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See detailLifestyle Behaviours and Plasma Vitamin C and β-Carotene Levels from ELAN Population (Liège, Belgium)
PINCEMAIL, Joël ULg; Vanbelle, Sophie ULg; Degrune, Fabien et al

in Journal of Nutrition and Metabolism (2011), 2011

Several factors, including fruit and vegetables intakes, have been shown to significantly influence the plasma concentrations of the two antioxidants vitamin C and β-carotene. Deficiency levels of 6 mg/L ... [more ▼]

Several factors, including fruit and vegetables intakes, have been shown to significantly influence the plasma concentrations of the two antioxidants vitamin C and β-carotene. Deficiency levels of 6 mg/L (34.2 μM) for vitamin C and of 0.22 mg/L (0.4 μM) for β-carotene have been suggested below which cardiovascular risk might be increased. The present study performed on 897 presumably healthy subjects aged 40–60 years aimed to examine how modifiable lifestyle factors may be related to vitamin C and/or β-carotene deficiency. Gender, smoking, lack of regular physical activity and of daily fruit consumption (≥2/day), and social status (in particular, unemployment) were found to be significant risk factors for vitamin C deficiency. For β-carotene deficiency, the same factors were identified except social status; moreover, overweight and OC use in women were also found to have a deleterious effect. For non exposed subjects, the probability of developing vitamin C deficiency was 4% in men and 2.4% in women. This probability increased to 66.3% for men and to 44.3% for women (and even to 50.4% under OC use), when all risk factors were present. For β-carotene deficiency, the corresponding probabilities were equal to 29.7% in men and 13.7% in women (no risk factor present), and to 86.1% for men and 69.9% (91.6% for OC use) for women (all factors present), respectively [less ▲]

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See detailInterest of routine dosage of meropenem in difficult to treat infections
Frippiat, Frédéric ULg; Bensahi, Ilham; Denooz, Raphael ULg et al

Poster (2010, October 23)

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See detailPenetration of enrofloxacin into the nasal secretions and relationship between nasal secretions and plasma enrofloxacin concentrations after intramuscular administration in healthy pigs
Bimazubute, M.; Cambier, Carole ULg; Baert, K. et al

in Journal of Veterinary Pharmacology & Therapeutics (2010), 33(2), 183-188

The pharmacokinetic behaviour of enrofloxacin (ENRO) in plasma and nasal secretions of healthy pigs was investigated, after a single-dose intramuscular administration of 2.5 mg/kg body weight of the drug ... [more ▼]

The pharmacokinetic behaviour of enrofloxacin (ENRO) in plasma and nasal secretions of healthy pigs was investigated, after a single-dose intramuscular administration of 2.5 mg/kg body weight of the drug. Blood samples and nasal secretions were collected at predetermined times after drug administration. Concentrations of ENRO and its active metabolite ciprofloxacin (CIPRO) were determined in plasma and nasal secretions by high-performance liquid chromatography (HPLC). CIPRO was not detected probably because we investigated young weaned pigs. The data collected in 12 pigs for ENRO were subjected to noncompartmental analysis. In plasma, the maximum concentration of drug (C-max), the time at which this maximum concentration of drug (T-max) was reached, the elimination half-life (t(beta)(1/2)) and the area under the concentration vs. time curve (AUC) were, respectively, 694.7 ng/mL, 1.0 h, 9.3 h and 8903.2 ng h/mL. In nasal secretions, Cmax, Tmax, t(beta)(1/2) and AUC were, respectively, 871.4 ng/mL, 2.0 h, 12.5 h and 11 198.5 ng.h/mL. In a second experiment conducted in 10 piglets, the relationship between concentrations of ENRO measured in the plasma and the nasal secretions has been determined following single-dose intramuscular administration of 2.5, 10 or 20 mg/kg body weight of the drug. It has been demonstrated that, among several variables, i.e., (1) the dose administered, (2) the time between intramuscular injection and blood sampling, (3) the age, (4) the sex, (5) the animal body weight and (6) the plasma concentration of the drug, only the latter influenced significantly the ENRO concentration in nasal secretions. Practically, using a generalized linear mixed model, ENRO concentrations in the nasal secretions (mu g/mL) can be predicted taking into account the ENRO concentrations in plasma (mu g/mL), according to the following equation: ENROnasal secretion 1.94 ENROplasma - 0.24. [less ▲]

