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See detailService de numérisation à la demande dans les Bibliothèques de l'Université de Liège : Rapport sur la phase pilote de mars à décembre 2016
Simon, Stéphanie ULg; Bougrine, Hassan ULg; Renaville, François ULg

Report (2017)

Le système de gestion de bibliothèque Alma intègre un processus de gestion des documents numériques (stockage et/ou fourniture). Une analyse préalable sur les possibilités, avantages et limites d'un ... [more ▼]

Le système de gestion de bibliothèque Alma intègre un processus de gestion des documents numériques (stockage et/ou fourniture). Une analyse préalable sur les possibilités, avantages et limites d'un service de numérisation à la demande géré par Alma, dans le contexte des Bibliothèques de l'Université, a été réalisée en 2015. L'analyse a suggéré la mise en place, pour une phase pilote, d'un service de numérisation partielle à destination des membres du personnel. Le présent rapport fait le point sur cette phase pilote (mars-décembre 2016) et adresse des recommandations pour l'avenir. [less ▲]

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See detailInvestigation of the copolymerization behavior of a cyclic carbonate with vinyl acetate using CMRP
Scholten, Philip ULg; Demarteau, Jérémy ULg; Debuigne, Antoine ULg et al

Poster (2017, March)

Ethylene is an unconjugated monomer difficult to copolymerise in a controlled fashion using common radical or coordination-insertion polymerisation. Cobalt-mediated radical polymerisation (CMRP) provides ... [more ▼]

Ethylene is an unconjugated monomer difficult to copolymerise in a controlled fashion using common radical or coordination-insertion polymerisation. Cobalt-mediated radical polymerisation (CMRP) provides a powerful means to radically copolymerise ethylene in a controlled fashion under mild conditions.[1][2] In addition, different copolymer structures, such as block or alternating, can be accessed. ACO2-based cyclic carbonate was chosen as a promising comonomer but conflicting reports on the copolymer structure have been reported.[3][4] To better understand the copolymerisation behaviour of this monomer, model copolymerisations with vinyl acetate were performed and are reported below with the aim of gaining insights into the copolymersiation behaviour, which will allow us to better tackle ethylene copolymerisations. [less ▲]

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See detailInactivation of the β(1,2)-xylosyltransferase and the α(1,3)-fucosyltransferase genes in Nicotiana tabacum BY-2 cells by a multiplex CRISPR/Cas9 strategy results in glycoproteins without plant-specific glycans
Mercx, Sébastien; Smargiasso, Nicolas ULg; Chaumont, François et al

in Frontiers in Plant Science (2017), 8

Plants or plant cells can be used to produce pharmacological glycoproteins such as antibodies or vaccines. However these proteins carry N-glycans with planttypical residues [β(1,2)-xylose and core α(1,3 ... [more ▼]

Plants or plant cells can be used to produce pharmacological glycoproteins such as antibodies or vaccines. However these proteins carry N-glycans with planttypical residues [β(1,2)-xylose and core α(1,3)-fucose], which can greatly impact the immunogenicity, allergenicity, or activity of the protein. Two enzymes are responsible for the addition of plant-specific glycans: β(1,2)-xylosyltransferase (XylT) and α(1,3)- fucosyltransferase (FucT). Our aim consisted of knocking-out two XylT genes and four FucT genes (12 alleles altogether) in Nicotiana tabacum BY-2 suspension cells using CRISPR/Cas9. Three XylT and six FucT sgRNAs were designed to target conserved regions. After transformation of N. tabacum BY-2 cells with genes coding for sgRNAs, Cas9, and a selectable marker (bar), transgenic lines were obtained and their extracellular as well as intracellular protein complements were analyzed by Western blotting using antibodies recognizing β(1,2)-xylose and α(1,3)-fucose. Three lines showed a strong reduction of β(1,2)-xylose and α(1,3)-fucose, while two lines were completely devoid of them, indicating complete gene inactivation. The absence of these carbohydrates was confirmed by mass spectrometry analysis of the extracellular proteins. PCR amplification and sequencing of the targeted region indicated small INDEL and/or deletions between the target sites. The KO lines did not show any particular morphology and grew as the wild-type. One KO line was transformed with genes encoding a human IgG2 antibody. The IgG2 expression level was as high as in a control transformant which had not been glycoengineered. The IgG glycosylation profile determined by mass spectrometry confirmed that no β(1,2)-xylose or α(1,3)-fucose were present on the glycosylation moiety and that the dominant glycoform was the GnGn structure. These data represent an important step toward humanizing the glycosylation of pharmacological proteins expressed in N. tabacum BY-2 cells. © 2017 Mercx, Smargiasso, Chaumont, De Pauw, Boutry and Navarre. [less ▲]

