http://hdl.handle.net/2268/114 Search this channel search http://orbi.ulg.ac.be/simple-search http://hdl.handle.net/2268/148448 Title: How to define responders in osteoarthritis <br/> <br/>Author, co-author: Cooper, Cyrus; Adachi, Jonathan D; Bardin, Thomas; Berenbaum, Francis; Flamion, Bruno; Jonsson, Helgi; Kanis, John A; Pelousse, Franz; Lems, Willem F; Pelletier, Jean-Pierre; Martel-Pelletier, Johanne; Reiter, Susanne; Reginster, Jean-Yves; Rizzoli, René; Bruyère, Olivier <br/> <br/>Abstract: Background: Osteoarthritis is a clinical syndrome of failure of the joint accompanied by varying degrees of joint pain, functional limitation, and reduced quality of life due to deterioration of articular cartilage and involvement of other joint structures. Scope: Regulatory agencies require relevant clinical benefit on symptoms and structure modification for registration of a new therapy as a disease-modifying osteoarthritis drug (DMOAD). An international Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and International Osteoporosis Foundation was convened to explore the current burden of osteoarthritis, review current regulatory guidelines for the conduct of clinical trials, and examine the concept of responder analyses for improving drug evaluation in osteoarthritis. Findings: The ESCEO considers that the major challenges in DMOAD development are the absence of a precise definition of the disease, particularly in the early stages, and the lack of consensus on how to detect structural changes and link them to clinically meaningful endpoints. Responder criteria should help identify progression of disease and be clinically meaningful. The ideal criterion should be sensitive to change over time and should predict disease progression and outcomes such as joint replacement. Conclusion: The ESCEO considers that, for knee osteoarthritis, clinical trial data indicate that radiographic joint space narrowing40.5mm over 2 or 3 years might be a reliable surrogate measure for total joint replacement. On-going research using techniques such as magnetic resonance imaging and biochemical markers may allow the identification of these patients earlier in the disease process Tue, 14 May 2013 09:54:03 GMT http://hdl.handle.net/2268/148430 Title: Gardes à domicile : un aidant professionnel peu connu en Wallonie <br/> <br/>Author, co-author: Ketterer, Frédéric; Duchesnes, Christiane; MASSART, Valérie; Denoël, Philippe; Giet, Didier <br/> <br/>Abstract: Contexte : La garde à domicile est une professionnelle d’aide au maintien à domicile qui assure essentiellement une présence auprès du patient. Une étude menée en Belgique sur les équipes de soins palliatifs à domicile visait à préciser le travail que ces professionnelles, mal connues des patients et des autres intervenants, effectuaient, les relations qu’elles tissaient avec les autres acteurs (professionnels comme patient et entourage familial) et les besoins qu’elles ressentaient dans le cadre des soins palliatifs. Méthode : 7 focus groups de professionnels ont été organisés. Deux comprenaient des infirmières, deux des coordinateurs de services de gardes à domicile et trois des gardes à domicile. Les entretiens ont été intégralement retranscrits et analysés, de manière thématique, par deux chercheurs indépendants. Résultats : Si les gardes à domicile sont des professionnelles formées à l’aide aux personnes, il n’existe pas de formation spécifique à la profession de garde à domicile. Leurs missions sont encore mal définies, allant de la présence auprès du patient à l’aide à la vie quotidienne. Les tâches ménagères sont exclues de leurs fonctions et les actes médicaux leur sont légalement défendus. Un de leurs souhaits est d’être formées, de manière spécifique, à l’accompagnement de patients palliatifs, tout en bénéficiant d’un