Bulletin de la Societe des sciences medicales du Grand-Duche de Luxembourg最新文献

Objective: The aim of our study was to assess the diagnostic performance of various serological markers and scores for predicting significant fibrosis retrospectively in a population of patients referring to our hospital for liver biopsy and chronic hepatitis C.

Materials and methods: Stored serum obtained from 186 patients were tested for a number of biological markers putatively associated with liver fibrosis. Fibrotest and Forns scores were compared with liver fibrosis pathology scored according to the METAVIR system by multiple logistic regression.

Results: The prevalence of significant fibrosis was 44%. Aspartate amino transferase (AST) and gamma-glutamyltransferase (GGT) were most correlated with METAVIR staging, followed by platelet counts and alpha2-macroglobulin. The negative predictive value was 77% and 83% and the positive predictive value was 100% and 84% for the Forns score and the Fibrotest, respectively. In multivariate analysis AST, GGT and alpha2-macroglobulin had independent predictive power.

Conclusions: The accuracy of serological markers in predicting significant fibrosis is limited, because approximately two thirds of patients lie into an indeterminate "grey zone". Serological markers might be useful for patients reluctant to undergo liver biopsy but current predictive scoring systems are too inaccurate to replace biopsies in a routine manner.

Background and purpose: A thrust plate prosthesis can be used as an alternative to a conventional stem prosthesis, preserving the diaphyseal bone stock. Recent findings however predict a higher rate of aseptic loosening than with intramedullary devices. The purpose of our investigation was to compare the clinical outcome and radiological findings with a finite element analysis of bone remodeling. The hypothesis was that aseptic loosening after thrust plate prosthesis of the hip is inherent to the design.

Methods: From 1997 to 2001, 58 thrust plates were implanted in 52 patients. Average age at the time of surgery was 40.9 years. Ninety four percent returned for follow up at an average of 26 months. A finite element model of the thrust plate within the femur was developed and stress shielding as well as bone remodeling were analyzed.

Results: A total of 4 patients required revision surgery (6.9%). Data from the finite element analysis revealed an inherent failure mechanism to the implant, facilitating stress shielding and loosening.

Interpretation: Lacking the ideal total hip prosthesis in young patients, the thrust plate can still be regarded as a feasible implant. However, surgeons and patients should be aware of possible mechanical problems regarding the design of the thrust plate. There is evidence that thrust plate prostheses are prone to early aseptic loosening. Clinical and radiological observations are in agreement with the results from the numerical simulations. Stress concentrations computed at the leash are interpreted as an explanation for leash pain. The authors regard computational methods as an aid to improve existing prosthesis design and future developments.

After Second World War cardiovascular disease (CVD), especially coronary artery disease (CAD), turned out to be an epidemic in the western countries including the Grand-Duchy of Luxembourg, and accounted for nearly half of all deaths. A lot of strategies, among them treatment by physical activity, were developed to fight this challenge and, fortunately, a mortality regression of about 50 % could be achieved. Nowadays, eastern European countries and, more recently, China and India face an increasing CVD mortality. During the seventies ambulatory heart sport clubs, then labeled as, "coronary clubs" became very popular in Europe especially in West-Germany. Around 2000 there were more than 6000 heart sports groups in Germany. In 1984 a first group was founded in Luxembourg City (Centre) a, 1991 a second group started in Esch/Alzette (South) and in 2002 a third regional group in Ettelbruck (North) so that, by now, the 3 main public health districts of the Grand-Duchy of Luxembourg can offer regular ambulatory sports activities to almost all concerned cardiac patients in the country. The ambulatory heart sport groups of Luxembourg cooperate in a federated association allowing an integrated logistic organization. Since the beginning nineties cardiac rehabilitation became a field of interest to the university faculties and later of scientific societies, like the American Heart Association (AHA) and the European Society of Cardiology (ESC). New subgroups were founded and guidelines were published and renewed. The movement of ambulatory heart sport groups was more or less neglected in the prevention and rehabilitation activities of the scientific societies. Recently the ESC proposed a new definition of comprehensive CVD prevention and rehabilitation programmes as "coordinated, multifaceted interventions designed to optimize a cardiac patient's physical, psychological, and social functioning, in addition to stabilizing, slowing, or even reversing the progression of the underlying atherosclerotic processes, thereby reducing morbidity and mortality". The responsible ESC cardiologists agree with the international community that fighting CVD risk factors is at least as important as the whole arsenal of modern heart surgery and interventional cardiology. The core activity of ambulatory heart sport groups remains physical activity, and nowadays 6 different activities can be offered (one activity each day of the week): exercise lesson, swimming, walking, cycling, Nordic Walking and water gymnastics On the other hand comprehensive prevention programs, especially concerning CVD risk factors are also endorsed by the ambulatory heart sport groups of Luxembourg via regular meetings, conferences, brochures and symposia. One advantage of the ambulatory heart sport movement in Luxembourg, in contrast to the German model, is the direct financial allowance of the health ministry, which permits a lifelong activity to all the active members. Another advantage is that al

