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BACKGROUND: Antiretroviral therapy reduces mortality and morbidity in HIVinfected individuals, most markedly when initiated early, before advanced immunodeficiency has developed. Although the international guidelines recommend starting antiretroviral therapy ART with a high CD4 cell count level, in the practice, this is particularly challenging to achieve, especially in late presentation of HIV diagnosis. The aim of this study was to determine the frequency and the demographic features associated with late presentation for HIV diagnosis in our Centre. METHODS: All newly diagnosed patients with HIV between January 2007 and December 2011 in our AIDS Reference Centre, were included. Late presenter patient was defined as patient with CD4 count 350/mm(3) at the time of diagnosis. Demographic age, sex, ethnicity, migration and clinical characteristics transmission mode, CD4 cell count, viral load were collected. We also collected data on outcome median day of hospitalization, mortality, virological response to ART and lost to followup LTFU. LTFU was defined as patient without any medical contact and viral load measurements during two consecutive years in our centre. RESULTS: From 2007 to 2011, 154 429 out of 359 patients newly diagnosed with HIV were late presenters. According to univariate analysis, age 50, female gender, migrant from subSaharan Africa and heterosexual contact were associated with late presentation for HIV diagnosis. In the multivariate analysis, age 50, heterosexual contact and migrant status particularly women were the only independent risk factors for late presentation. Late presenters tend to have a worse outcome than nonlate presenters. CONCLUSION: A considerable proportion of patients continue to be diagnosed with advanced HIV disease, despite the fact that risk factors for late presentation have been clearly identified. Despite high testing rate for HIV in Belgium, highrisk population like migrant, heterosexual contact, remain under tested. In ord

The mechanisms underlying cardiac automaticity are still incompletely understood and controversial. Here we report the complete conditional and time-controlled silencing of the 'funny' current (If) by expression of a dominant-negative, non-conductive HCN4-channel subunit (hHCN4-AYA). Heart-specific I-f silencing caused altered [Ca2+](i) release and Ca2+ handling in the sinoatrial node, impaired pacemaker activity and symptoms reminiscent of severe human disease of pacemaking. The effects of I-f silencing critically depended on the activity of the autonomic nervous system. We were able to rescue the failure of impulse generation and conduction by additional genetic deletion of cardiac muscarinic G-protein-activated (GIRK4) channels in I-f-deficient mice without impairing heartbeat regulation. Our study establishes the role of f-channels in cardiac automaticity and indicates that arrhythmia related to HCN loss-of-function may be managed by pharmacological or genetic inhibition of GIRK4 channels, thus offering a new therapeutic strategy for the treatment of heart rhythm diseases.

L'essentiel de l'interrogation de cette recherche se situe au niveau de la compréhension du contexte d'instauration d'un rituel ainsi que de l'observation des impacts de son utilisation chez des élèves du primaire. Afin de répondre à ces questionnements, le cadre conceptuel se penche d'abord sur la définition de chacun des termes. Puis, il en établit une distinction afin de guider la préparation de la cueillette des données. Par conséquent, la recherche a porté sur l'implantation d'un rituel dans une classe de première année du primaire. Les élèves ont donc participé à un rituel de partage dont le contenu était concentré, en majorité, sur l'expression, la compréhension et la gestion des émotions. Pour assurer une cueillette de données précise et complète, trois instruments de collecte ont été utilisés, soit des notes de terrain (compilées dans un journal de bord), deux grilles d'observation (implantation du rituel et observation des comportements des élèves) ainsi que des enregistrements vidéo. Les trois outils ont été utilisés simultanément et ont servi à compiler les données dans le but de les examiner.

Transmitted drug resistance (TDR) influencing nonnucleoside reverse transcriptase inhibitor (NNRTI) activity is increasing among new HIV-1 patients in several countries. As we recently observed an increase of K103N prevalence among new diagnoses in Belgium, we mined the Belgian national sequence database for homologous sequences. The earliest reverse transcriptase (RT) sequences available for drug-naive patients as well as sequences related to treatment failure were included. Fifty-five sequences were aligned and subjected to phylogenetic analysis, revealing the presence of a cluster of 29 virus sequences. All except one of those sequences were from antiretroviral (ARV)-naive patients at the time of sampling, and 22 had the K103N mutation. Epidemiological data of clustered patients were collected through the Institute of Public Health. Seventy-two percent of the clustered patients were infected through homosexual or bisexual contacts while the others reported heterosexual contacts only. All patients reside and were infected in Belgium. Sixteen were diagnosed between January 2011 and June 2012; 14 were aged between 18 and 29 years at the time of diagnosis. Nearly 60% of the clustered patients live close to the city of Namur, where HIV incidence substantially increased in the past 2 years. The identification of this transmission network advocates for local prevention reinforcement and underscores the need for continuous TDR monitoring. The spread of NNRTI TDR could affect ARV initiation schemes and prophylaxis strategies.

