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See detailComparison of the Timed 25-Foot and the 100-Meter Walk as Performance Measures in Multiple Sclerosis
Phan-Ba, Rémy ULg; Pace, Amy; CALAY, Philippe ULg et al

in Neurorehabilitation and neural repair (2011), 25(7), 672-9

BACKGROUND: Ambulation impairment is a major component of physical disability in multiple sclerosis (MS) and a major target of rehabilitation programs. Outcome measures commonly used to evaluate walking ... [more ▼]

BACKGROUND: Ambulation impairment is a major component of physical disability in multiple sclerosis (MS) and a major target of rehabilitation programs. Outcome measures commonly used to evaluate walking capacities suffer from several limitations. OBJECTIVES: To define and validate a new test that would overcome the limitations of current gait evaluations in MS and ultimately better correlate with the maximum walking distance (MWD). METHODS: The authors developed the Timed 100-Meter Walk Test (T100MW), which was compared with the Timed 25-Foot Walk Test (T25FW). For the T100MW, the subject is invited to walk 100 m as fast as he/she can. In MS patients and healthy control volunteers, the authors measured the test-retest and interrater intraclass correlation coefficient. Spearman rank correlations were obtained between the T25FW, the T100MW, the Expanded Disability Status Scale (EDSS), and the MWD. The coefficient of variation, Bland-Altman plots, the coefficient of determination, and the area under the receiver operator characteristic curve were measured. The mean walking speed (MWS) was compared between the 2 tests. RESULTS: A total of 141 MS patients and 104 healthy control volunteers were assessed. Minor differences favoring the T100MW over the T25FW were observed. Interestingly, the authors demonstrated a paradoxically higher MWS on a long (T100MW) rather than on a short distance walk test (T25FW). CONCLUSION: The T25FW and T100MW displayed subtle differences of reproducibility, variability, and correlation with MWD favoring the T100MW. The maximum walking speed of MS patients may be poorly estimated by the T25FW since MS patients were shown to walk faster over a longer distance. [less ▲]

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See detailNatalizumab induces a rapid improvement of disability status and ambulation after failure of previous therapy in relapsing-remitting multiple sclerosis.
Belachew, Shibeshih ULg; Phan-Ba, Rémy ULg; Bartholome, Emmanuel et al

in European Journal of Neurology (2010), 18(2), 240-245

Background: Natalizumab (Tysabri) is a monoclonal antibody that was recently approved for the treatment of relapsing-remitting multiple sclerosis (RRMS). Our primary objective was to analyse the efficacy ... [more ▼]

Background: Natalizumab (Tysabri) is a monoclonal antibody that was recently approved for the treatment of relapsing-remitting multiple sclerosis (RRMS). Our primary objective was to analyse the efficacy of natalizumab on disability status and ambulation after switching patients with RRMS from other disease-modifying treatments (DMTs). Methods: A retrospective, observational study was carried out. All patients (n = 45) initiated natalizumab after experiencing at least 1 relapse in the previous year under interferon-beta (IFNB) or glatiramer acetate (GA) treatments. The patients also had at least 1 gadolinium-enhancing (Gd+) lesion on their baseline brain MRI. Expanded Disability Status Scale (EDSS) scores, and performance on the Timed 25-Foot Walk Test and on the Timed 100-Metre Walk Test were prospectively collected every 4 weeks during 44 weeks of natalizumab treatment. Brain MRI scans were performed after 20 and 44 weeks of treatment. Results: Sixty-two per cent of patients showed no clinical and no radiological signs of disease activity, and 29% showed a rapid and confirmed EDSS improvement over 44 weeks of natalizumab therapy. Patients with improvement on the EDSS showed similar levels of baseline EDSS and active T1 lesions, but had a significantly higher number of relapses, and 92% of them had experienced relapse-mediated sustained EDSS worsening in the previous year. A clinically meaningful improvement in ambulation speed was observed in approximately 30% of patients. Conclusions: These results indicate that natalizumab silences disease activity and rapidly improves disability status and walking performance, possibly through delayed relapse recovery in patients with RRMS who had shown a high level of disease activity under other DMTs. [less ▲]

