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See detailNutritional status of inmates in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo
De Coninck, Gérard; Okenge Ngongo, Leon; Ilunga Ilunga, Félicien et al

E-print/Working paper (2020)

Background: The nutritional situation in prisons of developing countries and the health status of inmates remain a major human rights concern. The objective of the study was to assess the nutritional ... [more ▼]

Background: The nutritional situation in prisons of developing countries and the health status of inmates remain a major human rights concern. The objective of the study was to assess the nutritional status of inmates jailed in a prison of the Democratic Republic of Congo (DRC). Methods: This cross-sectional study was conducted over a 4-month period in the Central Prison of Mbuji-Mayi, DRC. Three hundred inmates were selected according to the Malnutrition Universal Screening Tool (MUST). Severe malnutrition was defined according to Buzby index and Nutritional Risk Index (NRI). Data were analyzed by logistic regression. Results: The inmates were aged between 18 and 70 years and primarily males (88.7%). Of them, 24% were suffering from severe malnutrition and 62% of moderate malnutrition as based on the NRI. At the time of study, 88% of inmates were incarcerated for more than 6 months. Multivariate logistic regression analysis showed that factors independently associated with severe malnutrition were incarceration of more than 6 months (OR=5.1; 95% CI [1.5-17.4]), origin of food (prison vs. family or NGO) (OR=4.7; 95% CI [1.6-13.8]) but also presence of tuberculosis, human immunodeficiency virus and/or intestinal infections (OR=2.6; 95% CI [1.4-4.7]). Conclusions: The nutritional situation in the Central Prison of Mbuji-Mayi is precarious. There is urgent need to supply enough nutrient-rich food to improve health of inmates. [less ▲]

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See detailSupplementation Effect of a Combination of Olive (Olea europea L.) Leaf and Fruit Extracts in the Clinical Management of Hypertension and Metabolic Syndrome
Hermans, Michel; Lempereur, Philippe; Salembier, Jean-Paul et al

in Antioxidants (2020), 9

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 ... [more ▼]

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. [less ▲]

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See detailEffects of Bifidobacterium longum BB536 and Lactobacillus rhamnosus HN001 in IBS patients.
Bonfrate, Leonilde; Di Palo, Domenica M.; Celano, Giuseppe et al

in European journal of clinical investigation (2020)

BACKGROUND: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder, which still lacks effective therapy. We aimed to investigate the effects of a novel formulation of Bifidobacterium longum ... [more ▼]

BACKGROUND: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder, which still lacks effective therapy. We aimed to investigate the effects of a novel formulation of Bifidobacterium longum BB536 and Lactobacillus rhamnosus HN001 with vitamin B6 (LBB) on symptoms, intestinal permeability, cultivable bacteria and metabolome in IBS subjects. MATERIALS AND METHODS: Twenty-five IBS patients (Rome IV criteria) (M:F = 8:17; age 48 years +/- 11 SD) were randomized to treatment (LBB) or placebo (one month each) in a crossover randomized double-blind controlled trial. Symptoms, intestinal habits, disease severity, intestinal permeability and intestinal microbiota were analysed at 0, 30, 45 and 60 days. RESULTS: Percentage decrease from baseline of abdominal pain (-48.8% vs -3.5%), bloating (-36.35% vs +7.35%) and severity of disease (-30.1% vs -0.4%) was significantly (P < .0001) greater with LBB than placebo, respectively. In IBS-D patients, the improvement from baseline of Bristol score was more consistent with LBB (from 6 +/- 0.4 to 4.3 +/- 1.1, P < .00001) than placebo (from 6.2 +/- 0.7 to 5.3 +/- 1.1, P = .04). In IBS-C patients, Bristol score tended to improve from baseline after LBB (2.6 +/- 1.1 vs 3.2 +/- 0.5, P = .06). LBB significantly improved the percentage of sucralose recovery (colonic permeability) (1.86 +/- 0.1 vs 1.1 +/- 0.2, P = .01). During treatment, presumptive lactic acid bacteria and bifidobacteria, relative abundance of propanoic, butanoic, pentanoic acids and hydrocarbons increased, while phenol decreased. CONCLUSIONS: The novel formulation of B. longum BB536 and L. rhamnosus HN001 with B6 vitamin improves symptoms and severity of disease, restores intestinal permeability and gut microbiota in IBS patients. [less ▲]

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See detailFacteurs associés à la survie en milieu pénitentiaire: étude en république Démocratique du Congo
Kalonji, Muasa Patoka ULiege; OKENGE, Ngongo Léon; ILUNGA-ILUNGA, Félicien et al

in Santé Publique (2019), 5.31(automne), 715-722

Objectif : L’objectif de cette étude était d’identifier les facteurs associés à la survie chez les détenus à la prison centrale de Mbuji-Mayi, située en République démocratique du Congo, entre janvier ... [more ▼]

