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Scaia D, Fombellida K, Maes N, El Moussaoui M, Darcis G. Risk Factors for Late HIV Presentation in Patients Treated at a Single Belgian Reference Centre from 2018 to 2022. Infect Dis Rep 2024; 16:239-248. [PMID: 38525766 PMCID: PMC10961754 DOI: 10.3390/idr16020019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 03/26/2024] Open
Abstract
A late HIV diagnosis is associated with increased mortality and morbidity, increased healthcare costs and increased onward viral transmission. In this regard, we retrospectively analysed the characteristics of patients who presented for care at our centre from January 2018 to December 2022 to assess the proportion of patients and factors associated with late HIV presentation. We collected data from the Liège University Hospital database, and we used binary logistic regression models to analyse the impact of individuals' characteristics on late presentation. Among 167 participants, 38.3% were late presenters (LPs) (presenting for care with a CD4+ T-cell count < 350 cells/mm3 or after an AIDS-defining event), and 21.6% were late presenters with advanced disease (LPs-AD) (presenting for care with a CD4+ T-cell count < 200 cells/mm3 or after an AIDS-defining event). The risk of being an LPs-AD was increased in older individuals (OR on log-transformed age: 7.5) and individuals of sub-Saharan African origin compared to individuals of Belgian or other origin (ORs of 0.30 and 0.25, respectively). The results of this study suggest that broadening the focus beyond the previously common risk groups is essential to prevent late diagnosis.
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Affiliation(s)
- Damien Scaia
- Public Health Science Department, University of Liège, 4000 Liège, Belgium
| | - Karine Fombellida
- Infectious Diseases Department, Liège University Hospital, 4000 Liège, Belgium
| | - Nathalie Maes
- Biostatistics and Research Method Center, Liège University Hospital, 4000 Liège, Belgium
| | | | - Gilles Darcis
- Infectious Diseases Department, Liège University Hospital, 4000 Liège, Belgium
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Layios N, Gosset C, Maes N, Delierneux C, Hego A, Huart J, Lecut C, Damas P, Oury C, Gothot A. Prospective flow cytometry analysis of leucocyte subsets in critically ill patients who develop sepsis: a pilot study. Infection 2023; 51:1305-1317. [PMID: 36696043 DOI: 10.1007/s15010-023-01983-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/13/2023] [Indexed: 01/26/2023]
Abstract
PURPOSE Sepsis in critically ill patients with injury bears a high morbidity and mortality. Extensive phenotypic monitoring of leucocyte subsets in critically ill patients at ICU admission and during sepsis development is still scarce. The main objective of this study was to identify early changes in leukocyte phenotype which would correlate with later development of sepsis. METHODS Patients who were admitted in a tertiary ICU for organ support after severe injury (elective cardiac surgery, trauma, necessity of prolonged ventilation or stroke) were sampled on admission (T1) and 48-72 h later (T2) for phenotyping of leukocyte subsets by flow cytometry and cytokines measurements. Those who developed secondary sepsis or septic shock were sampled again on the day of sepsis diagnosis (Tx). RESULTS Ninety-nine patients were included in the final analysis. Nineteen (19.2%) patients developed secondary sepsis or septic shock. They presented significantly higher absolute monocyte counts and CRP at T1 compared to non-septic patients (1030/µl versus 550/µl, p = 0.013 and 5.1 mg/ml versus 2.5 mg/ml, p = 0.046, respectively). They also presented elevated levels of monocytes with low expression of L-selectin (CD62Lneg monocytes) (OR[95%CI] 4.5 (1.4-14.5), p = 0.01) and higher SOFA score (p < 0.0001) at T1 and low mHLA-DR at T2 (OR[95%CI] 0.003 (0.00-0.17), p = 0.049). Stepwise logistic regression analysis showed that both monocyte markers and high SOFA score (> 8) were independently associated with nosocomial sepsis occurrence. No other leucocyte count or surface marker nor any cytokine measurement correlated with sepsis occurrence. CONCLUSION Monocyte counts and change of phenotype are associated with secondary sepsis occurrence in critically ill patients with injury.
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Affiliation(s)
- Nathalie Layios
- Department of Intensive Care, University Hospital of Liege, Domaine universitaire du Sart-Tilman, 4000, Liege, Belgium.
- Laboratory of Cardiology, GIGA Institute, University Hospital of Liege, Liege, Belgium.
| | - Christian Gosset
- Department of Hematobiology and Immuno-Hematology, University Hospital of Liege, Liege, Belgium
| | - Nathalie Maes
- Biostatistics and Research Method Center, University Hospital of Liege, Liege, Belgium
| | - Céline Delierneux
- Laboratory of Cardiology, GIGA Institute, University Hospital of Liege, Liege, Belgium
| | - Alexandre Hego
- Laboratory of Thrombosis and Hemostasis, GIGA-Cardiovascular Sciences, University of Liege, Liege, Belgium
| | - Justine Huart
- Department of Nephrology, University Hospital of Liege, Liege, Belgium
- Laboratory of Translational Research in Nephrology, GIGA, University Hospital of Liege, Liege, Belgium
| | - Christelle Lecut
- Department of Hematobiology and Immuno-Hematology, University Hospital of Liege, Liege, Belgium
| | - Pierre Damas
- Department of Intensive Care, University Hospital of Liege, Domaine universitaire du Sart-Tilman, 4000, Liege, Belgium
| | - Cécile Oury
- Laboratory of Cardiology, GIGA Institute, University Hospital of Liege, Liege, Belgium
| | - André Gothot
- Department of Hematobiology and Immuno-Hematology, University Hospital of Liege, Liege, Belgium
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El Moussaoui M, Desmecht S, Lambert N, Maes N, Braghini J, Marechal N, Quintana C, Briquet K, Gofflot S, Toussaint F, Hayette MP, Vermeersch P, Lutteri L, Grégoire C, Beguin Y, Rahmouni S, Moutschen M, Desmecht D, Darcis G. Cluster Analysis Identifies Distinct Patterns of T-Cell and Humoral Immune Responses Evolution Following a Third Dose of SARS-CoV-2 Vaccine in People Living with HIV. Viruses 2023; 15:1435. [PMID: 37515123 PMCID: PMC10383048 DOI: 10.3390/v15071435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Many vaccines require higher, additional doses or adjuvants to provide adequate protection for people living with HIV (PLWH). Despite their potential risk of severe coronavirus disease 2019, immunological data remain sparse, and a clear consensus for the best booster strategy is lacking. (2) Methods: Using the data obtained from our previous study assessing prospective T-cell and humoral immune responses before and after administration of a third dose of SARS-CoV-2 vaccine, we assessed the correlations between immune parameters reflecting humoral and cellular immune responses. We further aimed at identifying distinct clusters of patients with similar patterns of immune response evolution to determine how these relate to demographic and clinical factors. (3) Results: Among 80 PLWH and 51 healthcare workers (HCWs) enrolled in the study, cluster analysis identified four distinct patterns of evolution characterised by specific immune patterns and clinical factors. We observed that immune responses appeared to be less robust in cluster A, whose individuals were mostly PLWH who had never been infected with SARS-CoV-2. Cluster C, whose individuals showed a particularly drastic increase in markers of humoral immune response following the third dose of vaccine, was mainly composed of female participants who experienced SARS-CoV-2. Regarding the correlation study, although we observed a strong positive correlation between markers mirroring humoral immune response, markers of T-cell response following vaccination correlated only in a lesser extent with markers of humoral immunity. This suggests that neutralising antibody titers alone are not always a reliable reflection of the magnitude of the whole immune response. (4) Conclusions: Our findings show heterogeneity in immune responses among SARS-CoV-2 vaccinated PLWH. Specific subgroups could therefore benefit from distinct immunization strategies. Prior or breakthrough natural infection enhances the activity of vaccines and must be taken into account for informing global vaccine strategies among PLWH, even those with a viro-immunologically controlled infection.
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Affiliation(s)
- Majdouline El Moussaoui
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Salomé Desmecht
- Laboratory of Animal Genomics, GIGA-Medical Genomics, GIGA-Institute, University of Liège, 4000 Liège, Belgium
| | - Nicolas Lambert
- Department of Neurology, University Hospital of Liège, 4000 Liège, Belgium
| | - Nathalie Maes
- Biostatistics and Research Method Center (B-STAT), University Hospital of Liège, 4000 Liège, Belgium
| | - Joachim Braghini
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Nicole Marechal
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Céline Quintana
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Karine Briquet
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Stéphanie Gofflot
- Department of Biothèque Hospitalo-Universitaire de Liège (BHUL), University Hospital of Liège, 4000 Liège, Belgium
| | - Françoise Toussaint
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liège, Belgium
| | - Marie-Pierre Hayette
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liège, Belgium
| | - Pieter Vermeersch
- Department of Laboratory Medicine, University Hospital of Leuven, 3000 Leuven, Belgium
| | - Laurence Lutteri
- Department of Clinical Chemistry, University Hospital of Liège, 4000 Liège, Belgium
| | - Céline Grégoire
- Department of Haematology, University Hospital of Liège, University of Liège, 4000 Liège, Belgium
| | - Yves Beguin
- Department of Biothèque Hospitalo-Universitaire de Liège (BHUL), University Hospital of Liège, 4000 Liège, Belgium
- Department of Haematology, University Hospital of Liège, University of Liège, 4000 Liège, Belgium
| | - Souad Rahmouni
- Laboratory of Animal Genomics, GIGA-Medical Genomics, GIGA-Institute, University of Liège, 4000 Liège, Belgium
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
| | - Daniel Desmecht
- Department of Animal Pathology, Fundamental and Applied Research for Animals & Health, University of Liège, 4000 Liège, Belgium
| | - Gilles Darcis
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liège, Belgium
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Mayasi Ngongo N, Kamangu Ntambwe E, Situakibanza Nani-Tuma H, Mbula Mambimbi M, Mandina Ndona M, Longokolo Mashi M, Bepouka Izizag B, Lukiana T, Odio Ossam J, Mangala Sonzi D, Maes N, Moutschen M, El Moussaoui M, Darcis G. Human Immunodeficiency Virus Viral Load Monitoring and Rate of Virologic Suppression Among Patients Receiving Antiretroviral Therapy in Democratic Republic of the Congo, 2013-2020. Open Forum Infect Dis 2023; 10:ofad242. [PMID: 37363052 PMCID: PMC10287095 DOI: 10.1093/ofid/ofad242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/02/2023] [Indexed: 06/28/2023] Open
Abstract
Background Antiretroviral therapy (ART) expansion and viral load as a treatment monitoring approach have increased the demand for viral load testing. Many hurdles affect the coverage, quality, and use of viral load results. Estimates of viral load monitoring and viral suppression rates are needed to assess the performance of ART programs and improve human immunodeficiency virus (HIV) management outcomes. Methods People with HIV (PWH) viral load monitoring data were routinely collected in 84 health facilities in Kinshasa, Democratic Republic of the Congo (DRC), between 2013 and 2020. The number of PWH under ART, the number of participants with at least 1 viral load test result, the rate of viral suppression (defined as ≤1000 HIV ribonucleic acid copies per mL), and the mean turnaround time from sample collection to release of viral load test results were collected together with clinical data. Results A total of 14 057 PWH were included in the analysis. People with HIV were mainly enrolled after the "test and treat" implementation. The patients were followed for a median period of 27 months. The proportion of PWH with at least 1 available viral load largely increased in recent years. The delay from sample collection to release of viral load test results decreased overtime, from 35 days in 2018 to 16 days in 2020. Pregnancy and advanced HIV disease were associated with a lower chance of viral suppression. Conclusions There has been considerable success in increasing viral load access for all PWH under therapy in DRC. Nevertheless, viral load testing should be intensified with a particular effort to be made in groups at higher risk of viral failure.
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Affiliation(s)
- Nadine Mayasi Ngongo
- Correspondence: Gilles Darcis, MD, PhD, Avenue de l’hôpital 1, 4000 Liège, Belgium (); Nadine Mayasi Ngongo, MD, PhD, Avenue de l’hôpital 1, 4000 Liège, Belgium (nadiamayas02@gmail)
| | - Erick Kamangu Ntambwe
- Department of Molecular Biology of Basic Sciences, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Hippolyte Situakibanza Nani-Tuma
- Department of Internal Medicine, Infectious and Tropical Diseases, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Marcel Mbula Mambimbi
- Department of Internal Medicine, Infectious and Tropical Diseases, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Madone Mandina Ndona
- Department of Internal Medicine, Infectious and Tropical Diseases, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Murielle Longokolo Mashi
- Department of Internal Medicine, Infectious and Tropical Diseases, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ben Bepouka Izizag
- Department of Internal Medicine, Infectious and Tropical Diseases, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Tuna Lukiana
- Department of Internal Medicine, Infectious and Tropical Diseases, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jérôme Odio Ossam
- Department of Internal Medicine, Infectious and Tropical Diseases, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Donatien Mangala Sonzi
- Department of Internal Medicine, Infectious and Tropical Diseases, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Nathalie Maes
- Biostatistics and Research Method Center (B-STAT), University Hospital of Liège, Liège, Belgium
| | - Michel Moutschen
- Department of Internal Medicine and Infectious Diseases, Liège University Hospital, Liège, Belgium
- AIDS Reference Laboratory, University of Liège, Liège, Belgium
| | - Majdouline El Moussaoui
- Department of Internal Medicine and Infectious Diseases, Liège University Hospital, Liège, Belgium
| | - Gilles Darcis
- Correspondence: Gilles Darcis, MD, PhD, Avenue de l’hôpital 1, 4000 Liège, Belgium (); Nadine Mayasi Ngongo, MD, PhD, Avenue de l’hôpital 1, 4000 Liège, Belgium (nadiamayas02@gmail)
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5
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Henrotin Y, Dierckxsens Y, Delisse G, Maes N, Albert A. Curcuma longa and Boswellia serrata extract combination for hand osteoarthritis: an open-label pre-post trial. Pharm Biol 2022; 60:2295-2299. [PMID: 36416059 PMCID: PMC9704064 DOI: 10.1080/13880209.2022.2147550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/24/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
CONTEXT Osteoarthritis (OA) of the hand is a common painful musculoskeletal disorder with no cure. There is a need for an efficient and safe treatment to relieve OA pain. OBJECTIVE To investigate the effects of a Curcuma longa and Boswellia serrata food supplement in addition to standard care on hand pain. MATERIALS AND METHODS This open-label, non-controlled, post-observational study was based on 232 patients suffering from hand pain with or without joint deformity. Patients received a medical prescription for a three-month treatment with a food supplement containing 89 mg of C. longa dry extract, 120 mg of B. serrata resin, and 1.8 µg vitamin D. Pain was evaluated on a 10-point visual analog scale (VAS). The number of painful hand joints, patient satisfaction, nonsteroidal anti-inflammatory drugs intake, and side effects were also recorded. RESULTS Baseline pain intensity (regression coefficient ± SE: -0.19 ± 0.01, p < 0.0001) and the number of painful joints (regression coefficient ± SE: -0.022 ± 0.0029, p < 0.0001) decreased significantly throughout the 3 months treatment period. NSAIDs intake and topical drug application were significantly decreased by 64% (p < 0.0001) and 79% (p < 0.0001) after 12 weeks, respectively. Only 3/239 (1.3%) patients reported side effects probably related to the product. 80.3% were satisfied with the treatment and 75.5% wished to continue treatment. CONCLUSION This is the first clinical trial showing that C. longa and B. serrata resin can relieve symptoms in patients with hand osteoarthritis. The study provides useful information for the design of a clinical trial including a broader population.
