Francis Zech | UCLouvain (University of Louvain) (original) (raw)

Papers by Francis Zech

Research paper thumbnail of Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA) constatés lors de la prise en charge initiale du SMUR : résultats d’une étude observationnelle multicentrique nationale sur mission du SPF santé publique, Sé

Journal Européen des Urgences, 2008

Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA)... more Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA) constatés lors de la prise en charge initiale du SMUR : résultats d'une étude observationnelle multicentrique nationale sur mission du SPF santé publique, Sé

Research paper thumbnail of Severe imported plasmodium vivax malaria as a cause of pseudohypereosinophilia

Research paper thumbnail of Acute localized diverticulitis: Optimum management requires accurate staging

International Journal of Colorectal Disease - INT J COLORECTAL DIS, 1992

Between 1977 and 1989, 151 patients were treated in our institution for acute sigmoid diverticuli... more Between 1977 and 1989, 151 patients were treated in our institution for acute sigmoid diverticulitis. Thirty-one patients were operated on for diffuse peritonitis, and were excluded from the study. One hundred twenty patients had localized disease. There were 59 men and 61 women, with a mean age of 60 years (range, 30 to 87 years). Thirteen were under 40 years of age. A “phlegmonous” diverticulitis (no pericolic abscess) was diagnosed in 78 cases (group I). A pericolic abscess was identified in 42 cases (group II). The medical treatment was successful in 97% of the patients of the group I. Only 15 patients required a delayed elective resection for recurrence or chronic complications, within the next 24 months. There were no operative deaths. All the other patients were doing well after a mean follow-up of 5 years (9–144 months), without any disease-related death. Patients presenting with a localized pericolic abscess (group II,n=42) were initially treated either conservatively (n=22...

Research paper thumbnail of Early AIDS Cases Originating from Zaïre and Burundi (1962–1976)

Scandinavian Journal of Infectious Diseases, 1987

Three retrospectively diagnosed fatal AIDS cases are reported and discussed together with 4 other... more Three retrospectively diagnosed fatal AIDS cases are reported and discussed together with 4 other HIV seropositive patients, who all apparently contracted the HIV infection prior to the beginning of the present outbreak, without any other risk factor than heterosexual exposure in Central Africa. These data and simultaneous information from other sources contribute to the assumption that AIDS is an old disease in Central Africa. AIDS, having presented itself as a sporadic and ill defined entity, remained unrecognized in Central Africa until the outset of the present outbreak.

Research paper thumbnail of Quantification of darunavir and etravirine in human peripheral blood mononuclear cells using high performance liquid chromatography tandem mass spectrometry (LC-MS/MS), clinical application in a cohort of 110 HIV-1 infected patients and evidence of a potential drug-drug interaction

Clinical biochemistry, Jan 29, 2015

To describe the validation of a sensitive high performance liquid chromatography tandem mass spec... more To describe the validation of a sensitive high performance liquid chromatography tandem mass spectrometry (LC-MS/MS) method allowing the simultaneous quantification of darunavir (DRV) and etravirine (ETR) in peripheral blood mononuclear cells (PBMCs) and its application in a cohort of HIV-1 infected patients. Blood samples were obtained from 110 patients. PMBCs were isolated using density gradient centrifugation. Drug extraction from PBMCs was performed with a 60:40 methanol-water (MeOH-H2O) solution containing deuterated IS (DRV-d9 and ETR-d8). The chromatographic separation was performed on a RP18 XBridge™ column. The geometric mean (GM) of cell associated concentration ([DRV]CC) and plasmatic concentration ([DRV]plasma) were 360.5ng/mL (CI95%:294.5-441.2) and 1733ng/mL (CI95%:1486-2021), respectively. A geometric mean intracellular (IC)/plasma ratio (GMR) of 0.21 (CI95%:0.18-0.24) was calculated. Adjusted for dose/body surface area and post-intake time, a statistically significan...

