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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 detailStatistical analysis of serum protein electrophoresis results in External Quality Assessment schemes
Zhang, Lixin ULg; Van Campenhout, Christel; Devleeschouwer, Nicole et al

in Accreditation and Quality Assurance (2008), 13(3), 149-155

The goal of External Quality Assessment (EQA) schemes is to ensure that results obtained on a particular specimen in a given clinical laboratory are compatible with those obtained by other laboratories on ... [more ▼]

The goal of External Quality Assessment (EQA) schemes is to ensure that results obtained on a particular specimen in a given clinical laboratory are compatible with those obtained by other laboratories on the same specimen. Serum protein electrophoresis is a laboratory test consisting of five fractions (albumin, a1, a2, b and c globulins), which sum up to 100% of total proteins. So far, in EQA schemes the five fractions have been analyzed separately as for ordinary tests like glucose or cholesterol. This approach does not consider the fractions as a whole and the linear relationship between them. A statistical approach has been developed to analyze EQA electrophoresis results from a global standpoint by using robust multivariate method to eliminate the effect of outlying profiles. As illustrated on electrophoretic data from the Belgian EQA scheme, the novel approach improves the detection of poor performing laboratories. The method will be implemented in the Belgian EQA scheme on a routine basis. [less ▲]

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See detailBrief introduction to the use of the STATISTICA software
Albert, Adelin ULg; Donneau, Anne-Françoise ULg; Zhang, Lixin

Learning material (2008)

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See detailDétermination d'un index prédictif de la preeclampsie en préconceptionnel et propositions thérapeutiques de prévention primaire
Emonts, Patrick ULg; Seaksan, Sontera; Seidel, Laurence ULg et al

in Journal de Gynécologie, Obstétrique et Biologie de la Reproduction (2008), 37(5), 469-476

Objective To derive a prediction index based on the most salient history, laboratory and clinical parameters for identifying women at high risk of developing preeclampsia (PE) and to suggest a primary ... [more ▼]

Objective To derive a prediction index based on the most salient history, laboratory and clinical parameters for identifying women at high risk of developing preeclampsia (PE) and to suggest a primary prevention. Material and method Non-pregnant women with a history of PE (n =101) were compared to non-pregnant parous women with a history of one or more successful normotensive pregnancies (n =50) but with comparable age, gestation and parity profiles. The parameters included history and clinical examination; laboratory studies (hemostasis, coagulation, vitamins); and morphological and functional tests (cardiovascular and renal functions). Stepwise logistic regression analysis was applied to develop a three step PE prediction index based on the most discriminant parameters. Strategies to prevent PE in the high-risk group are described. Results Identification of women at high risk of PE can be done efficiently (88% sensitivity and specificity) using a predictive index based on a simple history, laboratory, clinical and functional information. Stategies to prevent PE in our high-risk group have given encouraging results during next pregnancy. Conclusion Our study gives a predictive index of PE outside of pregnancy and possibilities to do a primary prevention. [less ▲]

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See detailComparison between player specialization, anthropometric characteristics and jumping ability in top-level volleybal players
Ciccarone, Guido; Croisier, Jean-Louis ULg; Fontani, G. et al

in Medicina dello Sport : Rivista di Fisiopatologia dello Sport (2008), 61

Aim. Volleyball is an open skill sport with predominant anaerobic alactic acid power. At higher skill levels, performance characteristics are mainly determined by speed and vertical jumping ability. The ... [more ▼]

Aim. Volleyball is an open skill sport with predominant anaerobic alactic acid power. At higher skill levels, performance characteristics are mainly determined by speed and vertical jumping ability. The aim of this study was to compare anthropometric parameters and jumping ability in a group of elite male volleyball players in relation to technical skills required by player position. Methods. The study population included 36 elite male volleyball players (coming from the Italian First and Second Division Championships). Subjects were grouped by playing position on the court: setters (7); blockers (10); hitters (16); liberos (3). Assessment included anthropometric parameters such as height, weight, body mass index (weight in kg/height in m2), indirect calculation of body fat mass by means of the Katch method (%BFM), measurement of reach with one hand (R1) and two hands (R2); and indirect measurement of explosive strength by means of the Bosco method: squat jump, countermovement jump (CMJ), CMJ with arm swing (CMJas), and repeated jumps for 15 s (R15”); measurement of motor coordination and jumping ability by means of the Vertec test combined with specific offense (Vertec attack [VA]) and defense (Vertec block [VB]) skills. Results. Significant differences were observed between player specialization and anthropometric parameters (height, weight, BMI, R1 and R2). Results of the Bosco (SJ, CMJ, CMJas) and Vertec tests (VA and VB) also differed significantly among the player groups. Conclusion. Functional assessment protocols that evaluate anthropometric characteristics and jumping ability by means of two different unrelated methods, confirming that the two measure different aspects of the same performance, provide more complete indications for selecting players, workload planning and monitoring of player development during training. [less ▲]

