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Van Bree M.C.J.,Rotterdam Ophthalmic Institute | Van Verre H.P.,Queen Astrid Military Hospital | Devreese M.T.,Queen Astrid Military Hospital | Larminier F.,Queen Astrid Military Hospital | Van Den Berg T.J.T.P.,Royal Netherlands Academy
Ophthalmology | Year: 2011

Purpose To study straylight testing as a screening method for ocular fitness after refractive surgery in demanding professions and to determine the distribution of elevations in straylight as a result of refractive surgery in a non-research setting in contrast with earlier reports in research settings. Design Cross-sectional study. Participants and Controls The refractive surgery population consisted of 373 eyes in 198 subjects with a history of refractive surgery. The reference population consisted of 402 eyes in 214 young individuals without a history of refractive surgery. Methods Data were collected as part of routine testing at The Queen Astrid Military Hospital (Belgium), an independent military institution responsible for medical fitness examinations. Intraocular straylight was measured with the commercially available C-Quant instrument (Oculus Optikgerte GmbH, Wetzlar, Germany), using the psychophysical compensation comparison (CC) method. Fellow eyes were compared to evaluate methodological aspects. The prevalence of impairment was evaluated for 2 age-independent cutoff criteria, a 2.0-fold and 3.2-fold increase, and an age-dependent cutoff criterion corresponding to an increase of 0.20 log units. Main Outcome Measures Methodological aspects such as repeatability, systematic differences, and distance to impaired scores, and prevalence of impaired straylight values after refractive surgery using proposed cutoff criteria. Results The CC method exhibited good repeatability, and the chance of impaired scores due to variability in measurement was small. The prevalence of impaired straylight values was minimal in the reference population. In the refractive population, 9% (33/373) of values were above the factor 2.0 criterion, 2% (7/373) were above the factor 3.2 criterion, and 12% (45/373) were 0.20 log units above the age reference. Conclusions Straylight testing is a viable screening method for ocular fitness after refractive surgery. Patients from the general population who have undergone refractive surgery have significant elevations more frequently than surgery populations from high-quality research centers. Financial Disclosure(s) The authors have no proprietary or commercial interest in any of the materials discussed in this article. © 2011 American Academy of Ophthalmology.


Reusken C.,National Institute for Public Health and the Environment | Heyman P.,Queen Astrid Military Hospital
Current Opinion in Virology | Year: 2013

Hantaviruses cause hemorrhagic fever with renal syndrome (HFRS) in Eurasia. In Europe both the amplitude and the magnitude of outbreaks of HFRS have increased. The mechanisms that drive the incidences are complex and multi-factorial and only partially due to increased awareness and improved diagnostic tools. Risk determinants include reservoir ecology, virus ecology and anthropogenic factors. The dogma of one specific rodent species as primordial reservoir for a specific hantavirus is increasingly challenged. New hantaviruses have been discovered in shrews, moles and bats and increasing evidence points at host-switching events and co-circulation in multiple, sympatric reservoir species, challenging the strict rodent-virus co-evolution theory. Changing landscape attributes and climatic parameters determine fluctuations in hantavirus epidemiology, for instance through increased food availability, prolonged virus survival and decreased biodiversity. © 2013 Elsevier B.V.


Mullie P.,International Prevention Research Institute iPRI | Mullie P.,Queen Astrid Military Hospital | Godderis L.,Catholic University of Leuven | Clarys P.,Vrije Universiteit Brussel
Appetite | Year: 2012

Objectives: the objective was to study determinants and nutritional implications associated with low-fat food consumption. Methods: a cross-sectional design was used, 5,000 military men were contacted and 1,852 participated. Using mailed questionnaires, the low-fat food consumption frequency was recorded and stratified in number of portions a day. The following low-fat food items were included: mayonnaise, yoghurt, milk, cheese, cottage cheese and meat. Results: the two most daily consumed low-fat foods were meat and yoghurt by, respectively, 21.7% and 17.3% of the participants. Only 3.5% consumed a daily portion of low-fat cheese, and 7.4% consumed one or more daily portions of low-fat milk. After adjustment, Body Mass Index (BMI), physical activity and non-smoking were associated with an increasing consumption of low-fat foods. Consumption of low-fat foods was associated with a decreased daily total and saturated fat intake, from respectively, 37.9 and 14.7 energy-percent for low consumption to 30.5 and 11.6 energy-percent for high consumption. This decrease was compensated by an increased intake in carbohydrates and sugar, respectively, 42.5 and 16.7 energy-percent to 46.5 and 22.6 energy-percent. Conclusions: age, BMI, physical activity and non-smoking were associated with an increasing consumption of low-fat foods. The fact that low-fat foods consumers had a higher intake of carbohydrates and proteins question the efficacy of these items in energy reducing programs. © 2011 Elsevier Ltd.


