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See detailAging of monolithic zirconia dental prostheses: Protocol for a 5-year prospective clinical study using ex vivo analyses
KOENIG, Vinciane ULg; Wulfman, Claudine; DERBANNE, Mathieu et al

in Contemporary Clinical Trials Communication (2016), 4

Background: Recent introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) monolithic zirconia dental prostheses raises the issue of material low thermal degradation (LTD), a ... [more ▼]

Background: Recent introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) monolithic zirconia dental prostheses raises the issue of material low thermal degradation (LTD), a wellknown problem with zirconia hip prostheses. This phenomenon could be accentuated by masticatory mechanical stress. Until now zirconia LTD process has only been studied in vitro. This work introduces an original protocol to evaluate LTD process of monolithic zirconia prostheses in the oral environment and to study their general clinical behavior, notably in terms of wear. Methods/design: 101 posterior monolithic zirconia tooth elements (molars and premolars) are included in a 5-year prospective clinical trial. On each element, several areas between 1 and 2 mm2 (6 on molars, 4 on premolars) are determined on restoration surface: areas submitted or non-submitted to mastication mechanical stress, glazed or non-glazed. Before prosthesis placement, ex vivo analyses regarding LTD and wear are performed using Raman spectroscopy, SEM imagery and 3D laser profilometry. After placement, restorations are clinically evaluated following criteria of the World Dental Federation (FDI), complemented by the analysis of fracture clinical risk factors. Two independent examiners perform the evaluations. Clinical evaluation and ex vivo analyses are carried out after 6 months and then each year for up to 5 years. Discussion: For clinicians and patients, the results of this trial will justify the use of monolithic zirconia restorations in dental practice. For researchers, the originality of a clinical study including ex vivo analyses of material aging will provide important data regarding zirconia properties. [less ▲]

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See detailThe cardiovascular impact of intense eccentric isokinetic exercise versus aerobic treadmill running
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; LAURENT, Terry ULg et al

in Isokinetics & Exercise Science (2016), 24(3), 201-208

BACKGROUND: Regular physical activity is an important health factor, but intense physical stress can increase the risk of heart disease. OBJECTIVE: Our aim was to determine the potential cardiac ... [more ▼]

BACKGROUND: Regular physical activity is an important health factor, but intense physical stress can increase the risk of heart disease. OBJECTIVE: Our aim was to determine the potential cardiac repercussions of, and the oxidative stress resulting from a maximal eccentric isokinetic exercise and a 1-hour treadmill run at 75% ˙V O2 max (maximal exercise done 6 weeks before). METHODS: Twelve young sedentary healthy subjects randomly performed two tests separated by 6 weeks: 1) 3 sets of 30 maximal eccentric isokinetic contractions of the quadriceps; 2) a 1-hour running on treadmill at 75% ˙V O2 max. We drew blood samples just before each exercise (T1), and just after (T2), 3 hours after (T3), and 24 hours after (T4) the end of each exercise to measure cardiac and oxidative stress biomarkers. RESULTS: In the running group, we observed significant differences for myoglobin (T3: 145 ± 80 μg/L), creatinine kinase (T4: 593 ± 350 mg/L), oxidized glutathione (T2: 22 ± 15.6 μmol/L), and highly sensitive cardiac troponin T, (T3: 0.051 ± 0.038 ng/mL). In the isokinetic group, we observed significant differences for myoglobin (T3:1419 ± 2533 mg/L), creatine kinase (3303 ± 7159 mg/L), and oxidized glutathione (T4:24 ± 14 μmol/L). Between isokinetic exercise and running, we observed significant differences for uric acid (p < 0.05, running > eccentric), myoglobin (p < 0.05, ditto), NT-proBNP (p < 0.05, ditto), hsTnT (p < 0.01, ditto), and oxidized glutathione (p < 0.05). CONCLUSIONS: As cardiac biomarkers appear practically unmodified after the isokinetic exercise, despite the considerable oxidative stress, we suggest that the application of intense maximal eccentric isokinetic exercise, when indicated, should be safe for most patients including those whose cardiac status is unknown. On the other hand, the increase in cardiac biomarkers observed after running, could reflect leakage of these biomarkers from the cytosolic pool of cardiac cells, linked to membrane damage, rather than the result of a major injury and hence running is supposed to be a safe practice. However, since sudden death during running has been previously described, assesment of the cardiac biomarkers and a follow-up by a sport doctor is important especially if there is a cardiac family history. [less ▲]