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See detailReasoning versus knowledge retention and ascertainment throughout a problem-based learning curriculum
Collard, Anne ULg; Gelaes, Sabine ULg; Vanbelle, Sophie ULg et al

in Medical Education (2009), 43

CONTEXT: Since 2000, problem-based learning (PBL) seminars have been introduced into the curriculum of medical studies at the University of Liège. We aimed to carry out a cross-sectional investigation of ... [more ▼]

CONTEXT: Since 2000, problem-based learning (PBL) seminars have been introduced into the curriculum of medical studies at the University of Liège. We aimed to carry out a cross-sectional investigation of the maturational increase in biomedical reasoning capacity in comparison with factual knowledge retention throughout the curriculum. METHODS: We administered a factual knowledge test (i.e. a true ⁄ false test with ascertainment degree) and a biomedical reasoning test (i.e. an adapted script concordance test [SCT]) to 104 students (Years 3–6) and a reference panel. The selected topic was endocrinology. RESULTS: On the SCT, the students obtained higher scores in Years 5 and 6 than in Years 3 and 4. In Year 3, the scores obtained on SCT questions in a new context indicated transfer of reasoning skills. On the true ⁄ false test, the scores of Year 3 students were significantly higher than those of students in the other three year groups. A positive correlation between SCT scores and true ⁄ false test scores was observed only for students in Years 3 and 4. In each group, the ascertainment degree scores were higher for correct than for incorrect responses and the difference was calculated as an index of self-estimation of core knowledge. This index was found to be positively correlated to SCT scores in the four year groups studied. CONCLUSIONS: Biomedical reasoning skills are evidenced early in a curriculum involving PBL and further increase during training. This is accompanied by a decrease in factual knowledge retention. The self-estimation of core knowledge appears to be related to reasoning capacity, which suggests there is a link between the two processes. [less ▲]

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See detailBaseline inflammation is not predictive of periprocedural troponin elevation after elective percutaneous coronary intervention.
Gach, Olivier ULg; Louis, Olivier ULg; Chapelle, Jean-Paul ULg et al

in Heart & Vessels (2009), 24(4), 267-70

High-sensitivity C-reactive protein predicts future cardiovascular events in both healthy individuals and patients with unstable and stable coronary syndromes. Few data are available about the incidence ... [more ▼]

High-sensitivity C-reactive protein predicts future cardiovascular events in both healthy individuals and patients with unstable and stable coronary syndromes. Few data are available about the incidence and the relation to inflammation of troponin elevation following percutaneous coronary intervention (PCI), a potential predictor of longterm outcome. We sought to confirm the impact of embolization on long-term outcome and evaluate the ability of baseline inflammation to predict troponin elevation induced by PCI. We prospectively analyzed 200 patients treated by PCI for stable or Braunwald IIA class unstable angina. The patients were recruited between January 1997 and May 1999, and the population was followed during a mean follow-up of 32 months. Major adverse cardiac events (MACEs) were defined as the occurrence of death, myocardial infarction or recurrent angina requiring repeat PCI, or coronary artery bypass grafting. During the follow-up period, 58 MACEs were observed. By multivariate analysis, independent predictors for the occurrence of MACEs were unstable angina and troponin I level after PCI (P < 0.0001 for both). No correlation was found between baseline inflammation and significant troponin I elevation post PCI and by multivariate analysis, no biological variable was a predictor of troponin I elevation post PCI. Baseline inflammation cannot predict onset of minor myonecrosis damage (expressed by troponin elevation) induced by PCI, a significant predictor of long-term outcome in this setting. [less ▲]