Research paper thumbnail of High unacylated ghrelin levels support the concept of anorexia in infants with prader-willi syndrome

Orphanet journal of rare diseases, 2016

Prader-Willi syndrome (PWS) is a rare genetic neurodevelopmental disorder with different nutritio... more Prader-Willi syndrome (PWS) is a rare genetic neurodevelopmental disorder with different nutritional phases from suckling deficit with failure to thrive to early onset of obesity. Hyperghrelinemia has been described in PWS long before the development of obesity. Ghrelin is found in both acylated (AG) and unacylated (UAG) forms in the circulation. In contrast to AG, UAG has been shown to inhibit food intake and to be elevated in anorexia nervosa. The present project is aiming to determine the underlying mechanisms driving the different nutritional phases in PWS. Measurement of at least 4 h-fasting plasma acylated and unacylated ghrelin in 37 infants with a genetic diagnosis of PWS aged from 1 month to 4 years and in 100 age-matched controls without endocrine disorder recruited prior to minor surgery. One blood sampling was analysed for each patient/control and clinical data were recorded. Eleven PWS infants underwent repetitive blood samples at 3 or 6-month intervals during routine v...

Research paper thumbnail of Dans l'insuffisance respiratoire aiguë (IRA) du patient BPCO, le monitorage éléctromyographique quantitatif de surface (EMGs) de l'activité des muscles accessoires sternocleidomastoïdiens (SCM) est-il légitime pour quantifier l'effort respiratoire?

Journal Européen des Urgences, 2007

Research paper thumbnail of Les médecins urgentistes sont-ils responsables de la survenue aux soins intensifs de pneumonies associées à la ventilation mécanique ?

Journal Européen des Urgences, 2009

Research paper thumbnail of Épidémiologie des pneumonies communautaires en Belgique

Journal Européen des Urgences, 2007

Research paper thumbnail of Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA) constatés lors de la prise en charge initiale du SMUR : résultats d’une étude observationnelle multicentrique nationale sur mission du SPF santé publique, Sé

Journal Européen des Urgences, 2008

Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA)... more Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA) constatés lors de la prise en charge initiale du SMUR : résultats d'une étude observationnelle multicentrique nationale sur mission du SPF santé publique, Sé

Research paper thumbnail of Les furoncles vus en salle d'urgence portent la signature du staphylocoque doré sécréteur de la toxine Panton-Valentine

Journal Européen des Urgences, 2007

La prise en charge du sepsis grave à partir des structures d'urgence est-elle conforme au recomma... more La prise en charge du sepsis grave à partir des structures d'urgence est-elle conforme au recommandations ?

Research paper thumbnail of Characterization of insulin resistance in young adult survivors of childhood acute lymphoblastic leukaemia and non-Hodgkin lymphoma

Annales d'Endocrinologie, 2013

An increased prevalence of metabolic disorders and cardiovascular (CV) disease has been reported ... more An increased prevalence of metabolic disorders and cardiovascular (CV) disease has been reported in childhood acute lymphoblastic leukaemia (ALL)/non-Hodgkin lymphoma (NHL) cancer survivors. To characterize the determinants of insulin resistance (IR) observed in this population, according to the treatment received. Ninety one patients (45 men, mean age: 24 ± 5 years; mean follow-up: 15 ± 5 years) previously treated for a childhood ALL (n = 76) or NHL (n = 15) were grouped according to their previous treatment: chemotherapy only (Group I; n = 43), chemotherapy + cranial irradiation (CI) (Group II; n = 32) and chemotherapy + bone marrow transplant (BMT)/total body irradiation (TBI) (Group III, n = 16). A high prevalence of IR (HOMA-S < 60%) was observed in the BMT/TBI group (88%) compared to groups I (9%) and II (16%). The IR patients from groups [I+II] (12% of these groups) showed higher BMI, fat mass (FM) and visceral fat when compared with the non-IR patients. In contrast, the IR patients from group III had mean BMI and total FM similar to those of non-IR patients but showed a reduction of lean body mass and an increase in the relative proportion of trunk FM similar to the IR patients from groups [I + II]. This was associated with an altered lipid profile, high TNF-α and IL-6 levels, and reduced adiponectin levels compared to IR patients from group [I + II] and non-IR patients. Childhood ALL/NHL survivors treated by BMT/TBI frequently develop severe insulin resistance associated with peripheral-to-central fat redistribution, rather than increased total FM, and low adiponectin levels which may contribute to their increased CV risk.

