Publications by authors named "Cremer A"

Background: Fatigue is common among patients with inflammatory bowel diseases (IBDs) and is associated with decreased quality of life (QoL).

Aims: Describe fatigue evolution and identify factors associated with fatigue outcomes in patients with ulcerative colitis (UC) or Crohn's disease (CD) initiating biologic treatment.

Methods: Data from adult Belgian patients with UC or CD enrolled in a prospective real-world study were utilized.

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Central nervous system (CNS) relapse in acute myeloid leukemia (AML) is rare, but prognostically extremely unfavorable and associated with very high mortality rates. Aim of our single-center study was to define risk factors for CNS relapse in patients with FLT3-mutated AML after allogeneic hematopoietic cell transplantation (HCT) and to determine the impact of pre-emptive or salvage therapy with FLT3-inhibitors (FLT3i) on occurrence of CNS relapse and overall prognosis. We analyzed 39 FLT3-mutated AML patients who were treated with intensive induction therapy and consecutively underwent HCT at our institution.

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Malignant hypertension (MHT) crisis triggers widespread microvascular damage, particularly in the brain. Despite recent MRI evidence highlighting acute cerebral injuries during MHT crises, follow-up data remain scarce. This study seeks to fill this gap by exploring how brain MRI markers evolve following acute MHT crisis management.

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Background: Malignant hypertension has not disappeared and remains the most severe form of hypertension. More than 100 years after its description, many points remain unanswered. Mechanisms, definitions, and optimal treatment are still controversial.

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  • Laparoscopic adrenalectomy (LA) is a minimally invasive surgery that has become the preferred treatment for adrenal diseases, but its use in outpatient settings is still not widespread.
  • A study reviewed 76 LA procedures for primary aldosteronism (PA) conducted between 2013-2021, with 60 being outpatient procedures; these had a success rate of 95% and no readmissions within 48 hours.
  • Results showed low pain levels (average of 2.1/10) and high patient satisfaction (average of 9.4/10) after one day, with over half of patients cured or improved after six months, indicating outpatient LA is both feasible and effective for managing PA.
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Several high-quality, randomized, sham-controlled trials have provided evidence supporting the efficacy and safety of radiofrequency, ultrasound and alcohol catheter-based renal denervation (RDN) for reducing blood pressure (BP). A French clinical consensus document has therefore been developed to propose guidance for the appropriate use of RDN in the management of hypertension along with a dedicated care pathway and management strategy. The French experts group concluded that RDN can serve as an adjunct therapy for patients with confirmed uncontrolled, resistant essential hypertension despite treatment with≥3 antihypertensive drugs, including a long-acting calcium channel blocker, a renin-angiotensin system blocker and a thiazide/thiazide-like diuretic at maximally tolerated doses.

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  • - The study focused on understanding how common secondary hypertension (2HTN) is in young adults aged 18 to 40, finding that nearly 30% of patients had 2HTN.
  • - The most common causes of 2HTN were identified as primary aldosteronism, renovascular hypertension, and kidney diseases, with certain factors like being female and having a lower BMI linked to a higher prevalence.
  • - Based on their findings, the researchers recommend that all young adults with hypertension should be screened for secondary causes, as there is a significant risk present regardless of age or blood pressure levels.
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  • Patients getting stem cell transplants have a high chance of getting infections, especially right after the procedure, but using regular antibiotics can cause other health issues.
  • A study compared a new antibiotic treatment (IAT) with regular antibiotic use (SAP) and found that while IAT led to fewer days on antibiotics, patients had more bloodstream infections.
  • Overall, both treatments had similar long-term survival rates and health outcomes, suggesting that IAT could be a safe alternative to SAP for these patients.
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Background: Previous history of COVID-19 infection is a natural booster of the vaccine response in the general population. The response to COVID-19 vaccines is lessened in Inflammatory Bowel Disease patients on selected class of immunosuppressive treatments.

Aims: The study was to assess anti-SARS-CoV-2 spike-specific IgG antibody response in Inflammatory Bowel Disease patients with a history of COVID-19 infection.

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  • Thyroid disease impacts energy metabolism, temperature control, and anxiety, primarily through thyroid hormone receptor α1 (TRα1) in the brain, but the exact brain areas involved remain unclear.
  • Researchers used PET-CT scans to find the most affected brain region, the zona incerta (ZI), and inhibited TRα1 signaling there to study its effects on metabolism and behavior in mice.
  • The inhibition led to increased energy expenditure without affecting body temperature regulation, and heightened glucocorticoid levels were observed, indicating a link between altered thyroid hormone signaling in the ZI and stress responses, but not temperature control.
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Arterial stiffness is an independent predictor of cardiovascular events in different populations. Destiffening appears to be possible through the control of the main cardiovascular risk factors, with however important individual variations. There are so far too few data available on the prognostic importance of changes in arterial stiffness.

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  • NK cells are powerful immune cells with proven effectiveness in cancer therapy, especially when enhanced by CAR technology, allowing them to target cancer cells more specifically.
  • The study introduces a novel non-viral method using the Sleeping Beauty transposon system and minicircles to engineer CAR NK cells, resulting in stable CAR expression and improved genetic integration compared to traditional methods.
  • These engineered CAR NK cells showed greater effectiveness against leukemia cells in lab models, suggesting a promising avenue for developing cost-effective and safe cancer immunotherapies.
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The Rab-GTPase-activating protein (RabGAP) TBC1D4 (AS160) represents a key component in the regulation of glucose transport into skeletal muscle and white adipose tissue (WAT) and is therefore crucial during the development of insulin resistance and type 2 diabetes. Increased daily activity has been shown to be associated with improved postprandial hyperglycemia in allele carriers of a loss-of-function variant in the human TBC1D4 gene. Using conventional Tbc1d4-deficient mice (D4KO) fed a high-fat diet, we show that moderate endurance exercise training leads to substantially improved glucose and insulin tolerance and enhanced expression levels of markers for mitochondrial activity and browning in WAT from D4KO animals.

