Health-related costs in a sample of premenopausal non-diabetic overweight or obese females in Antwerp region : a cost-of-illness analysis

Background: People with overweight or obesity are at increased risk for disease later in life which cause important health costs. The aim of this study was to estimate the health status and the corresponding costs in a sample of females with overweight or obesity which were participating in a Randomized Controlled Trial (RCT) exploring the effect of lifestyle habits changes on ectopic adipose tissue. Methods: Sixty-two non-diabetic premenopausal females without major comorbidities of overweight and obesity were recruited among patients visiting endocrinologists at the obesity clinic of the University Hospital of Antwerp and the University of Antwerp. A RCT-embedded cost-of-illness approach with societal perspective, based on self-reported questionnaires and cost diaries (3 months recall) was applied to estimate the prevalence of different comorbidities and the related direct and indirect costs in this sample of overweight or obese females. The European Quality-of-Life-5D questionnaire was used to define the health state and the corresponding utility index of the participants. Results: The average direct health costs and health utilities observed in this sample were comparable with the general Flemish female population. This may partially be explained by the strict inclusion criteria of the RCT (i.e. overweight or obesity without diabetes type 2 or cardiovascular diseases). However, 15% of the participants had five or more comorbidities resulting in higher average costs and lower average health utility as compared to the general population, only 3 participants were diagnozed with the metabolic syndrome. In this subsample productivity was low due to high average absenteeism, yielding important total costs for the society. Conclusion: Secondary prevention to avoid health deterioration in overweight or obese females without major comorbidies is needed to contain health care costs. Trial registration: ClinicalTrials.gov: NCT02831621, approval of the ethics committee of the University Hospital of Antwerp (number: 14/17/205 -ref: 7543075363)

Effects of water availability on free amino acids, sugars, and acrylamide-forming potential in potato

Irrigation is used frequently in potato cultivation to maximize yield, but water availability may also affect the composition of the crop, with implications for processing properties and food safety. Five varieties of potatoes, including drought-tolerant and -sensitive types, which had been grown with and without irrigation, were analyzed to show the effect of water supply on concentrations of free asparagine, other free amino acids, and sugars and on the acrylamide-forming potential of the tubers. Two varieties were also analyzed under more severe drought stress in a glasshouse. Water availability had profound effects on tuber free amino acid and sugar concentrations, and it was concluded that potato farmers should irrigate only if necessary to maintain the health and yield of the crop, because irrigation may increase the acrylamide-forming potential of potatoes. Even mild drought stress caused significant changes in composition, but these differed from those caused by more extreme drought stress. Free proline concentration, for example, increased in the field-grown potatoes of one variety from 7.02 mmol/kg with irrigation to 104.58 mmol/kg without irrigation, whereas free asparagine concentration was not affected significantly in the field but almost doubled from 132.03 to 242.26 mmol/kg in response to more severe drought stress in the glasshouse. Furthermore, the different genotypes were affected in dissimilar fashion by the same treatment, indicating that there is no single, unifying potato tuber drought stress response

Biomass in the manufacture of industrial products—the use of proteins and amino acids

The depletion in fossil feedstocks, increasing oil prices, and the ecological problems associated with CO2 emissions are forcing the development of alternative resources for energy, transport fuels, and chemicals: the replacement of fossil resources with CO2 neutral biomass. Allied with this, the conversion of crude oil products utilizes primary products (ethylene, etc.) and their conversion to either materials or (functional) chemicals with the aid of co-reagents such as ammonia and various process steps to introduce functionalities such as -NH2 into the simple structures of the primary products. Conversely, many products found in biomass often contain functionalities. Therefore, it is attractive to exploit this to bypass the use, and preparation of, co-reagents as well as eliminating various process steps by utilizing suitable biomass-based precursors for the production of chemicals. It is the aim of this mini-review to describe the scope of the possibilities to generate current functionalized chemical materials using amino acids from biomass instead of fossil resources, thereby taking advantage of the biomass structure in a more efficient way than solely utilizing biomass for the production of fuels or electricity

A large-scale multicentre study of patient skin doses in interventional cardiology: dose-area product action levels and dose reference levels.