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See detailExtending abdominal aortic aneurysm detection to older age groups: preliminary results from the Liege screening programme.
MAKRYGIANNIS, Georgios ULg; Labalue, Philippe; Erpicum, Marie ULg et al

in Annals of Vascular Surgery (2016)

BACKGROUND: There is evident benefit in terms of reduced aneurysm related mortality from screening programmes of abdominal aortic aneurysm (AAA) in men aged 65 and more. Recent studies in UK and Sweden ... [more ▼]

BACKGROUND: There is evident benefit in terms of reduced aneurysm related mortality from screening programmes of abdominal aortic aneurysm (AAA) in men aged 65 and more. Recent studies in UK and Sweden have shown a decline of the prevalence of AAA in the general population. Current screening policies (e.g. men aged 65-74 years) however do not account for ageing and increased life expectancy of western populations. This study investigated AAA detection by extending the target population to older age groups (75-85 years). METHODS: AAA screening was conducted in the County of Chaudfontaine (Liege, Belgium) on the population of elderly (N=3,054). The participation rate was 36%. The 1,101 participants (722 men aged 65-85 and 379 women aged 74-85 years) were examined by ultrasound (US) scan. AAA was defined as an infrarenal aortic outer-outer diameter of at least 3 cm. Demographics, clinical parameters and risk factors were also recorded. AAA prevalence was estimated and patients with and without AAA were compared by logistic regression. RESULTS: The overall AAA prevalence was 3.6% (n=40). In female participants, AAA prevalence was low (1.3%). In men, it amounted 2.7% in the 65-74 age group but rose to 7.3% in the age-extended group (75-85 years). Further in addition to age, height, current smoking, history of coronary artery disease, hypercholesterolemia, peripheral artery disease of the lower limbs and varicose veins were significantly associated with the presence of AAA. CONCLUSION: These preliminary findings, based on a representative sample of the elderly population of the Liege region, support the idea that current AAA screening policies should be updated to cover an increasingly ageing population. The presence of varicose veins as a potential risk factor for AAA should also be considered during screening. [less ▲]

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See detail18F-FDG PET/CT imaging in rectal cancer: relationship with the RAS mutational status.
LOVINFOSSE, Pierre ULg; KOOPMANSCH, Benjamin ULg; LAMBERT, Frédéric ULg et al

in British Journal of Radiology (2016)

OBJECTIVE: Treating metastatic colorectal cancer with anti-EGFR monoclonal antibodies is recommended only for patients whose tumour does not harbour mutations of KRAS or NRAS. The aim of this study was to ... [more ▼]

