Stable HEV IgG seroprevalence in Belgium between 2006 and 2014.

Recent European studies suggest an emergence of hepatitis E virus (HEV) infection. We evaluated trends in birth cohort-specific HEV seroprevalence and regional differences in Belgium. HEV IgG seroprevalence was analysed on national serum banks (1579 and 2087 samples for 2006 and 2014, respectively.

The Second Strategic Reperfusion Early After Myocardial Infarction (STREAM-2) study optimizing pharmacoinvasive reperfusion strategy in older ST-elevation myocardial infarction patients.

Background: The STREAM study demonstrated that a pharmaco-invasive strategy was at least as effective as primary PCI (pPCI) in patients presenting early with ST-elevation myocardial infarction (STEMI). The current trial is a response to the finding that reduced intracranial hemorrhage (ICH) in patients ≥75 years occurred after halving the dose of tenecteplase. Additionally, a subsequent analysis of full dose tenecteplase or alteplase in the Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT) trials demonstrated a steep increase in bleeding events beginning around the age of 60 years.

Bayesian pooling versus sequential integration of small preclinical trials: a comparison within linear and nonlinear modeling frameworks.

Bayesian sequential integration is an appealing approach in drug development, as it allows to recursively update posterior distributions as soon as new data become available, thus considerably reducing the computation time. However, preclinical trials are often characterized by small sample sizes, which may affect the estimation process during the first integration steps, particularly when complex PK-PD models are used. In this case, sequential integration would not be practicable, and trials should be pooled together.

Statistical aspects in adjuvant and neoadjuvant trials for gastrointestinal cancer in 2020: focus on time-to-event endpoints.

Purpose Of Review: Clinical-trial design, analysis, and interpretation entails the use of efficient and reliable endpoints. Statistical issues related to endpoints warrant continued attention, as they may have a substantial impact on the conduct of clinical trials and on interpretation of their results.

Recent Findings: We review concepts and discuss recent developments related to the use of time-to-event endpoints in studies on adjuvant and neoadjuvant therapy for colon, pancreatic, and gastric adenocarcinomas.

Determinants of Total/ionized Calcium in patients undergoing citrate CVVH: A retrospective observational study.

Purpose: To identify potential determinants of the Total/ionized Ca ratio (T/iCa), a marker of citrate accumulation.

Materials And Methods: Single-center retrospective observational study evaluating citrate dose, citrate target, albumin, phosphate, pH, lactate, and APACHE II score as potential determinants. Linear mixed models (LMM) using citrate dose and citrate target were developed describing associations with T/iCa.

Ectoparasitism during an avian disease outbreak: An experiment with -infected house finches and ticks.

Hosts are typically co-parasitized by multiple species. Parasites can benefit or suffer from the presence of other parasites, which can reduce or increase the overall virulence due to competition or facilitation. Outcomes of new multi-parasite systems are seldom predictable.

Fluoroquinolone resistance in Escherichia coli isolates after exposure to non-fluoroquinolone antibiotics: a retrospective case-control study.

Objectives: To investigate whether prior exposure to non-fluoroquinolone antibiotics increases the risk of fluoroquinolone resistance in Escherichia coli.

Methods: This was a secondary analysis of data collected retrospectively in a case-control study linking microbiological test results (isolated bacteria and their susceptibility) of urine samples routinely collected from primary, secondary and tertiary care patients in Belgium with information on prior antibiotic use at the patient level up to 1 year previously.

Results: In urine samples from 6125 patients, 7204 E.

Optimising the case-crossover design for use in shared exposure settings.

With a case-crossover design, a case's exposure during a risk period is compared to the case's exposures at referent periods. The selection of referents for this self-controlled design is determined by the referent selection strategy (RSS). Previous research mainly focused on systematic bias associated with the RSS.

Outcome measures in multimodal rectal cancer trials.

There is a large variability regarding the definition and choice of primary endpoints in phase 2 and phase 3 multimodal rectal cancer trials, resulting in inconsistency and difficulty of data interpretation. Also, surrogate properties of early and intermediate endpoints have not been systematically assessed. We provide a comprehensive review of clinical and surrogate endpoints used in trials for non-metastatic rectal cancer.

