Ce cavernome cérébral est-il la cause d'un syndrome parkinsonien ?

in Revue Médicale de Liège (in press)

We report the case of a patient presenting with an akineto-rigid syndrome of the left hemibody whose etiological exploration by magnetic resonance imaging showed the presence of a cavernoma located in the ... [more ▼]

We report the case of a patient presenting with an akineto-rigid syndrome of the left hemibody whose etiological exploration by magnetic resonance imaging showed the presence of a cavernoma located in the right lenticular region. The interest of this situation lies in establishing whether pathophysiological link may exist between such symptoms and the lesion. [less ▲]

Syndromes canalaires rares du membre supérieur - Apport des bilans électrophysiologiques

in 32ème congrès AMDTS (2013, May 27)

Comparison between Perkin-Elmer and Chromsytem Vitamin D kit on TQ 5500 from AB SCIEX

(2013, May)

Background: Twenty-five hydroxy-vitamin D (25(OH) D) determination is now routinely prescribed in the Laboratory. Recently, different new methods have been available for this determination. Among them ... [more ▼]

Background: Twenty-five hydroxy-vitamin D (25(OH) D) determination is now routinely prescribed in the Laboratory. Recently, different new methods have been available for this determination. Among them, LCMS/MS methods have emerged in some laboratories. However these methods are generally “home-brewed” and an important variability between them can be seen on different external quality controls, mainly due to a lack of standardization. Recently, Perkin-Elmer (PE) (Turku, Finland) and Chromsystem (CS) (Grafelfing, Germany) launched a standardised method for 25(OH )D determination on LCMS/MS. The aim of our study was to compare these methods on the AB SCIEX TQ5500 (Framingham, Massachusetts, USA) LCMS/MS to measure 25(OH) D3. Methods All the samples were treated according to our preanalyitical procedure: after sampling, they were spun at +4°c at 3500G, aliquoted and kept frozen at -20°c until determination. A method comparison was assessed with CS and PE for the measurement of the 25(OH)D3. We selected 110 remnant samples with 25(OH)D3 levels ranging from 1.6 to 136.7 ng/ml with the PE method to cover the range of usually values Slope and intercept were calculated using Passing and Bablock linear regression and we compared the methods with the Bland and Altman plots. Results For CS, the method is linear up to 250 µg/L, the LOQ is 3.6 µg/L, the intra-assay CV is < 5% and the inter-assay is < 7%. For PE, the method is linear up to 314 µg/L, the LOQ is 3.4 µg/L, the intra-assay CV is < 7.8% and the inter-assay is < 8.5%. On the whole range of measure (n=110), the regression equation is PE = 0.8521+0.9226 (CS) (95%CI of the intercept: (-0.0048;1.37) and 95% CI of the slope (0.89;0.95). The Bland and Altman plot does not show any bias between the two methods (mean difference CS-PE= -2.5 ng/ml) and the standard deviation of the mean is 3,98 ng/ml Conclusion: The performances of these methods are comparable on our new TQ 5500 from AB SCIEX. For now, there is no consensus on a “reference” method for vitamin D quantification. We notice only that the values obtained by CS are systematically a little bit lower than PE’s values, especially for results below 20 ng/ml. However, we have no clear explanation for such behaviour. [less ▲]

Exuberant inflammatory reaction after an infiltration of platelet-rich plasma (PRP)

in Abstract Book of the 3rd Congress of the ECOSEP (2013, April)

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively ... [more ▼]