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Affiliation(s)
- Yves Henrotin
- Musculoskeletal Innovative Research Lab (mSKIL), Arthropôle Liège, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, CHU Sart-Tilman, Liège, Belgium
- Physical Therapy and Rehabilitation Department, Princess Paola Hospital, Marche-en-Famenne, Belgium
| | | | | | - Nathalie Maes
- Center of Biostatistics (B-STAT), University Hospital of Liège, Liège, Belgium
| | - Adelin Albert
- Center of Biostatistics (B-STAT), University Hospital of Liège, Liège, Belgium
- Department of Public Health, University of Liège, Liège, Belgium
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Denis A, Henket M, Ernst M, Maes N, Thys M, Regnier C, Malaise O, Frix AN, Gester F, Desir C, Meunier P, Louis R, Malaise M, Guiot J. Progressive fibrosing interstitial lung disease in rheumatoid arthritis: A retrospective study. Front Med (Lausanne) 2022; 9:1024298. [PMID: 36530900 PMCID: PMC9748274 DOI: 10.3389/fmed.2022.1024298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Rheumatoid arthritis associated-interstitial lung disease (RA-ILD) is the most common pulmonary manifestation of rheumatoid arthritis (RA) and an important cause of mortality. In patients suffering from interstitial lung diseases (ILD) from different etiologies (including RA-ILD), a significant proportion is exhibiting a fibrotic progression despite immunosuppressive therapies, defined as progressive fibrosing interstitial lung disease (PF-ILD). Here, we report the frequency of RA-ILD and PF-ILD in all RA patients' cohort at University Hospital of Liège and compare their characteristics and outcomes. METHODS Patients were retrospectively recruited from 2010 to 2020. PF-ILD was defined based on functional, clinical and/or iconographic progression criteria within 24 months despite specific anti-RA treatment. RESULTS Out of 1,500 RA patients, about one third had high-resolution computed tomography (HRCT) performed, 89 showed RA-ILD and 48 PF-ILD. RA-ILD patients were significantly older than other RA patients (71 old of median age vs. 65, p < 0.0001), with a greater proportion of men (46.1 vs. 27.7%, p < 0.0001) and of smoking history. Non-specific interstitial pneumonia pattern was more frequent than usual interstitial pneumonia among RA-ILD (60.7 vs. 27.0%) and PF-ILD groups (60.4 vs. 31.2%). The risk of death was 2 times higher in RA-ILD patients [hazard ratio 2.03 (95% confidence interval 1.15-3.57), p < 0.01] compared to RA. CONCLUSION We identified a prevalence of PF-ILD of 3% in a general RA population. The PF-ILD cohort did not seem to be different in terms of demographic characteristics and mortality compared to RA-ILD patients who did not exhibit the progressive phenotype yet.
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Affiliation(s)
- Anna Denis
- Department of Pneumology, CHU of Liège, Liège, Belgium
| | | | - Marie Ernst
- Department of Biostatistics and Medico-Economic, CHU of Liège, Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic, CHU of Liège, Liège, Belgium
| | - Marie Thys
- Department of Biostatistics and Medico-Economic, CHU of Liège, Liège, Belgium
| | - Céline Regnier
- Department of Rheumatology, CHU of Liège, Liège, Belgium
| | | | | | - Fanny Gester
- Department of Pneumology, CHU of Liège, Liège, Belgium
| | - Colin Desir
- Department of Radiology, CHU of Liège, Liège, Belgium
| | - Paul Meunier
- Department of Radiology, CHU of Liège, Liège, Belgium
| | - Renaud Louis
- Department of Pneumology, CHU of Liège, Liège, Belgium
| | - Michel Malaise
- Department of Rheumatology, CHU of Liège, Liège, Belgium
| | - Julien Guiot
- Department of Pneumology, CHU of Liège, Liège, Belgium
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Moussaoui ME, Desmecht S, Tashkeev A, Lambert N, Maes N, Braghini J, Marechal N, Quintana C, Briquet K, Gofflot S, Toussaint F, Hayette MP, Vermeersch P, Lutteri L, Grégoire C, Beguin Y, Rahmouni S, Moutschen M, Desmecht D, Darcis G. Reduced T-cell response following a third dose of SARS-CoV-2 vaccine in infection-naïve people living with HIV. J Infect 2022; 85:702-769. [PMID: 36096313 PMCID: PMC9458764 DOI: 10.1016/j.jinf.2022.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Majdouline El Moussaoui
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium.
| | - Salomé Desmecht
- Laboratory of Animal Genomics, GIGA-Medical Genomics. GIGA-Institute, University of Liege, Belgium
| | - Aleksandr Tashkeev
- Laboratory of Animal Genomics, GIGA-Medical Genomics. GIGA-Institute, University of Liege, Belgium
| | - Nicolas Lambert
- Department of Neurology, University Hospital of Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Belgium
| | - Joachim Braghini
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
| | - Nicole Marechal
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
| | - Céline Quintana
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
| | - Karine Briquet
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
| | - Stéphanie Gofflot
- Department of Biothèque Hospitalo-Universitaire de Liège (BHUL), University Hospital of Liège, Belgium
| | | | | | - Pieter Vermeersch
- Department of Laboratory Medicine, University Hospital of Leuven, Leuven, Belgium
| | - Laurence Lutteri
- Department of Clinical Chemistry, University Hospital of Liège, Belgium
| | - Céline Grégoire
- Department of Haematology, University Hospital of Liège, University of Liège, Belgium
| | - Yves Beguin
- Department of Biothèque Hospitalo-Universitaire de Liège (BHUL), University Hospital of Liège, Belgium; Department of Haematology, University Hospital of Liège, University of Liège, Belgium
| | - Souad Rahmouni
- Laboratory of Animal Genomics, GIGA-Medical Genomics. GIGA-Institute, University of Liege, Belgium
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
| | - Daniel Desmecht
- Department of Animal Pathology, Fundamental and Applied Research for Animals and Health, University of Liège, Liège 4000, Belgium
| | - Gilles Darcis
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Avenue de l'Hôpital, 1, 4000 Liège, Belgium
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Guiot J, Maes N, Winandy M, Henket M, Ernst B, Thys M, Frix AN, Morimont P, Rousseau AF, Canivet P, Louis R, Misset B, Meunier P, Charbonnier JP, Lambermont B. Automatized lung disease quantification in patients with COVID-19 as a predictive tool to assess hospitalization severity. Front Med (Lausanne) 2022; 9:930055. [PMID: 36106317 PMCID: PMC9465374 DOI: 10.3389/fmed.2022.930055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
The pandemic of COVID-19 led to a dramatic situation in hospitals, where staff had to deal with a huge number of patients in respiratory distress. To alleviate the workload of radiologists, we implemented an artificial intelligence (AI) - based analysis named CACOVID-CT, to automatically assess disease severity on chest CT scans obtained from those patients. We retrospectively studied CT scans obtained from 476 patients admitted at the University Hospital of Liege with a COVID-19 disease. We quantified the percentage of COVID-19 affected lung area (% AA) and the CT severity score (total CT-SS). These quantitative measurements were used to investigate the overall prognosis and patient outcome: hospital length of stay (LOS), ICU admission, ICU LOS, mechanical ventilation, and in-hospital death. Both CT-SS and % AA were highly correlated with the hospital LOS, the risk of ICU admission, the risk of mechanical ventilation and the risk of in-hospital death. Thus, CAD4COVID-CT analysis proved to be a useful tool in detecting patients with higher hospitalization severity risk. It will help for management of the patients flow. The software measured the extent of lung damage with great efficiency, thus relieving the workload of radiologists.
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Affiliation(s)
- Julien Guiot
- Respiratory Department, University Hospital of Liège, Liège, Belgium
- *Correspondence: Julien Guiot,
| | - Nathalie Maes
- Biostatistics and Medico-Economic Information Department, University Hospital of Liège, Liège, Belgium
| | - Marie Winandy
- Respiratory Department, University Hospital of Liège, Liège, Belgium
| | - Monique Henket
- Respiratory Department, University Hospital of Liège, Liège, Belgium
| | - Benoit Ernst
- Respiratory Department, University Hospital of Liège, Liège, Belgium
| | - Marie Thys
- Biostatistics and Medico-Economic Information Department, University Hospital of Liège, Liège, Belgium
| | - Anne-Noelle Frix
- Respiratory Department, University Hospital of Liège, Liège, Belgium
| | - Philippe Morimont
- Intensive Care Department, University Hospital of Liège, Liège, Belgium
| | | | - Perrine Canivet
- Department of Radiology, University Hospital of Liège, Liège, Belgium
| | - Renaud Louis
- Respiratory Department, University Hospital of Liège, Liège, Belgium
| | - Benoît Misset
- Intensive Care Department, University Hospital of Liège, Liège, Belgium
| | - Paul Meunier
- Department of Radiology, University Hospital of Liège, Liège, Belgium
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9
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Canivet P, Desir C, Thys M, Henket M, Frix AN, Ernst B, Walsh S, Occhipinti M, Vos W, Maes N, Canivet JL, Louis R, Meunier P, Guiot J. The Role of Imaging in the Detection of Non-COVID-19 Pathologies during the Massive Screening of the First Pandemic Wave. Diagnostics (Basel) 2022; 12:diagnostics12071567. [PMID: 35885473 PMCID: PMC9324631 DOI: 10.3390/diagnostics12071567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/25/2022] [Accepted: 06/26/2022] [Indexed: 11/24/2022] Open
Abstract
During the COVID-19 pandemic induced by the SARS-CoV-2, numerous chest scans were carried out in order to establish the diagnosis, quantify the extension of lesions but also identify the occurrence of potential pulmonary embolisms. In this perspective, the performed chest scans provided a varied database for a retrospective analysis of non-COVID-19 chest pathologies discovered de novo. The fortuitous discovery of de novo non-COVID-19 lesions was generally not detected by the automated systems for COVID-19 pneumonia developed in parallel during the pandemic and was thus identified on chest CT by the radiologist. The objective is to use the study of the occurrence of non-COVID-19-related chest abnormalities (known and unknown) in a large cohort of patients having suffered from confirmed COVID-19 infection and statistically correlate the clinical data and the occurrence of these abnormalities in order to assess the potential of increased early detection of lesions/alterations. This study was performed on a group of 362 COVID-19-positive patients who were prescribed a CT scan in order to diagnose and predict COVID-19-associated lung disease. Statistical analysis using mean, standard deviation (SD) or median and interquartile range (IQR), logistic regression models and linear regression models were used for data analysis. Results were considered significant at the 5% critical level (p < 0.05). These de novo non-COVID-19 thoracic lesions detected on chest CT showed a significant prevalence in cardiovascular pathologies, with calcifying atheromatous anomalies approaching nearly 35.4% in patients over 65 years of age. The detection of non-COVID-19 pathologies was mostly already known, except for suspicious nodule, thyroid goiter and the ascending thoracic aortic aneurysm. The presence of vertebral compression or signs of pulmonary fibrosis has shown a significant impact on inpatient length of stay. The characteristics of the patients in this sample, both from a demographic and a tomodensitometric point of view on non-COVID-19 pathologies, influenced the length of hospital stay as well as the risk of intra-hospital death. This retrospective study showed that the potential importance of the detection of these non-COVID-19 lesions by the radiologist was essential in the management and the intra-hospital course of the patients.
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Affiliation(s)
- Perrine Canivet
- Department of Radiology, University Hospital of Liège, 4000 Liège, Belgium; (C.D.); (P.M.)
- Correspondence:
| | - Colin Desir
- Department of Radiology, University Hospital of Liège, 4000 Liège, Belgium; (C.D.); (P.M.)
| | - Marie Thys
- Department of Medico-Economic Information, University Hospital of Liège, 4000 Liège, Belgium;
| | - Monique Henket
- Department of Pneumology, University Hospital of Liège, 4000 Liège, Belgium; (M.H.); (A.-N.F.); (B.E.); (R.L.); (J.G.)
| | - Anne-Noëlle Frix
- Department of Pneumology, University Hospital of Liège, 4000 Liège, Belgium; (M.H.); (A.-N.F.); (B.E.); (R.L.); (J.G.)
| | - Benoit Ernst
- Department of Pneumology, University Hospital of Liège, 4000 Liège, Belgium; (M.H.); (A.-N.F.); (B.E.); (R.L.); (J.G.)
| | - Sean Walsh
- Radiomics (Oncoradiomics SA), 4000 Liège, Belgium; (S.W.); (M.O.); (W.V.)
| | | | - Wim Vos
- Radiomics (Oncoradiomics SA), 4000 Liège, Belgium; (S.W.); (M.O.); (W.V.)
| | - Nathalie Maes
- Biostatistics and Medico-Economic Information Department, University Hospital of Liège, 4000 Liège, Belgium;
| | - Jean Luc Canivet
- Department of Intensive Unit Care, University Hospital of Liège, 4000 Liège, Belgium;
| | - Renaud Louis
- Department of Pneumology, University Hospital of Liège, 4000 Liège, Belgium; (M.H.); (A.-N.F.); (B.E.); (R.L.); (J.G.)
| | - Paul Meunier
- Department of Radiology, University Hospital of Liège, 4000 Liège, Belgium; (C.D.); (P.M.)
| | - Julien Guiot
- Department of Pneumology, University Hospital of Liège, 4000 Liège, Belgium; (M.H.); (A.-N.F.); (B.E.); (R.L.); (J.G.)
