Smoking and smoking cessation among Flemish women during pregnancy and postpartum

Tobacco use is an alarming public health problem worldwide and causes significant morbidity and mortality. Globally, 22% of the world’s population over 15 years are smokers. Smoking affects both male and female fertility in their reproductive age. Smoking during pregnancy is one of the single most important avoidable cause of adverse pregnancy outcomes. This work provides an overview of the determinants of smoking and smoking cessation during pregnancy and postpartum, based on the levels of the socio-ecological model. A qualitative study explored knowledge, beliefs and practice among midwives and gynaecologists concerning smoking cessation among pregnant women. The second study tested the factorial structure, validity and reliability of the Dutch version of the Modified Reasons for Smoking Scale in a sample of smoking pregnant women. The third study obtained insight into the associations between smoking patterns and depressive feelings during pregnancy and postpartum, taking into account several sociodemographic characteristics. The final study analysed the association between smoking cessation beliefs and smoking status, and between smoking cessations beliefs and intention to quit smoking, using the Theory of Planned Behaviour in pregnant smokers and ex-smokers. After presenting and discussing the results, recommendations and directions for further research are formulated, based on the socio-ecological model

Sleep apnea and the impact on cardiovascular risk in patients with Marfan syndrome

Background: Marfan syndrome (MFS) is an inherited connective tissue disorder characterized by ectopia lentis, aortic root dilation and dissection and specific skeletal features. Obstructive sleep apnea (OSA) in MFS has been described earlier but the prevalence and its relation with the cardiovascular risk is still controversial. This study aimed to further investigate these aspects. Methods: In this prospective longitudinal study, we performed an attended polysomnography in 40 MFS patients (60% women, 37 +/- 12.8 years) and evaluated several cardiovascular parameters through echocardiography, resting electrocardiogram, 24 hr-Holter monitoring and serum NT-ProBNP measurements. Results: We found that OSA was present in 42.5% of the patients and that higher body mass index was the most important factor associated with the presence of OSA. We observed that overweight was present in 27.5% of the patients in the whole cohort and in 55.6% if >40 years. Furthermore, when evaluating the impact of OSA on the cardiovascular system, we observed that patients with OSA tended to have higher systolic blood pressure, larger distal aortic diameters and a higher prevalence of ventricular arrhythmia. These differences were, however, not significant after adjusting for confounders. Conclusions: Our study shows a high prevalence of OSA and a high prevalence of overweight in MFS patients. We found some trends between OSA and cardiovascular features but we could not establish a solid association. Our study, however might be underpowered, and a multicenter collaborative study could be very useful to answer some important open questions

Different patterns of cerebral and muscular tissue oxygenation 10 years after coarctation repair

The purpose of this study was to assess whether the lower exercise tolerance in children after coarctation repair is associated with alterations in peripheral tissue oxygenation during exercise. A total of 16 children after coarctation repair and 20 healthy control subjects performed an incremental ramp exercise test to exhaustion. Cerebral and locomotor muscle oxygenation were measured by means of near infrared spectroscopy. The responses of cerebral and muscle tissue oxygenation index (cTOI, mTOI), oxygenated (O(2)Hb), and deoxygenated hemoglobin (HHb) as a function of work rate were compared. Correlations between residual continuous wave Doppler gradients at rest, arm-leg blood pressure difference and local oxygenation responses were evaluated. Age, length, and weight was similar in both groups. Patients with aortic coarctation had lower peak power output (Ppeak) (72.3 +/- 20.2% vs. 106 +/- 18.7%, P < 0.001), VO(2)peak/kg (37.3 +/- 9.1 vs. 44.2 +/- 7.6 ml/kg, P = 0.019) and %VO(2)peak/kg (85.7 +/- 21.9% vs. 112.1 +/- 15.5%, P < 0.001). Cerebral O(2)Hb and HHb had a lower increase in patients vs. controls during exercise, with significant differences from 60 to 90% Ppeak (O(2)Hb) and 70% to 100% Ppeak (HHb). Muscle TOI was significantly lower in patients from 10 to 70% Ppeak and muscle HHb was significantly higher in patients vs. controls from 20 to 80% Ppeak. Muscle O(2)Hb was not different between both groups. There was a significant correlation between residual resting blood pressure gradient and Delta muscle HHb/Delta P at 10-20W and 20-30W (r = 0.40, P = 0.039 and r = 0.43, P = 0.034). Children after coarctation repair have different oxygenation responses at muscular and cerebral level. This reflects a different balance between O-2 supply to O-2 demand which might contribute to the reduced exercise tolerance in this patient population

