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Antwerpen, Belgium

Ingels A.-S.,Ghent University | De Paepe P.,Ghent University | Anseeuw K.,ZNA Stuivenberg | Van Sassenbroeck D.,AZ Maria Middelares | And 4 more authors.
Bioanalysis | Year: 2011

Background: γ-hydroxybutyric acid (GHB), notorious as a club- and date-rape drug, was quantified in dried blood spots (DBS) by punching out a disc, followed by 'on-spot' derivatization and analysis by GC-MS. Results: A homogenous distribution in DBS was demonstrated and accurate results were obtained when analyzing a disc punched out from a 20-35 μl spot, regardless the hematocrit of the blood sample. Validation based on US FDA and European Medicines Agency guidelines was performed, with a calibration range covering 2-100 μg/ml. Conclusion: A sensitive GC-MS method for GHB analysis in DBS was successfully optimized and validated. The successful analysis of DBS collected from GHB abusers suggests the routine applicability of the DBS sampling technique for GHB analysis in toxicological cases. © 2011 Future Science Ltd. Source


Claes F.,University of Antwerp | Berger J.,ZNA Stuivenberg | Stassijns G.,University of Antwerp
Human Factors | Year: 2015

Objective: The aim of this study was to evaluate the prevalence of upper-body-quadrant pain among ultrasonographers and to evaluate the association between individual ergonomics, musculoskeletal disorders, and occurrence of neck pain. Method: A hundred and ten (N = 110) Belgian and Dutch male and female hospital ultrasonographers were consecutively enrolled in the study. Data on work-related ergonomic and musculoskeletal disorders were collected with an electronic inquiry, including questions regarding ergonomics (position of the screen, high-low table, and ergonomic chair), symptoms (neck pain, upper-limb pain), and work-related factors (consecutive working hours a day, average working hours a week). Results: Subjects with the screen on their left had significantly more neck pain (odds ratio [OR] = 3.6, ρ = .0286). Depending on the workspace, high-low tables increased the chance of developing neck pain (OR = 12.9, ρ = .0246). A screen at eye level caused less neck pain (OR = .22, ρ = .0610). Employees with a fixed working space were less susceptible to arm pain (OR = 0.13, ρ = .0058). The prevalence of arm pain was significantly higher for the vascular department compared to radiology, urology, and gynecology departments (OR = 9.2, ρ = .0278). Conclusions: Regarding prevention of upper-limb pain in ultrasonograph, more attention should be paid to the work environment and more specialty to the ultrasound workstation layout. Primary ergonomic prevention could provide a painless work situation for the ultrasonographer. Application: Further research on the ergonomic conditions of ultrasonography is necessary to develop ergonomic solutions in the work environment that will help to alleviate neck and arm pain. © 2014, Human Factors and Ergonomics Society. Source


Geisler C.H.,Rigshospitalet | Van t'Veer M.B.,Daniel Den Hoed Cancer Center | Jurlander J.,Rigshospitalet | Walewski J.,Center of Oncology of Poland | And 10 more authors.
Blood | Year: 2014

The randomized Haemato Oncology Foundation for Adults in The Netherlands 68 phase 3 trial compared front-line chemotherapy with chemotherapy plus the CD52 monoclonal antibody alemtuzumab for high-risk chronic lymphocytic leukemia, defined as at least 1 of the following: unmutated immunoglobulin heavy chain genes, deletion 17p or 11q, or trisomy 12. Fit patients were randomized to receive either 6 28-day cycles of oral FC chemotherapy (days 1 through 3: fludarabine 40 mg/m2 per day and cyclophosphamide 250 mg/m2 per day: n = 139) or FC plus subcutaneous alemtuzumab 30 mg day 1 (FCA, n = 133). FCA prolonged the primary end point, progression-free survival (3-year progression-free survival 53 vs 37%, P = .01), but not the secondary end point, overall survival (OS). However, a post hoc analysis showed that FCA increased OS in patients younger than 65 years (3-year OS 85%vs 76%, P = .035). FCA also increased the overall response rate (88 vs 78%, P = .036), and the bone marrow minimal residual disease-negative complete remission rate (64% vs 43%, P = .016). Opportunistic infections were more frequent following FCA, but without an increase in treatment related mortality (FCA: 3.8%, FC: 4.3%). FCA improves progression-free survival in high-risk chronic lymphocytic leukemia. As anticipated, FCA ismore immunosuppressive than FC, but with due vigilance, does not lead to a higher treatment-related mortality. This study was registered at www.trialregister.nl as trial no. NTR529. © 2014 by The American Society of Hematology. Source


