Publications by authors named "Louis G"

The increased prevalence of behavioral health problems in the US is intensified by the critical shortage of providers in the field. The historical failure of behavioral health specialties to attract BIPOC students and workers limits leadership, access to quality care, and the generalizability of research findings. Most workforce development programs serve only those with earned graduate degrees.

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  • A study involving 505 adult asthma patients from Belgium examined the relationship between detailed asthma symptoms reported by patients and their lung function and inflammation levels.
  • Key symptoms analyzed included cough, dyspnea, wheezing, chest tightness, and airway secretion, measured on a five-point scale, revealing several demographic and health-related factors influencing these symptoms.
  • The findings suggest that individualized treatment for asthma could be developed based on the specific symptoms and their associations with various demographic and health indicators.
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  • - Patient-reported outcome measures (PROMs) are tools that help assess a patient's health at a specific time and are important for personalized healthcare.
  • - The paper reviews the use of visual analog scales (VAS) for measuring asthma and allergic rhinitis control, particularly focusing on the MASK-air app, which includes electronic VAS forms.
  • - A randomized controlled trial was conducted to validate the electronic VAS, and further evaluations confirmed the effectiveness of VAS questions and additional medication scores for allergic asthma symptoms.
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Introduction: This research delves into the representation of homosexuality in the television series , adapted from George R.R. Martin's saga.

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Background: POINCARE-2 trial aimed to assess the effectiveness of a strategy designed to tackle fluid overload through daily weighing and subsequent administration of treatments in critically ill patients. Even in highly standardized care settings, such as intensive care units, effectiveness of such a complex intervention depends on its actual efficacy but also on the extent of its implementation. Using a process evaluation, we aimed to provide understanding of the implementation, context, and mechanisms of change of POINCARE-2 strategy during the trial, to gain insight on its effectiveness and inform the decision regarding the dissemination of the intervention.

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  • - The traditional healthcare approach often overlooks patients' personal experiences and strengths, focusing mainly on disease treatment. Person-centered care aims to align medical decisions with individual values and preferences, particularly for those with chronic conditions.
  • - This paper seeks to enhance care for rhinitis and asthma by developing digital care pathways and incorporating real-world evidence to create a more patient-centered approach.
  • - Key components of the review include advancements in mHealth, the integration of artificial intelligence, a novel classification system for airway diseases, and proposals for the ARIA 2024 guidelines, all targeting a sustainable and applicable healthcare model.
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Faced with the multiple challenges impacting the Belgian healthcare system - notably the aging of the population, the increase in chronic diseases and growing social inequalities in health - the development of a disruptive preventive approach rooted in health promotion is essential to address the population's health problems in a cross-sectional and intersectoral way. However, the scant attention paid to prevention and promotion in the Belgian political landscape (only 3 % of healthcare expenditure), accentuated by the fragmentation of its deployment between the various political-institutional entities (Federal Authority, Communities and Regions), represents a significant limitation. New opportunities, supported in particular by "4P medicine", are paving the way for a modernization of preventive approaches.

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Rationale: It is unclear how each individual asthma symptom is associated with asthma diagnosis or control.

Objectives: To assess the performance of individual asthma symptoms in the identification of patients with asthma and their association with asthma control.

Methods: In this cross-sectional study, we assessed real-world data using the MASK-air app.

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Background: Although asthma is often seen as an eosinophilic disease associated with atopy, patients with noneosinophilic asthma represent a substantial part of the population with asthma.

Objective: To apply an unsupervised clustering method in a cohort of 588 patients with noneosinophilic asthma (sputum eosinophils < 3%) recruited from an asthma clinic of a secondary care center.

Methods: Our cluster analysis of the whole cohort identified 2 subgroups as cluster 1 (n = 417) and cluster 2 (n = 171).

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Purpose: The effect of renal replacement therapy (RRT) in comatose patients with acute kidney injury (AKI) remains unclear. We compared two RRT initiation strategies on the probability of awakening in comatose patients with severe AKI.

Methods: We conducted a post hoc analysis of a trial comparing two delayed RRT initiation strategies in patients with severe AKI.

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Background: Acute kidney injury (AKI) in intensive care unit (ICU) patients with severe COVID-19 is common (> 50%). A specific inflammatory process has been suggested in the pathogenesis of AKI, which could be improved by dexamethasone (DXM). In a small monocenter study (n = 100 patients), we reported a potential protective effect of DXM on the risk of AKI.

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  • Intra-abdominal candidiasis (IAC) is challenging to diagnose in critically ill patients, often leading to excessive antifungal treatments; current markers like serum and peritoneal 1.3-beta-D-glucan (sBDG and pBDG) have shown inconsistent results in identifying IAC due to varying patient populations.
  • This study investigated a high-risk population of critically ill patients undergoing abdominal surgery, aiming to determine the prevalence of IAC and the effectiveness of sBDG and pBDG in its diagnosis, finding a 44% prevalence rate among 199 included patients.
  • Results showed that pBDG levels were significantly higher in patients with IAC compared to those without, suggesting pBDG could be
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Background: Randomised controlled trials have shown that benralizumab, an anti-interleukin-5 receptor monoclonal antibody, reduces exacerbations and oral corticosteroid dose and improves asthma control and lung function in severe eosinophilic asthma. The aim of this study was to confirm results of randomised controlled trials in real life in a population of 73 patients with severe eosinophilic asthma treated with benralizumab for at least 12 months.

