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Peltier A.,Institute Jules Bordet | Aoun F.,Institute Jules Bordet | Ameye F.,AZ Maria Middelares | Andrianne R.,CHU Sart Tilman | And 8 more authors.
Advances in Therapy | Year: 2015

Introduction: 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. Methods: 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. Results: 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). Conclusion: 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. Funding: Ipsen NV. © 2015, Springer Healthcare. Source

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. Source

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. Source

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. Source

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. Source

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