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See detailQuantum fidelity of symmetric multipartite states
Neven, Antoine ULg; Mathonet, Pierre ULg; Gühne, Otfried et al

Conference (2017, March)

For two symmetric quantum states one may be interested in maximizing the overlap under local operations applied to one of them. The question arises whether the maximal overlap can be obtained by applying ... [more ▼]

For two symmetric quantum states one may be interested in maximizing the overlap under local operations applied to one of them. The question arises whether the maximal overlap can be obtained by applying the same local operation to each party. We show [1] that for two symmetric multiqubit states and local unitary transformations this is the case; the maximal overlap can be reached by applying the same unitary matrix everywhere. For local invertible operations (stochastic local operations assisted by classical communication equivalence), however, we present counterexamples, demonstrating that considering the same operation everywhere is not enough. [less ▲]

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See detailErnst Mach, psychologue de la forme ?
Zincq, Aurélien ULg

in Philosophie (2017), 133

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See detailArtemisia campestris L.:Ethnomedical, phytochemical and pharmacological review
Dib, Ikram; Angenot, Luc ULg; Ziyyat, Abderrahim et al

in Journal of Herbal Medicine (2017), 7(1), 1-10

Artemisia campestris is a perennial herb, commonly known as field wormwood. it is widespread in Asia, North America, Europe and north Africa. the different parts of this plant are used as anthelmintic ... [more ▼]

Artemisia campestris is a perennial herb, commonly known as field wormwood. it is widespread in Asia, North America, Europe and north Africa. the different parts of this plant are used as anthelmintic, antidiabetic, antihypertensive, emmenagogue, antivenom, and to treat digestive and cutaneous problems. an exhaustive bibliographic research of this plant has been carried out by means of scientific engines and databases like Google scholar, PubMed, Sciencedirect and sciFinder; as a result, it has been found that this herb possesses a rich phytochemical content and a wide range of pharmacological activities such as antioxidant, antibacterial, antimutagenic , antivenom and antitumor effects. In an aim to highlight the importance of A. campestris L., this review has been established by discussing its ethnomedicinal, morphological, ecological, phytochemical, pharmacological and toxicological studies. [less ▲]

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See detailComplication with convective core boundary
Thoul, Anne ULg

Conference (2017, March)

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See detailHow the reference values for serum parathyroid hormone concentration are (or should be) established?
Souberbielle, J.-C.; Brazier, F.; Piketty, M.-L. et al

in Journal of Endocrinological Investigation (2017), 40(3), 241-256

Well-validated reference values are necessary for a correct interpretation of a serum PTH concentration. Establishing PTH reference values needs recruiting a large reference population. Exclusion criteria ... [more ▼]

Well-validated reference values are necessary for a correct interpretation of a serum PTH concentration. Establishing PTH reference values needs recruiting a large reference population. Exclusion criteria for this population can be defined as any situation possibly inducing an increase or a decrease in PTH concentration. As recommended in the recent guidelines on the diagnosis and management of asymptomatic primary hyperparathyroidism, PTH reference values should be established in vitamin D-replete subjects with a normal renal function with possible stratification according to various factors such as age, gender, menopausal status, body mass index, and race. A consensus about analytical/pre-analytical aspects of PTH measurement is also needed with special emphasis on the nature of the sample (plasma or serum), the time and the fasting/non-fasting status of the blood sample. Our opinion is that blood sample for PTH measurement should be obtained in the morning after an overnight fast. Furthermore, despite longer stability of the PTH molecule in EDTA plasma, we prefer serum as it allows to measure calcium, a prerequisite for a correct interpretation of a PTH concentration, on the same sample. Once a consensus is reached, we believe an important international multicentre work should be performed to recruit a very extensive reference population of apparently healthy vitamin D-replete subjects with a normal renal function in order to establish the PTH normative data. Due to the huge inter-method variability in PTH measurement, a sufficient quantity of blood sample should be obtained to allow measurement with as many PTH kits as possible. [less ▲]