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See detailAgreement between raters and groups of raters
Vanbelle, Sophie ULg

Doctoral thesis (2009)

Agreement between raters on a categorical scale is not only a subject of scientific research but also a problem frequently encountered in practice. Whenever a new scale is developed to assess individuals ... [more ▼]

Agreement between raters on a categorical scale is not only a subject of scientific research but also a problem frequently encountered in practice. Whenever a new scale is developed to assess individuals or items in a certain context, inter-rater agreement is a prerequisite for the scale to be actually implemented in routine use. Cohen's kappa coeffcient is a landmark in the developments of rater agreement theory. This coeffcient, which operated a radical change in previously proposed indexes, opened a new field of research in the domain. In the first part of this work, after a brief review of agreement on a quantitative scale, the kappa-like family of agreement indexes is described in various instances: two raters, several raters, an isolated rater and a group of raters and two groups of raters. To quantify the agreement between two individual raters, Cohen's kappa coefficient (Cohen, 1960) and the intraclass kappa coefficient (Kraemer, 1979) are widely used for binary and nominal scales, while the weighted kappa coefficient (Cohen, 1968) is recommended for ordinal scales. An interpretation of the quadratic (Schuster, 2004) and the linear (Vanbelle and Albert, 2009c) weighting schemes is given. Cohen's kappa (Fleiss, 1971) and intraclass kappa (Landis and Koch, 1977c) coefficients were extended to the case where agreement is searched between several raters. Next, the kappa-like family of agreement coefficients is extended to the case of an isolated rater and a group of raters (Vanbelle and Albert, 2009a) and to the case of two groups of raters (Vanbelle and Albert, 2009b). These agreement coefficients are derived on a population-based model and reduce to the well-known Cohen's kappa coefficient in the case of two single raters. The proposed agreement indexes are also compared to existing methods, the consensus method and Schouten's agreement index (Schouten, 1982). The superiority of the new approach over the latter is shown. In the second part of the work, methods for hypothesis testing and data modeling are discussed. Firstly, the method proposed by Fleiss (1981) for comparing several independent agreement indexes is presented. Then, a bootstrap method initially developed by McKenzie et al. (1996) to compare two dependent agreement indexes, is extended to several dependent agreement indexes (Vanbelle and Albert, 2008). All these methods equally apply to the kappa coefficients introduced in the first part of the work. Next, regression methods for testing the effect of continuous and categorical covariates on the agreement between two or several raters are reviewed. This includes the weighted least-squares method allowing only for categorical covariates (Barnhart and Williamson, 2002) and a regression method based on two sets of generalized estimating equations. The latter method was developed for the intraclass kappa coefficient (Klar et al., 2000), Cohen's kappa coefficient (Williamson et al., 2000) and the weighted kappa coefficient (Gonin et al., 2000). Finally, a heuristic method, restricted to the case of independent observations, is presented (Lipsitz et al., 2001, 2003) which turns out to be equivalent to the generalized estimating equations approach. These regression methods are compared to the bootstrap method extended by Vanbelle and Albert (2008) but they were not generalized to agreement between a single rater and a group of raters nor between two groups of raters. [less ▲]

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See detailAgreement between an isolated rater and a group of raters
Vanbelle, Sophie ULg; Albert, Adelin ULg

in Statistica Neerlandica (2009), 63(1), 82-100

The agreement between two raters judging items on a categorical scale is traditionally assessed by Cohen’s kappa coefficient. We introduce a new coefficient for quantifying the degree of agreement between ... [more ▼]

The agreement between two raters judging items on a categorical scale is traditionally assessed by Cohen’s kappa coefficient. We introduce a new coefficient for quantifying the degree of agreement between an isolated rater and a group of raters on a nominal or ordinal scale. The group of raters is regarded as a whole, a reference or gold-standard group with its own heterogeneity. The coefficient, defined on a population-based model, requires a specific definition of the concept of perfect agreement. It has the same properties as Cohen’s kappa coefficient and reduces to the latter when there is only one rater in the group. The new approach overcomes the problem of consensus within the group of raters and generalizes Schouten’s index. The method is illustrated on published syphilis data and on data collected from a study assessing the ability of medical students in diagnostic reasoning when compared with expert knowledge. [less ▲]