Objectif : L’objectif de cette étude était d’identifier les facteurs associés à la survie chez les détenus à la prison centrale de Mbuji-Mayi, située en République démocratique du Congo, entre janvier 2014 et décembre 2016. Méthodes : Il s’agit d’une étude de cohorte rétrospective. Le taux de mortalité a été calculé durant la période de suivi de trois ans et la courbe de survie de Kaplan-Meier déterminée. La régression de Cox et le rapport de risque (HR) ont été utilisés pour analyser et quantifier les facteurs associés à la survie. L’étude a porté sur un total de 793 détenus. Résultats : L’âge moyen des détenus était de 33 ± 10 ans (extrêmes : 17-67 ans) La durée médiane de suivi était de 12 mois pour un total de 7 513 personnes-mois. Le nombre de décès répertorié était de 135, soit un taux de mortalité de 17,9/1 000 personnes-mois. Les facteurs de risque associés au décès étaient la malnutrition (HR = 17,5 ; IC 95 % = [12,1 ; 25,4]) et la tuberculose (HR = 11,8 ; IC 95 % = [7,7 ; 17,8]). Conclusion : Cette étude met en évidence un taux élevé de décès en milieu carcéral et identifie les deux facteurs potentiels (malnutrition et tuberculose) sur lesquels les autorités pénitentiaires et sanitaires se doivent d’agir. [less ▲]

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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), 10.1093/ejo/cjy082

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 detailProtection in a model of liver injury is parallel to energy mobilization capacity under distinct nutritional status.
Papegay, Berengere; Nuyens, Vincent; Albert, Adelin ULiege et al

in Nutrition (Burbank, Los Angeles County, Calif.) (2019), 67-68

OBJECTIVE: Dietary and energetic restrictions are endowed with protection against experimental injuries. However, a drop in cell energetic status under a critical threshold may prevent protection, as ... [more ▼]

OBJECTIVE: Dietary and energetic restrictions are endowed with protection against experimental injuries. However, a drop in cell energetic status under a critical threshold may prevent protection, as previously observed for livers isolated from rat donors undergoing 18-h fasting versus feeding. The aim of this study was to further explore, in the latter model, links between nutritional status, energy availability, and protection through lengthening of rat fasting to 24 h and withdrawal of energy sources from perfusions. METHODS: Energy-free perfused ex vivo livers from fed, 18-h-fasted, and 24-h-fasted rats were studied during 135 min for cytolysis (potassium, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase releases in perfusates), cell deaths (activated caspase-3 [apoptosis], LC3 II/actin and p62/actin ratios [autophagy]), glycogen stores, glucose, and lactate production. RESULTS: Cytolysis was significantly increased by 18-h and 24-h fasting versus feeding but unexpectedly the increase was less for 24-h fasting than it was for 18-h fasting. Apoptotic marker caspase 3 significantly increased under fed and 18-h fasting but not 24-h fasting conditions. Autophagic marker LC3 II/actin significantly increased during perfusion in the 24-h fasted group but neither fed nor 18-h fasted groups. Autophagic induction also was supported by a drop in the p62/actin ratio. Under perfusion with 3-methyladenine, a standard autophagy inhibitor, protection and enhanced autophagy provided by 24-h but not 18-h fasting were lost without affecting apoptosis. CONCLUSIONS: Liver protections are obviously influenced by nutritional status in a way that is parallel to hepatic energy mobilization capacities (glycogen plus autophagy) with a decreased order of protection: Fed >24-h fasted >18-h fasted >24-h fasted+3-methyladenine livers. By showing that autophagy induction limits starvation-induced cytolysis, the present work supports the emerging view that autophagy inducers might improve health benefits of diet restriction. [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 detailEtat nutritionnel des détenus de la prison centrale de Mbuji-Mayi en République Démocratique du Congo
Kalonji, Muasa Patoka ULiege; Okenge Ngongo, Léon; Ilunga Ilunga, Félicien et al

Poster (2018, June 05)

Introduction La situation nutritionnelle dans les prisons des pays en développement nécessite une attention particulière et une évaluation de l’état de santé de la population carcérale. Objectif ... [more ▼]

Introduction La situation nutritionnelle dans les prisons des pays en développement nécessite une attention particulière et une évaluation de l’état de santé de la population carcérale. Objectif Déterminer l’état nutritionnel des détenus de la prison centrale de Mbuji-Mayi en République démocratique du Congo. Méthodologie Etude transversale réalisée sur une période de quatre mois, allant du 1er décembre 2015 au 30 mars 2016, à la prison centrale de Mbuji-Mayi. Un échantillon de 300 détenus a été retenu selon l’outil universel de dépistage (MUST). L’index de Buzby ou l’indice de risque nutritionnel (NRI) a servi à déterminer le pourcentage des détenus en état de dénutrition sévère. Résultats L’âge des 300 détenus variait entre 18 et 70 ans et la majorité (88.7%) était de sexe masculin. Au total, 24.0% de détenus présentaient une malnutrition sévère. Les détenus qui étaient en état de dénutrition modérée représentaient 62% selon le NRI. Au cours de l’étude, 75% avaient une durée de détention au-delà de six mois. En analyse multivariée, les facteurs associés à la malnutrition sévère chez les détenus sont essentiellement : la durée d’incarcération (OR ajusté=5.1 ; IC95%( 1.5-17.4), l’origine du repas (OR ajusté= 4.7 ; 1.6-13.8) et la présence de TB, VIH et/ou infections intestinales (OR ajusté=.2.6 ; 1.4-4.7). Conclusions Une prise en charge nutritionnelle et un apport en aliment en quantité suffisante, riche en nutriments permettrait d’améliorer la santé des détenus de la prison de Mbuji-Mayi. Mots clés : Etat de santé, Prison, nutrition, République démocratique du Congo [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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