References of "Albert, Adelin"
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See detailIs the triple stimulation technique a better quantification tool of motor dysfunction than motor evoked potentials in multiple sclerosis?
GIFFROY, Xavier ULiege; DIVE, Dominique ULiege; KAUX, Jean-François ULiege et al

in Acta Neurologica Belgica (2019), 119(1), 47-54

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 ... [more ▼]

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 (MSFCm) 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. [less ▲]

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See detailPiezocision-assisted orthodontic treatment using CAD/CAM customized orthodontic appliances: a randomized controlled trial in adults.
CHARAVET, Carole ULiege; LECLOUX, Geoffrey ULiege; JACKERS, Nastasia et al

in European Journal of Orthodontics (2019)

OBJECTIVE: The aim of this study was to investigate the effects of piezocision (surgical protocol with sutures) in orthodontic treatment using CAD/CAM (computer-aided design and computer-aided ... [more ▼]

OBJECTIVE: The aim of this study was to investigate the effects of piezocision (surgical protocol with sutures) in orthodontic treatment using CAD/CAM (computer-aided design and computer-aided manufacturing) customized orthodontic appliances. DESIGN: The study is designed as a parallel group, randomized controlled trial (RCT). SETTING: University Hospital. ETHICAL APPROVAL: The study was approved by the ethic committee of the University Hospital Liege, Belgium. SUBJECTS AND METHODS: This RCT was conducted on 24 adult patients requiring orthodontic treatment to release mild overcrowding. Patients were all treated with a customized appliance and randomly assigned by means of sealed envelopes containing group codes to either a test group treated with piezocision or a control group without any further treatment. A blinded orthodontist validated appliance removal or further adjustments based on the model study. OUTCOME MEASURES: The overall treatment time and the time between archwire changes were recorded. Moreover, clinical and radiological features such as tooth resorption, gingival recessions, and the presence of scars were evaluated. RESULTS: A total of 24 patients (12 control and 12 test) completed the study. The overall treatment time was significantly shorter in the test group than the control group. Likewise, the time difference between all arch changes was significantly lower when piezocision was performed, except for the first arch at the mandible and the last arches at both maxillae. During the fine-tuning phase, no significant difference was found between the two groups. All periodontal and radiographic parameters remained stable from the start to the end of treatment in both the groups. However, minor scars were found in 66 per cent cases. LIMITATIONS: This trial was a single-centre trial. CONCLUSIONS: Piezocision seems to be an effective method to accelerate orthodontic treatment in cases of mild overcrowding. However, the effect was only observed during the alignment phase and a greater efficiency was found in the maxilla. The technique may be contraindicated in patients with a high smile line since the risk of slight scarring exists. REGISTRATION: ClinicalTrails.gov (Identifier: NCT03406130). [less ▲]

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See detailEffects of Rapid Maxillary Expansion on Respiratory Events in Children: Are we doing no Harm?
REMACLE, Sarah ULiege; HENDRIX, Charlotte ULiege; BRUWIER, Annick ULiege et al

in B-ENT (2019)

Introduction and Aim: Rapid maxillary expansion devices are used in children with upper maxillary transverse deficit and cross-bite. They were consistently shown to improve obstructive apnoea syndrome in ... [more ▼]

Introduction and Aim: Rapid maxillary expansion devices are used in children with upper maxillary transverse deficit and cross-bite. They were consistently shown to improve obstructive apnoea syndrome in children. However, the impact of the device in place into the child’s mouth has never been studied. The aim of our study was to quantify the effect of the device on respiratory events while in place. Secondary endpoints were to evaluate its impact on quality of life and on respiratory events after treatment. Material and Methods: 12 consecutive children with maxillary cross-bite were prospectively included in this cohort study. Respiratory events were recorded before, during and after rapid maxillary expansion using a validated type 3 polygraphy including jaw movements. Subjective outcomes were evaluated using Obstructive Sleep Apnea (OSA)-18 quality-of-life questionnaire (OSA-18). Maxillary width and 16/26 distance were evaluated before and after rapid maxillary expansion on anterior radiography. Results: Estimated apnea hypopnea index increased from 2.67/h (±1.31/h) to 2.9/h (±2.4/h) with the device in place. Respiratory effort characterized by jaw motion > 0.4mm during the respiratory cycle increased from 7.58% (±10.01%) to 16.05% (±15.53%). Sleep-related breathing impairment was confirmed by parents’ questionnaires. Conclusion: While rapid maxillary expansion is an effective treatment for obstructive apnea syndrome in children, our study suggested a transient worsening of sleep breathing while the device is in place. It may be related to an incorrect tongue position and/or to the crowding of the device into the mouth. [less ▲]