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See detailAgreement between two independent groups of raters
Vanbelle, Sophie ULg; Albert, Adelin ULg

in Psychometrika (2009), 74

We propose a coefficient of agreement to assess the degree of concordance between two independent groups of raters classifying items on a nominal scale. This coefficient, defined on a population-based ... [more ▼]

We propose a coefficient of agreement to assess the degree of concordance between two independent groups of raters classifying items on a nominal scale. This coefficient, defined on a population-based model, extends the classical Cohen's kappa coefficient for quantifying agreement between two raters. Weighted and intraclass versions of the coefficient are also given and their sampling variance is determined by the Jackknife method. The method is illustrated on medical education data which motivated the research. [less ▲]

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See detailEarly termination of ISRCTN45828668, a phase 1/2 prospective, randomized study of sulfasalazine for the treatment of progressing malignant gliomas in adults.
Robe, Pierre ULg; Martin, Didier ULg; Nguyen-Khac, Minh-Tuan ULg et al

in BMC Cancer (2009), 9

BACKGROUND: Sulfasalazine, a NF-kappaB and x(c)-cystine/glutamate antiport inhibitor, has demonstrated a strong antitumoral potential in preclinical models of malignant gliomas. As it presents an ... [more ▼]

BACKGROUND: Sulfasalazine, a NF-kappaB and x(c)-cystine/glutamate antiport inhibitor, has demonstrated a strong antitumoral potential in preclinical models of malignant gliomas. As it presents an excellent safety profile, we initiated a phase 1/2 clinical study of this anti-inflammatory drug for the treatment of recurrent WHO grade 3 and 4 astrocytic gliomas in adults. METHODS: 10 patients with advanced recurrent anaplastic astrocytoma (n = 2) or glioblastoma (n = 8) aged 32-62 years were recruited prior to the planned interim analysis of the study. Subjects were randomly assigned to daily doses of 1.5, 3, 4.5, or 6 grams of oral sulfasalazine, and treated until clinical or radiological evidence of disease progression or the development of serious or unbearable side effects. Primary endpoints were the evaluation of toxicities according to the CTCAE v.3.0, and the observation of radiological tumor responses based on MacDonald criteria. RESULTS: No clinical response was observed. One tumor remained stable for 2 months with sulfasalazine treatment, at the lowest daily dose of the drug. The median progression-free survival was 32 days. Side effects were common, as all patients developed grade 1-3 adverse events (mean: 7.2/patient), four patients developed grade 4 toxicity. Two patients died while on treatment or shortly after its discontinuation. CONCLUSION: Although the proper influence of sulfasalazine treatment on patient outcome was difficult to ascertain in these debilitated patients with a large tumor burden (median KPS = 50), ISRCTN45828668 was terminated after its interim analysis. This study urges to exert cautiousness in future trials of Sulfasalazine for the treatment of malignant gliomas. TRIAL REGISTRATION: Current Controlled Trials ISRCTN45828668. [less ▲]

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See detailA note on the linearly weighted kappa coefficient for ordinal scales
Vanbelle, Sophie ULg; Albert, Adelin ULg

in statistical methodology (2009), 6

A frequent criticism formulated against the use of weighted kappa coeffcients is that the weights are arbitrarily defined. We show that using linear weights for a K-ordinal scale is equivalent to deriving ... [more ▼]

A frequent criticism formulated against the use of weighted kappa coeffcients is that the weights are arbitrarily defined. We show that using linear weights for a K-ordinal scale is equivalent to deriving a kappa coeffcient from K-1 embedded 2 x 2 tables. [less ▲]

