Aalst, Belgium
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de Leeuw B.H.C.G.M.,ASZ | Maraha B.,ASZ | Hollemans L.,ASZ | Sprong H.,Laboratory for Zoonoses and Environmental Microbiology | And 3 more authors.
Journal of Microbiological Methods | Year: 2014

Borrelia burgdorferi non. -sensu lato (s.l.) strains occurred in the Netherlands. A multiplex OspA, FlaB, IGS real time PCR was compared to 16S rRNA/rDNA RT-qPCR with lower average Cycle threshold (Ct) and LOD on strain dilutions. Multiplexing increased sensitivity on CSF samples (n = 74), distinguishing B. burgdorferi s.l. from non-s.l. strains. © 2014 Elsevier B.V.

PubMed | Oncologisch Centrum, UZ Brussel, ASZ, Consultant in Statistics and University Hospitals Leuven
Type: | Journal: Clinical colorectal cancer | Year: 2016

This study aims to evaluate the relevance of geriatric assessment (GA) in older patients with colorectal cancer (CRC) and to study functional status (FS) and chemotherapy-related toxicity during treatment.Patients with CRC aged 70 years were evaluated at baseline using a GA. Results were communicated to the treating physician. At 2 to 3 months follow-up, FS was reassessed, and chemotherapy-related toxicity was recorded.A total of 193 patients, with a median age of 77 years, were included. GA was abnormal in 75% and revealed unknown problems in 40%. Treatment was altered in 37% based on clinical assessment. GA led to geriatric interventions in 9 patients (5%) and additionally influenced treatment in 1 patient. At follow-up (n= 164), functional decline was observed in 29 patients (18%) for activities of daily living (ADL) and in 60 patients (37%) for instrumental activities of daily living (IADL). Baseline IADL, depression, fatigue, and cognition were predictors for ADL decline, whereas no predictors for IADL decline could be identified. In the 109 patients receiving chemotherapy, stage and baseline fatigue were predictive for grade 3/4 hematologic toxicity, and baseline ADL, fatigue, and nutrition were predictive for grade 3/4 nonhematologic toxicity.Although GA identified previously unknown problems in more than one-third of older CRC patients, the impact on interventions or treatment decisions was limited. Baseline GA parameters may predict functional decline and chemotherapy-related toxicity. Education of physicians treating older patients with CRC is an essential step in the implementation of GA and subsequent interventions.

Janssens X.,Ghent University | Decuman S.,Ghent University | De Keyser F.,Ghent University | Ackerman C.,AZ St. Lucas | And 22 more authors.
Clinical and Experimental Rheumatology | Year: 2013

Objectives To describe the construction and psychometric properties of the Belgian Rheumatoid Arthritis Disability Assessment (BRADA) questionnaire, a self-report tool to evaluate chronic activity limitations in patients with rheumatoid arthritis (RA). The BRADA was developed to assess the eligibility of patients with RA for financial and social support measures. Methods The BRADA questionnaire evaluates functioning in 6 functional domains (mobility, nutrition, self care, household tasks, awareness of danger and communication) over the past week and the past 3 months. To assess the psychometric properties of the BRADA, patients with moderate to severe RA filled out the BRADA, HAQ-DI and SF-36 questionnaires twice, with a four-week interval. At each visit, the total number of swollen and tender joints, and global disease activity were recorded. DAS 28 was measured at the first visit. Internal consistency of items per domain was evaluated with Cronbach's alpha method. Intraclass correlation coefficient (ICC) analysis was used to assess test-retest reliability. BRADA scores were compared to HAQ, SF-36 scores and disease activity parameters with Spearman's Rho correlation coefficients to assess construct validity. Results Experts considered the content and face validity of BRADA to be adequate. Internal consistency was satisfactory for all functional domains (alpha >0.75), as was the test-retest reliability (ICC 0.78). BRADA scores showed excellent correlation with other validated questionnaires in RA (HAQ-DI, SF-36) and with measures of disease activity (VAS, DAS28)(p<0.001). Conclusions Its psychometric properties indicate that the BRADA questionnaire is a suitable instrument to evaluate disease-specific activity limitations in patients with RA. © Copyright Clinical and Experimental Rheumatology 2013.

Janssens X.,Ghent University | Decuman S.,Ghent University | De Keyser F.,Ghent University | Ackerman C.,AZ St Lucas | And 16 more authors.
PLoS ONE | Year: 2014

Objective: This study investigated whether the Health Assessment Questionnaire (HAQ) can be used as an instrument to assess the need for social support measures that address activity limitations and participation issues in patients with rheumatoid arthritis (RA). Methods: This multicenter observational study included patients with RA and disease duration of at least one year, consulting their rheumatologist for routine evaluation of disease activity. In the single study visit data on demographics, disease history and current treatment were collected. DAS28 values were collected to evaluate current RA disease activity. Patients were asked to fill out the HAQ and SF-36 questionnaires. Receiver Operator Characteristics (ROC) curves were constructed to evaluate the performance of the HAQ, SF-36 and DAS28 in predicting the need for nine supporting measures available for chronically ill patients in the Belgian social security system. The expert opinion of the treating rheumatologist was used as a reference. Results: The study included 316 patients with a mean age of 59.8±12.6 years, disease duration of 11.4±9.3 years, mean DAS28 values of 2.83±1.17. Mean HAQ score was 0.95±0.73, mean SF-36 score 56.5±21.3. HAQ scores >1 were observed in 39.4% of patients. The area under the HAQ ROC curve was consistently >0.7 and higher for the HAQ than for SF-36 or DAS28 for all support measures. Rheumatologists on average recommended 3.67 support measures. Conclusion: The HAQ score was found to be a good predictor of the need for social support measures in patients with RA. © 2014 Janssens et al.

PubMed | ASZ and Maastricht University
Type: Journal Article | Journal: Annals of cardiothoracic surgery | Year: 2014

Treatment of atrial fibrillation (AF) in concomitant surgery is not unanimously agreed upon in the cardiac surgical community. The reason for this lack of consensus is threefold. Firstly, there is an absence of large multicenter randomized controlled trials (RCT) proving the benefit of restoring sinus rhythm in a patient population which we encounter almost daily (about 10% of cardiac surgery patients are diagnosed with AF). Secondly, for patients undergoing cardiac surgery without the need for an atriotomy, the Maze procedure is not widely accepted. In these patients, many surgeons do not think that the increased complexity outweighs the potential future benefits of sinus rhythm. Thirdly, due to our limited understanding of this pathology, we are confronted with many choices of ablation tools and lesion sets. In this perspective these issues are reviewed. As a possible solution, a total epicardial lesion set without any incisions is proposed.

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