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See detailEffects of rapid maxillary expansion on respiratory events in children: are we doing no harm?
HENDRIX, Charlotte ULiege; Bruwier, Annick ULiege; SEIDEL, Laurence ULiege et al

Conference (2018, November 09)

Introduction: Rapid maxillary expansion devices are used in children with upper maxillary transverse deficit and cross-bite. They were consistently shown to improve obstructive apnoea syndrome in children ... [more ▼]

Introduction: Rapid maxillary expansion devices are used in children with upper maxillary transverse deficit and cross-bite. They were consistently shown to improve obstructive apnoea syndrome in children. However, the impact of the device in place into the child’s mouth has never been studied. The aim of our study was to quantify the effect of the device on respiratory events while in place. Secondary endpoints were to evaluate its impact on quality of life and on respiratory events after treatment. Material and Methods: 12 consecutive children with maxillary cross-bite were prospectively included in this cohort study. Respiratory events were recorded before, during and after rapid maxillary expansion using a validated type 3 polygraphy including jaw movements. Subjective outcomes were evaluated using Obstructive Sleep Apnea (OSA)-18 quality-of-life questionnaire (OSA-18). Maxillary width and 16/26 distance were evaluated before and after RME on anterior radiography. Results: Estimated apnea hypopnea index increased from 2.67/h (±1.31/h) to 2.9/h (±2.4/h) with the device in place. Respiratory effort characterized by jaw motion > 0.4mm during the respiratory cycle increased from 7.58% (±10.01%) to 16.05% (±15.53%). Sleep-related breathing impairment was confirmed by parents’ questionnaires. Conclusion: While rapid maxillary expansion is an effective treatment for obstructive apnea syndrome in children, our study suggested a transient worsening of sleep breathing while the device is in place. It may be related to an incorrect tongue position and/or to the crowding of the device into the mouth. [less ▲]

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See detailIntérêts professionnels et représentations du métier de médecin des étudiants en quatrième année de médecine à l'Université de Liège
Lenoir, Anne-Laure ULiege; Ketterer, Frédéric ULiege; MAES, Nathalie ULiege et al

Poster (2018, September)

Cette étude avait pour objectif d’explorer les intérêts professionnels et les représentations du métier de médecin des étudiants de l’Université de Liège au début de la phase clinique de leurs études de ... [more ▼]

Cette étude avait pour objectif d’explorer les intérêts professionnels et les représentations du métier de médecin des étudiants de l’Université de Liège au début de la phase clinique de leurs études de médecine afin de voir si des différences s’exprimaient entre étudiants selon leur potentiel choix de spécialisation. [less ▲]

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See detailA new method to evaluate the part of stress in pain: injection of dextrose 5% (neural prolotherapy) on acupuncture points corresonponding to stellate, coeliac and mesenteric ganglions. A pilot study
BECO, Jacques ULiege; Mouchel, Jack; SEIDEL, Laurence ULiege et al

in Pelviperineology: Multidisciplinary Pelvic Floor Journal (2018), 37

In neuralgia (neuropathic pain), the skin rolling test is painful (allodynia to pinch) but when painful everywhere on the body (polyneuralgia) it often indicates that the patient is in a stress state, in ... [more ▼]

In neuralgia (neuropathic pain), the skin rolling test is painful (allodynia to pinch) but when painful everywhere on the body (polyneuralgia) it often indicates that the patient is in a stress state, in a fight or flight situation. Thus, when starting a treatment, it is important to differentiate between these patients and those who have perineal pain only. The aim of this study was to evaluate the effect on pain and stress of a neural prolotherapy treatment (dextrose 5% injections) at seven acupuncture points linked with orthosympathetic ganglia. The studied population comprised 55 patients treated in two private clinical settings (authors 1 and 2). The short-term effect on pain was studied by comparing the pain induced by the arm skin rolling test before and 15 minutes after injections. To evaluate the long term effect on pain, the average level of body pain during the two weeks preceding the treatment was compared with that following treatment. The World Health Organization (WHO) Five Well-Being Index was used to evaluate the patient’s level of stress before and two weeks after injections. Fifteen minutes after dextrose injections, pain induced by the skin rolling test at the arm was decreased (-3.0 ± 1.6; p<0.0001). Two weeks after treatment, the global body pain score was significantly reduced (-2.0 ± 2.4; p<0.0001) and the total WHO score increased (+21.0 ± 20.5; p<0.0001). Treatment of polyneuralgic patients with neural prolotherapy of seven acupuncture points significantly improves well-being sensation and reduces pain. [less ▲]

