Saint Luc University Hospital

Brussels, Belgium

Saint Luc University Hospital

Brussels, Belgium

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Verroken A.,Saint Luc University Hospital | Bauraing C.,Mont Godinne University Hospital | Deplano A.,Erasme University Hospital | Bogaerts P.,Mont Godinne University Hospital | And 3 more authors.
Clinical Microbiology and Infection | Year: 2014

During an 8-month period, 24 Corynebacterium striatum isolates recovered from lower respiratory tract specimens of 10 hospitalized patients were characterized. The organisms were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and by 16S rRNA gene sequencing. The cluster of C. striatum exclusively affected patients who had been admitted to an intensive care unit and/or subsequently transferred to one medium-size respiratory care unit. Prolonged duration of hospitalization, advanced stage of chronic obstructive pulmonary disease, recent administration of antibiotics and exposure to an invasive diagnostic procedure were the most commonly found risk factors in these patients. Seven patients were colonized and three infected. All strains displayed a similar broad spectrum resistance to antimicrobial agents, remaining susceptible to vancomycin only. Typing analysis by MALDI-TOF MS and by semi-automated repetitive sequence-based PCR (DiversiLab typing) showed that all outbreak-associated C. striatum isolates clustered together in one single type while they differed markedly from epidemiologically unrelated C. striatum isolates. Pulsed-field gel electrophoresis (PFGE) profiles revealed three distinct PFGE types among the C. striatum isolates associated with the outbreak while all external strains except one belonged to a distinct type. We conclude that C. striatum is an opportunistic nosocomial pathogen in long-term hospitalized patients and can be at the origin of major outbreaks. The routine use of MALDI-TOF MS greatly facilitated the recognition/identification of this organism in clinical samples and this technique could also offer the potential to be used as an easy and rapid epidemiological typing tool for outbreak investigation. © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Mabrut J.-Y.,University of Ruse | Bozio G.,University of Ruse | Hubert C.,Saint Luc University Hospital | Gigot J.-F.,Saint Luc University Hospital
Digestive Surgery | Year: 2010

Bile duct cysts (BDC) are rare congenital anomalies of the biliary tree that are characterized by cystic dilatation of the extrahepatic and/or intrahepatic bile ducts. Presence of an anomalous bilio-pancreatic junction allowing pancreatic juice to reflux into the biliary tree is the most widely aetiopathogenic concept currently accepted. BDC are associated with biliary stasis and lithiasis, and the whole biliary epithelium is considered at risk of malignant transformation. Magnetic resonance cholangio-pancreatography is currently the most accurate preoperative imaging study to assess cyst anatomy and classify the disease according to the standard Todani classification. Complete cyst excision with cholecystectomy followed by biliary reconstruction using a Roux-en-Y hepatico-jejunostomy is the treatment of choice for the extrahepatic component of the disease (type I and IV BDC), but cystic involvement up to the roof of the main biliary convergence represents a real surgical challenge to perform complete resection. The optimal treatment of intrahepatic bile duct dilatations remains controversial, especially for type IV-A BDC. In type V BDC (Caroli's disease), extent of the liver resection is tailored to intrahepatic disease extent and takes into consideration the presence and severity of underlying chronic liver (congenital hepatic fibrosis) and kidney disease. Late postoperative cholangitis secondary to intrahepatic strictures and lithiasis, as well as the risk of metachronous cholangiocarcinoma that can occur throughout the whole biliary tree even after complete cyst excision, represent serious complications justifying careful long-term follow-up. Copyright © 2010 S. Karger AG, Basel.

Hubinont C.,Saint Luc University Hospital
Journal of pregnancy | Year: 2011

The aim of this paper is to review available data about drugs for preventing preterm labour. Tocolytic therapy includes β adrenergic receptor agonists, NO donors, magnesium sulphate, prostaglandin-synthase inhibitors, oxytocin receptor antagonists, calcium-channel blockers, progesterone, 17-α-hydroxyprogesterone caproate, and antibiotics. Their specific effects on myometrial contractility, their safety, their efficiency, and side effects profile for the mother and the fetus are presented. The main question of why and for what reasons tocolysis should be administrated is discussed.