Qui dirige l’économie ?Qui détient le pouvoir de décision dans ce domaine ?Quelles sont les limites de ce pouvoir ?Ce Dossier tente d’apporter des réponses à ces questions en passant en revue les différents acteurs intervenant dans la sphère économique, l’étendue de leur capacité d’influence et les modes d’exercice de leur pouvoir.Parmi les acteurs économiques, les groupes d’entreprises, plus encore que les entreprises, représentent le pouvoir économique par excellence. Avec l’internationalisation et la financiarisation de l’économie, ils contribuent à accentuer la concentration des richesses. Par l’utilisation et l’affectation de leurs ressources, ils constituent par ailleurs des acteurs capables d’influencer la décision politique. Les rapports qu’ils entretiennent avec les États et leurs composantes deviennent manifestement de plus en plus déséquilibrés.Outre l’intervention des pouvoirs publics dans l’économie, ce Dossier aborde d’autres acteurs (syndicats, associations de consommateurs, médias ou organisations militantes) qui, dans un rôle secondaire mais non négligeable, tentent de peser sur la décision des détenteurs du pouvoir économique., info:eu-repo/semantics/published

L’actionnariat des entreprises est une donnée fondamentale de l’économie de marché, qu’il soit constitué de grandes familles, de multinationales ou de fonds publics, qu’il soit ou non concentré dans quelques mains, et qu’il concerne le secteur privé ou le secteur public. Par l’apport de capitaux, les actionnaires deviennent tout à la fois partenaires financiers et copropriétaires des sociétés dans lesquelles ils investissent. À l’échelle d’une région ou d’un pays, ils comptent donc parmi les principaux détenteurs du pouvoir économique.Réalisé par l’équipe du secteur Économie du CRISP, ce Courrier hebdomadaire présente la structure de l’actionnariat en Wallonie durant les années 2010 et 2011. Dans un premier temps, il étudie plus de 65 000 sociétés commerciales qui étaient présentes en Wallonie au cours de cette période. Dans un second temps, il se concentre sur les cent premières de ces entreprises, selon quatre classements :le chiffre d’affaires, les effectifs occupés, le capital souscrit et le total de l’actif.L’analyse met en évidence plusieurs réalités de l’économie wallonne, dont la concentration de l’emploi dans un nombre d’entreprises relativement restreint, l’évolution rapide de la structure de propriété dans certains secteurs, et l’importance des pouvoirs publics belges en termes de capital et d’emploi. L’étude permet également de cerner le poids relatif des groupes belges et étrangers (essentiellement français, allemands, néerlandais et anglais) dans l’actionnariat des entreprises de Wallonie., info:eu-repo/semantics/published

Osteonecrosis of the femoral head (ONFH) typically affects relatively young, active patients and frequently follows an unrelenting course resulting in considerable loss of function. In human immunodeficiency virus-infected patients, ONFH is a growing problem. Etiology, pathogenesis, and treatment of ONFH in these patients remain controversial. We analyzed retrospectively patients with ONFH in a series of 815 patients followed in our AIDS reference center. Six patients out of the 815 were affected by ONFH (0.74%). The sex ratio was 1. Two of the six patients (33.3%) had no evidence of risk factor, whereas four patients (66.6%) had risk factors. One patient had three cumulated risk factors which were corticosteroids, chemotherapy, and radiotherapy. For this patient, the onset time for ONFH was shorter (36 months). It is difficult to attribute the effect to any single class of antiretroviral agents because combination therapy is standard of care, and a change in therapies is common. All classes of antiretroviral drugs have been used: protease inhibitors (mean use duration of 15.2 months before the ONFH onset), non-nucleoside reverse transcriptase inhibitors (12 months), and nucleoside reverse transcriptase inhibitors (40.5 months). ONFH was bilateral in four cases (66.6%) and unilateral in two cases (33.3%). One patient had other osteonecrosis location (both shoulders). ONFH was classified on plain radiography stage IV in five patients and stage III in one patient. All patients received initial medical treatment. It consisted of painkillers and non-weight bearing of the hip. All were finally operated on by total hip arthroplasty (THA). The average interval between ONFH diagnosis and the first THA was 10.3 months for the six patients. A controlateral THA was performed for three patients after a mean interval of 23.3 months after ONFH diagnosis. Of the nine implanted prostheses, four were cemented, four were cementless, and one was resurfacing prosthesis.

book, info:eu-repo/semantics/published

SCOPUS: ar.j, info:eu-repo/semantics/published