43 results on '"Heyns, L."'
Search Results
2. Gynecologic Cancers in Pregnancy: Guidelines of an International Consensus Meeting
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Amant, Frédéric, Van Calsteren, Kristel, Halaska, M. J., Beijnen, J., Lagae, L., Hanssens, M., Heyns, L., Lannoo, L., Ottevanger, P., Van den Bogaert, W., Ungar, L., Vergote, I., du Bois, A., Reed, Nicholas, editor, Green, John Alan, editor, Gershenson, David M., editor, Siddiqui, Nadeem, editor, and Connor, Rachel, editor
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- 2011
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3. Optimizing anticancer drug treatment in pregnant cancer patients: pharmacokinetic analysis of gestation-induced changes for doxorubicin, epirubicin, docetaxel and paclitaxel
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van Hasselt, J.G.C., van Calsteren, K., Heyns, L., Han, S., Mhallem Gziri, M., Schellens, J.H.M., Beijnen, J.H., Huitema, A.D.R., and Amant, F.
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- 2014
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4. Gynecologic Cancers in Pregnancy: Guidelines of an International Consensus Meeting
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Amant, Frédéric, primary, Van Calsteren, Kristel, additional, Halaska, M. J., additional, Beijnen, J., additional, Lagae, L., additional, Hanssens, M., additional, Heyns, L., additional, Lannoo, L., additional, Ottevanger, P., additional, Van den Bogaert, W., additional, Ungar, L., additional, Vergote, I., additional, and du Bois, A., additional
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- 2010
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5. Tracheostomy home care: in a resource-limited setting
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Vanker, A, Kling, S, Booysen, J R, Rhode, D, Goussard, P, Heyns, L, and Gie, R P
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- 2012
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6. Cmv Pneumonia in Hiv-Infected Ventilated Infants
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Goussard, P., Kling, S., Gie, R. P., Nel, E. D., Heyns, L., Rossouw, G. J., and Janson, J. T.
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- 2010
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7. In vitro evaluation of the ability of platelet-rich plasma to seal an iatrogenic fetal membrane defect
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Lewi, L., Liekens, D., Heyns, L., Poliard, E., Beutels, E., Deprest, J., and Hoylaerts, M. F.
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- 2009
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8. Breast cancer during pregnancy: a literature review
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Han, S. N., van Calsteren, K., Heyns, L., Mhallem Gziri, M., Amant, F., and Academic Medical Center
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Breast cancer during pregnancy is relatively uncommon. However, the incidence is expected to increase as more women delay childbearing. A challenging situation emerges for all persons involved ‑ patient, family and medical care workers ‑ since two lives are at risk with contradicting priorities. Breast cancer treatment is possible during pregnancy. The treatment plan needs to adhere as closely as possible to standardised protocols for nonpregnant patients, with some considerations to minimize fetal exposure and risks. This concerns mainly limiting radiation exposure and timing of chemotherapy to start in the second trimester. The prognosis of pregnant women does not seem to differ from that of nonpregnant patients when matched for age and stage of the disease. This literature review concentrates on the diagnosis, treatment and outcome of patients diagnosed with breast cancer during pregnancy
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- 2010
9. Optimizing anticancer drug treatment in pregnant cancer patients: pharmacokinetic analysis of gestation-induced changes for doxorubicin, epirubicin, docetaxel and paclitaxel
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Sub Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, van Hasselt, J G C, van Calsteren, K, Heyns, L, Han, S, Mhallem Gziri, M, Schellens, J H M, Beijnen, J H, Huitema, A D R, Amant, F, Sub Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, van Hasselt, J G C, van Calsteren, K, Heyns, L, Han, S, Mhallem Gziri, M, Schellens, J H M, Beijnen, J H, Huitema, A D R, and Amant, F
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- 2014
10. Gynecologic cancers in pregnancy: guidelines of an international consensus meeting
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Amant, F., Calsteren, K. van, Halaska, M.J., Beijnen, J.H., Lagae, L., Hanssens, M., Heyns, L., Lannoo, L., Ottevanger, P.B., Bogaert, W. van den, Ungar, L., and Bois, A. du
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Quality of Care [ONCOL 4] - Abstract
Contains fulltext : 80545.pdf (Publisher’s version ) (Closed access)
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- 2009
11. Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study.
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Amant, F., Calsteren, K. van, Halaska, M.J., Gziri, M.M., Hui, W., Lagae, L., Willemsen, M.A.A.P., Kapusta, L., Calster, B. van, Wouters, H, Heyns, L., Han, S.N., Tomek, V., Mertens, L., Ottevanger, P.B., Amant, F., Calsteren, K. van, Halaska, M.J., Gziri, M.M., Hui, W., Lagae, L., Willemsen, M.A.A.P., Kapusta, L., Calster, B. van, Wouters, H, Heyns, L., Han, S.N., Tomek, V., Mertens, L., and Ottevanger, P.B.
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1 maart 2012, Item does not contain fulltext, BACKGROUND: Chemotherapy for the treatment of maternal cancers during pregnancy has become more acceptable in the past decade; however, the effect of prenatal exposure to chemotherapy on cardiac and neurodevelopmental outcomes of the offspring is still uncertain. We aimed to record the general health, cardiac function, and neurodevelopmental outcomes of children who were prenatally exposed to chemotherapy. METHODS: We did an interim analysis of a multicentre observational cohort study assessing children who were prenatally exposed to maternal cancer staging and treatment, including chemotherapy. We assessed children at birth, at age 18 months, and at age 5-6, 8-9, 11-12, 14-15, or 18 years. We did clinical neurological examinations, tests of the general level of cognitive functioning (Bayley or intelligence quotient [IQ] test), electrocardiography and echocardiography, and administered a questionnaire on general health and development. From age 5 years, we also did audiometry, the Auditory Verbal Learning Test, and subtasks of the Children's Memory Scale, and the Test of Everyday Attention for Children, and we also completed the Child Behavior Checklist. This study is registered with ClinicalTrials.gov, number NCT00330447. FINDINGS: 236 cycles of chemotherapy were administered in 68 pregnancies. We assessed 70 children, born at a median gestational age of 35.7 weeks (range 28.3-41.0; IQR 3.3; 47 women at <37 weeks), with a median follow-up period of 22.3 months (range 16.8-211.6; IQR 54.9). Although neurocognitive outcomes were within normal ranges, cognitive development scores were lower for children who were born preterm than for those born at full term. When controlling for age, sex, and country, the score for IQ increased by an average 11.6 points (95% CI 6.0-17.1) for each additional month of gestation (p<0.0001). Our measurements of the children's behaviour, general health, hearing, and growth corresponded with those of the general population. Cardiac dimensio
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- 2012
12. Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and the neonatal outcomes.
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Calsteren, K. van, Heyns, L., Smet, F. De, Eycken, L. Van, Gziri, M.M., Gemert, W. Van, Halaska, M., Vergote, I., Ottevanger, N., Amant, F., Calsteren, K. van, Heyns, L., Smet, F. De, Eycken, L. Van, Gziri, M.M., Gemert, W. Van, Halaska, M., Vergote, I., Ottevanger, N., and Amant, F.