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See detailIntroduction à l’evidence-based practice en psychologie
Durieux, Nancy ULg; Etienne, Anne-Marie ULg; Willems, Sylvie ULg

Article for general public (2017)

Beaucoup d’encre coule au sujet de l’evidence-based practice (EBP) en psychologie, approche recommandée par certains collègues, mais décriée par d’autres… Cet article a pour objectif d’introduire ... [more ▼]

Beaucoup d’encre coule au sujet de l’evidence-based practice (EBP) en psychologie, approche recommandée par certains collègues, mais décriée par d’autres… Cet article a pour objectif d’introduire brièvement l’EBP auprès des praticiens. Les auteurs tenteront de montrer que, malgré les obstacles et les développements essentiels pour que cette approche puisse être intégrée dans le quotidien des psychologues, l’EBP constitue une opportunité de faire évoluer les pratiques professionnelles et de permettre une meilleure valorisation de la psychologie. [less ▲]

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See detailInternational Osteoporosis Foundation and European Calcified Tissue Society working group. Recommendations for the screening of the adherence to oral bisphosphonates.
DIEZ-PEREZ, A; NAYLOR, K.E.; ABRAHAMSEN, B et al

in Osteoporosis International (2017), 28(3), 767-774

Summary: Adherence to oral bisphosphonates is low. A screening strategy is proposed based on the response of biochemical markers of bone turnover after 3 months of therapy. If no change is observed, the ... [more ▼]

Summary: Adherence to oral bisphosphonates is low. A screening strategy is proposed based on the response of biochemical markers of bone turnover after 3 months of therapy. If no change is observed, the clinician should reassess the adherence to the treatment and also other potential issues with the drug. Introduction: Low adherence to oral bisphosphonates is a common problem that jeopardizes the efficacy of treatment of osteoporosis. No clear screening strategy for the assessment of compliance is widely accepted in these patients. Methods: The International Osteoporosis Foundation and the European Calcified Tissue Society have convened a working group to propose a screening strategy to detect a lack of adherence to these drugs. The question to answer was whether the bone turnover markers (BTMs) PINP and CTX can be used to identify low adherence in patients with postmenopausal osteoporosis initiating oral bisphosphonates for osteoporosis. The findings of the TRIO study specifically address this question and were used as the basis for testing the hypothesis. Results: Based on the findings of the TRIO study, specifically addressing this question, the working group recommends measuring PINP and CTX at baseline and 3 months after starting therapy to check for a decrease above the least significant change (decrease of more than 38% for PINP and 56% for CTX). Detection rate for the measurement of PINP is 84%, for CTX 87% and, if variation in at least one is considered when measuring both, the level of detection is 94.5%. Conclusions: If a significant decrease is observed, the treatment can continue, but if no decrease occurs, the clinician should reassess to identify problems with the treatment, mainly low adherence. [less ▲]

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See detailPublic Health impact and economic evaluation of vitamin D-fortified dairy products for fracture prevention in France.
HILIGSMANN, M.; BURLET, N.; FARDELLONE, P. et al

in Osteoporosis International (2017), 28(3), 833-840

Summary: The recommended intake of vitamin D-fortified dairy products can substantially decrease the burden of osteoporotic fractures and seems an economically beneficial strategy in the general French ... [more ▼]

