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To investigate determinants of medication use among multi-ethnic pregnant women.A total of 641 pregnant women participated in this cross-sectional study in a Brussels university hospital. A questionnaire was used to obtain data on socio-demographic characteristics and medication use. Chi-squared tests and binary logistic regression analyses were performed using SPSS 19.Medication use during pregnancy (37%) was positively associated with age older than 35 years, Western origin, being born in Belgium, high education and employment status. Highly educated Western women had a greater exposure to drugs with an unknown safety profile than Arab/Turkish and 'Other (non-Western) origins' women. In the latter two groups, low education and nulliparity were the most important determinants of lower drug use. Nulliparous Arab/Turkish women used significantly less medications (17%) during pregnancy than parous women with the same ethnic background (34%; p = 0.024).Medication use during pregnancy is considerable but differs according to ethnicity. Age, parity, educational level, occupational status and duration of stay in Belgium are important determinants that should be taken into account for risk assessment and preventive measures targeting pregnant women.

Background: We investigated the associations between daily sales of respiratory medication and air pollutants for various age groups in the Brussels-Capital Region (about one million inhabitants). Methods: Daily average concentrations of PM10, and NO2 at a resolution 4x4km were derived by interpolation from monitoring stations. These data was combined with reimbursement data of prescribed asthma and COPD medication from the Belgian social security for years 2005 to 2011. In this time-series study, we used over-dispersed Poisson Generalized Linear Models adjusted for daily minimum temperature, relative humidity, day of the week and influenza. We obtained up-to-three-week cumulative risk ratios (RR) for interquartile range (IQR) of exposure and their 95% confidence intervals (CI) for all ages and seven age groups. Findings: Median daily concentrations of PM10 and NO2 were 25µg/m3 (IQR=17·1) and 38µg/m3 (IQR=20·5), respectively. PM10 was associated with daily medication sales among individuals aged 13 to 64 years. For NO2, significant associations were observed among all age groups except >84 years old. The strongest RR were for NO2, among adolescents, including three weeks lags (RR=1.187 95%CI: 1.097-1.285). Interpretation: Daily concentrations of PM10 and NO2 were associated with increased sales of asthma and COPD medication in Brussels. For NO2, these associations were already established among pre-school age children and evident up to the young elderly (

Introduction The adverse health effects of exposure to air pollution have been well-established and include mortality, hospital admissions, emergency department visits, etc, but also less severe outcomes such as medication use and purchase. The economic impact, an additional motivator for policy, has been studied primarily for the more severe outcomes. Methods Purchase data of reimbursed medications typically prescribed for asthma and chronic obstructive pulmonary disease, were obtained through the mandatory Belgian health insurance system. A time series analyses approach was used to model daily sales on daily air pollution concentrations (NO 2 , PM 10 and PM 2.5 ) for residents of the Brussels Capital Region as a whole. In addition, a higher geographical resolution of both sales and pollutant concentrations allowed for a multi-sector approach. Annual savings were estimated for the scenario of a 10% reduction in each of the pollutants. Results Medication purchase was significantly associated with NO 2 concentrations, leading to an annual cost saving potential of € 107,845 [95%CI: € 71,483–€ 143,823] in R03 sales (WHO classification for drugs of obstructive airway diseases). Saving potentials of PM 10 and PM 2.5 were not significant. Estimates were not sensitive to the geographical resolution, however, higher precision can be obtained with higher resolution data, subject to the condition that the number of sales is sufficiently large.

