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    ABSTRACT: Patients undergoing kidney transplantation are sometimes being treated with antiplatelet agents such as ticlopidine or clopidogrel. Some teams refuse to wait-list these patients for fear of bleeding during transplant surgery. We retrospectively reviewed the records of 702 adult patients with a kidney transplant alone between 2000 and 2010. Nineteen (2.7%) patients were taking clopidogrel or ticlopidine when called in for transplantation. Furthermore, 10 of these 19 patients were also taking low-dose aspirin (ASA). We compared the risk of bleeding peri- and postoperatively, and the occurrence of cardiovascular complications within 30 days after renal transplantation between 19 cases and 39 controls randomly selected within the cohort. Platelets were administered to 7 cases (37%) versus 0 controls (P < 0.001). A single case (5.3%) presented with significant bleeding during surgery following an implantation biopsy, and required 4 red bood cell (RBC) units. During the first day, 3 of the 19 cases (16%) and 1 of the 39 controls required RBC (P = 0.1). No reoperation was performed for bleeding. After the transplant, clopidogrel or ticlopidine was resumed in only two patients. The platelet count and haemoglobin were similar between cases and controls at Day 30. No cardiovascular event occurred in cases or controls during the first month post-transplantation. At 5 years, graft and patient survival was similar in cases and controls. Clopidogrel and ticlopidine, sometimes in combination with ASA, are associated with a low risk of bleeding during renal transplantation and does not seem to be a contraindication for renal transplant surgery.
    Nephrology Dialysis Transplantation 11/2013;
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    ABSTRACT: The aim of this study is to evaluate the feasibility and safety of the Glidesheath Slender in routine transradial (TR) coronary angiography and intervention. In recent years, The TR approach has gained in popularity because of several advantages such as reduced vascular access site complications and immediate patient mobilization. Procedural success has been further improved through technological innovations and the development of less invasive devices. The Glidesheath Slender (Terumo, Tokyo, Japan) is a new dedicated radial sheath with a thinner wall and hydrophilic coating. It combines an inner diameter compatible with 6Fr guiding catheter with an outer diameter close to current 5Fr sheaths. Its use has the potential to decrease invasiveness and access site complications during TR procedures. A total of 114 consecutive patients undergoing TR coronary angiography and/or PCI using the Gidesheath Slender were included in a prospective single-center feasibility and safety study. Procedural success was 99.1% with only one case requiring conversion to femoral access. There were six minor hematomas but none of the patients experienced major vascular complications. The rate of symptomatic radial spasm was 4.4%. No case of major sheath kinking was noted. Doppler ultrasound examination of the radial artery at 1 month follow-up was available in 113/114 patients with only one case of radial artery occlusion (RAO) (0.88%). Routine use of the Glidesheath Slender for TR coronary angiography and interventions is safe and feasible with a high rate of procedural success and a low rate of RAO. © 2013 Wiley Periodicals, Inc.
    Catheterization and Cardiovascular Interventions 10/2013; 84(3).
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    ABSTRACT: The trophicity of women's urogenital tissues depends on the hormone level and on the quality of the vaginal flora. Stresses of these mucous membranes, seemingly minor, give rise to complaints of a perceived perineal discomfort, which is disproportionate to the causes. Population in Occident has access to the best medical care and hygiene conditions ever. Yet, expenditures on treatment of these minor disorders are unwarranted. Cystalgia leads to a large number of consultations to general practitioner, gynaecologist and urologist. The aging of our societies is another reason. While life expectancy was 51 in 19th century, it is now 83. Women will now live a third of their life after menopause'. Complaints due to these hormonal withdrawal symptoms need to be heard as they are leading to specific psychological behaviours, which are disconcerting for the clinician. Patients will strive by all means to obtain treatments which are often inappropriate and which sometimes entails the risk of evolving to a chronicity of the pains.
    Revue medicale de Bruxelles 09/2013; 34(4):232-5.


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    Charleroi, Belgium
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Acta neurologica Belgica 04/2005; 105(1):14-7.
Acta neurologica Belgica 07/2006; 106(2):52-60.

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