Summary: The recommended intake of vitamin D-fortified dairy products can substantially decrease the burden of osteoporotic fractures and seems an economically beneficial strategy in the general French population aged over 60 years. Introduction: This study aims to assess the public health and economic impact of vitamin D-fortified dairy products in the general French population aged over 60 years. Methods: We estimated the lifetime health impacts expressed in number of fractures prevented, life years gained, and quality-adjusted life years (QALY) gained of the recommended intake of dairy products in the general French population over 60 years for 1 year (2015). A validated microsimulation model was used to simulate three age cohorts for both women and men (60–69, 70–79, and >80 years). The incremental cost per QALY gained of vitamin D-fortified dairy products compared to the absence of appropriate intake was estimated in different populations, assuming the cost of two dairy products per day in base case. Results: The total lifetime number of fractures decreased by 64,932 for the recommended intake of dairy products in the general population over 60 years, of which 46,472 and 18,460 occurred in women and men, respectively. In particular, 15,087 and 4413 hip fractures could be prevented in women and men. Vitamin D-fortified dairy products also resulted in 32,569 QALYs and 29,169 life years gained. The cost per QALY gained of appropriate dairy intake was estimated at €58,244 and fall below a threshold of €30,000 per QALY gained in women over 70 years and in men over 80 years. Conclusion: Vitamin D-fortified dairy products have the potential to substantially reduce the burden of osteoporotic fractures in France and seem an economically beneficial strategy, especially in the general population aged above 70 years. [less ▲]

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See detailConstruire un système de reconnaissance de l'économie sociale en Wallonie. Analyse des résultats issus des ateliers scénarios menés dans le cadre du projet SECOIA
Stassart, Isalyne ULg; Erpicum, Martin ULg; Fallon, Catherine ULg et al

Report (2017)

Quelles sont les pratiques communes aux entreprises d’économie sociale ? Quelles sont les dimensions qui pourraient les distinguer des autres entreprises dites capitalistiques ? Les membres actifs de ... [more ▼]

Quelles sont les pratiques communes aux entreprises d’économie sociale ? Quelles sont les dimensions qui pourraient les distinguer des autres entreprises dites capitalistiques ? Les membres actifs de l’économie sociale peuvent-ils proposer un ou plusieurs systèmes de reconnaissance de leurs spécificités ? Et sur base de quels indicateurs ? Tel était l’objet du troisième volet du projet SECOIA (projet de 22 mois commandité par la Région wallonne) qui visait à élaborer de manière participative et itérative un ou plusieurs système(s) de reconnaissance des entreprises de l’économie sociale. L’analyse de trois ateliers scénarios menés en décembre et février dernier avec 32 participants représentant les petites, moyennes et grandes entreprises de l’économie sociale en Région wallonne met en évidence une dimension transversale, et six dimensions spécifiques propres à l’économie sociale. [less ▲]

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See detailManagement of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: Joint position statement of the IOF, CABS, ECTS, IEG, ESCEO, IMS and SIOG.
HADJI, P.; AAPRO, M.S.; BODY, J.J. et al

in Journal of Bone Oncology (2017), 23(7), 1-12

Background: Several guidelines have been reported for bone-directed treatment in women with early breast cancer (EBC) for averting fractures, particularly during aromatase inhibitor (AI) therapy. Recently ... [more ▼]

