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P de Smet

Publications and source records attributed to P de Smet.

10 recordsLinked to original sources
PubMed2004

Obesity, body fat distribution and incidence of sick leave in the Belgian workforce: the Belstress study.

OBJECTIVES: In many studies, obesity has been associated with morbidity or mortality, but only a few have studied the relation between obesity and sick leave. Our aim is to analyse the independent effects of both adiposity and body fat distribution in relation to the 1-y incidence of sick leave in a large cohort of male and female workers covering a variety of occupations, taking into account a wide range of socio-demographic, behavioural and bioclinical variables. DESIGN AND SETTING: The baseline survey of the Belstress study was conducted in 25 companies across Belgium between 1994 and 1998. A cohort of 20 463 workers (15 557 males and 4906 females) aged 35-59 y was followed for absenteeism during 1 y. The 75th percentile of the distribution of the total annual sickness days was used as a cutoff to classify the workers with a high 1-y incidence rate of sick leave. The relation between sick leave and both obesity and body fat distribution assessed by the body mass index (BMI) and the waist circumference, respectively, was analysed by multivariate logistic regression models. RESULTS: Using a backward procedure based on the likelihood ratio, we found central abdominal fatness to be an independent predictor of sick leave in both genders (high sick-leave incidence and long spells), but not BMI. In men, the odds ratios was 1.31 (99% CI 1.12-1.52, P<0.0001) and in women it ranged from 1.32 (99% CI 1.03-1.70, P=0.005) to 1.47 (99% CI 1.14-1.90, P<0.0001). Two baseline covariables, respiratory problems and perceived health, are confounders or mediators. CONCLUSIONS: In this study, body fat distribution was associated with a high annual sick-leave incidence and long spells of sickness absence. If this link is reversible, employers may benefit from programs aiming at the prevention and treatment of central obesity.

Adipose Tissue↗
PubMed2003

Antibiotic use and the prevalence of antibiotic resistance in bacteria from healthy volunteers in the dutch community.

BACKGROUND: Although most antibiotics are consumed in the community (80%), the relation of antibiotic consumption and resistance in the community has not been thoroughly studied. MATERIALS AND METHODS: In the present study, antibiotic use was related to the prevalence of antibiotic resistance of Escherichia coli and enterococci isolated from healthy volunteers living in the southern part of the Netherlands in 1996 and 1999. RESULTS: No change in the total antibiotic use in the Dutch community was observed between 1996 and 1999 (3542 and 3598 defined daily doses [DDD] per 1000 inhabitants/year). However, the increased fluoroquinolone use (+ 18%) and the increased prevalence of ciprofloxacin resistance from 0 to 2% is a point of concern, especially since this was accompanied by a significant shift towards higher minimum inhibitory concentration (MIC) values (p < 0.05). A significant decrease in the prevalence of vancomycin-resistant enterococci (p < 0.05) was found in addition to a significant shift towards lower MIC valued for avoparcin, a glycopeptide previously used as growth promoter in animal husbandry (p < 0.05). This was very likely due to the banning of avoparcin for this purpose from April 1997 onwards. CONCLUSION: In order to maintain the low level of antibiotic use and resistance in The Netherlands, surveillance of antibiotic resistance in nonclinical isolates in relation to antibiotic use is very important.

Anti-Bacterial Agents↗
PubMed2002

Job conditions and fibrinogen in 14226 Belgian workers: the Belstress study.

AIMS: To investigate the relationship between fibrinogen and stressful work conditions, where perceived strain is defined by the simultaneous presence of high psychological demands and low control, according to Karasek's Demand/Control/(Social Support) model. METHODS AND RESULTS: A cross-sectional study was realized between 1994 and 1998 in 24 Belgian enterprises, on 16335 male and 5084 female middle-aged workers of different Belgian companies participating in the Belstress study. This study confirmed the well-documented bivariate relationship between plasma fibrinogen levels and gender, age, educational level, smoking, obesity, physical activity, alcohol consumption, total cholesterol, HDL-cholesterol, arterial hypertension and diabetes. No independent multivariate relationship was observed between job control, psychological job demands or social support at work and plasma fibrinogen, but after stratification a positive association (P< or =0.05) was observed between psychological job demands and plasma fibrinogen for males in the lowest educational level. Moreover a positive statistically significant association between job strain and plasma fibrinogen was observed in males but not in females. After stratification for educational level this association remained significant for males especially in the lowest educational level (P< or =0.001) and became significant for females in the middle educational level. CONCLUSIONS; As suggested in our study and others, plasma fibrinogen could be one of the potential mediators explaining the relationship between job stress and coronary heart disease.

Adult↗
PubMed2001

Calcium puffs are generic InsP(3)-activated elementary calcium signals and are downregulated by prolonged hormonal stimulation to inhibit cellular calcium responses.