Research paper thumbnail of Venous thromboembolism associated with acute cytomegalovirus infection: epidemiology and predisposing conditions

Acta Clinica Belgica, 2016

Venous thromboembolism has been reported in association with cytomegalovirus (CMV) infection both... more Venous thromboembolism has been reported in association with cytomegalovirus (CMV) infection both in immunocompromised and immunocompetent patients. In this population, it is yet undetermined whether CMV alone provokes VTE or other predisposing conditions are involved. 1007 VTE patients consecutively recruited in one academic hospital were analyzed retrospectively in order to identify acute CMV infection. Acquired and inherited risk factors were screened. Only adults and immunocompetent patients were included. Among 1007 consecutive VTE patients, we identified 10 patients with synchronous acute CMV infection. Patients with coexistent VTE and acute CMV infection were younger (37.5 years vs. 56.6 years; p = 0.0088) and exhibited a female predominance (90% vs. 56%; p = 0.026), in comparison to the whole cohort. Hereditary thrombophilia was identified in 9 out of 10 patients. Acquired risk factors for VTE like estrogens administration and pregnancy were equally prevalent in patients with and without CMV infection. Acute CMV infection is a potential contributor to VTE whenever other prothrombotic conditions are required. This should help clinicians to privilege a limited duration of anticoagulant treatment like in other provoked VTE.

Research paper thumbnail of Sinusoidal obstruction syndrome (SOS) related to chemotherapy for colorectal liver metastases: factors predictive of severe SOS lesions and protective effect of bevacizumab

Hpb the Official Journal of the International Hepato Pancreato Biliary Association, Jan 18, 2013

OBJECTIVES: The most frequent presentation of chemotherapy-related toxicity in colorectal liver m... more OBJECTIVES: The most frequent presentation of chemotherapy-related toxicity in colorectal liver metastases (CRLM) is sinusoidal obstruction syndrome (SOS). The purpose of the present study was to identify preoperative factors predictive of SOS and to establish associations between type of chemotherapy and severity of SOS. METHODS: A retrospective study was carried out in a tertiary academic referral hospital. Patients suffering from CRLM who had undergone resection of at least one liver segment were included. Grading of SOS on the non-tumoral liver parenchyma was accomplished according to the Rubbia-Brandt criteria. A total of 151 patients were enrolled and divided into four groups according to the severity of SOS (grades 0-3). RESULTS: Multivariate analysis identified oxaliplatin and 5-fluorouracil as chemotherapeutic agents responsible for severe SOS lesions (P < 0.001 and P = 0.005, respectively). Bevacizumab was identified as having a protective effect against the occurrence of SOS lesions (P = 0.005). Univariate analysis identified the score on the aspartate aminotransferase : platelets ratio index (APRI) as the most significant biological factor predictive of severe SOS lesions. Splenomegaly is also significantly associated with the occurrence of severe SOS lesions. CONCLUSIONS: The APRI score and splenomegaly are effective as factors predictive of SOS. Bevacizumab has a protective effect against SOS.

Research paper thumbnail of Étude Des Facteurs Déterminant Le Développement Précoce D'Athérosclérose Chez L'Enfant et L'Adolescent en Excès Pondéral

Research paper thumbnail of Prognostic risk factors of survival after resection of hepatocellular carcinoma

Hepato Gastroenterology, Sep 1, 2007

Surgical resection is a standard treatment of hepatocellular carcinoma, but liver cirrhosis is kn... more Surgical resection is a standard treatment of hepatocellular carcinoma, but liver cirrhosis is known to be associated to a high tumor recurrence rate. A retrospective study of 55 consecutive patients (37 males, 18 females) suffering from hepatocellular carcinoma having undergone surgical resection. Hepatocellular carcinoma developed in 29 patients with normal liver (group A) and in 26 patients with chronic liver disease (CLD) (group B). Patients were significantly older and at high-risk in Group B. Radical liver resection was achieved in 98% (100% in group A; 96% in group B). Overall 2-month mortality was 2% (0% in group A; 4% in group B). The 5-year overall and disease-free survival was respectively 55% and 35%. However, the 5-year overall and disease-free survival was significantly better in Group A (71% and 59%) compared to Group B (37% and 6%) (p < 0.001), respectively. Multivariate statistical analysis demonstrated that age > 50 years, poor tumor differentiation and presence of satellite nodules were significant independent adverse predictive factors of overall and disease-free survival. Resection of HCC is safe and effective with satisfactory overall and disease-free survival rates, except when underlying chronic liver disease and poor tumor differentiation are present.