Introduction The aim of study is comparing the haemostatic properties of conventional monopolar resection (TURP) and bipolar transurethral resection in saline (TURIS) of the prostate in patients under chronic oral anticoagulants. Material and methods Out of a cohort group of 550 endoscopic resections for bladder outlet obstruction, 176 patients on chronic oral anticoagulant therapy required endoscopic resection either by monopolar TURP or bipolar TURIS technology. Changes in haemoglobin, blood transfusion, and clot retention were compared between both groups. Results Mean postoperative change in haemoglobin level was -1.21 ±0.92 mg/dl in the TURP group compared to -1.29 ±0.99 mg/dl in the TURIS group (p = 0.603). The need for blood transfusions and the mean numbers of units transfused did not significantly differ between the 2 groups. Clot retention appeared in 12 patients (15%) in the TURP group compared to 13 patients (13%) in the TURIS group (p = 0.828). Conclusions Despite promising experimental results of better haemostasis and deeper coagulation depth, bipolar technology does not permit one to reduce the amount of blood loss when compared to patients treated by conventional monopolar technology in this study group of patients on oral anticoagulation therapy. Patients on oral anticoagulants suffer more incidents of clot retention, which sometimes results in re-hospitalisation.

INTRODUCTION: The aim was to evaluate the postoperative morbidity and outcome of palliative endoscopic resections for relief of infravesical obstruction in prostate cancer patients with hormone deprivation therapy, and to investigate the added value of bipolar technology over conventional monopolar resections. MATERIAL AND METHODS: A retrospective study was performed on 70 patients with prostate cancer under hormone deprivation therapy undergoing 75 endoscopic procedures, by either monopolar or bipolar technology, between August 2005 and March 2009 at a single institution. The analysis used outpatient, inpatient, and operative records, and observations of electrolyte changes in the serum, postoperative morbidity, and the overall results of palliative endoscopic resections. Preoperative cancer stages and grades were compared with the pathological findings after surgery. Postoperative outcome and complications of conventional monopolar and bipolar technology were compared. RESULTS: Over a period of 44months, 34 conventional monopolar resections were performed in 32 patients and 41 bipolar resections in 38 patients. Patients' profiles regarding age, initial cancer stage and grade, resection weight, resection speed, catheterization time, and hospital stay were similar in both groups. No statistically significant difference was observed in sodium drop (p = 0.802), clot retention (p = 0.565), or urinary retention (p = 0.292). The overall success rate in relieving obstruction leading to spontaneous voiding was 77%. While 38% of the patients had a high grade tumour at diagnosis, 79% were found to be high grade after the endoscopic resection (p

The objective of this study was to compare the efficacy and safety of bipolar transurethral resection in saline (TURIS) and conventional monopolar transurethral resection (TURP) in men with voiding difficulties due to high volume (>60g) benign prostatic hyperplasia. Between May 2005 and January 2009, 66 men with bladder outlet obstruction due to large benign hyperplasia (BPH) (>60 g) underwent transurethral resection, either by Olympus monopolar or Olympus bipolar TURIS technique. Perioperative and outcome data were recorded and compared. There was no significant difference in patient age, prostate size, PSA, uroflow rate, post voiding residual urine, operation time, catheterization time, and hospital stay. In the monopolar TURP group, an important drop in serum sodium was observed (3.12 mmol/L), statistically significantly different (p = 0.012) from the 1.30 mmol/L drop in the bipolar TURIS group. One case of clinical TUR syndrome was observed in the conventional monopolar TURP group. Early and late complications such as clot retention, urinary retention, bladder neck stenosis, and urethral stricture were identical in both groups. The bipolar TURIS device is a valid treatment option for patients with BPH-related voiding disorders due to high volume BPH. Obviating the risk of TUR syndrome, this minimally invasive procedure may be a good surgical option in the urologist's armamentarium.