meilleur soutien et d’un plus fort encadrement de la part de leurs services. C’est, en effet, un accompagnement vers la fin de vie, accompagnement difficile tant pour le patient que pour le personnel. Tout en augmentant leurs compétences, cela leur permettrait d’agir plus efficacement lorsque les autres professionnels ne sont pas disponibles, puisqu’elles sont appelées à travailler surtout la nuit et les week-ends. Elles souhaiteraient aussi que leur profession soit mieux reconnue et valorisée. Elles évoquent toute l’importance de leur présence pour assurer confort, écoute et surveillance du patient. Il est vrai que la famille mentionne souvent le coût de ce professionnel qui assure parfois seulement une présence et ne semble rien apporter de plus que ce que ne fait déjà la famille. Elles sont d’ailleurs appelées souvent tardivement lorsque les proches sont exténués. Les autres professionnels interrogés reconnaissent ignorer les missions précises des gardes à domicile ; certains nient leur utilité tandis que d’autres reconnaissent leur apport. Les gardes elles-mêmes se sentent dénigrées parfois par d’autres intervenants. La famille met en avant le soutien psychologique qu’elles apportent au patient et à l’entourage par leur présence. Discussion : La reconnaissance de ces professionnelles passe par plusieurs domaines. Il faut assurer une formation d’ensemble clairement définie ainsi que des formations plus spécifiques selon le type de travail qu’elles doivent effectuer. Une meilleure définition de leur travail devrait susciter des vocations pour un métier mieux ciblé et davantage reconnu. La diffusion de leur profil de travail ainsi qu’une meilleure information auprès des autres professionnels et des familles permettrait de mieux comprendre leur travail et de les appeler au bon moment. Perspectives : Réfléchir à un référentiel de compétences de ces professionnelles permettrait de créer un référentiel de formation qui, nous semble-t-il, devrait être centré sur les compétences communicationnelles. Tue, 14 May 2013 08:11:30 GMT http://hdl.handle.net/2268/148361 Title: La santé des indépendants : qui s'en préoccupe vraiment ? "L'enquête et ses principaux résultats" <br/> <br/>Author, co-author: Mairiaux, Philippe Mon, 13 May 2013 11:35:09 GMT http://hdl.handle.net/2268/147951 Title: Retour au travail après une longue absence... <br/> <br/>Author, co-author: Mairiaux, Philippe Mon, 06 May 2013 12:19:12 GMT http://hdl.handle.net/2268/147917 Title: NEONATAL INVASIVE GROUP B STREPTOCOCCAL (GBS) INFECTIONS IN EUROPE <br/> <br/>Author, co-author: MELIN, Pierrette; Berner, Reinhard; Afshar, Baharak; Baldassarri, Lucilla; Detcheva, Antoaneta; de la Rosa, Manuel; Kunze, Mirjam; Kriz, Paula; Efstratiou, Androulla; Hufnagel, Markus; Kilian, Mogens; SEIDEL, Laurence; Telford, John <br/> <br/>Abstract: Objectives: To describe clinical characteristics and capsular type of GBS isolates responsible of invasive infections in infants from Belgium, Bulgaria, Czech-Republic, Denmark, Germany, Italy, Spain and United Kingdom, representing one of the main objectives of the DEVANI (DEsign of a Vaccine Against Neonatal Infections) project. Methods: Surveillance of invasive GBS infections in infants was performed from mid-2008 through December 2010. For each case, a standardized case report form was filled. Samples from cases were processed using local procedures. GBS isolates were characterised in national central labs using standardised type-specific (Ia, Ib-IX) latex agglutination and molecular typing methods. Results: Data on 188 infants with invasive infection were analysed: 144 (60.6%) early onset diseases (EOD) and 74 (39.4%) late onset diseases (LOD). In EOD, mean/median ages at onset were 14/0 hours and the male:female ratio was 1.25. The predominant manifestation at onset was