Research paper thumbnail of Percutaneous and surgical radiofrequency ablation of liver malignancies: a single institutional experience

Acta gastro-enterologica Belgica

the purpose of this study was to report a single academic institution's experience with radio... more the purpose of this study was to report a single academic institution's experience with radiofrequency ablation (RFA) of liver malignancies Sixty-five patients underwent RFA technique through a percutaneous (Group I: 33 patients) or a surgical approach (Group II: 32 patients). The two groups were different according to type of disease selection (more hepatocellular carcinoma in Group I and liver metastases in Group II) and tumour features (smaller size but greater number of lesions in Group II). In Group II, RFA was associated to liver resection in 23 patients (72%). The 2-month postoperative mortality and complication rates were low in both groups. The postoperative hospital stay was longer in Group II. During a median follow-up of 24 months in Group I and 21 months in Group II, the local "in-situ" recurrence rate was 41.4% and 9.1%, respectively. For RFA-treated tumours < 30 mm in size, the local "in-situ" recurrence rate was 40.5% in Group I and 0% in G...

Research paper thumbnail of Severe imported plasmodium vivax malaria as a cause of pseudohypereosinophilia

Research paper thumbnail of The outcome after transjugular intrahepatic portosystemic shunt (TIPS) for hepatic hydrothorax is closely related to liver dysfunction: a long-term study in 28 patients

Acta gastro-enterologica Belgica

Hepatic hydrothorax is a rare but challenging complication of cirrhosis. The Transjugular Intrahe... more Hepatic hydrothorax is a rare but challenging complication of cirrhosis. The Transjugular Intrahepatic Portosystemic Shunt (TIPS) appears as one of the most successful approach of therapy. To assess long-term efficacy and safety, we reviewed 28 patients (Child B/C: 43/57%) who underwent TIPS placement for refractory hepatic hydrothorax in our institution between 1992 and 2001. The 30-days mortality was 14%, reaching 25% at 90 days. The one-year survival without liver transplantation was 41.2%. Reduction in the volume of pleural effusion and improvement in clinical symptoms was observed in 68% while a complete radiological and echographic disappearance of hydrothorax was documented in 57%. Statistical analysis showed that poor liver function was predictive of mortality and non-response. Of the different liver function parameters and in this small series, the Child-Pugh score was more discriminating than the recently described Mayo risk score. This study shows that TIPS is effective i...

Research paper thumbnail of Evaluation of tumor necrosis factor-alpha, interleukin-6 and C-reactive protein plasma levels as predictors of bacteremia in patients presenting signs of sepsis without shock

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 1997

OBJECTIVE: To evaluate the sensitivity of interleukin-6 (IL-6) and tumor necrosis factor-alpha (T... more OBJECTIVE: To evaluate the sensitivity of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) plasma measurement to detect bacteremia in patients presenting sepsis signs, and to evaluate the potential benefit of such measurement in terms of early antimicrobial therapy initiation. METHODS: Plasma was obtained from 166 hospitalized patients for whom blood cultures were drawn for sepsis. Clinical data and antimicrobial therapies were noted. IL-6, TNF and C-reactive protein (CRP) were measured. The sensitivities of these markers were retrospectively compared with the accuracy of the attending physician in initiating empirical antimicrobial therapy. The setting was an 850-bed university hospital. RESULTS: Thirty-four bacteremias and 69 non-bacteremic infections were noted. In 63 others, no infection was documented. Median (range) IL-6 plasma levels in the three groups of patients were 462 (15--50 850), 189 (<15--38 300) and 91 (<10--13 750) pg/mL, respectively (p<0....