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See detailNatalizumab induced freedom from disease activity after failure to previous therapy in relapsing remitting multiple sclerosis.
Belachew, Shibeshih ULg; Bartholome E.; DELVAUX, Valérie ULg et al

Conference (2009, June)

Objectives: To analyze the efficacy of natalizumab after switching relapsing-remitting multiple sclerosis (RRMS) patients from other disease modifying treaments (DMTs). Background: Natalizumab (Tysabri ... [more ▼]

Objectives: To analyze the efficacy of natalizumab after switching relapsing-remitting multiple sclerosis (RRMS) patients from other disease modifying treaments (DMTs). Background: Natalizumab (Tysabri) is a monoclonal antibody directed against VLA4 that was recently approved for the treatment of RRMS. Due to safety concerns, the use should be restricted to highly active patients and/or patients with insufficient response to other DMTs. The pivotal trials were not designed to examine the effect of natalizumab as an escalation monotherapy. Methods: Prospective, open label, observational study. All patients initiating natalizumab had experienced at least 1 relapse in the previous year under DMTs and had at least 1 Gd-enhancing lesion on their brain MRI. Previous treatment with interferon-beta (IFN-beta) or glatiramer acetate (GA) were stopped at least one week and azathioprine or mitoxantrone at least 3 months before switching. The minimum therapy duration with natalizumab was 6 months for all patients. 21 RRMS patients were included in this analysis. The mean age of the patients was 25,5 yo with mean disease duration of 6,8 years. All patients were under IFN-beta (17) or GA (4) during at least the previous year before starting natalizumab therapy. Four patients had also received azathioprine and 1 patient mitoxantrone. Results: The mean relapse rate in the previous year was 2.15 (1-4), the mean EDSS at baseline was 3.3 (1,0-6.0), the mean number of Gd+ lesions at baseline 2,58 (1-6). Under tysabri treatment the annualized relapse rate dropped to 0,20. Eleven patients improved their EDSS (0,5 to 1,5 steps down), others remained stable at 6 months. The mean number of Gd+ T1 lesions dropped to 0,23 and the mean number of new T2 lesions was 0.25 on the control MRI at 6 months. 55% of patients were free from disease activity, i.e. had no relapses, no EDSS progression, no new T2 lesion and no Gd+ T1 lesions after 6 months of Tysabri. 5 patients experienced minor adverse events (1 zona, 2 flu-like symptoms, 1 gastroenteritis, 1 allergic reaction). Conclusion: Natalizumab was well tolerated and safe as escalation therapy when previous DMTs had failed to control disease progression in this group of highly active RRMS patients. These results suggest comparable efficacy to the phase III AFFIRM trial of natalizumab when the drug is used in a context of breakthrough disease. Although data from preliminary analyses are promising, long term investigations are warranted. [less ▲]

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See detailPathologies infiltratives et inflammatoires de l'hypophyse
Burlacu, C.; Hansen, Isabelle ULg; Daly, Adrian ULg et al

in Chanson, Philippe; Young, Jacques (Eds.) Traité d'Endocrinologie (2007)

C’est le traité de référence dans la discipline : livre unique, sans concurrent de cette envergure. Il couvre toute l’endocrinologie moderne, qui s’appuie sur l’apport de la biologie moléculaire, de la ... [more ▼]

