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See detailImpact of the COVID-19 pandemic situation on HIV care in Liège, Belgium
El Moussaoui, Majdouline ULiege; Lambert, Nicolas ULiege; MAES, Nathalie ULiege et al

in HIV Research & Clinical Practice (2021)

Background: The COVID-19 pandemic and associated containment measures dramatically affected the health care systems including the screening of human immunodeficiency virus and the management people living ... [more ▼]

Background: The COVID-19 pandemic and associated containment measures dramatically affected the health care systems including the screening of human immunodeficiency virus and the management people living with HIV around the world by making the access to preventive care services and specific medical monitoring more difficult. Objective: To study the impact of the COVID-19 pandemic on the holistic care of people living with HIV in Liège (Belgium). Methods: In this retrospective observational study conducted in Liège University Hospital, we compared the out-patient follow-up of HIV-infected individuals as well as the number of new HIV diagnoses between 2019 and 2020 and between the different waves of the COVID-19 pandemic in 2020. Results: In 2020, when compared to 2019, we observed a significant decrease in the number of new HIV diagnoses, especially during the first wave of the pandemic, and in the number of consultations undertaken by sexual health services, psychologists and specialists in infectious diseases at our HIV clinic. We also observed a decrease in the number of viral load assays and blood CD4 + T-cells count analyses performed, although we found less patients with HIV plasma viral load above 400 copies per mL in 2020. Finally, we noted a significant reduction in terms of screening of our HIV-infected patients for hepatitis C, syphilis, colorectal and anal cancers and hypercholesterolemia. Conclusions: Our experience exhibits the deleterious impact of the COVID-19 pandemic on the HIV care and the need to implement new strategies to guarantee its continuum. [less ▲]

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See detailAsthma and COPD Are Not Risk Factors for ICU Stay and Death in Case of SARS-CoV2 Infection
CALMES, Doriane ULiege; Graff, Sophie ULiege; MAES, Nathalie ULiege et al

in Journal of Allergy and Clinical Immunology: In Practice (2021), 9(1), 160-169

BACKGROUND: Asthmatics and patients with chronic obstructive pulmonary disease (COPD) have more severe outcomes with viral infections than people without obstructive disease. OBJECTIVE: To evaluate if ... [more ▼]

BACKGROUND: Asthmatics and patients with chronic obstructive pulmonary disease (COPD) have more severe outcomes with viral infections than people without obstructive disease. OBJECTIVE: To evaluate if obstructive diseases are risk factors for intensive care unit (ICU) stay and death due to coronavirus disease 2019 (COVID19). METHODS: We collected data from the electronic medical record from 596 adult patients hospitalized in University Hospital of Liege between March 18 and April 17, 2020, for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. We classified patients into 3 groups according to the underlying respiratory disease, present before the COVID19 pandemic. RESULTS: Among patients requiring hospitalization for COVID19, asthma and COPD accounted for 9.6% and 7.7%, respectively. The proportions of asthmatics, patients with COPD, and patients without obstructive airway disease hospitalized in the ICU were 17.5%, 19.6%, and 14%, respectively. One-third of patients with COPD died during hospitalization, whereas only 7.0% of asthmatics and 13.6% of patients without airway obstruction died due to SARS-CoV2. The multivariate analysis showed that asthma, COPD, inhaled corticosteroid treatment, and oral corticosteroid treatment were not independent risk factors for ICU admission or death. Male gender (odds ratio [OR]: 1.9; 95% confidence interval [CI]: 1.1-3.2) and obesity (OR: 8.5; 95% CI: 5.1-14.1) were predictors of ICU admission, whereas male gender (OR 1.9; 95% CI: 1.1-3.2), older age (OR: 1.9; 95% CI: 1.6-2.3), cardiopathy (OR: 1.8; 95% CI: 1.1-3.1), and immunosuppressive diseases (OR: 3.6; 95% CI: 1.5-8.4) were independent predictors of death. CONCLUSION: Asthma and COPD are not risk factors for ICU admission and death related to SARS-CoV2 infection. [less ▲]