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See detailImpact of bone marker feedback on adherence to once monthly ibandronate for osteoporosis among Asian postmenopausal women
Kung, Annie Wai-Chee; Rachman, A Ichramsjah; Adam, MF John et al

in International Journal of Rheumatic Diseases (2009), 12

Aim: This study assesses the impact of serum carboxy-terminal collagen crosslinks (CTX) bone marker feedback (BMF) on adherence to ibandronate treatment in Asian postmenopausal women with osteoporosis ... [more ▼]

Aim: This study assesses the impact of serum carboxy-terminal collagen crosslinks (CTX) bone marker feedback (BMF) on adherence to ibandronate treatment in Asian postmenopausal women with osteoporosis. Methods: This was a 12-month (6-monthly phased), randomized, prospective, open-label, multi-center study conducted in 596 (of 628 enrolled) postmenopausal women with osteoporosis (£ 85 years old) who were naı¨ve, lapsed, or current bisphosphonate users. Patients were randomized into two arms: serum CTX BMF at 3 months versus no-BMF. Once-monthly 150 mg ibandronate tablet was administered for 12 months and adherence to therapy was assessed at 6 and 12 months. In addition, patient satisfaction and safety of ibandronate treatment were also assessed. Results: Serum CTX BMF at 3 months showed no impact on adherence. The proportions of adherent patients were comparable in the BMF versus no-BMF arms (92.6% vs. 96.0%, P = 0.16); overall, serum CTX levels were similar for adherent and non-adherent patients. However, BMF patients felt more informed about their osteoporosis (P < 0.001) and more satisfied (P < 0.01) than no-BMF patients. Conclusions: The Asian postmenopausal osteoporosis patients in this study had a high adherence rate to once-monthly ibandronate therapy. Use of serum CTX BMF had no further impact on increasing adherence, but increased treatment satisfaction. [less ▲]

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See detailA bootstrap method for comparing correlated kappa coefficients
Vanbelle, Sophie ULg; Albert, Adelin ULg

in Journal of Statistical Computation & Simulation (2008), 78(11), 1009-1015

Cohen’s kappa coefficient is traditionally used to quantify the degree of agreement between two raters on a nominal scale. Correlated kappas occur in many settings (e.g., repeated agreement by raters on ... [more ▼]

Cohen’s kappa coefficient is traditionally used to quantify the degree of agreement between two raters on a nominal scale. Correlated kappas occur in many settings (e.g., repeated agreement by raters on the same individuals, concordance between diagnostic tests and a gold standard) and often need to be compared. While different techniques are now available to model correlated κ coefficients, they are generally not easy to implement in practice. The present paper describes a simple alternative method based on the bootstrap for comparing correlated kappa coefficients. The method is illustrated by examples and its type I error studied using simulations. The method is also compared with the generalized estimating equations of the second order and the weighted least-squares methods. [less ▲]

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See detailAgreement between two independent groups of raters
Vanbelle, Sophie ULg

Poster (2008)

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See detailCharacteristics and expectations of patients with erectile dysfunction: results of the SCORED study.
Claes, Hubert; Opsomer, R.-J.; Andrianne, Robert ULg et al

in International Journal of Impotence Research : Official Journal of the International Society for Impotence Research (2008), 20(4), 418-24

In an observational study in men with erectile dysfunction (ED) consulting a general practitioner (GP) or urologist in Belgium, demographics, ED characteristics (including erection hardness score), co ... [more ▼]

In an observational study in men with erectile dysfunction (ED) consulting a general practitioner (GP) or urologist in Belgium, demographics, ED characteristics (including erection hardness score), co-morbidities and treatment expectations were evaluated using a structured questionnaire. In total, 341 GPs and 41 urologists recruited 1492 patients. Most (74%) were untreated and 25% had ED for >3 years. Considering PDE5 inhibitors, erection hardness (89%) and maintenance (92%) were considered 'very important' by most patients. Only 18% of physicians initiated discussion about ED, despite 41% of patients having >or=3 known risk factors. The questionnaire was considered helpful by 81% of GPs and 83% of their patients. Overall, patients are under-diagnosed, and physicians are reluctant to ask about ED. A questionnaire including erection hardness score is useful to facilitate discussion about ED in general practice. Erection hardness and maintenance are more important to patients as compared to fast onset or long duration of action. [less ▲]

