Center Hospitalier Regional Of Namur

Namur, Belgium

Center Hospitalier Regional Of Namur

Namur, Belgium
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Paternot G.,Leuven University Fertility Center | Wetsels A.M.,Radboud University Nijmegen | Vansteenbrugge A.,Center Hospitalier Regional Of Namur | Willemen D.,Leuven University Fertility Center | And 4 more authors.
Reproductive Biology and Endocrinology | Year: 2011

Background: Quality control programs are necessary to maintain good clinical practice. Embryo grading has been described as one of the external quality assurance schemes. Although the evaluation of embryos is based on the assessment of morphological characteristics, considerable intra- and inter-observer variability has been described. In this multicentre study, the variability in the embryo evaluation has been evaluated using morphological characteristics on day 1, day 2 and day 3 of embryo development.Methods: Five embryologists of four different IVF centers participated in this study. Multilevel images of embryos were presented on a website at different time points to evaluate intra-and inter-observer agreement in the assessment of embryo morphology. The embryos were evaluated on day 1, day 2 and day 3 of their development and each embryologist had to decide if the embryo had to be transferred, cryopreserved or discarded.Results: Both intra-observer agreement and inter-observer agreement were good to excellent for the position of the pronuclei on day 1, the number of blastomeres on day 2 and day 3 and the clinical decision (transfer, cryopreservation, discard). For all other characteristics (size of pronuclei, presence of cytoplasomic halo, degree of fragmentation and size of blastomeres) the intra- and inter-observer agreement was moderate to very poor.Conclusions: Mono- or multicentre quality control on embryo scoring by morphological assessment can easily be performed through the design of a simple website. In the future the website design can be adapted to generate statistical feedback upon scoring and can even include a training module. © 2011 Paternot et al; licensee BioMed Central Ltd.

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.

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.

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.

PubMed | Catholic University of Louvain, Center Hospitalier Regional Of Namur and Center Hospitalier Of Mouscron
Type: Journal Article | Journal: Clinical kidney journal | Year: 2016

A few single cases of Mycobacterium chelonae skin infection have been reported in haemodialysis patients. We report three additional cases that share peculiar clinical characteristics, pointing to diagnostic clues. All three cases presented as erythematous nodules developing distally to a proximal arteriovenous fistula (AVF). This presentation was identical to that of two published cases. A survey of all Belgian haemodialysis units during the period 2007-11 yields an estimated incidence of 0.9/10 000 patient-years. Although the source of M. chelonae remains unclear, this specific clinical presentation should be added to the listing of potential complications of an AVF and should be recognized, as it is fully treatable if diagnosed by culture and tissue biopsy.

Haccuria A.,Free University of Colombia | Haccuria A.,Center Hospitalier Regional Of Namur | Michils A.,Free University of Colombia | Michiels S.,Free University of Colombia | Van Muylem A.,Free University of Colombia
Journal of Allergy and Clinical Immunology | Year: 2014

Background The increased fraction of exhaled nitric oxide (Feno) values observed in asthmatic patients are thought to reflect increased airway inflammation. However, Feno values can be affected by airway caliber reduction, representing a bias when using Feno values to assess asthma control. Objective We sought to determine the effect of changes in both airway caliber and inflammation on Feno values using the allergen challenge model. Methods FEV 1 and Feno values were measured during early airway responses (EARs) and late airway responses after challenge with house dust mite allergens in 15 patients with mild allergic asthma. Helium and sulfur hexafluoride (SF 6) phase III expired concentration slopes (SHe and S SF6, respectively) from single-breath washout tests were measured to identify sites of airway constriction. Results In EARs, FEV1 and Feno value decreases reached 36.8% and 22%, respectively (P <.001). ΔS He was greater than ΔSSF6 (+189.4% vs +82.2%, P =.001). In late airway responses FEV1 and Feno value decreases reached 31.7% and 28.7%, respectively (P <.001), with the same ΔS He and ΔSSF6 pattern (+155.8% vs +76%, P =.001). Eight hours after the EAR, FEV1 was still decreased (P <.001), whereas Feno values had returned to baseline. At 24 hours, FEV1 had returned to baseline, with Feno values increased by 38.7% (P =.04). Conclusion In patients with mild allergic asthma, airway caliber changes modulate changes in Feno values resulting from airway inflammation. Therefore Feno should no longer be considered solely an inflammation biomarker but rather a biomarker that integrates both airway inflammation and lung function changes. Furthermore, early and late phases resulting from allergen exposure were shown to involve similar lung regions. © 2014 The Authors. Published by Elsevier Inc.

Michils A.,Free University of Colombia | Elkrim Y.,Free University of Colombia | Haccuria A.,Center Hospitalier Regional Of Namur | Van Muylem A.,Free University of Colombia
Journal of Applied Physiology | Year: 2011

Adenosine 5′-monophosphate (AMP) and methacholine are commonly used to assess airway hyperreactivity. However, it is not fully known whether the site of airway constriction primarily involved during challenges with either agent is similar. Using a ventilation distribution test, we investigated whether the constriction induced by each agent involves the lung periphery in a similar fashion. Ventilation distribution was evaluated by the phase III slope (S) of the single-breath washout, using gases with different diffusivities like helium (He) and hexafluorosulfur (SF6). A greater postchallenge increase in SHe reflects alterations at the level of terminal and respiratory bronchioles, while a greater increase in SSF6 reflects alterations in alveolar ducts, increases to an equal extent reflecting alterations in more proximal airways where gas transport is still convective for both gases. S SF6 and SHe were measured in 15 asthma patients before and after airway challenges (20% forced expired volume in 1-s fall) with AMP and methacholine. SHe increased to a greater extent than SSF6 after AMP challenge (5.7 vs. 3.7%/l; P = 0.002), with both slopes increasing to an equal extent after methacholine challenge (3.1%/l; P = 0.959). The larger increase in SHe following AMP challenge suggests distal ventilation impairment up to the level of terminal and respiratory bronchioles. With methacholine, the similar increases in SHe and SSF6 suggest a less distal impairment. AMP, therefore, seems to affect more extensively the very peripheral airways, whereas methacholine seems to have an effect on less distal airways. © 2011 the American Physiological Society.

Magnette C.,Catholic University of Leuven | Magnette C.,Center Hospitalier Regional Of Namur | De Saint Hubert M.,Catholic University of Leuven | Swine C.,Catholic University of Leuven | 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 Leuven | Sindic C.,Catholic University of Leuven | Van Pesch V.,Catholic University of Leuven | El Sankari S.,Catholic University of Leuven | 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.

Boutchichi A.,Center Hospitalier Regional Of Namur | Ciornohac J.,Center Hospitalier Regional Of Namur | Daubresse F.,Center Hospitalier Regional Of Namur
Acta Orthopaedica Belgica | Year: 2013

We report three cases of false aneurysm involving the popliteal artery or one of its branches following total knee replacement. Two of them developed after primary total knee arthroplasty (TKA) and the third one after a revision TKA. False aneurysm is a rare complication of TKA. The main symptom is generally a painful pulsatile mass which develops postoperatively but our cases occurred with three distinct clinical manifestations. Doppler ultrasonographic and angio-CT investigations were used to achieve the correct diagnosis. Two patients were treated by percutaneous embolization; the third patient required a mini-open surgery with an endovascular prosthesis. No complications were encountered. © 2013, Acta Orthopædica Belgica.

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