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See detailSmartphone application-assisted oral hygiene of orthodontic patients: a multicentre randomized controlled trial in adolescents
Deleuse, Marine; BRUWIER, Annick ULiege; MAES, Nathalie ULiege

in European Journal of Orthodontics (2020), 42

Objective: The aim of this trial was to test whether the use of a smartphone application (app) connected to a toothbrush improves the oral hygiene compliance of adolescent orthodontic patients. Design ... [more ▼]

Objective: The aim of this trial was to test whether the use of a smartphone application (app) connected to a toothbrush improves the oral hygiene compliance of adolescent orthodontic patients. Design: The study was designed as a multicentre, randomized, controlled clinical trial. Setting: Two academic hospitals. Ethical approval: The study was approved by the ethics committee. Subjects and methods: This multicentre randomized controlled trial was conducted on 38 adolescents aged 12–18 years with full-fixed orthodontic appliances. Participants were randomly assigned either to a test group that used an interactive oscillating/rotating electric toothbrush connected to a brushing aid app or to a control group that used an oscillating/rotating electric toothbrush alone. At baseline, all patients received verbal and written oral hygiene instructions. Outcome measurements: Data collection was performed at T1 (baseline), T2 (6 weeks), T3 (12 weeks) and T4 (18 weeks—end of the study). At each time point, the plaque index (PI), gingival index (GI) and white spot lesion (WSL) score were recorded. Several app-related parameters were evaluated. Patient-related outcome measures were investigated in the test group. Results: Test and control groups were similar at baseline except for WSL score. Between T1 and T4, PI and GI decreased significantly in both groups but evolutions were globally similar in both groups. Interestingly, at T3 (12 weeks), the PI was significantly lower in the app group than in the control group (P = 0.014). Data showed a marked decline in the use of the app over time in the test group. Conclusions: This trial, conducted over 18 weeks in two academic hospitals, showed no significant effect of the use of the app in promoting oral hygiene. [less ▲]

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See detailRôle de la médecine physique et réadaptation fonctionnelle dans les suites d’une atteinte au SARS-CoV-2
Sauvant, Céline ULiege; Bodet, Colin ULiege; MORICLET, Tommy ULiege et al

in Revue Médicale de Liège (2020), 75(Supplément 1), 153-158

2020 will be remembered as the year of SARSCoV-2 pandemic which confined most of the world’s population at home. Rehabilitation units will have to face specific challenges to protect the vulnerable in ... [more ▼]

2020 will be remembered as the year of SARSCoV-2 pandemic which confined most of the world’s population at home. Rehabilitation units will have to face specific challenges to protect the vulnerable in-patients. Moreover, they must prepare for post-COVID-19 patients who might suffer from illness consequences or present a post intensive care syndrome secondary to the increased ICU length of stay. The purpose of this paper is to highlight the deficiencies of post-COVID-19 patients and suggest a decision algorithm to best match their needs. [less ▲]

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See detailContinuous infusion of cefepime and neurotoxicity: a retrospective cohort study.
Vercheval, Christelle ULiege; Sadzot, Bernard ULiege; MAES, Nathalie ULiege et al

in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases (2020)

Objectives: Neurotoxicity related to cefepime is increasingly reported in the literature but specific data concerning continuous infusion (CI) of the drug are still lacking. Our primary objective was to ... [more ▼]