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See detailPrediction of maternal predisposition to preeclampsia
Emonts, Patrick ULg; Seaksan, S.; Seidel, Laurence ULg et al

in Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy (2008), 27(3), 237-45

Objective: To derive a prediction index based on the most salient patient history, laboratory, and clinical parameters for identifying women at high risk for developing preeclampsia (PE). Methods ... [more ▼]

Objective: To derive a prediction index based on the most salient patient history, laboratory, and clinical parameters for identifying women at high risk for developing preeclampsia (PE). Methods: Nonpregnant women with a history of PE (n = 101) were compared with nonpregnant parous women with a history of one or more successful normotensive pregnancies (n = 50) but with comparable age, gestation, and parity profiles. The parameters included a medical examination (demographics, patient history, family history, and clinical and obstetrical findings), laboratory investigations (hemostasis, coagulation, and vitamins), and morphological and functional tests (cardiovascular and renal functions). Stepwise logistic regression analysis was applied to develop a three-step PE prediction index based on the most discriminant parameters. Results: Patients with and without PE differed significantly (p < 0.05) with respect to 1) maternal history of chronic hypertension, body mass index, and blood pressure; 2) APTT, PT, activated factor VIII, homocystein, free protein S and vitamin B1; and 3) relative plasma volume. Based on these three sets of parameters, a three-step PE prediction index was developed. The likelihood ratio of a positive index score was equal to 3.4, 7.3, and 8.8, respectively. Thus, assuming a PE prevalence (or prior probability) of 5%, a patient's chances of developing PE when presenting with a positive score on the three-step prediction index were 15%, 28%, and 32%, respectively. Discussion: In the absence of welldefined pre-pregnancy screening guidelines for PE, the present study attempts to proceed in a stepwise fashion by looking at medical examination data first, requesting, if necessary, specific hemostasis and coagulation tests next, and finally measuring the relative plasma volume for confirmatory purposes. This approach offers a satisfactory positive predictive value and cost efficiency ratio. [less ▲]

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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 detailBelgian schizophrenia outcome survey (SOS)
Peuskens, J.; Gillain, B.; De Graeve, D. et al

in European Psychiatry (2007, March), 22(Suppl. 1), 132

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See detailLong-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma
Rutten, Isabelle; Baumert, B. G.; Seidel, Laurence ULg et al

in Radiotherapy & Oncology (2007), 82(1), 83-89

AIM: The long-term effects of radiosurgery of vestibular schwannomas were investigated in a group of consecutively treated patients. METHODS AND MATERIALS: Between 1995 and 2001, 26 patients (median age ... [more ▼]

AIM: The long-term effects of radiosurgery of vestibular schwannomas were investigated in a group of consecutively treated patients. METHODS AND MATERIALS: Between 1995 and 2001, 26 patients (median age: 67, range: 30-82) with a vestibular schwannoma were treated by Linac-based stereotactic radiosurgery (SRS). The median follow-up was 49 months (16-85 months). Only progressive tumours were treated. The median size of tumours was 18 mm (range 9-30 mm). Before SRS, 11 patients had a useful hearing (Gardner-Robertson classes 1 and 2). Single doses of 10-14 Gy were prescribed at the 80% isodose at the tumour margin. The follow-up consisted of regular imaging with MRI the first 3-6 months after the intervention, followed by additional yearly MRIs, a hearing test and a neurological examination. RESULT: The 5-year-probability of tumour control (defined as stabilization or decrease in size) was 95%. Five-year-probability of preservation of hearing and facial nerve function was 96% and 100%, respectively. Hearing was preserved in 10 out of 11 patients who had a normal or useful hearing at the time of treatment. Mild and transient trigeminal toxicity occurred in 2 (8%) patients. It appeared to be significantly correlated to the dose used (p=0.044). However, only a tendency to significance could be demonstrated in the relationship between the two factors when using the Cox analysis (hazard ratio=1.7; 95% CI: 0.7-3.9; p=0.23). CONCLUSIONS: With the doses used, our study demonstrates that SRS provides an equivalent tumour control rate when compared to surgery, as well as on a long-term basis, an excellent preservation of the facial and the acoustic nerves. Although no permanent trigeminal toxicity was observed, our data confirm that doses below 14 Gy can avoid transient dysesthesias. [less ▲]