Research paper thumbnail of Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA) constatés lors de la prise en charge initiale du SMUR : résultats d’une étude observationnelle multicentrique nationale sur mission du SPF santé publique, Sé

Journal Européen des Urgences, 2008

Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA)... more Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA) constatés lors de la prise en charge initiale du SMUR : résultats d'une étude observationnelle multicentrique nationale sur mission du SPF santé publique, Sé

Research paper thumbnail of Severe imported plasmodium vivax malaria as a cause of pseudohypereosinophilia

Research paper thumbnail of Acute localized diverticulitis: Optimum management requires accurate staging

International Journal of Colorectal Disease - INT J COLORECTAL DIS, 1992

Between 1977 and 1989, 151 patients were treated in our institution for acute sigmoid diverticuli... more Between 1977 and 1989, 151 patients were treated in our institution for acute sigmoid diverticulitis. Thirty-one patients were operated on for diffuse peritonitis, and were excluded from the study. One hundred twenty patients had localized disease. There were 59 men and 61 women, with a mean age of 60 years (range, 30 to 87 years). Thirteen were under 40 years of age. A “phlegmonous” diverticulitis (no pericolic abscess) was diagnosed in 78 cases (group I). A pericolic abscess was identified in 42 cases (group II). The medical treatment was successful in 97% of the patients of the group I. Only 15 patients required a delayed elective resection for recurrence or chronic complications, within the next 24 months. There were no operative deaths. All the other patients were doing well after a mean follow-up of 5 years (9–144 months), without any disease-related death. Patients presenting with a localized pericolic abscess (group II,n=42) were initially treated either conservatively (n=22...

Research paper thumbnail of Early AIDS Cases Originating from Zaïre and Burundi (1962–1976)

Scandinavian Journal of Infectious Diseases, 1987

Three retrospectively diagnosed fatal AIDS cases are reported and discussed together with 4 other... more Three retrospectively diagnosed fatal AIDS cases are reported and discussed together with 4 other HIV seropositive patients, who all apparently contracted the HIV infection prior to the beginning of the present outbreak, without any other risk factor than heterosexual exposure in Central Africa. These data and simultaneous information from other sources contribute to the assumption that AIDS is an old disease in Central Africa. AIDS, having presented itself as a sporadic and ill defined entity, remained unrecognized in Central Africa until the outset of the present outbreak.

Research paper thumbnail of Quantification of darunavir and etravirine in human peripheral blood mononuclear cells using high performance liquid chromatography tandem mass spectrometry (LC-MS/MS), clinical application in a cohort of 110 HIV-1 infected patients and evidence of a potential drug-drug interaction

Clinical biochemistry, Jan 29, 2015

To describe the validation of a sensitive high performance liquid chromatography tandem mass spec... more To describe the validation of a sensitive high performance liquid chromatography tandem mass spectrometry (LC-MS/MS) method allowing the simultaneous quantification of darunavir (DRV) and etravirine (ETR) in peripheral blood mononuclear cells (PBMCs) and its application in a cohort of HIV-1 infected patients. Blood samples were obtained from 110 patients. PMBCs were isolated using density gradient centrifugation. Drug extraction from PBMCs was performed with a 60:40 methanol-water (MeOH-H2O) solution containing deuterated IS (DRV-d9 and ETR-d8). The chromatographic separation was performed on a RP18 XBridge™ column. The geometric mean (GM) of cell associated concentration ([DRV]CC) and plasmatic concentration ([DRV]plasma) were 360.5ng/mL (CI95%:294.5-441.2) and 1733ng/mL (CI95%:1486-2021), respectively. A geometric mean intracellular (IC)/plasma ratio (GMR) of 0.21 (CI95%:0.18-0.24) was calculated. Adjusted for dose/body surface area and post-intake time, a statistically significan...