respiratory distress (42% cases); 83% cases were associated with sepsis/bacteremia, 15% with pneumonia and 6% with meningitis. Late-prenatal screening cultures were obtained from 51% of cases’ mothers and only half of these were positive for GBS. Non-elective C-section, intrapartum fever and rupture of membrane (>18h) were more frequent in EO-cases’ mothers versus healthy babies’ GBS-positive mothers. The major serotypes were III (43%), V (21%) and Ia (18%). In LOD, mean/median ages at onset were 42/34 days and the male:female ratio was 0.9. The predominant characteristic at onset was fever (62% cases); 70% cases were associated with sepsis and 30% with meningitis. Very rare manifestations were osteomyelitis and cellulitis. Serotype III was highly predominant (80.6%) followed mainly by Ia (12.5%). Death rates were 4.7/1.5% in EOD/LOD. Conclusions: Clinical presentations were associated with age at onset of infection. Serotype III predominated in neonatal infections. Prenatal screening was not universal neither sensitive. Study funded through the European Commission Seventh Framework. Mon, 06 May 2013 06:46:03 GMT http://hdl.handle.net/2268/147904 Title: Group B streptococci, a European perspective with results of the DEVANI project <br/> <br/>Author, co-author: MELIN, Pierrette <br/> <br/>Abstract: In 2011, neonatal group B streptococcal (GBS) diseases remain a global public health concern. Where consensus guidelines to detect and treat intrapartum women with GBS colonization have been widely adopted, incidence of neonatal early onset disease (EOD) has dramatically declined, however despite preventive strategies cases still occur. The strategy was not expected to prevent all cases and there are challenges and limitations to this preventive approach. The best strategy for European countries is still a matter of debate and intrapartum antimicrobial prophylaxis (IAP) is not widely recommended. To adopt the best preventive strategy, we first need better data assessing more accurately the true burden of GBS diseases in the different countries. Furthermore, as the current screening-based strategy for prevention is highly effective but imperfect, given the challenges, limitations and potential complications of maternal IAP, a new approach is still needed. Maternal immunization against GBS is an attractive alternative for the prevention of not only neonatal diseases but also stillbirths and maternal diseases. Vaccines against GBS may likely become the most effective and sustainable long-term preventive strategy. But the development of vaccines with global relevance has been hampered by changes in the distribution of GBS serotypes of strains causing diseases over time and in different parts of the world. A multivalent vaccine to cover against the more prevalent serotypes suitable for European populations might not be suitable for Asian or African populations. To overcome type-specificity, new developments target vaccines based on conserved surface antigenic proteins, such as Sip protein located at the cell surface of all GBS and on immunogenic proteins from GBS pili. A pilus-based GBS vaccine is appealing and could become a globally relevant reality. The DEVANI (DEsign of a Vaccine Against Neonatal Infections) programme funded through the European Commission Seventh Framework was launched on 1 January 2008 with the key objective being the assessment of European GBS epidemiology to facilitate the design of a new vaccine that will confer neonatal immunity through a durable maternal immune response. A major component was to undertake pan European surveillance of maternal colonisation, maternal GBS antibody responses and neonatal diseases in eight European countries. Through 2009 and 2010, all Belgian laboratories sending any neonatal GBS invasive isolate to the National