Stroke is a neurological emergency condition that warrants immediate hospitalisation on a stroke unit, where a dedicated team offers state-of-the-art diagnostic and therapeutic measures. Stroke units have shown to reduce mortality and handicap especially if thrombolysis is possible. A critical mass of stroke patients with standardised, simplified and automated processes is required to achieve good results. Stroke teams are no alternative to a stroke unit as a geographic unit. A turnover of less than 200-250 strokes per year is associated with a worse patient outcome and the treatment effect of a stroke unit may be abolished. The situation in Luxembourg offers the possibility to create units of this size and performance if all the concerned physicians and hospitals, health insurance and health administration join their efforts.

Factor analysis has been widely used in economics and finance in situations where a relatively large number of variables are believed to be driven by few common causes of variation. Dynamic factor analysis (DFA) which is a combination of factor and time series analysis, involves autocorrelation matrices calculated from multivariate time series. Dynamic factor models were traditionally used to construct economic indicators, macroeconomic analysis, business cycles and forecasting. In recent years, dynamic factor models have become more popular in empirical macroeconomics. They have more advantages than other methods in various respects. Factor models can for instance cope with many variables without running into scarce degrees of freedom problems often faced in regression-based analysis. In this study, a model which determines the effect of the global crisis on Turkey is proposed. The main aim of the paper is to analyze how several macroeconomic quantities show an alteration before the evolution of the crisis and to decide if a crisis can be forecasted or not.

The first chapter analyses the ART methods of the Centre Hospitalier of Luxembourg, in the department of reproductive medicine between 2001 and 2009. The second chapter examines the techniques individually, their influence on pregnancy outcomes, the complications on offsprings and their health. The results coincide with literature in that risks are acceptable as long as good medical and biological conditions are maintained. Multiple pregnancies remain the most frequent complication, particularly once out of IVF. These are analysed separately as well as the pregnancies after egg and semen donation.

The aim of this article is to compare the description of two opposite feelings, i.e. love and hate, expressed in the narratives created by persons with an antisocial personality disorder. Several researchers point to the fact that persons suffering from antisocial personality disorder display an incapacity for love, that their descriptions of love are poor, and that their language related to love is poor. On the contrary, they have an ability to experience anger and hate, therefore their possibilities to describe hate and their language related to hate are developed. We focus on verifying these scientific opinions. We examined 50 prisoners diagnosed with antisocial personality disorder, 40 prisoners without antisocial personality, and 50 men outside of prison without antisocial tendencies. The participants had to describe situations presented at photographs linked to love and hate. The qualitative data (elements of narrative discourse) were analyzed concerning two feelings, using nonparametric statistics. The results show that persons with antisocial personality disorder are able to describe both love and hate feelings, and that their language is expressive and convincing. They have affective knowledge and the capacities to imagine the feelings. They were more concentrated on themselves than the control groups.