C’est le traité de référence dans la discipline : livre unique, sans concurrent de cette envergure. Il couvre toute l’endocrinologie moderne, qui s’appuie sur l’apport de la biologie moléculaire, de la biochimie, de l’immunocytochimie, de l’imagerie moderne avec, en particulier la T.E.P. La physiopathologie, les symptômes, les éléments du diagnostic, les orientations pronostiques, les choix thérapeutiques sont exposés de façon exhaustive pour les affections touchant toutes les glandes endocrines : thyroïde, parathyroïde, surrénales, testicules, ovaires, hypophyse. Au total, il s’agit d’un ouvrage complet, moderne et pratique ; la richesse des illustrations, des arbres décisionnels, l’abondante bibliographie contribuent à en faire un outil indispensable au quotidien. Ce Traité d'endocrinologie conçu par et maintenant publié sous la direction de Philippe Chanson et Jacques Young est remarquable, par son contenu, d'abord, ensuite, par le fait qu'il est écrit en français, ce qui en fait un ouvrage unique. En effet, les grands traités d'endocrinologie de ces dernières années sont en anglais. La liste des 154 chapitres couvre la totalité de l'endocrinologie d'aujourd'hui dans tous ses aspects, depuis la biologie moléculaire à la pratique du clinicien, interniste ou chirurgien. Et le texte, les textes, sont d'enseignement fondamental pour l'étudiant autant que de présentations et discussions diagnostiques pour le clinicien averti comme pour celui qui cherche à s'instruire. Comme la nostalgie, pour reprendre le cliché bien connu, l'endocrinologie n'est plus ce qu'elle était. Le concept de glandes endocrines, s'il reste vrai dans son ensemble, est cependant dépassé par ces nouvelles découvertes qui montrent sécrétion et utilisation in loto de ces mêmes substances (hormones ?) par des organes aussi variés que le cerveau ou le tissu adipeux. Et le Traité d'endocrinologie présente et discute, nombreuses références à l'appui, les nouveaux concepts des mécanismes d'action des différentes classes d'hormones tant au niveau du soma que du psyché. Les implications pour la thérapeutique sont considérables et ce sera le malade qui finalement, bénéficiera de toutes ces connaissances présentées ici à son médecin. L'endocrinologie et son ouverture sur la neuro-endocrinologie constituent plus que jamais la science de nous-mêmes, dans la santé comme dans la maladie. Ce Traité d'endocrinologie est une magnifique présentation de l'état des choses. [less ▲]

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See detailPathologie inflammatoire de l'hypophyse et grossesse
Hansen, Isabelle ULg; Vroonen, Laurent ULg; Tichomirova, M. et al

in Pathologie hypophysaire et grossesse (2006)

Les affections hypophysaires, tumorales ou non tumorales, sont classiquement responsables d'infertilité. Grâce aux progrès des traitements médicaux et chirurgicaux développés pour le traitement de ces ... [more ▼]

Les affections hypophysaires, tumorales ou non tumorales, sont classiquement responsables d'infertilité. Grâce aux progrès des traitements médicaux et chirurgicaux développés pour le traitement de ces affections hypophysaires, les grossesses sont de plus en plus fréquentes chez les patientes ayant en particulier un adénome hypophysaire sécrétant ou une insuffisance anté-hypophysaire ou un diabète insipide central. Cependant, les conséquences de l'affection hypophysaire et des traitements pour la mère ou le f¿tus sont toujours discutés par les endocrinologues, les gynécologues, les obstétriciens et les pédiatres. Le but de cet ouvrage unique en français est une mise au point de nos connaissances sur le sujet, et tout particulièrement sur le diagnostic hormonal et radiologique d'un syndrome d'hypersécrétion ou d'une insuffisance hypophysaire au cours d'une grossesse, ainsi que sur la prise en charge des patientes présentant une pathologie hypophysaire tumorale ou non tumorale, désirant ou présentant une grossesse. [less ▲]

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See detailResidual cerebral functioning in the vegetative state
Laureys, Steven ULg; Faymonville, Marie-Elisabeth ULg; De Tiège, X. et al

in Arco di Giano (2004)

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See detailBrain function in the vegetative state
Laureys, Steven ULg; Antoine, S.; Boly, Mélanie ULg et al

in Acta Neurologica Belgica (2002), 102(4), 177-185

Positron emission tomography (PET) techniques represent a useful tool to better understand the residual brain function in vegetative state patients. It has been shown that overall cerebral metabolic rates ... [more ▼]