Maurage P.,Catholic University of Leuven | Joassin F.,Catholic University of Leuven | Pesenti M.,Catholic University of Leuven | Grandin C.,Catholic University of Leuven | And 5 more authors.
Cortex | Year: 2013

Introduction: Crossmodality (i.e., the integration of stimulations coming from different sensory modalities) is a crucial ability in everyday life and has been extensively explored in healthy adults. Still, it has not yet received much attention in psychiatry, and particularly in alcohol-dependence. The present study investigates the cerebral correlates of crossmodal integration deficits in alcohol-dependence to assess whether these deficits are due to the mere accumulation of unimodal impairments or rather to specific alterations in crossmodal areas. Methods: Twenty-eight subjects [14 alcohol-dependent subjects (ADS), 14 paired controls] were scanned using fMRI while performing a categorization task on faces (F), voices (V) and face-voice pairs (FV). A subtraction contrast [FV-(F+V)] and a conjunction analysis [(FV-F)∩(FV-V)] isolated the brain areas specifically involved in crossmodal face-voice integration. The functional connectivity between unimodal and crossmodal areas was explored using psycho-physiological interactions (PPI). Results: ADS presented only moderate alterations during unimodal processing. More centrally, in the subtraction contrast and conjunction analysis, they did not show any specific crossmodal brain activation while controls presented activations in specific crossmodal areas (inferior occipital gyrus, middle frontal gyrus, superior parietal lobule). Moreover, PPI analyses showed reduced connectivity between unimodal and crossmodal areas in alcohol-dependence. Conclusions: This first fMRI exploration of crossmodal processing in alcohol-dependence showed a specific face-voice integration deficit indexed by reduced activation of crossmodal areas and reduced connectivity in the crossmodal integration network. Using crossmodal paradigms is thus crucial to correctly evaluate the deficits presented by ADS in real-life situations. © 2012 Elsevier Ltd.

Rousselle L.,Catholic University of Leuven | Dembour G.,Saint Luc University Hospital | Noel M.-P.,Catholic University of Leuven
PLoS ONE | Year: 2013

For some authors, the human sensitivity to numerosities would be grounded in our ability to process non-numerical magnitudes. In the present study, the developmental relationships between non numerical and numerical magnitude processing are examined in people with Williams syndrome (WS), a genetic disorder known to associate visuo-spatial and math learning disabilities. Twenty patients with WS and 40 typically developing children matched on verbal or non-verbal abilities were administered three comparison tasks in which they had to compare numerosities, lengths or durations. Participants with WS showed lower acuity (manifested by a higher Weber fraction) than their verbal matched peers when processing numerical and spatial but not temporal magnitudes, indicating that they do not present a domain-general dysfunction of all magnitude processing. Conversely, they do not differ from non-verbal matched participants in any of the three tasks. Finally, correlational analyses revealed that non-numerical and numerical acuity indexes were both related to the first mathematical acquisitions but not with later arithmetical skills. © 2013 Rousselle et al.

Maurage P.,Catholic University of Leuven | de Timary P.,Catholic University of Leuven | de Timary P.,Saint Luc University Hospital | Billieux J.,Catholic University of Leuven | And 2 more authors.
Alcoholism: Clinical and Experimental Research | Year: 2014

Background: Attentional biases and deficits play a central role in the development and maintenance of alcohol dependence, but the underlying attentional processes accounting for these deficits have been very little explored. Importantly, the differential alterations across the 3 attentional networks (alerting, orienting, and executive control) remain unclear in this pathology. Methods: Thirty recently detoxified alcohol-dependent individuals and 30 paired controls completed the Attention Network Test, which allow exploring the attentional alterations specifically related to the 3 attentional networks. Results: Alcohol-dependent individuals presented globally delayed reaction times compared to controls. More centrally, they showed a differential deficit across attention networks, with a preserved performance for alerting and orienting networks but impaired executive control (p < 0.001). This deficit was not related to psychopathological comorbidities but was positively correlated with the duration of alcohol-dependence habits, the number of previous detoxification treatments and the mean alcohol consumption before detoxification. Conclusions: These results suggest that attentional alterations in alcohol dependence are centrally due to a specific alteration of executive control. Intervention programs focusing on executive components of attention should be promoted, and these results support the frontal lobe hypothesis. © 2014 by the Research Society on Alcoholism.

Thienpont E.,Saint Luc University Hospital
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2013