Background: Several guidelines have been reported for bone-directed treatment in women with early breast cancer (EBC) for averting fractures, particularly during aromatase inhibitor (AI) therapy. Recently, a number of studies on additional fracture related risk factors, new treatment options as well as real world studies demonstrating a much higher fracture rate than suggested by randomized clinical controlled trials (RCTs). Therefore, this updated algorithm was developed to better assess fracture risk and direct treatment as a position statement of several interdisciplinary cancer and bone societies involved in the management of AI-associated bone loss (AIBL). Patients and methods: A systematic literature review identified recent advances in the management of AIBL. Results with individual agents were assessed based on trial design, size, follow-up, and safety. Results: Several fracture related risk factors in patients with EBC were identified. Although, the FRAX algorithm includes fracture risk factors (RF) in addition to BMD, it does not seem to adequately address the effects of AIBL. Several antiresorptive agents can prevent and treat AIBL. However, concerns regarding compliance and longterm safety remain. Overall, the evidence for fracture prevention is strongest for denosumab 60 mg s.c. every 6 months. Additionally, recent studies as well as an individual patient data meta-analysis of all available randomized trial data support additional anticancer benefits from adjuvant bisphosphonate treatment in postmenopausal women with a 34% relative risk reduction in bone metastasis and 17% relative risk decrease in breast cancer mortality that needs to be taken into account when advising on management of AIBL. Conclusions: In all patients initiating AI treatment, fracture risk should be assessed and recommendation with regard to exercise and calcium/vitamin D supplementation given. Bone-directed therapy should be given to all patients with a T-score<−2.0 or with a T-score of<–1.5 SD with one additional RF, or with ≥2 risk factors (without BMD) for the duration of AI treatment. Patients with T-score>−1.5 SD and no risk factors should be managed based on BMD loss during the first year and the local guidelines for postmenopausal osteoporosis. Compliance should be regularly assessed as well as BMD on treatment after 12 - 24 months. Furthermore, because of the decreased incidence of bone recurrence and breast cancer specific mortality, adjuvant bisphosphonates are recommended for all postmenopausal women at significant risk of disease recurrence. [less ▲]

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See detailUltrasonic spray pyrolysis as a processing route for templated electrochromic tungsten oxide films
Chatzikyriakou, Dafni ULg; Maho, Anthony ULg; Cloots, Rudi ULg et al

in Microporous and Mesoporous Materials (2017), 240

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See detailNeural correlates of subsequent recollection and familiarity in ageing
François, Sarah ULg; Angel, Lucie; Salmon, Eric ULg et al

Poster (2017, March)

It is now commonly accepted that, in ageing, recollection processes are impaired and familiarity seems to be relatively preserved. In this study, we were interested in the differences between younger and ... [more ▼]

It is now commonly accepted that, in ageing, recollection processes are impaired and familiarity seems to be relatively preserved. In this study, we were interested in the differences between younger and older participants regarding cerebral activity during encoding depending on whether the item later elicited recollection or familiarity. Twenty young volunteers and 19 older volunteers were presented visual stimuli depicting objects. After a first fMRI session in which the items were encoded, they underwent a recognition memory task in which they judged whether items were Remembered, Familiar or New. Data were analysed using SPM8, with an event-related design comparing modifications in cerebral activity between the two subjects groups during encoding (1) for the items leading to recollection compared to those leading to familiarity, and (2) for the items associated with familiarity compared to those which were not recognized. Results showed that older adults displayed a heightened activity in regions of the default-mode network for subsequent recollection. As it does not appear to be deleterious, it could stem from a more frequent use of self-referential appraisal as an encoding strategy in older adults. Furthermore, they show supplementary contralateral activations in frontal and temporal regions, which could be indicative of dedifferentiation or attempted compensation. To conclude, it appears that despite relying less on elaborative encoding, older adults seem to be able to perform recollection using qualitatively different strategies than young adults. [less ▲]

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See detailLésions mixtes des mâchoires, radio-opaques et radio-transparentes
MILICEVIC, Mladen ULg

in Revue Médicale de Liège (2017), 72(3), 151-155

Les Lésions néoplasiques et non néoplasiques des mâchoires sont généralement classifiées comme radio-opaques ou radio-transparentes, odontogènes ou non odontogènes. Toutefois, il existe un nombre ... [more ▼]

Les Lésions néoplasiques et non néoplasiques des mâchoires sont généralement classifiées comme radio-opaques ou radio-transparentes, odontogènes ou non odontogènes. Toutefois, il existe un nombre significatif de pathologies qui peuvent être classifiées comme étant mixtes ou qui, au départ, sont radio-transparentes et deviennent ultérieurement radio-opaques ou mixtes. certaines pathologies s'expriment en différents stades de développement qui sont radio-transparents, radio-opaques ou mixtes. Le but de cet article est d'apporter une meilleure compréhension de l'imagerie de ces lésions, fondée sur une revue de la littérature, illustrée par des images de cas cliniques personnels. [less ▲]