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See detailLong-term stability of open bite treatments
Bruwier, Annick ULiege; THONNART, François ULiege; Gelin, Emilie ULiege et al

in Long-term stability of combined orthodontic and orthognathic treatments (2018, February 23)

The long-term stability of open bite treatments is very difficult to obtain due to several parameters (genetic, myofunctional or/and parafunctional diseases). Methods :17 adult patients suffering from ... [more ▼]

The long-term stability of open bite treatments is very difficult to obtain due to several parameters (genetic, myofunctional or/and parafunctional diseases). Methods :17 adult patients suffering from basal open bite were treated by a combined orthodontic treatment and orthognathic surgery. The surgery protocol was always a Lefort I osteotomy, except in case of class II, where a sagittal mandibular osteotomy was also performed in the same operation. Five parameters were taken into account to assess the long term stability of the treatment : Angle class, occlusal plane rotation, type and duration of retention after orthodontic treatment, tongue position and overbite. Results : we had a minimum 2-years observation after a combined orthodontic/orthognathic surgery treatment to evaluate the long-term stability of this type of treatment. Cephalometric parameters (Angle class, occlusal plane rotation, tongue position and overbite) measured at T2 and T3 showed a good long term stability after 2 years (T3). Conclusions : The posterior maxillar impaction must be more important than the anterior maxillar impaction to be the key to a long-term stability in open bite treatments. The tongue position is also a relevant element to maintain the right dental occlusion. A minimum one year combined with bimaxillar retention is also required to obtain a good and stable result of treatment. [less ▲]

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See detailHeterogeneity of estrogen receptor alpha and progesterone receptor distribution in lesions of deep infiltrating endometriosis of untreated women or during exposure to various hormonal treatments.
BRICHANT, Géraldine ULiege; NERVO, Patricia ULiege; Albert, Adelin ULiege et al

in Gynecological Endocrinology (2018)

Deep infiltrating endometriosis (DIE) responds variably to hormonal therapy. Mutations in cancer driver genes have been identified in a fraction of the ectopic endometrial epithelial cells, suggesting a ... [more ▼]

Deep infiltrating endometriosis (DIE) responds variably to hormonal therapy. Mutations in cancer driver genes have been identified in a fraction of the ectopic endometrial epithelial cells, suggesting a functional heterogeneity of these lesions. To evaluate the phenotype heterogeneity of cells in DIE, we measured the expression of estrogen receptor alpha (ERalpha) and of progesterone receptor (PR) in DIE of untreated women or under various treatments. We analyzed the luminal epithelial height (LEH), immunoreactive epithelial staining (IRS) and stromal staining intensity (SSI) of ERalpha and PR. We observed a high variability in the same gland, among distinct glands in the same sample and among distinct patients receiving the same treatment. LEH variability was primarily due to epithelial cells heterogeneity in a gland, secondarily to the glands randomly evaluated on the same section, and tertiary to the patient category. Variability in IRS and SSI scores was primarily the consequence of their heterogeneity in the same woman and to a lesser extent to variability among patients. LEH and SSI were not modified according to treatment. IRS for PR was lower in treated patients. This heterogeneity of ERalpha and PR distribution could explain why endocrine treatments are unable to cure this condition. [less ▲]

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See detailRelationship between beliefs about medicines, adherence to treatment, and disease activity in patients with rheumatoid arthritis under subcutaneous anti-TNFalpha therapy.
Horne, Rob; Albert, Adelin ULiege; Boone, Caroline

in Patient preference and adherence (2018), 12

Objective: In patients with rheumatoid arthritis (RA), nonadherence to treatment is often related to patients' beliefs and concerns regarding their medication. This study aimed to analyze the correlations ... [more ▼]