Tumorbank@uza: A Collection of Tissue, Fluid Samples and Associated Data of Oncology Patients for the Use in Translational Research

Tumorbank@UZA is an academic hospital integrated biobank that collects tissue, blood and urine samples from oncology patients. We work according to a quality management system and have established SOPs for all work procedures in the biobank. Tumorbank@UZA is funded by the National Cancer Plan, an initiative from the Belgian government since 2009. Samples from our biobank are available for both academic as well as commercial researchers, through a well-established access procedure. Currently the collection consists of more than 85.000 samples of more than 8000 patients. Funding statement: Tumorbank@UZA is funded by the National Cancer Plan (initiative 27) from the Ministry of Health of the Belgian Federal Government.</p

Analysis of the recovery phase after maximal exercise in children with repaired tetralogy of Fallot and the relationship with ventricular function

Background Few studies demonstrate delayed recovery after exercise in children and adults with heart disease. We assess the recovery patterns of gas exchange parameters and heart rate (HR) in children with repaired Tetralogy of Fallot (rToF) compared to healthy peers and investigate the correlation with ventricular function and QRS duration. Methods 45 children after rToF and 45 controls performed a maximal incremental cardiopulmonary exercise test. In the subsequent recovery period, patterns of VO2, VCO2 and HR were analysed. Half-life time (T-1/2) of the exponential decay and drop per minute (Rec(min)) were compared between groups. In the rToF group, correlations were examined between the recovery parameters and QRS-duration and ventricular function, described by fractional shortening (FS) and tricuspid annular plane systolic excursion (TAPSE) measured at baseline prior to exercise. Results Recovery of VO2 and VCO2 was delayed in rToF patients, half-life time values were higher compared to controls (T1/2VO2 52.51 11.29 s vs. 44.31 +/- 10.47 s; p = 0.001 and T1/2VCO2 68.28 +/- 13.84 s vs. 59.41 +/- 12.06 s; p = 0.002) and percentage drop from maximal value was slower at each minute of recovery (p<0.05). Correlations were found with FS (T1/2VO2: r = -0.517; p<0.001; Rec(1min)VO(2): r = -0.636, p<0.001; Rec(1min)VCO(2): r = -0.373, p = 0.012) and TAPSE (T1/2VO2: r = -0.505; p<0.001; Rec(1min)VO(2): r = -0.566, p<0.001; T1/2VCO2: r = -0.466; p = 0.001; Rec(1min)VCO(2): r = -0.507, p<0.001), not with QRS-duration. No difference was found in HR recovery between patients and controls. Conclusions Children after rToF show a delayed gas exchange recovery after exercise. This delay correlates to ventricular function, demonstrating its importance in recovery after physical activity

mTor inhibitor GDC-0349 improves ASO induced SAMMSON knock down resulting in enhanced anti-tumor efficacy in uveal melanoma

Uveal melanoma (UM) is the most common intraocular malignancy in adults. The lack of an effective treatment results in a median survival time of less than one year for patients with metastatic disease and shows the high unmet need for the development of effective treatments. Recently, the melanoma-specific lncRNA SAMMSON was shown to be essential for skin melanoma survival. Analysis of a PAN cancer RNA-sequencing dataset revealed consistent expression of SAMMSON in uveal melanoma tumors. Targeting SAMMSON by means of antisense oligonucleotides (ASOs) results in a strong reduction in cell viability with induction of apoptosis of UM cells and slows down tumor growth in multiple UM PDX models. These effects were driven by impaired mitochondrial function and protein translation, resulting in cell death. To identify potential synergistic combinations, we combined SAMMSON knockdown with a library of 2911 FDA-approved drugs and quantified cell viability in a uveal melanoma cell line. The strongest synergy was obtained with the mTOR inhibitor GDC-0349. Combining SAMMSON knockdown with mTOR inhibition resulted in enhanced impairment of mitochondrial function and protein synthesis. Interestingly, we observed a more pronounced knockdown of SAMMSON when combining SAMMSON targeting ASOs with GDC-0349, suggesting mTOR inhibition facilitates ASO uptake in uveal melanoma cells. Further experiments are ongoing to confirm this mechanism. Taken together, these results demonstrate that SAMMSON inhibition in combination with mTOR inhibition could be a novel treatment option for uveal melanoma patients