Vestibular Infant Screening (VIS)–Flanders : results after 1.5 years of vestibular screening in hearing-impaired children

Due to the close anatomical relationship between the auditory and vestibular end organs, hearing-impaired children have a higher risk for vestibular dysfunction, which can affect their (motor) development. Unfortunately, vestibular dysfunction often goes unnoticed, as vestibular assessment in these children is not standard of care nowadays. To timely detect vestibular dysfunction, the Vestibular Infant Screening–Flanders (VIS–Flanders) project has implemented a basic vestibular screening test for hearing-impaired infants in Flanders (Belgium) with a participation rate of 86.7% during the first year and a half. The cervical Vestibular Evoked Myogenic Potentials (cVEMP) test was applied as vestibular screening tool to map the occurrence of vestibular (mainly saccular) dysfunction in this population. At the age of 6 months, 184 infants were screened. No refers on vestibular screening were observed in infants with permanent conductive hearing loss. In infants with permanent sensorineural hearing loss, a cVEMP refer rate of 9.5% was observed. Failure was significantly more common in infants with severe-profound compared to those with mild-moderate sensorineural hearing loss (risk ratio = 9.8). Since this is the first regional study with a large sample size and successful participation rate, the VIS–Flanders project aims to set an example for other regions worldwide

Ijzer, essentieel voor een goede gezondheid

Ijzer is essentieel voor ons lichaam. Zonder ijzer is zuurstoftransport doorheen ons lichaam niet mogelijk. We halen ijzer uit de voeding in de vorm van haemijzer en non-haemijzer. Beide vormen worden voornamelijk opgenomen ter hoogte van het duodenum. De opname kan beïnvloed worden door tal van factoren. Een ijzertekort zal onder meer de ijzeropname stimuleren. Een belangrijk hormoon dat bij dit proces is betrokken, is hepcidine. Kinderen, adolescenten, zwangere vrouwen en premenopauzale vrouwen hebben een verhoogd risico op een ijzertekort. Ook pathologische aandoeningen kunnen meespelen, zoals gastro-intestinale bloedingen en bariatrische chirurgie. Een ijzerdeficiëntie kan aanleiding geven tot een anemie. Vandaar het belang om voldoende ijzer op te nemen via de voeding en mogelijke oorzaken van een ijzerdeficiëntie tijdig te voorkomen of te behandelen.status: publishe

Iron Deficiency After Roux-en-Y Gastric Bypass: Insufficient Iron Absorption from Oral Iron Supplements

Roux-en-Y gastric bypass (RYGB) may reduce the absorption of iron, but the extent to which this absorption is impeded is largely unknown. First, we determined the prevalence of iron deficiency following RYGB and explored the risk factors for its development. Second, we examined to what extent oral iron supplements are absorbed after RYGB.status: publishe

Prevalence of Fragilysin Gene in Bacteroides fragilis Isolates from Blood and Other Extraintestinal Samples

Of 166 Bacteroides fragilis isolates, 26.2% of 103 isolates from blood and 20.6% of 63 extraintestinal isolates harbored the fragilysin gene (difference not statistically significant). Clinical characteristics and evolution were comparable in patients with B. fragilis bacteremia with or without this enterotoxin. Fragilysin seems not to be an important virulence factor in B. fragilis disease

Barriers in the approach of obese patients undergoing bariatric surgery in Flemish hospitals

BACKGROUND: Bariatric surgery is associated not only with weight loss and improvement of comorbidities of obesity but also with short and long-term complications. Preoperative screening and lifelong follow-up of these patients are important to optimize the effect of bariatric surgery and minimize complications. The objective of this study was to create an inventory of the current care offered to bariatric patients before and after surgery in Flemish hospitals, Belgium and to identify barriers for optimal care. METHODS: Semi-structured interviews with healthcare professionals involved in screening and follow-up of bariatric patients in 12 hospitals in Flanders, Belgium were performed. Interviews were transcribed verbatim and analyzed with NVivo 10.0. RESULTS: In each participating hospital, except one, biochemical screening before and after bariatric surgery was performed, but the extent and timing varied between hospitals. In ten hospitals, a standard multivitamin preparation was started in all patients after surgery, but there was a large variation for timing of initiation and duration between hospitals. The interviewees indicated that the knowledge about appropriate dosage and formulation adjustments after surgery was limited. Most of the performed drug adjustments were due to improvement of comorbidities. In 9 out of 12 hospitals, a multidisciplinary team was involved, but the approach varied widely. Only in 3 out of 12 hospitals, eligibility of patients for bariatric surgery was discussed in team meetings. CONCLUSIONS: Strategies to implement existing guidelines are required in order to obtain more uniform, interdisciplinary support for bariatric patients, resulting in an increase of efficiency of surgery and improved patient care.status: publishe