Research paper thumbnail of High unacylated ghrelin levels support the concept of anorexia in infants with prader-willi syndrome

Orphanet journal of rare diseases, 2016

Prader-Willi syndrome (PWS) is a rare genetic neurodevelopmental disorder with different nutritio... more Prader-Willi syndrome (PWS) is a rare genetic neurodevelopmental disorder with different nutritional phases from suckling deficit with failure to thrive to early onset of obesity. Hyperghrelinemia has been described in PWS long before the development of obesity. Ghrelin is found in both acylated (AG) and unacylated (UAG) forms in the circulation. In contrast to AG, UAG has been shown to inhibit food intake and to be elevated in anorexia nervosa. The present project is aiming to determine the underlying mechanisms driving the different nutritional phases in PWS. Measurement of at least 4 h-fasting plasma acylated and unacylated ghrelin in 37 infants with a genetic diagnosis of PWS aged from 1 month to 4 years and in 100 age-matched controls without endocrine disorder recruited prior to minor surgery. One blood sampling was analysed for each patient/control and clinical data were recorded. Eleven PWS infants underwent repetitive blood samples at 3 or 6-month intervals during routine v...

Research paper thumbnail of Dans l'insuffisance respiratoire aiguë (IRA) du patient BPCO, le monitorage éléctromyographique quantitatif de surface (EMGs) de l'activité des muscles accessoires sternocleidomastoïdiens (SCM) est-il légitime pour quantifier l'effort respiratoire?

Journal Européen des Urgences, 2007

Research paper thumbnail of Les médecins urgentistes sont-ils responsables de la survenue aux soins intensifs de pneumonies associées à la ventilation mécanique ?

Journal Européen des Urgences, 2009

Research paper thumbnail of Épidémiologie des pneumonies communautaires en Belgique

Journal Européen des Urgences, 2007

Research paper thumbnail of Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA) constatés lors de la prise en charge initiale du SMUR : résultats d’une étude observationnelle multicentrique nationale sur mission du SPF santé publique, Sé

Journal Européen des Urgences, 2008

Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA)... more Valeur pronostique en termes de gravité des principaux symptômes des urgences respiratoires (IRA) constatés lors de la prise en charge initiale du SMUR : résultats d'une étude observationnelle multicentrique nationale sur mission du SPF santé publique, Sé

Research paper thumbnail of Les furoncles vus en salle d'urgence portent la signature du staphylocoque doré sécréteur de la toxine Panton-Valentine

Journal Européen des Urgences, 2007

La prise en charge du sepsis grave à partir des structures d'urgence est-elle conforme au recomma... more La prise en charge du sepsis grave à partir des structures d'urgence est-elle conforme au recommandations ?

Research paper thumbnail of Characterization of insulin resistance in young adult survivors of childhood acute lymphoblastic leukaemia and non-Hodgkin lymphoma

Annales d'Endocrinologie, 2013

An increased prevalence of metabolic disorders and cardiovascular (CV) disease has been reported ... more An increased prevalence of metabolic disorders and cardiovascular (CV) disease has been reported in childhood acute lymphoblastic leukaemia (ALL)/non-Hodgkin lymphoma (NHL) cancer survivors. To characterize the determinants of insulin resistance (IR) observed in this population, according to the treatment received. Ninety one patients (45 men, mean age: 24 ± 5 years; mean follow-up: 15 ± 5 years) previously treated for a childhood ALL (n = 76) or NHL (n = 15) were grouped according to their previous treatment: chemotherapy only (Group I; n = 43), chemotherapy + cranial irradiation (CI) (Group II; n = 32) and chemotherapy + bone marrow transplant (BMT)/total body irradiation (TBI) (Group III, n = 16). A high prevalence of IR (HOMA-S &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 60%) was observed in the BMT/TBI group (88%) compared to groups I (9%) and II (16%). The IR patients from groups [I+II] (12% of these groups) showed higher BMI, fat mass (FM) and visceral fat when compared with the non-IR patients. In contrast, the IR patients from group III had mean BMI and total FM similar to those of non-IR patients but showed a reduction of lean body mass and an increase in the relative proportion of trunk FM similar to the IR patients from groups [I + II]. This was associated with an altered lipid profile, high TNF-α and IL-6 levels, and reduced adiponectin levels compared to IR patients from group [I + II] and non-IR patients. Childhood ALL/NHL survivors treated by BMT/TBI frequently develop severe insulin resistance associated with peripheral-to-central fat redistribution, rather than increased total FM, and low adiponectin levels which may contribute to their increased CV risk.

