Anévrisme de l’artère ulnaire chez un couvreur

in Revue Médicale de Liège (in press)

A case of ulnar artery aneurysm in an independent roofer is reported. It is a rare disease often associated with the Hammer Hypothenar Syndrome specifically found in manual workers and athletes exposed to ... [more ▼]

A case of ulnar artery aneurysm in an independent roofer is reported. It is a rare disease often associated with the Hammer Hypothenar Syndrome specifically found in manual workers and athletes exposed to repetitive palmar trauma. [less ▲]

Platelet-rich plasma (PRP) to treat chronic upper patellar tendinopathies

in British Journal of Sports Medicine (2013, July), 47(10 (e3)), 15

Background: Upper patellar tendinopathies remain often chronic and rebel to a thorough conservative treatment. Moreover, the option of a surgical treatment could be disappointing. New treatments are being ... [more ▼]

Background: Upper patellar tendinopathies remain often chronic and rebel to a thorough conservative treatment. Moreover, the option of a surgical treatment could be disappointing. New treatments are being developed. Injection of PRP is one of these. Platelets contain lot of growth factors which would have the potentiality to enhance the healing process of tendons. Even if in vitro and animal experiments have demonstrated this stimulation of tendon healing process1, clinical series are subject to controversy2. Methods: Twenty patients with chronic upper patellar tendinopathy were enrolled. Assessments ［VAS, clinical examination with an algometer, algofunctional scores (IKDC and VISA-P), functional assessments (isokinetic and Optojump) and imagery (ultrasounds and MRI)］were made before infiltration of PRP, and 6 weeks and 3 months after. The PRP was obtained by an apheresis system (COM.TEC, Fresenius). Six millilitres of PRP were injected without local anaesthetic. One week after infiltration, patients started a 6-week standardised sub-maximal eccentric reeducation. Results: We observed a very significant improvement of the algofunctional status as soon as 6 weeks after the infiltration of PRP, and continued to a lesser extent up to 3 months. During functional evaluation, pain decreased as well, but without significant improvement of performances. No significant improvements in the imagery were observed. Interestingly, patients who had a VAS equal or below 1 after 3 months post-infiltration were younger (24.7 vs 32.2 y.o.). Moreover, these younger patients had a significant increase of the IKDC score (p=0.003), a significant improvement of pain during isokinetic evaluations (p<0.05), and during Optojump assessments (p=0.01). Seventy-five percent of subjects were able to return to sport, even if only half of these patients recovered the same level than before the tendinopathy. Discussion / Conclusions: This study demonstrates that a local infiltration of PRP associated with a submaximal eccentric protocol is efficient to improve symptoms of chronic upper patellar tendinopathies, non-responsive to classical conservative treatments. However, up to now, there is no consensus on the method to prepare the PRP. Indeed, each technique could provide a very different PRP (variations in the platelet concentrations and of the amount of red and white cells). [less ▲]

Syndromes canalaires du pied - Apport des bilans électrophysiologiques

Conference (2013, May 29)

Impact of strenuous exercise on the release of cardiac biomarkers

in Biochimica Clinica (2013, May), 37(SS), 545

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. In this study, cTnT was measured ... [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. In this study, cTnT was measured by new commercially available high-sensitive methods in subjects un-dergoing the Maasmarathon. Our aim was to compare cTnT and NT-proBNP levels before and after the stress tests, in sportive subjects. Methods: Twenty eight subjects (26 ♂, 42.5±11yo) underwent a race of 42.195 kilometers be-tween Visé (Belgium) and Maastricht (The Netherlands). We drowned blood sample before (T0), just after (T1) and three hours after the race (T3). In all patients, 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. The protocol was approved by the ethics committee of the University of Liège (Belgium). All subjects gave their informed consent. All statistical analyses were performed using Medcalc version 8.1 for Windows. p-value <0.01 was regarded as statistically significant. Results: There was a significant difference between hsTnT concentrations at T0 and T1 (p<0.0001), and between T0 and T3 (p<0.001) for NT-proBNP, but not between T1 and T3. This observation appeared only after a strenuous exercise but today this type of exercise is not reproduce easier in a laboratory of sport. Moreover, at this moment, nobody knows if these observations would have cardiac consequences at long terms. Conclusions: 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 ▲]

Race Cycling: biological evolution

in Biochimica Clinica (2013, May), 37(SS), 544

Background: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and ... [more ▼]

Background: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and metabolic) released during an international cycling race. Methods: Venous blood samples of 15 young men (25.1 ± 6.4 y.o.) were collected just before (T1), just after (T2), 3 hours (T3) after an international cycling race of 179.6 kilometers in Belgium for the determination of cardiac and metabolic biomarkers: red blood cell (RBC), haemoglobin (HgB), creatinin (Cr), highly sensitive troponin T (hsTnT), myoglobin (MYO) and NT-proBNP. All automated assays were performed according to the manufacter’s specifications. For the statistical analysis, an Anova calculated with the Statistica Software version 9.1 was used. Results: RBC and HgB levels varied significantly between T0 and T3 (respectively p=0.0026, and p=0.002). Cr concentration also varied significantly between all times (T0-T1:p<0.0001, T1-T3:p=0.0326 and T0-T3 p=0.0001). These changes might be related to renal flow depletion during exercice. MYO increased significantly between T0 and T1 (p<0.0001), but quickly decreased between T1 and T3, however the T3 level stay higher than T0 (p=0.014). The stress delivered from the physical activity performed during the race induced a significant variation of hsTnT which increased significantly between T0 and T1 (p<0.0001) and stayed higher 3 hours after the end of the exercise (T0-T3: p<0.0001) .The intense exercise delivery by the race induced a significant variation of NT-proBNP, that followed the same kinetic of hsTnT but in smaller proportion. We noticed variations statistically significant between T0 and T1 and between T0 and T3 for NT-proBNP. These increases of cardiac biomarkers were significant but reasonable and could not allow us to talk about cellular necrosis or irreversible injury. Conclusion: Our results show that stress generated by a cycling race could be the cause for the different metabolic variations observed. Troponin T stays without a doubt the most specific marker for stress related to myocardial tissue. Its increase can then be considered as being of interest. [less ▲]

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

in Biochimica Clinica (2013, May), 37(SS), 471

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 ▲]

Thérapeutiques récentes des tendinopathies du sportif (ondes de choc, injections de plaquettes, ...)

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

Le travail excentrique : aspects musculaires et tendineux

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

La lésion musculaire des ischio-jambiers

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

L'équilibre de force musculaire agonistes / antagonistes

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