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See detailEpidemiology and familiarity
Beckers, Albert ULg

Scientific conference (2009, November)

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See detailEpidemiology and genetics of FIPA
Beckers, Albert ULg

in 12th ESE PostGraduate Course in Clinical Endocrinology - Abstract book (2012)

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See detailEpidemiology and genetics of FIPA
Beckers, Albert ULg

in 15th annual Canadian Society of Endocrinology and metabolism - Abstract book (2012, October)

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See detailEpidemiology and genetics of FIPA
Beckers, Albert ULg

Scientific conference (2011, November 18)

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See detailEpidemiology and genetics of FIPA
Beckers, Albert ULg

Scientific conference (2011, June 06)

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See detailEpidemiology and genetics of pituitary adenomas
Beckers, Albert ULg

Scientific conference (2014, March 14)

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See detailEpidemiology and Genetics of pituitary adenomas
Beckers, Albert ULg

Scientific conference (2009, May 01)

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See detailEpidemiology and Genetics of pituitary adenomas
Beckers, Albert ULg

Scientific conference (2009, March 02)

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See detailThe epidemiology and genetics of pituitary adenomas.
Daly, Adrian ULg; Tichomirowa, M. A.; Beckers, Albert ULg

in Best Practice & Research. Clinical Endocrinology & Metabolism (2009), 23(5), 543-554

According to data derived from autopsy and radiological imaging series, pituitary tumours occur very commonly in the general population; however, most of these tumours are incidental findings with no ... [more ▼]

According to data derived from autopsy and radiological imaging series, pituitary tumours occur very commonly in the general population; however, most of these tumours are incidental findings with no obvious clinical impact. The historical data on the prevalence of pituitary adenomas in the clinical setting are scant and point to such tumours being relatively rare. Recent studies have shown that the prevalence of clinically relevant pituitary adenomas is 3-5 times higher than previously reported, which adds impetus to research into the aetiology of these tumours. Although the majority of pituitary adenomas are sporadic, approximately 5% of all cases occur in a familial setting and over half of these are due to Multiple Endocrine Neoplasia Type 1 (MEN-1) and Carney's Complex (CNC) disorders. Since the late 1990 s, we have described non-MEN1/CNC familial pituitary tumours that include all tumour phenotypes as a condition termed Familial Isolated Pituitary Adenomas (FIPAs). The clinical characteristics of the FIPAs vary from those sporadic pituitary adenomas, as patients with FIPAs have a younger age at diagnosis and larger tumours. About 15% of the FIPA patients have mutations in the aryl hydrocarbon receptor-interacting protein gene (AIP), which indicates that the FIPA may have a diverse genetic pathophysiology. [less ▲]

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See detailEpidemiology and genetics of pituitary tumors
Beckers, Albert ULg

Scientific conference (2013, February)

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See detailEpidemiology and genetics of pituitary tumors
Beckers, Albert ULg

Scientific conference (2007)

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See detailEpidemiology and genetics of pituitary tumors
Beckers, Albert ULg

Scientific conference (2007, February 01)

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See detailEpidemiology and genetics of pituitary tumours
Beckers, Albert ULg

in Chanson, Philippe (Ed.) Best Practice Research - Clinical Endocrinology and Metabolism (2008)

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See detailEpidemiology and Genetics of Pituitary Tumours
Daly, Adrian ULg

Doctoral thesis (2008)

To have a full understanding of a disease, it is necessary to at least know how frequently it occurs, its clinical features and by what means it is caused. In the case of pituitary adenomas, data in the ... [more ▼]