Research paper thumbnail of Venous thromboembolism associated with acute cytomegalovirus infection: epidemiology and predisposing conditions

Acta Clinica Belgica, 2016

Venous thromboembolism has been reported in association with cytomegalovirus (CMV) infection both... more Venous thromboembolism has been reported in association with cytomegalovirus (CMV) infection both in immunocompromised and immunocompetent patients. In this population, it is yet undetermined whether CMV alone provokes VTE or other predisposing conditions are involved. 1007 VTE patients consecutively recruited in one academic hospital were analyzed retrospectively in order to identify acute CMV infection. Acquired and inherited risk factors were screened. Only adults and immunocompetent patients were included. Among 1007 consecutive VTE patients, we identified 10 patients with synchronous acute CMV infection. Patients with coexistent VTE and acute CMV infection were younger (37.5 years vs. 56.6 years; p = 0.0088) and exhibited a female predominance (90% vs. 56%; p = 0.026), in comparison to the whole cohort. Hereditary thrombophilia was identified in 9 out of 10 patients. Acquired risk factors for VTE like estrogens administration and pregnancy were equally prevalent in patients with and without CMV infection. Acute CMV infection is a potential contributor to VTE whenever other prothrombotic conditions are required. This should help clinicians to privilege a limited duration of anticoagulant treatment like in other provoked VTE.

Research paper thumbnail of Sinusoidal obstruction syndrome (SOS) related to chemotherapy for colorectal liver metastases: factors predictive of severe SOS lesions and protective effect of bevacizumab

Hpb the Official Journal of the International Hepato Pancreato Biliary Association, Jan 18, 2013

OBJECTIVES: The most frequent presentation of chemotherapy-related toxicity in colorectal liver m... more OBJECTIVES: The most frequent presentation of chemotherapy-related toxicity in colorectal liver metastases (CRLM) is sinusoidal obstruction syndrome (SOS). The purpose of the present study was to identify preoperative factors predictive of SOS and to establish associations between type of chemotherapy and severity of SOS. METHODS: A retrospective study was carried out in a tertiary academic referral hospital. Patients suffering from CRLM who had undergone resection of at least one liver segment were included. Grading of SOS on the non-tumoral liver parenchyma was accomplished according to the Rubbia-Brandt criteria. A total of 151 patients were enrolled and divided into four groups according to the severity of SOS (grades 0-3). RESULTS: Multivariate analysis identified oxaliplatin and 5-fluorouracil as chemotherapeutic agents responsible for severe SOS lesions (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001 and P = 0.005, respectively). Bevacizumab was identified as having a protective effect against the occurrence of SOS lesions (P = 0.005). Univariate analysis identified the score on the aspartate aminotransferase : platelets ratio index (APRI) as the most significant biological factor predictive of severe SOS lesions. Splenomegaly is also significantly associated with the occurrence of severe SOS lesions. CONCLUSIONS: The APRI score and splenomegaly are effective as factors predictive of SOS. Bevacizumab has a protective effect against SOS.

Research paper thumbnail of Étude Des Facteurs Déterminant Le Développement Précoce D'Athérosclérose Chez L'Enfant et L'Adolescent en Excès Pondéral

Research paper thumbnail of Prognostic risk factors of survival after resection of hepatocellular carcinoma

Hepato Gastroenterology, Sep 1, 2007

Surgical resection is a standard treatment of hepatocellular carcinoma, but liver cirrhosis is kn... more Surgical resection is a standard treatment of hepatocellular carcinoma, but liver cirrhosis is known to be associated to a high tumor recurrence rate. A retrospective study of 55 consecutive patients (37 males, 18 females) suffering from hepatocellular carcinoma having undergone surgical resection. Hepatocellular carcinoma developed in 29 patients with normal liver (group A) and in 26 patients with chronic liver disease (CLD) (group B). Patients were significantly older and at high-risk in Group B. Radical liver resection was achieved in 98% (100% in group A; 96% in group B). Overall 2-month mortality was 2% (0% in group A; 4% in group B). The 5-year overall and disease-free survival was respectively 55% and 35%. However, the 5-year overall and disease-free survival was significantly better in Group A (71% and 59%) compared to Group B (37% and 6%) (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), respectively. Multivariate statistical analysis demonstrated that age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 50 years, poor tumor differentiation and presence of satellite nodules were significant independent adverse predictive factors of overall and disease-free survival. Resection of HCC is safe and effective with satisfactory overall and disease-free survival rates, except when underlying chronic liver disease and poor tumor differentiation are present.