Objective: We have previously demonstrated high concentrations of the glycoprotein osteoprotegerin (OPG) in biopsies of abdominal aortic aneurysm (AAA), and demonstrated that ligation of the nuclear receptor peroxisome proliferator-activated receptor gamma (PPARγ) downregulates OPG in vitro and within a mouse model. The aims of this study were to assess the associations between circulating concentrations of OPG, polymorphisms of the gene encoding PPARγ (PPARG), AAA presence and growth. Design, patients and measurements: Two genetic polymorphisms in PPARG were assessed in 4227 men, 699 of whom had an AAA. For 631 men, who had AAAs, maximum aortic diameter was monitored by yearly ultrasound for a median of 5 years. Plasma OPG was measured in 838 men, 318 of whom had an AAA. Results: Plasma concentrations of OPG were independently associated with AAA (adjusted odds ratio 1.38, 95% CI 1.10–1.72). The PPARG c.1347C > T polymorphism was associated with plasma concentrations of OPG (beta 0.12, P C polymorphism was weakly associated with AAA (adjusted odds ratio 1.28, 95% CI 1.01–1.61). PPARG c.1347C > T was associated with increased AAA growth (recessive model, P = 0.03). Conclusions: Circulating concentrations of osteoprotegerin are associated with abdominal aortic aneurysm and with one peroxisome proliferator-activated receptor gamma gene polymorphism. Peroxisome proliferator-activated receptor gamma gene polymorphisms are weakly associated with abdominal aortic aneurysm presence and growth. Confirmation of these findings is required in other cohorts.

Objective: To investigate early changes in leukocyte subsets and autonomic function as predictors of the development of poststroke infections.Methods: We assessed the time course of leukocyte subsets in the blood of 59 patients with acute ischemic stroke. We divided the patients into 2 groups: those who developed infections during the first 7 days after stroke onset and those who did not. We measured urinary norepinephrine and epinephrine concentrations and pulse rate variability indices within 24 hours of admission.Results: We found that the number of circulating natural killer (NK) cells within the first hours after stroke was higher in stroke patients who developed infections (mean 435 cells/mL; 95% confidence interval [CI] 321-588) than in stroke patients who did not develop infections (mean 236 cells/mL; 95% CI 186-300; p = 0.001). This was followed by a decrease in all lymphocyte subsets from admission to day 1, varying between 22% and 40%, which was not seen in patients without poststroke infection (mean increase varied between 2% and 23%; all p Conclusions: High circulating NK cell count within the first hours after ischemic stroke onset followed by a drop in all lymphocyte subsets identified patients who developed infections and may be caused by a sympathovagal imbalance with sympathetic overweight. These findings need to be validated in larger studies.

Wavelet based analysis for mass spectrometry (MS) profiles of three groups of patients are analyzed for the purpose of developing a classification model. The first step in our model uses a DWT for feature extraction, using a linear combination of Symlets, Daubechies and Coiflets wavelet bases – collectively known as a super wavelet. Random Forests and Treeboost are then used to analyze the super wavelet coefficients to form the classification model. The method is illustrated using the publicly available prostate SELDI-TOF MS data from the American National Cancer Institute (NCI). The NCI data consists of 322 MS profiles with 15154 M / Z ratios, comprising of 69 malignant, 190 benign and 63 control patients, which we randomly divided into 70% training and 30% testing. From the Random Forest models, the super wavelet performed 2.7% to 5.7% better than other single wavelet types to give a 100% test set prediction rate for cancerous patients.

On October 4, 1992, the El Al Boeing crashed in the residential quarter ‘Bijlmermeer’ in Amsterdam (The Netherlands). In the years after the plane crash, local residents and assistance personnel began reporting a variety of unusual symptoms not unlike those reported by patients with chronic fatigue syndrome (CFS) and Gulf War Syndrome (GWS). The aim of this study was to define the symptom constellations reported by the patients and assess the possible causes of the illness. Standardized psychological questionnaires (MMPI-II, SCL-90, KPS and a complaints checklist) were used to screen for psychological changes and to describe the symptoms reported by the patients. Differences between local residents and assistance personnel, gender differences, Mycoplasma-infected and Mycoplasma non-infected patients were monitored. The major symptoms reported were extreme fatigue, non-restorative sleep, concentration-problems, memory problems and muscle and joint pains. There were no changes in the SCL-90 response...