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Contains fulltext : 88224.pdf (publisher's version ) (Open Access), PURPOSE: The aim of this study was to assess the management and the obstetrical and neonatal outcomes of pregnancies complicated by cancer. PATIENTS AND METHODS: In an international collaborative setting, patients with invasive cancer diagnosed during pregnancy between 1998 and 2008 were identified. Clinical data regarding the cancer diagnosis and treatment and the obstetric and neonatal outcomes were collected and analyzed. RESULTS: Of 215 patients, five (2.3%) had a pregnancy that ended in a spontaneous miscarriage and 30 (14.0%) pregnancies were interrupted. Treatment was initiated during pregnancy in 122 (56.7%) patients and postpartum in 58 (27.0%) patients. The most frequently encountered cancer types were breast cancer (46%), hematologic malignancies (18%), and dermatologic malignancies (10%). The mean gestational age at delivery was 36.3 +/- 2.9 weeks. Delivery was induced in 71.7% of pregnancies, and 54.2% of children were born preterm. In the group of patients prenatally exposed to cytotoxic treatment, the prevalence of preterm labor was increased (11.8%; P = .012). Furthermore, in this group a higher proportion of small-for-gestational-age children (birth weight below 10th percentile) was observed (24.2%; P = .001). Of all neonates, 51.2% were admitted to a neonatal intensive care unit, mainly (85.2%) because of prematurity. There was no increased incidence of congenital malformations. CONCLUSION: Pregnant cancer patients should be treated in a multidisciplinary setting with access to maternal and neonatal intensive care units. Prevention of iatrogenic prematurity appears to be an important part of the treatment strategy.
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- 2010
13. Pharmacokinetics of chemotherapeutic agents in pregnancy: a preclinical and clinical study.
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Calsteren, K. van, Verbesselt, R., Ottevanger, N., Halaska, M., Heyns, L., Bree, R. de, Bruijn, E. de, Chai, D., Delforge, M., Noens, L., Renard, V., Witteveen, E., Rob, L., Hoon, J. de, Amant, F., Calsteren, K. van, Verbesselt, R., Ottevanger, N., Halaska, M., Heyns, L., Bree, R. de, Bruijn, E. de, Chai, D., Delforge, M., Noens, L., Renard, V., Witteveen, E., Rob, L., Hoon, J. de, and Amant, F.
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1 oktober 2010, Contains fulltext : 89768.pdf (publisher's version ) (Closed access), OBJECTIVE: To determine the impact of physiologic changes of pregnancy on pharmacokinetics of chemotherapeutic agents. DESIGN: A preclinical and a clinical case-control trial. SETTING: Institute of Primate Research Nairobi and collaborating hospitals in Belgium, the Netherlands and Czech Republic. POPULATION: Pregnant and nonpregnant women and baboons receiving chemotherapy. METHODS: Chemotherapy pharmacokinetics was compared between the pregnant and nonpregnant state. Standard-dosed chemotherapy regimens were administered in pregnant and nonpregnant baboons/women, followed by serial blood samplings. Drug plasma levels were determined using high performance liquid chromatography and atomic absorption spectrometry. MAIN OUTCOME MEASURES: Area under the curve (AUC), maximal plasma concentration, terminal elimination half-life, clearance and distribution volume of each drug in pregnant and nonpregnant state. RESULTS: Intraindividual comparative pharmacokinetic data were obtained for doxorubicin and paclitaxel/platinum in three and two baboons, respectively. In the clinical trial, two patients were exposed to doxorubicin and one patient was exposed to paclitaxel/platinum during and after pregnancy. Furthermore, a pooled analysis was performed based on 16 cycles of pregnant and 11 cycles of nonpregnant women. Numbers of pregnant/nonpregnant patients were 5/2, 7/5, 4/4 and 2/2 for paclitaxel, doxorubicin, epirubicin and platinum, respectively. For all drugs tested in the preclinical and clinical study, a decreased AUC and maximal plasma concentration and an increased distribution volume and clearance were observed in pregnancy. CONCLUSIONS: Although numbers were too small for statistical significance, pregnancy-associated physiologic alterations appear to lead to a decrease in plasma exposure of chemotherapeutic drugs. The importance of long-term follow-up of women treated with chemotherapy during pregnancy is underscored.
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- 2010
14. Transplacental transfer of anthracyclines, vinblastine, and 4-hydroxy-cyclophosphamide in a baboon model
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Van Calsteren, K., primary, Verbesselt, R., additional, Beijnen, J., additional, Devlieger, R., additional, De Catte, L., additional, Chai, D.C., additional, Van Bree, R., additional, Heyns, L., additional, de Hoon, J., additional, and Amant, F., additional
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- 2010
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15. Tracheostomy home care: in a resource-limited setting
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Vanker, A, primary, Kling, S, additional, Booysen, J R, additional, Rhode, D, additional, Goussard, P, additional, Heyns, L, additional, and Gie, R P, additional
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- 2010
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16. In vitroevaluation of the ability of platelet-rich plasma to seal an iatrogenic fetal membrane defect
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Lewi, L., primary, Liekens, D., additional, Heyns, L., additional, Poliard, E., additional, Beutels, E., additional, Deprest, J., additional, and Hoylaerts, M. F., additional
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- 2009
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17. 135 Intravenous antibiotic treatment in children with cystic fibrosis: home versus hospital setting
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Proesmans, M., primary, Heyns, L., additional, Moons, P., additional, Havermans, T., additional, and De Boeck, K., additional
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- 2007
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18. Evangelisasie in die Nederduitsch Hervormde Kerk van Afrika
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Schutte, Philippus Jacobus Wilhelmus, Heyns, L. M. (Louis Michiel), 1934, Schutte, Philippus Jacobus Wilhelmus, and Heyns, L. M. (Louis Michiel), 1934
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Evangelisasiewerk het in die Hervormde Kerk nog nooit regtig van die grand af gekom nie. Jaar na jaar word daar op vergaderings verslag gedoen dat daar in die meeste gemeentes op hierdie gebied nie·veel gebeur nie. Hierdie studie het gevra na die werklike stand van sake tans in die Kerk; die paradigmaverskuiwing wat besig is om plaas te vind; en na 'n moontlike nuwe teorie om die huidige praxis mee te probeer wysig. Die resultate van die ondersoek het die volgende opgelewer: - Tans is daar ongeveer 15% van die gemeentes wat hoegenaamd op 'n georganiseerde wyse by evangelisasiewerk betrokke is; - 0,38% van die totale lidmaattal van die Kerk is toegerus vir evangelisasiewerk, en gebruik hulle opleiding; - Die Kerk het egter reeds die regte besluite in sy vergaderings geneem, soos bv dat die gemeente die evangelis is en dat elke lidmaat betrokke moet wees. Hierdie besluite moet geimplementeer word. Myns insiens kan dit alleen gebeur wanneer daar op gemeentevlak met harde teologiese arbeid deelgeneem word aan die huidige gesprek random 'n prakties-teologiese ekklesiologie., When the annual reports of the Hervormde Kerk are being studied, it becomes clear that the church finds itself in a crisis. The essence of this crisis manifests itself in the fact that the church is not evangelising the world as it is suppose to do. This study was undertaken to ask what is really going on in the field of evangelisation in the church; to look at the paradigm shift that is taken place at the moment; and, to ask for a new theory to try to alter the current praxis. The results of this study are: - Only 15% of the congregations of the church are involved in organised evangelisation activities; - 0,38% of churchmembers are trained and are using their training to do evangelisation; - The church has already realised that the congregation is suppose to be the evangelist and that every member must be involved in this ministry. But it has not yet come from the ground. This can only happen, I believe, when the congregation starts to participate in finding an ecclesiology for the time and context that we are living in.
