VERBRUGGE, Frederik; GRIETEN, Lars; MULLENS, Wilfried
Background: The management of the cardiorenal syndrome (CRS) in decompensated heart failure (HF) is challenging, with high-quality evidence lacking. Summary: The pathophysiology of CRS in decompensated HF is complex, with glomerular filtration rate (GFR) and urine output representing different aspects of kidney function. GFR depends on structural factors (number of functional nephrons and integrity of the glomerular membrane) versus hemodynamic alterations (volume status, renal perfusion, arterial blood pressure, central venous pressure or intra-abdominal pressure) and neurohumoral activation. In contrast, urine output and volume homeostasis are mainly a function of the renal tubules. Treatment of CRS in decompensated HF patients should...
Duchenne, Jurgen; VERBRUGGE, Frederik; DUPONT, Matthias; Vercammen, Jan; Jacobs, Linda; GRIETEN, Lars; VANDERVOORT, Pieter; MULLENS, Wilfried
Objective The objective of this study was to assess the feasibility and impact on readmissions of transmural disease management across the borders of the cardiology department in patients with advanced heart failure (HF). Methods and results Consecutive patients, readmitted within one year for advanced HF by a dedicated specialist (n = 55), were followed for 22 10 months after implementation of a hospitalwide transmural disease management strategy. Participants received a tag in their electronic medical record, triggering a HF caregiver contact, with subsequent guideline-recommended, protocol-driven care on each cardiac or non-cardiac hospitalization as well as outpatient evaluation. Upon transition to...
Puttevils, Daisy; DE VUSSER, Philip; GEUSENS, Piet; DENS, Jo
Patients with established rheumatoid arthritis (RA) have a higher cardiovascular morbidity and mortality in comparison with the general population. It is considered to be an independent risk factor for cardiovascular disease. The purpose of this article is to describe the mechanisms responsible for accelerated atherogenesis in RA patients and to give an overview of the effects of different RA therapies (methotrexate, TNF antagonists and other biologicals).
Storms, Hannelore; Marquet, Kristel; Nelissen, Katherine; Hulshagen, Leen; Lenie, Jan; Remmen, Roy; Claes, Neree
Background: An accurate medication overview is essential to reduce medication errors. Therefore, it is essential to keep the medication overview up-to-date and to exchange healthcare information between healthcare professionals and patients. Digitally shared information yields possibilities to improve communication. However, implementing a digitally shared medication overview is challenging. This articles describes the development process of a secured, electronic platform designed for exchanging medication information as executed in a pilot study in Belgium, called “Vitalink”.
Findings: The goal of “Vitalink” is to improve the exchange of medication information between professionals working in healthcare and patients in order to achieve a more efficient...
Storms, Hannelore; Claes, Neree; Hulshagen, Leen; Conings, Stefanie; Nelissen, Katherine
Medicatiemanagement vereist een goede communicatie tussen zorgverleners intra- en transmuraal.
In deze studie wordt nagegaan of een papieren medicatieschema de communicatie tussen zorgverleners van de eerste en tweede lijn in Zuidoost-Limburg verbetert.
In deze regio werd een papieren medicatieschema geïmplementeerd.
Via een voor- en na-bevraging bij deelnemende zorgverleners werd het potentieel van het papieren medicatieschema nagegaan. De verwachtingen, de bevindingen en het gebruik van dit schema werden bevraagd.
Als belangrijkste valkuilen worden tijdsinvestering van zorgverleners en de medewerking van patiënten genoteerd.
Een papieren medicatieschema blijkt voornamelijk te worden gebruikt om medicatiefouten te reduceren.
Daarnaast zien slechts enkele zorgverleners het potentieel van een papieren medicatieschema als instrument...
Teuns, Greet B. A.; Geys, Helena; Geuens, Sonja M. A.; STINISSEN, Piet; Meert, Theo F.
Objectives: Preclinical abuse liability assessment of novel clinical CNS-active candidates involves several tests, addressing different aspects characteristic for abuse potential, which are considered predictive for substance abuse of these candidates, thus ensuring an appropriate translational approach. To demonstrate how such a strategy could work, a known drug of abuse, methylphenidate was evaluated in a full rodent test battery, comprising four test models, and in accordance with the requirements of the FDA, ICH and EMA guidelines. Methods: Methylphenidate was tested orally at 2.5, 5 or 10 mg/kg for its physical dependence potential in a repeated dose non-precipitated withdrawal test, for its...