Anseeuw K.,ZNA Stuivenberg | Delvau N.,Cliniques universitaires Saint Luc | Burillo-Putze G.,Hospital Universitario Of Canarias | De Iaco F.,ASL | And 4 more authors.
European Journal of Emergency Medicine | Year: 2013

Smoke inhalation is a common cause of cyanide poisoning during fires, resulting in injury and even death. In many cases of smoke inhalation, cyanide has increasingly been recognized as a significant toxicant. The diagnosis of cyanide poisoning remains very difficult, and failure to recognize it may result in inadequate or inappropriate treatment. Findings suggesting cyanide toxicity include the following: (a) a history of enclosed-space fire; (b) any alteration in the level of consciousness; (c) any cardiovascular changes (particularly inexplicable hypotension); and (d) elevated plasma lactate. The feasibility and safety of empiric treatment with hydroxocobalamin for fire smoke victims have been reported in the literature. On the basis of a literature review and a panel discussion, a group of European experts has proposed emergency management protocols for cyanide toxicity in fire smoke victims. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source


Malbrain M.L.N.G.,ZNA Stuivenberg | De Potter T.J.R.,ZNA Stuivenberg | Dits H.,ZNA Stuivenberg | Reuter D.A.,University of Hamburg
Acta Anaesthesiologica Scandinavica | Year: 2010

Background: Volumetric monitoring with right ventricular end-diastolic volume indexed (RVEDVi) and global end-diastolic volume indexed (GEDVi) is increasingly being suggested as a superior preload indicator compared with the filling pressures central venous pressure (CVP) or the pulmonary capillary wedge pressure (PCWP). However, static monitoring of these volumetric parameters has not consistently been shown to be able to predict changes in cardiac index (CI). The aim of this study was to evaluate whether a correction of RVEDVi and GEDVi with a measure of the individual contractile reserve, assessed by right ventricular ejection fraction (RVEF) and global ejection fraction, improves the ability of RVEDVi and GEDVi to monitor changes in preload over time in critically ill patients. Methods: Hemodynamic measurements, both by pulmonary artery and by transcardiopulmonary thermodilution, were performed in 11 mechanically ventilated medical ICU patients. Correction of volumes was achieved by normalization to EF deviation from normal EF values in an exponential fashion. Data before and after fluid administration were obtained in eight patients, while data before and after diuretics were obtained in seven patients. Results: No correlation was found between the change in cardiac filling pressures (δCVP, δPCWP) and δCI (R2 0.01 and 0.00, respectively). Further, no correlation was found between δRVEDVi or δGEDVi and δCI (R2 0.10 and 0.13, respectively). In contrast, a significant correlation was found between δRVEDVi corrected to RVEF (δcRVEDVi) and δCI (R2 0.64), as well as between δcGEDVi and δCI (R2 0.59). An increase in the net fluid balance with +844 ± 495 mlm2 resulted in a significant increase in CI of 0.5 ± 0.3 lminm2; however, only δcRVEDVi (R2 0.58) and δcGEDVi (R2 0.36) correlated significantly with δCI. Administration of diuretics resulting in a net fluid balance of -942 ± 658 mlm2 caused a significant decrease in CI with 0.7 ± 0.5 lminm2; however, only δcRVEDVi (R2 0.80) and δcGEDVi (R2 0.61) correlated significantly with δCI. Conclusion: Correction of volumetric preload parameters by measures of ejection fraction improved the ability of these parameters to assess changes in preload over time in this heterogeneous group of critically ill patients. © 2010 The Acta Anaesthesiologica Scandinavica Foundation. Source

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