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- 1998
19. Diens as kommunikasievoertuig van die evangelie in 'n post-apartheid samelewing
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Kruger, Johannes Stephanus, Heyns, L. M. (Louis Michiel), 1934, Kruger, Johannes Stephanus, and Heyns, L. M. (Louis Michiel), 1934
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Apartheid is verby. Die nuwe Suid-Afrika het gekom. Maar met die koms van die nuwe Suid-Afrika het die oue nie verdwyn nie. Die oue van die apartheidsverlede is nog met ons. Ons is die erfgename van apartheid en dra die letsels van apartheid nog saam met ons. Armoede, werkloosheid, behuisingsnood en geweld en misdaad is deel van die post-apartheid samelewing en kan nie weggewens word nie. Die kerk is geroep om die evangelie in die samelewing aan alle mense te kommunikeer. In hierdie kommunikasie moet die evangelie in 'n post-apartheid samelewing gesien en ervaar kan word in dade van diens. Daarom staan dade van diens in hierdie studie sentraal. Hierdie studie handel dus oor die diens van gelowiges wat 'n kommunikasievoertuig is van die evangelie in 'n post-apartheid samelewing. Vanuit die nood en behoeftes van mense in die post-apartheid samelewing is twee dade van diens geidentifiseer wat sentraal staan in die kommunikasie van die evangelie. Dit is bemagtiging en versoening. Omdat 'n groot dee! van die samelewing in die verlede geen mag op ekonomiese en politieke terreine gehad het nie, is dade van diens wat mense bemagtig noodsaaklik. In hierdie bemagtiging speel ekonomiese-, sosiale- en psigologiese bemagtiging 'n groot rol. En omdat mense deur die verlede van apartheid op grond van velkleur van mekaar geskei en geisoleer is, vra dit dat mense met mekaar versoen word. In die proses om versoening tussen mense te bewerkstellig speel verantwoordelikheid, erkenning van apartheidskuld, restitusie, regstellende aksie, die luister na mense se stories en vergifnis 'n baie belangrike rol. Vanuit 'n geloofsperspektief is die
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- 1998
20. Die gemeenteboumodel van Kenon L Callahan : die prakties- teologiese implikasie vir die gemeenskap van gelowiges in die Nederduitsch Hervormde Kerk van Afrika
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Meyer, Lukas Johannes., Heyns, L. M. (Louis Michiel), 1934, Meyer, Lukas Johannes., and Heyns, L. M. (Louis Michiel), 1934
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Talle Christelike kerke in Suid- Afrika, onder meer die Nederduitsch Hervormde Kerk van Afrika, verkeer tans in 'n krisis. Die lidmaattalle toon 'n drasties dalende tendens, minder kinders word gedoop en minder Iidmate le belydenis van geloof af Hierdie krisis, asook die invloed van die postmodernisme op die hedendaagse mens, word aan die hand van die handelingswetenskaplike benadering ondersoek. Die gemeenteboumodel van Kenon L Callahan word gebruik, en daar word gevra tot watter mate hierdie model op die Nederduitsch Hervormde Kerk van Afrika toegepas kan word. Wat sal die prakties- teologiese implikasies daarvan op die gemeenskap van gelowiges in die Nederduitsch Hervormde Kerk van Afrika wees? Die resultaat van die studie is dat die Nederduitsch Hervormde Kerk van Afrika wel met vrug gebruik kan maak van Callahan se model, met inagneming van die kerk se bestaande struktuur, tradisie en geskiedenis. In die toepassing van die model sal daar nuwe, ongekende eise aan die kerk gestel word., Numerous christian churches in South Africa, including the Dutch Reformed Church of Africa is currently experiencing a crisis. Membership is declining, less children are baptised While new and unknown demands will be made on the church, new and exciting opportunities will also be met each year, and less members are confirmed. This crisis, together with the influence of the post- modernism, is explored using an operational science approach, and a possible solution to this problem is sought. The church growth model ofK.L. Callahan is used to facilitate this research. The applicability of this model to the Dutch Reformed Church of Africa is explored, together with the practical theological implications thereof on the holy community. The result of the study is that the Dutch Reformed Church of Africa can apply Callahan' s model to great affect, while cognisance should be taken of the church's own structure, tradition and history.
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- 1997
21. Gemeentebou in diens van die Koninkryk van God
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Havemann, Garfield Garbet, Heyns, L. M. (Louis Michiel), 1934, Havemann, Garfield Garbet, and Heyns, L. M. (Louis Michiel), 1934
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Gemeentebou funksioneer binne die raamwerk van die koninkryk van God en nie slegs binne 'n gemeente nie. Om hierdie rede word die ondersoekvraag gestel naamlik wanneer staan gemeentebou in diens van die koninkryk van God. Dit is 'n tersaaklike vraag in die lig van die feit dat gemeentebouliteratuur die opbou en by geleentheid ook die uitbou van die gemeente beskryf maar opbou met die oog op die samelewing geniet nie die nodige aandag nie. Die koninkryk van God staan sentraal in die kosmos. Om Sy koningsheerskappy op aarde te vestig gebruik God die gemeente. Daarom vind die gemeente sy oorsprong in God; dit beskik oor 'n koninkryksbepaalde identiteit; dit bestaan met 'n koninkryksdienstige doel; sy funksionering realiseer die gemeente se koninkryksdiens en dit bestaan binne 'n bepaalde konteks om tekens van die Koninkryk daar op te rig. Die koninkryk van God bepaal alle gemeentehandelinge en dit dien as korrektief daarop. Gemeentebou vestig en bevorder hierdie koninkryksperspektief binne elke handeling van die gemeente. Binne die raamwerk van die koninkryk word aspekte vir die aandag van verruimde gemeentebou in hierdie studie geidentifiseer (antropologie; ekonomie; ekologie; strukture). 'n Positiewe verband tussen gemeentebou en volle werklikheid van die koninkryk van God bou gemeentesentriese bouwerk uit tot effektiewe en omvattende kommunikatiewe handelinge in diens van die Koninkryk binne die gemeentekonteks. Hierdie verhouding tussen die koninkryk, die gemeente en die samelewing word deur Christus bepaal. Om dit op die mees effektiewe wyse te realiseer, is drie dimensies in hierdie studie geidentifiseer wat deel van gemeentebou behoort uit te maak (basisteorie). Gemeentebou dien die koninkryk wanneer dit lidmate se verstaan van die gemeente verruim om dit in toto in koninkryksdiens te stel; wanneer dit die gemeente se vermoe om in diens van die koninkryk te staan realiseer, en wanneer die gemeente opgebou word om met sy konteks rekening te hou. Gemeentebou staan, The building up of the congregation functions within the framework of the Kingdom of God and not only within the congregation. For this reason the question is raised i.e. when does the building up of the congregation serves the Kingdom of God. It is relevant in view of the fact that the literature about the building up of the congregation covers the building up of the congregation, but the emphasis on the community does not enjoy the necessary attention it deserves. Centrally within the cosmos the Kingdom of God exists. To establish His Kingdom on earth, God uses the congregation. Thus "the origins of the congregation is found in God; its identity is determined by the Kingdom; it exists for Kindompurposes; its functioning is aimed at serving the Kingdom, and it exists within a certain context where it should erect signs of the kingdom of God. The kingdom of God determines all congregational activities. The building up of the congregation establishes and promotes this kingdomperspective within every aspect of its actions. In this study certain aspects have been identified to broaden the scope of the building up of the congregation within the framework of the kingdom (i.e. anthropology; economy; ecology; structures). When the building up of the congregation is understood from a kingdomperspective, congregation-centered upbuilding developes into effective and comprehensive communicative actions in the service of the kingdom. The relationship between the kingdom, the congregation and the community is determined by Christ. In this study three dimensions are identified which ought to constitute the building up of the congregation for this to be realised most effectively. It serves the kingdom as it increases the congregations' understanding of its total service of the kingdom; as it realizes the church's service of the.kingdom through continuing change, and as it takes the context of the congregation sufficiently into consideration. An empirical research into the views of
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- 1996
22. Ghetto of woestyntog? : 'n ondersoek na die geloofsbeeld in die kategesemateriaal van die Nederduitse Gereformeerde Kerk
