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D'Hondt M.,AZ Groeninge | Lucidi V.,Hopital Erasme | Vermeiren K.,AZ Imelda | Van Den Bossche B.,Algemeen Stedelijk Ziekenhuis | And 2 more authors.
World Journal of Surgical Oncology | Year: 2017

Background: The waiting interval after chemoradiotherapy (CRT) is an interesting therapeutic window to treat patients with synchronous liver metastases (SLM) from rectal cancer. Methods: A retrospective analysis was performed of 18 consecutive patients (M/F 10/8, age (range) 60 (51-75) years) from five institutions who underwent liver resection of SLM during the waiting interval after CRT for rectal adenocarcinoma. Results: All patients underwent interval liver surgery for a median (range) of 4 (2-14) liver metastases. Metastases involved a median (range) of 4 (1-7) liver segments. Median (range) time between end of CRT and liver surgery was 22 (6-45) days. Laparoscopic liver surgery was performed in 12 (67%) patients. No severe complications (Clavien-Dindo≥3b) occurred after liver surgery. Median (range) length of hospital stay after liver surgery was 5 (1-10) days. All patients subsequently underwent rectal resection at a median (range) of 10 (8-13) weeks after end of CRT. Median (IQR) time-to-progression after liver surgery was 4.2 (2.8-9.2) months. Conclusions: The waiting interval after neoadjuvant CRT is a valuable option to treat SLM from rectal cancer. More data are necessary to confirm its oncological efficacy. © 2017 The Author(s).


Picard F.,University of Geneva | Makrythanasis P.,IGE | Navarro V.,French Institute of Health and Medical Research | Navarro V.,Paris-Sorbonne University | And 48 more authors.
Neurology | Year: 2014

Objective: To study the prevalence of DEPDC5 mutations in a series of 30 small European families with a phenotype compatible with autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE). Methods: Thirty unrelated families referred with ADNFLE were recruited in France, Italy, Germany, Belgium, and Norway. Whole-exome sequencing was performed in 10 probands and direct sequencing of the DEPDC5 coding sequence in 20 probands. Testing for nonsense-mediated messenger RNA decay (NMD) was performed in lymphoblastic cells. Results: Exome sequencing revealed a splice acceptor mutation (c.2355-2A>G) in DEPDC5 in the proband of aGerman family. In addition, 3 nonsense DEPDC5 mutations (p.Arg487*, p.Arg1087*, and p.Trp1369*) were detected in the probands of 2 French and one Belgian family. The nonsense mutations p.Arg487* and p.Arg1087* were targeted by NMD, leading to the degradation of the mutated transcripts. At the clinical level, 78% of the patients with DEPDC5 mutations were drug resistant. Conclusions: DEPDC5 loss-of-function mutations were found in 13% of the families with a presentation of ADNFLE. The rate of drug resistance was high in patients with DEPDC5 mutations. Small ADNFLE pedigrees with DEPDC5 mutations might actually represent a part of the broader familial focal epilepsy with variable foci phenotype. © 2014 American Academy of Neurology.


PubMed | AZ Sint Trudo, AZ Sint Andries, Hopital De Jolimont, Sainte Elisabeth and 19 more.
Type: Journal Article | Journal: Urologic oncology | Year: 2016

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).Records from 368 patients with mCRPC from 23 different Belgian hospitals who started AA 1000mg per day with 10mg prednisone or equivalent were retrospectively reviewed (September 2013-December 2014). Prostate-specific antigen (PSA) response (decrease50%), 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.Overall, 92 patients (25%) had an Eastern Cooperative Oncology Group performance status2. Median age was 73 years, median PSA was 103ng/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.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.


PubMed | Catholic University of Louvain, Algemeen Stedelijk Ziekenhuis, University of Sao Paulo and Vrije Universiteit Brussel
Type: Journal Article | Journal: Archives of toxicology | Year: 2016

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.


Fonteyne V.,Ghent University | Soete G.,Universitair Ziekenhuis Brussels | Arcangeli S.,Regina Elena Cancer Institute | De Neve W.,Ghent University | And 5 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2012

Purpose: To report late gastrointestinal (GI) and genitourinary (GU) toxicity, biochemical and clinical outcomes, and overall survival after hypofractionated radiation therapy for prostate cancer (PC). Methods and Materials: Three institutions included 113 patients with T1 to T3N0M0 PC in aphase II study. Patients were treated with 56 Gy in 16 fractions over 4 weeks. Late toxicity was scored using Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria extended with additional symptoms. Biochemical outcome was reported according to the Phoenix definition for biochemical failure. Results: The incidence of late GI and GU toxicity was low. The 3-year actuarial risk of developing late GU and GI toxicity of grade ≥2 was 13% and 8% respectively. Five-year biochemical non-evidence of disease (bNED) was 94%. Risk group, T stage, and deviation from planned hormone treatment were significant predictive factors for bNED. Deviation from hormone treatment remained significant in multivariate analysis. Five-year clinical non evidence of disease and overall survival was 95% and 91% respectively. No patient died from PC. Conclusions: Hypofractionated high-dose radiation therapy is a valuable treatment option for patients with PC, with excellent biochemical and clinical outcome and low toxicity. © 2012 Elsevier Inc.


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.


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


Ringoir A.,Algemeen Stedelijk Ziekenhuis | Rappe B.,Algemeen Stedelijk Ziekenhuis | Dhaene K.,Algemeen Stedelijk Ziekenhuis | Schallier D.,Universitair Ziekenhuis Brussel
Urology Case Reports | Year: 2016

A pure leiomyoma of the prostate is a rare tumor. Less than 30 cases about prostatic leiomyoma have been reported. Pathologic anatomy examination is the only medium for definitive diagnosis and is important to rule out malignancies such as leiomyosarcoma. We describe an accidental finding of a tumor in the right prostate lobe of a 54 year old man, who was diagnosed with prostatic leiomyoma and treated with open radical prostatectomy. © 2016 The Authors


PubMed | Universitair Ziekenhuis Brussel and Algemeen Stedelijk Ziekenhuis
Type: | Journal: Urology case reports | Year: 2016

A pure leiomyoma of the prostate is a rare tumor. Less than 30 cases about prostatic leiomyoma have been reported. Pathologic anatomy examination is the only medium for definitive diagnosis and is important to rule out malignancies such as leiomyosarcoma. We describe an accidental finding of a tumor in the right prostate lobe of a 54year old man, who was diagnosed with prostatic leiomyoma and treated with open radical prostatectomy.


Raaijmaakers M.,UZ Pellenberg | Steenbrugge F.,Algemeen Stedelijk Ziekenhuis | Mulier M.,UZ 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.

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