Research paper thumbnail of Percutaneous and surgical radiofrequency ablation of liver malignancies: a single institutional experience

Acta gastro-enterologica Belgica

the purpose of this study was to report a single academic institution's experience with radio... more the purpose of this study was to report a single academic institution's experience with radiofrequency ablation (RFA) of liver malignancies Sixty-five patients underwent RFA technique through a percutaneous (Group I: 33 patients) or a surgical approach (Group II: 32 patients). The two groups were different according to type of disease selection (more hepatocellular carcinoma in Group I and liver metastases in Group II) and tumour features (smaller size but greater number of lesions in Group II). In Group II, RFA was associated to liver resection in 23 patients (72%). The 2-month postoperative mortality and complication rates were low in both groups. The postoperative hospital stay was longer in Group II. During a median follow-up of 24 months in Group I and 21 months in Group II, the local "in-situ" recurrence rate was 41.4% and 9.1%, respectively. For RFA-treated tumours < 30 mm in size, the local "in-situ" recurrence rate was 40.5% in Group I and 0% in G...

Research paper thumbnail of Severe imported plasmodium vivax malaria as a cause of pseudohypereosinophilia

Research paper thumbnail of The outcome after transjugular intrahepatic portosystemic shunt (TIPS) for hepatic hydrothorax is closely related to liver dysfunction: a long-term study in 28 patients

Acta gastro-enterologica Belgica

Hepatic hydrothorax is a rare but challenging complication of cirrhosis. The Transjugular Intrahe... more Hepatic hydrothorax is a rare but challenging complication of cirrhosis. The Transjugular Intrahepatic Portosystemic Shunt (TIPS) appears as one of the most successful approach of therapy. To assess long-term efficacy and safety, we reviewed 28 patients (Child B/C: 43/57%) who underwent TIPS placement for refractory hepatic hydrothorax in our institution between 1992 and 2001. The 30-days mortality was 14%, reaching 25% at 90 days. The one-year survival without liver transplantation was 41.2%. Reduction in the volume of pleural effusion and improvement in clinical symptoms was observed in 68% while a complete radiological and echographic disappearance of hydrothorax was documented in 57%. Statistical analysis showed that poor liver function was predictive of mortality and non-response. Of the different liver function parameters and in this small series, the Child-Pugh score was more discriminating than the recently described Mayo risk score. This study shows that TIPS is effective i...

Research paper thumbnail of Evaluation of tumor necrosis factor-alpha, interleukin-6 and C-reactive protein plasma levels as predictors of bacteremia in patients presenting signs of sepsis without shock

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 1997

OBJECTIVE: To evaluate the sensitivity of interleukin-6 (IL-6) and tumor necrosis factor-alpha (T... more OBJECTIVE: To evaluate the sensitivity of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) plasma measurement to detect bacteremia in patients presenting sepsis signs, and to evaluate the potential benefit of such measurement in terms of early antimicrobial therapy initiation. METHODS: Plasma was obtained from 166 hospitalized patients for whom blood cultures were drawn for sepsis. Clinical data and antimicrobial therapies were noted. IL-6, TNF and C-reactive protein (CRP) were measured. The sensitivities of these markers were retrospectively compared with the accuracy of the attending physician in initiating empirical antimicrobial therapy. The setting was an 850-bed university hospital. RESULTS: Thirty-four bacteremias and 69 non-bacteremic infections were noted. In 63 others, no infection was documented. Median (range) IL-6 plasma levels in the three groups of patients were 462 (15--50 850), 189 (<15--38 300) and 91 (<10--13 750) pg/mL, respectively (p<0....