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Neu D.,Free University of Colombia | Mairesse O.,Free University of Colombia | Mairesse O.,Vrije Universiteit Brussel | Mairesse O.,Royal Military Academy | And 10 more authors.
European Journal of Applied Physiology | Year: 2014

Objectives To investigate associated dimensions of fatigue regarding cognitive impairment, psychomotor performances, muscular effort power and circulating cytokine levels and their relations to symptom intensity in a sample of pure chronic fatigue syndrome (CFS) patients without overlapping objective sleepiness or sleep disorders. Methods 16 CFS patients were compared to 14 matched controls. We assessed structured symptom-scales, polysomnography, multiple sleep latency tests, attention (Zazzo-Cancellation ZCT, digit-symbol-substitution DSST), psychomotor vigilance and speed (PVT, finger tapping test, FTT), dynamometer handgrip force (tonic and phasic trials) and circulating cytokines (IFN-γ, IL-1b, IL-6, IL-8, IL-10, TNF-α). Results In addition to fatigue, CFS patients presented with higher affective symptom intensity and worse perceived sleep quality. Polysomnography showed more slow-wave sleep and microarousals in CFS but similar sleep time, efficiency and light-sleep durations than controls. Patients presented with impaired attention (DSST, ZCT), slower reaction times (PVT) but not with lower hit rates (FTT). Notwithstanding lower grip strength during tonic and phasic trials, CFS also presented with higher fatigability during phasic trials. Cytokine levels were increased for IL-1b, IL-8, IL-10 and TNF-α and fatigue intensity was correlated to grip strength and IL-8. Conclusions In contrast to sleepiness, chronic fatigue is a more complex phenomenon that cannot be reduced to one single measured dimension (i.e., sleep propensity). Showing its relations to different measurements, our study reflects this multidimensionality, in a psychosomatic disorder such as CFS. To obtain objective information, routine assessments of fatigue should rule out sleepiness, combine aspects of mental and physical fatigue and focus on fatigability. © 2014 Springer-Verlag Berlin Heidelberg.


Roumeguer T.,Laboratory of Experimental Medicine | Roumeguer T.,University Clinics of Brussels | Delree P.,Institute of Pathology and Genetics IPG | Van Antwerpen P.,Laboratory of Pharmaceutical Chemistry and Analytical Platform | And 7 more authors.
Prostate | Year: 2012

Background: Myeloperoxidase (MPO) is a member of the peroxidase- cyclooxygenase superfamily, which is secreted from stimulated leucocytes at inflammatory sites. It is well known that MPO catalyses oxidation reactions via the release of reactive halogenating and nitrating species and thus induces tissue damage. Several studies have already implicated MPO in the development of neoplasia. Chronic or recurrent prostatic inflammation has long been recognized as having the potential to initiate and promote the development of prostate cancer. The objective was to investigate whether MPO is present in the prostate. METHODS Human prostate material was obtained from biopsies, transurethral resections of the prostate (TURP), prostatic adenomectomies, and retropubic radical prostatectomies. Twenty-nine slides of normal prostate tissue, benign prostatic hyperplasia (BPH), and prostate cancer were reviewed by a pathologist. Immunohistochemical analysis using MPO-specific human antibody was performed to detect MPO in the prostate tissue. Results: Immunocytohistochemistry showed cellular colocalization of MPO in the secretory epithelial cells of the prostate with staining varying from light to strong intensity. Staining in the glandular apical snouts was often reinforced although staining of basal as well as of luminal glandular cells was also present. Conclusions: We identified, for the first time, the presence of MPO at the surface of prostatic epithelial cells. In view of the pro-oxidant properties of this enzyme, further research is needed to define whether MPO contributes to the development of prostatic lesions. © 2011 Wiley Periodicals,Inc.


Roumeguere T.,Laboratory of Experimental Medicine | Roumeguere T.,University Clinics of Brussels | Zouaoui Boudjeltia K.,Laboratory of Experimental Medicine | Babar S.,Free University of Brussels | And 6 more authors.
European Urology | Year: 2010

Background: Sildenafil, vardenafil, and tadalafil are phosphodiesterase type 5 inhibitors (PDE5-Is) usually used in the treatment of erectile dysfunction (ED). Previously, we have shown the presence of myeloperoxidase-modified low-density lipoprotein (Mox-LDL) in the penises of patients with ED, and we have shown the impact of Mox-LDL on cyclic monophosphate (cGMP) level. In vitro, Mox-LDL triggered the inflammatory response by increasing the release of both interleukin 8 (IL-8) and tumor necrosis factor alpha (TNF-α) by endothelial cells (ECs) and monocytes respectively. Objective: To determine whether or not the three therapeutically PDE5-Is protect against the proinflammatory effects of Mox-LDL or TNF-α on ECs. Design, setting, and participants: ECs (EA.hy926) were incubated in the presence of either TNF-α (100 pg/ml) or Mox-LDL (200 μg/ml) with each of the three PDE5-Is (1 μM, 5 μM, and 10 μM) respectively. IL-8 production was measured in the supernatant after 48 h of incubation. Measurements: All experiments were repeated at least three times. Statistical analysis was performed with an ANOVA. Results and limitations: Two-way ANOVA analysis showed that TNF-α alone (p < 0.001) or Mox-LDL alone (p < 0.001) increased IL-8 production. Sildenafil, vardenafil, or tadalafil alone did not generate an increase of IL-8 production. Tadalafil in combination with Mox-LDL and TNF-α showed a decrease of IL-8 (p < 0.05) compared with sildenafil and vardenafil. Conclusions: Among the three available PDE5-Is, tadalafil showed an additional potentially anti-inflammatory effect on relaxation. Those data could be considered for the chronic use of PDE5-Is, but extrapolations of experimental evidence to the clinical setting should be made cautiously. © 2009 European Association of Urology.


