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Ecomard L.-M.,Institute Bergonie | Malingret N.,Center Hospitalier Regional Of Namur | Asad-Syed M.,Institute Bergonie | Dilhuydy M.-H.,URPS medecins Liberaux Aquitaine | And 3 more authors.
Bulletin du Cancer | Year: 2013

Background. Breast cancer among older women is a major and increasing public health issue. No clear recommendation has been established in France after 74 years, the age limit for state-organised screening program. A survey was performed among all regional agencies in charge of the breast screening to analyse which information is delivered to women reaching the age of 75 years. Methods. A postal survey sent to 91 French organised cancer screening agencies. Results. Among the 89 agencies that answered, only 22 deliver a systematic written information. Twelve suggest that mammographic screening should be continued, and five mention clinical examination. Twenty agencies dispatch the screening to general practitionners or gynaecologists. Two information letters insist on the ongoing risk of breast cancer. Most of the written information is given with the last mammography report. No impact study has ever been performed. Conclusion. In our study, only 25% of the screening agencies give systematic information to women. The modalities and the substance of this information are heterogeneous. A better information seems to be a key-point for earlier clinical breast cancer diagnosis among older women, forwhom there is little direct evidence of the benefit of systematic mammographic screening. © John Libbey Eurotext.

Raes M.,Virga Jesse Ziekenhuis | Strens D.,Deloitte | Vergison A.,Free University of Colombia | Verghote M.,Center Hospitalier Regional Of Namur | Standaert B.,Glaxosmithkline
Pediatric Infectious Disease Journal | Year: 2011

Background: This study investigated the effect of pediatric vaccination against rotavirus on the number of rotavirus-related hospitalizations of children in Belgium. Methods: This retrospective database study was conducted at 12 pediatric hospitals in Belgium (546 pediatric beds, 30.6% of Belgian total). Children ≤5 years attending hospital for any reason were eligible if they had a rotavirus stool test at one of the study centers. The number of rotavirus-positive stool tests and hospitalizations for acute gastroenteritis (AGE) were compared for prevaccination (June 2004-May 2006) and postvaccination (June 2007-May 2009) study periods. Results: The number of rotavirus-positive stool tests in children who were ≤5 years of age decreased from an average of 881 in the prevaccination period to 368 in the first year postvaccination period and 199 in the second. In children 2 to 24 months of age, the percentage reductions were 65% (95% confidence interval [CI]: 62%, 69%) and 80% (95% CI: 77%, 83%) in the first and second years after vaccination, respectively, compared with prevaccination. In children <2 months, the reductions were 50% (95% CI: 36%, 64%) and 64% (95% CI: 49%, 76%), respectively, and in children >24 months the corresponding values were 20% (95% CI: 14%, 28%) and 64% (95% CI: 56%, 72%). The number of AGE-driven hospital admissions and hospitalization days for AGE declined by 33% and 36%, respectively, from prevaccination to the second year postvaccination in children ≤2 years of age. Conclusions: Pediatric rotavirus vaccination in Belgium significantly reduced rotavirus-related hospitalizations in the first and second years after introduction. © 2011 Lippincott Williams & Wilkins.

Magnette C.,Catholic University of Louvain | Magnette C.,Center Hospitalier Regional Of Namur | De Saint Hubert M.,Catholic University of Louvain | Swine C.,Catholic University of Louvain | And 4 more authors.
Minerva Anestesiologica | Year: 2015

Background. Because the proportion of elderly patients admitted to the intensive care unit (ICU) is increasing, the objective of this study was to test the hypothesis that very elderly patients with better preadmission functional status would have better medium-term survival and functional status after an ICU stay. Methods. In this observational study, 96 patients (68% surgical and 32% medical) aged ?80 years and admitted to the ICU between May 2008 and June 2009 were recruited. Functional status was assessed using a modified Katz Scale and the Lawton Scale. Primary outcomes were: one-year mortality and its independent predictive factors, oneyear functional status and perceived quality of life. Results. Multivariate analysis showed that type of admission (surgical vs. medical), existence of cancer, Sequential Organ Failure Assessment (SOFA) Score at ICU admission and occurrence of septic complications during the ICU stay were independent predictive factors for one-year mortality, but preadmission functional status was not. At one year, despite functional decline in 50% of survivors, 68% perceived their health status to be equivalent to or better than before and 82.6% would agree to a further ICU stay. Conclusion. One-year mortality of very elderly patients after an ICU stay is not related to preadmission functional status but to the type of admission, existence of cancer, SOFA Score at ICU admission and occurrence of septic complications during the ICU stay. Despite functional decline in half of these patients, one year after admission 82.6% would agree to another ICU stay. © 2015 edizioni minerva medica.

Finne Lenoir X.,Catholic University of Louvain | Sindic C.,Catholic University of Louvain | Van Pesch V.,Catholic University of Louvain | El Sankari S.,Catholic University of Louvain | And 3 more authors.
Neurocritical Care | Year: 2013

Background: To describe a case of auto-immune encephalitis in an adolescent with favorable outcome despite prolonged status epilepticus. Methods: A 17 year old Asian man without previous medical history developed alteration of consciousness and partial seizures. The diagnosis of anti-N-methyl-D-aspartate receptor encephalitis was confirmed by the detection of specific antibodies in both cerebrospinal fluid and serum. Results: The clinical course was complicated by prolonged status epilepticus which was refractory to a large number of antiepileptic drugs, including barbiturate coma. Immunomodulatory therapy included steroids, plasma exchanges, and intravenous immunoglobulins. After 86 days of intensive therapy, the patient regained consciousness progressively. Brain magnetic resonance imaging never demonstrated any lesion. Extensive search for a tumor was negative. At 12 month follow-up, the patient had made an excellent recovery. Conclusion: Auto-immune encephalitis is likely underdiagnosed in adolescents. In their most severe presentation, seizures may be resistant to a large number of anti-epileptic drugs, and the clinical improvement seems to be mainly because of the immunomodulatory therapy. Relapse is possible, as well as the delayed development of a teratoma or other tumor. © 2012 Springer Science+Business Media New York.

Joassin R.,Pole reeducation | Joassin R.,Center Hospitalier Regional Of Namur | Bonniaud V.,Pole reeducation | Barra J.,University of Paris Descartes | And 3 more authors.
Annals of Physical and Rehabilitation Medicine | Year: 2010

Purpose: The perception of verticality results from the integration of vestibular, visual and somatosensory information. Spinal cord injured patients with complete paraplegia have total somatosensory deafferentation below a certain metameric segment. In our study, we were interested in the implication of somatosensory signal in the construction of verticality and in the possible effect of somatosensory loss on spatial representation. Method: We analysed haptic and postural aspects of perceived verticality in 14 spinal cord injured patients with complete paraplegia and in an age- and gender-matched group of 13 controls. We also conducted a structured interview on the existence of vertigo or postural instability in daily life. Results: The spinal cord injured patients perceived verticality without any significant directional bias in the orientation of the vertical but with a greater uncertainty than control subjects, both in haptic and postural modalities. If paraplegic did not report vertigo, half described an altered spatial perception without vision. Conclusion: The present results confirm the importance of sensory input from the trunk and the lower limbs in the perception of the vertical. However, visual and vestibular information appear to compensate for somatosensory deafferentation. © 2010 Elsevier Masson SAS.

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