Lemaire S.,Catholic University of Louvain | Kosowska-Shick K.,Hershey Medical Center | Appelbaum P.C.,Hershey Medical Center | Verween G.,Queen Astrid Military Hospital | And 2 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2010

Radezolid is a novel biaryloxazolidinone in clinical development which shows improved activity, including against linezolid-resistant strains. In a companion paper (29), we showed that radezolid accumulates about 11-fold in phagocytic cells, with ∼60% of the drug localized in the cytosol and ∼40% in the lysosomes of the cells. The present study examines its activity against (i) bacteria infecting human THP-1 macrophages and located in different subcellular compartments (Listeria monocytogenes, cytosol; Legionella pneumophila, vacuoles; Staphylococcus aureus and Staphylococcus epidermidis, mainly phagolysosomal), (ii) strains of S. aureus with clinically relevant mechanisms of resistance, and (iii) isogenic linezolid-susceptible and -resistant S. aureus strains infecting a series of phagocytic and nonphagocytic cells. Radezolid accumulated to similar levels (∼10-fold) in all cell types (human keratinocytes, endothelial cells, bronchial epithelial cells, osteoblasts, macrophages, and rat embryo fibroblasts). At equivalent weight concentrations, radezolid proved consistently 10-fold more potent than linezolid in all these models, irrespective of the bacterial species and resistance phenotype or of the cell type infected. This results from its higher intrinsic activity and higher cellular accumulation. Time kill curves showed that radezolid's activity was more rapid than that of linezolid both in broth and in infected macrophages. These data suggest the potential interest of radezolid for recurrent or persistent infections where intracellular foci play a determinant role. Copyright © 2010, American Society for Microbiology. All Rights Reserved.


Li S.,Catholic University of Louvain | Heyman P.,Queen Astrid Military Hospital | Cochez C.,Queen Astrid Military Hospital | Simons L.,Queen Astrid Military Hospital | Vanwambeke S.O.,Catholic University of Louvain
Parasites and Vectors | Year: 2012

Background: Ticks are the most important pathogen vectors in Europe. They are known to be influenced by environmental factors, but these links are usually studied at specific temporal or spatial scales. Focusing on Ixodes ricinus in Belgium, we attempt to bridge the gap between current single-sided studies that focus on temporal or spatial variation only. Here, spatial and temporal patterns of ticks are modelled together. Methods: A multi-level analysis of the Ixodes ricinus patterns in Belgium was performed. Joint effects of weather, habitat quality and hunting on field sampled tick abundance were examined at two levels, namely, sampling level, which is associated with temporal dynamics, and site level, which is related to spatial dynamics. Independent variables were collected from standard weather station records, game management data and remote sensing-based land cover data. Results: At sampling level, only a marginally significant effect of daily relative humidity and temperature on the abundance of questing nymphs was identified. Average wind speed of seven days prior to the sampling day was found important to both questing nymphs and adults. At site level, a group of landscape-level forest fragmentation indices were highlighted for both questing nymph and adult abundance, including the nearest-neighbour distance, the shape and the aggregation level of forest patches. No cross-level effects or spatial autocorrelation were found. Conclusions: Nymphal and adult ticks responded differently to environmental variables at different spatial and temporal scales. Our results can advise spatio-temporal extents of environment data collection for continuing empirical investigations and potential parameters for biological tick models. © 2012 Li et al.; licensee BioMed Central Ltd.


Hall A.R.,University of Oxford | De Vos D.,Queen Astrid Military Hospital | Friman V.-P.,University of Oxford | Friman V.-P.,University of Exeter | And 2 more authors.
Applied and Environmental Microbiology | Year: 2012

Interest in using bacteriophages to treat bacterial infections (phage therapy) is growing, but there have been few experiments comparing the effects of different treatment strategies on both bacterial densities and resistance evolution. While it is established that multiphage therapy is typically more effective than the application of a single phage type, it is not clear if it is best to apply phages simultaneously or sequentially. We tried single-and multiphage therapy against Pseudomonas aeruginosa PAO1 in vitro, using different combinations of phages either simultaneously or sequentially. Across different phage combinations, simultaneous application was consistently equal or superior to sequential application in terms of reducing bacterial population density, and there was no difference (on average) in terms of minimizing resistance. Phage-resistant bacteria emerged in all experimental treatments and incurred significant fitness costs, expressed as reduced growth rate in the absence of phages. Finally, phage therapy increased the life span of wax moth larvae infected with P. aeruginosa, and a phage cocktail was the most effective short-term treatment. When the ratio of phages to bacteria was very high, phage cocktails cured otherwise lethal infections. These results suggest that while adding all available phages simultaneously tends to be the most successful short-term strategy, there are sequential strategies that are equally effective and potentially better over longer time scales. © 2012, American Society for Microbiology.