The aim of this study was to determine if hyperbaric oxygen treatment (HBOT) could be used as adjunctive therapy and if HBOT could increase the quality of life in such a way that the functional status would improve in patients with an infection. A randomized, controlled trial was conducted on 15 Mycoplasma sp. infected CFS (CDC 1994) patients and 14 CFS (CDC 1994) patients with no evidence of a Mycoplasma infection were enrolled in a convenience randomization sample from our referral clinic. No statistical differences were found by use of univariate repeated measures although Bodily Pain as measured by the SF-36 seems to decrease after hyperbaric therapy (Greenhouse-Geisser: p = .010). Trends were found using paired t-testing for Mycoplasma infected CFS patients. The general perceived fatigue seemed to decrease after hyperbaric therapy (General Fatigue: p = .06). Directly after one week of hyperbaric therapy general fatigue improved (p = .03) but there was a reduction of activity (reduced activity: p = .05) and general perceived health (general health: p = .04). One month later the physical role increased (Role-Physical: p = .07). Although more data is required to make firm conclusions, trends were found. Reduced fatigue, increased levels of activity and an improved reaction time improved significantly their quality of life and therefore, enhanced also their functional status and thus could be used as an adjunctive therapy.

The deregulation of the 2,5A synthetase RNase L antiviral pathway and the prevalence of Mycoplasma spp. in subsets of Chronic Fatigue Syndrome (CFS) have been separately reported in the scientific literature. We hypothesised that a co-morbid pathophysiological mechanism involving infection by Mycoplasma spp. and the deregulation of the 2,5A synthetase/RNase L antiviral pathway may exist in CFS. Therefore, 186 consecutive CFS patients were enrolled. Mycoplasma detection was performed using forensic polymerase chain reaction. For RNase L determination, a radioactive probe was used to label 2,5A binding proteins in unfractionated peripheral blood mononuclear cell extracts. Myco-plasma-infected CFS patients presented with significantly elevated RNase L-ratio, compared to non-infected age- and sex-matched patients (p = 0.016). These results suggest that mycoplasma infections may cause deregulation of the 2,5A synthetase RNase L antiviral pathway in patients with CFS

An impaired immune system and opportunistic infections are considered important characteristics in the pathophysiology of Chronic Fatigue Syndrome (CFS). Using immunofluorescence we examined healthy subjects (N = 35) and two subsets of CFS patients: those without evidence of Mycoplasma (N = 55) and those with evidence of a Myco-plasma infection in their blood (N = 131). Using monoclonal antibodies and forensic polymerase chain reaction for detection of M. hominis, M. fermentans, M. pneumoniae and M. penetrans, we examined leukocytes in peripheral blood samples. Both patient groups presented with significantly elevated CD25+ (activated) cells as compared to healthy volunteers. CFS patients without evidence of mycoplasma infection(s) had increased amounts of CD5+ B-cells. Stepwise discriminant analysis indicated the number of activated cells, number of memory CD4+ cells and percentage of suppressor T-cells (lower in Mycoplasma+ patients as compared to Mycoplasma- patients) as the discriminant variab...

PURPOSE: To investigate a computed tomographic (CT) protocol with iterative reconstruction at conventional radiography dose levels for the assessment of structural lung abnormalities in patients with cystic fibrosis ( CF cystic fibrosis ). MATERIALS AND METHODS: In this institutional review board-approved study, 38 patients with CF cystic fibrosis (age range, 6-58 years; 21 patients 18 years) underwent investigative CT (at minimal exposure settings combined with iterative reconstruction) as a replacement of yearly follow-up posteroanterior chest radiography. Verbal informed consent was obtained from all patients or their parents. CT images were randomized and rated independently by two radiologists with use of the Bhalla scoring system. In addition, mosaic perfusion was evaluated. As reference, the previous available conventional chest CT scan was used. Differences in Bhalla scores were assessed with the χ(2) test and intraclass correlation coefficients ( ICC intraclass correlationcoefficient s). Radiation doses for CT and radiography were assessed for adults (>18 years) and children (