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Agouti-related peptide (AgRP)-expressing and proopiomelanocortin (POMC)-expressing neurons reciprocally regulate food intake. Here, we combine non-interacting recombinases to simultaneously express functionally opposing chemogenetic receptors in AgRP and POMC neurons for comparing metabolic responses in male and female mice with simultaneous activation of AgRP and inhibition of POMC neurons with isolated activation of AgRP neurons or isolated inhibition of POMC neurons. We show that food intake is regulated by the additive effect of AgRP neuron activation and POMC neuron inhibition, while systemic insulin sensitivity and gluconeogenesis are differentially modulated by isolated-versus-simultaneous regulation of AgRP and POMC neurons.

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Background: As real-world data on risankizumab in patients with moderate to severe Crohn's disease (CD) are scarce, we evaluated its effectiveness and safety in multirefractory Belgian patients.

Methods: Data from consecutive adult CD patients who started risankizumab before April 2023 were retrospectively collected at 6 Belgian centers. Clinical remission and response were defined using the 2-component patient-reported outcome.

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Introduction: A major issue confronting clinicians treating hypertension in pregnancy is the limited number of pharmacological options. Endovascular catheter-based renal denervation (RDN) is a new method to lower blood pressure (BP) in patients with hypertension by reducing the activity of the renal sympathetic nervous system. Drugs that affect this system are safe in pregnant women.

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The addition of midostaurin to standard chemotherapy has improved survival in patients with FLT3-mutated AML. However, the impact of midostaurin and other FLT3 inhibitors (FLT3i) on cardiovascular adverse events (CAEs) has not been studied in patients who underwent allogeneic hematopoietic stem cell transplantation in a real-world setting. We reviewed 132 patients with AML who were treated with intensive induction therapy and consecutive allogeneic stem cell transplantation at our institution (42 FLT3-mutated AML and 90 with FLT3 wildtype).

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Objective: Hypertension management is directed by cuff blood pressure (BP), but this may be inaccurate, potentially influencing cardiovascular disease (CVD) events and health costs. This study aimed to determine the impact on CVD events and related costs of the differences between cuff and invasive SBP.

Methods: Microsimulations based on Markov modelling over one year were used to determine the differences in the number of CVD events (myocardial infarction or coronary death, stroke, atrial fibrillation or heart failure) predicted by Framingham risk and total CVD health costs based on cuff SBP compared with invasive (aortic) SBP.

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  • Advanced therapies like biologics and small molecules have been approved for treating moderate-to-severe ulcerative colitis, but patients with isolated proctitis were often excluded from clinical trials, creating an evidence gap for this specific group.
  • In a study of 167 patients with active ulcerative proctitis who had already failed conventional treatments, it was found that 36.3% achieved short-term steroid-free remission, with better outcomes for bionaive patients and those treated with vedolizumab.
  • The results support the effectiveness and safety of advanced therapies for ulcerative proctitis, suggesting that future trials should include these patients to better understand treatment options.
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  • Arterial stiffness, an indicator of cardiovascular risk, comprises a BP-dependent elastic behavior and long-term structural changes due to various risk factors, which can be assessed using the QKD method through 24-hour monitoring.
  • This study hypothesizes that QKD measured at 100 mmHg SBP and 60 bpm heart rate is unaffected by 24-hour SBP levels in normotensive and treated hypertensive individuals, but shows a weak correlation in untreated hypertensive patients.
  • Results indicated that QKD100-60 was not significantly related to 24-hour SBP in normal and treated hypertensive groups, while showing a weak but noteworthy relationship in untreated hypertensives, suggesting QKD's potential to improve risk assessment in
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  • Human learning involves both reinforcement learning (RL) and working memory (WM) systems that interact in complex ways, presenting a trade-off where high WM load can slow down learning but improve retention of information.
  • Studies conducted with EEG showed that while a higher WM load slowed down the ability to learn, it ultimately led to stronger reinforcement signals that enhanced future retention of learned behaviors.
  • Induced stress was found to have a limited effect on the ability to switch between focusing on immediate learning and long-term retention, highlighting the intricate relationship between WM and RL systems in effective learning processes.
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Background: Malignant hypertension has not disappeared and is associated with a poor prognosis. Yet, so far, it has received limited attention from the medical community. Guidelines are mainly based on expert consensus and low quality evidences.

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Background: Type 2 Diabetes mellitus (T2DM) is a major risk factor for cardiovascular disease and associated with poor outcome after myocardial infarction (MI). In T2DM, cardiac metabolic flexibility, i.e.

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Arterial stiffness, most often assessed with carotido-femoral pulse wave velocity predicts cardiovascular events but its use in clinical practice remains limited. The 24 h ambulatory monitoring of Blood pressure and timing of Korotkoff sounds (QKD interval) allows an automatic assessment of arterial stiffness and is an independent predictor of cardiovascular events in hypertensive patients. The long term follow up of our cohort of hypertensive patients gave us the opportunity to test the consequences of increased arterial stiffness on the incidence of all causes deaths and to define the populations who could benefit of this measurement beyond risk scores.

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