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. Case report: A 35-year-old patient had a right upper patellar tendinopathy which was resistant to all conservative treatments for more than 6 months. The patient was a type 1 diabetic (well controlled). He had an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after disinfection but without local anaesthetic. Immediately following the infiltration, local cryotherapy was performed for 15 minutes. NSAIDs were avoided, but class-1 or -2 pain-killers were authorised if necessary. A standardised sub-maximal eccentric rehabilitation should have been started 1 week after. However, the patient experienced local swelling with erythema, increased heating and pain which appeared just underneath the patella, but without biological inflammatory syndrome. A great Doppler signal in a thicker patellar tendon was observed by US, but there was no sign of local infectious disease demonstrated by either CT or MRI. However, the local inflammation did not decrease after a progressive 3-week treatment of local cryotherapy, local and oral NSAIDs and colchicine 1 mg. Thus, an insidious infection was suspected, even though there was neither evidence of biological inflammatory syndrome nor sign of infectious lesion on imagery examination. An antibiotic therapy (rifampicine 600 mg + minocycline 100 mg) was initiated for 3 months. Finally, a 3-phase bone scintigraphy suggested the presence of a complex regional pain syndrome type 1 treated by a classical physical therapy and concomitant class-2 pain killers. The evolution was favourable after 6 months of symptomatic treatment, and the pain decreased to a level similar to that before the infiltration of PRP. Discussion/Conclusions: This case report draws attention to potential side effects that are linked to this new therapy by infiltration of platelet rich plasma in case of tendinopathy, in particular when used in patients with type 1 diabetes. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment in patients with type 1 diabetes. Reference: Platelet-rich plasma application in the management of chronic tendinopathies. Acta Orthop Belg 2013; 79: 10-15. [less ▲]

Tendinopathies et lésions particulières de la cheville et du pied du sportif

in Abstract book du 21ème Séminaire hivernal de Médecine sportive 2013 (2013, April)

Synovite villonodulaire pigmentée du genou

in Revue Médicale de Liège (2013), 68(3), 104-109

This case report is concerned with a 30 year old patient diagnosed with pigmented villonodular synovitis (PVNS) in the knee. The patient underwent an orthopedic surgical operation to remove the lesions ... [more ▼]

This case report is concerned with a 30 year old patient diagnosed with pigmented villonodular synovitis (PVNS) in the knee. The patient underwent an orthopedic surgical operation to remove the lesions. PVNS is a rare proliferative disorder, mostly benign and affecting the knee; its aetiology remains unclear. It represents a medical challenge because of non-specific symptoms that delay the diagnosis with a very high rate of recurrence. MRI imaging is necessary to explore the lesions, but the final diagnosis can only be made after anatomopathologic analysis of the excised lesions. When multiple lesions are present, the treatment consists of their excision by arthrotomy, or by arthroscopy if the disease is localized. [less ▲]

Approche préventive de la lésion d'épaule chez le sportif

in Prévention des troubles musculo-squelettiques chez le sportif (2013)

Platelet-rich plasma application in the management of chronic tendinopathies

in Acta Orthopaedica Belgica (2013), 79(1), 10-15

Platelet-rich plasma (PRP) may represent a new therapeutic option for chronic tendinopathies. Platelets release various cytokines and growth factors which promote angiogenesis, tissue remodeling, and ... [more ▼]

Platelet-rich plasma (PRP) may represent a new therapeutic option for chronic tendinopathies. Platelets release various cytokines and growth factors which promote angiogenesis, tissue remodeling, and wound healing. We made an exhaustive review of the use of PRP in chronic tendinopathies: epicondylitis, rotator cuff, patellar and calcaneal tendinopathies, and plantar fasciitis. Medline, Embase and Google Scholar were used (until July 31, 2012). Clinical studies about PRP and tendinopathies (in English and French language peer-reviewed journals) were included. Articles with a high level of evidence were considered preferentially. Despite the proven efficacy of PRP on tissue regeneration in experimental studies, there is currently scanty tangible clinical evidence with respect to chronic tendon disorders. The few studies that have been performed appear unlikely to be comparable. Randomized controlled studies with appropriate placebo groups are needed to determine the real effectiveness of PRP for treating chronic musculoskeletal injuries. [less ▲]

Ostéomalacie hypophosphatémique hyperphosphaturique avec hypersécrétion de FGF-23

in Lettre du Rhumatologue (La) (2012), 387

Performances isocinétiques et risque lésionnel de l’épaule chez le joueur de handball de haut niveau

in Abstract book des XIVèmes Rencontres isocinétiques MEDIMEX / ROTHSCHILD (2012, November)