Objective: In patients with rheumatoid arthritis (RA), nonadherence to treatment is often related to patients' beliefs and concerns regarding their medication. This study aimed to analyze the correlations regarding patients' medication beliefs, medication adherence, and objective measures of disease activity and safety in patients with RA established on subcutaneous (SC) anti-tumor necrosis factor alpha (TNFalpha) therapy. Methods: This Phase IV, noninterventional, non-drug-specific study enrolled patients with RA being treated with stable-dose SC anti-TNFalpha (adalimumab, etanercept, golimumab, and certolizumab pegol). At initial visit and 6 and 12 months later, patients completed the Beliefs about Medicines Questionnaire-Specific section, assessing perceptions of personal need for anti-TNFalpha therapy (anti-TNFalpha-Necessity) and concerns (anti-TNFalpha-Concerns), Medication Adherence Rating Scale (MARS), mean Disease Activity Score in 28 joints (DAS28), and other scales. Longitudinal data were analyzed by linear mixed models. Results: A total of 460 patients were included. At initial visit, anti-TNFalpha-Necessity beliefs were high (mean +/- SD: 4.3 +/- 0.55) vs anti-TNFalpha-Concerns (2.8 +/- 0.78). Medication adherence (MARS) was high (4.8 +/- 0.39). All scores remained stable over the 1-year follow-up period. Anti-TNFalpha-Necessity beliefs and anti-TNFalpha-Concerns were not related to each other, but strongly correlated with medication adherence. While concerns worsened with disease activity, clinical status, and low quality of life, necessity beliefs remained unaffected. Conclusion: In patients with RA established on stable-dose SC anti-TNFalpha, anti-TNFalpha-Necessity beliefs persistently outweighed anti-TNFalpha-Concerns, but both correlated with adherence. These findings may be of use in subsequent studies looking to predict adherence in patients starting treatment with SC anti-TNFalpha. [less ▲]

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See detailExtended Progression-Free Survival of Renal Cell Carcinoma with Axitinib: Case Report
Munoz, Rene; Cabezas, Maria; Castillo, José Antonio et al

in Journal of Urology an Renal Diseases (2018), (5),

Axitinib is a selective inhibitor of vascular endothelial growth factor receptors approved for second line treatment of advanced renal cell carcinoma. The case report concerns an 85-year-old man with ... [more ▼]

Axitinib is a selective inhibitor of vascular endothelial growth factor receptors approved for second line treatment of advanced renal cell carcinoma. The case report concerns an 85-year-old man with renal cell carcinoma of clear cells initially treated by left nephrectomy who presented with pulmonary progression 7 years later. Systemic treatment with pazopanib was initiated but disease progression and gastrointestinal toxicity were observed after 4 months. A second line treatment implemented with axitinib (5 mg twice daily, later reduced to 5 mg once daily due to gastrointestinal toxicity) led to favorable outcome and control of pulmonary progression. This case report demonstrates that axitinib in reduced dose can improve progression free survival (34 months at present) and surpass data published in Phase III clinical trials on patients with localized renal cell carcinoma of clear cells. It further contributes to the limited information currently available on axitinib in Latin-American populations. [less ▲]

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See detailContextual factors influence work outcomes in employed patients with ankylosing spondylitis starting etanercept: 2-year results from AS@Work.
Boonen, Annelies; Boone, Caroline; Albert, Adelin ULiege et al

in Rheumatology (Oxford, England) (2018), 57(5), 791-797

Objectives: The aim was to determine changes over time in work outcomes and investigate the predictive value of baseline personal and work-related factors on the evolution of work outcomes among employed ... [more ▼]

Objectives: The aim was to determine changes over time in work outcomes and investigate the predictive value of baseline personal and work-related factors on the evolution of work outcomes among employed patients with AS initiating etanercept. Methods: Employment status, absenteeism and presenteeism were assessed using the Work Productivity and Activity Impairment for AS questionnaire in a 24-month open-label, observational study (NCT01421303). The potential effect of baseline factors on work outcomes was analysed using predictive modelling (Cox regression and linear mixed models). Results: After 24 months, 11/75 (14.7%) patients had permanently withdrawn from employment (seven because of AS). Absenteeism and presenteeism decreased significantly within 6 months of etanercept treatment and remained stable thereafter. Predictive modelling indicated that male sex (hazard ratio = 0.18; 95% CI: 0.04, 0.85), (log) number of working hours per week (hazard ratio = 0.13; 95% CI: 0.03, 0.51) and the possibility of developing skills (hazard ratio = 0.42; 95% CI: 0.19, 0.91) positively influenced time in employment. Over time, lower absenteeism was significantly associated with the quality of contact with colleagues [coefficient (s.e.): -0.35 (0.10)] and importance of the job for quality of life [-0.49 (0.17)], and higher absenteeism with current smoking [1.66 (0.44)] and change in job because of illness [1.51 (0.66)]. Over time, lower presenteeism was associated with male sex [-14.5 (2.64)], the possibility of postponing work [-6.60 (2.73)], quality of contact with colleagues [-2.04 (0.96)] and >50 workers in the company [-7.65 (2.76)], and higher presenteeism with manual profession [8.41 (2.72)]. Conclusion: Contextual factors influence work outcomes over time and should not be ignored when aiming to improve work outcomes in patients with AS. Trial registration: ClinicalTrials.gov, http://clinicaltrials.gov, NCT01421303. [less ▲]

