[Hooping cough in adults, think about it!]. / Coqueluche chez l'adulte, pensez-y!

We report the case of a 47 year old patient who had been suffering from persistent cough for more than three weeks. Patient coughed predominantly during night time, without fever. The amoxicillin-clavulanic acid initially prescribed was not effective. A series of complementary investigations were performed before serology finally identified Bordetella pertussis infection after two months of symptoms which improved slowly without evident benefit of macrolide treatment. The diagnosis of whooping cough was also established for the wife of the patient with fast resolution of the symptoms after rapid unset of treatment with macrolides.

[The complex interactions between the origins of HIV and its epidemic, colonial activities in Africa and colonial medicine in Belgian Congo]. / Des interactions complexes entre les origines du VIH et sa pandémie, les activités coloniales en Afrique et la médecine coloniale Belge au Congo.

In this review article on the origin of HIV, we start from a historical fact which involved physicians from Liège working in Belgian Congo: the vaccination against polio of hundreds of thousands of Congolese between 1957 and 1960. We explain the genesis of an alternative hypothesis postulating that this campaign was at the origin of HIV pandemy. We show that the hypothesis is unfounded in view of genetic and epidemiological evidence on the one hand and after thorough examination of the activity reports of the Laboratoire Médical de Stanleyville on the other. In the second part of the article, we analyse the importance of other factors which might have contributed to the emergence of the pandemy. Some of these are clearly iatrogenic such as the prophylactic injections of pentamidine against trypanosomiasis, others are of demographic and sociological nature. All of them have a direct link with colonisation.

Impact of chondroitin sulphate on health utility in patients with knee osteoarthritis: towards economic analysis.

OBJECTIVES: The first objective was to assess the effect of the chondroitin 4 and 6 sulphate (CS) on health-related quality of life using utility values in patients with knee osteoarthritis (OA) during a 24-month treatment course. The second objective was, using these data, to conduct economic analyses. METHODS: Data from the STOPP study was used. This study was a randomised, double-blind, placebo (PL) -controlled trial of 2-year duration. In the STOPP study, authors assessed quality of life using the Western Ontario and McMaster Osteoarthritis Index (WOMAC). WOMAC scores were translated into Health Utility Index (HUI) scores using a specific formula. Incremental cost effectiveness ratio (ICER) was calculated taking into account the cost of CS and its effect on HUI scores, compared to PL. RESULTS: At baseline, the mean (SD) HUI scores were 0.59 (0.17), and 0.59 (0.18) for the PL and CS groups, respectively (p=0.31 between the two groups). The mean (SD) HUI scores changes from baseline to 6 months were 0.02 (0.02), and 0.05 (0.01) for the PL and CS groups, respectively (p=0.03). After 24 months of follow-up, HUI score increases by 0.04 (0.02) in the PL group and by 0.05 (0.02) in the CS group (p=0.37). Using the price bracket of CS in Europe, ICER assessment always resulted in a cost below €30,000 per QALY gained, after 6, 12 and 24 months of treatment. CONCLUSION: CS treatment increases health utilities in patients with knee OA compared to PL over the first 6 months of treatment. Economic evaluation based on these data suggests that CS treatment could be considered as cost-effective in patients with knee OA up to a period of 24 months. A limitation in this study is the absence of direct utility assessment as well as the absence of effective treatment as comparator.