OBJECTIVE: Treating metastatic colorectal cancer with anti-EGFR monoclonal antibodies is recommended only for patients whose tumour does not harbour mutations of KRAS or NRAS. The aim of this study was to investigate the biology of rectal cancers and specifically to evaluate the relationship between fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) intensity and heterogeneity parameters and their mutational status. METHODS: 151 patients with newly diagnosed rectal cancer were included in this retrospective study. All patients underwent a baseline 18F-FDG PET/CT within a median time interval of 27 days of tumour tissue sampling, which was performed before any treatment. Standardized uptake values (SUVs), volume-based parameters and texture analysis were studied. We retrospectively performed KRAS genotyping on codons 12, 13, 61, 117 and 146, NRAS genotyping on codons 12, 13 and 61 and BRAF on codon 600. Associations between PET/CT parameters and the mutational status were assessed using univariate and multivariate analysis. RESULTS: 83 (55%) patients had an RAS mutation: 74 KRAS and 9 NRAS, while 68 patients had no mutation (wild-type tumours). No patient had BRAF mutation. First-order features based on intensity histogram analysis were significantly associated with RAS mutations: maximum SUV (SUVmax) (p-value = 0.002), mean SUV (p-value = 0.006), skewness (p-value = 0.049), SUV standard deviation (p-value = 0.001) and SUV coefficient of variation (SUVcov) (p-value = 0.001). Both SUVcov and SUVmax showed an area under the curve of 0.65 with sensitivity of 56% and 69%, respectively, and specificity of 64% and 52%, respectively. None of the volume-based (metabolic tumour volume and total lesion glycolysis), nor local or regional textural features were associated with the presence of RAS mutations. CONCLUSION: Although rectal cancers with KRAS or NRAS mutations display a significantly higher glucose metabolism than wild-type cancers, the accuracy of the currently proposed quantitative metrics extracted from 18F-FDG PET/CT is not sufficiently high for playing a meaningful clinical role. ADVANCES IN KNOWLEDGE: RAS-mutated rectal cancers have a significantly higher glucose metabolism. However, the accuracy of 18F-FDG PET/CT quantitative metrics is not as such as the technique could play a clinical role. [less ▲]

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See detailComment améliorer la réussite à l'examen d'anatomie en 1ère année de bachelier en médecine? Etude de l'impact d'une activité intégrée dans un dispositif hybride de formation
Ernst, Denise ULg; SEIDEL, Laurence ULg; Defaweux, Valérie ULg et al

Poster (2015, November 17)

The course of “Introduction to Human Anatomy” is part of the curriculum delivered to the undergraduated students (Freshman year) at the Faculty of Medecine of the University of Liege. The course is taught ... [more ▼]

The course of “Introduction to Human Anatomy” is part of the curriculum delivered to the undergraduated students (Freshman year) at the Faculty of Medecine of the University of Liege. The course is taught in a blending learning mode combining traditional intructor-led and e-learning activities. The MCQ 2 test is one of the three components of the final written exam (which consists of 3 MCQ tests). This test requires students to recognize and identify the organ’s orientation in cross-sections represented in different spatial views. In our study, we tried to evaluate how the online training exercises provided by the instructors team for that particular ability was appreciated by students and if students benefited from this type of online activities to improve their examination results for MCQ 2 test. Further in our research, we asked student about their perceptions of coherence between the aims, methods and evaluation of our entire system. Then this perception has been compared with the overall score of the exam to look for the present of correlation elements. We observed that the MCQ 2 test results are significantly better for students who practiced the new online exercises and for students having seen the value of this activity. The perception of consistency or coherence between the objectives, methods and assessment is not correlated to the overall score of the student. As conclusion, we can declare that the new learning scenario proposed positively enriches the learning environment for students. It can be easily scaled up for important groups and accessed at any time by users. It focusses on specific objectives, is directly linked to the examination system of the course (MCQ 2) and also allows developing a competence expertise related to their future medical profession. [less ▲]

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See detailOccurrence and risk indicators of medication-related osteonecrosis of the jaw after dental extraction: a systematic review and meta-analysis.
GAUDIN, Elise ULg; SEIDEL, Laurence ULg; Bacevic, Miljana ULg et al

in Journal of Clinical Periodontology (2015)

AIMS: The primary objective was to assess the occurrence rate of Medication-Related OsteoNecrosis of the Jaw (MRONJ) after dental extraction in patients treated with Anti-Resorptive Drugs (ARD) for ... [more ▼]