OBJECTIVE: To investigate the differences in exposure to medications in a cohort of multi-ethnic pregnant women. METHODS: Six hundred and forty-one pregnant women of Western, Arab/Turkish and "other origins" participated in this cross-sectional study using a questionnaire in a university hospital in Brussels, Belgium. Assessment of the drug safety was done using the food and drug administration (FDA) risk classification system. Data analysis was performed using SPSS (Chicago, IL). RESULTS: In overall cohort, 83.8% used at least one preparation (including multivitamins) during pregnancy and 37.0% of women used at least one drug (excluding multivitamins). Significantly more Western women (43.7%) used one or more medications compared to Arab/Turkish women (28.7%; p = 0.000). This difference in exposure was most pronounced for over-the-counter (OTC) drugs for occasional and pregnancy-related complaints, and was observed for potentially unsafe drugs or drugs with unknown safety. None of the womenreported use of FDA X category drugs. CONCLUSIONS: The use of drugs known to be harmful was not observed, but a higher prevalence of exposure to potentially harmful drugs (FDA C/D) was found among Western women who also consumed more OTC drugs. This highlights the need for cautious prescribing for women in the fertile age in general and for continuous monitoring of medication use during pregnancy.

AIMS To investigate the possible differences in folic acid use and to identify the determinants of antenatal folic acid use among multi-ethnic pregnant women. METHODS Three hundred and fifty pregnant women participated in this cross-sectional study in a university hospital in Brussels, Belgium. A questionnaire was used to obtain data on socio-demographic characteristics and folic acid use. χ(2)-tests and binary logistic regression analyses were performed using SPSS 17. RESULTS In the overall cohort, 59.2% used folic acid supplements during pregnancy. This supplement use was associated with an age of 26-35 years, being of Western origin, with high education and employment status, understanding physician's instructions, and early booking for antenatal care. Education (odds ratio, OR: 2.24; 95% confidence interval, CI: 1.08-4.63) and early booking for antenatal care OR: 2.45; 95% CI: 1.11-5.40) were the most important determinants. In particular for Arab/Turkish women, a lower employment status OR: 0.42; 95% CI: 0.24-0.73) was associated with a higher risk of not using folic acid supplements. CONCLUSIONS The lower use of folic acid supplements in Arab/Turkish ethnicities, which may be associated with an increased risk of neural tube defects, is related to socio-economic factors rather than to lower educational attainment. As recommended by other studies, fortification of ethnic minority food may be warranted to reduce the risk of neural tube defects.

Item does not contain fulltext AIMS: We sought to investigate the value of a family history of sudden death (SD) in Brugada syndrome (BS). METHODS AND RESULTS: Two hundred and eighty consecutive patients (mean age: 41 +/- 18 years, 168 males) with diagnostic type I Brugada ECG pattern were included. Sudden death occurred in 69 (43%) of 157 families. One hundred and ten SDs were analysed. During follow-up VF (ventricular fibrillation) or SD-free survival rate was not different between patients with or without a family history of SD of a first-degree relative, between patients with or without a family history of multiple SD of a first-degree relative at any age and between patients with or without a family history of SD in first-degree relatives

To compare serum sodium changes and the incidence of transurethral resection (TUR) syndrome after monopolar transurethral resection of the prostate (TURP) and bipolar transurethral resection in saline (TURIS) for symptomatic benign prostatic hyperplasia.Between January 2005 and August 2009, 550 consecutive patients with symptomatic benign prostate hyperplasia underwent TURP, by either a monopolar or bipolar technique. Preoperative and postoperative blood parameters were analysed to compare preoperative and postoperative electrolyte concentrations.Over 56 months, 265 patients underwent a conventional monopolar TURP and 285 patients had a bipolar TURIS (Olympus). Patient profiles regarding age, operation time, resection weight and resection speed were similar in both groups. A drop in sodium of 2.5 mmol/l was measured in the conventional monopolar resection group. The decline of 1.5 mmol/l in the bipolar group, although smaller, was still statistically significant (p = 0.001). With longer operation times (1 h) the difference between the groups became more important (p0.001). Two clinical TUR syndromes were observed in the monopolar group, while none occurred in the bipolar group.Bipolar TURP in saline is a safe technique and obviates the risk of TUR syndrome. Repeated serum analysis of electrolytes after TURIS can be omitted.

