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Elhadidy M.,Mansoura University | Elkhatib W.F.,Ain Shams University | Elkhatib W.F.,Hampton University | Pierard D.,University Hospital Brussels Brussel | And 3 more authors.
Diagnostic Microbiology and Infectious Disease | Year: 2015

This study addresses the potential association of Escherichia coli O157:H7 genetic clusters with severe clinical manifestations in humans. The genotypes used in this model-based clustering had been delineated on the basis of lineage-specific polymorphism assay, Shiga toxin-encoding bacteriophage insertion site assay, clade typing, tir (. A255T) polymorphism, variant analysis of Shiga toxin 2 gene, and antiterminator Q genes. Based on this model, the distribution of genotypes among tested strains suggested the presence of 6 main genetic clusters of E. coli O157:H7 strains. Clusters 1 and 3 were observed to be more frequent among E. coli O157:H7 strains isolated from bloody diarrhea and hemolytic uremic syndrome, respectively. Consequently, our findings supported the growing evidence of the existence of distinct genotypes of E. coli O157:H7 that differ in their virulence levels to human. © 2015 Elsevier Inc..

Nansseu J.R.N.,Sickle Cell Disease Unit | Nansseu J.R.N.,University of Yaounde I | Fokom-Domgue J.,University of Yaounde I | Noubiap J.J.N.,University of Cape Town | And 6 more authors.
BMJ Open | Year: 2015

Introduction: Fructosamine is a marker of glucose control reflecting the average glycaemic level over the preceding 2-3 weeks. Fructosamine has not gained as much popularity as glycated haemoglobin (HbA1c) for diabetes mellitus (DM) control monitoring, and the related underlying reasons remain unclear. We aim to search for and summarise available evidence on the accuracy of fructosamine measurements to diagnose and monitor DM. Methods and analysis: This systematic review will include randomised control trials, controlled before-and-after studies, time series designs, cohort studies, case-control studies and cross-sectional surveys reporting the diagnosis and/or monitoring of DM (type 1 DM, type 2 DM and gestational DM) with fructosamine compared with other measures of glycaemia (fasting glucose, oral glucose tolerance test, random glucose, HbA1c), without any language restriction. We will perform electronic searches in PubMed, Scopus and other databases, supplemented with manual searches. Articles published from 1 January 1980 to 30 June 2015 will be eligible for inclusion in this review. Two authors will independently screen, select studies, extract data and assess the risk of bias with discrepancies resolved by consensus. We will assess clinical heterogeneity by examining the types of interventions and outcomes in each study, and pool studies judged to be clinically homogeneous. We will also assess statistical heterogeneity using the χ2 test of homogeneity and quantify it using the I2 statistic. Absolute accuracy measures (sensitivity, specificity) will be pooled in a bivariate random-effects model, allowing for intersetting variability. Negative and positive predictive values will be computed for fructosamine, compared with another measure of glycaemia from the pooled estimates of sensitivity and specificity, using Bayes' theorem. Ethics and dissemination: This systematic review will use data from published studies and does not require ethics approval. Findings will be published in a peer-reviewed journal and presented at scientific conferences. Trial registration number: PROSPERO (ID=CRD42015015930). © 2015, BMJ Publishing Group. All rights reserved.

O'Donnell D.E.,Queens University | Casaburi R.,Los Angeles Biomedical Research Institute | Vincken W.,University Hospital Brussels Brussel | Puente-Maestu L.,Complutense University of Madrid | And 3 more authors.
Respiratory Medicine | Year: 2011