Simoens S.,Catholic University of Leuven | Verbeken G.,Catholic University of Leuven | Verbeken G.,Queen Astrid Military Hospital | Huys I.,Catholic University of Leuven
Targeted Oncology | Year: 2012

This article discusses specific issues related to the market access of biosimilars. Biopharmaceuticals are complex molecules produced by living cells. Copies of these medicines, called biosimilars, are not identical to their reference medicine and therefore specific regulatory requirements apply. When considering the use of biosimilars, the question of the degree of comparability between a biosimilar and the reference biopharmaceutical needs to be considered for registration, pricing and reimbursement purposes in addition to the cost issue. To date, many key concepts (like clinically meaningful differences) remain undefined and the question of the degree of comparability is not yet resolved. © 2012 Springer-Verlag.


Mullie P.,Catholic University of Leuven | Mullie P.,Queen Astrid Military Hospital | Clarys P.,Vrije Universiteit Brussel | Hulens M.,Catholic University of Leuven | Vansant G.,Catholic University of Leuven
European Journal of Clinical Nutrition | Year: 2010

Background/Objectives: To test a socioeconomic hypothesis on three dietary patterns and to describe the relation between three commonly used methods to determine dietary patterns, namely Healthy Eating Index, Mediterranean Diet Score and principal component analysis. Subjects/Methods: Cross-sectional design in 1852 military men. Using mailed questionnaires, the food consumption frequency was recorded. Results: The correlation coefficients between the three dietary patterns varied between 0.43 and 0.62. The highest correlation was found between Healthy Eating Index and Healthy Dietary Pattern (principal components analysis). Cohen's kappa coefficient of agreement varied between 0.10 and 0.20. After age-adjustment, education and income remained associated with the most healthy dietary pattern. Even when both socioeconomic indicators were used together in one model, higher income and education were associated with higher scores for Healthy Eating Index, Mediterranean Diet Score and Healthy Dietary Pattern. The least healthy quintiles of dietary pattern as measured by the three methods were associated with a clustering of unhealthy behaviors, that is, smoking, low physical activity, highest intake of total fat and saturated fatty acids, and low intakes of fruits and vegetables. Conclusions: The three dietary patterns used indicated that the most healthy patterns were associated with a higher socioeconomic position, while lower patterns were associated with several unhealthy behaviors. © 2010 Macmillan Publishers Limited All rights reserved.


OBJECTIVE:: To describe a case of partial nephrogenic diabetes insipidus in a burned patient after prolonged delivery of low inspired concentrations of sevoflurane via an Anesthetic Conserving Device. DATA SOURCES:: Clinical observation. STUDY SELECTION:: Case report. DATA EXTRACTION:: Relevant clinical information. DATA SYNTHESIS:: A 34-year-old man was admitted with burns covering 52% of his total body surface area. Mechanical ventilation was provided during sedation with continuous infusions of sufentanil and midazolam. Sedation became increasingly difficult, and in order to limit administration of IV agents, sevoflurane was added to the inspiratory gas flow. This was provided using an Anesthetic Conserving Device and continued for 8 days. The patient rapidly developed polyuria and hypernatremia with an inappropriate decrease in urinary osmolality. Administration of desmopressin resulted in only a modest effect on renal concentrating ability. After cessation of sevoflurane, all variables returned to normal within 5 days. The results of further investigations (cerebral computed tomographic scan, cerebral magnetic resonance imaging, and serum arginine vasopressin concentration) were compatible with a diagnosis of partial nephrogenic diabetes insipidus. The temporal sequence of clinical findings in relation to sevoflurane administration suggests that the sevoflurane was the probable underlying cause. CONCLUSIONS:: Clinicians should be aware of the possibility of sevoflurane-induced diabetes insipidus not only during general anesthesia but also in the intensive care setting of sedation in critically ill patients. This is especially important in patients, such as those with severe burns, in whom preserved renal concentrating ability is important to ensure compensation for extrarenal fluid losses. Copyright © by 2016 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.


Heyman P.,Queen Astrid Military Hospital | Simons L.,Queen Astrid Military Hospital | Cochez C.,Queen Astrid Military Hospital
Viruses | Year: 2014

The English sweating sickness caused five devastating epidemics between 1485 and 1551, England was hit hardest, but on one occasion also mainland Europe, with mortality rates between 30% and 50%. The Picardy sweat emerged about 150 years after the English sweat disappeared, in 1718, in France. It caused 196 localized outbreaks and apparently in its turn disappeared in 1861. Both diseases have been the subject of numerous attempts to define their origin, but so far all efforts were in vain. Although both diseases occurred in different time frames and were geographically not overlapping, a common denominator could be what we know today as hantavirus infections. This review aims to shed light on the characteristics of both diseases from contemporary as well as current knowledge and suggests hantavirus infection as the most likely cause for the English sweating sickness as well as for the Picardy sweat. © 2014 by the authors; licensee MDPI, Basel, Switzerland.

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