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Biomedical subjects

C Cornu

Publications and source records attributed to C Cornu.

At least 37 records · Page 2Linked to original sources
PubMed1998

Stiffness of knee extensors in Duchenne muscular dystrophy.

The series elastic component (SEC) of Hill's muscle model is sensitive to a modification in muscle functional demand. In this study, SEC stiffness was quantified from quick-released movements in knee extensors of Duchenne muscular dystrophy (DMD) boys to look for possible modifications with the stage of disease. A SEC stiffness index (SI) was defined and was found significantly lower for controls than for DMD. Moreover, a linear relationship was established between mean SI and knee extensors involvement. This suggests a role for this parameter, together with other functional tests, for following patients with DMD.

Adolescent↗
PubMed1998

Universal precautions prevent hepatitis C virus transmission: a 54 month follow-up of the Belgian Multicenter Study. The Universitaires Cliniques St-Luc (UCL) Collaborative Group.

The isolation of anti-hepatitis C virus (HCV) in hemodialyzed (HD) patients has been repeatedly advocated to prevent nosocomial HCV transmission. We evaluated the incidence of seroconversion for HCV in Belgian HD patients, and demonstrate the complete prevention of HCV transmission by adherence to the universal precautions advocated by the Centers for Disease Control (Atlanta, GA, USA). All (N = 963) HD patients from 15 units, none of which isolates anti-HCV positive patients, were tested by a second or third generation enzyme-linked immunosorbent assay (with confirmation by a second- or third-generation recombinant immunoblot assay or the polymerase chain reaction) every 18 months from May 1991 to November 1995. Follow-up was available in 488 patients (drop-outs resulting from death or transplantation mainly). The yearly incidence of seroconversion for HCV over the initial 18 months was 1.41%, with evidence suggestive of nosocomial HCV transmission. Universal precautions were therefore reinforced. The incidence of seroconversion subsequently fell to 0.56% and 0%, respectively (P = 0.014), despite the facts that the average transfusion load and the proportion of patients with dialyzer reuse or with monitors disinfected after each session did not change significantly. We conclude that the strict enforcement of universal precautions fully prevents HCV transmission to HD patients. The isolation of anti-HCV positive patients is not warranted.

Adolescent↗
PubMed1998

Molecular analysis of GB virus C isolates in Belgian hemodialysis patients.

GB virus C (GBV-C) has been detected in Belgian hemodialysis patients. To study their genomic diversity and phylogenetic relationship, a 592 nucleotide fragment extending from the 5' non-coding region to part of the E1 gene of the GBV-C genome was amplified and sequenced from 12 Belgian hemodialysis patients in two different centers. Together with strains from different geographical origins, these sequences were analyzed phylogenetically using three different methods. A consistent tree topology was obtained with all methods. Three GBV-C genotypes were observed with two subtypes in type 2 and a questionable subtyping in type 1. Except for one isolate falling into type 1 cluster which mainly consists of African strains, all the other Belgian strains clustered within the type 2a branch. Two GBV-C isolates in two patients from the same hemodialysis center clustered together closely, suggesting a nosocomial transmission. In view of their long branch length, it seems unlikely that the other Belgian strains evolved recently from a common ancestor. Our results indicate that the major type circulating among Belgian hemodialysis patients seems to be 2a, which is usual for Europe and North America, but that the African type 1 also exists to a minor extent. Although patient to patient transmission of GBV-C in Belgian hemodialysis centers did occur, it may not account for the majority of infections.

Base Sequence↗
PubMed1997

Influence of plyometric training on the mechanical impedance of the human ankle joint.

The objective of this work was to study the effects of plyometric training on the mechanical properties of the ankle joint in humans. Changes in the mechanical parameters of this musculo-articular structure were quantified with the aid of a sinusoidal perturbation technique. This technique allowed the expression of the mechanical impedance of the musculo-articular system in terms of stiffness, viscosity and inertia. Measurements were performed under passive conditions and when the subject performed plantar flexion. A 7-week period of training induced a decrease in the slope of the relationship between stiffness and plantar flexion torque, whereas passive stiffness was increased. A slight decrease in viscosity and an invariability in inertia were also found. These results are interpreted in terms of the possible adaptations of the musculo-articular structure and ultrastructure involved in the performance of plantar flexion.

Adult↗
PubMed1997

Hepatitis G virus infection in haemodialysed patients: epidemiology and clinical relevance.