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See detail"Respect when you can, resect when you should": A realistic approach to posterior leaflet mitral valve repair.
Dreyfus, Gilles D.; Dulguerov, Filip; Marcacci, Cecilia et al

in Journal of Thoracic and Cardiovascular Surgery (2018), 156(5), 1856-18663

OBJECTIVE: Avoiding resection to treat posterior leaflet prolapse has become popular to repair degenerative mitral regurgitation. We never subscribed to such simplification but advocated an alternative ... [more ▼]

OBJECTIVE: Avoiding resection to treat posterior leaflet prolapse has become popular to repair degenerative mitral regurgitation. We never subscribed to such simplification but advocated an alternative approach based on the "respect when you can, resect when you should" concept. The present study reviewed posterior leaflet prolapse in degenerative disease with the aim to expose the 10-year experience with this surgical policy, in particular long-term outcomes such as survival, recurrent/severe mitral regurgitation, and reoperation. METHODS: From January 2005 to December 2015, 701 consecutive patients with severe mitral regurgitation underwent mitral valve repair in 2 distinct institutions. Mitral regurgitation was degenerative in 441 patients, of whom the 376 with posterior leaflet prolapse constituted the study population. Patients were followed up by echocardiograms until December 2017. Longitudinal data stratified by institution were analyzed by mixed-effects models. Outcome measures were analyzed by Kaplan-Meier test. RESULTS: Patients with posterior leaflet prolapse (24.7% isolated P2 and 75.3% P2 associated with other segments) were aged 65.8 +/- 13 years, and 70.5% were male. Median follow-up was 61.1 months. There were 3 hospital deaths (0.8%). Reoperation was necessary in 7 patients (1.9%). After 1, 5, and 10 years, overall survival was 97.8%, 93.6%, and 86.7%, respectively; the overall survival of the proportion of patients with recurrent/residual >2+ mitral regurgitation was estimated at 0.7%, 1.9%, and 5.9% and that of patients with New York Heart Association III/IV at 0.8%, 1.9%, and 5.3%. CONCLUSIONS: The "resect with respect" approach yields low operative mortality, no systolic anterior motion, good surface of coaptation, and low incidence of residual/recurrent mitral regurgitation and of reoperation, thus supporting resection when required concept. [less ▲]

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See detailHumor Associated with Positive Outcomes in Individual Psychotherapy
Panichelli, Christophe ULiege; Albert, Adelin ULiege; Donneau, Anne-Françoise ULiege et al

in American Journal of Psychotherapy (2018), APT-2018-0021

Considerable anecdotal evidence points to the usefulness of humor in the therapeutic process, but empirical evidence is still lacking. This study searched for an association between humor and therapy ... [more ▼]

Considerable anecdotal evidence points to the usefulness of humor in the therapeutic process, but empirical evidence is still lacking. This study searched for an association between humor and therapy outcomes in a real-life population of 110 adult psychotherapy clients who attended at least 10 therapy sessions. Clients and their therapist evaluated the frequency and intensity of humorous events, as well as therapy effectiveness, therapeutic alliance, perceived hope and pleasure to participate in therapy sessions. We found a strong positive correlation between humor and therapy effectiveness, in both client (rs = .40; p < .0001) and therapist perspectives (rs = .37; p < .0001). The link between humor and effectiveness remained significant in more severe subgroups of clients, even though these clients reported less humor in their therapies. Further research is needed to determine if humor actually enhances therapy outcomes, or if positive outcomes trigger the occurrence of humor. [less ▲]

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See detailEfficacy of bio-optimized extracts of turmeric and essential fennel oil on the quality of life in patients with irritable bowel syndrome
Di Ciaula, Agostino; Portincasa, Piero; MAES, Nathalie ULiege et al

in Annals of Gastroenterology (2018), 31(6), 685-691

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 ... [more ▼]

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(R)) 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(R), 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. [less ▲]