Reference Centre for GBS were invited to bring their contribution to this project. Belgium, Bulgaria, Czech Republic, Denmark, Germany, Italy, Spain and the United Kingdom established specific GBS screening studies during 2008/10. Maternal vaginal/rectal swabs and sera were taken between 34-37 weeks gestation and processed using a standardised microbiological screening protocol. Samples from neonatal cases were processed using local procedures. For each pregnant woman and each case of GBS neonatal disease, standardized case report forms were filled. GBS isolates were characterised using standardised serological and molecular typing methods for detection of all ten GBS capsular polysaccharide types (Ia to IX). Furthermore all the collected isolates were screened by multiplex PCR and FACS analysis to evaluate respectively gene presence and surface-exposure of pili. And clonal analysis of these isolates was performed using multi-locus sequence typing (MLST). The main microbiological results of this pan European surveillance are following. Carriage rates among pregnant women in all countries ranged from 8% to 26%. The most common GBS capsular types were III (33%), Ia (25%) and V (8%). Among GBS from EOD, the major serotypes were III (43%), V (21%) and Ia (18%). In contrast among GBS isolated from neonatal late onset disease (LOD), serotype III was highly predominant (80.6%) followed mainly by Ia (12.5%). Analysis of the pattern of pili genes showed that all isolates contained at least one gene coding for pili. The most common gene patterns found were PI-2a alone, PI 1+2a and PI 1+2b, while the PI-2b gene alone was very rare. The most prominent result was that a majority of isolates from neonatal infections carried the PI-1+2b gene pattern, while the most common pattern among pregnant women was PI-1+2a. Most of analyzed strains express at least one pilus on their surface. The clonal analysis showed that 66 sequence types were found to belong to nine clonal complexes (CC). Among these nine CCs, five were prevailing and covered 92 % of GBS isolates tested. The GBS population in pregnant women was found to be more heterogeneous than the GBS isolated from neonatal infection cases. Among neonatal isolates, the most frequent CC was CC17 (43 %) known as a highly virulent clone. Among participating countries, there were no significant differences in the occurrence of clonal complexes. The analysis of the levels of specific antibodies as surrogate markers of protection is still ongoing. More detailed and additional results as the main conclusions will be presented. Sat, 04 May 2013 13:47:53 GMT http://hdl.handle.net/2268/147714 Title: Retour au travail après une absence de longue durée : Comment dynamiser le dispositif légal existant ? <br/> <br/>Author, co-author: Mairiaux, Philippe Tue, 30 Apr 2013 09:32:10 GMT http://hdl.handle.net/2268/147562 Title: Equivalence of a single dose (1200mg) compared to a 3-time a day dose (400mg) of chondroitin 4&6 sulfate in patients with knee osteoarthritis: Results of a randomized double blind placebo controlled study <br/> <br/>Author, co-author: Zegels, Brigitte; LEONORI, Lorenzo; Crozes, P; Uebelhart, D; Bruyère, Olivier; Reginster, Jean-Yves Mon, 29 Apr 2013 09:25:25 GMT http://hdl.handle.net/2268/147554 Title: Reproducibility of joint space width assessment when external calibration on the radiograph is missing <br/> <br/>Author, co-author: DEROISY, Rita; Reginster, Jean-Yves; Bruyère, Olivier Mon, 29 Apr 2013 09:04:02 GMT http://hdl.handle.net/2268/147553 Title: Validity of the French hip and knee replacement expectations surveys <br/> <br/>Author, co-author: NEUPREZ, Audrey; François, Garance; Delcour, JP; Fatemi, F; Bruyère, Olivier; Gosset, Christiane; Mancuso, C; Gillet, Philippe; Reginster, Jean-Yves Mon, 29 Apr 2013 