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10
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El Moussaoui M, Maes N, Hong SL, Lambert N, Gofflot S, Dellot P, Belhadj Y, Huynen P, Hayette MP, Meex C, Bontems S, Defêche J, Godderis L, Molenberghs G, Meuris C, Artesi M, Durkin K, Rahmouni S, Grégoire C, Beguin Y, Moutschen M, Dellicour S, Darcis G. Evaluation of Screening Program and Phylogenetic Analysis of SARS-CoV-2 Infections among Hospital Healthcare Workers in Liège, Belgium. Viruses 2022; 14:v14061302. [PMID: 35746774 PMCID: PMC9227503 DOI: 10.3390/v14061302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/16/2022] Open
Abstract
Healthcare workers (HCWs) are known to be at higher risk of developing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections although whether these risks are equal across all occupational roles is uncertain. Identifying these risk factors and understand SARS-CoV-2 transmission pathways in healthcare settings are of high importance to achieve optimal protection measures. We aimed to investigate the implementation of a voluntary screening program for SARS-CoV-2 infections among hospital HCWs and to elucidate potential transmission pathways though phylogenetic analysis before the vaccination era. HCWs of the University Hospital of Liège, Belgium, were invited to participate in voluntary reverse transcriptase-polymerase chain reaction (RT-PCR) assays performed every week from April to December 2020. Phylogenetic analysis of SARS-CoV-2 genomes were performed for a subgroup of 45 HCWs. 5095 samples were collected from 703 HCWs. 212 test results were positive, 15 were indeterminate, and 4868 returned negative. 156 HCWs (22.2%) tested positive at least once during the study period. All SARS-CoV-2 test results returned negative for 547 HCWs (77.8%). Nurses (p < 0.05), paramedics (p < 0.05), and laboratory staff handling respiratory samples (p < 0.01) were at higher risk for being infected compared to the control non-patient facing group. Our phylogenetic analysis revealed that most positive samples corresponded to independent introduction events into the hospital. Our findings add to the growing evidence of differential risks of being infected among HCWs and support the need to implement appropriate protection measures based on each individual’s risk profile to guarantee the protection of both HCWs and patients. Furthermore, our phylogenetic investigations highlight that most positive samples correspond to distinct introduction events into the hospital.
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Affiliation(s)
- Majdouline El Moussaoui
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
- Correspondence:
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, 4000 Liege, Belgium;
| | - Samuel L. Hong
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; (S.L.H.); (S.D.)
| | - Nicolas Lambert
- Department of Neurology, University Hospital of Liège, 4000 Liege, Belgium;
| | - Stéphanie Gofflot
- Department of Biothèque Hospitalo-Universitaire de Liège (BHUL), University Hospital of Liège, 4000 Liege, Belgium;
| | - Patricia Dellot
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Yasmine Belhadj
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Pascale Huynen
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Marie-Pierre Hayette
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Cécile Meex
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Sébastien Bontems
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Justine Defêche
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, Katholieke Universiteit Leuven, 3000 Leuven, Belgium;
| | - Geert Molenberghs
- Institute for Biostatistics and Statistical Bioinformatics, Katholieke Universiteit Leuven, 3000 Leuven, Belgium;
| | - Christelle Meuris
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Maria Artesi
- Laboratory of Human Genetics, GIGA-Institute, University of Liège, 4000 Liege, Belgium; (M.A.); (K.D.)
| | - Keith Durkin
- Laboratory of Human Genetics, GIGA-Institute, University of Liège, 4000 Liege, Belgium; (M.A.); (K.D.)
| | - Souad Rahmouni
- Laboratory of Animal Genomics, GIGA-Medical Genomics, GIGA-Institute, University of Liège, 4000 Liege, Belgium;
| | - Céline Grégoire
- Department of Haematology, University Hospital of Liège, 4000 Liege, Belgium; (C.G.); (Y.B.)
| | - Yves Beguin
- Department of Haematology, University Hospital of Liège, 4000 Liege, Belgium; (C.G.); (Y.B.)
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; (S.L.H.); (S.D.)
- Spatial Epidemiology Lab, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - Gilles Darcis
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
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11
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Grégoire C, Huynen P, Gofflot S, Seidel L, Maes N, Vranken L, Delcour S, Moutschen M, Hayette MP, Kolh P, Melin P, Beguin Y. Predictive factors for the presence and long-term persistence of SARS-CoV-2 antibodies in healthcare and university workers. Sci Rep 2022; 12:9790. [PMID: 35697828 PMCID: PMC9191528 DOI: 10.1038/s41598-022-13450-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/24/2022] [Indexed: 11/30/2022] Open
Abstract
While patient groups at risk for severe COVID-19 infections are now well identified, the risk factors associated with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) transmission and immunization are still poorly understood. In a cohort of staff members of a Belgian tertiary academic hospital tested for SARS-CoV-2 antibodies during the early phase of the pandemic and followed-up after 6 weeks, 3 months and 10 months, we collected personal, occupational and medical data, as well as symptoms based on which we constructed a COVID-19 score. Seroprevalence was higher among participants in contact with patients or with COVID-19 confirmed subjects or, to a lesser extent, among those handling respiratory specimens, as well as among participants reporting an immunodeficiency or a previous or active hematological malignancy, and correlated with several symptoms. In multivariate analysis, variables associated with seropositivity were: contact with COVID-19 patients, immunodeficiency, previous or active hematological malignancy, anosmia, cough, nasal symptoms, myalgia, and fever. At 10 months, participants in contact with patients and those with higher initial COVID-19 scores were more likely to have sustained antibodies, whereas those with solid tumors or taking chronic medications were at higher risk to become seronegative.
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Affiliation(s)
- Céline Grégoire
- Division of Hematology, CHU Sart-Tilman, Avenue de l'hôpital 1, 4000, Liège, Belgium.
| | - Pascale Huynen
- Division of Medical Microbiology, Unilab, CHU of Liège, Liège, Belgium.,Center for Interdisciplinary Research On Medicines, University of Liège, Liège, Belgium
| | - Stéphanie Gofflot
- Biothèque Hospitalo-Universitaire de Liège (BHUL), CHU of Liège, Liège, Belgium
| | - Laurence Seidel
- Department of Biostatistics and Medico-Economic Information, CHU of Liège, Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, CHU of Liège, Liège, Belgium
| | | | | | - Michel Moutschen
- Division of Infectious Diseases and General Internal Medicine, CHU of Liège, Liège, Belgium.,GIGA-I3 Laboratory of Immunology, University of Liège, Liège, Belgium
| | - Marie-Pierre Hayette
- Division of Medical Microbiology, Unilab, CHU of Liège, Liège, Belgium.,Center for Interdisciplinary Research On Medicines, University of Liège, Liège, Belgium
| | - Philippe Kolh
- Department of Information System Management, CHU of Liège, Liège, Belgium.,Department of Biomedical and Preclinical Sciences, University of Liège, Liège, Belgium
| | - Pierrette Melin
- Division of Medical Microbiology, Unilab, CHU of Liège, Liège, Belgium.,Center for Interdisciplinary Research On Medicines, University of Liège, Liège, Belgium
| | - Yves Beguin
- Division of Hematology, CHU Sart-Tilman, Avenue de l'hôpital 1, 4000, Liège, Belgium.,Biothèque Hospitalo-Universitaire de Liège (BHUL), CHU of Liège, Liège, Belgium.,GIGA-I3 Laboratory of Hematology, University of Liège, Liège, Belgium
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12
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Huynen P, Grégoire C, Gofflot S, Seidel L, Maes N, Vranken L, Delcour S, Moutschen M, Hayette MP, Kolh P, Melin P, Beguin Y. Long-term longitudinal evaluation of the prevalence of SARS-CoV-2 antibodies in healthcare and university workers. Sci Rep 2022; 12:5156. [PMID: 35338237 PMCID: PMC8948456 DOI: 10.1038/s41598-022-09215-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
Abstract
Asymptomatic and pauci-symptomatic cases contribute to underestimating the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Moreover, we have few studies available on the longitudinal follow-up of SARS-CoV-2 antibodies after natural infection. We tested staff members of a Belgian tertiary academic hospital for SARS-CoV-2 IgG, IgM, and IgA antibodies. We analyzed the evolution of IgM and IgG after 6 weeks, and the persistence of IgG after 3 and 10 months. At the first evaluation, 409/3776 (10.8%) participants had a positive SARS-CoV-2 serology. Among initially seropositive participants who completed phases 2 and 3, IgM were still detected after 6 weeks in 53.1% and IgG persisted at 12 weeks in 82.0% (97.5% of those with more than borderline titers). IgG levels were higher and increased over time in symptomatic but were lower and stable in asymptomatic participants. After 10 months, 88.5% of participants had sustained IgG levels (97.0% of those with more than borderline titers).
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Affiliation(s)
- Pascale Huynen
- Division of Medical Microbiology, Unilab, CHU of Liège, Liège, Belgium.,Center for Interdisciplinary Research on Medicines, University of Liège, Liège, Belgium
| | - Céline Grégoire
- Department of Hematology, CHU of Liège, Avenue de l'hôpital 1, 4000, Liège, Belgium.
| | - Stéphanie Gofflot
- Biothèque Hospitalo-Universitaire de Liège (BHUL), CHU of Liège, Liège, Belgium
| | - Laurence Seidel
- Department of Biostatistics and Medico-Economic Information, CHU of Liège, Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, CHU of Liège, Liège, Belgium
| | | | | | - Michel Moutschen
- Division of Infectious Diseases and General Internal Medicine, CHU of Liège, Liège, Belgium.,GIGA-I3 Laboratory of Immunology, University of Liège, Liège, Belgium
| | - Marie-Pierre Hayette
- Division of Medical Microbiology, Unilab, CHU of Liège, Liège, Belgium.,Center for Interdisciplinary Research on Medicines, University of Liège, Liège, Belgium
| | - Philippe Kolh
- Department of Information System Management, CHU of Liège, Liège, Belgium.,Department of Biomedical and Preclinical Sciences, University of Liège, Liège, Belgium
| | - Pierrette Melin
- Division of Medical Microbiology, Unilab, CHU of Liège, Liège, Belgium.,Center for Interdisciplinary Research on Medicines, University of Liège, Liège, Belgium
| | - Yves Beguin
- Department of Hematology, CHU of Liège, Avenue de l'hôpital 1, 4000, Liège, Belgium.,Biothèque Hospitalo-Universitaire de Liège (BHUL), CHU of Liège, Liège, Belgium.,GIGA-I3 Laboratory of Hematology, University of Liège, Liège, Belgium
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13
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Mayasi N, Situakibanza H, Mbula M, Longokolo M, Maes N, Bepouka B, Ossam JO, Moutschen M, Darcis G. Retention in care and predictors of attrition among HIV-infected patients who started antiretroviral therapy in Kinshasa, DRC, before and after the implementation of the 'treat-all' strategy. PLOS Glob Public Health 2022; 2:e0000259. [PMID: 36962315 PMCID: PMC10022330 DOI: 10.1371/journal.pgph.0000259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 02/13/2022] [Indexed: 11/18/2022]
Abstract
The retention of patients in care is a key pillar of the continuum of HIV care. It has been suggested that the implementation of a "treat-all" strategy may favor attrition (death or lost to follow-up, as opposed to retention), specifically in the subgroup of asymptomatic people living with HIV (PLWH) with high CD4 counts. Attrition in HIV care could mitigate the success of universal antiretroviral therapy (ART) in resource-limited settings. We performed a retrospective study of PLWH at least 15 years old initiating ART in 85 HIV care centers in Kinshasa, Democratic Republic of Congo (DRC), between 2010 and 2019, with the objective of measuring attrition and to define factors associated with it. Sociodemographic and clinical characteristics recorded at ART initiation included sex, age, weight, height, WHO HIV stage, pregnancy, baseline CD4 cell count, start date of ART, and baseline and last ART regimen. Attrition was defined as death or loss to follow-up (LTFU). LTFU was defined as "not presenting to an HIV care center for at least 180 days after the date of a last missed visit, without a notification of death or transfer". Kaplan-Meier curves were used to present attrition data, and mixed effects Cox regression models determined factors associated with attrition. The results compared were before and after the implementation of the "treat-all" strategy. A total of 15,762 PLWH were included in the study. Overall, retention in HIV care was 83% at twelve months and 77% after two years of follow-up. The risk of attrition increased with advanced HIV disease and the size of the HIV care center. Time to ART initiation greater than seven days after diagnosis and Cotrimoxazole prophylaxis was associated with a reduced risk of attrition. The implementation of the "treat-all" strategy modified the clinical characteristics of PLWH toward higher CD4 cell counts and a greater proportion of patients at WHO stages I and II at treatment initiation. Initiation of ART after the implementation of the 'treat all" strategy was associated with higher attrition (p<0.0001) and higher LTFU (p<0.0001). Attrition has remained high in recent years. The implementation of the "treat-all" strategy was associated with higher attrition and LTFU in our study. Interventions to improve early and ongoing commitment to care are needed, with specific attention to high-risk groups to improve ART coverage and limit HIV transmission.
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Affiliation(s)
- Nadine Mayasi
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo [DRC]
| | - Hippolyte Situakibanza
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo [DRC]
| | - Marcel Mbula
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo [DRC]
| | - Murielle Longokolo
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo [DRC]
| | - Nathalie Maes
- Biostatistics and Medico-Economic Information Department, University Hospital of Liège, Liège, Belgium
| | - Ben Bepouka
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo [DRC]
| | - Jérôme Odio Ossam
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo [DRC]
| | - Michel Moutschen
- Department of Internal Medicine and Infectious Diseases, Liège University Hospital, Liège, Belgium
- AIDS Reference Laboratory, University of Liège, Liège, Belgium
| | - Gilles Darcis
- Department of Internal Medicine and Infectious Diseases, Liège University Hospital, Liège, Belgium
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14
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Plum PE, Maes N, Sauvage AS, Frippiat F, Meuris C, Uurlings F, Lecomte M, Léonard P, Paquot N, Fombellida K, Vaira D, Moutschen M, Darcis G. Impact of switch from tenofovir disoproxil fumarate-based regimens to tenofovir alafenamide-based regimens on lipid profile, weight gain and cardiovascular risk score in people living with HIV. BMC Infect Dis 2021; 21:910. [PMID: 34488664 PMCID: PMC8420041 DOI: 10.1186/s12879-021-06479-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/19/2021] [Indexed: 12/22/2022] Open
Abstract
Background As cardiovascular diseases represent the main cause of non-AIDS related death in people living with HIV (PLWH) with undetectable viral load, we evaluated lipid profile, weight gain and calculated cardiovascular risk change after switching from tenofovir disoproxil fumarate (TDF)-based regimens to tenofovir alafenamide (TAF)-based regimens. Methods For this retrospective study, we selected HIV-infected patients with suppressed viral load who fitted in one of the two groups below: First group (TDF/TDF): Patients treated continuously with TDF-based regimens. Second group (TDF/TAF): Patients treated with TDF-regimens during at least 6 months then switched to TAF-regimens while maintaining other drugs unchanged. Available data included date of birth, gender, ethnicity, lymphocyte T CD4+ count, weight, height, blood pressure, current/ex/non-smoker, diabetes mellitus, familial cardiovascular event, lipid profile, duration and nature of antiretroviral therapy. Lipid parameters, weight and calculated cardiovascular risk using 5-year reduced DAD score algorithm [Friis-Møller et al. in Eur J Cardiovasc Prev Rehabil 17:491–501, 2010] were analyzed in each groups. Results Switching from TDF to TAF resulted in a significant increase in triglycerides levels, total cholesterol and HDL cholesterol. LDL cholesterol and total cholesterol/HDL ratio did not show significant changes. Calculated cardiovascular risk increased after switch from TDF- to TAF-based therapy. Conclusions Together with favorable outcomes at the bone and kidney levels, potential negative impact of TAF on lipid profile should be included in the reflection to propose the most appropriate and tailored ARV treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06479-9.