PubMed | CHU Sart Tilman, University Clinics of Brussels, UZ Gent, Oncology Center Antwerp and 5 more.
Type: Journal Article | Journal: Advances in therapy | Year: 2015

This large multicenter study aimed to assess the impact of the use of multimedia tools on the duration and the quality of the conversation between healthcare providers (urologists, radiotherapists and nurses) and their patients.30 urological centers in Belgium used either videos or other instructive tools in their consultation with prostate cancer patients. Each consultation was evaluated for duration and quality using a visual analog scale.In total, 905 patient visits were evaluated: 447 without and 458 with video support. During consultations with video support, an average of 2.3 videos was shown. Video support was judged to be practical and to improve the quality of consultations, without loss of time, regardless of patient age or stage of disease management (p>0.05).Healthcare providers indicate that the use of videos improved patient comprehension about prostate cancer, as well as the quality information exchange, without increasing consultation time. The use of video material was feasible in daily practice, and was easy to understand, relevant and culturally appropriate, even for the most elderly men. Multimedia education also helped to empower men to actively participate in their healthcare and treatment discussions.Ipsen NV.


Zlotta A.R.,Mount Sinai Hospital | Zlotta A.R.,University of Toronto | Zlotta A.R.,Urologic | Roumeguere T.,University Clinics of Brussels | And 12 more authors.
European Urology | Year: 2011

Background: More than 25% of bladder cancer (BC) cases are still muscle-invasive at first diagnosis. Screening is unproven to enable the detection of more non-muscle-invasive tumors. BC association with aristolochic acid nephropathy (AAN) was reported after intake of slimming pills containing Chinese herbs. Objective: We evaluated whether a BC screening protocol in a high-risk and unique patient population had an impact on the stage of tumor presentation. Design, setting, and participants: Forty-eight AAN-affected patients were enrolled in a screening program, establishing BC incidence during prospective screening cystoscopies and biopsies biannually for up to 10 yr. Two patients were lost to follow-up, and three refused screening after consenting. Measurements: Patients were evaluated for presence of BC and tumor stage at diagnosis. Results and limitations: BC was diagnosed in 25 patients (52%). Among 43 patients who underwent screening cystoscopies (median follow-up: 94 mo), 22 were first diagnosed with non-muscle-invasive BC but none with muscle-invasive tumors and none died of BC. Three women who declined follow-up were diagnosed and died with advanced metastatic disease. The limitations of our findings include the small sample size of this case series, the absence of a real control group, and the particular risk factor in these patients that differs from the usual risk factors, such as smoking or industrial chemicals. Conclusions: BC screening in high-risk groups may allow identification of tumors before muscle invasion. The optimal screening schedule and the relevance of the present findings in smoking-related BC remain to be defined. © 2011 European Association of Urology.


Avni E.F.,University Clinics of Brussels | Vandenhoute K.,Brugmann Hospital | Devriendt A.,University Clinics of Brussels | Ismaili K.,University Children Hospital Reine Fabiola | And 3 more authors.
Pediatric Radiology | Year: 2011

The clinical classification of nephrotic syndrome (NS) is based on age at presentation. However, this classification is arbitrary because the majority of early onset NS has a genetic origin and has a widespread age of onset (from fetal life to several years). The aims of this review are to illustrate the knowledge accumulated on congenital nephrotic syndrome (CNS) in terms of genetics, classification, findings at histology and US-based on a review of the literature. © 2010 Springer-Verlag.


Neu D.,Free University of Colombia | Linkowski P.,University Clinics of Brussels | Le Bon O.,Free University of Colombia | Le Bon O.,Tivoli University Hospital
Acta Neurologica Belgica | Year: 2010