AIMS: The primary objective was to assess the occurrence rate of Medication-Related OsteoNecrosis of the Jaw (MRONJ) after dental extraction in patients treated with Anti-Resorptive Drugs (ARD) for OsteoPorosis (OP) or for oncological reasons. The secondary objective was to compare the extraction techniques regarding the occurrence of MRONJ. MATERIALS AND METHODS: A systematic search in PubMed/MEDLINE, EMBASE and LILACS databases was performed. Prospective studies considering human patients treated with ARD and providing information regarding the occurrence of MRONJ after dental extraction were selected. Meta-analysis for incidence of MRONJ at the patient level was performed. The effect of administration route and surgical technique on MRONJ was evaluated. RESULTS: The risk of MRONJ after dental extraction was significantly higher in patients treated with ARD for oncological reasons (3.2%) than in those treated with per os ARD for OP (0.15%) (p<0.0001). Dental extraction performed with adjusted extraction protocols decreased significantly MRONJ development. Potential risk indicators such as concomitant medications and pre-existing osteomyelitis were identified. CONCLUSION: The risk of MRONJ after dental extraction in patients treated with ARD exists, especially in patients treated for oncologic reasons. This risk tends to decrease with adjusted extraction protocols. This article is protected by copyright. All rights reserved. [less ▲]

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See detailImmune Recovery after Allogeneic Hematopoietic Stem Cell Transplantation following Flu-TBI versus TLI-ATG Conditioning
HANNON, Muriel ULg; BEGUIN, Yves ULg; Ehx, Grégory ULg et al

in Clinical Cancer Research : An Official Journal of the American Association for Cancer Research (2015), 21(14), 3131-9

Purpose: A conditioning regimen for allogeneic hematopoietic cell transplantation (HCT) combining total lymphoid irradiation (TLI) plus anti-thymocyte globulin (ATG) has been develop to induce graft ... [more ▼]

Purpose: A conditioning regimen for allogeneic hematopoietic cell transplantation (HCT) combining total lymphoid irradiation (TLI) plus anti-thymocyte globulin (ATG) has been develop to induce graft-versus-tumor effects without graft-versus-host disease (GVHD). Experimental Design: We compared immune recovery in 53 patients included in a phase II randomized study comparing nonmyeloablative HCT following either fludarabine plus 2 Gy total body irradiation (TBI arm, n=28) or 8 Gy TLI plus anti-thymocyte globulin (TLI arm, n=25). Results: In comparison to TBI patients, TLI patients had a similarly low 6-month incidence of grade II-IV acute GVHD, a lower incidence of moderate/severe chronic GVHD (P=0.02), a higher incidence of CMV reactivation (P<0.001), and a higher incidence of relapse (P=0.01). While recovery of total CD8+ T cells was similar in the two groups, with median CD8+ T cell counts reaching the normal values 40-60 days after allo-HCT, TLI patients had lower percentages of naïve CD8 T cells. Median CD4+ T cell counts did not reach the lower limit of normal values the first year after allo-HCT in the two groups. Further, CD4+ T cell counts were significantly lower in TLI than in TBI patients the first 6 months after transplantation. Interestingly, while median absolute regulatory T cell (Treg) counts were comparable in TBI and TLI patients, Treg/naïve CD4+ T cell ratios were significantly higher in TLI than in TBI patients the 2 first years after transplantation. Conclusions: Immune recovery differs substantially between these two conditioning regimens possibly explaining the different clinical outcomes observed (NCT00603954). [less ▲]

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See detailEstimation of the Time Interval between the Administration of Heroin and the Sampling of Blood in Chronic Inhalers
DUBOIS, Nathalie ULg; HALLET, Claude ULg; SEIDEL, Laurence ULg et al

in Journal of Analytical Toxicology (2015)

To develop a model for estimating the time delay between last heroin consumption and blood sampling in chronic drug users. Eleven patients, all heroin inhalers undergoing detoxification, were included in ... [more ▼]

To develop a model for estimating the time delay between last heroin consumption and blood sampling in chronic drug users. Eleven patients, all heroin inhalers undergoing detoxification, were included in the study. Several plasma samples were collected during the detoxification procedure and analyzed for the heroin metabolites 6-acetylmorphine (6AM), morphine (MOR), morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G), according to a UHPLC/MSMS method. The general linear mixed model was applied to time-related concentrations and a pragmatic four-step delay estimation approach was proposed based on the simultaneous presence of metabolites in plasma. Validation of the model was carried out using the jackknife technique on the 11 patients, and on a group of 7 test patients. Quadratic equations were derived for all metabolites except 6AM. The interval delay estimation was 2–4 days when only M3G present in plasma, 1–2 days when M6G and M3G were both present, 0–1 day when MOR, M6G and M3G were present and <2 h for all metabolites present. The ‘jackknife’ correlation between declared and actual estimated delays was 0.90. The overall precision of the delay estimates was 8–9 h. The delay between last heroin consumption and blood sampling in chronic drug users can be satisfactorily predicted from plasma heroin metabolites. [less ▲]

