an echographic stress test (ST) for suspected ischemic heart disease. Of these 50 patients, 28 received pharmacological ST (dobutamine injection) and 22 dynamic ST (bicycle exercise). The patients were subdivided into two groups according to the presence or absence of documented transient reversible ischemia: 14 with reversible ischemia ( mean age: 67.71±9.66 y) and 36 without ischemia ( mean age: 63.17±11.72 y). In all patients, cTnT and cTnI concentrations were measured by high sensitive methods (hsTnT, Roche Diagnostics and TnI II, Abbott Diagnostics) on heparin plasma immediately before (T0) and after ST (T1).The lower detection limit of these assays was 0.005μg/L for hsTnT and 0.01μg/L for TnI II. The protocol was approved by the ethics committee of the University of Liège (Belgium). All patients gave informed consent. All statistical analyses were performed using Medcalc version 8.1 for Windows. P value <0.05 was regarded as statistically significant. Results: There was no significant difference between hsTnT concentrations at T0 and T1, neither in the whole patient group, nor in the subgroups of subjects who received pharmacological ST or dynamic ST. The same was true for TnI II. Although there was no change in hsTnT levels during test in ischemic and in non ischemic patients, the latter tend to demonstrate higher median T0 levels (25th, 75th percentiles) than the others [0.011 (0.007, 0.029) vs 0.007 (0.0047, 0.1125) ng/ml, p=0.09]. They also showed higher median T1 levels [0.014 (0.065, 0.03) vs 0.007 (0.003, 0.0102) ng/ml, p=0.08]. Higher TnI II levels were also recorded in ischemic patients as compared to non ischemic patients at T0[ 0.014 (0.0072; 0.0265) vs 0.005 (0.003; 0.01) ng/ml, p=0.08] and T1[ 0.013 (0.0085- 0.03) vs 0.006 (0.0035-0.008) ng/ml, p=0.08]. Also, TnI II levels did not change during test in both subgroups. Conclusions: Measurement of cardiac troponins by high sensitive methods did not allow to detect significant release of biomarkers from the heart during exercise-or pharmacologic-induced ST, even in patients who demonstrated reversible myocardial ischemia. The type of test – pharmacological or dynamic - was without effect. The patients with induced transient ischemia had however higher troponin T and I levels at baseline, this difference remaining during test. [less ▲]

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See detailLa vignette therapeutique de l'etudiant. Premier episode de fibrillation auriculaire.
MELON, Pierre ULg; GARWEG, Christophe ULg; Pierard, Luc ULg et al

in Revue Médicale de Liège (2010), 65(4), 224-7

We report the case of a patient seen at the outpatient clinic for a first episode of atrial fibrillation. We discussed the steps of the treatment including anticoagulation, rate and rhythm control.

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See detailComment je traite...une tachycardie paroxystique a QRS fins par reentree.
GARWEG, Christophe ULg; MELON, Pierre ULg; Pierard, Luc ULg et al

in Revue Médicale de Liège (2010), 65(9), 486-9

Paroxysmal narrow complex QRS tachycardias are a clinical entity characterized by abrupt onset and termination of palpitations, dyspnea, dizziness. They depend on mechanisms of reentry within the atrio ... [more ▼]

Paroxysmal narrow complex QRS tachycardias are a clinical entity characterized by abrupt onset and termination of palpitations, dyspnea, dizziness. They depend on mechanisms of reentry within the atrio-ventricular node or with the participation of an accessory pathway (reciprocating orthodromic tachycardia). We review the clinical and electrocardiographical diagnosis as well as the acute and long term treatment of these tachycardias. [less ▲]

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See detailAdhesion aux regles du traitement anti-thrombotique dans la fibrillation auriculaire.
MELON, Pierre ULg; GARWEG, Christophe ULg; LANCELLOTTI, Patrizio ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 299-303

Adherence to the rules for antithrombotic ment in atrial fibrillation patients significantly reduces the risk of stroke. We review the criteria for the use of anti-vitamin K as well as its daily ... [more ▼]

Adherence to the rules for antithrombotic ment in atrial fibrillation patients significantly reduces the risk of stroke. We review the criteria for the use of anti-vitamin K as well as its daily management in patients with atrial fibrillation. [less ▲]