Methods: Patients underwent careful monitoring of asthma exacerbations, exhaled nitric oxide fraction, lung function, asthma control and quality of life questionnaire responses and sputum induction, and gave a blood sample at baseline, after 6 months and then every year.

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Background: Intention-to-treat analyses of POINCARE-2 trial led to inconclusive results regarding the effect of a conservative fluid balance strategy on mortality in critically ill patients. The present as-treated analysis aimed to assess the effectiveness of actual exposure to POINCARE-2 strategy on 60-day mortality in critically ill patients.

Methods: POINCARE‑2 was a stepped wedge randomized controlled trial.

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Chemotaxis is a widespread strategy used by unicellular and multicellular living organisms to maintain their fitness in stressful environments. We previously showed that bacteria can trigger a negative chemotactic response to a copper (Cu)-rich environment. Cu ion toxicity on bacterial cell physiology has been mainly linked to mismetallation events and reactive oxygen species (ROS) production, although the precise role of Cu-generated ROS remains largely debated.

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Background: EQ-5D-5L (EuroQOL, 5 Domains, 5 Levels) is a widely used health-related quality-of-life instrument, comprising 5 domains. However, it is not known how each domain is impacted by rhinitis or asthma control.

Objective: To assess the association between rhinitis or asthma control and the different EQ-5D-5L domains using data from the MASK-air mHealth app.

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We report a previously healthy woman in her 50s who presented with sepsis, rapidly progressive purpuric rash and disseminated intravascular coagulation. She was diagnosed with acute infective purpura fulminans due to invasive pneumococcal infection likely secondary to sinusitis. Our case report discusses our initial diagnostic uncertainty and approach in investigating and treating such a critically unwell patient.

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Background: Venous thromboembolism is a major complication of coronavirus disease 2019 (COVID-19). We hypothesized that a weight-adjusted intermediate dose of anticoagulation may decrease the risk of venous thromboembolism COVID-19 patients.

Methods: In this multicenter, randomised, open-label, phase 4, superiority trial with blinded adjudication of outcomes, we randomly assigned adult patients hospitalised in 20 French centers and presenting with acute respiratory SARS-CoV-2.

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Article Synopsis
  • - Dyspnea is a type of respiratory discomfort often linked to heart or lung issues, but it can also stem from metabolic disorders.
  • - The cause of dyspnea is complicated, arising from various brain interactions responding to internal sensations and pain.
  • - When there's no obvious physical cause for dyspnea, known as dyspnea "sine materia," treatment focuses on behavioral therapy and breathing exercises, especially for those who are physically deconditioned.
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Background: Staphylococcus aureus enterotoxins (SE) may act as superantigens and induce an intense T-cell activation, causing local production of polyclonal IgE and resultant eosinophil activation.

Objective: To assess whether asthma with sensitization to SE but not to common aeroallergens (AAs) displays different inflammatory characteristics.

Methods: We conducted a prospective study on a series of 110 consecutive patients with asthma recruited from the University Asthma Clinic of Liège.

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Introduction: Recently, the literature has promoted the use of patient-reported outcome measures (PROMs) in clinical practice as a means to foster patient engagement. However, conditions necessary to support the use of PROMs to encourage asthma patient engagement are not clearly defined. Therefore, we sought (1) to explore the current and ideal use of PROMs by healthcare professionals (HP) in specialized asthma management centers in French-speaking Belgium and (2) to understand under which conditions the use of PROMs contributes to patient engagement.

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Background: A common method for diagnosing sarcopenia involves estimating the muscle mass by computed tomography (CT) via measurements of the cross-sectional muscle area (CSMA) of all muscles at the third lumbar vertebra (L3) level. Recently, single-muscle measurements of the psoas major muscle at L3 have emerged as a surrogate for sarcopenia detection, but its reliability and accuracy remain to be demonstrated.

Methods: This prospective cross-sectional study involved 29 healthcare establishments and recruited patients with metastatic cancers.

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  • This study aimed to understand the outcomes of patients with severe meningoencephalitis in intensive care, analyzing data from 599 adults across 68 medical centers in 7 countries from 2017 to 2020.
  • Results showed that more than half of the patients (50.5%) had poor functional outcomes at three months, with 25.8% resulting in death; causes of meningoencephalitis were varied, with acute bacterial meningitis being the most common.
  • Key factors linked to worse outcomes included being older than 60, having a weakened immune system, delays in ICU admission, and severe neurological impairments, highlighting the need for timely care and monitoring.
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