For 318 patients in 8 different Belgian hospitals, the entire skin-dose distribution was mapped using a grid of 70 thermoluminescence dosimeters per patient, allowing an accurate determination of the maximum skin dose (MSD). Dose-area product (DAP) values, exposure parameters and geometry, together with procedure, patient and cardiologist characteristics, were also registered. Procedures were divided into two groups: diagnostic procedures (coronary angiography) and therapeutic procedures (dilatation, stent, combined procedures (e.g. coronary angiography + dilatation + stent)). The mean value of the MSD was 0.310 Gy for diagnostic and 0.699 Gy for therapeutic procedures. The most critical projection for receiving the MSD is the LAO90 (left anterior oblique) geometry. In 3% of cases, the MSD exceeded the 2 Gy dose threshold for deterministic effects. Action levels in terms of DAP values as the basis for a strategy for follow-up of patients for deterministic radiation skin effects were derived from measured MSD and cumulative DAP values. Two DAP action levels are proposed. A first DAP action level of 125 Gy cm(2) corresponding to the dose threshold of 2 Gy would imply an optional radiopathological follow-up depending on the cardiologist's decision. A second DAP action level of 250 Gy cm(2) corresponding to the 3 Gy skin dose would imply a systematic follow-up. Dose reference levels - 71.3 Gy cm(2) for diagnostic and 106.0 Gy cm(2) for therapeutic procedures - were derived from the 75 percentile of the DAP distributions. As a conclusion, we propose that total DAP is registered in patient's record file, as it can serve to improve the follow-up of patients for radiation-induced skin injuries

Cost-effectiveness of diet plus exercise versus diet alone on the reduction of ectopic fat deposition in adults with overweight: study protocol of a trial based health economic evaluation

Background: Excess ectopic fat deposition is associated with the development of cardiovascular and metabolic diseases. This study investigates the added value of exercise to diet on ectopic fat reduction and metabolic factors. Objective: The purpose of this report is to present and discuss the rationale, design and methods of this randomized controlled trial and cost-effectiveness analysis. Method: Participanùs: Endocrinologists of the University Hospital of Antwerp are recruiting premenopausal women during consultations. Intervention: 60 potential participants meeting all a priori set inclusion and exclusion criteria are randomized by minimization method to get usual care (hypocaloric diet) or combined therapy (hypocaloric diet and physical fitness training) during 6 months. Outcome measures: Primary outcomes include ectopic fat deposition (intramyocellular lipids, intra hepatic lipids, epicardial adipose tissue and visceral adipose tissue) objectively assessed by imaging techniques. Patients were instructed to record all health-related care and costs through diaries. Secondary outcome parameters are metabolic parameters, anthropometrics and lifestyle parameters assessed by clinical examinations, blood analyses, anthropometric measures, questionnaires and activity trackers. Results/Conclusions: This is the first trial discussing the added value of supervised exercise to hypocaloric diet on ectopic fat deposition and secondary health parameters. Clinical and economic results are presented as changes in ectopic fat deposition, metabolic risk profile and qualityadjusted life years. This RCT provides novel evidence for the use of supervised exercise interventions besides energy restriction in people with overweight

Treatment of malignant pericardial tamponade with sclerosis induced by instillation of bleomycin

Five patients with pericardial tamponade of neoplastic origin were treated by pericardiocentesis, drainage and local instillation of bleomycin. The pericardial effusion was adequately controlled in all patients. Survival was influenced not by the pericardial involvement, but by the natural evolution of the tumour. Side effects were minimal. The technique of drainage and bleomycin sclerosis is simple, safe, effective and inexpensive for the management of a malignant pericardial tamponade, providing all precautions necessary for diagnosis and pericardiocentesis are adequately taken. © 1987.SCOPUS: ar.jinfo:eu-repo/semantics/publishe