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See detailOncological and surgical outcome after oncoplastic breast surgery
NIZET, Jean-Luc ULg; MAWEJA, Sylvie ULg; LAKOSI, Ferenc ULg et al

in Acta Chirurgica Belgica (2015), 115

BACKGROUND: Oncoplastic surgery combines breast-conserving treatment and plastic surgery techniques. The aim of the study was to identify breast and tumor-related characteristics that contribute to the ... [more ▼]

BACKGROUND: Oncoplastic surgery combines breast-conserving treatment and plastic surgery techniques. The aim of the study was to identify breast and tumor-related characteristics that contribute to the rate of complications and recurrence. METHODS: This retrospective study included 72 patients with a median follow-up of 32 months. For each patient, a comprehensive set of data was collected, including epidemiology, tumor characteristics, preoperative information, detailed pathology reports, radiotherapy treatment and type of surgical technique. The rate of complications, recurrence and survival were studied. RESULTS: Complete tumor removal was performed with clear margins in all patients but in 25 of them margins were less than 2 mm. One patient had local recurrence and another developed distant metastases. The study showed that the size of the margin was not predictive of recurrence as long as not positive; the greater the resection volume, the larger the excision margin. The resection size was the only factor influencing complications and no specific tumor-related factor significantly increased the complication rate. Surgical complications did not delay the initiation of chemotherapy and radiotherapy. CONCLUSIONS: This is the first oncoplastic study where both tumor and breast characteristics were analyzed using the most recent criteria of the literature. Oncoplastic surgery can be considered as oncologically safe. The resection size was the sole significant risk factor for postoperative complications. Complications after oncoplastic breast surgery did not differ neoadjuvant therapy. Long-term event-free survival was excellent (96% at 7 years). [less ▲]

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See detail(Tissue PET) vascularmetabolic imaging and peripheral plasma biomarkers in the evolution of chronic aortic dissections
SAKALIHASAN, Natzi ULg; NIENABER, Christoph; HUSTINX, Roland ULg et al

in European Heart Journal - Cardiovascular Imaging (2015)

Enhanced FDG uptake may be considered as a complementary imaging marker associated with secondary complications in type B dissections. During follow-up, aneurysmal progression is related to PET/CT and ... [more ▼]

Enhanced FDG uptake may be considered as a complementary imaging marker associated with secondary complications in type B dissections. During follow-up, aneurysmal progression is related to PET/CT and biomarkers of thrombus renewal and lysis. [less ▲]

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See detailPersisting signs of disease activity at magnetic resonance enterocolonography predict clinical relapse and disease progression in quiescent Crohn's disease
MEUNIER, Paul ULg; COUSIN, François ULg; VAN KEMSEKE, Catherine ULg et al

in Acta Gastro-Enterologica Belgica (2015), 73(3), 274-81

INTRODUCTION: Deep remission including clinical remission and tissue healing has been advocated as the therapeutic target in Crohn's disease. Yet, the definition of deep remission remains unclear. The aim ... [more ▼]