PURPOSE: To compare the incidence of urethral strictures after monopolar transurethral resection of the prostate (TURP) and bipolar transurethral resection in saline (TURIS) for symptomatic benign prostatic hyperplasia. PATIENTS AND METHODS: Between January 2005 and January 2009, 518 patients with symptomatic benign prostate hyperplasia underwent either monopolar or bipolar resection. In a randomized trial, the incidence of urethral strictures after both treatment modalities was analyzed. RESULTS: Over 48 months, 255 patients were treated with conventional TURP and 263 patients with TURIS. Patient related, operation, and hospitalization characteristics were similar in both groups. After a mean follow-up of 32.1 months (range 50-7 months), the incidence of urethral strictures was 2.4% in the TURP group. After a comparable period of 31.4 months (range 50-7 months), the incidence in the TURIS group was 1.5%. No statistically significant difference was obtained (P = 0.539). These values were compared with the results of other randomized controlled trials with the same or other bipolar technology. No statistically significant difference in urethral structures was noticed between monopolar and bipolar resections (P = 0.739). CONCLUSIONS: With a stricture incidence of 1.5%, bipolar transurethral prostate resection has a low stricture rate, comparable with monopolar TURP (2.4%).

The present study is a follow-up of the research conducted by Jason, Fennell et al. (1995, 1999, 2000) on a multistage theory for chronic fatigue syndrome (CFS). This multistage model is a very promising method for the evaluation of patients suffering from CFS and could facilitate the appropriate selection of various psychosocial therapies that improve the patient's ability to cope with their illness. Four predictive factors emerged with moderate to excellent reliability. A Spearman's rank correlation revealed positive correlations between our four-factor model and the three-factor model identified by Jason et al. (1999). A correlation matrix between the dimensional psychological investigation and the Fennell Phases revealed characteristics as suggested by previous research. Biological parameters varied over the different phases suggesting an important interaction between body and psyche.

The present study is a follow-up of the research conducted by Jason, Fennell et al. (1995,1999, 2000) on a multistage theory for chronic fatigue syndrome (CFS). This multistage model is a very promising method for the evaluation of patients suffering from CFS and could facilitate the appropriate selection of various psychosocial therapies that improve the patient's ability to cope with their illness. Four predictive factors emerged with moderate to excellent reliability. A Spearman's rank correlation revealed positive correlations between our four-factor model and the three-factor model identified by Jason et al. (1999). A correlation matrix between the dimensional psychological investigation and the Fennell Phases revealed characteristics as suggested by previous research. Biological parameters varied over the different phases suggesting an important interaction between body and psyche.

Prevalence of Mycoplasma species infections in chronic fatigue syndrome (CFS) has been extensively reported in the scientific literature. However, all previous reports highlighted the presence of Mycoplasmas in American patients. In this prospective study, the presence of Mycoplasma fermentans, M. penetrans, M. pneumoniae and M. hominis in the blood of 261 European CFS patients and 36 healthy volunteers was examined using forensic polymerase chain reaction. One hundred and seventy-nine (68.6%) patients were infected by at least one species of Mycoplasma, compared to two out of 36 (5.6%) in the control sample (P0.001). Among Mycoplasma-infected patients, M. hominis was the most frequently observed infection (n=96; 36.8% of the overall sample), followed by M. pneumoniae and M. fermentans infections (equal frequencies; n=67; 25.7%). M. penetrans infections were not found. Multiple mycoplasmal infections were detected in 45 patients (17.2%). Compared to American CFS patients (M. pneumoniaeM. hominisM. penetrans), a slightly different pattern of mycoplasmal infections was found in European CFS patients (M. hominisM. pneumoniae, M. fermentansz.Gt;M. penetrans).

