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).
RAVINDRAN NAIR, Ambily; SMEETS, Karen; KEUNEN, Els; Lee, Wing-Kee; Thévenod, Frank; VAN KERKHOVE, Emmy; CUYPERS, Ann
Cadmium (Cd) is a toxic metal with a long half-life in biological systems. This half-life is partly as a result of metallothioneins (MTs), metal-binding proteins with a high affinity for Cd. The high retention properties of the kidneys reside in proximal tubular cells that possess transport mechanisms for Cd-MT uptake, ultimately leading to more Cd accumulation. Researchers have studied MT–metal interactions using various techniques including quantitative real-time PCR (qPCR), an efficient tool for quantifying gene expression. Often a poor choice of reference genes, which is represented by their instability and condition dependency, leads to inefficient normalization of gene expression data...
Ravindran Nair, Ambily; Lee, Wing-Kee; Smeets, Karen; Swennen, Quirine; Sanchez, Amparo; Thévenod, Frank; Cuypers, Ann
Cadmium (Cd2+) induces oxidative stress that ultimately defines cell fate and pathology. Mitochondria are the main energy-producing organelles in mammalian cells, but they also have a central role in formation of reactive oxygen species, cell injury, and death signaling. As the kidney is the major target in Cd2+ toxicity, the roles of oxidative signature and mitochondrial function and biogenesis in Cd2+-related stress outcomes were investigated in vitro in cultured rat kidney proximal tubule cells (PTCs) (WKPT-0293 Cl.2) for acute Cd2+ toxicity (1–30 µM, 24 h) and in vivo in Fischer 344 rats for sub-chronic Cd2+ toxicity (1 mg/kg CdCl2 subcutaneously,...
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...
Neyt, Mattias; Hulstaert, Frank; GYSELAERS, Wilfried
Background: The first- and second-trimester screening for trisomy 21 (T21) are reimbursed for all pregnant women in Belgium. Using a cut-off risk of 1: 300 for T21, about 5% of all pregnant women are referred for definitive prenatal diagnosis using an invasive test, at a sensitivity of (only) 72.5%. The sensitivity and specificity of the non-invasive prenatal test (NIPT) are over 99% but come at a cost of (sic)460 (373) pound per test. The objective is to estimate the consequences of introducing NIPT for the detection of T21. Methods: A cost-consequences analysis was performed presenting the impact on benefits, harms...
LEMMENS, Stefanie; Brône, Bert; Dooley, Dearbhaile; HENDRIX, Sven; Geurts, Nathalie
Many researchers have attempted to pharmacologically modulate the adrenergic system to control locomotion, pain, and spasms after central nervous system (CNS) trauma, although such efforts have led to conflicting results. Despite this, multiple studies highlight that α-adrenoceptors (α-ARs) are promising therapeutic targets because in the CNS, they are involved in reactivity to stressors and regulation of locomotion, pain, and spasms. These functions can be activated by direct modulation of these receptors on neuronal networks in the brain and the spinal cord. In addition, these multifunctional receptors are also broadly expressed on immune cells. This suggests that they might play a...
Oehninger, Sergio; Franken, Daniel R.; OMBELET, Willem
Several semen parameters are used to discriminate the fertile male from the subfertile male. The most widely used parameters are sperm concentration, motility, progressive motility, and sperm morphology. Semen analysis is usually applied as described in the World Health Organization manual for semen analysis. In addition to a routine semen analysis, sperm functional tests have been described for many years, which in most cases are regarded as research tools and not part of the routine semen testing in an infertility clinic. In this review we report on the value of four sperm function tests: the sperm penetration assay, the sperm-...
GYSELAERS, Wilfried; De Bruyn, C.; KERKHOFS, Cecile
Genbrugge, Cornelia; BOER, Willem; Meex, Ingrid; Jans, Frank; Dens, Jo; De Deyne, Cathy
The goal of cardiopulmonary resuscitation (CPR) is to preserve the pre-arrest neurological state by maintaining sufficient cerebral blood flow and oxygenation, but the predictors thereof remain largely unknown. Despite recent attempts to improve the quality of basic and advanced life support, no monitored link to the neurological and physiological response of these CPR efforts has been established. The difficult decision to end pre-hospital resuscitation efforts is currently based on the circumstances of cardiac arrest, length of resuscitation efforts (if available), knowledge of pre-morbid physiological reserves, and (if present) end-tidal carbon dioxide (ETCO2) measurement. ETCO2 is currently the only parameter proven...
Bertrand, P. B.; Smeets, C. J.; Verbrugge, F. H.; GRIETEN, Lars; MULLENS, Wilfried; GUTERMANN, Herbert; Verhaert, D.; Dion, R. A.; Vandervoort, P. M.