Purpose: To identify whether less proximal muscle damage during minimally invasive surgery will allow faster recovery after total knee arthroplasty in comparison with a quadriceps incision approach. A limited medial parapatellar approach without tibial medial collateral ligament (MCL) release was compared to a subvastus approach without tibial medial collateral ligament release (far medial subvastus). Methods: One hundred and eighty patients were studied. In the mini-parapatellar group, ninety patients and in the far medial subvastus group, the remaining ninety patients were included. The evaluation was based on the Knee Society Score, VAS, morphine consumption, range of motion, time to straight leg raising, walking without aid, stairs and period of hospitalization. Alignment on full leg radiographs and component position on plain films were measured. Results: The far medial subvastus group showed faster recovery with earlier straight leg raising (1.7 ± 0.5 vs. 2.7 ± 0.4 days), postoperative weight bearing without aid (1.7 ± 0.6 vs. 2 ± 0.8 days) and stair negotiation (3 ± 0.4 vs. 4 ± 0.3 days) resulting in shorter length of stay (4 ± 0.5 vs. 5 ± 1.2 days). Comparable Knee Society Scores (88.5 ± 6.8 vs. 90 ± 10), Function Scores (90 ± 10) and alignment (5.4° ± 2.1° vs. 5.0° ± 2.4°) between the medial parapatellar and far medial subvastus group were observed at a follow-up of 24 months. An increase in operative time for the far medial subvastus was observed (55 ± 10.6 min vs. 67 ± 12 min tourniquet time) but without complications. Conclusion: The MCL sparing far medial subvastus approach allows good surgical exposure, faster straight leg raising, full weight bearing without aid and shorter length of stay with most importantly no radiological malalignment. Level of evidence: Therapeutic study, Level II. © 2012 Springer-Verlag Berlin Heidelberg.

Thienpont E.,Saint Luc University Hospital | Berger Y.,Saint Luc University Hospital
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2013

Hypersensitivity to metallic implants remains relatively unpredictable and poorly understood. Although 20-25 % of total joint arthroplasty patients develop metal sensitivity, only a few highly susceptible persons (< 1 %) exhibit symptoms. We present a case report of a fifty-two-year-old woman with a preoperatively documented metal allergy who underwent bilateral total knee arthroplasty using a titanium-niobium-coated implant on one side and a chrome-cobalt implant on the other side because of a logistics problem. At 2-year follow-up, no clinical symptoms of allergy or loosening of the implant were observed. Level of evidence IV. © 2012 Springer-Verlag.

Thienpont E.,Saint Luc University Hospital
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2013

Purpose: The aim of the study was to identify whether less soft tissue and muscle damage during surgery will allow faster recovery after total knee arthroplasty in comparison with the conventional technique. A limited medial parapatellar approach without tibial medial collateral ligament (MCL) desinsertion was compared with the conventional parapatellar approach. Methods: Three hundred patients were randomized either into the minimally invasive group (MIS group) or into the conventional group (CON group). The evaluation was based on the Knee Society Score, range of motion, blood loss, period of hospitalization and postoperative hemoglobin level. Results: The MIS group showed faster recovery with immediate postoperative full weight-bearing and shorter length of stay (5 vs 10 days). Comparable Knee Society Scores (87.5 vs 88), function scores (90) and alignment (5.5° vs 5.2°) between the CON and MIS group were observed at a follow-up of 24 months. No increase in operative times (52 vs 51 min tourniquet time) or no complications were observed. Reduced blood loss was observed in the MIS group (590 vs 989 ml). Conclusion: The MCL sparing limited medial parapatellar approach allows good surgical exposure, easy extension proximally if necessary, contained closure after surgery with less bleeding, faster recovery, full weight-bearing without aid and most importantly no radiological malalignment. Level of evidence: Therapeutic study, Level II. © 2012 Springer-Verlag.

Koninckx A.,Saint Luc University Hospital | Schwab P.-E.,Saint Luc University Hospital | Deltour A.,Saint Luc University Hospital | Thienpont E.,Saint Luc University Hospital
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2014

Purpose: The lateral approach in the valgus knee asks for a lot of soft tissue releases during the arthrotomy. The hypothesis of this study was that the far medial subvastus approach could be used in valgus knees and would guarantee both functional and radiological good to excellent results. Methods: This is a retrospective study on 78 patients (84 knees) undergoing primary total knee arthroplasty (TKA) for type I or II fixed valgus knees. The mean (SD) preoperative mechanical alignment was 187° (4°) HKA angle. Functional recovery, pain, tourniquet times, necessary soft tissue releases as well as radiological alignment were measured. Results: The Knee Score improved significantly from 45 (10) to 90 (10) (P < 0.05) and the function score improved as well from 35 (20) to 85 (10) (P < 0.05). Flexion improved from 110° (10°) to 137° (8°). Hospital stay was 4 (1.2) days. Alignment was corrected to 181° (1.5°) HKA angle with a postoperative joint line shift of +2.8 (3.2) mm. No clinical instability, as evaluated by the senior author, or osteolytic lines was observed at minimal one-year radiological follow-up. Conclusion: The far medial subvastus approach is an excellent approach to perform Krackow type I and II TKA with primary PS implants. Level of evidence: IV. © 2013 Springer-Verlag Berlin Heidelberg.

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