To have a full understanding of a disease, it is necessary to at least know how frequently it occurs, its clinical features and by what means it is caused. In the case of pituitary adenomas, data in the literature on the epidemiology of these tumors is conflicting, with some studies suggesting a high frequency, others that they occur rarely in the clinical setting. In parallel, the understanding of the pathophysiology of endocrine tumors like pituitary adenomas has advanced greatly with the advent of molecular genetic techniques. However, much remains unclear regarding pathophysiology. A valuable avenue for studying the causes of endocrine tumors has been to focus on the familial setting. With respect to pituitary adenomas, apart from multiple endocrine neoplasia type 1 (MEN1) and Carney complex (CNC), the field of familial pituitary tumors is poorly understood. Indeed, apart from familial acromegaly, there have been virtually no studies on other pituitary adenomas occurring in the familial setting. The aims of the work described in this thesis were based on addressing aspects of the epidemiology and genetics of pituitary tumors. Firstly, the disconnect between the prevalence rates for pituitary adenomas from autopsy/radiology studies (incidentalomas being very common) and cancer registries/population data (rare) was studied. An intensive, comprehensive, case-finding study of the prevalence of pituitary adenomas was performed in three tightly-defined geographical areas in the Province of Liège. In this study, which involved a population of more than 70,000 people, diagnosed pituitary adenomas were sought in collaboration with the entire group of community medical practitioners in the study areas, and the demographics and clinical, hormonal, radiological and pathological features of all patients were confirmed independently. On a fixed date, it was found that clinically diagnosed pituitary adenomas occurred with a prevalence of 1 case per 1064 individuals residing within the geographic boundaries of the study. These results report a clinical prevalence of pituitary adenomas that is 3.5 to 5 times higher than previous population/registry estimates. It suggests that clinically relevant pituitary adenomas occur frequently in the everyday clinical setting, which may have important implications for health resource allocations. Also, it is possible to undertake detailed, comprehensive, crosssectional epidemiological studies in well-defined geographic areas, and this methodology can be applied internationally Studying the familial occurrence of pituitary adenomas outside of MEN1 and CNC was the next aim of the work described. Up to this time, only the familial occurrence of acromegaly had been reported with any frequency in the literature. An international study was undertaken to assess whether isolated pituitary adenomas of all types could occur in the familial setting, a suspicion raised in Liège over the past decade. This study demonstrated that familial isolated pituitary adenomas (FIPA) occur in about 2% of pituitary adenoma populations, and 64 FIPA families were characterized clinically. The study demonstrated for the first time that all phenotypes of pituitary adenomas can occur together in families; some families exhibit only one phenotype among affected members (homogeneous FIPA kindreds), others have multiple tumor types among affected family members (heterogeneous FIPA). In FIPA families, pituitary tumors were more aggressive and tended to occur at a younger age than sporadic pituitary adenomas. FIPA families display a high degree of familiality, suggesting a dominant mode of inheritance. Subsequent studies were performed on the genetic and pathological features of pituitary adenomas, particularly those occurring as FIPA. The discovery of a novel gene, aryl hydrocarbon receptor interacting protein ( AIP), mutations in which were associated with isolated pituitary adenomas, led us to undertake the first such genetic studies in FIPA. AIP mutations account for a minority (15%) of FIPA families and 50% of familial acromegaly kindreds in FIPA. This suggests that other genetic causes for FIPA also exist. In AIP mutation carrying FIPA families, tumors were larger and had a younger age at diagnosis than non- AIP mutated FIPA kindreds. A series of 9 novel AIP mutations were identified, the majority of which led to predicted loss of vital ligand and receptor interacting regions of the AIP protein. AIP mutations in FIPA were associated with multiple pituitary adenoma types, including acromegaly, prolactinomas, mixed growth hormone/prolactin secreting adenomas and non-secreting tumors. It was also found that the same AIP mutation was responsible for different pituitary adenoma types in two separate FIPA families. A detailed follow-up study of an individual FIPA kindred with an AIP mutation found for the first time that non-pituitary tumor-associated endocrine abnormalities (elevated circulating insulin-like growth factor-1) occur in AIP mutation carriers. A detailed analysis of germline and somatic DNA from a large international European cohort of sporadic (non-familial) pituitary adenoma cases showed that AIP mutations occur rarely in this setting. In conclusion, the work undertaken has provided new understanding of the true prevalence of clinically-relevant pituitary adenomas in the population, in addition to codifying and characterizing FIPA, a new clinical entity that represents a potentially valuable area for genetic and clinical studies involving the function of AIP and other as yet unidentified associated genetic causes. [less ▲]

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See detailThe epidemiology and management of pituitary incidentalomas
Daly, Adrian ULg; Burlacu, M. C.; Livadariu, E. et al

in Hormone Research (2007), 68(Suppl. 5), 195-198

Prevalence: The prevalence of pituitary tumors has been a topic of controversy for many years. Autopsy and radiological series show that pituitary incidentalomas may be present in one of six people ... [more ▼]