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Gerber, J. J., Heyns, L. M. (Louis Michiel), 1934, Gerber, J. J., and Heyns, L. M. (Louis Michiel), 1934
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Geloof wat in die kategese as deel van 'n to tale geloofsvormingsproses op die tafel kom, moet holisties-ekosistemies verstaan word met die 'hic et nunc'- relevansie daarvan as 'n kwalifiserende maatstaf. Geloof so gesien, behoort in die kategesemateriaal van die Nederduitse Gereformeerde Kerk na vore te kom. Die grootste deel van die studie is gewy aan die bree teoretisering in holisties-ekosistemiese perspektief. Vanuit 'n wetenskapsteoretiese vertrekpunt is 'n eie prakties-teologiese teorie oor geloof ontwerp wat geloof enersyds sien as die dinamiese interaksie van gawe, inhoud en respons, en andersyds as 'n aantal perspektiewe daarop. Hierdie teorie het as vertrekpunt gedien om sekere van die kontekste waarbinne geloof funksioneer, te beskryf, naamlik die koninkryk van God, die samelewing, die gemeente, die kategese, die adolessent, die jeugsubkultuur en die skool. In hierdie beskrywing is 'n omvattende teorie oor die kategese daargestel wat dit holisties-ekosistemies sien. Deur middel van inhoudsanalise is fasette van die teoriee getoets aan die lesse in die handboeke van die kategete wat met die adolessente in standerd 5 tot 8 werk. Daar is bevind dat die geloofsbeeld wat na vore kom steriel kognitief-vertikaal is. Oor 'n tydperk van meer as twintig jaar is weinig samelewingsrelevante kwessies aangeraak. Die belangwekkende dokumente Ras, Volk en Nasie en Kerk en Samelewing het nie gefunksioneer nie. In terme van die teorie oor geloof fasiliteer die kategesemateriaal nie relevante geloof midde-in die wereld waarin die adolessente moet glo nie. Dit het ook geblyk dat die inhoudsanalise as werkwyse en die meetinstrument wat ontwerp is, bruikbaar was. Die studie formuleer vanuit die teoriee en die empiriese ondersoek 'n aantal perspektiewe van waaruit die kategese en die lesmateriaal daarvan die kritiese hantering van die verhouding kognitief-affektief-konatief en die gerigtheid individueel-vertikaal, horisontaal-ekklesiaal en horisontaal-sosiaal kan hanteer met d, Faith which is handled in catechesis as part of the total process of the formation of faith should be understood in a holistic-ecosystemic way with its 'hic et nunc' relevance as a qualifying criterion. It should also appear in this form in the material for catechesis in the Nederduitse Gereformeerde Kerk. The greater part of the study focuses on broad theorising from a holistic-ecosystemic perspective. An independent practical-theological theory on faith is developed from a scientific-theoretical basis. This theory sees faith as a dynamic interaction of gift, content and response on the one hand and a number of different perspectives on the other. It serves as the point of departure for describing some of the contexts in which faith functions, namely the kingdom of God, society, the community, catechesis, the adolescent, the youth subculture and the school. In the process a comprehensive theory about catechesis is developed which sees it holistically ecosystemically. Content analysis is used to test aspects of the theories against the lessons in the manuals for catechists working with adolescents in standards 5 to 8. The resultant image of faith is found to be cognitively-vertically sterile. Over a period of more than twenty years few socially relevant issues were touched on. The important documents Ras, Volk en Nasie and Kerk en Samelewing did not function. In terms of the theory of faith this material for catechesis does not facilitate relevant faith in the world in which the adolescent has to have faith. It is also apparent that content analysis as a method and the measuring instrument used were suitable. Using the theories and the empirical investigation the study formulates a number of perspectives from which catechesis and the lesson material can deal with the critical handling of the relationship cognitively-affectively-conatively and the directedness individually-vertically, horizontally-ecclesially and horizontally-socially so that the church does not impr
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- 1994
23. A describing-function based criterion for a route to chaos in autonomous nonlinear systems
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HEYNS, L. J., primary and KRÜGER, J. J., additional
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- 1995
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24. Describing Function-based Analysis of a Nonlinear Hydraulic Transmission Line
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Heyns, L. J., primary and Kruger, J. J., additional
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- 1992
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25. Management of cancer during pregnancy emphasizing maternal and fetal effects
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Gziri, M. M., Calsteren, K., Heyns, L., Han, S., Frédéric Debiève, and Amant, F.
26. TREATMENT OF BREAST CANCER DURING PREGNANCY: AN OBSERVATIONAL STUDY.
- Author
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Loibl, S., Han, S. N., von Minckwitz, G., Bontenbal, M., Ring, A., Giermek, J., Fehm, T., Van Calsteren, K., Linn, S. C., Schlehe, B., Gziri, M. M., Westenend, P. J., Müller, V., Heyns, L., Rack, B., Van Calster, B., Harbeck, N., Lenhard, M., Halaska, M. J., and Kaufmann, M.
- Subjects
BREAST cancer treatment ,CANCER in pregnancy ,BREAST cancer diagnosis ,RETROSPECTIVE studies ,DELIVERY (Obstetrics) ,CLINICAL trials ,FOLLOW-up studies (Medicine) - Abstract
Copyright of Meme Sagligi Dergisi / Journal of Breast Health is the property of Turkish Federation of Breast Diseases Associations and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2012
27. Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study.
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Amant F, Van Calsteren K, Halaska MJ, Gziri MM, Hui W, Lagae L, Willemsen MA, Kapusta L, Van Calster B, Wouters H, Heyns L, Han SN, Tomek V, Mertens L, and Ottevanger PB
- Abstract
BACKGROUND: Chemotherapy for the treatment of maternal cancers during pregnancy has become more acceptable in the past decade; however, the effect of prenatal exposure to chemotherapy on cardiac and neurodevelopmental outcomes of the offspring is still uncertain. We aimed to record the general health, cardiac function, and neurodevelopmental outcomes of children who were prenatally exposed to chemotherapy. METHODS: We did an interim analysis of a multicentre observational cohort study assessing children who were prenatally exposed to maternal cancer staging and treatment, including chemotherapy. We assessed children at birth, at age 18 months, and at age 5-6, 8-9, 11-12, 14-15, or 18 years. We did clinical neurological examinations, tests of the general level of cognitive functioning (Bayley or intelligence quotient [IQ] test), electrocardiography and echocardiography, and administered a questionnaire on general health and development. From age 5 years, we also did audiometry, the Auditory Verbal Learning Test, and subtasks of the Children's Memory Scale, and the Test of Everyday Attention for Children, and we also completed the Child Behavior Checklist. This study is registered with ClinicalTrials.gov, number NCT00330447. FINDINGS: 236 cycles of chemotherapy were administered in 68 pregnancies. We assessed 70 children, born at a median gestational age of 35·7 weeks (range 28·3-41·0; IQR 3·3; 47 women at <37 weeks), with a median follow-up period of 22·3 months (range 16·8-211·6; IQR 54·9). Although neurocognitive outcomes were within normal ranges, cognitive development scores were lower for children who were born preterm than for those born at full term. When controlling for age, sex, and country, the score for IQ increased by an average 11·6 points (95% CI 6·0-17·1) for each additional month of gestation (p<0·0001). Our measurements of the children's behaviour, general health, hearing, and growth corresponded with those of the general population. Cardiac dimensions and functions were within normal ranges. We identified a severe neurodevelopmental delay in both members of one twin pregnancy. INTERPRETATION: Fetal exposure to chemotherapy was not associated with increased CNS, cardiac or auditory morbidity, or with impairments to general health and growth compared with the general population. However, subtle changes in cardiac and neurocognitive measurements emphasise the need for longer follow-up. Prematurity was common and was associated with impaired cognitive development. Therefore, iatrogenic preterm delivery should be avoided when possible. FUNDING: Research Foundation-Flanders; Research Fund-K U Leuven; Agency for Innovation by Science and Technology; Stichting tegen Kanker; Clinical Research Fund-University Hospitals Leuven; and Belgian Cancer Plan, Ministery of Health. [ABSTRACT FROM AUTHOR]