The objective of the present study was to identify factors influencing body image dissatisfaction in female patients with anorexia and bulimia nervosa. 61 women, aged 16 to 31, (M = 21.69; SD = 3.85) filled questionnaires evaluating dissatisfaction with their body (Body Dissatisfaction Scale by Garner & al., 1984), attitudes about the body (Body Attitude Test by Probst & al., 1995), avoidance with regard to body image (Body Image Avoidance Questionnaire by Rosen & al., 1991), negative mood states (Hospital Anxiety and Depression Scale by Zigmond and Snaith, 1983) as well as self-esteem (Self-Esteem Inventory by Coopersmith, 1984). Negative appreciation of body size, symptoms of depression, grooming and weighting, lack of familiarity with one's own body, as well as low self-esteem in general, could predict the body image dissatisfaction among eating disordered women. The fact of knowing the most important determinants of body image could give indications for the prevention of the cognitive distortions concerning body image.

This study aims at showing the positive effects of arts therapies in individual and group sessions, with an aging, valid or dependent population, presenting symptoms of dementia or not. The improvement of cognition (including memory), well-being, as well as of certain medical problems (pain, tension...) was underlined in several studies on arts therapies, including especially the use of music therapeutic techniques. Indeed, music stimulates the emotional memory, causing the emergence of ancient memories, thus restoring narcissism. The well-being of participants is increased. Our population consists of elderly people, most of them suffering from dementia. They come to the workshops by themselves or led by their families. Music but also pictorial arts are used as a therapeutic mediation for one session per week during the time of hospitalization. This period varies depending on the condition of the subject. The scales used in T1 and T2 with patients suffering from dementia are the Echelle d'appréciation clinique en gériatrie by Bouvard & Cottraux and the Fragebogen zur Beurteilung der Behandlung durch den Therapeuten (FBB-T) by Mattejat and Remschmidt. Regarding the criteria for external validation, a semi-structured interview is proposed to the nurses in T2. The scales used with valid people are the Index of Well-being by Campbell et al, the Hospital Anxiety and Depression Scale (HADS) by Zigmond and Snaith, the Rosenberg Self-esteem Scale (RSES), validated by Vallières and Vallerand in 1990, and the Stressverarbeitungsfragebogen (SVF 78) by Janke et al. CDC: There was a positive effect for most seniors who attended the sessions: an increased well-being and a temporary appropriation of memories. However, given the small size and the heterogeneity of samples, the irregularity of attendance, the results cannot be generalized. More regular sessions of arts therapies would be favorable for a consolidation of results.

Performance of the company staff is determined by the proficiency of available personal resources. Some of the respective key indicators could be influenced by planner, but most of them are out of direct control. This opens the strong demand on reliable prediction modeling. Decision maker is interested not only in knowing of labor supply/demand situation, but also about the proficiency and reliability of employees. Presented work is intended to find out, which statistical methods are suitable for certain aspects of the staff planning process. General broad modeling of stochastically changing workforce availability numbers could be considered like a description of the random events observation. These events could be categorized and forecasted by the mean of further development of NPI (nonparametric predictive inference) method suggested by Augustin and Coolen. Its capability to learn from multinomial data, especially such as strongly influenced by business environment, geography, state policy, etc., extracted from market reports, and induced from managerial experience seems to be promising. After demand and supply of workforce is forecasted, manager must start the process of hiring. Individual staff evaluation is also quite challenging because of lack or incorrectness of initial information about possible profile type of the candidate. Dempster-Shafer Theory may be good one, but speaking of "gambles" could disappoint many HRspecialists. So, adaptation of the Theory of Adaptive Utility proposed by Houlding and Coolen is assumed as perspective tool for solving this problem. HR decision maker can also follow this kind of sequential process. When the completion of team and groups is done, the labor activity begins. Here, each employee demonstrates his performance rate, qualification and reliability. In this case interaction between workers is strongly matters. Conditional probability is in charge of that kind of evaluation and therefore Bayesian schemes and Walley technique are further developed and applied. Dismissed employees flowing out of the firm again into workforce market and will be available for other companies, also for competitors. Feedback to initial step is recommended.