ARAIN, Amber; ROBAEYS, Geert; St??ver, Heino
Globally, over 10 million people are held in prisons and other places of detention at any given time. People who inject drugs (PWID) comprise 10-48% of male and 30-60% of female prisoners. The spread of hepatitis C in prisons is clearly driven by injection drug use, with many infected prisoners unaware of their infection status. Risk behaviour for acquisition of hepatitis C via common use of injecting equipment is widespread in many prison settings. In custodial settings, effective and efficient prevention models applied in the community are very rarely implemented. Only approximately 60 out of more than 10,000 prisons worldwide...
WENS, Inez; Dalgas, Ulrik; VANDENABEELE, Frank; Krekels, Maartje; Grevendonk, Lotte; EIJNDE, OP 'T Bert
Background: The impact of multiple sclerosis (MS) on skeletal muscle characteristics, such as muscle fiber cross sectional
area (CSA), fiber type proportion, muscle strength and whole muscle mass, remains conflicting.
Methods: In this cross sectional study, body composition and muscle strength of the quadriceps were assessed in 34 MS
(EDSS: 2.560.19) patients and 18 matched healthy controls (HC). Hereafter a muscle biopsy (m.vastus lateralis) was taken.
Results: Compared to HC, mean muscle fiber CSA of all fibers, as well as CSA of type I, II and IIa fibers were smaller and
muscle strength of the quadriceps was lower in MS patients. Whole body composition was...
THEWISSEN, Kristof; HENDRIKS, Jerome; STINISSEN, Piet; Slaets, Leen; HELLINGS, Niels
DE BOCK, Laura; SOMERS, Klaartje; FRAUSSEN, Judith; Hendriks, Jerome J. A.; VAN HORSSEN, Jack; ROUWETTE, Myrthe; HELLINGS, Niels; Villar, Luisa M.; Alvarez-Cermeno, Jose C.; Hupperts, Raymond; Jongen, Peter; Damoiseaux, Jan; Verbeek, Marcel M.; De Deyn, Peter P.; D'hooghe, Marie; Van Wijmeersch, Bart; Stinissen, Piet; Somers, Veerle
JANSSENS, Kris; Van den Haute, Chris; Baekelandt, Veerle; VAN HORSSEN, Jack; VAN WIJMEERSCH, Bart; STINISSEN, Piet; Hendriks, Jerome J. A.; Slaets, Leen; HELLINGS, Niels
Heesen, Christoph; Bruce, Jared; FEYS, Peter; Sastre-Garriga, Jaume; Solari, Alessandra; Eliasson, Lina; Matthews, Vicki; Hausmann, Bettina; Ross, Amy Perrin; Asano, Miho; Imonen-Charalambous, Kaisa; K??pke, Sascha; Clyne, Wendy; Bissell, Paul
Background: Adherence to medical interventions is a global problem. With an increasing amount of partially effective but expensive drug treatments adherence is increasingly relevant in multiple sclerosis (MS). Perceived lack of efficacy and side effects as well as neuropsychiatric factors such as forgetfulness, fatigue and depression are major determinants. However, research on adherence to behavioural interventions as part of rehabilitative interventions has only rarely been studied. Methods: In a one-day meeting health researchers as well as patient representatives and other stakeholders discussed adherence issues in MS and developed a general draft research agenda within a focus group session. Results: The...
BROUX, Bieke; Shamim, Z.; Wang, T.; Spellman, S.; Haagenson, M.; STINISSEN, Piet; Ryder, L. P.; Muller, K.; HELLINGS, Niels
We investigated the influence of IL-7 receptor -chain (IL-7R) gene haplotypes in donors on the outcome of haematopoietic cell transplantation (HCT). Unlike the association between single donor SNPs and HCT outcome found previously, only trends towards association were found here, due to dilution' of SNPs into haplotypes.
STAPPERS, Mark; THYS, Yati; Oosting, M.; Plantinga, T. S.; Ioana, M.; Reimnitz, P.; Mouton, J. W.; Netea, M. G.; Joosten, L. A. B.; Gyssens, Inge C.
Complicated skin and skin structure infections (cSSSIs) are caused by Gram-positive and Gram-negative, aerobic and anaerobic pathogens, with a polymicrobial aetiology being frequent. Recognition of invading pathogens by the immune system results in the production of pro- and anti-inflammatory cytokines, which are extremely important for intercellular communication and control of infection. This study assessed whether genetic variation in genes encoding cytokines influences the susceptibility to cSSSIs. For the association study, 318 patients with cSSSI and 328 healthy controls were genotyped for single nucleotide polymorphisms (SNPs) in cytokine genes IL1A, IL1B, IL1RN, TNF, IL10, IL17A, IL17F and IFNG. For immunological validation,...