- Published
- 2012
28. Leopard Density Estimation within an Enclosed Reserve, Namibia Using Spatially Explicit Capture-Recapture Models.
- Author
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Noack J, Heyns L, Rodenwoldt D, and Edwards S
- Abstract
The establishment of enclosed conservation areas are claimed to be the driving force for the long-term survival of wildlife populations. Whilst fencing provides an important tool in conservation, it simultaneously represents a controversial matter as it stops natural migration processes, which could ultimately lead to inbreeding, a decline in genetic diversity and local extinction if not managed correctly. Thus, wildlife residing in enclosed reserves requires effective conservation and management strategies, which are strongly reliant on robust population estimates. Here, we used camera traps combined with the relatively new class of spatially explicit capture-recaptured models (SECR) to produce the first reliable leopard population estimate for an enclosed reserve in Namibia. Leopard density was estimated at 14.51 leopards/100 km
2 , the highest recorded density in Namibia to date. A combination of high prey abundance, the absence of human persecution and a lack of top-down control are believed to be the main drivers of the recorded high leopard population. Our results add to the growing body of literature which suggests enclosed reserves have the potential to harbour high densities and highlight the importance of such reserves for the survival of threatened species in the future., Competing Interests: The authors declare no conflict of interest.- Published
- 2019
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29. Tongue cancers during pregnancy: Case reports and review of literature.
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Mhallem Gziri M, Han SN, Van Calsteren K, Heyns L, Delaere P, Nuyts S, Van den Heuvel F, Cheron AC, Fossion E, Van den Weyngaert D, Lok C, and Amant F
- Subjects
- Adult, Chemoradiotherapy, Female, Humans, Pregnancy, Pregnancy Complications, Neoplastic diagnosis, Tongue Neoplasms diagnosis, Treatment Outcome, Pregnancy Complications, Neoplastic therapy, Tongue pathology, Tongue Neoplasms therapy
- Abstract
Background: Due to its rarity, there is no standard treatment for tongue cancers that concur with pregnancy. Treatment depends on the stage of cancer, gestational age of the pregnancy, and the wish of the mother to maintain the pregnancy. The purpose of this study was to review the literature and to report 5 new cases., Methods: Twelve cases of tongue cancer during pregnancy were already reported between 1987 and 2009. We report 5 new cases and first administration of concomitant radiochemotherapy for tongue cancer., Results: Median age of the patients was 29 years, 65% of diagnoses were made after the first trimester of pregnancy. Different treatment modalities are used to treat tongue cancer during pregnancy., Conclusion: We hypothesize that tongue cancer treatment adhering to standard protocols provides the best guarantee to cure the mother. Based on a growing experience and insight taking fetal safety into consideration, the available data suggest that standard treatment is a realistic option., (Copyright © 2011 Wiley Periodicals, Inc.)
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- 2013
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30. Chemotherapy during pregnancy: effect of anthracyclines on fetal and maternal cardiac function.
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Gziri MM, Debiève F, DE Catte L, Mertens L, Barrea C, VAN Calsteren K, Han SN, Heyns L, and Amant F
- Subjects
- Belgium, Case-Control Studies, Female, Fetal Heart diagnostic imaging, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Cardiovascular diagnostic imaging, Pregnancy Outcome, Prospective Studies, Ultrasonography, Prenatal, Anthracyclines adverse effects, Antibiotics, Antineoplastic adverse effects, Fetal Heart drug effects, Neoplasms drug therapy, Pregnancy Complications, Cardiovascular chemically induced
- Abstract
Chemotherapy and especially anthracyclines are associated to cardiotoxicity. To assess this potential risk during pregnancy a clinical case-control trial was conducted. Maternal cardiac function, fetal Doppler and fetal cardiac function were evaluated before and after chemotherapy. Maternal cardiac function was assessed by echocardiography before and after the third cycle of anthracyclines and compared with a control group of 10 non-pregnant women matched for age, type of cancer and anthracycline treatment. Ten fetuses exposed to chemotherapy were compared with 10 control fetuses matched for gestational age and gender. Biometry, amniotic fluid index, fetal Doppler and cardiac function were assessed before and after each cycle of chemotherapy. In all, 108 fetal ultrasounds scans were performed before and after 36 cycles of chemotherapy. Anthracycline exposure did not result in acute maternal and fetal cardiac dysfunction in this small cohort study., (© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.)
- Published
- 2012
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31. Treatment of breast cancer during pregnancy: an observational study.
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Loibl S, Han SN, von Minckwitz G, Bontenbal M, Ring A, Giermek J, Fehm T, Van Calsteren K, Linn SC, Schlehe B, Gziri MM, Westenend PJ, Müller V, Heyns L, Rack B, Van Calster B, Harbeck N, Lenhard M, Halaska MJ, Kaufmann M, Nekljudova V, and Amant F
- Subjects
- Adult, Apgar Score, Breast Neoplasms diagnosis, Breast Neoplasms pathology, Breast Neoplasms surgery, Carcinoma, Ductal diagnosis, Carcinoma, Ductal drug therapy, Carcinoma, Ductal pathology, Carcinoma, Ductal secondary, Carcinoma, Lobular diagnosis, Carcinoma, Lobular drug therapy, Carcinoma, Lobular pathology, Carcinoma, Lobular secondary, Carcinoma, Lobular surgery, Cohort Studies, Delivery, Obstetric statistics & numerical data, Disease-Free Survival, Europe, Female, Humans, Incidence, Infant, Newborn, Lymphatic Metastasis, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Organ Preservation, Pregnancy, Pregnancy Complications, Neoplastic drug therapy, Registries, Retrospective Studies, Young Adult, Abnormalities, Drug-Induced epidemiology, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Birth Weight drug effects, Breast Neoplasms drug therapy, Infant, Newborn, Diseases chemically induced, Infant, Newborn, Diseases epidemiology, Pregnancy Outcome epidemiology
- Abstract
Background: Little is known about the treatment of breast cancer during pregnancy. We aimed to determine whether treatment for breast cancer during pregnancy is safe for both mother and child., Methods: We recruited patients from seven European countries with a primary diagnosis of breast cancer during pregnancy; data were collected retrospectively if the patient was diagnosed before April, 2003 (when the registry began), or prospectively thereafter, irrespective of the outcome of pregnancy and the type and timing of treatment. The primary endpoint was fetal health for up to 4 weeks after delivery. The registry is ongoing. The study is registered with ClinicalTrials.gov, number NCT00196833., Findings: From April, 2003, to December, 2011, 447 patients were registered, 413 of whom had early breast cancer. Median age was 33 years (range 22-51). At the time of diagnosis, median gestational age was 24 weeks (range 5-40). 197 (48%) of 413 women received chemotherapy during pregnancy with a median of four cycles (range one to eight). 178 received an anthracycline, 15 received cyclophosphamide, methotrexate, and fluorouracil, and 14 received a taxane. Birthweight was affected by chemotherapy exposure after adjustment for gestational age (p=0·018), but not by number of chemotherapy cycles (p=0·71). No statistical difference between the two groups was observed for premature deliveries before the 37th week of gestation. 40 (10%) of 386 infants had side-effects, malformations, or new-born complications; these events were more common in infants born before the 37th week of gestation than they were in infants born in the 37th week or later (31 [16%] of 191 infants vs nine [5%] of 195 infants; p=0·0002). In infants for whom maternal treatment was known, adverse events were more common in those who received chemotherapy in utero compared with those who were not exposed (31 [15%] of 203 vs seven [4%] of 170 infants; p=0·00045). Two infants died; both were exposed to chemotherapy and delivered prematurely, but both deaths were thought not to be related to treatment. Median disease-free survival for women with early breast cancer was 70·6 months (95% CI 62·1-105·5) in women starting chemotherapy during pregnancy and 94·4 months (lower 95% CI 64·4; upper 95% CI not yet reached) in women starting chemotherapy after delivery (unadjusted hazard ratio 1·13 [95% CI 0·76-1·69]; p=0·539)., Interpretation: Although our data show that infants exposed to chemotherapy in utero had a lower birthweight at gestational age than did those who were unexposed, and had more complications, these differences were not clinically significant and, since none of the infants was exposed to chemotherapy in the first trimester, were most likely related to premature delivery. Delay of cancer treatment did not significantly affect disease-free survival for mothers with early breast cancer. Because preterm birth was strongly associated with adverse events, a full-term delivery seems to be of paramount importance., Funding: BANSS Foundation, Biedenkopf, Germany and the Belgian Cancer Plan, Ministry of Health, Belgium., (Copyright © 2012 Elsevier Ltd. All rights reserved.)
