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van Praet C.,Ghent University | Rottey S.,Ghent University | Van Hende F.,University Hospital Leuven | Pelgrims G.,AZ Turnhout | And 21 more authors.
Urologic Oncology: Seminars and Original Investigations | Year: 2016

Background: Abiraterone acetate (AA) is licensed for treating metastatic castration-resistant prostate cancer (mCRPC). Real-world data on oncological outcome after AA are scarce. The current study assesses efficacy and safety of AA in mCRPC patients previously treated with docetaxel who started treatment during the Belgian compassionate use program (January 2011-July 2012). Patients and methods: Records from 368 patients with mCRPC from 23 different Belgian hospitals who started AA 1000 mg per day with 10 mg prednisone or equivalent were retrospectively reviewed (September 2013-December 2014). Prostate-specific antigen (PSA) response (decrease≥50%), time to PSA progression (increase>50% over PSA nadir in case of PSA response/>25% in absence of PSA response), time to radiographic progression (on bone scans or for soft tissue lesions using Response Evaluation Criteria In Solid Tumors 1.1), overall survival and adverse event rate (Common Terminology Criteria for Adverse Events v4.03) were analyzed. Kaplan-Meier statistics were applied. Results: Overall, 92 patients (25%) had an Eastern Cooperative Oncology Group performance status≥2. Median age was 73 years, median PSA was 103 ng/dl. PSA response was observed in 131 patients (37.4%). Median time to PSA and radiographic progression was 4.1 months (95% CI: 3.6-4.6) and 5.8 months (5.3-6.4), respectively. Median overall survival was 15.1 months (13.6-16.6). Most common grade 3 to 4 adverse events were anemia (13.9%), hypokalemia (7.3%), fatigue (6.8%), and pain (6.3%). Median duration of AA treatment was 5.3 months (interquartile range: 2.8-10.3). The main study limitation is its retrospective design. Conclusions: These real-world data on post-docetaxel AA efficacy are in line with the COU-AA-301 trial. Importantly, incidence of severe anemia and hypokalemia is up to 50% higher than reported in previous studies. © 2016 Elsevier Inc. Source

Raaijmaakers M.,U.Z. Pellenberg | Steenbrugge F.,Algemeen Stedelijk Ziekenhuis | Mulier M.,U.Z. Pellenberg
Ortopedia Traumatologia Rehabilitacja | Year: 2010

Slipped capital femoral epiphysis occurs in adolescents, most often shortly after the onset of puberty. In patients suffering form renal osteodystrophy, the incidence is higher and the condition usually occurs at a younger age. Metabolic changes induce weakening of the bone, which makes the hip joint vulnerable. The initial treatment consists of phosphate-restricted diet, lanthanum carbonate, cinacalcet (a calcimimetic), calcium carbonate and oral calcitriol, aiming at restoration of bone quality. The use of several surgical treatment options has been reported. In this case, which was diagnosed at a later age because no radiographic work-up was performed in the patient's homeland, the only possible treatment option was a total hip arthroplasty. The use of a commercially available femoral stem was impossible because of the abnormal anatomy of the proximal femur. This patient was treated with a custom stem prosthesis manufactured intraoperatively. Six weeks post surgery, HHS and VAS were improved. Ten weeks post surgery a fracture of the femoral diaphysis was treated with revision surgery using a 20 cm long custom-made stem. At 12 weeks post surgery progressive physical therapy is being instituted. Timely detection of slipped capital femoral epiphysis is a cornerstone of adequate management. In this specific case, the diagnosis was missed and salvage treatment required total hip arthroplasty with a stem prosthesis adapted to the patient's anatomy. © 2010 MEDSPORTPRESS. Source

Buysschaert I.,Heilig Hartziekenhuis | De Rybel R.,Algemeen Stedelijk Ziekenhuis | Dujardin K.,Heilig Hartziekenhuis
Acta Cardiologica | Year: 2013

Syncope, non-specific ST-segment alterations and elevated troponin (cTn) are suspicious of an acute coronary syndrome (ACS). While an ACS is excluded when the coronary angiogram returns normal, the raised cTn should prompt a search for other potentially lethal diseases, such as pulmonary embolism, myocarditis or malignant ventricular arrhythmias. Here we describe a 42-year-old man presenting with syncope, ST-segment elevation, cTn rise and a normal angiogram. He was ultimately diagnosed with Brugada syndrome. Source

Crespo Yanguas S.,Vrije Universiteit Brussel | Cogliati B.,University of Sao Paulo | Willebrords J.,Vrije Universiteit Brussel | Maes M.,Vrije Universiteit Brussel | And 7 more authors.
Archives of Toxicology | Year: 2015

Hepatic fibrosis is a wound healing response to insults and as such affects the entire world population. In industrialized countries, the main causes of liver fibrosis include alcohol abuse, chronic hepatitis virus infection and non-alcoholic steatohepatitis. A central event in liver fibrosis is the activation of hepatic stellate cells, which is triggered by a plethora of signaling pathways. Liver fibrosis can progress into more severe stages, known as cirrhosis, when liver acini are substituted by nodules, and further to hepatocellular carcinoma. Considerable efforts are currently devoted to liver fibrosis research, not only with the goal of further elucidating the molecular mechanisms that drive this disease, but equally in view of establishing effective diagnostic and therapeutic strategies. The present paper provides a state-of-the-art overview of in vivo and in vitro models used in the field of experimental liver fibrosis research. © 2015 Springer-Verlag Berlin Heidelberg Source

Christiaanse E.,Universitair Ziekenhuis Brussel | Jager T.,Algemeen Stedelijk Ziekenhuis | Lenchik L.,Wake forest University | Buls N.,Universitair Ziekenhuis Brussel | And 2 more authors.
Journal of Ultrasound in Medicine | Year: 2014

Objectives - An important sign of proximal intersection syndrome is thickening of the tendons at the area where the first extensor compartment tendons cross over the second compartment. Normal values for the thickness of the tendons have not been reported. Our purpose was to measure the thickness of the tendons with sonography at the level of the intersection in healthy volunteers and assess differences between men and women, dominant and nondominant sides, and different tendons. Methods - Forty-one asymptomatic volunteers (25 women and 16 men) were examined by 2 radiologists experienced in musculoskeletal sonography. The thickness of the tendons in the first and second compartments was measured at their intersection at standardized proximal and distal levels. Descriptive statistics were obtained. Differences between men and women, dominant and nondominant sides, and different tendons were evaluated by a Student t test. Results - The 95% confidence intervals for measurements of superimposed tendon groups varied between 0.30 and 0.40 cm in women and between 0.36 and 0.48 cm in men. There were no statistically significant differences in comparisons of the different tendon groups (P > .05). There were statistically significant differences (P < .05) between tendon thickness in men and women except for the right extensor carpi radialis longus + abductor pollicis longus (proximal measurement) and extensor carpi radialis brevis + extensor pollicis brevis (distal measurement). On comparison of dominant and nondominant sides, there were no statistically significant differences. Conclusions - Normal tendon thickness should be between 0.30 and 0.40 cm in women and 0.36 and 0.48 cm in men. A comparison between asymptomatic and symptomatic sides and proximal and distal measurements is recommended. ©2014 by the American Institute of Ultrasound in Medicine Source

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