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Affiliation(s)
| | - Nathalie Maes
- Biostatistics and Medico-Economic Information Department, Liège University Hospital, Liège, Belgium
| | | | - Frédéric Frippiat
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Christelle Meuris
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Françoise Uurlings
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Marianne Lecomte
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Philippe Léonard
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Nicolas Paquot
- Diabetology Department, Liège University Hospital, Liège, Belgium
| | - Karine Fombellida
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Dolores Vaira
- AIDS Reference Laboratory, Liège University, Liège, Belgium
| | - Michel Moutschen
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium.,AIDS Reference Laboratory, Liège University, Liège, Belgium
| | - Gilles Darcis
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium.
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15
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Ngongo NM, Nani-Tuma HS, Mambimbi MM, Mashi ML, Izizag BB, Ndolumingu FK, Maes N, Moutschen M, Darcis G. Decrease in late presentation for HIV care in Kinshasa, DRC, 2006-2020. AIDS Res Ther 2021; 18:41. [PMID: 34271957 PMCID: PMC8283988 DOI: 10.1186/s12981-021-00366-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/07/2021] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Late presentation for HIV care is a well-described issue for the success of ART outcomes and the cause of higher morbidity, mortality and further transmission. Monitoring the level of late presentation and understanding the factors associated with it would help to tailor screening and information strategies for better efficiency. We performed a retrospective cohort study in Kinshasa, the capital of the DRC. The studied population included HIV-positive adults newly enrolled in HIV care between January 2006 and June 2020 at 25 HIV urban care facilities. Patient information collected at presentation for HIV care included age, sex, WHO clinical stage and screening context. We used 2 definitions of late presentation: the WHO definition of advanced HIV disease (WHO stage 3/4 or CD4 cell count < 200 cells/mm3) and a more inclusive definition (WHO stage 3/4 or CD4 cell count < 350 cells/mm3). RESULTS A total of 10,137 HIV-infected individuals were included in the analysis. The median age was 40 years; 68% were female. A total of 45.9% or 47.5% of the patients were late presenters, depending on the definition used. The percentage of patients with late presentation (defined as WHO stage 3/4 or CD4 cell count < 350 cells/mm3) decreased during recent years, from 70.7% in 2013 to 46.5% in 2017 and 23.4% in 2020. Age was associated with a significantly higher risk of LP (p < 0.0001). We did not observe any impact of sex. CONCLUSIONS The frequency of late presentation for care is decreasing in Kinshasa, DRC. Efforts have to be continued. In particular, the issue of late diagnosis in older individuals should be addressed.
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Affiliation(s)
- Nadine Mayasi Ngongo
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo.
| | - Hippolyte Situakibanza Nani-Tuma
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Marcel Mbula Mambimbi
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Murielle Longokolo Mashi
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ben Bepouka Izizag
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Faustin Kitetele Ndolumingu
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Nathalie Maes
- Biostatistics and Medico-economic Information Department, University Hospital of Liege, Liège, Belgium
| | - Michel Moutschen
- Department of Internal Medicine and Infectious Diseases, Liège University Hospital, Liège, Belgium
- AIDS reference laboratory, University of Liège, Liège, Belgium
| | - Gilles Darcis
- Department of Internal Medicine and Infectious Diseases, Liège University Hospital, Liège, Belgium.
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Darcis G, Bouquegneau A, Maes N, Thys M, Henket M, Labye F, Rousseau AF, Canivet P, Desir C, Calmes D, Schils R, De Worm S, Léonard P, Meunier P, Moutschen M, Louis R, Guiot J. Long-term clinical follow-up of patients suffering from moderate-to-severe COVID-19 infection: a monocentric prospective observational cohort study. Int J Infect Dis 2021; 109:209-216. [PMID: 34273510 PMCID: PMC8278829 DOI: 10.1016/j.ijid.2021.07.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives Various symptoms and considerable organ dysfunction persist following infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Uncertainty remains about the potential mid- and long-term health sequelae. This prospective study of patients hospitalized with coronavirus disease 2019 (COVID-19) in Liège University Hospital, Belgium aimed to determine the persistent consequences of COVID-19. Methods Patients admitted to the University Hospital of Liège with moderate-to-severe confirmed COVID-19, discharged between 2 March and 1 October 2020, were recruited prospectively. Follow-up at 3 and 6 months after hospital discharge included demographic and clinical data, biological data, pulmonary function tests (PFTs) and high-resolution computed tomography (CT) scans of the chest. Results In total, 199 individuals were included in the analysis. Most patients received oxygen supplementation (80.4%). Six months after discharge, 47% and 32% of patients still had exertional dyspnoea and fatigue. PFTs at 3-month follow-up revealed a reduced diffusion capacity of carbon monoxide (mean 71.6 ± 18.6%), and this increased significantly at 6-month follow-up (P<0.0001). Chest CT scans showed a high prevalence (68.9% of the cohort) of persistent abnormalities, mainly ground glass opacities. Duration of hospitalization, intensive care unit admission and mechanical ventilation were not associated with the persistence of symptoms 3 months after discharge. Conclusion The prevalence of persistent symptoms following hospitalization with COVID-19 is high and stable for up to 6 months after discharge. However, biological, functional and iconographic abnormalities improved significantly over time.
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Affiliation(s)
- Gilles Darcis
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium.
| | - Antoine Bouquegneau
- Department of Nephrology-Dialysis-Transplantation, University Hospital of Liège, Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Liège, Belgium
| | - Marie Thys
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Liège, Belgium
| | - Monique Henket
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
| | - Florence Labye
- Department of Internal Medicine, University Hospital of Liège, Liège, Belgium
| | | | - Perrine Canivet
- Department of Radiology, University Hospital of Liège, Liège, Belgium
| | - Colin Desir
- Department of Radiology, University Hospital of Liège, Liège, Belgium
| | - Doriane Calmes
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
| | - Raphael Schils
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Sophie De Worm
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Philippe Léonard
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Paul Meunier
- Department of Radiology, University Hospital of Liège, Liège, Belgium
| | - Michel Moutschen
- Department of Infectious Diseases, University Hospital of Liège, Liège, Belgium
| | - Renaud Louis
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
| | - Julien Guiot
- Department of Pneumology, University Hospital of Liège, Liège, Belgium
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El Moussaoui M, Lambert N, Maes N, Fombellida K, Vaira D, Moutschen M, Darcis G. Impact of the COVID-19 pandemic situation on HIV care in Liège, Belgium. HIV Res Clin Pract 2021; 22:63-70. [PMID: 34308800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Background: The COVID-19 pandemic and associated containment measures dramatically affected the health care systems including the screening of human immunodeficiency virus and the management people living with HIV around the world by making the access to preventive care services and specific medical monitoring more difficult. OBJECTIVE Objective: To study the impact of the COVID-19 pandemic on the holistic care of people living with HIV in Liège (Belgium). METHODS Methods: In this retrospective observational study conducted in Liège University Hospital, we compared the out-patient follow-up of HIV-infected individuals as well as the number of new HIV diagnoses between 2019 and 2020 and between the different waves of the COVID-19 pandemic in 2020. RESULTS Results: In 2020, when compared to 2019, we observed a significant decrease in the number of new HIV diagnoses, especially during the first wave of the pandemic, and in the number of consultations undertaken by sexual health services, psychologists and specialists in infectious diseases at our HIV clinic. We also observed a decrease in the number of viral load assays and blood CD4 + T-cells count analyses performed, although we found less patients with HIV plasma viral load above 400 copies per mL in 2020. Finally, we noted a significant reduction in terms of screening of our HIV-infected patients for hepatitis C, syphilis, colorectal and anal cancers and hypercholesterolemia. CONCLUSIONS Conclusions: Our experience exhibits the deleterious impact of the COVID-19 pandemic on the HIV care and the need to implement new strategies to guarantee its continuum.
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Affiliation(s)
- Majdouline El Moussaoui
- Department of Infectious Diseases and General Internal Medicine, Liège University Hospital, Liège, Belgium
| | - Nicolas Lambert
- Department of Neurology, Liège University Hospital, Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, Liège University Hospital, Liège, Belgium
| | - Karine Fombellida
- Department of Infectious Diseases and General Internal Medicine, Liège University Hospital, Liège, Belgium
| | - Dolores Vaira
- AIDS Reference Laboratory, Liège University, Liège, Belgium
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, Liège University Hospital, Liège, Belgium
- AIDS Reference Laboratory, Liège University, Liège, Belgium
| | - Gilles Darcis
- Department of Infectious Diseases and General Internal Medicine, Liège University Hospital, Liège, Belgium
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Charavet C, Van Hede D, Maes N, Albert A, Lambert F. Disentangling the effects of CAD/CAM customized appliances and piezocision in orthodontic treatment: New evidence. Angle Orthod 2021; 91:764-771. [PMID: 33961005 DOI: 10.2319/112620-962.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To discern the effects of computer-aided design (CAD)/computer-aided manufactured (CAM) customized appliances and piezocision on orthodontic treatment (OT). MATERIALS AND METHODS The study combined findings from two previously published randomized controlled trials: (1) standard OT vs piezocision-assisted standard OT, and (2) CAD/CAM OT vs piezocision-assisted CAD/CAM OT. Piezocision is a minimally invasive corticotomy surgical procedure used to accelerate orthodontic treatment and CAD/CAM refers to CAD/CAM customized brackets and archwires. The outcomes were the overall treatment time, and the durations of the alignment phase and fine-tuning phase. Clinical and radiological features also were evaluated. RESULTS The combined study included 48 patients with similar baseline characteristics. Compared to the standard treatment, CAD/CAM technology alone significantly decreased the overall median OT time from 543 to 394 days (P < .001) and from 543 to 254 days (P < .0001) when combined with piezocision. Although piezocision significantly reduced the duration of the alignment phase in the mandible and maxilla, CAD/CAM technology considerably shortened the fine-tuning phase. All periodontal and radiographic parameters remained stable from the start to the end of treatment in all groups. CONCLUSIONS CAD/CAM technology combined with piezocision accelerates the entire OT process, during the alignment phase for piezocision and during the fine-tuning phase for CAD/CAM, with a global reduction of the overall treatment time of more than 50%.
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19
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Ngongo NM, Nani-Tuma HS, Mambimbi MM, Mashi ML, Izizag BB, Maes N, Moutschen M, Darcis G. Progressive phasing out of baseline CD4+ cell count testing for people living with HIV in Kinshasa, Democratic Republic of the Congo. AIDS 2021; 35:841-843. [PMID: 33369905 DOI: 10.1097/qad.0000000000002802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Nadine Mayasi Ngongo
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo (DRC)
| | - Hippolyte Situakibanza Nani-Tuma
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo (DRC)
| | - Marcel Mbula Mambimbi
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo (DRC)
| | - Murielle Longokolo Mashi
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo (DRC)
| | - Ben Bepouka Izizag
- Department of Internal Medicine, Infectious and Tropical Diseases, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo (DRC)
| | - Nathalie Maes
- Biostatistics and Medico-economic Information Department, University Hospital of Liege
| | - Michel Moutschen
- Department of Internal Medicine and Infectious Diseases, Liège University Hospital
- AIDS reference laboratory, University of Liège, Liège, Belgium
| | - Gilles Darcis
- Department of Internal Medicine and Infectious Diseases, Liège University Hospital
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20
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Jackers N, Maes N, Lambert F, Albert A, Charavet C. Standard vs computer-aided design/computer-aided manufacturing customized self-ligating systems using indirect bonding with both. Angle Orthod 2021; 91:74-80. [PMID: 33289798 DOI: 10.2319/012920-59.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 05/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare treatment duration and quality between standard vs computer-aided design/computer-aided manufacturing (CAD/CAM) customized self-ligating systems using indirect bonding with both. MATERIALS AND METHODS This comparative trial included 24 patients: 12 treated with a CAD/CAM custom indirect bonding self-ligating system (CAD/CAM) and 12 others treated with an indirect bonding self-ligating standard system (I-STD). For each group, overall orthodontic treatment (OT) time was calculated and included the time needed to place each arch as well as the duration of the alignment and fine-tuning phases. The quality of the final result was analyzed using the American Board of Orthodontics Cast-Radiograph Evaluation. Patient-reported outcome measures (PROMs) were also evaluated. RESULTS Patient characteristics were similar between the 2 groups except for age, which was slightly lower in the I-SDT group. Overall OT time was increased by 26% in the I-STD group compared with the CAD/CAM group (497 ± 40 days vs 393 ± 55 days, P = 0.0002) due to a shorter fine-tuning phase in the latter group (P<0.01). No difference was found between the groups for alignment phase. Quality of the final result was similar (I-STD, 25.7 ± 6.1; CAD/CAM, 21.6 ± 6.3) among the groups. Finally, no difference was found in the PROMs variables. CONCLUSIONS Despite a 26% longer OT time when compared with the CAD/CAM customized bracket system, the indirect bonding self-ligating bracket system demonstrated the same quality of treatment. PROMs demonstrated a high level of acceptance and satisfaction for both techniques.