INTRODUCTION: Deep remission including clinical remission and tissue healing has been advocated as the therapeutic target in Crohn's disease. Yet, the definition of deep remission remains unclear. The aim of this study was to assess the persisting lesions at magnetic resonance enterocolonography (MREC) in clinically quiescent Crohn's disease as well as their relapse predictive value. METHODS: we performed a prospective monocentre cohort study. We included patients with clinical remission. At baseline, these patients had blood tests, the measurement of fecal calprotectin and underwent a MREC. They were then followed up clinically for a minimum of 1 year. A relapse was defined by a HBI > 4 with an increase of at least 3 points. Correlations between clinical, demographic, biological parameters and MREC signs were assessed as well as the time-to-relapse predictive value of the studied variables. RESULTS: Twenty seven patients were recruited. Fourteen out of 27 had persisting disease activity at MREC. MREC signs only partly correlated with biomarkers. Ten out of 27 patients relapsed over a median follow up of 25 months. In univariate analysis, relative contrast enhancement of the most affected segment (HR: 2.56; P = 0.046), ulcers (HR: 12.5; P = 0.039), fistulas (HR: 14.1; P = 0.009) and target sign (HR: 3.63; P = 0.049) were associated with relapse. In multivariate analysis, fistula was the only one. CONCLUSIONS: Half of the patients with clinically quiescent Crohn's disease had persisting signs of disease activity at MREC. These signs predicted time-to-relapse. [less ▲]

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See detailNon-myeloablative allogeneic hematopoietic cell transplantation following fludarabine plus 2 Gy TBI or ATG plus 8 Gy TLI: a phase II randomized study from the Belgian Hematological Society
Baron, Frédéric ULg; Zachée, Pierre; Maertens, Johan et al

in Journal of Hematology & Oncology (2015), 8(4), 10118613045-014-0098-9

Background: Few studies thus far have compared head-to-head different non-myelooablative conditioning regimens for allogeneic hematopoietic cell transplantation (allo-HCT). Methods: Here, we report the ... [more ▼]

Background: Few studies thus far have compared head-to-head different non-myelooablative conditioning regimens for allogeneic hematopoietic cell transplantation (allo-HCT). Methods: Here, we report the results of a phase II multicenter randomized study comparing non-myeloablative allo-HCT from HLA-identical siblings (n = 54) or from 10/10 HLA-matched unrelated donors (n = 40) with either fludarabine plus 2 Gy total body irradiation (Flu-TBI arm; n = 49) or 8 Gy TLI + anti-thymocyte globulin (TLI-ATG arm; n = 45) conditioning. Results: The 180-day cumulative incidences of grade II-IV acute GVHD (primary endpoint) were 12.2% versus 8.9% in Flu-TBI and TLI-ATG patients, respectively (P = 0.5). Two-year cumulative incidences of moderate/severe chronic GVHD were 40.8% versus 17.8% in Flu-TBI and TLI-ATG patients, respectively (P = 0.017). Five Flu-TBI patients and 10 TLI-ATG patients received pre-emptive DLI for low donor chimerism levels, while 1 Flu-TBI patient and 5 TLI-ATG patients (including 2 patients given prior pre-emptive DLIs) received a second HCT for poor graft function, graft rejection, or disease progression. Four-year cumulative incidences of relapse/progression were 22% and 50% in Flu-TBI and TLI-ATG patients, respectively (P = 0.017). Four-year cumulative incidences of nonrelapse mortality were 24% and 13% in Flu-TBI and TLI-ATG patients, respectively (P = 0.5). Finally, 4-year overall (OS) and progression-free survivals (PFS) were 53% and 54%, respectively, in the Flu-TBI arm, versus 54% (P = 0.9) and 37% (P = 0.12), respectively, in the TLI-ATG arm. Conclusions: In comparison to patients included in the Flu-TBI arm, patients included in the TLI-ATG arm had lower incidence of chronic GVHD, higher incidence of relapse and similar OS. [less ▲]

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See detailPrehospital identification of trauma patients with early acute coagulopathy and massive bleeding: results of a prospective non-interventional clinical trial evaluating the Trauma Induced Coagulopathy Clinical Score (TICCS).
TONGLET, Martin ULg; Minon, Jean Marc; SEIDEL, Laurence ULg et al

in Critical Care (2014)

Introduction: Identifying patients who need damage control resuscitation (DCR) early after trauma is pivotal for adequate management of their critical condition. Several trauma-scoring systems have been ... [more ▼]