Objectives: Neurotoxicity related to cefepime is increasingly reported in the literature but specific data concerning continuous infusion (CI) of the drug are still lacking. Our primary objective was to evaluate the incidence of neurotoxicity related to CI of cefepime and the associated risk factors. Our secondary objectives were to analyse the plasma cefepime concentrations and to define the threshold above which neurotoxicity occurs. Methods: In this single-centre retrospective cohort study, all adult patients who underwent at least one cefepime therapeutic drug monitoring (TDM) and were treated with CI of 4 g/day between January 2017 and June 2019 were included. Neurotoxicity was evaluated according to a strict definition and was correlated with steady-state concentration at the time of toxicity presentation. Results: Ninety-eight patients with 201 cefepime TDM studies were included, with an incidence of neurotoxicity of 14.3% (14/98). Patients with neurotoxicity had more often underlying brain disease (35.7% (5/14) vs 11.9% (10/84), p = 0.030)) and higher steady-state concentrations (mean ± standard deviation 71.8 ± 32.9 mg/L vs 49.6 ± 30.6, p = 0.036) than the others. A receiver operating characteristic curve analysis yielded a cefepime steady-state concentration of 63.2 mg/L as the best cut-off point between patients with or without neurotoxicity. A mean steady-state concentration of 46.4 mg/L was achieved if the dosages of cefepime were adapted to renal function which was under our threshold concentration but above our highest pharmacokinetic/pharmacodynamic target of 32-40 mg/L. Conclusions: Our results suggest that 4 g/day of cefepime adapted to renal function and infused over 24 h is a trade-off for the risk/benefit ratio, when used empirically. [less ▲]

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See detailSympathetic Effect of Auricular Transcutaneous Vagus Nerve Stimulation on Healthy Subjects: A Crossover Controlled Clinical Trial Comparing Vagally Mediated and Active Control Stimulation Using Microneurography.
Gauthey, Anaïs; Morra, Sofia; van de Borne, Philippe et al

in Frontiers in physiology (2020), 11

INTRODUCTION: Auricular low-level transcutaneous vagus nerve stimulation (aLL-tVNS) has emerged as a promising technology for cardiac arrhythmia management but is still experimental. In this physiological ... [more ▼]

INTRODUCTION: Auricular low-level transcutaneous vagus nerve stimulation (aLL-tVNS) has emerged as a promising technology for cardiac arrhythmia management but is still experimental. In this physiological study, we hypothesized that aLL-tVNS modulated the autonomic nervous balance through a reduction of sympathetic tone and an increase in heart rate variability (HRV). We investigated the muscle sympathetic nerve activity (MSNA) recorded by microneurography during vagally mediated aLL-tVNS and active control on healthy volunteers. METHODS: In this crossover, double-blind controlled study, healthy men (N = 28; 27 ± 4 years old) were assigned to aLL-tVNS applied to cymba and lobe (active control) of the right ear. Each participant was randomly allocated to the three sequences (5 Hz, 20 Hz, and active control-5 Hz) during one session. MSNA signal was recorded at rest, during voluntarily apnea and aLL-tVNS. Sympathetic activity was expressed as: 1) number of bursts per minute (burst frequency, BF) and 2) MSNA activity calculated as BF x mean burst amplitude and expressed as changes from baseline (%). RR intervals, HRV parameters and sympathetic activity were analyzed during 5 min-baseline, 10 min-stimulation, and 10 min-recovery periods. Mixed regression models were performed to evaluate cymba-(5-20 Hz) effects on the parameters with stimulation. RESULTS: During apnea and compared to baseline, BF and MSNA activity increased (p = 0.002, p = 0.001, respectively). No stimulation effect on RR intervals and HRV parameters were showed excepted a slightly increase of the LF/HF ratio with stimulation in the cymba-5Hz sequence (coef. ± SE: 0.76 ± 0.32%; p = 0.02). During stimulation, reductions from baseline in BF (Coef. ± SE: -4.8 ± 1.1, p < 0.001) was observed but was not statistically different from that one in the active control. Reduction of MSNA activity was not significantly different between sequences. CONCLUSION: Acute right cymba aLL-tVNS did not induce any overall effects neither on heart rate, HRV nor MSNA variables on healthy subjects when compared to active control. Interestingly, these findings questioned the role of active controls in medical device clinical trials that implied subjective endpoints. [less ▲]

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See detailStandard vs computer-aided design/computer-aided manufacturing customized self-ligating systems using indirect bonding with both.
Jackers, Nastasia; MAES, Nathalie ULiege; Lambert, France ULiege et al

in Angle Orthodontist (2020)