BACKGROUND: The prevalence, incidence, risk factors, and clinical impact of infection by the recently discovered hepatitis G virus (HGV) in haemodialysed (HD) patients, are poorly defined. METHODS: All 119 HD patients from two Belgian units selected for their different hepatitis C virus (HCV) prevalences (A: 19.2%, B: 3.4%) were tested for the presence of HGV-RNA, using the reverse transcriptase polymerase chain reaction (RT-PCR) and primers from the 5'-NC and NS 5a genome regions. The results of anti-HCV antibodies and alamine aminotransferase levels (ALT) at the time of RT-PCR, number of transfusions from the onset of HD, and time on HD were retrieved from the medical charts. Forty patients were retested by RT-PCR 3-64 months later. RESULTS: HGV-RNA was detected with both sets of primers in 11/78 patients (14.1%) from centre A and 8/41 patients (19.5%) from centre B, for an average prevalence of 16%. One patient was indeterminate (positive with one set of primers). The presence of HGV-RNA correlated neither with time on HD (P = 0.18), nor with the number of transfusions on HD (P = 0.14). It was associated with the presence of anti-HCV antibodies in centre A (P < 0.01) but not B (P > 0.5). Twenty-seven initially negative (-) patients (A: n = 18; B: n = 9) were retested: two became positive (+) both in the absence of transfusions for years, giving a yearly incidence of 1.7%. The 13 initially HGV-RNA (+) patients remained so over time (33 patient-years). The presence of HGV-RNA alone does not increase significantly the ALT level, in contrast to the strong influence of HCV. CONCLUSION: The prevalence and yearly incidence of HGV infection are 16% and 1.7%, respectively, in our HD patients. Neither the number of transfusions on HD nor the time on HD are significant risk factors. Although mixed HCV/HGV infections indicate common risks, the prevalence of HCV in a particular setting does not predict prevalence of HGV. As new infections are detected in the absence of blood transfusions, HGV may be another marker of nosocomial viral transmission. Once acquired, the infection persists for many years in HD patients.

Adult↗
PubMed1997

Hepatitis C virus genotypes in hemodialyzed patients: a multicentric study.

The few studies concerning HCV genotypes in hemodialyzed patients concerned small groups of patients, issued from single units. Using the RFLP typing method in the 5' non-coding region (5' NCR), we performed the genotyping of HCV strains of 80 patients issued from 14 Belgian dialysis units. Forty-seven of the 80 patients were also tested by Inno-Lipa II (Innogenetics, Gent, Belgium). Sixty-four of 80 patients (80%) were infected with subtype 1b, 2 (2.5%) with subtype 1a, 6 (7.5%) with subtype 2a and 1 (1%) with subtype 2b; 6 patients (7.5%) showed a type 4 and 2 patients (2.5%) a type 5 infection, respectively. Only 1 patient (1%) showed a mixed infection (1a and 1b). In the 47 patients tested by both methods, we observed a very good agreement (98%) between RFLP and Inno-Lipa II's results. Our multicentric study detected HCV genotypes 4 or 5 in 8/80 (10%) of hemodialyzed patients in Belgium. The substantial prevalence of these genotypes could not be fully explained by a nosocomial spread of HCV infection: indeed, four patients belonged to dialysis units located in different cities, and two appeared infected with distinct subtypes in a same unit. Thus, the discovery of a "rare" HCV genotype in several hemodialyzed patients does not always point to nosocomial HCV transmission.

Belgium↗
PubMed1996

Thrombolytic therapy with streptokinase in acute ischemic stroke.

BACKGROUND: In patients with acute ischemic stroke, early treatment with thrombolytic agents is thought to permit reperfusion of ischemic neurons and to promote recovery of function. The Multicenter Acute Stroke Trial-Europe (MAST-E) was designed to assess the efficacy and safety of streptokinase in patients with acute ischemic stroke. METHODS: Patients with moderate-to-severe ischemia in the territory of the middle cerebral artery were randomly assigned to receive streptokinase (1.5 million units over a period of one hour) or placebo within six hours after the onset of stroke. The primary efficacy outcome was a binary criterion combining mortality and severe disability at six months, with severe disability defined as a score of 3 or higher on the Rankin scale. The primary safety outcomes were mortality at 10 days and cerebral hemorrhage. RESULTS: All randomized patients (156 in the streptokinase group and 154 in the placebo group) were evaluated at six months. The incidence of the primary efficacy outcome was similar in the two groups (124 patients in the streptokinase group and 126 in the placebo group died or had a Rankin score > or = 3). However, the mortality rate at 10 days was significantly higher in the streptokinase group than in the placebo group (34.0 percent vs. 18.2 percent, P = 0.002). The higher rate in the streptokinase group was mainly due to the hemorrhagic transformation of ischemic cerebral infarcts. At six months, more deaths had occurred in the streptokinase group than in the placebo group (73 vs. 59, P = 0.06). CONCLUSIONS: In patients with acute ischemic stroke, treatment with streptokinase resulted in an increase in mortality. The routine use of streptokinase cannot be recommended in acute ischemic stroke.

Acute Disease↗
PubMed1996

[Presentation of OCTAVE II. A current epidemiologic study in France of the added prognostic value of ambulatory blood pressure monitoring].

The diagnosis of "white coat" hypertension, the measurement of indices of 24 hour variability of the blood pressure and increased accuracy of blood pressure estimation are some of the advantages of ambulatory blood pressure monitoring. They are part of the reason why the method has been adopted by ambulatory blood pressure monitoring is really useful in the treatment of hypertension is fragile: although the correlation with target organ complications seems better than with conventional blood pressure measurement, it remains to be shown that this information helps to predict and then improve the prognosis of hypertension. With respect to this first stage of demonstration of the added prognostic value attributable to ambulatory blood pressure monitoring, several studies have been undertaken, one of which is OCTAVE II. The goals were to analyse the predictive values of the indices obtained by ambulatory blood pressure monitoring in terms of cardiovascular morbidity and mortality after having described the correlations between these indices and the characteristics of individual patients. Two hundred and sixty six cardiologists, members of the French College of Cardiology, included 3,569 patients in whom an indication for ambulatory blood pressure monitoring had been retained, over a period of 10 months in 1991. These patients were 56.4 year old on average, with 52.6% men, hypertensive or not. The 5 year follow-up should end at the beginning of 1997.