- Published
- 2012
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32. Substantial variation in transplacental transfer of chemotherapeutic agents in a mouse model.
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Van Calsteren K, Verbesselt R, Van Bree R, Heyns L, de Bruijn E, de Hoon J, and Amant F
- Subjects
- Animals, Antineoplastic Agents administration & dosage, Antineoplastic Agents blood, Carboplatin blood, Carboplatin pharmacokinetics, Cytarabine blood, Cytarabine pharmacokinetics, Doxorubicin blood, Doxorubicin pharmacokinetics, Epirubicin blood, Epirubicin pharmacokinetics, Female, Fetal Blood chemistry, Gestational Age, Injections, Intravenous, Mice, Mice, Inbred C57BL, Models, Animal, Paclitaxel blood, Paclitaxel pharmacokinetics, Placenta metabolism, Pregnancy, Vinblastine blood, Vinblastine pharmacokinetics, Antineoplastic Agents pharmacokinetics, Maternal-Fetal Exchange
- Abstract
Objective: Data on the transplacental transfer of chemotherapeutic agents are lacking. We aimed to measure the maternofetal transfer of cytotoxic drugs in a mouse model., Study Design: The transplacental transfer of doxorubicin (9 mg/kg), epirubicin (11 mg/kg), vinblastine (6 mg/kg), carboplatin (50 mg/kg), paclitaxel (10 mg/kg), and cytarabine (100 mg/kg) was tested in a C57/Bl6J mouse model. Ninety minutes after intravenous (IV) drug injection on gestational day 18.5, maternal and fetal blood were collected simultaneously. Plasma drug levels were determined using high performance liquid chromatography or atomic absorption spectrometry., Results: Fetal plasma concentrations of doxorubicin, epirubicin, vinblastine, and cytarabine were 5.1% ± 0.6% (n = 8), 4.8% ± 3.8% (n = 8), 13.8% ± 5.8% (n = 6), and 56.7% ± 22.6% (n = 6) of the maternal concentrations, respectively. Total platinum passed the mouse placenta easily (117.0% ± 38.9%, n = 6). Paclitaxel could not be detected in fetal plasma samples (n = 6)., Conclusions: Substantial variations in transplacental transfer were noted among the tested drugs. Current findings contribute to the understanding of reported pregnancy outcomes in humans.
- Published
- 2011
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33. Breast cancer during pregnancy: a literature review.
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Han SN, Van Calsteren K, Heyns L, Mhallem Gziri M, and Amant F
- Subjects
- Belgium epidemiology, Breast Neoplasms epidemiology, Breast Neoplasms pathology, Breast Neoplasms therapy, Chemotherapy, Adjuvant, Evidence-Based Medicine, Female, Global Health, Humans, Incidence, Mastectomy methods, Neoplasm Staging, Pregnancy, Pregnancy Complications, Neoplastic epidemiology, Pregnancy Complications, Neoplastic pathology, Pregnancy Complications, Neoplastic therapy, Pregnancy Outcome, Prognosis, Radiotherapy, Adjuvant, Risk Factors, Breast Neoplasms diagnosis, Pregnancy Complications, Neoplastic diagnosis
- Abstract
Breast cancer during pregnancy is relatively uncommon. However, the incidence is expected to increase as more women delay childbearing. A challenging situation emerges for all persons involved ‑ patient, family and medical care workers ‑ since two lives are at risk with contradicting priorities. Breast cancer treatment is possible during pregnancy. The treatment plan needs to adhere as closely as possible to standardised protocols for nonpregnant patients, with some considerations to minimize fetal exposure and risks. This concerns mainly limiting radiation exposure and timing of chemotherapy to start in the second trimester. The prognosis of pregnant women does not seem to differ from that of nonpregnant patients when matched for age and stage of the disease. This literature review concentrates on the diagnosis, treatment and outcome of patients diagnosed with breast cancer during pregnancy.
- Published
- 2010
34. Transplacental transfer of paclitaxel, docetaxel, carboplatin, and trastuzumab in a baboon model.
- Author
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Calsteren KV, Verbesselt R, Devlieger R, De Catte L, Chai DC, Van Bree R, Heyns L, Beijnen J, Demarsin S, de Bruijn E, de Hoon J, and Amant F
- Subjects
- Animals, Antibodies, Monoclonal pharmacokinetics, Antibodies, Monoclonal, Humanized, Biological Transport physiology, Carboplatin pharmacokinetics, Docetaxel, Female, Gestational Age, Maternal-Fetal Exchange drug effects, Paclitaxel pharmacokinetics, Placenta drug effects, Pregnancy, Taxoids pharmacokinetics, Trastuzumab, Antineoplastic Agents pharmacokinetics, Models, Animal, Papio, Placenta metabolism, Pregnancy, Animal metabolism
- Abstract
Background: The paucity of data on fetal effects of prenatal exposure to chemotherapy prompted us to study the transplacental transport of commonly used anticancer agents in a pregnant baboon model., Methods: Single or combination chemotherapy with paclitaxel, docetaxel, carboplatin, and trastuzumab was administered to 9 baboons at a mean (SD) gestational age of 117 (26) days (paclitaxel, 100 mg/m2 [n = 2]; docetaxel, 100 mg/m2 [n = 2]; paclitaxel, 175 mg/m2 with carboplatin, area under the curve of 6 at standard dosage [n = 2] and 50% dosage [n = 1]; docetaxel, 75 mg/m2 with carboplatin, area under the curve 6 [n = 1]; and docetaxel, 75 mg/m2 with trastuzumab, 8 mg/kg [n = 1]). Serial fetal and maternal blood samples, amniotic fluid, maternal urine, and fetal and maternal tissue samples were collected for the first 76 hours after drug infusion. Levels of carboplatin were determined by atomic absorption spectrometry, docetaxel and paclitaxel by high-performance liquid chromatography, and trastuzumab by enzyme-linked immunosorbent assay., Results: Fetal plasma concentrations of carboplatin averaged 57.5% (14.2%) of maternal concentrations (n = 7). Fetal plasma concentrations were 1.5% (0.8%) of maternal concentrations (n = 7). Immediately after ending the infusion, paclitaxel was not detectable in fetal tissues, whereas, after 3 hours, fetal tissues contained 15% of maternal tissue concentrations.Docetaxel could not be detected in fetal blood samples (n = 9). In the first 3 hours after docetaxel infusion, fetal tissues contained 5.0% to 50.0% of maternal tissue concentrations, whereas equal fetal and maternal tissue concentrations were found after 26 and 76 hours.The transplacental passages of trastuzumab were 85.0% and 3.0%, 2 and 26 hours after trastuzumab infusion, respectively. After 26 hours, amniotic fluid contained 36.4% of the fetal plasma concentration. Fetal tissue concentrations varied between 5.0% and 14.0% of the maternal concentration., Conclusion: Variable plasma and/or tissue concentrations of taxanes, carboplatin, and trastuzumab were encountered in the fetal compartment. These data are important when cancer treatment is considered during pregnancy and underline the need for long-term follow-up of children after prenatal exposure to these cytotoxic agents.
- Published
- 2010
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35. Pharmacokinetics of chemotherapeutic agents in pregnancy: a preclinical and clinical study.