Hristova, K.; Shuie, I.; FERFERIEVA, Vesselina; Bogdanova, V.; Katova, T. Z.
VERBRUGGE, Frederik; NIJST, Petra; DUPONT, Matthias; Reynders, Carmen; PENDERS, Joris; Tang, W. H. Wilson; Mullens, Wilfried
Background: Glomerular filtration rate (GFR) and natriuretic response to diuretics represent important treatment targets in acute decompensated heart failure (ADHF). Methods and Results: Consecutive ADHF patients (n = 50) with ejection fraction <= 45% and clinical signs of volume overload received protocol-driven decongestive therapy. Serum creatinine (Cr), cystatin C (CysC), and beta-trace protein (beta TP) were measured on admission and three subsequent days of treatment. Worsening renal function (WRF) was defined as a >= 0.3 increase in absolute biomarker levels or >= 20% decrease in estimated GFR. Consecutive 24-hour urinary collections were simultaneously performed to measure Cr clearance and natriuresis....
Mesens, Tinne; TOMSIN, Kathleen; STAELENS, Anneleen; OBEN, Jolien; MOLENBERGHS, Geert; GYSELAERS, Wilfried
Objectives: To evaluate in early and late preeclampsia a correlation of maternal venous Doppler flow characteristics with biochemical parameters in maternal serum and urine, or with gestational outcome. Study design: In this observational cross-sectional study, renal interlobar vein impedance index (RIVI) was measured according to a standardised protocol for combined electrocardiogram-Doppler ultrasonography in 86 women with uncomplicated pregnancy, 78 women with late onset preeclampsia (>= 34 w) and 67 with early onset preeclampsia (<34 w). For each group, maternal age, pre-gestational BMI and parity were recorded together with birth weight and percentile. For both early onset and late onset preeclampsia,...
Koopman, P.; Keulards, D.; Falter, M.; Gruwez, H.; ter Bekke, R. M. A.; DENDALE, Paul; Volders, P. G. A.; Gorgels, A. P. M.
AVILA MACAYA, Ariel; Vidal, Pia M.; Tielens, S.; MORELLI, Giovanni; Laguesse, S.; Harvey, R. J.; Rigo, J. M.; Nguyen, L.
The development of the cerebral cortex requires coordinated regulation of proliferation, specification, migration and differentiation of cortical progenitors into functionally integrated neurons. The completion of the neurogenic program requires a dynamic interplay between cell intrinsic regulators and extrinsic cues, such as growth factor and neurotransmitters. We previously demonstrated a role for extrasynaptic glycine receptors (GlyRs) containing the alpha 2 subunit in cerebral cortical neurogenesis, revealing that endogenous GlyR activation promotes interneuron migration in the developing cortical wall. The proliferative compartment of the cortex comprises apical progenitors that give birth to neurons directly or indirectly through the generation of basal progenitors,...
Janssen, Bram; Byun, H. M.; Cox, Bianca; Gyselaers, Wilfried; Izzi, B.; Baccarelli, Andrea A.; Nawrot, Tim
Background: Epigenetics is tissue-specific and potentially even cell-specific, but little information is available from human reproductive studies about the concordance of DNA methylation patterns in cord blood and placenta, as well as within-placenta variations. We evaluated methylation levels at promoter regions of candidate genes in biological ageing pathways (SIRT1, TP53, PPARG, PPARGC1A, and TFAM), a subtelomeric region (D4Z4) and the mitochondrial genome (MT-RNR1, D-loop).
Methods: Ninety individuals were randomly chosen from the ENVIRONAGE birth cohort to evaluate methylation concordance between cord blood and placenta using highly quantitative bisulfite-PCR pyrosequencing. In a subset of nineteen individuals, a more extensive sampling scheme...
OBEN, Jolien; TOMSIN, Kathleen; Mesens, Tinne; STAELENS, Anneleen; MOLENBERGHS, Geert; GYSELAERS, Wilfried
Objective: In this study, we determine whether maternal cardiovascular (CV) profiling can detect first trimester differences between women with uncomplicated pregnancies (UP) and those who will develop gestational hypertensive disorders (GHD) or normotensive fetal growth retardation (FGR). Methods: Cardiac, arterial, and venous function were evaluated in 242 pregnant women around 12 weeks of gestation, using impedance cardiography (ICG) and combined electrocardiogram Doppler ultrasonography. After postnatal determination of gestational outcome, first trimester measurements were compared between groups using Mann-Whitney U test for continuous data or Fisher's Exact test for categorical variables (SPSS 20.0). Results: Compared to UP, first trimester aortic flow...