[Extract] Despite a number of large randomised trials (with more underway) the management of small abdominal aortic aneurysms remains controversial.1–3 In this issue of the European journal of vascular and endovascular surgery Vega de Ceniga and colleagues report on the growth rate of abdominal aortic aneurysms measuring !5 cm in maximum diameter followed for a mean of four and half years.4 The authors divide the patients into two groups with aortic diameters measuring 3–3.9 cm (nZ246) and 4–4.9 cm (nZ106) imaged by annual ultrasound and 6-monthly CT, respectively. The authors report that the larger aneurysms grow at over twice the rate of smaller aneurysms (4.7 compared to 2.1 mm/year) and using Kaplan–Meier analysis estimated that 56 and 82% compared to 2 and 18% of aortas reached 5 cm diameter by 2 and 5 years, respectively.4

Belgium is among the European countries that are the most affected by allergic rhinitis. Pollen grains and fungal spores represent important triggers of symptoms. However, few studies have investigated their real link with disease morbidity over several years. Based on aeroallergen counts and health insurance datasets, the relationship between daily changes in pollen, fungal spore concentrations and daily changes in reimbursable systemic antihistamine sales has been investigated between 2005 and 2011 in the Brussels-Capital Region. A Generalized Linear Model was used and adjusted for air pollution, meteorological conditions, flu, seasonal component and day of the week. We observed an augmentation in drug sales despite no significant increase in allergen levels in the long term. The relative risk of buying allergy medications associated with an interquartile augmentation in pollen distributions increased significantly for Poaceae, Betula, Carpinus, Fraxinus and Quercus. Poaceae affected the widest age group and led to the highest increase of risk which reached 1.13 (95% CI [1.11-1.14]) among the 19- to 39-year-old men. Betula showed the second most consistent relationship across age groups. Clear identification of the provoking agents may improve disease management by customizing prevention programmes. This work also opens several research perspectives related to impact of climate modification or subpopulation sensitivity.

We performed a retrospective study on 163 subjects suffering from rheumatic fever (16), rheumatoid arthritis (36), lupus erythematosus (17), gout (21), arthrosis (50) and osteomyelitis (23). The number of variables evaluated was 39. These were all of a general biochemical and haematological nature. A feature reduction resulted in sixteen variables that matched well with those known from the literature. Linear discriminant analysis yielded poor results in classifying the six disease categories (with 18 variables 61.8%). A reduction to three disease categories improved the classification results remarkably. This, and the excellent discriminating power between patients and the reference group, shows that the selected variables are illustrative only for general clinical pictures, such as infection, and not for the desired differential diagnosis.

SummaryThe differential diagnosis between multiple myeloma and benign monoclonal gammopathy has been investigated on the basis of a statistical model incorporating simultaneously four parameters, which refer to the cellular monoclonal event. The combination of the amount of bone marrow plasma cells, their monoclonal fraction and the concentration of the monoclonal immunoglobulin in the serum has been proven to give an optimal classification of patients with multiple myeloma and benign monoclonal gammopathy. Symptom free patients belonging to this group, are of special interest for the clinical follow-up, as they present an initial high monoclonal plasma cell mass.

The intrathyroidal stable iodine (ITI) determined in 776 patients chosen at random. Ninety % of these patients presented with nontoxic goiter. Curve-filtering analysis techniques showed a seasonal variation in ITI: an acrophase was found in April/May, a nadir in September/October. The possible relationship of this seasonal variation with the intake of iodine or alimentary antithyroid substances are discussed, as well as possible relationship with variation in chronic TSH stimulation related to ambient temperature.

A retrospective study was performed on 186 subjects suffering from rheumatic fever, rheumatoid arthritis, lupus erythematosus, gout, arthrosis, osteomyelitis and a group of patients with negative rheuma-serology test results but positive joint complaints. The aim was to examine by means of selected variables the group with negative rheuma-serology test results and positive joint complaints. In order to see if these patients were distinct from the other disease categories or were ’precursor’ to one of these disease states. The statistical methods used were: stepwise linear discriminant analysis, k-nearest neighbour method, linear learning machine, hierarchical clustering and principal component analysis.