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See detailEvaluation d'un an de parcours de patients schizophrenes en service psychiatrique liegeois
Sarto, D.; Desseilles, Martin ULg; Martin, Michel ULg et al

in Encéphale (L') (2006), 32(5, Pt 1), 722-8

OBJECTIVE: The study was aimed at assessing the clinical evolution and mobility of schizophrenic patients within the healthcare network of the Psychiatric Platform of Liege (Belgium) after a one-year ... [more ▼]

OBJECTIVE: The study was aimed at assessing the clinical evolution and mobility of schizophrenic patients within the healthcare network of the Psychiatric Platform of Liege (Belgium) after a one-year follow-up period. MATERIAL: and methods. The study material consisted of a random sample of 184 patients with schizophrenia drawn from the population of schizophrenic patients treated in the Liege psychiatric care network. The characteristics of these patients have been described previously (18). The 184 patients were followed-up for one-year and reassessed at the end of this period. Mobility (ie, changes between psychiatric care institutions, including home) was recorded for each patient within the institutional network. The diagnosis of schizophrenia was based on the DSM IV. Demographic, social and global functioning (GAF scale) data were collected from the "Resume psychiatrique Minimum (RPM)", a clinical summary which has been imposed by the Belgian Ministry of Public Health for each psychiatric hospital stay. Symptom components were derived from the Psychosis Evaluation tool for Common Use by Caregivers (PECC). RESULTS: Among the 184 patients enrolled in the initial analysis, 6 refused to participate in the follow-up study. The 178 remaining schizophrenic patients included 131 men (74%) and 47 women (26%) with a mean age of 43.1 +/- 13.6 and 48.8 +/- 14.9 years, respectively (p<0.05). The majority of patients (53%) suffered from paranoid schizophrenia. At baseline, 63% of the patients were hospitalised full-time, 6% part-time and 31% received ambulatory care. During the one-year follow-up period, 4 patients died, including one from suicide. When considering mobility, 48% of the patients experienced at least one change of institution, whereas 52% of the patients didn't change at all (see figure 1). The total number of changes over the 1-year period amounted 189, yielding a mean value of 1.1 changes per patient per year. Changes mostly occurred between institutions of similar care setting (see figure 2). Transfers (30%) were also observed directly between hospital and home. A multivariate Poisson regression analysis showed that the number of changes was unrelated to gender and initial care setting but decreased with age (p<0.0001). It was also higher for patients with schizo-affective disorders (2.5 +/- 1.9, p<0.01) or with residual type (1.2 +/- 1.8; p<0.05) than for patients with other types of schizophrenia (ranging from 0.3 +/- 0.5 to 0.9 +/- 1.4). No association was found with initial GAF or PECC, except for negative symptoms (p<0.05). After one year, despite the high proportion of institutional changes (48% of the patients), the distribution of the patients according to care setting remained the same (p=0.77). However, GAF scores significantly improved from 39.7 +/- 16.1 to 44.4 +/- 16.1 (p<0.0001) and likewise for total PECC scores (70 +/- 19.1 vs 63.2 +/- 19.4, p<0.001). Excitatory and disease perception items of the PECC remained unchanged. CONCLUSION: The present study reveals that mobility within the institutional network did affect about half of the schizophrenic patients. Mobility was related to age, type of schizophrenia and disease evolution. Changes occur mainly between psychiatric structures of similar care setting but also directly from hospital to home without passing through an intermediate care structure. Further efforts should be made to provide schizophrenic patients with a more coordinated care provision throughout the course of their disease. [less ▲]

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See detailMicroleakage after thermocycling of 4 etch and rinse and 3 self-etch adhesives with and without a flowable composite lining
Guéders, Audrey; Charpentier, Joseph ULg; Albert, Adelin ULg et al

in Operative Dentistry (2006), 31(4), 450-455

This study evaluated the microleakage of composite fillings prepared with 4 etch and rinse and 3 self-etch adhesive systems after thermocycling. Also evaluated was the potential improvement of cavity ... [more ▼]

This study evaluated the microleakage of composite fillings prepared with 4 etch and rinse and 3 self-etch adhesive systems after thermocycling. Also evaluated was the potential improvement of cavity sealing when utilizing a low charge resine lining for preparations. [less ▲]

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