Positron emission tomography (PET) techniques represent a useful tool to better understand the residual brain function in vegetative state patients. It has been shown that overall cerebral metabolic rates for glucose are massively reduced in this condition. However, the recovery of consciousness from vegetative state is not always associated with substantial changes in global metabolism. This finding led us to hypothesize that some vegetative patients are unconscious not just because of a global loss of neuronal function, but rather due to an altered activity in some critical brain regions and to the abolished functional connections between them. We used voxel-based Statistical Parametric Mapping (SPM) approaches to characterize the functional neuroanatomy of the vegetative state. The most dysfunctional brain regions were bilateral frontal and parieto-temporal associative cortices. Despite the metabolic impairment, external stimulation still induced a significant neuronal activation (i.e., change in blood flow) in vegetative patients as shown by both auditory click stimuli and noxious somatosensory stimuli. However this activation was limited to primary cortices and dissociated from higher-order associative cortices, thought to be necessary for conscious perception. Finally, we demonstrated that vegetative patients have impaired functional connections between distant cortical areas and between the thalami and the cortex and, more importantly, that recovery of consciousness is paralleled by a restoration of this cortico-thalamo-cortical interaction. [less ▲]

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See detailPathologies inflammatoires de l'hypophyse durant la grossesse
Hansen, Isabelle ULg; Betea, Daniela ULg; Beckers, Albert ULg

in Annales d'Endocrinologie (2002), 63(5), 464-469

Well-known pituitary inflammatory diseases (sarcoidosis, Wegener granulomatosis, Langerhans and non-Langerhans histiocytosis, inflammatory pseudotumors) may occur during pregnancy or apart from it ... [more ▼]

Well-known pituitary inflammatory diseases (sarcoidosis, Wegener granulomatosis, Langerhans and non-Langerhans histiocytosis, inflammatory pseudotumors) may occur during pregnancy or apart from it. Moreover, some inflammatory diseases, such as lymphocytic hypophysitis occur most of the time during pregnancy. In this chapter, we shall consider these different pathologies as well as the specific treatment of lymphocytic hypophysitis. [less ▲]

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See detailAcromégalie et grossesse
Betea, Daniela ULg; Valdes Socin, Hernan Gonzalo ULg; Hansen, Isabelle ULg et al

in Annales d'Endocrinologie (2002), 63(5), 457-63

Acromegaly usually results from GH hypersecretion by a somatotroph adenoma. The fertility of acromegalic patients is often impaired. Several factors may impact the course of pregnancy in acromegaly ... [more ▼]

Acromegaly usually results from GH hypersecretion by a somatotroph adenoma. The fertility of acromegalic patients is often impaired. Several factors may impact the course of pregnancy in acromegaly. Disturbed pituitary function might lead to infertility or spontaneous abortion. GH is a powerful insulin antagonist, and pregnant acromegalic patients are prone to added glucose intolerance and diabetes. Pregnancy itself might also impact the course of the pituitary tumor. During pregnancy, the normal pituitary increases in size due to estrogens-mediated hyperplasia. Therefore, tumors are at risk for hemorrhage due to enhanced vascularity, and might compress the optic chiasm. In this article we summarize the data on the literature on the reciprocal influences between acromegaly and pregnancy, we discuss therapeutic options and advance diagnostic and surveillance schedules of acromegaly during pregnancy. [less ▲]

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See detailSyndrome du canal lent associe a une translocation autosomique 2q31-9p27.
Zeevaert, Bernard ULg; Hansen, Isabelle ULg; Crielaard, Jean-Michel ULg et al

in Revue Neurologique (2002), 158(5 Pt 1), 605-8

A 27-year-old man complained of cervicoscapular and forearm weakness and amyotrophy. Electromyographic evaluation showed neuromuscular transmission dysfunction and a repetitive compound muscle action ... [more ▼]