Background: Indacaterol is a novel, inhaled, once-daily ultra long-acting β2-agonist (ultra-LABA) for the treatment of COPD. This study investigated the effect of indacaterol on exercise endurance, and on lung hyperinflation during exercise and at rest in patients with moderate-to-severe COPD. Methods: In this double-blind, placebo-controlled, two-period crossover study (3-week treatment, 3-week washout between treatments), patients were randomized to receive indacaterol 300 μg once-daily or matching placebo. The primary efficacy variable was exercise endurance time after 3 weeks of treatment, measured through constant-load cycle ergometry testing performed at 75% of the peak work rate in a screening incremental exercise test. Results: Of 90 patients randomized (mean age: 62.8 years; post-bronchodilator FEV 1: 61.2% predicted and FEV1/FVC: 51.6%), 74 completed the study. Pre-treatment exercise tolerance averaged 459 s. Improvement in exercise endurance time was higher with indacaterol 300 μg than with placebo both after the first dose (treatment difference: 101 s; p < 0.001) and after 3 weeks (treatment difference: 111 s; p = 0.011). In addition, indacaterol increased end-exercise inspiratory capacity (IC) versus placebo after 3 weeks (0.28 L, p = 0.002). Significant improvements were also observed in resting IC (0.17 L, p = 0.001), FEV1 (0.25 L, p < 0.001) and FVC (0.26 L, p < 0.001) with indacaterol compared with placebo at 75 min post-dose after 3 weeks. Conclusion: In conclusion, indacaterol treatment improved the ability of patients with COPD to exercise. In addition, the improvements observed in resting and end-exercise IC indicate reductions in lung hyperinflation after 3 weeks treatment (ClinicalTrials.gov registration number: NCT00620022). © 2011 Elsevier Ltd. All rights reserved.

Vanderhasselt M.-A.,Ghent University | De Raedt R.,Ghent University | Leyman L.,Ghent University | Baeken C.,University Hospital Brussels Brussel
Neuropsychobiology | Year: 2010

The precise role of the dorsolateral prefrontal cortex (DLPFC) in attentional set activation is still not entirely clear. Hence, repetitive transcranial magnetic stimulation (rTMS) can be applied to interfere with neural processing to determine whether a specific brain area is required in task performance. In this study, the influence of one session of high-frequency (HF)-rTMS of the left DLPFC on a reaction task using visual and auditory trials was investigated. Participants were instructed to pay constant attention to the visual stimuli, and they were informed that distracting auditory stimuli could also appear. Participants had to respond to both stimuli. Results indicate that after one session of HF-rTMS of the left DLPFC, performance was improved for the primary task, but not for the distracters. Specifically, we found decreased response time for an endogenous component of attentional control which embodies the online representations of task-relevant information. To conclude, the current results highlight a specific role of the left DLPFC in actively preparing for a specific task in the presence of a distracting task. Copyright © 2010 S. Karger AG.

Cortoos P.-J.,Catholic University of Leuven | Cortoos P.-J.,University Hospital Brussels Brussel | Gilissen C.,Ziekenhuis Oost Limburg | Laekeman G.,Catholic University of Leuven | And 4 more authors.
Scandinavian Journal of Infectious Diseases | Year: 2013

Background: Community-acquired pneumonia (CAP) has a considerable clinical and economic impact. The aim of this study was to identify drivers of hospital costs associated with CAP in 2 Belgian hospitals. Specifically, the influence of patient characteristics, quality indicators, and other treatment aspects on hospital costs was explored. Methods: The following were registered for patients admitted with a confirmed diagnosis of CAP in a large university hospital (Universitaire Ziekenhuizen Leuven, UZL) and a medium-sized secondary care hospital (Ziekenhuis Oost-Limburg, ZOL) in Belgium: the pneumonia severity index (PSI), time to clinical stability, length of stay, antibiotic therapy, outcomes, compliance with validated quality indicators, and the different costs (pharmacy, laboratory, and radiology, and total). Regression analysis was used to identify influential variables. Results: Between October 2007 and June 2010, 803 patients were included, with a median total cost of €4794.57. The length of stay after clinical stability and time to clinical stability had the highest influence on the total cost (+6.3% and +4.9% per additional day, respectively; p < 0.0001). Other important drivers of higher costs were total therapy duration, PSI score, age, and admission to intensive care. Patients treated with moxifloxacin had significantly, but limited, lower costs. Quality indicator compliance, including guideline-compliant antibiotic treatment and therapy streamlining, had little influence. Conclusions: The most important driver of hospital costs associated with CAP was the time between clinical stability and actual hospital discharge. In order to substantially decrease the costs of CAP treatment, this period should be rigorously evaluated for possible intervention targets that would allow costs in CAP treatment to be decreased in a substantial manner. © 2013 Informa Healthcare.

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