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21
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Gauthey A, Morra S, van de Borne P, Deriaz D, Maes N, le Polain de Waroux JB. Sympathetic Effect of Auricular Transcutaneous Vagus Nerve Stimulation on Healthy Subjects: A Crossover Controlled Clinical Trial Comparing Vagally Mediated and Active Control Stimulation Using Microneurography. Front Physiol 2020; 11:599896. [PMID: 33343394 PMCID: PMC7744823 DOI: 10.3389/fphys.2020.599896] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/16/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction: Auricular low-level transcutaneous vagus nerve stimulation (aLL-tVNS) has emerged as a promising technology for cardiac arrhythmia management but is still experimental. In this physiological study, we hypothesized that aLL-tVNS modulated the autonomic nervous balance through a reduction of sympathetic tone and an increase in heart rate variability (HRV). We investigated the muscle sympathetic nerve activity (MSNA) recorded by microneurography during vagally mediated aLL-tVNS and active control on healthy volunteers. Methods: In this crossover, double-blind controlled study, healthy men (N = 28; 27 ± 4 years old) were assigned to aLL-tVNS applied to cymba and lobe (active control) of the right ear. Each participant was randomly allocated to the three sequences (5 Hz, 20 Hz, and active control-5 Hz) during one session. MSNA signal was recorded at rest, during voluntarily apnea and aLL-tVNS. Sympathetic activity was expressed as: 1) number of bursts per minute (burst frequency, BF) and 2) MSNA activity calculated as BF x mean burst amplitude and expressed as changes from baseline (%). RR intervals, HRV parameters and sympathetic activity were analyzed during 5 min-baseline, 10 min-stimulation, and 10 min-recovery periods. Mixed regression models were performed to evaluate cymba-(5—20 Hz) effects on the parameters with stimulation. Results: During apnea and compared to baseline, BF and MSNA activity increased (p = 0.002, p = 0.001, respectively). No stimulation effect on RR intervals and HRV parameters were showed excepted a slightly increase of the LF/HF ratio with stimulation in the cymba-5Hz sequence (coef. ± SE: 0.76 ± 0.32%; p = 0.02). During stimulation, reductions from baseline in BF (Coef. ± SE: −4.8 ± 1.1, p < 0.001) was observed but was not statistically different from that one in the active control. Reduction of MSNA activity was not significantly different between sequences. Conclusion: Acute right cymba aLL-tVNS did not induce any overall effects neither on heart rate, HRV nor MSNA variables on healthy subjects when compared to active control. Interestingly, these findings questioned the role of active controls in medical device clinical trials that implied subjective endpoints.
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Affiliation(s)
- Anaïs Gauthey
- Department of Cardiology, Saint-Luc Hospital, Université catholique de Louvain, Brussels, Belgium
| | - Sofia Morra
- Department of Cardiology, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Philippe van de Borne
- Department of Cardiology, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium
| | - Denis Deriaz
- Department of Biomedical and Preclinical Sciences, Université de Liège, Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistic and Medico-Economic Information, CHU Hospital of Liège, Liège, Belgium
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Deriaz D, Maes N, Kolh P, Krzesinski JM. Sodium and Potassium Intake: A New Statistical Model to Test Their Effects on Health Outcomes. Kidney Int Rep 2020; 5:2403. [PMID: 33305141 PMCID: PMC7710821 DOI: 10.1016/j.ekir.2020.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/15/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Denis Deriaz
- Biostatistics and Medico-economic Information Department, CHU of Liege, Liege, Belgium
| | - Nathalie Maes
- Biostatistics and Medico-economic Information Department, CHU of Liege, Liege, Belgium
| | - Philippe Kolh
- Department of Biomedical and Preclinical Sciences, University of Liege, Liege, Belgium.,Department of Information System Management, CHU of Liege, Liege, Belgium
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23
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Deleuse M, Meiffren C, Bruwier A, Maes N, Le Gall M, Charavet C. Smartphone application-assisted oral hygiene of orthodontic patients: a multicentre randomized controlled trial in adolescents. Eur J Orthod 2020; 42:605-611. [PMID: 32006440 DOI: 10.1093/ejo/cjz105] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
OBJECTIVE The aim of this trial was to test whether the use of a smartphone application (app) connected to a toothbrush improves the oral hygiene compliance of adolescent orthodontic patients. DESIGN The study was designed as a multicentre, randomized, controlled clinical trial. SETTING Two academic hospitals. ETHICAL APPROVAL The study was approved by the ethics committee. SUBJECTS AND METHODS This multicentre randomized controlled trial was conducted on 38 adolescents aged 12-18 years with full-fixed orthodontic appliances. Participants were randomly assigned either to a test group that used an interactive oscillating/rotating electric toothbrush connected to a brushing aid app or to a control group that used an oscillating/rotating electric toothbrush alone. At baseline, all patients received verbal and written oral hygiene instructions. OUTCOME MEASUREMENTS Data collection was performed at T1 (baseline), T2 (6 weeks), T3 (12 weeks) and T4 (18 weeks-end of the study). At each time point, the plaque index (PI), gingival index (GI) and white spot lesion (WSL) score were recorded. Several app-related parameters were evaluated. Patient-related outcome measures were investigated in the test group. RESULTS Test and control groups were similar at baseline except for WSL score. Between T1 and T4, PI and GI decreased significantly in both groups but evolutions were globally similar in both groups. Interestingly, at T3 (12 weeks), the PI was significantly lower in the app group than in the control group (P = 0.014). Data showed a marked decline in the use of the app over time in the test group. CONCLUSIONS This trial, conducted over 18 weeks in two academic hospitals, showed no significant effect of the use of the app in promoting oral hygiene. TRIAL REGISTRATION Not registered.
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Affiliation(s)
- Marine Deleuse
- Department of Orthodontics and Dento-Facial Orthopedics, University Hospital of Liège, Belgium
| | - Catherine Meiffren
- Department of Orthodontics and Dento-Facial Orthopedics, Faculty of Odontology of Aix Marseille, France
| | - Annick Bruwier
- Department of Orthodontics and Dento-Facial Orthopedics, University Hospital of Liège, Belgium
| | - Nathalie Maes
- Biostatistics and Medico-Economic Information Department, University Hospital of Liège, Belgium
| | - Michel Le Gall
- Department of Orthodontics and Dento-Facial Orthopedics, Faculty of Odontology of Aix Marseille, France
| | - Carole Charavet
- Department of Orthodontics and Dento-Facial Orthopedics, University Hospital of Liège, Belgium
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Sauvant C, Bodet C, Moriclet T, Manto F, Bartsch V, Pirnay L, Kellens I, Maes N, Thys M, Kaux JF. [Role of physical and rehabilitation medicine in the aftermath of SARS-CoV-2 disease]. Rev Med Liege 2020; 75:153-158. [PMID: 33211439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
2020 will be remembered as the year of SARS-CoV-2 pandemic which confined most of the world's population at home. Rehabilitation units will have to face specific challenges to protect the vulnerable in-patients. Moreover, they must prepare for post-COVID-19 patients who might suffer from illness consequences or present a post intensive care syndrome secondary to the increased ICU length of stay. The purpose of this paper is to highlight the deficiencies of post-COVID-19 patients and suggest a decision algorithm to best match their needs.
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Affiliation(s)
- C Sauvant
- Service de Médecine physique, Réadaptation fonctionnelle et Traumatologie du sport, CHU Liège, Belgique
| | - C Bodet
- Service de Médecine physique, Réadaptation fonctionnelle et Traumatologie du sport, CHU Liège, Belgique
| | - T Moriclet
- Service de Médecine physique, Réadaptation fonctionnelle et Traumatologie du sport, CHU Liège, Belgique
| | - F Manto
- Service de Médecine physique, Réadaptation fonctionnelle et Traumatologie du sport, CHU Liège, Belgique
| | - V Bartsch
- Service de Médecine physique, Réadaptation fonctionnelle et Traumatologie du sport, CHU Liège, Belgique
| | - L Pirnay
- Service de Médecine physique, Réadaptation fonctionnelle et Traumatologie du sport, CHU Liège, Belgique
| | - I Kellens
- Service de Médecine physique, Réadaptation fonctionnelle et Traumatologie du sport, CHU Liège, Belgique
| | - N Maes
- Département de Biostatistiques et d'Informations médico-économiques, CHU Liège, Belgique
| | - M Thys
- Département de Biostatistiques et d'Informations médico-économiques, CHU Liège, Belgique
| | - J F Kaux
- Service de Médecine physique, Réadaptation fonctionnelle et Traumatologie du sport, CHU Liège, Belgique
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El Moussaoui M, Lambert I, Maes N, Sauvage AS, Frippiat F, Meuris C, Uurlings F, Lecomte M, Léonard P, Fombellida K, Vaira D, Vercheval C, Moutschen M, Darcis G. Evolution of Drug Interactions With Antiretroviral Medication in People With HIV. Open Forum Infect Dis 2020; 7:ofaa416. [PMID: 33204748 PMCID: PMC7651038 DOI: 10.1093/ofid/ofaa416] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/08/2020] [Indexed: 01/02/2023] Open
Abstract
Background Polypharmacy and drug interactions are important issues for HIV-infected individuals. The number and nature of those interactions are continuously evolving with the use of new antiretroviral drugs and the aging of HIV-infected individuals. We aimed to analyze this evolution over time. Methods This retrospective cohort study was conducted in the University Hospital of Liège (Belgium). Treatments of HIV-infected outpatients attending Liège University Hospital were collected and analyzed in 2012 and 2016. The University of Liverpool HIV drug interactions database was used to determine drug interactions. Results We included 1038 patients in 2016, of whom 78% had 1 comedication. Polypharmacy was seen in 20% of the cohort. Four percent of the patients presented red flag interactions, and 38% had orange flag interactions. Nonantiretroviral (non-ARV) therapeutic classes involved in drug interactions were mostly cardiovascular and central nervous system drugs. They were followed by hormone drugs and dietary supplements for orange flag interactions. Two factors significantly contributed to both red and orange flag interactions: the number of non-ARV comedications and protease inhibitor–based ARV regimens. The proportion of patients with red or orange flag interactions remained stable from 2012 to 2016. Conclusions This study highlights the persistence of an alarming number of contraindicated drug interactions and a high prevalence of potential drug interactions over time. Identification, prevention, and management of drug interactions remain a key priority in HIV care.
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Affiliation(s)
| | - Iseult Lambert
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics, Liège University Hospital, Liège, Belgium.,Department of Medico-Economic Information, Liège University Hospital, Liège, Belgium
| | | | - Frédéric Frippiat
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Christelle Meuris
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Françoise Uurlings
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Marianne Lecomte
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Philippe Léonard
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Karine Fombellida
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
| | - Dolores Vaira
- AIDS Reference Laboratory, Liège University, Liège, Belgium
| | | | - Michel Moutschen
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium.,AIDS Reference Laboratory, Liège University, Liège, Belgium
| | - Gilles Darcis
- Infectious Diseases Department, Liège University Hospital, Liège, Belgium
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Hermans MP, Lempereur P, Salembier JP, Maes N, Albert A, Jansen O, Pincemail J. Supplementation Effect of a Combination of Olive ( Olea europea L.) Leaf and Fruit Extracts in the Clinical Management of Hypertension and Metabolic Syndrome. Antioxidants (Basel) 2020; 9:antiox9090872. [PMID: 32942738 PMCID: PMC7554871 DOI: 10.3390/antiox9090872] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The role of herbal products in the prevention of cardiovascular disease requires supporting evidence. This open pilot study assessed the effect of 2-month supplementation of a combination of olive leaf and fruit extracts (Tensiofytol®, Tilman SA, Baillonville, Belgium) in the clinical management of hypertension and metabolic syndrome (MetS). METHODS A total of 663 (pre)-hypertensive patients were enrolled by general practitioners and supplemented for two months with Tensiofytol®, two capsules per day (100 mg/d of oleuropein and 20 mg/d of hydroxytyrosol). Systolic and diastolic blood pressures (SBP/DBP) were measured before and after treatment. Markers of MetS, high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), fasting blood glucose (FG) and waist circumference (WC), were also examined. RESULTS Significant reductions (p < 0.0001) in SBP/DBP (13 ± 10/7.1 ± 6.6 mmHg) were observed and similarly in pre-diabetic and diabetic patients. Improvements in SBP/DPB were independent of age and gender but greater for elevated baseline SBP/DBP. Tensiofytol® supplementation also significantly improved markers of MetS, with a decrease of TG (11%), WC (1.4%) and FG (4.8%) and an increase of HDL-C (5.3%). Minor side effects were reported in 3.2% patients. CONCLUSIONS This real-life, observational, non-controlled, non-randomized pilot study shows that supplementation of a combination of olive leaf and fruit extracts may be used efficiently and safely in reducing hypertension and MetS markers.
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Affiliation(s)
- Michel P. Hermans
- Service d’Endocrinologie et de Nutrition and Pôle Endocrinologie, Diabète et Nutrition (EDIN), Institut de Recherche expérimentale et clinique, UCLouvain, 1200 Brussels, Belgium;
| | - Philippe Lempereur
- Service de Cardiologie, Centre Hospitalier Bois de l’Abbaye, 4100 Seraing, Belgium;
| | - Jean-Paul Salembier
- Service de Cardiologie, CHU UCL Namur - site Sainte-Elisabeth, 5000 Namur, Belgium;
| | - Nathalie Maes
- Biostatistics and Medico-economic Information Department, University Hospital of Liège, 4000 Liège, Belgium; (N.M.); (A.A.)
| | - Adelin Albert
- Biostatistics and Medico-economic Information Department, University Hospital of Liège, 4000 Liège, Belgium; (N.M.); (A.A.)
| | - Olivia Jansen
- Laboratoire de Pharmacognosie, Centre Interdisciplinaire de Recherche sur le Médicament (CIRM), Université de Liège, 4000 Liège, Belgium;
| | - Joël Pincemail
- Department of Cardiovascular Surgery, CREDEC and Platform Nutrition Antioxydante et Santé, CHU and University of Liège, Sart Tilman, 4000 Liège, Belgium
- Correspondence:
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Vercheval C, Sadzot B, Maes N, Denooz R, Damas P, Frippiat F. Continuous infusion of cefepime and neurotoxicity: a retrospective cohort study. Clin Microbiol Infect 2020; 27:S1198-743X(20)30386-4. [PMID: 32653661 DOI: 10.1016/j.cmi.2020.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Neurotoxicity related to cefepime is increasingly reported in the literature but specific data concerning continuous infusion (CI) of the drug are still lacking. Our primary objective was to evaluate the incidence of neurotoxicity related to CI of cefepime and the associated risk factors. Our secondary objectives were to analyse the plasma cefepime concentrations and to define the threshold above which neurotoxicity occurs. METHODS In this single-centre retrospective cohort study, all adult patients who underwent at least one cefepime therapeutic drug monitoring (TDM) and were treated with CI of 4 g/day between January 2017 and June 2019 were included. Neurotoxicity was evaluated according to a strict definition and was correlated with steady-state concentration at the time of toxicity presentation. RESULTS Ninety-eight patients with 201 cefepime TDM studies were included, with an incidence of neurotoxicity of 14.3% (14/98). Patients with neurotoxicity had more often underlying brain disease (35.7% (5/14) vs 11.9% (10/84), p = 0.030)) and higher steady-state concentrations (mean ± standard deviation 71.8 ± 32.9 mg/L vs 49.6 ± 30.6, p = 0.036) than the others. A receiver operating characteristic curve analysis yielded a cefepime steady-state concentration of 63.2 mg/L as the best cut-off point between patients with or without neurotoxicity. A mean steady-state concentration of 46.4 mg/L was achieved if the dosages of cefepime were adapted to renal function which was under our threshold concentration but above our highest pharmacokinetic/pharmacodynamic target of 32-40 mg/L. CONCLUSIONS Our results suggest that 4 g/day of cefepime adapted to renal function and infused over 24 h is a trade-off for the risk/benefit ratio, when used empirically.