MATHEVE, Thomas; Timmermans, Annick
The aim of this systematic review is (1) to provide an overview of the available Technology Supported Exercise Therapy (TSET) programs for low back pain, and (2) to assess the effectiveness of TSET compared to other forms of rehabilitation, placebo interventions or no treatment.
METHODS Electronic databases (Pubmed, Embase, Cochrane Central Register of Controlled Trials, PEDro, IEEE and ACM) were searched until January 2014. Randomized controlled trials comparing TSET to other forms of rehabilitation, placebo interventions or no treatment were included. Further inclusion criteria were: (1) patients with low back pain of musculoskeletal origin, (2) adult population, (3) technologies with an...
BERVOETS, Liene; MEWIS, Alex; MASSA, Guy
It is hypothesized that the shape of the glucose curve during an oral glucose tolerance test is an early indicator of the risk for developing type 2 diabetes mellitus. In this study, we aimed to examine the shape of plasma glucose response curves and study their relationship with insulin sensitivity, insulin secretion and components of the metabolic syndrome in end-pubertal obese girls. Eighty one end-pubertal obese girls (median (range) age: 14.4 (11.2 ??? 18.0) years; BMI: 34.6 (25.4???50.8) kg/m??) who underwent a 2-hour oral glucose tolerance test were classified according to the shape of the glucose curve. Four shape types...
Bervoets, Liene; Van Noten, Caroline; Van Roosbroeck, Sofie; Hansen, Dominique; Van Hoorenbeeck, Kim; Verheyen, Els; Van Hal, Guido; Vankerckhoven, Vanessa
This study was designed to validate the Dutch Physical Activity Questionnaires for Children (PAQ-C) and Adolescents (PAQ-A).
After adjustment of the original Canadian PAQ-C and PAQ-A (i.e. translation/backtranslation and evaluation by expert committee), content validity of both PAQs was assessed and calculated using item-level (I-CVI) and scale-level (S-CVI) content validity indexes. Inter-item and inter-rater reliability of 196 PAQ-C and 95 PAQ-A filled in by both children or adolescents and their parent, were evaluated. Inter-item reliability was calculated by
Cronbach’s alpha(α) and inter-rater reliability was examined by percent observed agreement and weighted kappa(κ). Concurrent validity of PAQ-A was examined in a subsample of...
FRAUSSEN, Judith; CLAES, Nele; DE BOCK, Laura; SOMERS, Veerle
Multiple sclerosis (MS) is an inflammatory disorder of the central nervous system (CNS) with heterogeneous clinical, genetic and pathophysiological characteristics. The establishment of reliable biomarkers for diagnosis, prognosis and treatment of MS has therefore proven to be very difficult. During the last decades, mounting evidence has been collected for the involvement of B cells and antibodies in MS pathogenesis. A wide variety of autoantibodies has been described in MS and these autoantibodies could be useful biomarkers for MS. Since demyelination is a key component of MS pathogenesis, myelin antigens were first investigated as primary targets of autoantibodies in MS. More...
STEVENS, An; HANSEN, Dominique; HERBOTS, Lieven; WENS, Inez; CREEMERS, An; DENDALE, Paul; EIJNDE, Bert O.
PURPOSE: Chronic heart failure (CHF) patients often present with (pre)diabetes, which negatively influences prognosis. Unlike the proven effect of exercise on glucose regulation in the general population, its effect in CHF is unclear. Therefore, this study aimed at investigating the effect of exercise training on glucose regulation in stable CHF patients.
METHODS: Twenty-two CHF patients were randomized into training (EX,n = 15) and control (CON, n = 7) groups. Before and after a 12-week training intervention involving endurance and resistance training, glucose tolerance (2-hour oral glucose tolerance test), exercise tolerance (cardiopulmonary exercise test), muscle strength (isokinetic dynamometer), heart function (echocardiography), glycated...
LOUWIES, Tijs; Nawrot, Tim; Cox, Bianca; Dons, Evi; Penders, Joris; PROVOST, Eline; Int Panis, Luc; De Boever, Patrick
Exposure to ambient particulate matter and elevated blood pressure are risk factors for cardiovascular morbidity and mortality. Microvascular changes might be an important pathway in explaining the association between air pollution and blood pressure. The objective of the study was to evaluate the role of the retinal microcirculation in the association between black carbon (BC) exposure and blood pressure.We estimated subchronic BC exposure based on 1-week personal measurements (μAethalometer, AethLabs) in 55 healthy nurses. Blood pressure and retinal microvasculature were measured on four different days (range: 2–4) during this week.Subchronic BC exposure averaged (± SD) 1334 ± 631 ng/m3 and...