Introduction: Identifying patients who need damage control resuscitation (DCR) early after trauma is pivotal for adequate management of their critical condition. Several trauma-scoring systems have been developed to identify such patients, but most of them are not simple enough to be used in prehospital settings in the early post-traumatic phase. The Trauma Induced Coagulopathy Clinical Score (TICCS) is an easy-to-measure and strictly clinical trauma score developed to meet this medical need. Methods: TICCS is a 3-item clinical score (range: 0 to 18) based on the assessment of general severity, blood pressure and extent of body injury and calculated by paramedics on-site for patients with severe trauma. This non-interventional prospective study was designed to assess the ability of TICCS to discern patients who need DCR. These patients were patients with early acute coagulopathy of trauma (EACT), haemorrhagic shock, massive transfusion and surgical or endovascular haemostasis during hospitalization. Diagnosis of EACT was assessed by both thromboelastometry and conventional coagulation tests. Results: During an 18-month period, 89 severe trauma patients admitted to the general emergency unit at our hospital were enrolled in the study, but 7 were excluded for protocol violations. Of the 82 remaining patients, 8 needed DCR and 74 did not. With receiver operating characteristic curve analysis, TICCS proved to be a powerful discriminant test (area under the curve = 0.98; 95% CI: 0.92 to 1.0). A cutoff of 10 on the TICCS scale provided the best balance between sensitivity (100%; 95% CI: 53.9 to 100) and specificity (95.9%; 95% CI: 88.2 to 99.2). The positive predictive value was 72.7%, and the negative predictive value was 100.0%. Conclusion: TICCS can be easily and rapidly measured by paramedics at the trauma site. In this study of blunt trauma patients, TICCS was able to discriminate between patients with and without need for DCR. TICCS on-site evaluation should allow initiation of optimal care immediately upon hospital admission of patients with severe trauma in need of DCR. However, a larger multicentre prospective study is needed for in-depth validation of TICCS. [less ▲]

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See detailModelled target attainment after meropenem infusion in patients with severe nosocomial pneumonia: the PROMESSE study.
FRIPPIAT, Frédéric ULg; Musuamba, Flora Tshinanu; Seidel, Laurence ULg et al

in Journal of Antimicrobial Chemotherapy (2014), 70

OBJECTIVES: The objective of this study was to propose an optimal treatment regimen of meropenem in critically ill patients with severe nosocomial pneumonia. PATIENTS AND METHODS: Among 55 patients in ... [more ▼]

OBJECTIVES: The objective of this study was to propose an optimal treatment regimen of meropenem in critically ill patients with severe nosocomial pneumonia. PATIENTS AND METHODS: Among 55 patients in intensive care treated with 1 g of meropenem every 8 h for severe nosocomial pneumonia, 30 were assigned to intermittent infusion (II; over 0.5 h) and 25 to extended infusion (EI; over 3 h) groups. Based on plasma and epithelial lining fluid (ELF) concentrations determined at steady-state, pharmacokinetic modelling and Monte Carlo simulations were undertaken to assess the probability of attaining drug concentrations above the MIC for 40%-100% of the time between doses (%T > 1-fold and 4-fold MIC), for 1 or 2 g administered by either method. RESULTS: Penetration ratio, measured by the ELF/plasma ratio of AUCs, was statistically higher in the EI group than in the II group (mean +/- SEM: 0.29 +/- 0.030 versus 0.20 +/- 0.033, P = 0.047). Considering a maximum susceptibility breakpoint of 2 mg/L, all dosages and modes of infusions achieved 40%-100% T > 1-fold MIC in plasma, but none did so in ELF, and only the 2 g dose over EI achieved 40%-100% T > 4-fold MIC in plasma. CONCLUSIONS: The optimum regimen to treat severe nosocomial pneumonia was 2 g of meropenem infused over 3 h every 8 h. This regimen achieved the highest pharmacodynamic targets both in plasma and in ELF. [less ▲]