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Affiliation(s)
- C Vercheval
- Department of Clinical Pharmacy, University Hospital of Liège, Liège, Belgium; Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium.
| | - B Sadzot
- Department of Neurology, University Hospital of Liège, Liège, Belgium
| | - N Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Liège, Belgium
| | - R Denooz
- Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium; Laboratory of Clinical, Forensic, Industrial and Environmental Toxicology, University Hospital of Liege, Belgium
| | - P Damas
- Department of Intensive Care Unit, University Hospital of Liège, Liège, Belgium
| | - F Frippiat
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Liège, Belgium
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Leduc G, Bawin M, Kesteman M, Mutijima E, Maes N, Coimbra C, Delvenne P, Somja J. [Influence of clinical and pathological factors on lymph node harvesting in surgical specimens of colorectal cancer]. Rev Med Liege 2019; 74:535-542. [PMID: 31609557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In colorectal cancer staging, pathologic lymph node analysis is a crucial information for the clinician and must be performed with a maximal level of accuracy. Therefore, the surgical sample analysis needs harvesting of as many lymph nodes as possible from the mesentery. In this study, we analysed the influence of a series of clinical and pathological factors which could influence lymph node harvesting. A total of 239 patients were included in our study. The factors with a statistically significant influence on lymph node collection (pinferior to0.05) were the age, gender of the patient, size of the primitive neoplasm, size of the surgical specimen, expertise of the surgeon and the pathology department. The presence of a radiochimiotherapy did not have any influence on the lymph node collection. This study highlights the importance of lymph node harvesting in colorectal surgical specimens of colo-rectal cancers.
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Affiliation(s)
- G Leduc
- Service de Médecine générale, Liège Université, Belgique
| | - M Bawin
- Service de Chirurgie orthopédique, CHC Liège, Belgique
| | - M Kesteman
- Service d'Anatomie pathologique, CHU Liège, Belgique
| | - E Mutijima
- Service d'Anatomie pathologique, CHU Liège, Belgique
| | - N Maes
- Service des informations médico-économiques, secteur «Appui à la Recherche Clinique et Biostatistique», CHU Liège, Belgique
| | - C Coimbra
- Service de Chirurgie abdominale, CHU Liège, Belgique
| | - P Delvenne
- Service d'Anatomie pathologique, CHU Liège, Belgique
| | - J Somja
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Charavet C, Van Hede D, Anania S, Maes N, Lambert F. Multilevel biological responses following piezocision to accelerate orthodontic tooth movement: A study in rats. J World Fed Orthod 2019. [DOI: 10.1016/j.ejwf.2019.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Charavet C, Lecloux G, Jackers N, Maes N, Lambert F. Patient-reported outcomes measures (PROMs) following a piezocision-assisted versus conventional orthodontic treatments: a randomized controlled trial in adults. Clin Oral Investig 2019; 23:4355-4363. [DOI: 10.1007/s00784-019-02887-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 03/27/2019] [Indexed: 12/16/2022]
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Giffroy X, Dive D, Kaux JF, Maes N, Albert A, Göbels C, Wang F. Is the triple stimulation technique a better quantification tool of motor dysfunction than motor evoked potentials in multiple sclerosis? Acta Neurol Belg 2019; 119:47-54. [PMID: 30136146 DOI: 10.1007/s13760-018-1001-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/13/2018] [Indexed: 01/07/2023]
Abstract
The triple stimulation technique (TST) was rarely used in multiple sclerosis (MS). This study aimed to compare TST and motor evoked potentials (MEP) for the quantification of motor dysfunction. Central motor conduction based on MEP (four limbs) and TST (upper limbs) was assessed in 28 MS patients with a median Expanded Disability Status Scale (EDSS) of 4. EDSS, timed 25-foot walk (T25FW), grasping strength and motor components of the MS functional composite were evaluated. Regression analysis was used to assess the relationship between MEP, TST and clinical findings. TST was negatively correlated with EDSS (r = - 0.74, p < 0.0001) and to a lesser extent with T25FW (r = - 0.47, p < 0.05), and grasping strength (r = - 0.43, p < 0.05). A multiple regression analysis underlined the better correlation between clinical data and TST (R2 = 0.56, p < 0.0005) than with MEP (0.03 < R2 < 0.22, p > 0.05). This study evidenced the value of TST as a quantification tool of motor dysfunction. TST appeared to reflect a global disability since it was correlated not only to hand function but also to walking capacity.
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Pirotte B, Frippiat F, Darcis G, Rassenfosse M, Fombellida K, Maes N, Moerman F, Moutschen M. [Emergency department utilization by HIV-positive adults in a Belgian setting]. Rev Med Liege 2019; 74:28-35. [PMID: 30680971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The use of the emergency department (ED) by human immunodeficiency virus (HIV)-infected adults undergoes an evolution following the introduction of antiretroviral therapy (ART). Improving our knowledge about ED use characteristics will contribute to a correct diagnosis and therapeutic approach in this patient group, at the moment they are discharged from the ED. We conducted a one-year retrospective study on characteristics of ED use involving 1026 patients living with HIV. The majority of them was treated with antiretroviral therapy (95 %) and had a viral load lower than 50 copies (73.6 %). Among them, 117 patients (11.8 %) were admitted at least once to the ED. The most common ED discharge diagnoses were related to trauma (30 %). This study shows that the great majority of diagnoses were not related to infectious diseases (6.3 %, of which half were HIV-related). One hypothesis to explain these results would be that HIV-positive adults in this study had excellent antiretroviral coverage and were well controlled in terms of HIV.
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Affiliation(s)
- B Pirotte
- Département des maladies infectieuses, Liège Université, CHU de Liège, Belgique
| | - F Frippiat
- Département des maladies infectieuses, Liège Université, CHU de Liège, Belgique
| | - G Darcis
- Département des maladies infectieuses, Liège Université, CHU de Liège, Belgique
| | | | - K Fombellida
- Département des maladies infectieuses, Liège Université, CHU de Liège, Belgique
| | - N Maes
- Département des maladies infectieuses, Liège Université, CHU de Liège, Belgique
| | - F Moerman
- Département de Biostatistique et d'Information Médico-Economique, CHU de Liège, Domaine Universitaire du Sart Tilman, Liège, Belgique
| | - M Moutschen
- Département des maladies infectieuses, Liège Université, CHU de Liège, Belgique
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Di Ciaula A, Portincasa P, Maes N, Albert A. Efficacy of bio-optimized extracts of turmeric and essential fennel oil on the quality of life in patients with irritable bowel syndrome. Ann Gastroenterol 2018; 31:685-691. [PMID: 30386118 PMCID: PMC6191874 DOI: 10.20524/aog.2018.0304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 07/16/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The use of herbal products to treat irritable bowel syndrome (IBS), a disease that frequently affects the quality of life (QoL), is still under evaluation. This open pilot study assessed the efficacy of bio-optimized extracts of turmeric and essential fennel oil (Enterofytol®) in IBS patients. METHODS A total of 211 patients (14% diarrhea-predominant, IBS-D; 24% constipation-predominant, IBS-C; 62% mixed, IBS-M) were enrolled by general practitioners and completed questionnaires measuring symptom severity and QoL before and after Enterofytol®, two capsules b.i.d. for one month, followed by two capsules q.d. for another month. RESULTS IBS severity index and QoL were inversely related. A significant reduction in the severity index and an improvement in QoL were evident following treatment in all IBS subgroups. IBS-D patients showed the worst clinical picture at entry, with the highest IBS severity index and the lowest QoL score, compared with IBS-C and IBS-M subtypes. IBS-D patients, however, also showed the most pronounced response to therapy, considering both scores. The improvement in the IBS severity index was independent of age and sex. CONCLUSIONS Results from this "real-life" study show that the combination of turmeric and essential fennel oil over two months improves both symptoms and QoL in IBS patients, irrespectively of age, sex, initial severity of symptoms and IBS-subtypes, suggesting a potential role for the natural treatment of IBS.
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Affiliation(s)
- Agostino Di Ciaula
- Division of Internal Medicine, Hospital of Bisceglie, ASL-BAT, Italy (Agostino Di Ciaula)
- Correspondence to: Prof. Piero Portincasa, MD, PhD, Clinica Medica “Augusto Murri”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School - Piazza Giulio Cesare 11, 70124 Bari, Italy; e-mail:
| | - Piero Portincasa
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Bari, Italy (Piero Portincasa)
- Correspondence to: Prof. Piero Portincasa, MD, PhD, Clinica Medica “Augusto Murri”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School - Piazza Giulio Cesare 11, 70124 Bari, Italy; e-mail:
| | - Nathalie Maes
- Biostatistics, University Hospital of Liège, Belgium (Nathalie Maes, Adelin Albert)
| | - Adelin Albert
- Biostatistics, University Hospital of Liège, Belgium (Nathalie Maes, Adelin Albert)
- Department of Public Health, University of Liège, Belgium (Adelin Albert)
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Durce D, Aertsens M, Jacques D, Maes N, Van Gompel M. Transport of dissolved organic matter in Boom Clay: Size effects. J Contam Hydrol 2018; 208:27-34. [PMID: 29224930 DOI: 10.1016/j.jconhyd.2017.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/23/2017] [Accepted: 12/02/2017] [Indexed: 06/07/2023]
Abstract
A coupled experimental-modelling approach was developed to evaluate the effects of molecular weight (MW) of dissolved organic matter (DOM) on its transport through intact Boom Clay (BC) samples. Natural DOM was sampled in-situ in the BC layer. Transport was investigated with percolation experiments on 1.5cm BC samples by measuring the outflow MW distribution (MWD) by size exclusion chromatography (SEC). A one-dimensional reactive transport model was developed to account for retardation, diffusion and entrapment (attachment and/or straining) of DOM. These parameters were determined along the MWD by implementing a discretisation of DOM into several MW points and modelling the breakthrough of each point. The pore throat diameter of BC was determined as 6.6-7.6nm. Below this critical size, transport of DOM is MW dependent and two major types of transport were identified. Below MW of 2kDa, DOM was neither strongly trapped nor strongly retarded. This fraction had an averaged capacity factor of 1.19±0.24 and an apparent dispersion coefficient ranging from 7.5×10-11 to 1.7× 10-11m2/s with increasing MW. DOM with MW>2kDa was affected by both retardation and straining that increased significantly with increasing MW while apparent dispersion coefficients decreased. Values ranging from 1.36 to 19.6 were determined for the capacity factor and 3.2×10-11 to 1.0×10-11m2/s for the apparent dispersion coefficient for species with 2.2kDa<MW<9.3kDa. Straining resulted in an immobilisation of in average 49±6% of the injected 9.3kDa species. Our findings show that an accurate description of DOM transport requires the consideration of the size effects.
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Affiliation(s)
- D Durce
- Belgian Nuclear Research Centre (SCK.CEN), Expert Group Waste&Disposal, Boeretang 2400, Mol, Belgium.