Chronic daytime fatigue and excessive daytime sleepiness (EDS) are potentially invalidating and also common complaints in primary care and general neurological practice. The lack of distinction in the clinical use of terms like fatigue and sleepiness is an important issue. Although these semiological concepts present fundamental differences from physiological and pathological points of view, general medical literature still often confuses both symptoms. The objective of the present review is to contribute to the clinical distinction between fatigue and sleepiness and describe available measurement tools and respective treatment options. We found that sleepiness and fatigue both present with semiological multidimensionality and clinical complexity. Although relating to different underlying concepts, they can show overlapping features and several clinical conditions can present with both complaints simultaneously. Existing specific assessment tools are sometimes underutilised, causing EDS and fatigue to continue to be confounded. The blurring contributions of several studies are mainly due to the fact that typically only one of these two clinical dimensions is investigated. Despite consensus on objective sleepiness measures, simple and validated objective fatigue assessments are generally lacking and seem elusive. Causal and symptomatic treatment options exist predominantly for sleepiness-associated conditions. Although comprehension of sleepiness and its under - lying physiology has seemed to improve over time, descriptions of common pathways of fatigue remain relatively incomplete. Clinical research and practice should systematically investigate both conditions with adequate measurement tools. Behavioural medicine is certainly underestimated, especially in the management of chronic daytime fatigue.


Alkhateeb S.S.,University of Toronto | Neill M.,University of Toronto | Bar-Moshe S.,University of Toronto | Rhijn B.V.,University of Toronto | And 11 more authors.
Urology Annals | Year: 2011

Background and Objectives: To evaluate the long-term prognostic value of the combination of the EORTC risk calculator and proapoptotic, antiapoptotic, proliferation, and invasiveness molecular markers in predicting the outcome of intermediate-and high-risk non-muscle-invasive bladder cancer (NMIBC) treated with intravesical Bacille Calmette-Gurin (BCG) therapy. Materials and Methods: This study included 42 patients accrued prospectively presenting with intermediate-to high-risk NMIBC (high-grade T1 tumors or multiple rapidly recurrent tumors refractory to intravesical chemotherapy) treated with transurethral resection (TUR) and BCG. TUR samples were analyzed for the molecular markers p53, p21 waf1/cip, Bcl-2, CyclinD1, and metallothionein 9 (MMP9) using immunohistochemistry. Frequency of positivity, measured as a percentage, was assessed alone or in combination with EORTC risk calculator, for interaction with outcome in terms of recurrence and progression using univariate analysis and Kaplan-Meier survival curves. Results: Median follow-up was 88 months (mean, 99; range, 14-212 months). The overall recurrence rate was 61.9% and progression rate was 21.4%. In univariate analysis, CyclinD1 and EORTC risk groups were significantly associated with recurrence (P value 0.03 and 0.02, respectively), although none of the markers showed a correlation to progression. In combining EORTC risk groups to markers expression status, high-risk group associated with positive MMP9, Bcl-2, CyclinD1, or p21 was significantly correlated to tumor recurrence (log rank P values <0.001, 0.03, 0.02, and 0.006, respectively) and when associated with positive MMP9 or p21, it was significantly correlated to progression (log rank P values 0.01 and 0.04, respectively). Conclusion: Molecular markers have a long-term prognostic value when combined with EORTC scoring system and they may be used to improve the predictive accuracy of currently existing scoring system. Larger series are needed to confirm these findings.


PubMed | University Clinics of Brussels
Type: Case Reports | Journal: JOP : Journal of the pancreas | Year: 2011

Pancreatitis is a common complication of acquired immunodeficiency syndrome. The most common causes of acute pancreatitis in an HIV population are medication and opportunistic infections.We report the case of a young, untreated, HIV-infected female who presented with acute pancreatitis of unknown origin. Unique to this case are the autoimmune pancreatitis-like features on imaging studies associated with renal mass-like lesions and lymph node involvement as well as the favorable outcome using highly active antiretroviral therapy alone.In HIV-infected patients, acute pancreatitis may present on imaging studies as autoimmune pancreatitis. In patients with uncontrolled HIV infection and imaging studies suggestive of autoimmune pancreatitis, direct HIV-related inflammation should be considered after exclusion of all other causes of pancreatitis.


PubMed | University Clinics of Brussels
Type: Journal Article | Journal: Acta neuropsychiatrica | Year: 2016

Advances towards the understanding of the etiological mechanisms involved in mood disorders provide interesting yet diverse hypotheses and promising models. In this context, molecular genetics has now been widely incorporated into genetic epidemiological research in psychiatry. Affective disorders and, in particular, bipolar affective disorder (BPAD) have been examined in many molecular genetic studies which have covered a large part of the genome, specific hypotheses such as mutations have also been studied. Most recent studies indicate that several chromosomal regions may be involved in the aetiology of BPAD. Other studies have reported the presence of anticipation in BPAD. This phenomenon describes the increase in clinical severity and decrease in age of onset observed in successive generations. This mode of transmission correlates with the presence of specific mutations (Trinucleotide Repeat Sequences) and may represent a genetic factor involved in the transmission of the disorder. In parallel to these new developments in molecular genetics, the classical genetic epidemiology, represented by twin, adoption and family studies, provided additional evidence in favour of the genetic hypothesis in mood disorders. Moreover, these methods have been improved through models to test the gene-environment interactions. While significant advances have been made in this major field of research, it appears that integrative models, taking into account the interactions between biological (genetic) factors and social (psychosocial environment) variables offer the most reliable way to approach the complex mechanisms involved in the etiology and outcome of mood disorders.

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