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See detailL'acte d'imagination: Approches phénoménologiques
Hagelstein, Maud ULg; Hervy, Alievtina ULg; Leclercq, Bruno ULg

in Bulletin d'Analyse Phénoménologique (2017), 13 (2017)(2),

Du 25 au 29 avril 2016, le centre « Phénoménologies » de l’Université de Liège a tenu la dixième édition de son séminaire international de recherche en phénoménologie. Autour du thème général L’Acte ... [more ▼]

Du 25 au 29 avril 2016, le centre « Phénoménologies » de l’Université de Liège a tenu la dixième édition de son séminaire international de recherche en phénoménologie. Autour du thème général L’Acte d’imagination : approches phénoménologiques, vingt-huit chercheurs issus de vingt-deux universités différentes se sont rencontrés pendant une semaine entière pour discuter dans le détail plusieurs aspects de la problématique. Le volume actuel reprend la plupart des communications qui avaient été présentées durant cette semaine, communications ici retravaillées pour intégrer les propositions qu’avaient suscitées leur présentation originale et plus généralement l’ensemble des débats très riches qu’avait permis la constitution ponctuelle d’une vraie communauté philosophique. Kant avait notoirement fait de la faculté d’imagination un intermédiaire (un peu indécis) entre la réceptivité de l’expérience sensible et la spontanéité de l’entendement. En s’installant plus nettement sur le terrain de la psychologie descriptive et en abandonnant le vocabulaire des « facultés » pour lui préférer celui des actes mentaux ou des fonctions psychiques, les brentaniens s’étaient donné les moyens d’analyser plus finement les composantes de l’acte d’imagination (mode de visée, contenu réel, contenu intentionnel...), les rapports de fondation qu’il entretient avec d’autres types d’actes, et par là le rôle qu’il peut jouer dans les fonctions cognitives ou évaluatives de l’esprit. C’est de cet acte d’imagination, envisagé par la phénoménologie en tant que psychologie descriptive, qu’il sera ici question. [less ▲]

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See detailLA THÉRAPIE MANUELLE ORTHOPÉDIQUE : définition, caractéristiques et mise au point sur la situation en Belgique
Demoulin, Christophe ULg; Depas, Yannick ULg; Vanderthommen, Marc ULg et al

in Revue Médicale de Liège (2017), 72(3), 126-131

Orthopaedic manual therapy : definition, characteristics and update on the situation in Belgium Summary : Although orthopaedic manual therapy (OMT) has existed for decades, and although a recent Belgian ... [more ▼]

Orthopaedic manual therapy : definition, characteristics and update on the situation in Belgium Summary : Although orthopaedic manual therapy (OMT) has existed for decades, and although a recent Belgian Royal Decree, published in 2014, recognized it as a particular professional qualification in physiotherapy for the treatment of neuromusculoskeletal dysfunctions, OMT remains little known by patients, but also by healthcare professionals. Yet, this professional qualification, based on clinical reasoning, using highly specific treatments, guided by the best available scientific and clinical evidence and the specific biopsychosocial characteristics of each patient, is the subject of a growing number of scientific studies pointing out its effectiveness. This article summarizes the knowledge related to OMT (definition, history, characteristics, techniques, indications, access and reimbursement) and describes its situation in Belgium. [less ▲]

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See detailAnalytical and clinical validation of the new Abbot Architect 25(OH)D assay: fit for purpose?
Cavalier, Etienne ULg; LUKAS, Pierre ULg; BEKAERT, Anne-Catherine ULg et al

in Clinical Chemistry & Laboratory Medicine (2017), 55(3), 378-384

BACKGROUND: We provide a clinical and analytical evaluation of the reformulated version of the Abbott Architect 25-hydroxyvitamin D assay. We compared this assay with three commercial automated ... [more ▼]