Prevalence: The prevalence of pituitary tumors has been a topic of controversy for many years. Autopsy and radiological series show that pituitary incidentalomas may be present in one of six people. Recent epidemiological data suggest that clinically apparent pituitary adenomas have a prevalence of approximately one in 1,000 people in the general population. The disconnect between these two prevalence rates underlines the common clinical quandary of how to manage pituitary incidentalomas, particularly those lacking clinical signs/symptoms or hormonal abnormalities. Management: The natural history of incidentalomas suggests that periodic hormonal, clinical and radiological follow-up is the optimal approach. In the absence of tumor growth or relevant symptoms, screening can be continued intermittently or curtailed based on the clinical judgment of the physician. In the presence of hormonal hypersecretion, the management of pituitary incidentalomas, whether they are micro- or macroadenomas, should follow accepted clinical guidelines. For incidental pituitary macroadenomas without hormonal hypersecretion, clinical management should also include assessments for visual field impairment or hypopituitarism. In such cases, regular radiological and hormonal follow-up is required to identify tumor growth or the appearance of new symptoms. In the presence of tumor growth or new hormonal abnormalities, surgical options should be considered and discussed with the patient. Copyright (C) 2007 S. Karger AG, Basel. [less ▲]

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See detailEpidemiology and outcome of acute lung injury in European intensive care units. Results from the ALIVE study
Brun-Buisson, Christian; Minelli, Cosetta; Bertolini, Guido et al

in Intensive Care Medicine (2004), 30(1), 51-61

Abstract Objectives: To re-examine the epidemiology of acute lung injury (ALI) in European intensive care units (ICUs). Design and setting: A 2-month inception cohort study in 78 ICUs of 10 European ... [more ▼]

Abstract Objectives: To re-examine the epidemiology of acute lung injury (ALI) in European intensive care units (ICUs). Design and setting: A 2-month inception cohort study in 78 ICUs of 10 European countries. Patients: All patients admitted for more than 4 h were screened for ALI and followed up to 2 months. Measurements and main results: Acute lung injury occurred in 463 (7.1%) of 6,522 admissions and 16.1% of all mechanically ventilated patients; 65.4% cases occurred on ICU admission. Among 136 patients initially presenting with “mild ALI” (200< PaO2/FiO2 £300), 74 (55%) evolved to acute respiratory distress syndrome (ARDS) within 3 days. Sixty-two patients (13.4%) remained with mild ALI and 401 had ARDS. The crude ICU and hospital mortalities were 22.6% and 32.7% (p<0.001), and 49.4% and 57.9% (p=0.0005), respectively, for mild ALI and ARDS. ARDS patients initially received a mean tidal volume of 8.3±1.9 ml/kg and a mean PEEP of 7.7±3.6 cmH2O; air leaks occurred in 15.9%. After multivariate analysis, mortality was associated with age (odds ratio (OR) =1.2 per 10 years; 95% confidence interval (CI): 1.05–1.36), immuno-incompetence (OR: 2.88; Cl: 1.57–5.28), the severity scores SAPS II (OR: 1.16 per 10% expected mortality; Cl: 1.02–1.31) and logistic organ dysfunction (OR: 1.25 per point; Cl: 1.13–1.37), a pH less than 7.30 (OR: 1.88; Cl: 1.11–3.18) and early air leak (OR: 3.16; Cl: 1.59–6.28). Conclusions: Acute lung injury was frequent in our sample of European ICUs (7.1%); one third of patients presented with mild ALI, but more than half rapidly evolved to ARDS. While the mortality of ARDS remains high, that of mild ALI is twice as low, confirming the grading of severity between the two forms of the syndrome. [less ▲]

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See detailThe Epidemiology of Acromegaly
Beckers, Albert ULg; Daly, Adrian ULg

in John Wass (Ed.) Acromegaly book (2009)

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See detailEpidemiology of atypical myopathy: descriptive phase
Votion, Dominique ULg; Linden, Annick ULg; Desmecht, Daniel ULg et al

in In Proceeding: First Scientific Symposium of the European College of Equine Internal Medicine (ECEIM) (2005, January)

Atypical myopathy (AM) in grazing horses is a frequently fatal condition that has been reported in several European countries. In Belgium, since autumn 2000, AM was confirmed in 39 equids based on ... [more ▼]

