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L Bruckers

Publications and source records attributed to L Bruckers.

7 recordsLinked to original sources

Daily induction combination treatment with alpha 2b interferon and ribavirin or standard combination treatment in naive chronic hepatitis C patients. A multicentre randomized controlled trial.

The standard treatment for patients with chronic hepatitis C is a 6-12-month combination therapy with interferon alpha and ribavirin. Induction treatment could result in a faster early decline of the hepatitis C virus (HCV) load and a better response rate. Naive chronically infected HCV patients (n = 454) were randomized into two arms to receive either induction treatment with interferon alpha 2b 5 million units (MU) subcutaneously (s.c.) daily during a period of 8 weeks (arm A); or treatment with interferon alpha 2b 5 MU s.c. three times a week (TIW) for a period of 8 weeks (arm B). After week 8, interferon treatment in both arms was 3 MU s.c. TIW for a total period of 12 months. In both arms, ribavirin (1000-1200 mg orally per day) was added at week 4. Induction treatment resulted in a higher virological response at week 8 of treatment (66%vs 47%; P < 0.01). However, response at the end of treatment and at 6 months follow-up was not different (53%vs 50%, 41%vs 33%). The occurrence of adverse events and the drop-out rate were similar in both arms. Although an early virological response is observed more frequently in the induction treatment, end of treatment response and sustained responses did not differ.

Adolescent↗

Repeated-measures models to evaluate a hepatitis B vaccination programme.

In 1985-1986, a hepatitis B vaccination programme was conducted in a Belgian institution for the mentally handicapped. A group of 97 residents was followed up for 11 years in order to characterize the long-term persistence of hepatitis B antibodies after vaccination. This paper proposes the use of linear mixed-effects models to account for serial correlation and between-individual heterogeneity in the data, while adjusting the analysis for various individual characteristics and important risk factors in the response to vaccination. We propose several model building strategies and focus on the prediction of future levels of antibodies.

Belgium↗

Pesticides and mortality from hormone-dependent cancers.

Endocrine-disrupting chemicals are considered to be a possible cause of hormone-dependent cancers. In areas of high exposure to pesticides, people are concerned about the long lasting toxicity of pesticides, some of which are possibly hormonally active. We collected for each Belgian municipality (n = 589) the latest mortality statistics from breast and prostate cancer (period 1985-1994) and the latest data on crops and pesticides (1998). In addition, data on possible confounders such as population density, degree of urbanization, industrial activity and the presence of an incinerator were collected as well. The data were analysed with spatial statistics that takes into account the spatial nature of the data. There is a large variation in crops and pesticide exposure among the municipalities, the highest exposure being seen in the fruit production area. Apart from use of defoliants and potato cultivation, no consistent correlation was detected between crops, pesticides and mortality from breast and prostate cancer. Our data cannot support the hypothesis of a relationship between total and class-related pesticide use and breast and prostate cancer mortality. However, the increased mortality due to breast cancer and to a lesser extent due to prostate cancer in traditional potato-growing areas needs attention and more research.

Belgium↗

Evidence of declining STD prevalence in a South African mining community following a core-group intervention.

OBJECTIVES: To reduce the prevalence of curable sexually transmitted diseases (STDs) in a South African mining community through provision of STD treatment services, including periodic presumptive treatment and prevention education to a core group of high-risk women living in areas around the mines. METHODS: Women at high risk for STDs attended a mobile clinic monthly for examination and counseling, and were treated presumptively for bacterial STDs with a directly observed 1-g dose of azithromycin. Gonococcal and chlamydial infection rates were measured by urine ligase chain reaction, and genital ulcers were assessed by clinical examination. Changes in STD prevalence among local miners were assessed through comparison of prevalence in two cross-sectional samples of miners taken 9 months apart, and through routine disease surveillance at mine health facilities. RESULTS: During the first 9 months of the intervention, 407 women used the services. Baseline prevalence of Neisseria gonorrhoeae and/or Chlamydia trachomatis in women was 24.9%; 9.7% of these women had clinical evidence of genital ulcer disease (GUD). The proportion of women with incident gonococcal or chlamydial infections at the first monthly return visit (69% follow-up rate) was 12.3%, and genital ulcers were found in 4.4% of these women. In the miner population, the prevalence of N gonorrhoeae and/or C trachomatis was 10.9% at baseline and 6.2% at the 9-month follow-up examination (P<0.001). The prevalence of GUD by clinical examination was 5.8% at baseline and 1.3% at follow-up examination (P< 0.001). Rates of symptomatic STDs seen at mine health facilities decreased among miners in the intervention area compared with miners living farther from the site and with less exposure to the project. DISCUSSION: Provision of STD treatment services to a core group of high-risk women may significantly reduce their burden of disease, and may contribute to a reduction in community STD prevalence. In the absence of sensitive and affordable screening tests for STDs in women, periodic presumptive treatment coupled with prevention education is a feasible approach to providing STD services in this population.

Adult↗

Modelling long-term persistence of hepatitis B antibodies after vaccination.

Antibody response to hepatitis B vaccination was measured in 97 institutionalized, mentally handicapped patients after a 0-, 1-, 6-month vaccination schedule. Two groups were formed at month 7 according to the antibody response, which determined whether they needed an additional vaccine dose at month 12, to achieve an antibody titre of 100 IU/liter. All residents were followed up yearly for the first 5 years, after which, they received another booster dose. Another blood sample was taken 11 years after the start of the program. A linear mixed-regression model was used to analyze the data. Random and fixed effects were included to determine the generally known risk factors and the still unknown individual characteristics that influence the titre of hepatitis B surface antibodies (anti-HBs). The mean anti-HBs titre was a function of time, type of mental retardation (Down's syndrome or other types of mental retardation), the use of antiepileptic drugs, and the additional booster at month 12. The immediate and vigorous response of the immune system to booster vaccination shows that the immunologic memory is good after primary vaccination. For the maintenance of protection, the recommendation for mentally retarded patients in institutions is vaccination of all seronegative residents as well as new entrants, after which, no additional boosters will be necessary.

Anticonvulsants↗

Effects of soft drink and table beer consumption on insulin response in normal teenagers and carbohydrate drink in youngsters.

There is ample evidence that breast cancer susceptibility is induced during the developmental stages of the human breast where, in a manner related to sex-steroid hormones, insulin plays an important role. In turn, nutrition might be implicated. Regular soft drinks and table beer, both carbohydrate-containing drinks, are candidates affecting insulin concentrations. Eleven teenagers, between the ages of 13 and 17 years, consumed a soft drink and a table beer in a crossover study. The blood levels of insulin and glucose were related to anthropomorphometric and endocrine factors. In contrast to table beer, consumption of regular soft drinks induced a fast and dramatic increase in both glucose and insulin concentration within a maximum 1 hour after consumption. The insulin response was linearly correlated to the body mass index (BMI). Children with a small increase in BMI are highly sensitive to regular soft drinks with regard to glucose and insulin response. The finding suggests a vicious circle of high caloric drinks, increase in BMI and insulin response. It is one of the nutritional pathways which might affect susceptibility for breast cancer in youngsters. Table beer, a drink with fermented sugars, does not share these effects on carbohydrate metabolism.

Adolescent↗