Elementary Ca(2+) signals, such as "Ca(2+) puffs", which arise from the activation of inositol 1,4,5-trisphosphate receptors, are building blocks for local and global Ca(2+) signalling. We characterized Ca(2+) puffs in six cell types that expressed differing ratios of the three inositol 1,4,5-trisphosphate receptor isoforms. The amplitudes, spatial spreads and kinetics of the events were similar in each of the cell types. The resemblance of Ca(2+) puffs in these cell types suggests that they are a generic elementary Ca(2+) signal and, furthermore, that the different inositol 1,4,5-trisphosphate isoforms are functionally redundant at the level of subcellular Ca(2+) signalling. Hormonal stimulation of SH-SY5Y neuroblastoma cells and HeLa cells for several hours downregulated inositol 1,4,5-trisphosphate expression and concomitantly altered the properties of the Ca(2+) puffs. The amplitude and duration of Ca(2+) puffs were substantially reduced. In addition, the number of Ca(2+) puff sites active during the onset of a Ca(2+) wave declined. The consequence of the changes in Ca(2+) puff properties was that cells displayed a lower propensity to trigger regenerative Ca(2+) waves. Therefore, Ca(2+) puffs underlie inositol 1,4,5-trisphosphate signalling in diverse cell types and are focal points for regulation of cellular responses.

Adenosine Triphosphate↗
PubMed2000

Mapping of IP(3)-mediated Ca(2+) signals in single human neuroblastoma SH-SY5Y cells: cell volume shaping the Ca(2+) signal.

Fast confocal laser-scanning microscopy was used to study spatiotemporal properties of IP(3)-mediated Ca(2+) release signals in human SH-SY5Y neuroblastoma cells. [Ca(2+)](i) increases were not affected by ryanodine (30 microgM) or caffeine (10 mM) and largely insensitive to removal of external Ca(2+), indicating predominance of IP(3)-induced Ca(2+) release. Ca(2+) signals evoked by high concentration (10 microM) of the muscarinic agonist carbachol appeared as self-propagating waves initiating in cell processes. At low carbachol concentrations (500 nM) Ca(2+) changes in most cells displayed striking spatiotemporal heterogeneity. The Ca(2+) response in the cell body was delayed and had a smaller amplitude and a slower rise time than that in processes. Ca(2+) changes in processes either occurred in a homogeneous manner throughout the whole process or were sometimes confined to hot spots. Regional differences in surface-to-volume ratio appear to be critical clues that determine the spatiotemporal pattern of intracellular Ca(2+) release signals.

Caffeine↗
PubMed2000

Trends and regional differences in coronary risk factors in two areas in Belgium: final results from the MONICA Ghent-Charleroi Study.

OBJECTIVE: To study regional differences and trends in coronary risk factors and in predicted coronary risk calculated on the basis of multiple logistic function equations for the general population aged 25-64 years in two areas in Belgium during the period 1985-1992. DESIGN: A comparison of cross-sectional data on coronary risk factors between two cities and different survey periods. METHOD: In the cities of Ghent (in Flanders) and Charleroi (in Walloonia) in Belgium, three consecutive cross-sectional age-stratified and sex-stratified random samples of 2000 subjects each were selected from the general population. We studied their coronary risk factors between 1985 and 1992. The field work was carried out according to the protocol of the international WHO-MONICA project. RESULTS: We observed a significant decrease in the prevalence of smoking among men in the two cities over the three surveys, while a gradual increase in diastolic blood pressure for all subgroups in Ghent was seen (this was statistically significant for men aged 45-64 years and women aged 25-44 years). The overall coronary risk predicted on the basis of multiple-logistic-function equations did not however, exhibit significant trends over time in either city. Comparisons between the two centres revealed significantly higher mean serum levels of total cholesterol in Charleroi than in Ghent (for all subgroups except women aged 45-64 years) and significantly higher mean systolic blood pressures in Charleroi for all subgroups defined in terms of age and sex. Prevalences of hypertension in Ghent were significantly lower than those in Charleroi for individuals aged 25-44 years, while the prevalence of obesity in all subgroups in Ghent was also significantly lower. The overall predicted coronary risk in Charleroi was also significantly higher, except for men aged 45-64 years. The differences in mean predicted risk ranged from 5.0% for men aged 45-64 years to 21.2% for women aged 45-64 years. CONCLUSIONS: From the data in this article it seems that the trends in overall coronary risk profiles in Ghent and Charleroi are not in accordance with the observed trends in incidence of coronary heart disease (CHD) in these two cities. On the other hand, the differences in predicted coronary risk between the two cities are in the same direction as the observed differences in incidence of CHD between the two cities, but are however too small to explain fully the observed difference in incidence of CHD between the two centres.

Adult↗
PubMed1999

Trends in coronary heart disease in two Belgian areas: results from the MONICA Ghent-Charleroi Study.