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See detailAortic coarctation treated by extraanatomic aortic bypass.
GARWEG, Christophe ULg; MELON, Pierre ULg; LANCELLOTTI, Patrizio ULg

in Acta Cardiologica (2010), 65(3), 365

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See detailAfterload mismatch revealed by an exercise biphasic response in aortic stenosis
Lancellotti, Patrizio ULg; Moonen, Marie ULg; Garweg, Christophe ULg et al

in Archives of Cardiovascular Diseases (2009), 102(6-7), 593-594

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See detailFunctional connectivity in the default network during resting state is preserved in a vegetative but not in a brain dead patient.
Boly, Mélanie ULg; Tshibanda, Luaba ULg; Vanhaudenhuyse, Audrey ULg et al

in Human Brain Mapping (2009), 30(8), 2393-400

Recent studies on spontaneous fluctuations in the functional MRI blood oxygen level-dependent (BOLD) signal in awake healthy subjects showed the presence of coherent fluctuations among functionally ... [more ▼]

Recent studies on spontaneous fluctuations in the functional MRI blood oxygen level-dependent (BOLD) signal in awake healthy subjects showed the presence of coherent fluctuations among functionally defined neuroanatomical networks. However, the functional significance of these spontaneous BOLD fluctuations remains poorly understood. By means of 3 T functional MRI, we demonstrate absent cortico-thalamic BOLD functional connectivity (i.e. between posterior cingulate/precuneal cortex and medial thalamus), but preserved cortico-cortical connectivity within the default network in a case of vegetative state (VS) studied 2.5 years following cardio-respiratory arrest, as documented by extensive behavioral and paraclinical assessments. In the VS patient, as in age-matched controls, anticorrelations could also be observed between posterior cingulate/precuneus and a previously identified task-positive cortical network. Both correlations and anticorrelations were significantly reduced in VS as compared to controls. A similar approach in a brain dead patient did not show any such long-distance functional connectivity. We conclude that some slow coherent BOLD fluctuations previously identified in healthy awake human brain can be found in alive but unaware patients, and are thus unlikely to be uniquely due to ongoing modifications of conscious thoughts. Future studies are needed to give a full characterization of default network connectivity in the VS patients population. [less ▲]

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See detailFunctional residual capacity measurement as a guide during Peep titration in ARDS
Lambermont, Bernard ULg; Ghuysen, Alexandre ULg; MOMMENS, Véronique et al

in ESICM (2007)

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See detailCombination therapy versus monotherapy: a randomised pilot study on the evolution of inflammatory parameters after ventilator associated pneumonia
Damas, Pierre ULg; Garweg, Christophe ULg; Monchi, Mehran et al

in Critical Care (2006), 10(2), 52

Introduction Combination antibiotic therapy for ventilator associated pneumonia (VAP) is often used to broaden the spectrum of activity of empirical treatment. The relevance of such synergy is commonly ... [more ▼]

Introduction Combination antibiotic therapy for ventilator associated pneumonia (VAP) is often used to broaden the spectrum of activity of empirical treatment. The relevance of such synergy is commonly supposed but poorly supported. The aim of the present study was to compare the clinical outcome and the course of biological variables in patients treated for a VAP, using a monotherapy with a beta-lactam versus a combination therapy. Methods Patients with VAP were prospectively randomised to receive either cefepime alone or cefepime in association with amikacin or levofloxacin. Clinical and inflammatory parameters were measured on the day of inclusion and thereafter. Results Seventy-four mechanically ventilated patients meeting clinical criteria for VAP were enrolled in the study. VAP was microbiologically confirmed in 59 patients (84%). Patients were randomised to receive cefepime (C group, 20 patients), cefepime with amikacin (C-A group, 19 patients) or cefepime with levofloxacin (C-L group, 20 patients). No significant difference was observed regarding the time course of temperature, leukocytosis or C-reactive protein level. There were no differences between length of stay in the intensive care unit after infection, nor in ventilator free days within 28 days after infection. No difference in mortality was observed. Conclusion Antibiotic combination using a fourth generation cephalosporin with either an aminoside or a fluoroquinolone is not associated with a clinical or biological benefit when compared to cephalosporin monotherapy against common susceptible pathogens causing VAP. [less ▲]

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See detailGhreline et obesite
Garweg, Christophe ULg; Scholtes, Félix ULg; Gérard, J. et al

in Revue Médicale de Liège (2005), 60(1), 35-40

Ghrelin is a peptide hormone secreted by the stomach. It was initially described as a stimulant of growth hormone secretion. Soon, however, it was discovered to play an important role in feeding behaviour ... [more ▼]

Ghrelin is a peptide hormone secreted by the stomach. It was initially described as a stimulant of growth hormone secretion. Soon, however, it was discovered to play an important role in feeding behaviour in animals and in appetite regulation in man: ghrelin stimulates appetite, and as such is an orexigenic peptide implicated in energy balance mechanisms and weight gain. Abnormal ghrelin activity leads to over- or underweight. Additionally, the efficacy of different treatment strategies against obesity seems to be related to modifications in plasma ghrelin levels. This review summarizes the current knowledge about ghrelin and its implications in obesity medicine. [less ▲]

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