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See detailEffect of different contraceptive methods on the oxidative stress status in women aged 40-48 years from the ELAN study in the province of Liege, Belgium
Pincemail, Joël ULg; Vanbelle, Sophie ULg; Gaspard, Ulysse ULg et al

in Human Reproduction (2007), 22(8), 2335-2343

Oxidative stress is associated with the development of several disorders including cardiovascular disease and cancer. Among conditions known to influence oxidative stress, the use of oral contraception ... [more ▼]

Oxidative stress is associated with the development of several disorders including cardiovascular disease and cancer. Among conditions known to influence oxidative stress, the use of oral contraception (OC) in women has been a matter of ongoing discussion. METHODS: A total of 897 eligible and healthy volunteers were recruited from among the patients of 50 general practitioners participating in the ELAN study (Etude Liegeoise sur les ANtioxydants). A subsample consisting of 209 women aged 40-48 years was studied for a comprehensive oxidative stress status (OSS), including the analysis of antioxidants, trace elements and three markers of oxidative damage to lipids. Among 209 subsample, 49 (23%) were OC users (OCU), 119 (57%) non-contraception users (NCU) and 41 (20%) were intrauterine (hormonal and copper) devices users (IUD). RESULTS: After adjustment for smoking, systolic and diastolic blood pressure and BMI (or waist circumference), a marked and significant increase in lipid peroxides was observed among OCU women when compared with NCU and IUD users. A cut-off value of 660 mu M in lipid peroxides allowed the discrimination of OCU from the two other groups. In contrast, no difference was observed in the plasma concentration of both oxidized low-density lipoprotein (LDL) and their related antibodies. The increased level in lipid peroxides was strongly related to higher concentrations of copper (r < 0.84; P < 0.0001, cut-off value 1.2 mg/1). When compared with NCU and IUD users, plasma antioxidant defences were significantly altered in OCU women as shown by lower levels of beta-carotene (decrease of 39%; P < 0.01) andytocopherol (decrease by 22%; P < 0.01). In contrast, higher concentrations of selenium (increased by 11.8%; P < 0.01) were observed in OCU women. Blood concentrations of vitamin C, alpha-tocopherol and zinc were unaffected by OC use. CONCLUSIONS: The intake of OC significantly increases the lipid peroxidation in women aged 40-48 years. This may represent a potential cardiovascular risk factor for these women. [less ▲]

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See detailPancreatic cellular injury after cardiac surgery with cardiopulmonary bypass: Frequency, time course and risk factors
Nys, Monique ULg; Venneman, Ingrid ULg; Deby-Dupont, G. et al

in Shock (Augusta, Ga.) (2007), 27(5), 474-481

Although often clinically silent, pancreatic cellular injury (PCI) is relatively frequent after cardiac surgery with cardiopulmonary bypass; and its etiology and time course are largely unknown. We ... [more ▼]