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See detailComprehensive plasma profiling for the characterization of graft-versus-host disease biomarkers
De Bock, Muriel; BEGUIN, Yves ULg; Leprince, Pierre ULg et al

in Talanta (2014), 125

Acute graft-versus-host disease (aGVHD) remains a life-threatening complication of hematopoietic stem cell transplantation (HSCT), limiting its application. To optimize management of aGVHD and reduce ... [more ▼]

Acute graft-versus-host disease (aGVHD) remains a life-threatening complication of hematopoietic stem cell transplantation (HSCT), limiting its application. To optimize management of aGVHD and reduce therapy-related toxicity, early specific markers are needed. The main objective of this study was thus to uncover diagnostic biomarkers comparing plasma protein profiles of patients at the time of acute GVHD diagnosis and of patients undergoing HSCT without aGVHD. Additional analysis of samples taken 15 days before aGVHD diagnosis was also performed to evaluate the potential of the newly discovered biomarkers for early diagnosis. To extract a maximum of information from plasma samples, we used three complementary proteomic approaches, namely 2D-DIGE, SELDI-TOF-MS and 2D-LC-MSE. We identified and confirmed by means of a independent techniques, the differential expression of several proteins indicating significantly increased inflammation response and disturbance in the coagulation cascade. The variation of these proteins was already observed 15 days before GVHD diagnosis, suggesting the potential early detection of the disease before symptoms appearance. Finally, logistic regression analysis determines a composite biomarker panel comprising fibrinogen, fragment of fibrinogen beta chain, SAA, prothrombin fragments, apolipoprotein A1 and hepcidin that optimally discriminated patients with and without GVHD. The area under the receiver operating characteristic curve distinguishing these 2 groups was 0.95. [less ▲]

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See detailInfusion of clinical-grade enriched regulatory T cells delays experimental xenogeneic graft-versus-host disease
Hannon, Muriel ULg; LECHANTEUR, Chantal ULg; Lucas, Sophie et al

in Transfusion (2014), 54(February), 353-363

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See detailMandible behaviour interpretation during wakefulness, sleep and sleep-disordered breathing
Maury, Gisèle; Senny, Frédéric; CAMBRON, Laurent ULg et al

in Journal of Sleep Research (2014), (23), 709-716

The mandible movement (MM) signal provides information on mandible activity. It can be read visually to assess sleep–wake state and respiratory events. This study aimed to assess (1) the training of ... [more ▼]

The mandible movement (MM) signal provides information on mandible activity. It can be read visually to assess sleep–wake state and respiratory events. This study aimed to assess (1) the training of independent scorers to recognize the signal specificities; (2) intrascorer reproducibility and (3) interscorer variability. MM was collected in the mid-sagittal plane of the face of 40 patients. The typical MM was extracted and classified into seven distinct pattern classes: active wakefulness (AW), quiet wakefulness or quiet sleep (QW/S), sleep snoring (SS), sleep obstructive events (OAH), sleep mixed apnea (MA), respiratory related arousal (RERA) and sleep central events (CAH). Four scorers were trained; their diagnostic capacities were assessed on two reading sessions. The intra- and interscorer agreements were assessed using Cohen’s j. Intrascorer reproducibility for the two sessions ranged from 0.68 [95% confidence interval (CI): 0.59–0.77] to 0.88 (95% CI: 0.82–0.94), while the between-scorer agreement amounted to 0.68 (95% CI: 0.65–0.71) and 0.74 (95% CI: 0.72–0.77), respectively. The overall accuracy of the scorers was 75.2% (range: 72.4–80.7%). CAH MMs were the most difficult to discern (overall accuracy 65.6%). For the two sessions, the recognition rate of abnormal respiratory events (OAH, CAH, MA and RERA) was excellent: the interscorer mean agreement was 90.7% (Cohen’s j: 0.83; 95% CI: 0.79–0.88). The discrimination of OAH, CAH, MA characteristics was good, with an interscorer agreement of 80.8% (Cohen’s j: 0.65; 95% CI: 0.62–0.68). Visual analysis of isolated MMs can successfully diagnose sleep–wake state, normal and abnormal respiration and recognize the presence of respiratory effort. [less ▲]

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