Evaluation of Different Cytomegalovirus (CMV) DNA PCR Protocols for Analysis of Dried Blood Spots from Consecutive Cases of Neonates with Congenital CMV Infections▿

Two protocols for the extraction of cytomegalovirus (CMV) DNA and two methods for the amplification of CMV DNA in dried blood spots were evaluated for the retrospective diagnosis of congenital CMV infection. During the period from 1996 to 2006, a urine screening program detected 76 congenitally infected neonates. Stored Guthrie cards with blood from 55 cases and 12 controls were tested. Two spots of dried blood were cut from each card and evaluated in two centers. CMV DNA was extracted from a whole single spot. Center 1 used phenol-chloroform extraction and ethanol precipitation followed by a conventional PCR. Center 2 used the NucliSens easyMAG automated DNA/RNA extraction platform (bioMérieux) followed by a real-time PCR. For evaluation of the extraction method, DNA extracted from each blood spot was evaluated by the amplification method used by the collaborating center. The sensitivities were 66% for center 1 and 73% for center 2. None of the controls were positive. A sensitivity as high as 82% could be obtained by combining the most sensitive extraction method (the phenol-chloroform procedure) with the most sensitive PCR method (real-time PCR). The detection rate was not influenced by the duration of storage of the spots. The sensitivity was higher with blood from congenitally infected cases due to a primary maternal CMV infection, regardless of the protocol used. However, the difference reached significance only for the least-sensitive protocol (P = 0.036)

Do Roux-en-Y gastric bypass patients meet the dietary guidelines?

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Congenital cytomegalovirus infection: contribution and best timing of prenatal MR imaging

Objective: To predict sensorineural hearing loss (SNHL) and neurological impairment in congenital cytomegalovirus (cCMV) infection using MR imaging and define the best timing in pregnancy for prenatal assessment. Methods: In 121 patients with confirmed cCMV infection, brain features at MR imaging were respectively graded from 1 to 5: normal; isolated frontal/parieto–occipital hyperintensity; temporal periventricular hyperintensity; temporal/occipital cysts and/or intraventricular septa; migration disorders. Grading was correlated with postnatal SNHL and neurological impairment using regression analysis. In 51 fetuses with MR examinations at 26.9 and 33.0 weeks, the predictive value of SNHL and neurological impairment was compared using ROC curves. Results: Postnatal follow-up showed SNHL in 18 infants and neurological impairment in 10. MR grading was predictive of SNHL and of neurological impairment (P < 0.001). In grade 1 or 2, none had SNHL and 1/74 had neurological impairment. The areas under ROC curves for prediction of postnatal SNHL and of neurological impairment from first and second MR examination were comparable. Conclusion: Our data suggest that in cCMV infection, prediction of SNHL and neurological impairment is feasible by fetal MR imaging with a high negative predictive value and can equally be done at 27 or 33 weeks of gestation. Key points: • In cCMV, isolated periventricular T2-weighted signal hyperintensity has a good postnatal prognosis. • In cCMV, SNHL and neurological impairment can be predicted at 27 or 33 weeks. • In cCMV, fetal MR has a high NPV in predicting SNHL. • In cCMV, fetal MR has a high NPV in predicting neurological impairment.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Congenital cytomegalovirus infection: contribution and best timing of prenatal MR imaging

To predict sensorineural hearing loss (SNHL) and neurological impairment in congenital cytomegalovirus (cCMV) infection using MR imaging and define the best timing in pregnancy for prenatal assessment.status: publishe

Drug disposition before and after gastric bypass: fenofibrate and posaconazole

Roux-en-Y gastric bypass (RYGB) alters the anatomical structure of the gastrointestinal tract, which can result in alterations in drug disposition. The aim of the present study was to evaluate the oral disposition of two compounds belonging to the Biopharmaceutical Classification System Class II - fenofibrate (bile salt-dependent solubility) and posaconazole (gastric pH-dependent dissolution) - before and after RYGB in the same individuals.status: publishe