BACKGROUND: We provide a clinical and analytical evaluation of the reformulated version of the Abbott Architect 25-hydroxyvitamin D assay. We compared this assay with three commercial automated immunoassays and against a VDSP-traceable liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) in six different populations. We also supplemented 40 healthy volunteers with either 600,000 IU of vitamin D2 or 100,000 of vitamin D3 to evaluate the performance of the immunoassays vs. the LC-MS/MS. METHODS: Precision and limit of quantification were assessed, 25(OH)D2 and C3-epimer recovery were calculated. Two hundred and forty samples obtained in healthy Caucasians and Africans, osteoporotic, hemodialyzed and intensive care patients and 3rd trimester pregnant women were analyzed by all methods. Correlation was studied using Passing-Bablok and Bland-Altman analysis. Concordance correlation coefficient (CCC) was calculated to evaluate agreement between immunoassays and LC-MS/MS. We verified if patients were homogeneously classified with the immunoassays when they took vitamin D2 or vitamin D3 after 1, 7 and 28 days. RESULTS: We observed excellent analytical features and showed a very good correlation to the LC-MS/MS results in the overall population. Compared to the other immunoassays, concordance of the new Abbott assay with the LC-MS/MS was at least similar, and often better in diseased populations. Althought the cross-reactivity with 25(OH)D2 was not of 100%, there was no significant difference in the classifications of the patients, either supplemented with D2 or D3 or after 7 or 28 days. CONCLUSIONS: This modified version of the Abbott Architect assay is clearly improved compared to the previous one and presents a better agreement with the LC-MS/MS. [less ▲]

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See detail2 Years outcome of patients in unresponsive wakefulness syndrome/vegetative state and minimally conscious state
Cassol, Helena ULg; LEDOUX, Didier ULg; Thibaut, Aurore ULg et al

Poster (2017, March)

INTRODUCTION: Following severe acute brain damage, patients typically evolve from coma to an unresponsive wakefulness syndrome/vegetative state (UWS/VS; wakefulness without awareness) and later to a ... [more ▼]

INTRODUCTION: Following severe acute brain damage, patients typically evolve from coma to an unresponsive wakefulness syndrome/vegetative state (UWS/VS; wakefulness without awareness) and later to a minimally conscious state (MCS; fluctuating but consistent nonreflex behaviors). MCS is subcategorized in MCS+ (i.e., command following) and MCS- (i.e., visual pursuit, localization of noxious stimulation or contingent behaviours). Reliable and consistent interactive communication and/or functional use of objects indicate the next boundary – emergence from MCS (EMCS). To date, there is still no reliable predictive model of recovery from the UWS/VS and the MCS. A better understanding of patients' outcome would help in decisions regarding patients’ care and rehabilitation, as well as end-of-life decisions. METHODS: We collected demographic information, acute care history and longitudinal follow-up of patients in UWS/VS and MCS admitted in 15 expert centers in Belgium (via the Belgian Federal Public Service Health). Patients were evaluated at 1, 3, 6, 12 and 24 months post injury with the Coma Recovery Scale-Revised and the diagnosis was based on internationally accepted criteria of UWS/VS, MCS or EMCS. Results were considered significant at p<0.001. RESULTS: 24 months follow-up was available for 476 patients including 261 diagnosed in UWS/VS (88 traumatic, 173 non-traumatic) and 215 diagnosed in MCS (80 traumatic, 135 non-traumatic) one month after the injury. Patients who were in MCS one month after the insult were more likely to recover functional communication or object use after 24 months than patients in UWS/VS. Moreover, functional recovery occurred more often in MCS+ (79%) as compared to MCS- (29%), and mortality rate was more important in MCS- patients (68%) as compared to MCS+ (21%). Comparisons within UWS/VS and MCS groups based on etiology showed that traumatic patients had a better outcome at 24 months than non-traumatic patients. Among non-traumatic patients, no difference was found between anoxic patients and patients with other etiologies regarding functional recovery. CONCLUSION: Our study highlights that the outcome is significantly better for patients who are in MCS one month post-injury as compared to patients who remain in UWS/VS at that time. Concerning MCS patients, the outcome is significantly better for patients who are MCS+ one month post-injury as compared to patients who are MCS- at that time. This study also confirms that patients with traumatic etiology have better prognosis than patients with non-traumatic causes. [less ▲]

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