A 27-year-old man complained of cervicoscapular and forearm weakness and amyotrophy. Electromyographic evaluation showed neuromuscular transmission dysfunction and a repetitive compound muscle action potential to a single stimulus. Prostigmine did not improve neuromuscular transmission. The genetic analysis of the patient's lymphocytes demonstrated a chromosomic 2q31-9p27 translocation. The combination of the clinical and electrophysiological data as well as the lack of auto-immunity signs against neuromuscular junction constituents led to the diagnosis to congenital postsynaptic myasthenic syndrome also called slow channel syndrome. This congenital myasthenic syndrome is for the first time associated with an autosomal translocation 2q31-9p27. [less ▲]

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See detailExtensive inflammatory pseudotumor of the pituitary.
Hansen, Isabelle ULg; Petrossians, Patrick ULg; Thiry, Albert ULg et al

in Journal of Clinical Endocrinology and Metabolism (2001), 86(10), 4603-4610

A 40-yr-old female presented with an extensive lesion of the sellar area and the sphenoid sinus, spreading to the optic nerves and associated with pachymeningitis. Histological findings were consistent ... [more ▼]

A 40-yr-old female presented with an extensive lesion of the sellar area and the sphenoid sinus, spreading to the optic nerves and associated with pachymeningitis. Histological findings were consistent with an inflammatory pseudotumor, and steroid treatment allowed the disappearance of all the lesions. Inflammatory pseudotumors of the pituitary are very rare. This case appears unique with regard to the extension of the lesions and the dramatic response to medical treatment. The differential diagnosis of inflammatory lesions of the pituitary is difficult. It relies mainly on histological analysis and includes sarcoidosis, Wegener's granulomatosis, histiocytosis (Langerhans, Rosai-Dorfman, and Erdheim-Chester diseases) and lymphocytic hypophysitis. [less ▲]

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See detailInsuffisance hypophysaire et amaurose subaiguës causées par une pseudotumeur inflammatoire extensive du sinus sphénoïde
Hansen, Isabelle ULg; Petrossians, Patrick ULg; Flandroy, Pierre et al

in XVI Congrès de la Société Française d'Endocrinologie - Abstract book (1998)

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See detailPrimary Systemic Amyloidosis - A report of 2 cases
Dezfoulian, Bita ULg; Arrese Estrada, Jorge ULg; Fernandez, A. et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (1996), 192

We report 2 cases of primary systemic amyloidosis. A monoclonal gammopathy was confirmed at the postmortem examination of the first patient. An extensive search for evidence of chronic infection ... [more ▼]

We report 2 cases of primary systemic amyloidosis. A monoclonal gammopathy was confirmed at the postmortem examination of the first patient. An extensive search for evidence of chronic infection, inflammation, neoplasms and paraproteinemia was conclusively negative in the other patient. The recognition of cutaneous signs of primary systemic amyloidosis is crucial to insure a rapid management aimed at postponing the fatal issue of the disease. [less ▲]

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See detailNeutrophilic Eccrine Hidradenitis. A Case Report
Nikkels, Arjen ULg; Hansen, Isabelle ULg; Collignon, Jacques ULg et al

in Acta Clinica Belgica (1993), 48(6), 397-400

Neutrophilic eccrine hidradenitis (NEH) is a rare neutrophilic dermatosis occurring most frequently during induction chemotherapy for a variety of malignancies. We report a case of NEH in a 41-year-old ... [more ▼]

Neutrophilic eccrine hidradenitis (NEH) is a rare neutrophilic dermatosis occurring most frequently during induction chemotherapy for a variety of malignancies. We report a case of NEH in a 41-year-old woman with acute myeloblastic leukemia under daunorubicin, cytarabine and etoposide chemotherapy. She developed red, tender and painful nodules on a shoulder. The lesions resolved spontaneously. Histological examination is mandatory as the clinical presentation of this dermatosis is highly polymorphic. Leukemia cutis, sepsis, deep fungal infection and Sweet's syndrome must be excluded as these implicate different therapies. [less ▲]

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