| | - M Aertsens
- Belgian Nuclear Research Centre (SCK.CEN), Expert Group Waste&Disposal, Boeretang 2400, Mol, Belgium
| | - D Jacques
- Belgian Nuclear Research Centre (SCK.CEN), Expert Group Waste&Disposal, Boeretang 2400, Mol, Belgium
| | - N Maes
- Belgian Nuclear Research Centre (SCK.CEN), Expert Group Waste&Disposal, Boeretang 2400, Mol, Belgium
| | - M Van Gompel
- Belgian Nuclear Research Centre (SCK.CEN), Expert Group Waste&Disposal, Boeretang 2400, Mol, Belgium
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Layios N, Delierneux C, Hego A, Huart J, Gosset C, Lecut C, Maes N, Geurts P, Joly A, Lancellotti P, Albert A, Damas P, Gothot A, Oury C. Sepsis prediction in critically ill patients by platelet activation markers on ICU admission: a prospective pilot study. Intensive Care Med Exp 2017; 5:32. [PMID: 28699088 PMCID: PMC5505890 DOI: 10.1186/s40635-017-0145-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 07/03/2017] [Indexed: 01/17/2023] Open
Abstract
Background Platelets have been involved in both immune surveillance and host defense against severe infection. To date, whether platelet phenotype or other hemostasis components could be associated with predisposition to sepsis in critical illness remains unknown. The aim of this work was to identify platelet markers that could predict sepsis occurrence in critically ill injured patients. Methods This single-center, prospective, observational, 7-month study was based on a cohort of 99 non-infected adult patients admitted to ICUs for elective cardiac surgery, trauma, acute brain injury, and post-operative prolonged ventilation and followed up during ICU stay. Clinical characteristics and severity score (SOFA) were recorded on admission. Platelet activation markers, including fibrinogen binding to platelets, platelet membrane P-selectin expression, plasma soluble CD40L, and platelet-leukocytes aggregates were assayed by flow cytometry at admission and 48 h later, and then at the time of sepsis diagnosis (Sepsis-3 criteria) and 7 days later for sepsis patients. Hospitalization data and outcomes were also recorded. Methods Of the 99 patients, 19 developed sepsis after a median time of 5 days. These patients had a higher SOFA score at admission; levels of fibrinogen binding to platelets (platelet-Fg) and of D-dimers were also significantly increased compared to the other patients. Levels 48 h after ICU admission no longer differed between the two patient groups. Platelet-Fg % was an independent predictor of sepsis (P = 0.0031). By ROC curve analysis, cutoff point for Platelet-Fg (AUC = 0.75) was 50%. In patients with a SOFA cutoff of 8, the risk of sepsis reached 87% when Platelet-Fg levels were above 50%. Patients with sepsis had longer ICU and hospital stays and higher death rate. Conclusions Platelet-bound fibrinogen levels assayed by flow cytometry within 24 h of ICU admission help identifying critically ill patients at risk of developing sepsis. Electronic supplementary material The online version of this article (doi:10.1186/s40635-017-0145-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nathalie Layios
- Department of General Intensive Care, University Hospital of Liège, Liège, Belgium.,Laboratory of Thrombosis and Hemostasis, GIGA-Cardiovascular Sciences, University of Liège, Department of Cardiology, University Hospital of Liège, Liège, Belgium
| | - Céline Delierneux
- Laboratory of Thrombosis and Hemostasis, GIGA-Cardiovascular Sciences, University of Liège, Department of Cardiology, University Hospital of Liège, Liège, Belgium
| | - Alexandre Hego
- Laboratory of Thrombosis and Hemostasis, GIGA-Cardiovascular Sciences, University of Liège, Department of Cardiology, University Hospital of Liège, Liège, Belgium
| | - Justine Huart
- Laboratory of Thrombosis and Hemostasis, GIGA-Cardiovascular Sciences, University of Liège, Department of Cardiology, University Hospital of Liège, Liège, Belgium
| | - Christian Gosset
- Laboratory of Hematology, University Hospital of Liège, Liège, Belgium
| | - Christelle Lecut
- Laboratory of Hematology, University Hospital of Liège, Liège, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Liège, Belgium
| | - Pierre Geurts
- Systems and Modeling, Department of Electrical Engineering and Computer Science, University of Liège, Liège, Belgium
| | - Arnaud Joly
- Systems and Modeling, Department of Electrical Engineering and Computer Science, University of Liège, Liège, Belgium
| | - Patrizio Lancellotti
- Laboratory of Thrombosis and Hemostasis, GIGA-Cardiovascular Sciences, University of Liège, Department of Cardiology, University Hospital of Liège, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Adelin Albert
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Liège, Belgium
| | - Pierre Damas
- Department of General Intensive Care, University Hospital of Liège, Liège, Belgium
| | - André Gothot
- Laboratory of Hematology, University Hospital of Liège, Liège, Belgium
| | - Cécile Oury
- Laboratory of Thrombosis and Hemostasis, GIGA-Cardiovascular Sciences, University of Liège, Department of Cardiology, University Hospital of Liège, Liège, Belgium.
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Bruwier A, Poirrier R, Albert A, Maes N, Limme M, Charavet C, Milicevic M, Raskin S, Poirrier AL. Three-dimensional analysis of craniofacial bones and soft tissues in obstructive sleep apnea using cone beam computed tomography. Int Orthod 2016; 14:449-461. [PMID: 27836768 DOI: 10.1016/j.ortho.2016.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A total of 154 adult patients with sleep complaints underwent a polysomnography and a craniofacial cone beam computed tomography (CBCT). OSA was defined as an apnea and hypopnea index (AHI) or an oxygen desaturation index (ODI) ≥ 10. Soft tissues and craniofacial bones volumes were prospectively measured by CBCT and collected blindly from sleep polysomnography. Among the study patients, 127 (83%) suffered from OSA and 27 (17%) did not. OSA patients demonstrated a narrower maxillo-palatine core volume (11.7±3.2 vs 14.6±4.9cm3) even when adjusting for age, gender, height, neck circumference and body mass index. These upper airway measures provide a comprehensive analysis of bony structures and soft tissues, which can be involved in OSA.
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Affiliation(s)
- Annick Bruwier
- Department of Orthodontics, Liege University Hospital, Liege, Belgium.
| | - Robert Poirrier
- Sleep Disorder Center, Department of Neurology, Liege University Hospital, Liege, Belgium
| | - Adelin Albert
- Biostatistics, Liege University Hospital, Liege, Belgium
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, Liege University Hospital, Liege, Belgium
| | - Michel Limme
- Department of Orthodontics, Liege University Hospital, Liege, Belgium
| | - Carole Charavet
- Department of Orthodontics, Liege University Hospital, Liege, Belgium
| | - Mladen Milicevic
- Department of Medical Imaging, Liege University Hospital, Liege, Belgium
| | - Sylvianne Raskin
- Department of Orthodontics, Liege University Hospital, Liege, Belgium
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Bruwier A, Poirrier R, Albert A, Maes N, Limme M, Charavet C, Milicevic M, Raskin S, Poirrier AL. Analyse tridimensionnelle des os craniofaciaux et des tissus mous dans l’apnée obstructive du sommeil utilisant la tomographie volumétrique à faisceau conique. Int Orthod 2016; 14:449-461. [PMID: 27836770 DOI: 10.1016/j.ortho.2016.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Annick Bruwier
- Department of Orthodontics, Liege University Hospital, Liège, Belgique.
| | - Robert Poirrier
- Sleep Disorder Center, Department of Neurology, Liege University Hospital, Liège, Belgique
| | - Adelin Albert
- Biostatistics, Liege University Hospital, Liège, Belgique
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, Liege University Hospital, Liège, Belgique
| | - Michel Limme
- Department of Orthodontics, Liege University Hospital, Liège, Belgique
| | - Carole Charavet
- Department of Orthodontics, Liege University Hospital, Liège, Belgique
| | - Mladen Milicevic
- Department of Medical Imaging, Liege University Hospital, Liège, Belgique
| | - Sylvianne Raskin
- Department of Orthodontics, Liege University Hospital, Liège, Belgique
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Vercheval C, Gillet M, Maes N, Albert A, Frippiat F, Damas P, Van Hees T. Quality of documentation on antibiotic therapy in medical records: evaluation of combined interventions in a teaching hospital by repeated point prevalence survey. Eur J Clin Microbiol Infect Dis 2016; 35:1495-500. [PMID: 27255220 DOI: 10.1007/s10096-016-2690-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/20/2016] [Indexed: 11/29/2022]
Abstract
This study aimed to improve the quality of documentation on antibiotic therapy in the computerized medical records of inpatients. A prospective, uncontrolled, interrupted time series (ITS) study was conducted by repeated point prevalence survey (PPS) to audit the quality of documentation on antibiotic therapy in the medical records before and after a combined intervention strategy (implementation of guidelines, distribution of educational materials, educational outreach visits, group educational interactive sessions) from the antimicrobial stewardship team (AST) in the academic teaching hospital (CHU) of Liège, Belgium. The primary outcome measure was the documentation rate on three quality indicators in the computerized medical records: (1) indication for treatment, (2) antibiotics prescribed, and (3) duration or review date. Segmented regression analysis was used to analyze the ITS. The medical records of 2306 patients receiving antibiotics for an infection (1177 in the pre-intervention period and 1129 in the post-intervention period) were analyzed. A significant increase in mean percentages in the post-intervention period was observed as compared with the pre-intervention period for the three quality indicators (indication documented 83.4 ± 10.4 % vs. 90.3 ± 6.6 %, p = 0.0013; antibiotics documented 87.9 ± 9.0 % vs. 95.6 ± 5.1 %, p < 0.0001; and duration or review date documented 31.9 ± 15.4 % vs. 67.7 ± 15.2 %, p < 0.0001). The study demonstrated the successful implementation of a combined intervention strategy from the AST. This strategy was associated with significant changes in the documentation rate in the computerized medical records for the three quality indicators.
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Affiliation(s)
- C Vercheval
- Department of Clinical Pharmacy, CIRM (Center for Interdisciplinary Research on Medicines), University Hospital of Liège, Liège, Belgium. .,Service de Pharmacie Clinique, CHU de Liège, Avenue de l'hôpital, 1 - B35, Sart Tilman, 4000, Liège, Belgium.
| | - M Gillet
- Department of Clinical Pharmacy, CIRM (Center for Interdisciplinary Research on Medicines), University Hospital of Liège, Liège, Belgium
| | - N Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Liège, Belgium
| | - A Albert
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, Liège, Belgium
| | - F Frippiat
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Liège, Belgium
| | - P Damas
- Department of Intensive Care Unit, University Hospital of Liège, Liège, Belgium
| | - T Van Hees
- Department of Clinical Pharmacy, CIRM (Center for Interdisciplinary Research on Medicines), University Hospital of Liège, Liège, Belgium
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Giffroy X, Maes N, Albert A, Maquet P, Crielaard JM, Dive D. Multimodal evoked potentials for functional quantification and prognosis in multiple sclerosis. BMC Neurol 2016; 16:83. [PMID: 27245221 PMCID: PMC4888661 DOI: 10.1186/s12883-016-0608-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 05/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Functional biomarkers able to identify multiple sclerosis (MS) patients at high risk of fast disability progression are lacking. The aim of this study was to evaluate the ability of multimodal (upper and lower limbs motor, visual, lower limbs somatosensory) evoked potentials (EP) to monitor disease course and identify patients exposed to unfavourable evolution. METHODS One hundred MS patients were assessed with visual, somatosensory and motor EP and rated on the Expanded Disability Status Scale (EDSS) at baseline (T0) and about 6 years later (T1). The Spearman correlation (rS) was used to evaluate the relationship between conventional EP scores and clinical findings. Multiple (logistic) regression analysis estimated the predictive value of baseline electrophysiological data for three clinical outcomes: EDSS, annual EDSS progression, and the risk of EDSS worsening. RESULTS In contrast to longitudinal correlations, cross-sectional correlations between the different EP scores and EDSS were all significant (0.33 ≤ rS < 0.67, p < 0.001). Baseline global EP score and EDSS were highly significant predictors (p < 0.0001) of EDSS progression 6 years later. The baseline global EP score was found to be an independent predictor of the EDSS annual progression rate (p < 0.001), and of the risk of disability progression over time (p < 0.005). Based on a ROC curve determination, we defined a Global EP Score cut off point (17/30) to identify patients at high risk of disability progression illustrated by a positive predictive value of 70%. CONCLUSION This study provides a proof of the concept that electrophysiology could be added to MRI and used as another complementary prognostic tool in MS patients.
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Affiliation(s)
- Xavier Giffroy
- Department of Neurology, University Hospital of Liege, Rue Grandfosse 31-33, 4130, Esneux, Belgium.
- Department of Physical Medicine and Rehabilitation, University Hospital of Liege, B35, 4000, Liege, Belgium.
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital (CHU, ULg) of Liege, B35, 4000, Liège, Belgium
| | - Adelin Albert
- Department of Biostatistics and Medico-Economic Information, University Hospital (CHU, ULg) of Liege, B35, 4000, Liège, Belgium
| | - Pierre Maquet
- Department of Neurology, University Hospital of Liege, Rue Grandfosse 31-33, 4130, Esneux, Belgium
| | - Jean-Michel Crielaard
- Department of Physical Medicine and Rehabilitation, University Hospital of Liege, B35, 4000, Liege, Belgium
| | - Dominique Dive
- Department of Neurology, University Hospital of Liege, Rue Grandfosse 31-33, 4130, Esneux, Belgium
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Charavet C, Lecloux G, Bruwier A, Rompen E, Maes N, Limme M, Lambert F. Localized Piezoelectric Alveolar Decortication for Orthodontic Treatment in Adults: A Randomized Controlled Trial. J Dent Res 2016; 95:1003-9. [PMID: 27129491 DOI: 10.1177/0022034516645066] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
This randomized controlled trial aimed to evaluate the benefits and clinical outcomes of piezocision, which is a minimally invasive approach to corticotomy that is used in orthodontic treatments. Twenty-four adult patients presenting with mild overcrowdings were randomly allocated to either a control group that was treated with conventional orthodontics or a test group that received piezo-assisted orthodontics. The piezocisions were performed 1 wk week after the placement of the orthodontic appliances. Neither grafting material nor sutures were used. All patients were followed every 2 wk, and archwires were changed only when they were no longer active. The periods required for the completion of the overall orthodontic treatments were calculated, and the periodontal parameters were evaluated at baseline and at the end of the orthodontic treatment. Patient-centered outcomes were assessed with a visual analog scale; analgesic use following the procedures was also recorded. The patient characteristics were similar between the 2 groups. The overall treatment time was significantly reduced by 43% in the piezocision group as compared with the control group. In both groups, periodontal parameters (i.e., recession depth, pocket depth, plaque index, and papilla bleeding index) remained unchanged between the baseline and treatment completion time points. No increase in root resorption was observed in either group. Scars were observed in 50% of the patients in the piezocision group. Analgesic consumption was similar following orthodontic appliance placement and piezocision surgery. Patient satisfaction was significantly better in the piezocision group than in the control group. In these conditions, the piezocision technique seemed to be effective in accelerating orthodontic tooth movement. No gingival recessions were observed. The risk of residual scars might limit the indications for piezocision in patients with a high smile line (ClinicalTrials.gov NCT02590835).