Short-term associations between Legionnaires' disease incidence and meteorological variables in Belgium, 2011-2019.

The number of reported cases with Legionnaires' disease (LD) is increasing in Belgium. Previous studies have investigated the associations between LD incidence and meteorological factors, but the Belgian data remained unexplored. We investigated data collected between 2011 and 2019.

Indications for healthcare surge capacity in European countries facing an exponential increase in coronavirus disease (COVID-19) cases, March 2020.

European healthcare systems face extreme pressure from coronavirus disease (COVID-19). We relate country-specific accumulated COVID-19 deaths (intensity approach) and active COVID-19 cases (magnitude approach) to measures of healthcare system capacity: hospital beds, healthcare workers and healthcare expenditure. Modelled by the intensity approach with a composite measure for healthcare capacity, the countries experiencing the highest pressure on 25 March 2020 - relative to Italy on 11 March - were Italy, Spain, the Netherlands and France (www.

Late-onset Pompe disease (LOPD) in Belgium: clinical characteristics and outcome measures.

Background: Late-onset Pompe disease (LOPD) is a rare, hereditary, progressive disorder that is usually characterized by limb-girdle muscle weakness and/or respiratory insufficiency. LOPD is caused by mutations in the acid alpha-glucosidase (GAA) gene and treated with enzyme replacement therapy (ERT).

Methods: We studied the clinical, brain imaging, and genetic features of the Belgian cohort of late-onset Pompe disease patients (N = 52), and explored the sensitivity of different outcome measures, during a longitudinal period of 7 years (2010-2017), including the activity limitations ActivLim score, 6 min walking distance (6MWD), 10 m walk test (10MWT), MRC sum score, and forced vital capacity (FVC) sitting/supine.

Lower respiratory tract infection in the community: associations between viral aetiology and illness course.

Objectives: This study determined associations between respiratory viruses and subsequent illness course in primary care adult patients presenting with acute cough and/or suspected lower respiratory tract infection.

Methods: A prospective European primary care study recruited adults with symptoms of lower respiratory tract infection between November 2007 and April 2010. Real-time in-house polymerase chain reaction (PCR) was performed to test for six common respiratory viruses.

Withdrawal of Neurohumoral Blockade After Cardiac Resynchronization Therapy.

Background: The necessity of neurohumoral blockers in patients with heart failure who demonstrate normalized ejection fractions after cardiac resynchronization therapy remains unclear.

Objectives: The aim of this study was to investigate the feasibility and safety of neurohumoral blocker withdrawal in patients with normalized ejection fractions after cardiac resynchronization therapy.

Methods: In this prospective, open-label, randomized controlled pilot trial with a 2 × 2 factorial design, subjects were randomized to withdrawal of renin-angiotensin-aldosterone system inhibitors and/or beta-blockers versus continuation of treatment.

Malocclusion, Dental Caries and Oral Health-Related Quality of Life: A Comparison between Adolescent School Children in Urban and Rural Regions in Peru.

Rural, isolated areas benefit less from caries prevention programs and access to treatment than urban areas, and, hence, differences in oral health can be expected. This study aims to assess the prevalence of caries and malocclusion in urban and rural areas of Peru and to compare them with patients' oral health perception. A total of 1062 adolescents were examined in five schools of rural (Titicaca) and urban (Lima and Cuzco) areas in Peru.

Single versus Multiple Dose Ivermectin Regimen in Onchocerciasis-Infected Persons with Epilepsy Treated with Phenobarbital: A Randomized Clinical Trial in the Democratic Republic of Congo.

Background: There is anecdotal evidence that ivermectin may decrease seizure frequency in -infected persons with epilepsy (PWE).

Methods: In October 2017, a 12-month clinical trial was initiated in rural Democratic Republic of Congo. PWE with onchocerciasis-associated epilepsy experiencing ≥2 seizures/month were randomly allocated to receive, over a one-year period, ivermectin once or thrice (group 1), while other onchocerciasis-infected PWE (OIPWE) were randomized to ivermectin twice or thrice (group 2).

Urinary N-acetyltyramine-O,β-glucuronide in Persons with OnchocerciasisAssociated Epilepsy.

