CHU Ambroise Paré

About: CHU Ambroise Paré is a healthcare organization based out in Mons, Belgium. It is known for research contribution in the topics: Population & Interventional radiology. The organization has 129 authors who have published 112 publications receiving 5880 citations. The organization is also known as: Hopital Ambroise Pare.

Hypertension in Chronic Kidney Disease Part 2: Role of Ambulatory and Home Blood Pressure Monitoring for Assessing Alterations in Blood Pressure Variability and Blood Pressure Profiles

Abstract: Blood pressure (BP) is characterized by high variability, including changes beat-to-beat (very short term), within 24 hours (short term), from day to day (midterm), and between visits spaced by weeks, months, seasons, and even years (long term). These variations can be estimated by means of continuous beat-to-beat BP recordings, repeated conventional office BP measures, 24-hour ambulatory BP monitoring (ABPM), or home BP monitoring (HBPM) over longer time windows (Table). A main advantage of ABPM over other BP measurement techniques is represented by its ability to track BP changes occurring in daily life conditions and during 24 hours, thus allowing assessment of overall BP variability (BPV) as well as identification of its specific components, such as nocturnal hypertension and altered day-to-night BP profiles (ie, morning BP rise, nondipping pattern of BP) which become manifest early in the course of chronic kidney disease (CKD). These alterations are even more significant in subjects with end-stage renal disease (ESRD) mainly, but not exclusively, because of the marked reduction in intravascular volume immediately after hemodialysis followed by the progressive increase in volemia throughout the interdialytic period,2 combined with an enhanced sympathetic activity. The higher frequency of alterations in 24-hour BP profiles and BPV in subjects with CKD and in those with ESRD not only makes a proper assessment and achievement of BP control more difficult in these subjects but may be prognostically relevant on the background of the evidence from longitudinal and observational studies indicating that increased BPV may predict the development of cardiovascular and renal disease, over and above the contribution of elevated mean BP levels per se3–11 (Figure 1). The purpose of this review is to address the currently available evidence on the role of ABPM and HBPM for the assessment and management of alterations in circadian BP profiles …

Nationwide incidence of sarcomas and connective tissue tumors of intermediate malignancy over four years using an expert pathology review network

Abstract: Background Since 2010, NETSARC and RREPS collected and reviewed prospectively all cases of sarcomas and tumors of intermediate malignancy (TIM) nationwide Methods The nationwide incidence of sarcoma or TIM (2013-2016), confirmed by expert pathologists using WHO classification are presented Yearly variations and correlation with published clinical trials was analyzed Results 139 histological subtypes are reported among the 25172 patients with sarcomas (n=18710, 64%) or TIM (n=6460, 36%), respectively n=5838, n=6153, n=6654, and n=6527 yearly from 2013 to 2016 Over these 4 years, the yearly incidence of sarcomas and TIM was therefore 797, 249 and 951/106/year, above that previously reported GIST, liposarcoma, leiomyosarcomas, undifferentiated sarcomas represented 13%, 13%, 11% and 11% of tumors Only GIST, as a single entity had a yearly incidence above 10/million/year There were respectively 30, 63 and 66 different histological subtypes of sarcomas or TIM with an incidence ranging from 10 to 1/106, 1-01/106, or Conclusions This nationwide registry of sarcoma patients with histology reviewed by sarcoma experts shows that the incidence of sarcoma and TIM is higher than reported, and that tumors with an incidence

Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism

Abstract: We analysed a cohort of patients with normotensive pulmonary embolism (PE) in order to assess whether combining echocardiography and biomarkers with the pulmonary embolism severity index (PESI) improves the risk stratification in comparison to the PESI alone. The PESI was calculated in normotensive patients with PE who also underwent echocardiography and assays of cardiac troponin I and brain natriuretic peptide. 30-day adverse outcome was defined as death, recurrent PE or shock. 529 patients were included, 25 (4.7%, 95% CI 3.2-6.9%) had at least one outcome event. The proportion of patients with adverse events increased from 2.1% in PESI class I-II to 8.4% in PESI class III-IV, and to 14.3% in PESI class V (p<0.001). In PESI class I-II, the rate of outcome events was significantly higher in patients with abnormal values of biomarkers or right ventricular dilatation. In multivariate analysis, the PESI (class III-IV versus I-II, OR 3.1, 95% CI 1.2-8.3; class V versus I-II, OR 5.5, 95% CI 1.5-25.5 and echocardiography (right ventricular/left ventricular ratio, OR (for an increase of 0.1) 1.3, 95% CI 1.1-1.5) were independent predictors of an adverse outcome. In patients with normotensive PE, biomarkers and echocardiography provided additional prognostic information to the PESI.

The HIV/AIDS epidemic in Cuba: description and tentative explanation of its low HIV prevalence

Abstract: Background The Cuban HIV/AIDS epidemic has the lowest prevalence rate of the Caribbean region. The objective of this paper is to give an overview of the HIV/AIDS epidemic in Cuba and to explore the reasons for this low prevalence.

Hypertension in Chronic Kidney Disease Part 1: Out-of-Office Blood Pressure Monitoring: Methods, Thresholds, and Patterns

Abstract: Hypertension is highly prevalent in chronic kidney disease (CKD), particularly in patients with end-stage renal disease (ESRD) receiving hemodialysis.1,2 The identification and treatment of hypertension in CKD has to face peculiar problems because of the marked alterations in 24-hour blood pressure (BP) profile, in particular of a reduced BP dipping at night, and the high prevalence of specific hypertension phenotypes, such as white coat (WCH) and masked hypertension (MH). Moreover, the ebb and flow of fluid volume in hemodialysis patients makes a proper assessment and achievement of BP control even more difficult. Although conventional BP measurements (CBP), performed in the office or in the dialysis unit by healthcare personnel, are currently recommended and applied for the diagnosis and management of hypertension in patients with CKD, including those on dialysis, these metrics are intrinsically inaccurate.3,4 CBP measurements are known to fail providing reliable estimates of the actual BP burden in several clinical conditions, and this is even more so in CKD and in hemodialysis patients. Thus, in addition to CBP measurements, proper assessment and management of hypertension in these patients should be ideally based also on out-of-office BP measurements, including ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM), as acknowledged by a consensus document by the American Society of Hypertension and the American Society of Nephrology.5 In this article, we highlight the advantages and disadvantages of out-of-office BP monitoring for the management of arterial hypertension in these conditions, based on a thorough literature search through classical engines, such as Pubmed and Web of Science, supplemented by the authors' own expertise. The thresholds to define hypertension and BP targets for antihypertensive treatment in CKD patients are debated.6,7 The recommendation to lower office BP to <130/80 mm Hg in CKD provided by …