Healthcare consumption and direct costs of rheumatoid arthritis in Belgium

in Clinical Rheumatology (2005), 24(6), 615-619

The aim of this study was to compare the socioeconomic consequences of early and late rheumatoid arthritis in Belgium and to assess the patient out-of-pocket contributions. This multicentre longitudinal ... [more ▼]

The aim of this study was to compare the socioeconomic consequences of early and late rheumatoid arthritis in Belgium and to assess the patient out-of-pocket contributions. This multicentre longitudinal study in Belgium evaluated patients with rheumatoid arthritis. Early disease was defined as diagnosis since less than 1 year. At baseline sociodemographic and disease characteristics were assessed and during the following year patients recorded all healthcare- and non-healthcare-related direct costs and out-of-pocket contributions. The study included 48 patients with early and 85 patients with late rheumatoid arthritis. Mean disease duration was 0.5 vs 12.5 years in patients with early and late rheumatoid arthritis, respectively. The disease activity score (DAS28) was comparable between both groups (4.1 vs 4.5, p=0.14), but physical function (Health Assessment Questionnaire, HAQ) was more impaired in patients with long-standing disease (1.0 vs 1.7, p < 0.001). Work disability had increased from 2% in patients with early to 18% in patients with late disease. The annual societal direct costs per patient were E 3055 (median: E 1518) opposed to E 9946 (median: E 4017) for early and late rheumatoid arthritis, respectively. The higher direct cost for patients with long-standing disease was seen for all categories, but especially for physiotherapy and need for devices and adaptations. Patients with early as well as late disease contribute out of pocket about one-third to the direct healthcare costs. Within each group, HAQ was a strong determinant of costs. In Belgium, patients with long-standing rheumatoid arthritis are nine times more likely to be work disabled than patients with less than 1 year disease duration and have a threefold increase in costs. Differences in healthcare consumption between patients could be mainly explained by differences in physical function (HAQ). [less ▲]

Control of puberty by excitatory amino acid neurotransmitters and its clinical implications

in Endocrine (2005), 28(3), 281-285

Excitatory amino acids, glutamate in particular, have a marked stimulatory effect on the reproductive axis, particulary at puberty. Glutamate, N-methyl-D-aspartate (NMDA), and kainate stimulate ... [more ▼]

Excitatory amino acids, glutamate in particular, have a marked stimulatory effect on the reproductive axis, particulary at puberty. Glutamate, N-methyl-D-aspartate (NMDA), and kainate stimulate gonadotropin-releasing hormone (GnRH) secretion in immature mammals and NMDA receptor stimulation results in precocious puberty in rats and monkeys. Puberty is characterized by an increased sensitivity of GnRH to glutamate as well as an increase in glutaminase activity in the hypothalamus. Glutamatergic and GABAergic regulation of GnRH secretion seem strongly interdependent around puberty. in addition to the transsynaptic glutamatergic regulation of GnRH secretion, a coordinated activity of glutamatergic neurons and astroglial cells has been shown to play an active role in puberty. The participation of kainate receptors in the estradiol-induced advancement of puberty suggest that these receptors may be involved in the estradiol-mediated activation of GnRH secretion at puberty. A case of precocious puberty associated with hyperglycinemia illustrates the NMDA involvement in puberty in humans. in this patient, the occurrence of precocious puberty was thought to result from excessive stimulation by glycine of the NMDA receptors linked to the GnRH neurons. Glutamate plays several roles in the hypothalamic mechanism of puberty as it has been shown in animal models, but there are still few clinical data supporting the role of glutamate in human puberty. [less ▲]

Synthesis of the ISR determinant by Pseudomonas putida BTP1 is influenced by physiological and environmental factors.

Poster (2005, December)

Molecular study of aphid farnesyl diphosphate synthase: Implications for the development of biorational insecticides targeting juvenile hormone biosynthesis

Poster (2005, December)

Overhead power lines real time monitoring : a future trend ?

in Revue d'Electricité et d'Electronique Industrielle (2005), 4

Overview of the needs which exist to monitor overhead lines in real time. Application to ampacity is detailed to determine the load available on a given line at a given time. After an overview of the ... [more ▼]

Overview of the needs which exist to monitor overhead lines in real time. Application to ampacity is detailed to determine the load available on a given line at a given time. After an overview of the existing sensors, a new device is proposed (Ampacimon) and first results are detailed on a 70 kV line. [less ▲]

Modelling the climate effect on Black Grouse Population Dynamic in Rhön Biopshere Reserve

in Plummer, Ron (Ed.) Black Grouse Endangered Species (2005, December)

Molecular study of aphid farnesyl diphosphate synthase: Implications for the development of biorational insecticides targeting juvenile hormone biosynthesis

Poster (2005, December)

Quantifying consciousness

in Lancet Neurology (2005), 4(12), 789-790

Three year joint space narrowing predicts long term incidence of knee surgery in patients with osteoarthritis: an eight year prospective follow up study

in Annals of the Rheumatic Diseases (2005), 64(12), 1727-1730

OBJECTIVE: To assess the clinical relevance of mean and minimum femorotibial joint space narrowing (JSN) for predicting future osteoarthritis related surgery in patients with knee osteoarthritis. METHODS ... [more ▼]

OBJECTIVE: To assess the clinical relevance of mean and minimum femorotibial joint space narrowing (JSN) for predicting future osteoarthritis related surgery in patients with knee osteoarthritis. METHODS: 126 subjects with primary knee osteoarthritis were followed prospectively for a mean eight years. Minimum and mean joint space width (JSW) were assessed from standard x rays at baseline and after a follow up of three years. The rate of knee osteoarthritis related surgery was recorded for the following five years. RESULTS: After a mean follow up of eight years, 16 patients (12.7%) had received osteoarthritis related joint surgery. The areas under the curves (AUC) resulting from the receiver operating characteristic curve analyses for predicting osteoarthritis surgery were 0.73 (p=0.006) for minimum JSN and 0.55 (p=0.54) for mean JSN. The cut off for minimum JSN maximising sensitivity and specificity for predicting future surgery was a change of 0.7 mm or more in minimum joint space width over a period of three years. However, no meaningful differences were observed for cut off values between 0.5 and 0.8 mm The relative risk (adjusted for age, body mass index, baseline symptoms, and baseline JSW) of experiencing osteoarthritis related surgery during the eight year of follow up was 5.15 (95% confidence interval, 1.70 to 15.60) (p=0.004) in patients with a minimum joint space narrowing of 0.7 mm or more during the first three years of the study. CONCLUSIONS: A cut off of 0.5 to 0.8 mm in minimum JSN, measured on standard x rays, reflects a clinically relevant progression in patients with knee osteoarthritis. [less ▲]

Dépression et maladies coronariennes: quand les émotions nous brisent le coeur...

in Revue Médicale de Liège (2005), 60(12), 931-8

Depression and cardiovascular diseases represent a major public health problem worldwide. Recent studies have shown that depression is a risk factor for the development of coronary artery disease (CAD) in ... [more ▼]

Depression and cardiovascular diseases represent a major public health problem worldwide. Recent studies have shown that depression is a risk factor for the development of coronary artery disease (CAD) in healthy people and also increases morbidity and mortality in depressed patients with CAD. Others studies have shown that selective serotonin inhibitors (SSRIs) constitute a safe and effective treatment for depressed patients with heart disease. There are also data suggesting that treating depression with SSRIs has a protective role in myocardial infarction and may improve outcomes, including mortality. [less ▲]