We investigated urinary N-acetyltyramine-O,β-glucuronide (NATOG) levels as a biomarker for active infection in an onchocerciasis-endemic area in the Democratic Republic of Congo with a high epilepsy prevalence. Urinary NATOG was measured in non-epileptic men with and without infection, and in infected persons with epilepsy (PWE). Urinary NATOG concentration was positively associated with microfilarial density ( < 0.

A general frailty model to accommodate individual heterogeneity in the acquisition of multiple infections: An application to bivariate current status data.

The analysis of multivariate time-to-event (TTE) data can become complicated due to the presence of clustering, leading to dependence between multiple event times. For a long time, (conditional) frailty models and (marginal) copula models have been used to analyze clustered TTE data. In this article, we propose a general frailty model employing a copula function between the frailty terms to construct flexible (bivariate) frailty distributions with the application to current status data.

Overall survival and factors predicting long-term outcome after thoracic aortic endovascular repair.

Purposes: To assess overall survival and to determine factors predicting outcome after thoracic endovascular aortic repair.

Materials And Methods: A Retrospective analysis was performed on a cohort of 212 consecutive patients (165 men and 47 women; mean age 64 years) who underwent thoracic endovascular aortic repair in a tertiary referral center for aortic disease. Main indications were true thoracic aortic aneurysm (n = 58; 27.

Long-term outcome and pre-interventional predictors for late intervention after uterine fibroid embolization.

Objectives: To assess the long-term freedom of surgical conversion after uterine fibroid embolization (UFE) and to define predictors for better clinical outcome. Additionally, the potential of pregnancy after UFE is assessed.

Study Design: Single-center retrospective cohort study including 190 patients who underwent UFE between 2001 and 2016.

Effectiveness of a blended care programme for the discontinuation of benzodiazepine use for sleeping problems in primary care: study protocol of a cluster randomised trial, the Big Bird trial.

Introduction: Problematic benzodiazepine use is a global health issue. Although the adverse side effects of long-term use of benzodiazepines are well known, it remains difficult to implement interventions for discontinuation in primary care. Considering the success of blended care for the treatment of sleeping disorders and the support of substance use disorders, evidence suggests that a blended care approach, combining face-to-face consultations with the general practitioner with web-based self-learning by the patient, is beneficial for the discontinuation of chronic benzodiazepine use for primary insomnia in general practice.

Prediction of maxillary canine impaction based on panoramic radiographs.

Objectives: The objective of this article is to establish a large sample-based prediction model for maxillary canine impaction based on linear and angular measurements on panoramic radiographs and to validate this model.

Materials And Methods: All patients with at least two panoramic radiographs taken between the ages of 7 and 14 years with an interval of minimum 1 year and maximum 3 years (T1 and T2) were selected from the Department of Oral Health Sciences, University Hospital Leuven database. Linear and angular measurements were performed at T1.

Antibiotic use and resistance in Belgium: the impact of two decades of multi-faceted campaigning.

: To present an overview of almost two decades of multi-faceted campaigning by the Belgian Antibiotic Policy Coordination Committee (BAPCOC) and partners, and its impact on public and prescribers' awareness, outpatient antibiotic use, its cost and antimicrobial resistance in Belgium.: Awareness of both public and prescribers was assessed through pre- and post-campaign interviews and surveys. Outpatient antibiotic use was evaluated using national reimbursement data expressed in number of defined daily doses and packages (a good proxy for treatments) per 1000 inhabitants per day (DID and PID, respectively) from July 1997 to June 2018.

Spatial Modelling to Inform Public Health Based on Health Surveys: Impact of Unsampled Areas at Lower Geographical Scale.

Small area estimation is an important tool to provide area-specific estimates of population characteristics for governmental organizations in the context of education, public health and care. However, many demographic and health surveys are unrepresentative at a small geographical level, as often areas at a lower level are not included in the sample due to financial or logistical reasons. In this paper, we investigated (1) the effect of these unsampled areas on a variety of design-based and hierarchical model-based estimates and (2) the benefits of using auxiliary information in the estimation process by means of an extensive simulation study.