08:59:08 GMT http://hdl.handle.net/2268/147550 Title: Evaluation of the impact of a 6-month training by whole body vibration on the risk of falls among nursing home residents <br/> <br/>Author, co-author: Beaudart, Charlotte; Buckinx, Fanny; Demonceau, Marie; Maquet, Didier; Crielaard, Jean-Michel; Reginster, Jean-Yves; Bruyère, Olivier Mon, 29 Apr 2013 08:51:57 GMT http://hdl.handle.net/2268/147547 Title: Clinical characteristics of patients responsive to whole body vibration <br/> <br/>Author, co-author: Beaudart, Charlotte; Buckinx, Fanny; Maquet, Didier; Crielaard, Jean-Michel; Reginster, Jean-Yves; Bruyère, Olivier Mon, 29 Apr 2013 08:47:41 GMT http://hdl.handle.net/2268/147540 Title: Quantitative gait assessment using an accelerometer technology as a predictive tool of falls among nursing home residents: a 6-month prospective study <br/> <br/>Author, co-author: Bruyère, Olivier; Detalle, Anne-Sophie; Demonceau, Marie; Beaudart, Charlotte; Croisier, Jean-Louis; Crielaard, Jean-Michel; Reginster, Jean-Yves; Maquet, Didier Mon, 29 Apr 2013 08:31:03 GMT http://hdl.handle.net/2268/147537 Title: Changes in the structure and the symptoms of the osteoarthritis knee and prediction of future knee replacement over an 8-year follow-up period <br/> <br/>Author, co-author: Bruyère, Olivier; Cooper, Cyrus; Pavelka, Karel; Rabenda, Véronique; Buckinx, Fanny; Beaudart, Charlotte; Reginster, Jean-Yves Mon, 29 Apr 2013 08:24:58 GMT http://hdl.handle.net/2268/147534 Title: Cost-effectiveness of vitamin D and calcium supplementation in the treatment of postmenopausal women <br/> <br/>Author, co-author: Hiligsmann, Mickaël; Ben Sedrine, Wafa; Rabenda, Véronique; Bruyère, Olivier; Reginster, Jean-Yves Mon, 29 Apr 2013 08:08:04 GMT http://hdl.handle.net/2268/147529 Title: What is the predictive value of MRI for the occurrence of hard clinical endpoints in knee osteoarthritis? <br/> <br/>Author, co-author: Pelletier, Jean-Pierre; Peterfy, Charles; Brandi, Maria Luisa; Bruyère, Olivier; Chapurlat, Roland; Cicuttini, Flavia; Conaghan, P; Doherty, M; Genant, Harry K; Guermazi, A; Hochberg, Mark; Hunter, D; Kanis, John A; Kloppenburg, Margreet; Laredo, JD; Martel-Pelletier, Johanne; McAlindon, T; Nevitt, M; Raynauld, Jean-Pierre; Rizzoli, René; Zilkens, C; Reginster, Jean-Yves; Cooper, Cyrus Mon, 29 Apr 2013 08:02:39 GMT http://hdl.handle.net/2268/147527 Title: Role of nutraceuticals in the symptomatic and structural management of osteoarthritis <br/> <br/>Author, co-author: Bruyère, Olivier Mon, 29 Apr 2013 07:52:46 GMT http://hdl.handle.net/2268/147526 Title: Health economics in osteoarthritis <br/> <br/>Author, co-author: Hiligsmann, Mickaël; Cooper, Cyrus; Arden, Nigel; Boers, Marteen; Branco, Jaime; Brandi, Maria Luisa; Bruyère, Olivier; Guillemin, Francis; Hochberg, Marc; Hunter, David; Kanis, John A; Kvien, Tore; Laslop, Andrea; Petit-Dop, Florence; Pelletier, Jean-Pierre; Pinto, Daniel; Reiter, Susanne; Rizzoli, René; Rovati, Lucio C; Severens, Hans; Silverman, Stuart; Tsouderos, Yannis; Tugwell, Peter; Reginster, Jean-Yves Mon, 29 Apr 2013 07:49:54 GMT http://hdl.handle.net/2268/147524 Title: Case management projects enabling frail older people to stay in their own home a nested analysis within the framework of the evaluation of Protocol 3 projects <br/> <br/>Author, co-author: Van Durme, Thérèse; Macq, Jean; Lopez Hartmann, Maja; Remmen, Roy; Maggi, Patrick; Delye, Samuel; Gosset, Christiane; Schmitz, Olivier Mon, 29 Apr 2013 07:42:23 GMT http://hdl.handle.net/2268/147523 Title: An occupational therapist as a new professional at home: which profiles of clients are reached ? <br/> <br/>Author, co-author: Maggi, Patrick; de Almeida Mello, Johanna; Delye, Samuel; Van Durme, Thérèse; Cès, Sophie; Macq, Jean; Declercq, Anja; Gosset, Christiane Mon, 29 Apr 2013 07:41:50 GMT