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Van Calsteren K, Verbesselt R, Ottevanger N, Halaska M, Heyns L, Van Bree R, de Bruijn E, Chai D, Delforge M, Noens L, Renard V, Witteveen E, Rob L, de Hoon J, and Amant F
- Subjects
- Animals, Antineoplastic Agents blood, Area Under Curve, Bleomycin pharmacokinetics, Carboplatin pharmacokinetics, Case-Control Studies, Chromatography, High Pressure Liquid, Dacarbazine pharmacokinetics, Doxorubicin pharmacokinetics, Epirubicin pharmacokinetics, Female, Humans, Models, Animal, Paclitaxel pharmacokinetics, Papio, Pregnancy blood, Spectrophotometry, Atomic, Vinblastine pharmacokinetics, Antineoplastic Agents pharmacokinetics, Pregnancy metabolism
- Abstract
Objective: To determine the impact of physiologic changes of pregnancy on pharmacokinetics of chemotherapeutic agents., Design: A preclinical and a clinical case-control trial., Setting: Institute of Primate Research Nairobi and collaborating hospitals in Belgium, the Netherlands and Czech Republic., Population: Pregnant and nonpregnant women and baboons receiving chemotherapy., Methods: Chemotherapy pharmacokinetics was compared between the pregnant and nonpregnant state. Standard-dosed chemotherapy regimens were administered in pregnant and nonpregnant baboons/women, followed by serial blood samplings. Drug plasma levels were determined using high performance liquid chromatography and atomic absorption spectrometry., Main Outcome Measures: Area under the curve (AUC), maximal plasma concentration, terminal elimination half-life, clearance and distribution volume of each drug in pregnant and nonpregnant state., Results: Intraindividual comparative pharmacokinetic data were obtained for doxorubicin and paclitaxel/platinum in three and two baboons, respectively. In the clinical trial, two patients were exposed to doxorubicin and one patient was exposed to paclitaxel/platinum during and after pregnancy. Furthermore, a pooled analysis was performed based on 16 cycles of pregnant and 11 cycles of nonpregnant women. Numbers of pregnant/nonpregnant patients were 5/2, 7/5, 4/4 and 2/2 for paclitaxel, doxorubicin, epirubicin and platinum, respectively. For all drugs tested in the preclinical and clinical study, a decreased AUC and maximal plasma concentration and an increased distribution volume and clearance were observed in pregnancy., Conclusions: Although numbers were too small for statistical significance, pregnancy-associated physiologic alterations appear to lead to a decrease in plasma exposure of chemotherapeutic drugs. The importance of long-term follow-up of women treated with chemotherapy during pregnancy is underscored.
- Published
- 2010
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36. High-grade endometrial stromal sarcoma presenting in a 28-year-old woman during pregnancy: a case report.
- Author
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Amant F, Van Calsteren K, Debiec-Rychter M, Heyns L, De Beeck KO, Sagaert X, Bollen B, and Vergote I
- Abstract
Introduction: To the best of our knowledge, soft tissue sarcomas have not prevously been reported as a complication during pregnancy., Case Presentation: A 28-year-old Caucasian woman was diagnosed with a transperitoneal sarcoma during pregnancy. Morphological, immunohistochemical, chromosomal and mutational analyses pointed towards a high-grade endometrial stromal sarcoma. Although surgery and chemotherapy are possible during pregnancy, we were unable to perform these in this case., Conclusion: The potential to treat gynecological cancer during pregnancy should always be assessed individually.
- Published
- 2010
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37. Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and the neonatal outcomes.
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Van Calsteren K, Heyns L, De Smet F, Van Eycken L, Gziri MM, Van Gemert W, Halaska M, Vergote I, Ottevanger N, and Amant F
- Subjects
- Adult, Birth Weight, Female, Gestational Age, Humans, Incidence, Infant, Newborn, Intensive Care, Neonatal, International Agencies, Neoplasm Recurrence, Local therapy, Obstetric Labor, Premature, Pregnancy, Pregnancy Complications, Neoplastic therapy, Prognosis, Risk Assessment, Delivery, Obstetric statistics & numerical data, Infant, Small for Gestational Age, Neoplasm Recurrence, Local diagnosis, Pregnancy Complications, Neoplastic diagnosis, Pregnancy Outcome
- Abstract
Purpose: The aim of this study was to assess the management and the obstetrical and neonatal outcomes of pregnancies complicated by cancer., Patients and Methods: In an international collaborative setting, patients with invasive cancer diagnosed during pregnancy between 1998 and 2008 were identified. Clinical data regarding the cancer diagnosis and treatment and the obstetric and neonatal outcomes were collected and analyzed., Results: Of 215 patients, five (2.3%) had a pregnancy that ended in a spontaneous miscarriage and 30 (14.0%) pregnancies were interrupted. Treatment was initiated during pregnancy in 122 (56.7%) patients and postpartum in 58 (27.0%) patients. The most frequently encountered cancer types were breast cancer (46%), hematologic malignancies (18%), and dermatologic malignancies (10%). The mean gestational age at delivery was 36.3 +/- 2.9 weeks. Delivery was induced in 71.7% of pregnancies, and 54.2% of children were born preterm. In the group of patients prenatally exposed to cytotoxic treatment, the prevalence of preterm labor was increased (11.8%; P = .012). Furthermore, in this group a higher proportion of small-for-gestational-age children (birth weight below 10th percentile) was observed (24.2%; P = .001). Of all neonates, 51.2% were admitted to a neonatal intensive care unit, mainly (85.2%) because of prematurity. There was no increased incidence of congenital malformations., Conclusion: Pregnant cancer patients should be treated in a multidisciplinary setting with access to maternal and neonatal intensive care units. Prevention of iatrogenic prematurity appears to be an important part of the treatment strategy.
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- 2010
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38. Gynecologic cancers in pregnancy: guidelines of an international consensus meeting.
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Amant F, Van Calsteren K, Halaska MJ, Beijnen J, Lagae L, Hanssens M, Heyns L, Lannoo L, Ottevanger NP, Vanden Bogaert W, Ungar L, Vergote I, and du Bois A
- Subjects
- Algorithms, Female, Genital Neoplasms, Female pathology, Gynecologic Surgical Procedures methods, Humans, International Cooperation, Pregnancy, Pregnancy Complications, Neoplastic pathology, Pregnancy Outcome, Prenatal Diagnosis methods, Prenatal Exposure Delayed Effects epidemiology, Prenatal Exposure Delayed Effects etiology, Genital Neoplasms, Female therapy, Pregnancy Complications, Neoplastic therapy
- Abstract
Background: Gynecologic cancer during pregnancy is a special challenge because cancer or its treatment may affect not only the pregnant women in general but directly involve the reproductive tract and fetus. Currently, there are no guidelines on how to deal with this special coincidence., Methods: An international consensus meeting on staging and treatment of gynecological malignancies during pregnancy was organised including a systematic literature search, and interpretation followed by a physical meeting of all participants with intensive discussion. In the absence of large trials and randomized studies, recommendations were based on available literature data and personal experience thus representing a low but best achievable level of evidence., Findings: Randomized trials and prospective studies on cancer treatment during pregnancy are lacking. Gynecological cancer during pregnancy is a demanding problem, and multidisciplinary expertise should be available. Counseling both parents on the maternal prognosis and fetal risk is needed. When there is a firm desire to continue the pregnancy, gynecological cancer can be treated in selected cases. The staging and treatment should follow the standard approach as much as possible. Guidelines for safe pelvic surgery during pregnancy are presented. Mainly in cervical and ovarian cancer, chemotherapy and an alternative surgical approach need to be considered. Administration of chemotherapy during the second or third trimester may probably not increase the incidence of congenital malformations. Until now, the long-term outcome of children in utero exposed to oncological treatment modalities is poorly documented, but preterm birth on its own is associated with cognitive impairment. Delivery should be postponed preferably until after a gestational age of 35 weeks., Interpretation: Further research including international registries for gynecologic cancer in pregnancy is urgently needed. The gathering of both available literature and personal experience allowed only suggesting models for treatment of gynecologic cancer in pregnancy.