Although often clinically silent, pancreatic cellular injury (PCI) is relatively frequent after cardiac surgery with cardiopulmonary bypass; and its etiology and time course are largely unknown. We defined PCI as the simultaneous presence of abnormal values of pancreatic isoamylase and immunoreactive trypsin (IRT). The frequency and time evolution of PCI were assessed in this condition using assays for specific exocrine pancreatic enzymes. Correlations with inflammatory markers were searched for preoperative risk factors. One hundred ninety-three patients submitted to cardiac surgery were enrolled prospectively. Blood IRT, amylase, pancreatic isoamylase, lipase, and markers of inflammation (alpha1-protease inhibitor, alpha2-macroglobulin, myeloperoxidase) were measured preoperatively and postoperatively until day 8. The postoperative increase in plasma levels of pancreatic enzymes and urinary IRT was biphasic in all patients: early after surgery and later (from day 4 to 8 after surgery). One hundred thirty-three patients (69%) experienced PCI, with mean IRT, isoamylase, and alpha1-protease inhibitor values higher for each sample than that in patients without PCI. By multiple regression analysis, we found preoperative values of plasma IRT >or=40 ng/mL, amylase >or=42 IU/mL, and pancreatic isoamylase >or=20 IU/L associated with a higher incidence of postsurgery PCI (P < 0.005). In the PCI patients, a significant correlation was found between the 4 pancreatic enzymes and urinary IRT, total calcium, myeloperoxidase, alpha1-protease inhibitor, and alpha2-macroglobulin. These data support a high prevalence of postoperative PCI after cardiac surgery with cardiopulmonary bypass, typically biphasic and clinically silent, especially when pancreatic enzymes were elevated preoperatively. [less ▲]

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See detailTest de Concordance de Script: un nouveau mode d’établissement des scores limitant l’effet du hasard
Vanbelle, Sophie ULg; Massart, Valérie ULg; Giet, Didier ULg et al

in Pédagogie médicale (2007), 8

Context: The method of combined scores is currently used to determine the score obtained by the Script Concordance Test (SCT). Goal: To propose a novel measure of agreement between the SCT responses given ... [more ▼]

Context: The method of combined scores is currently used to determine the score obtained by the Script Concordance Test (SCT). Goal: To propose a novel measure of agreement between the SCT responses given by the candidate and those provided by the panel of experts. Results: The current scoring method of the SCT does not take into account the fact that agreement between the candidate and the panel of experts may be arbitrary. The proposed measure allows correcting this fact. Conclusion: This article addresses the problem of scores obtained by guessing. The new measure of agreement allows to improve the actual scoring method. [less ▲]

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See detailLong-term prognostic significance of high-sensitivity C-reactive protein before and after coronary angioplasty in patients with stable angina pectoris
Gach, Olivier ULg; Legrand, Victor ULg; Biessaux, Yves ULg et al

in American Journal of Cardiology (2007), 99(1), 31-35

We examined whether an increase in high-sensitivity C-reactive protein (hs-CRP) after percutaneous coronary intervention (PCI) predicts long-term prognosis in patients with stable angina pectoris. hs-CRP ... [more ▼]

We examined whether an increase in high-sensitivity C-reactive protein (hs-CRP) after percutaneous coronary intervention (PCI) predicts long-term prognosis in patients with stable angina pectoris. hs-CRP is an inflammatory marker that predicts future cardiovascular events in healthy subjects and patients with unstable and stable coronary syndromes. Long-term evaluation of pre- and postprocedural inflammatory markers has not been widely reported. In particular, the effect of the magnitude of increase in hs-CRP after PCI in stable patients is unknown. We prospectively analyzed 89 stable patients treated by PCI for stable angina pectoris. Patients were recruited between August 1998 and May 1999, and the population was followed until August 2005 (mean follow-up 79.5 +/- 10.3 months). A major adverse cardiac event (MACE) was defined as the occurrence of cardiac death, myocardial infarction, or recurrent angina requiring repeat PCI or coronary artery bypass grafting. During the follow-up period, 36 patients presented with > or =1 MACE. In multivariate analysis, independent predictors of the occurrence of MACEs were previous myocardial infarction and a significant increase in hs-CRP after PCI (p = 0.004 and 0.003, respectively). A significant increase in hs-CRP after PCI was found to be more predictive of MACEs than hs-CRP before and after PCI. In conclusion, in stable coronary artery disease, inflammation is associated with long-term adverse events, but the magnitude of the inflammatory reaction after PCI appears more predictive than the baseline value. [less ▲]

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See detailAccord entre observateurs et coefficient Kappa de Cohen
Vanbelle, Sophie ULg

Master's dissertation (2002)

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