Verhandelingen - Koninklijke Academie voor Geneeskunde van België
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Verh. K. Acad. Geneeskd. Belg. · Jan 2011
ReviewInternational and national initiatives in biobanking.
Translational research and biobanking are "in", also in Flanders and in Belgium. In Flanders the Advice report 120 from the Flemish Council for Science and innovation, entitled "Extension of translational research in Flanders" paved the way for the Center for Medical Innovation. ⋯ However, the scientific interest in the human tissues is not new, at all. This text aims at giving an overview of the development and evolutions of "biobanking" initiatives.
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Verh. K. Acad. Geneeskd. Belg. · Jan 2010
ReviewEndocrine and metabolic disturbances in critical illness: relation to mechanisms of organ dysfunction and adverse outcome.
Critically ill patients face a high risk of death, which is mostly due to non-resolving multiple organ failure. The plethora of endocrine and metabolic disturbances that hallmark critical illness may play a key role. The major part of our research performed during the period 2004-2009 focused on the disturbed glucose metabolism that commonly develops during critical illness. ⋯ Avoiding hyperglycemia protected the endothelium and the mitochondria. In our animal model, nutritional interventions counteracted the hypercatabolic state of critical illness and insulin improved myocardial contractility, but only when normoglycemia was maintained. Interestingly, we identified the adipose tissue as a functional storage depot for toxic metabolites during critical illness.
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Verh. K. Acad. Geneeskd. Belg. · Jan 2009
ReviewCardiovascular characteristics in Marfan syndrome and their relation to the genotype.
Marfan syndrome (MFS) is a systemic disorder of connective tissue with autosomal dominant inheritance. The diagnosis of MFS is based on the identification of a combination of clinical manifestations in the ocular, musculoskeletal, and cardiovascular organ systems defined in the Ghent Nosology (De Paepe et al, 1996). Confirmation of the diagnosis in an individual requires the presence of major clinical manifestations in at least two organ systems associated with involvement of a third organ system. ⋯ In conclusion, we have refined diagnostic guidelines for the assessment of minor cardiovascular manifestations in MFS, shown that LV dysfunction is part of the cardiovascular spectrum and should be followed in the management of MFS patients, and demonstrated that aortic wave reflection is not elevated in MFS. In this work, we also investigated genotype/phenotype correlations, illustrated the marked (intrafamilial) variability in phenotypic expression of the condition, and the value of molecular testing in the diagnosis of MFS. Overall, this thesis nicely illustrates that close interaction and collaboration between cardiology and genetics is an added value to the study of disease pathogenesis of MFS and aortic aneurysms in general.
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The first Belgian nuclear emergency plan was drawn up in the aftermath of the Chernobyl accident and was primarily aimed at dealing with the consequences of major accidents happening in large nuclear facilities like nuclear power plants. Both the experience during a decade of nuclear emergency exercises and a changing environment with increased menace of malevolent actions by terrorists urged the modification and extension of the initial plan; The latest "Nuclear and radiological emergency plan for the Belgian territory" was published as the Royal Decree of October 17th, 2003. In contrast to what happened in other emergency situations, nuclear and radiological emergencies are, from the moment they are recognised as such and regardless of their (potential) impact, coordinated at the level of the federal authorities. ⋯ The radiological evaluation is being prepared by introducing "emergency reference levels", for which the Federal Agency for Nuclear Control is responsible. This consists in pre-defining radiation doses which "generally" to "almost invariably" call for the adoption of a given countermeasure. Finally, the nuclear and radiological emergency plan includes stipulations on the required information to the population, on the education and training of (potentially) intervening parties as well as on the minimum requirements for running nuclear emergency exercises.
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Verh. K. Acad. Geneeskd. Belg. · Jan 2004
Review[Predictive models for the early diagnosis of ectopic pregnancy].
In the past patients with acute abdominal pain and presumably suffering from an ectopic pregnancy often required an immediate surgical intervention. The diagnosis of ectopic pregnancy has become more frequent during the last decades but the incidence of ectopic pregnancy rupture has declined. This decline is due to quantitative hCG measurements, minimally invasive surgery and transvaginal ultrasonography. ⋯ The usual biochemical procedures for diagnosing ectopic pregnancy have been developed for pregnancies associated with abdominal pain and abnormal bleeding and not for asymptomatic pregnant women with a much lower pre-test probability of ectopic pregnancy. For this reason new diagnostic procedures and criteria had to be developed and tested to detect ectopic pregnancies in women with PUL, without exerting any deleterious effect on early intra-uterine pregnancies. In our experience the hCG-ratio and our new mathematical model seem to be the best method to satisfy these criteria.