Atypical myopathy (AM) in grazing horses is a frequently fatal condition that has been reported in several European countries. In Belgium, since autumn 2000, AM was confirmed in 39 equids based on characteristic histological lesions in postural and respiratory muscles. This study describes the history, clinical signs and biochemical changes associated with AM in these confirmed cases. [less ▲]

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See detailEpidemiology of brucellosis in humans and domestic ruminants in Bangladesh
Rahman, AKM Anisur ULg

Doctoral thesis (2015)

Background Brucellosis is an ancient and one of the world’s most widespread zoonotic diseases affecting both, public health and animal production. It is endemic in many developing countries of Asia ... [more ▼]

Background Brucellosis is an ancient and one of the world’s most widespread zoonotic diseases affecting both, public health and animal production. It is endemic in many developing countries of Asia, Africa and Latin America including Bangladesh. Since the first report in 1970, a lot of brucellosis seroprevalence reports are available in cattle, goats, sheep and humans in Bangladesh. Most of the previously reported prevalence studies were based on non-random samples, which may not give a true representation of the status of the disease in respective populations. Some authors also investigated the risk factors in cattle. The tests used for the diagnosis of brucellosis in domestic ruminants and humans are imperfect and their performance was not evaluated in Bangladesh. The true prevalence of brucellosis in domestic ruminants is not known and is essential for analyzing the impact of this disease in domestic ruminants in Bangladesh. Indeed, when diagnostic tests are used without evaluating their performance in a context usually generate unreliable results, which in turn may lead to wrong epidemiological inferences. In addition, information on risk factors of brucellosis in humans and animals is also scarce. Moreover, the different species of Brucella prevalent in animals is scarce and not known in humans in Bangladesh. The overall objective of this thesis was to investigate the epidemiology of brucellosis in humans and domestic ruminants in Bangladesh in terms of the evaluation of commonly used diagnostic tests, estimation of true prevalence, identification of risk factors and detection of Brucella species in order to provide information that will guide the selection of appropriate control strategies. Study design and data analysis Sampling To collect random samples of animals a system of map digitization and selection of one geographical point from selected unions (Sub-Upazilla) using a hand held GPS machine was used. Blood (milk also where applicable) samples were then collected from livestock farmers and their animals within 0.5 km of the selected points. A convenient blood sample of butchers, dairy hands and veterinary practitioners were collected from Dhaka and Mymensingh districts. The sera of pyretic humans were collected from Mymensingh Medical College hospital randomly once in a week. Random milk samples were collected from Sirajgonj and Chittagong districts. Systematic random milk and blood samples of cattle including breeding bulls (semen also) of central cattle breeding and dairy farm (CCBDF) were also collected. Milk and blood samples of gayals of a herd in regional Bangladesh Livestock Research Institute at Naikhonchari, Bandarban were also collected. Convenient samples of placenta and vaginal swabs were also collected from Mymensingh district. Data collection and Analysis Data on serology was generated by using Rose Bengal test (RBT), Slow Agglutination test (SAT) /Standard tube agglutination test (STAT) (animals/humans) and indirect enzyme linked immunosorbent assay (iELISA). Animal, their herd level data and human data on potential risk factors were collected using a pretested questionnaire. The data was stored in Microsoft Excels worksheets and transferred to respective software for analysis. To estimate true prevalence and evaluate three conditionally dependent serological tests, Bayesian latent class models were used. Random effect and Firth’s logistic regression analyses were used to determine the risk factors of human brucellosis. The STATA, R and OpenBUGS softwares were used for data analyses. Staining, culture, genus and species-specific real time PCR assays were applied to isolate and to detect Brucella Spp./DNA in seropositive human sera and animal samples. Main results: Only 0.29% (95% CI: 0.06-0.86) cattle were acutely infected whereas 0.49% (95% CI: 0.16- 8 1.1) were chronically infected with brucellosis in Mymensingh. On the other hand, in CCBDF 15.58% (95% CI:11.89-19.89) cattle were acutely infected with brucellosis and only 3.2%(95%CI: 1.63-5.72) were