SETTING: As part of the WHO-MONICA study, acute coronary events have been registered from 1983 until 1992 in the general population aged 25-69 years in two Belgian cities--Ghent in the northern Dutch speaking part of Belgium and Charleroi in the southern French speaking part. Registration of events was done according to an international standard protocol. OBJECTIVE: To study trends in total, fatal and non-fatal event rates and trends in case fatality rates in these two cities. MAIN RESULTS: Incidence of CHD was on average 50% higher in Charleroi compared with Ghent in both men and women (attack rate ratio Charleroi/Ghent was 1.5 in both sexes). In both men and women, diverging trends were observed between the two cities for total and non-fatal event rates, while parallel declining trends were observed in fatal event rates and in case fatality rates. In both sexes, total attack rates showed a significant decrease in Ghent and a significant increase in Charleroi. Also in the two sexes, attack rates of non-fatal events increased significantly in Charleroi and remained stable in Ghent. Attack rates of fatal events decreased significantly in men and women in Ghent and in men in Charleroi. Both "total" and "in hospital" case fatality rates declined significantly in both sexes in the two cities. CONCLUSIONS: Important differences in coronary heart disease (CHD) incidence and CHD trends between Ghent and Charleroi were observed. These differences and trends are interpreted in the context of existing and still growing differences in the overall socioeconomic situation between the north and the south of the country. On the other hand, the efficacy of medical treatment of CHD is comparable in the two regions, as reflected by similar figures and trends for case fatality rates.

Adult↗
PubMed1998

Misclassification of coronary heart disease in mortality statistics. Evidence from the WHO-MONICA Ghent-Charleroi Study in Belgium.

STUDY OBJECTIVE: To validate the Belgian vital statistics for coronary heart disease (CHD) on the basis of an independent acute myocardial infarction (AMI) register, carried out as part of the WHO-MONICA project. DESIGN: Records of fatal cases of AMI in the WHO-MONICA register were individually linked to the corresponding death certificates. SETTING: Since 1983, the WHO-MONICA Collaborating Centre Ghent/Charleroi registers all fatal and non-fatal AMI in the age group 25-69 years in two geographical areas, Ghent in the northern Dutch speaking part and Charleroi in the southern French speaking part of Belgium. Registration is done according to the MONICA protocol. The official vital statistics in Belgium are published on a yearly basis. They are essentially a reflection of the "underlying" causes of death, coded according to the 9th revision of the International Classification of Diseases (ICD). The study was undertaken in the period 1983-1991. MAIN RESULTS: Out of a total of 741 (Ghent) and 934 (Charleroi) well documented MONICA fatal cases of AMI, 492 (66.4%) and 641 (68.6%), respectively, were officially labelled as CHD (ICD code 410-414); 438 (59.1%) and 385 (41.2%), respectively, were officially labelled as AMI (ICD code 410). A substantial fraction of the MONICA AMI cases--27.1% in Ghent and 38.2% in Charleroi--was coded as "other forms of CHD" (ICD 411-414) or as "other forms of heart disease" (ICD 420-429). The remaining MONICA AMI cases--13.8% in Ghent and 20.6% in Charleroi--were classified in either very aspecific (for example, atherosclerosis, ICD 440) or totally unrelated ICD codes (for example, neoplasm, ICD 140-239). CONCLUSIONS: It is concluded from the results in this paper that a substantial part of all deaths caused by CHD in Belgium are labelled with incorrect ICD codes and are therefore misclassified in the official mortality statistics for Belgium. This is partly caused by a "drainage" of cases towards less specific CHD related ICD categories. A considerable fraction, however, seems to be absolutely misclassified.

Adult↗
PubMed1995

[Lessons from the MONICA project].

The authors review the various aspects of the MONICA project (Monitoring of Trends and Determinants in Cardiovascular Diseases) coordinated by the World Health Organization. This study comprises, in a defined geographical or administrative entity, an infarction Registry, two or three population surveys and two or three surveys concerning the treatment of the acute phase of myocardial infarction. It is a ten-year study conducted by 39 collaborative centres in 4 continents. The main hypotheses of this study have not yet been verified, as some centres have not completed the 10 years of infarction recording and/or the last population survey. However, the results collected to date and reported in about ten publications grouping all centres, and more than 500 articles published by various centres, demonstrate the wealth of precious information for clinicians provided by this public health project. For example, the infarction Registry demonstrates marked regional differences in myocardial infarction rates in the population and therefore marked differences in acute coronary bed requirements. The Registry also confirms the higher mortality rates in women and at the end of infarction compared to men. Population surveys can be used to follow the course of the main coronary risk factors and to compare the levels of risk factors in different centres. Regional differences clearly show that a more or less aggressive approach to primary prevention is required. Finally, the presence of an infarction Registry and population surveys allow the elaboration of case-control study protocols, several examples of which are mentioned by the authors. All of these techniques will be able to more clearly define the aetiology of coronary heart disease and, consequently, the reduction of this disease in the population by adequate primary and secondary prevention.

Acute Disease↗