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Affiliation(s)
- C Charavet
- Department of Orthodontics and DentoFacial Orthopedics, University Hospital of Liège, Belgium Dental Biomaterials Research Unit, Faculty of Medicine, University of Liège, Belgium
| | - G Lecloux
- Dental Biomaterials Research Unit, Faculty of Medicine, University of Liège, Belgium Department of Periodontolgy and Oral Surgery, University Hospital of Liège, Belgium
| | - A Bruwier
- Department of Orthodontics and DentoFacial Orthopedics, University Hospital of Liège, Belgium
| | - E Rompen
- Dental Biomaterials Research Unit, Faculty of Medicine, University of Liège, Belgium Department of Periodontolgy and Oral Surgery, University Hospital of Liège, Belgium
| | - N Maes
- Biostatistics and Medico-economic Information Department, University Hospital of Liège, University of Liège, Belgium
| | - M Limme
- Department of Orthodontics and DentoFacial Orthopedics, University Hospital of Liège, Belgium
| | - F Lambert
- Dental Biomaterials Research Unit, Faculty of Medicine, University of Liège, Belgium Department of Periodontolgy and Oral Surgery, University Hospital of Liège, Belgium
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Durce D, Maes N, Bruggeman C, Van Ravestyn L. Alteration of the molecular-size-distribution of Boom Clay dissolved organic matter induced by Na(+) and Ca(2). J Contam Hydrol 2016; 185-186:14-27. [PMID: 26788872 DOI: 10.1016/j.jconhyd.2015.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 12/04/2015] [Accepted: 12/18/2015] [Indexed: 06/05/2023]
Abstract
In porous media, the extent of dissolved organic matter (DOM)-facilitated contaminant transport depends on the concentration, conformation and the size of the dissolved organic species. Yet, these parameters are highly sensitive to the ionic strength (IS) and the ionic composition of the solution. Boom Clay (BC) which is considered in Belgium as a potential host rock for nuclear waste disposal contains polydisperse DOM that might associate with radionuclide and increase their mobility. To get more insight into the effect of IS on DOM structure and into its impact on the solid/solution partitioning of OM in BC is essential for safety assessment. In a first set, we investigated the influence of NaCl and CaCl2 content on the concentration, the MW distribution and UV spectral parameters of DOM collected from BC. With an increase in IS two main mechanisms were identified: a compaction and/or dissociation of the DOM molecules and an aggregation. We showed that the sensitivity of the DOM species to these two mechanisms was size/MW dependent and that the presence of Ca(2+) promotes the aggregation. The largest species are more prone to aggregation which at the extreme leads to their transfer to particulate OM. On the contrary, small DOM species hardly aggregate but compact or dissociate with an increase of IS. These observations were confirmed in the second experimental set in which we followed the release of DOM from BC rock in various electrolytes. The increase of IS and multivalent cations content reduces the amount, the degree of aromaticity and the MW of DOM released from BC which limit the extent of DOM-facilitated contaminant transport in BC.
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Affiliation(s)
- D Durce
- Belgian Nuclear Research Centre (SCK.CEN), Expert Group Waste&Disposal, Boeretang, 2400 Mol, Belgium.
| | - N Maes
- Belgian Nuclear Research Centre (SCK.CEN), Expert Group Waste&Disposal, Boeretang, 2400 Mol, Belgium
| | - C Bruggeman
- Belgian Nuclear Research Centre (SCK.CEN), Expert Group Waste&Disposal, Boeretang, 2400 Mol, Belgium
| | - L Van Ravestyn
- Belgian Nuclear Research Centre (SCK.CEN), Expert Group Waste&Disposal, Boeretang, 2400 Mol, Belgium
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Glaus MA, Aertsens M, Maes N, Van Laer L, Van Loon LR. Treatment of boundary conditions in through-diffusion: A case study of (85)Sr(2+) diffusion in compacted illite. J Contam Hydrol 2015; 177-178:239-248. [PMID: 26004771 DOI: 10.1016/j.jconhyd.2015.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/20/2015] [Accepted: 03/28/2015] [Indexed: 06/04/2023]
Abstract
Valuable techniques to measure effective diffusion coefficients in porous media are an indispensable prerequisite for a proper understanding of the migration of chemical-toxic and radioactive micropollutants in the subsurface and geosphere. The present article discusses possible pitfalls and difficulties in the classical through-diffusion technique applied to situations where large diffusive fluxes of cations in compacted clay minerals or clay rocks occur. The results obtained from a benchmark study, in which the diffusion of (85)Sr(2+) tracer in compacted illite has been studied using different experimental techniques, are presented. It is shown that these techniques may yield valuable results provided that an appropriate model is used for numerical simulations. It is further shown that effective diffusion coefficients may be systematically underestimated when the concentration at the downstream boundary is not taken adequately into account in modelling, even for very low concentrations. A criterion is derived for quasi steady-state situations, by which it can be decided whether the simplifying assumption of a zero-concentration at the downstream boundary in through-diffusion is justified or not. The application of the criterion requires, however, knowledge of the effective diffusion coefficient of the clay sample. Such knowledge is often absent or only approximately available during the planning phase of a diffusion experiment.
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Affiliation(s)
- M A Glaus
- Laboratory for Waste Management, Paul Scherrer Institut, CH-5232 Villigen PSI, Switzerland.
| | - M Aertsens
- Belgian Nuclear Research Centre (SCK•CEN), Expert Group Waste & Disposal, 2400 Mol, Belgium
| | - N Maes
- Belgian Nuclear Research Centre (SCK•CEN), Expert Group Waste & Disposal, 2400 Mol, Belgium
| | - L Van Laer
- Belgian Nuclear Research Centre (SCK•CEN), Expert Group Waste & Disposal, 2400 Mol, Belgium
| | - L R Van Loon
- Laboratory for Waste Management, Paul Scherrer Institut, CH-5232 Villigen PSI, Switzerland
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Appelboom T, Maes N, Albert A. A new curcuma extract (flexofytol®) in osteoarthritis: results from a belgian real-life experience. Open Rheumatol J 2014; 8:77-81. [PMID: 25352926 PMCID: PMC4209497 DOI: 10.2174/1874312901408010077] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 08/04/2014] [Accepted: 09/05/2014] [Indexed: 11/22/2022] Open
Abstract
This retrospective observational study summarizes the experiences of 820 patients treated with a new Curcuma extract (Flexofytol®, 4-6 capsules per day), for more than 6 months for various forms of painful osteoarthritis. These experiences were reported by 110 Belgian general practitioners via a questionnaire that included quality-of-life parameters for assessing patient experience. Data were submitted to an independent statistician for analysis. Within the first 6 weeks, Flexofytol® improved patient pain, articular mobility, and quality of life. Excellent tolerance was reported, and more than half of these patients were able to discontinue analgaesic and anti-inflammatory drugs. Patient satisfaction was confirmed by their decision to maintain Flexofytol® therapy for more than 6 months. These data must be confirmed with randomized controlled studies. We currently conclude that Flexofytol® which is based on a new preparation of curcumin, is as a potential neutraceutical for the care of patients complaining of joint problems, with excellent tolerance and rapid benefits for articular mobility, pain, and quality of life.
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Maes N, Moors H, De Canniere P, Aertsens M, Put M. Determination of the Diffusion Coefficient of Ionic Species in Boom Clay by Electromigration: Feasibility Study. RADIOCHIM ACTA 2013. [DOI: 10.1524/ract.1998.82.special-issue.183] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- N. Maes
- Waste and Disposal - Migration Group, SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, B-2400 Mol, Belgium
| | - H. Moors
- Waste and Disposal - Migration Group, SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, B-2400 Mol, Belgium
| | - P. De Canniere
- Waste and Disposal - Migration Group, SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, B-2400 Mol, Belgium
| | - M. Aertsens
- Waste and Disposal - Migration Group, SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, B-2400 Mol, Belgium
| | - M. Put
- Waste and Disposal - Migration Group, SCK-CEN, Belgian Nuclear Research Centre, Boeretang 200, B-2400 Mol, Belgium
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Bruggeman C, Maes N. Uptake of uranium(VI) by pyrite under boom clay conditions: influence of dissolved organic carbon. Environ Sci Technol 2010; 44:4210-4216. [PMID: 20438072 DOI: 10.1021/es100919p] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The uptake of uranium(VI) by natural pyrite, FeS(2), was studied under conditions relevant for geological disposal of radioactive waste (anoxic atmosphere, approximately 0.014 mol.L(-1) NaHCO(3) electrolyte) with special emphasis on the role of dissolved organic matter. Solution analysis of batch experiments with different initial concentrations of uranium(VI) (10(-8)-10(-4) mol.L(-1)) was combined with X-ray absorption spectroscopy on the solid phase to elucidate the speciation of uranium in these systems and to gain insight into the major reaction mechanisms between uranium and pyrite. The results showed that, under the conditions of the experiments, uranium(VI) was at least partly reduced to a UO(2)(s)-like precipitate, although the predominant valence state of uranium in solution was likely uranium(VI). All observations indicate that the uranium solid-liquid distribution is governed by both reduction and adsorption processes. No significant amounts of uranium colloids (either intrinsic UO(2) colloids or complexes with natural organic matter) were found in any of the samples. The presence of dissolved organic matter did, however, increase the final uranium solution concentration and decrease the fraction of uranium(IV) found in the solid phase.
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Affiliation(s)
- C Bruggeman
- Waste & Disposal Expert Group, Unit R&D Disposal, Belgian Nuclear Research Centre (SCK*CEN), Boeretang, Mol, Belgium.
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Maes N, Moors H, Wang L, Delècaut G, De Cannière P, Put M. The use of electromigration as a qualitative technique to study the migration behaviour and speciation of uranium in the Boom Clay. RADIOCHIM ACTA 2009. [DOI: 10.1524/ract.2002.90.9-11_2002.741] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Summary
Under the geochemical conditions prevailing in situ in the Boom Clay Formation (pH, Eh, …), calculations predict that U(OH)4 is the dominant uranium species present in the interstitial water and the concentration is solubility limited. However the boundary of the domain where the non solubility limited UO2(CO3)3
4− species dominates is very close. It is therefore of prime interest to know the correct speciation of uranium during the migration process.
Electromigration was used as technique with the advantage that it can provide information on the speciation because the movement of the species towards the electrodes depends on its charge and speciation. Electromigration experiments have been performed with preconditioned 233UO2(CO3)3
4− sources, starting from the hypothesis that this species should migrate without retardation towards the anode. Despite relatively long electromigration times, sufficient to displace strong retarded tracers, no displacement of the migration profile towards the anode was observed. All 233U remained near the source position, but the electropherograms clearly showed the presence of species moving towards the cathode. This indicates the presence of neutral or positively charged uranium species. These electropherograms are interpreted as a change in uranium valence state: reduction of UO2(CO3)3
4− and precipitation of U(IV) oxy-hydroxides near the source position. The solubility limited species, U(OH)4(aq), are carried with the pore water towards the cathode. The electromigration experiments indicate, in support of the speciation calculations, that the dominant migrating U-species is probably the solubility limited U(OH)4.
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Delécaut G, Maes N, De Cannière P, Wang L. Effect of reducing agents on the uranium concentration above uranium(IV) amorphous precipitate in Boom Clay pore water. RADIOCHIM ACTA 2009. [DOI: 10.1524/ract.92.9.545.54969] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
SummaryThe solubility of U(IV) amorphous precipitates was measured in Boom Clay water in the presence of reducing agents and under thein situpartial pressure of CO2(g) at 10-2.4atm. Boom Clay pore water is of the sodium bicarbonate type (NaHCO3∼ 10-2M) and contains about 100 mg l-1of dissolved organic carbon. The total U concentration measured after two-months equilibrating time and the 0.45 μm filtration was about 10-6 M and higher. This concentration is about 3 orders of magnitude higher than literature data for U(IV) solubility and may suggest the existence of colloids and/or U(VI) species. The U concentration was found decreasing as a function of time within the experimental period. Further experiments are currently performed to evaluate the contribution of the colloids and the role of organic matter.
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Abstract
The deep geological disposal of the high level radioactive wastes is expected to be a safe disposal method in most countries. The long-lived fission product99Tc is present in large quantities in nuclear wastes and its chemical behavior in aqueous solution is of considerable interest. Under oxidizing conditions technetium exists as the anionic species TcO4−whereas under the reducing conditions, expected to exist in a deep geological repository, it is generally predicted that technetium will be present as TcO2·nH2O. Hence, the mobility of Tc(IV) in reducing groundwater may be limited by the solubility of TcO2·nH2O under these conditions. Due to this fact it is important to investigate the solubility of TcO2·nH2O. The solubility determines the release of radionuclides from waste form and is used as a source term in radionuclide migration analysis in performance assessment of radioactive waste repository. Technetium(IV) was prepared by reduction of a technetate solution with Sn2+. The solubility of Tc(IV) has been determined in simulated groundwater and redistilled water under aerobic and anaerobic conditions. The effects of pH and CO32−concentration of solution on solubility of Tc(IV) were studied. The concentration of total technetium and Tc(IV) species in the solutions were periodically determined by separating the oxidized and reduced technetium species using a solvent extraction procedure and counting the beta activity of the99Tc with a liquid scintillation counter. The experimental results show that the rate of oxidation of Tc(IV) in simulated groundwater and redistilled water is about (1.49∼1.86)×10−9mol L−1d−1under aerobic conditions, while no Tc(IV) oxidation was detected in simulated groundwater and redistilled water under anaerobic conditions. Under aerobic or anaerobic conditions the solubility of Tc(IV) in simulated groundwater and redistilled water is equal on the whole after centrifugation or ultrafiltration. The solubility of Tc(IV) increases with the decrease of pH at pH<2, increases with the increase of pH at pH>11 and is pH independent in the range 2<pH<11. The concentrations of Tc(IV) species were in the range of 10−8to 10−9mol L−1at 2<pH<11. The solubility of Tc(IV) slightly increases with increasing the increase of CO32−concentration. Geochemical modelling showed a good agreement between our experimental results and thermodynamic constants from the NEA TDB review. These data could be used to estimate the Tc(IV) solubility for cases where solubility limits transport of technetium in reducing environments of high-level waste repositories.
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Hallin M, Maes N, Byl B, Jacobs F, De Gheldre Y, Struelens MJ. Clinical impact of a PCR assay for identification of Staphylococcus aureus and determination of methicillin resistance directly from blood cultures. J Clin Microbiol 2003; 41:3942-4. [PMID: 12904425 PMCID: PMC179783 DOI: 10.1128/jcm.41.8.3942-3944.2003] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We evaluated the clinical usefulness of a PCR assay that discriminates Staphylococcus aureus from coagulase-negative staphylococci and detects methicillin resistance on blood cultures by measuring the adaptation of antimicrobial therapy based on the PCR results. Only 7 of 28 patients (25%) benefited from a modification of antibiotic therapy based on the PCR results, since empirical therapy was appropriate in a majority of cases.
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Affiliation(s)
- M Hallin
- Laboratory of Microbiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
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Maes N, Magdalena J, Rottiers S, De Gheldre Y, Struelens MJ. Evaluation of a triplex PCR assay to discriminate Staphylococcus aureus from coagulase-negative Staphylococci and determine methicillin resistance from blood cultures. J Clin Microbiol 2002; 40:1514-7. [PMID: 11923385 PMCID: PMC140352 DOI: 10.1128/jcm.40.4.1514-1517.2002] [Citation(s) in RCA: 159] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A triplex PCR targeting the 16S rRNA, mecA, and nuc genes was developed for identification of staphylococci and detection of methicillin resistance. After validation of the assay with a collection of strains of staphylococci and enterococci (n = 169), the assay was evaluated with cultures of blood with gram-positive cocci from 40 patients. Accurate results were obtained for 59 (98%) of 61 cultures within 6 h of growth detection.
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Affiliation(s)
- N Maes
- Center for Molecular Diagnostics, Service de Microbiologie, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
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