chronically infected. The true prevalence of brucellosis among cattle in Mymensingh and CCBDF were 0.3% (95%CI: 0.03-0.7) and 20.5% (95% CI: 16.4-26.3) respectively. The performance of iELISA was best in both Mymensingh and CCBDF with the sensitivity of 90.5% and 91.3% and specificity of 99.3% and 99.2% respectively. The performance of RBT was better in Mymensingh than CCBDF with 81.0% and 76.1% sensitivity and 99.0% and 95.6% specificity respectively. Similar to RBT, the performance of SAT was also better in Mymensingh than CCBDF with 63.5% and 79.7% sensitivity and 98.6% and 95.3% specificity respectively. Through this test validation study, a new cut-off of 5 IU/ml for iELISA was recommended both in low (as at Mymensingh) and high prevalence scenarios in cattle populations (as at CCBDF) for routine screening. It was recommended to do nothing for the control of bovine brucellosis under small-scale dairy and subsistence management systems in Bangladesh. However, vaccination should be applied in herds where the prevalence is very high as like CCBDF. The true prevalence of brucellosis in goats and sheep were estimated as 1% (95% CI): 0.7–1.8) and 1.2% (95% CI: 0.6–2.2) respectively. The sensitivity of iELISA was 92.9% in goats and 92.0% in sheep with corresponding specificities of 96.5% and 99.5% respectively. The sensitivity and specificity estimates of RBT were 80.2% and 99.6% in goats and 82.8% and 98.3% in sheep. The sensitivity and specificity of SAT were 57.1% and 99.3% in goats and 72.0% and 98.6% in sheep. The prevalence of brucellosis in occupationally exposed people (HROG) using three tests was observed to be 4.4% based on a parallel interpretation. The results of the multiple random effects logistic regression analysis with random intercept for district revealed that the odds of brucellosis seropositivity among individuals who had been in contact with livestock for more than 26 years was about 14 times higher as compared to those who had less than 5 years of contact with livestock. In addition, when the contact was with goats, the odds of brucellosis seropositivity were about 60 times higher as compared to when contact was with cattle only. The seroprevalence of brucellosis among patients with pyrexia of unknown origin (PUO) was estimated to be 2.7% (95% CI: 1.2-5.2). The age, residence, type of patient, contact with animals, type of animal handled, arthralgia and backache were found to be significantly associated with a positive serological result in bivariable Firth’s logistic regression. Brucella abortus was detected from seropositive pyretic patients. Conclusion: The true exposure prevalence of brucellosis in cattle under small-scale dairy and subsistence/backyard management systems is very low (0.3%; 95% CI: 0.03-0.7). The active/acute infection is also very low (0.29%: 95% CI: 0.06-0.86) and similar to true exposure prevalence. The brucellosis in cattle under such management system is naturally controlled and further control program is not recommended considering the poor socioeconomic conditions. The true exposure prevalence of brucellosis in CCBDF is very high (20.5%; 95% CI: 16.4-26.3). The acute infection in this farm is also very high (15.58%; 95% CI: 11.89-19.89). Immediate control measures by initiating calf hood (female calf) vaccination are recommended to protect a valuable herd which also provides frozen semen for artificial insemination all over the country. The SAT and iELISA may simultaneously be applied to know the stage of brucellosis infection in domestic ruminants in high prevalence scenarios. The true exposure prevalence of brucellosis in goats and sheep are also low and around 1%. Due to lower positive predictive value, these test results should be interpreted with caution to avoid misleading information. Breeding bulls used for artificial insemination all over the country were found to be infected with brucellosis. Brucellosis is not a serious problem for the general population in Bangladesh as drinking raw milk and milk products is unusual and not a risk factor. The apparent prevalence of brucellosis in high risk occupationally exposed people (4.4%; 95% CI: 2.8-6.6) and in pyretic patients (2.7%; 95% CI: 1.2-5.2) are also low. The RBT may be applied as a screening test in humans having signs and symptoms of brucellosis along with the history of animal contact. In case of suspicion, genus or species specific rt PCR may be applied for confirmation. Only B. abortus DNA was amplified from 19 seropositive human samples (both HROG and PUO) and six animal samples (3 cows milk, one goat milk, one gayal milk and one bull semen). No Brucella like organism was observed under microscope in stained smears. Similarly, no Brucella organism was isolated from any of the clinical samples. [less ▲]

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