OBJECTIVE: To compare treatment duration and quality between standard vs computer-aided design/computer-aided manufacturing (CAD/CAM) customized self-ligating systems using indirect bonding with both ... [more ▼]

OBJECTIVE: To compare treatment duration and quality between standard vs computer-aided design/computer-aided manufacturing (CAD/CAM) customized self-ligating systems using indirect bonding with both. MATERIALS AND METHODS: This comparative trial included 24 patients: 12 treated with a CAD/CAM custom indirect bonding self-ligating system (CAD/CAM) and 12 others treated with an indirect bonding self-ligating standard system (I-STD). For each group, overall orthodontic treatment (OT) time was calculated and included the time needed to place each arch as well as the duration of the alignment and fine-tuning phases. The quality of the final result was analyzed using the American Board of Orthodontics Cast-Radiograph Evaluation. Patient-reported outcome measures (PROMs) were also evaluated. RESULTS: Patient characteristics were similar between the 2 groups except for age, which was slightly lower in the I-SDT group. Overall OT time was increased by 26% in the I-STD group compared with the CAD/CAM group (497 ± 40 days vs 393 ± 55 days, P = 0.0002) due to a shorter fine-tuning phase in the latter group (P<0.01). No difference was found between the groups for alignment phase. Quality of the final result was similar (I-STD, 25.7 ± 6.1; CAD/CAM, 21.6 ± 6.3) among the groups. Finally, no difference was found in the PROMs variables. CONCLUSIONS: Despite a 26% longer OT time when compared with the CAD/CAM customized bracket system, the indirect bonding self-ligating bracket system demonstrated the same quality of treatment. PROMs demonstrated a high level of acceptance and satisfaction for both techniques. [less ▲]

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See detailSodium and Potassium Intake: A New Statistical Model to Test Their Effects on Health Outcomes.
Dériaz, Denis ULiege; MAES, Nathalie ULiege; Kolh, Philippe ULiege et al

in Kidney International Reports (2020), 5(12), 2403

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See detailEvolution of Drug Interactions With Antiretroviral Medication in People With HIV.
El Moussaoui, Majdouline ULiege; Lambert, Iseult ULiege; MAES, Nathalie ULiege et al

in Open Forum Infectious Diseases (2020), 7(11), 416

BACKGROUND: Polypharmacy and drug interactions are important issues for HIV-infected individuals. The number and nature of those interactions are continuously evolving with the use of new antiretroviral ... [more ▼]

BACKGROUND: Polypharmacy and drug interactions are important issues for HIV-infected individuals. The number and nature of those interactions are continuously evolving with the use of new antiretroviral drugs and the aging of HIV-infected individuals. We aimed to analyze this evolution over time. METHODS: This retrospective cohort study was conducted in the University Hospital of Liège (Belgium). Treatments of HIV-infected outpatients attending Liège University Hospital were collected and analyzed in 2012 and 2016. The University of Liverpool HIV drug interactions database was used to determine drug interactions. RESULTS: We included 1038 patients in 2016, of whom 78% had 1 comedication. Polypharmacy was seen in 20% of the cohort. Four percent of the patients presented red flag interactions, and 38% had orange flag interactions. Nonantiretroviral (non-ARV) therapeutic classes involved in drug interactions were mostly cardiovascular and central nervous system drugs. They were followed by hormone drugs and dietary supplements for orange flag interactions. Two factors significantly contributed to both red and orange flag interactions: the number of non-ARV comedications and protease inhibitor-based ARV regimens. The proportion of patients with red or orange flag interactions remained stable from 2012 to 2016. CONCLUSIONS: This study highlights the persistence of an alarming number of contraindicated drug interactions and a high prevalence of potential drug interactions over time. Identification, prevention, and management of drug interactions remain a key priority in HIV care. [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 detailPatient-reported outcomes measures (PROMs) following a piezocision-assisted versus conventional orthodontic treatments : a randomized controlled trial in adults
CHARAVET, Carole ULiege; LECLOUX, Geoffrey ULiege; JACKERS, Nastasia et al

in Clinical Oral Investigations (2019)