- Published
- 2009
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39. Real life evaluation of intravenous antibiotic treatment in a paediatric cystic fibrosis centre: outcome of home therapy is not inferior.
- Author
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Proesmans M, Heyns L, Moons P, Havermans T, and De Boeck K
- Subjects
- Adolescent, Child, Child, Preschool, Clinical Protocols, Drug Administration Routes, Female, Home Care Services standards, Humans, Injections, Intravenous methods, Male, Quality of Life psychology, Respiratory Tract Infections complications, Retrospective Studies, Anti-Bacterial Agents administration & dosage, Cystic Fibrosis complications, Respiratory Tract Infections drug therapy
- Abstract
Background: Limited data exist on the efficacy and safety of home intravenous antibiotic (IV-AB) therapy for pulmonary infection specifically in children with cystic fibrosis (CF)., Methods: We report on the outcome of IV-AB in the home vs hospital setting based on retrospective single centre patient data from 1999 to 2004 (age >5 and <18 years). Treatment location was chosen based on estimation of competence, adherence, social background and patient preference. Primary outcome parameter was change in FEV(1). Secondary outcome parameters were weight and IgG as well as occurrence of complications., Results: One hundred and thirty-one treatment observations (TOs) were analysed for 47 patients. Mean age was 13.32 (+/-2.9) years and mean FEV(1) 65 (+/-19) % predicted. Fifty-four (41%) TO's were home and 77 (59%) were hospital treatments. Percent change in FEV(1) and weight gain was comparable in the 2 settings. Complications were rare in both groups., Conclusion: The outcome of IV-AB therapy for lung infection in children with CF was not inferior in the home compared to the hospital setting. In our centre, home IV-AB treatment is a valuable treatment option for children with CF.
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- 2009
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40. Enrichment of collagen plugs with platelets and amniotic fluid cells increases cell proliferation in sealed iatrogenic membrane defects in the foetal rabbit model.
- Author
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Liekens D, Lewi L, Jani J, Heyns L, Poliard E, Verbist G, Ochsenbein-Kölble N, Hoylaerts M, and Deprest J
- Subjects
- Animals, Collagen, Disease Models, Animal, Female, Fetus, Pregnancy, Rabbits, Amniotic Fluid cytology, Blood Platelets physiology, Cell Proliferation, Extraembryonic Membranes injuries, Wound Healing physiology
- Abstract
Objectives: The purpose of this study was to evaluate cell proliferation in platelet-enriched collagen plugs with and without addition of amniotic fluid-derived heterologous foetal cells to seal an iatrogenic membrane defect in the foetal rabbit model., Methods: Amniotic fluid cells were harvested from three donor does at 23 days of gestation (term = 32 days) and labelled with carboxyfluorescein diacetate succinimidyl ester (CFDA-SE). In 42 other does, foetal membrane defects were induced by foetoscopic needle puncture at 23 days of gestation, and closed with either a platelet-enriched collagen plug with (n = 44) or without (n = 32) amniotic fluid cells. At 30 days of gestation, the defects were harvested and assessed microscopically., Results: The plugs enriched with heterologous amniotic fluid cells more commonly had proliferating cells in the centre of the plug than those without cell addition. CFDA-SE labelling confirmed the presence of heterologous amniotic fluid cells over the entire membrane plug. Cell typing showed a mixture of fibroblasts and epithelial cells at the wound edges, whereas in the centre, there was an abundance of fibroblasts., Conclusion: When sealing iatrogenic membrane defects in the foetal rabbit model, enrichment of collagen plugs with platelets and amniotic fluid-derived heterologous foetal cells increases local cell proliferation.
- Published
- 2008
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41. Nosocomial transmission of Mycobacterium tuberculosis in kangaroo mother care units: a risk in tuberculosis-endemic areas.
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Heyns L, Gie RP, Goussard P, Beyers N, Warren RM, and Marais BJ
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- Female, Humans, Infant, Infant, Newborn, Infant, Premature, Male, Tuberculosis, Pulmonary therapy, Contact Tracing, Cross Infection transmission, Infant Care, Mycobacterium tuberculosis, Tuberculosis, Pulmonary transmission
- Abstract
Background and Aim: Kangaroo mother care (KMC) has become the standard of care for low-risk preterm babies born in developing countries. However, the potential risk of nosocomial transmission of Mycobacterium tuberculosis within KMC units, particularly in tuberculosis-endemic areas, has not been explored. We report an infant (sentinel case) who was admitted to our paediatric intensive care unit (PICU) with extensive pulmonary tuberculosis., Methods and Results: When interviewed, the mother reported no household contact with a tuberculosis source case, but mentioned that she shared a KMC room with someone who had symptoms suspicious of tuberculosis. We found molecular evidence that nosocomial transmission of M. tuberculosis occurred within the KMC unit and conducted a contact investigation of all infants exposed to this infectious source case during her stay in the KMC unit., Conclusion: We present the findings of the contact investigation and discuss the implications of these findings for KMC units, particularly in tuberculosis-endemic areas.
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- 2006
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42. Management of children with tuberculosis admitted to a pediatric intensive care unit.
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Heyns L, Gie RP, Kling S, Samaai P, Schaaf HS, and Beyers N
- Subjects
- Adolescent, Bronchoscopy, Child, Child, Preschool, Female, HIV Infections complications, Humans, Incidence, Infant, Intensive Care Units, Pediatric statistics & numerical data, Length of Stay, Male, Patient Admission, Respiratory Insufficiency etiology, Respiratory Insufficiency therapy, Retrospective Studies, Tuberculosis diagnosis, Tuberculosis mortality, Tuberculosis therapy, Tuberculosis epidemiology
- Abstract
Objectives: To review the incidence, clinical features, ventilatory support and outcome of children with tuberculosis (TB) admitted to a Pediatric Intensive Care Unit (PICU) in a region with an high incidence of TB., Materials and Methods: The study was performed in a PICU situated in a province with a extremely high incidence of TB (> 700 new cases/ 100000/year). This is a retrospective descriptive study of TB admissions to the PICU in a 4-year period. Data regarding indications for admission, clinical picture, duration of ventilation, PICU and hospital stay were collected from patient files. Outcome measures included mortality and long term morbidity., Results: Of the 1862 children admitted to the hospital for TB during the 4 years, 57 (3.1%) required PICU admission (1 to 6% of annual admissions). Of these 57 children 41 (72%) were admitted for respiratory failure. In 12 cases TB was the cause of the respiratory failure, 17 cases suffered from other respiratory diseases and in 12 cases the cause was nonrespiratory disease of which TB meningitis (n=8) was the most common. Mechanical ventilation was indicated in 43 (75%) patients who were ventilated for 7.3+/-11.5 days. The duration of PICU admission was 10.2+/-2.4 days whereas the duration of hospitalization was 70.3+/-148.9 days. The PICU mortality was 23% with TB meningitis having the highest mortality of 75%., Conclusions: In a region with a high incidence of TB, tuberculous patients constitute up to 6% of PICU admissions. A high degree of suspicion for the diagnosis is needed because in 30% of our cases the diagnosis was not initially considered.
- Published
- 1998
- Full Text
- View/download PDF
43. Syndrome of inappropriate antidiuretic hormone secretion, an unusual complication of an elapid snakebite.
- Author
-
Cotton MF, Shahak E, Muller GJ, Heyns L, Kalis NN, and Aalbers C
- Subjects
- Child, Preschool, Elapid Venoms, Humans, Male, Inappropriate ADH Syndrome etiology, Snake Bites complications
- Published
- 1991
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