Blood Pressure↗
PubMed1995

Precore mutant chronic hepatitis B in an autochthonous Belgian population: a study of ten patients.

The mode of contamination, presentation, clinical evolution and liver histology of 10 native Belgian patients with chronic hepatitis B likely due to a peculiar viral strain, the so called precore mutant hepatitis B virus were reviewed. This viral strain first described in Southern European regions is characterized by a mutation of a single base change at nucleotide 1896 in the preterminal codon of the precore region which creates a stop codon that prevents the production of HBeAg. In this setting, abnormal liver biochemistry and active viral replication as evidenced by HBV DNA positivity often coincides with a serological profile similar to that observed in healthy HBsAg carriers. Our data indicate that chronic hepatitis related to such a viral strain may be observed in a native Belgian population. This unusual presentation of chronic hepatitis B should thus be kept in mind when interpreting atypical sero-biochemical features, evaluating the risk of infectivity and the potential benefit of antiviral therapy.

Adolescent↗
PubMed1995

Anti-hepatitis C virus positivity (HCV) in Belgian volunteer blood donors: source of contamination and HCV-testing among donors and related recipients.

We investigated a group of Belgian HCV-100 Elisa positive volunteer blood donors for potential sources of contamination and the presence of liver biochemical abnormalities. In addition, results of serological testing and liver biochemistry of their related blood products recipients were also analysed. In blood donors, anti-HCV-100 repeat reactive rate was 0.77% with a 34% rate of abnormal liver function tests. A potential source of parenteral exposure was found in all donors with RIBA-confirmed HCV-100 positivity. Among recipients, anti-HCV-100 RIBA-2 positive blood product donations were associated with RIBA-2 seroconversion, a history of transfusion in donors being of high predictive value of infectivity.

Adolescent↗
PubMed1995

Role of hepatitis C virus in chronic liver disease occurring after orthotopic liver transplantation.

Paediatric orthotopic liver transplant recipients may develop chronic hepatitis after surgery. To investigate the role of hepatitis C virus in this pathology a cohort of 249 paediatric orthotopic liver transplant recipients was studied. Sixteen children (6.4%) were found to have chronic hepatitis C virus hepatitis after orthotopic liver transplantation. All but one of them had serum transaminase values which were persistently raised two to eight times the upper limit of normal. Thirteen were positive for both serology and serum hepatitis C virus RNA. Serum hepatitis C virus RNA detection occurred five to 33 months before hepatitis C virus antibodies. Liver tissue hepatitis C virus RNA and hepatitis C virus core antigen were detected in five. In one patient, tissue hepatitis C virus core antigen was detected when other tests for hepatitis C were negative. Two patients had positive human cytomegalovirus serum antibodies and RNA before transplantation. Although serum hepatitis C virus RNA was not detected after transplantation, serum enzyme immunosorbent assay and tissue core antigen were still detectable in both patients. In another child, serum hepatitis C virus RNA was positive and hepatitis C virus core antigen was found on a liver biopsy specimen but antihepatitis C virus antibodies were negative as well as liver hepatitis C virus RNA. No patient developed severe liver disease or cirrhosis during a follow up of up to 72 months. It is concluded that hepatitis C virus is a significant cause of morbidity after paediatric orthotopic liver transplantation. Diagnosis cannot rely on serological testing only. The patients remained stable on follow up, but longer prospective histological studies remain necessary to establish prognosis.

Antigens, Viral↗
PubMed1994

Survey of the attitudes to management of acute pyelonephritis in children. GEP.

Although urinary tract infections are of particular concern in young children, as they may lead to permanent health problems, there is no consensus for their acute management. We carried out a mailed survey of 455 general practitioners, 143 paediatricians (randomly selected from a list of physicians in the Rhône-Alpes region of France) and 45 paediatric nephrologists (all the members of the "Société de Néphrologie Pédiatrique") to examine their attitudes to the management of a fictitious case of a young girl with symptoms indicative of acute pyelonephritis. The responses given by the general practitioners and paediatricians were similar, whereas those given by the paediatric were similar, whereas those given by the paediatric nephrologists were often different, for example 20% of the general practitioners and 17% of the paediatricians said they would hospitalize the child, compared with 69% of the paediatric nephrologists. The majority of the general practitioners and paediatricians favoured single oral antibiotic therapy, whereas the paediatric nephrologists were split between single and combined antibiotic therapy, but preferred intravenous administration. The most frequently prescribed drug was a penicillin. The heterogeneity of the results from this survey stresses the need for the assessment of various strategies in terms of their efficacy for preventing kidney scarring and their risk-to-benefit ratios in well-designed randomised controlled trials.

Acute Disease↗