Objective : To explore patient-related outcomes measures (PROMs) of piezocision-assisted orthodontic treatment compared to aconventional orthodontic treatment using customized appliance. Materials and ... [more ▼]

Objective : To explore patient-related outcomes measures (PROMs) of piezocision-assisted orthodontic treatment compared to aconventional orthodontic treatment using customized appliance. Materials and methods : Twenty-four adult patients requiring orthodontic treatment for mild-to-moderate overcrowding in both jaws were randomly assigned to a test group, treated with a piezocision-assisted orthodontic treatment, or to a control group, where piezocision was not applied. The patient-related outcomes were recorded using a 0–10 visual analog scale (VAS). Daily analgesic consumption and pain level were also recorded following the placement of the orthodontic appliance in both groups and after the piezocision procedure in the test group. Moreover, levels of apprehension and satisfaction were also assessed in both groups. Results : In the piezocision group, over the 7-day period, paracetamol consumption was comparable after the placement of the orthodontic appliance and after the piezocision surgery. Pain levels after the orthodontic and the surgical procedure decreased with time (p < 0.0001) but remained globally higher after piezocision (p = 0.0056). Significantly, more patients of the piezocision group reported that they would undergo the treatment again (p = 0.033) and that they greatly appreciated the duration of treatment(p = 0.0008). However, the level of apprehension was significantly higher in the piezocision group compared to the test group(p =0.012). Conclusions : Although, the degree of apprehension before the surgery and higher pain level in the piezocision group, PROMs emphasized similar pain killer consumption in both group and revealed high acceptance and satisfaction with piezocision approach. Clinical relevance : The benefit of piezocision-assisted orthodontic treatment seems to be relevant from a patient perspective. Trial registration : NCT03406130 [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 detailEtude des motifs d'admission au service des Urgences d'une cohorte de patients
Pirotte, Benoit; FRIPPIAT, Frédéric ULiege; DARCIS, Gilles ULiege et al

in Revue Médicale de Liège (2019)

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See detailFacteurs anatomo-cliniques influançant la collecte ganglionnaire dans les pièces de résection chirurgicale pour cancer colorectal
LEDUC, G; BAWIN, Maxime; KESTEMAN, M et al

in Revue Médicale de Liège (2019), 74:10

Dans la stadification de l’adénocarcinome colorectal, le statut ganglionnaire anatomopathologique constitue une information capitale pour le clinicien et doit être défini avec un maximum d’exactitude ... [more ▼]

Dans la stadification de l’adénocarcinome colorectal, le statut ganglionnaire anatomopathologique constitue une information capitale pour le clinicien et doit être défini avec un maximum d’exactitude. L’analyse de la pièce de résection chirurgicale requiert la collecte au sein du méso du plus grand nombre possible de ganglions lymphatiques. Dans cette étude, nous avons analysé une série de facteurs anatomo-cliniques pouvant influencer la collecte ganglionnaire. Un total de 239 patients a été inclus dans notre étude. Les facteurs avec une influence statistiquement significative sur la collecte ganglionnaire (p < 0,05) ont été l’âge et le sexe du patient, la taille de la tumeur primitive, la taille de la pièce d’exérèse, le degré d’activité du chirurgien et le laboratoire d’anatomie pathologique. La présence ou non d’une radiochimiothérapie néoadjuvante n’a pas eu d’impact sur le nombre de ganglions prélevés. Cette étude souligne l’importance de la collecte ganglionnaire au sein des pièces de résection chirurgicale d’un cancer colo-rectal. [less ▲]

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See detailMultilevel biological responses following piezocision to accelerate orthodontic tooth movement: A study in rats
CHARAVET, Carole ULiege; Van hede, Dorien ULiege; Anania, Sandy ULiege et al

in Journal of the World Federation of Orthodontists (2019)

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