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See detailPelvic trauma and pudendal syndrome (post-traumatic pudendal syndrome)
BECO, Jacques ULiege; ANTOLAK, Stanley; SEIDEL, Laurence ULiege et al

in Pelviperineology: Multidisciplinary Pelvic Floor Journal (2018)

The pudendal syndrome can result from pelvic trauma but the link is difficult to prove. The study was intended to disentangle potentially linking elements of the post-traumatic pudendal syndrome, in ... [more ▼]

The pudendal syndrome can result from pelvic trauma but the link is difficult to prove. The study was intended to disentangle potentially linking elements of the post-traumatic pudendal syndrome, in particular perineodynia (perineal pain), one of the salient symptoms of the pudendal syndrome. Two case reports were used to illustrate the point. The study was based on 394 female patients of whom 216 (54.8%) had a history of pelvic trauma. Patients were further classified into mutually exclusive groups according to presence/absence of perineodynia and, for those with pelvic trauma, according to latency of pain appearance (pain before trauma, early onset, or late onset). Urge urinary incontinence, cystalgia, anal incontinence and proctalgia fugax were found statistically more frequent in the pelvic trauma group. Perineodynia visual analog score, NHI-CPSI score and Wexner’s score were also significantly greater in traumatic patients. The three pudendal syndrome clinical signs were significantly more present in pelvic trauma patients than in non-trauma subjects. In the three post-traumatic perineodynia groups with different latency, only minor significant symptoms frequency differences were observed but importantly urge incontinence, cystalgia, anal incontinence and proctalgia fugax remained more frequent than in the non-trauma perineodynia group for similar pain scores. Post-traumatic pudendal syndrome is a reality. Perineodynia, urge incontinence, anal incontinence, proctalgia fugax and cystalgia are the most frequently symptoms encountered. These findings recommend performing a detailed history search for any symptom of the pudendal syndrome and a comprehensive clinical examination including its three clinical signs after any significant pelvic trauma. [less ▲]

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See detailEndoscopic transperineal pudendal nerve decompression: operative pudendoscopy.
Beco, Jacques; SEIDEL, Laurence ULiege; Albert, Adelin ULiege

in Surgical Endoscopy (2018), 32(8), 3720-3731

BACKGROUND: Pudendal nerve entrapment can produce a pudendal syndrome comprising perineodynia together with urinary, sexual, and anorectal symptoms. This syndrome can be treated surgically by the ... [more ▼]

BACKGROUND: Pudendal nerve entrapment can produce a pudendal syndrome comprising perineodynia together with urinary, sexual, and anorectal symptoms. This syndrome can be treated surgically by the transperineal approach. By using an endoscope during the procedure ("operative pudendoscopy"), the surgeon has close-up visual control of each decompression steps, demonstrates the different levels of entrapment, and cuts the sacrospinous ligament under visual control. The aim of this study was to describe the technical details of this new technique and its outcome in the treatment of the pudendal syndrome. METHODS: A series of 113 patients with severe pudendal syndrome underwent operative pudendoscopy. A complete history, pain visual analog scale (VAS) for perineodynia, and four scores evaluating the main symptoms (ICIQ-SF, NHI-CPSI, St Mark's, and Wexner) were obtained before and at least 24 months after surgery. The three clinical signs of pudendal syndrome (abnormal pinprick sensitivity, painful skin rolling test, and painful pudendal nerve) and perineal descent were analyzed before and after surgery in 91 patients. RESULTS: The mean operating time per side was 50.3 +/- 15.2 min and the average hospital stay was 2.1 +/- 0.4 days. Perineodynia VAS dropped from 7.2 +/- 1.4 to 4.5 +/- 2.9 after surgery (p < 0.0001) and the symptoms scores significantly improved. Frequency of sexual arousal syndrome, dyspareunia, and cystalgia was also significantly reduced. Pathological perineal descent (>/= 1.5 cm measured with a Perineocaliper(R)) observed in 13 patients was reduced from 1.81 to 0.77 cm after surgery (p < 0.0001). The only significant complication was severe hemorrhage in one patient induced by an inferior gluteal vessel laceration and successfully treated by arterial embolization. CONCLUSIONS: A complete pudendal nerve decompression, from the distal branches to the sacral foramina, safely performed under visual control by using operative pudendoscopy markedly improves clinical signs and symptoms of the pudendal syndrome. [less ▲]

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See detailPatient compliance and orthodontic treatment efficacy of Planas functional appliances with TheraMon microsensors
CHARAVET, Carole ULiege; LE GALL, Michel; Albert, Adelin ULiege et al

in Angle Orthodontist (2018)

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