Can Flanders resist the measles outbreak? Assessing vaccination coverage in different age groups among Flemish residents.

The Belgian strategic plan to eliminate measles contains several vaccination strategies including routine immunisation programmes and catch-up campaigns. A new expanded programme on immunisation-based survey (2016) assessed the uptake of the recommended measles-mumps-rubella (MMR) vaccine in three different cohorts: toddlers, adolescents and parents of toddlers. A two-stage cluster sampling technique was used to select 875 toddlers (age 18-24 months) and 1250 adolescents (born in 2000) from 107 municipalities in Flanders. After consent of the parent(s), 746 (85.2%) families of toddlers and 1012 (81.0%) families of adolescents were interviewed at home. Measles vaccination coverage was high at 18-24 months (96.2%) and 81.5% were vaccinated at recommended age. Toddlers who had two siblings or a non-working mother or changed vaccinator were more at risk for not being vaccinated. Coverage of the teenager dose reached 93.5% and was lower in adolescents with educational underachievement or whose mother was part-time working or with a non-Belgian background. Only 56.0% of mothers and 48.3% of fathers remembered having received at least one measles-containing vaccine. Although measles vaccination coverage in toddlers meets the required standards for elimination, administration of the teenager dose of MMR vaccine and parent compliance to the recent measles catch-up campaign in Flanders leave room for improvement.

Poor trabecular microarchitecture at the distal radius in older men with increased concentration of high-sensitivity C-reactive protein--the STRAMBO study.

Low-grade inflammation, assessed by serum high-sensitivity C-reactive protein (hsCRP) concentration, is associated with higher fracture risk irrespective of areal bone mineral density (aBMD). We assessed the association of hsCRP with bone microarchitecture (measured by high-resolution pQCT) at the distal radius and tibia in 1,149 men, aged 19-87 years. hsCRP concentration increased with age until the age of 72, then remained stable. aBMD was not correlated with hsCRP level. After adjustment for confounders, bone microarchitecture was not associated with hsCRP level in men aged <72. After the age of 72, hsCRP >5 mg/L was associated with lower trabecular density, lower trabecular number, higher trabecular spacing, and more heterogeneous trabecular distribution (p < 0.05-0.005) at the distal radius versus hsCRP ≤ 5 mg/L. Similar differences were found for the fourth hsCRP quartile (>3.69 mg/L) versus the three lower quartiles combined. Cortical parameters of distal radius and microarchitectural parameters of distal tibia did not vary according to hsCRP concentration in men aged ≥ 72. Fracture prevalence increased with increasing hsCRP level. After adjustment for confounders (including aBMD), odds for fracture were higher in men with hsCRP >5 mg/L compared to hsCRP <1 mg/L (OR = 2.22, 95 % CI 1.29-3.82) and did not change after additional adjustment for microarchitectural parameters. The association between hsCRP level and bone microarchitecture was observed only for trabecular parameters at the radius in men aged ≥72. Impaired bone microarchitecture does not seem to explain the association between elevated CRP level and higher risk of fracture.

Poor bone microarchitecture in older men with impaired physical performance--the STRAMBO study.

UNLABELLED: In 810 men ≥ 60 years, poor physical performance of lower limbs was associated with lower areal bone mineral density (aBMD) of total hip and poor bone microarchitecture at the distal tibia (assessed by HR-pQCT). Men who reported falls had lower hip aBMD and lower cortical density at the distal tibia. INTRODUCTION: The aim of this study was to assess the association between bone microarchitecture and physical performance in older men. METHODS: Volumetric bone mineral density (vBMD) and bone microarchitecture were assessed in 810 men ≥ 60 years at the distal radius and tibia by high resolution pQCT. aBMD was measured at the spine, hip, whole body, and distal radius by dual energy X-ray absorptiometry. Clinical tests included chair stands and tests of static and dynamic balance. We calculated a composite score summarizing abilities and time required to perform the tests. RESULTS: In multivariable models, men who failed in ≥ one test had lower total hip aBMD than men who accomplished all the tests. They had lower total vBMD (Tt.vBMD), cortical thickness (Ct.Th), trabecular vBMD (Tb.vBMD), and more heterogenous trabecular distribution (Tb.Sp.SD) at the distal tibia (p < 0.05). Men who failed in ≥ two tests had lower aBMD at the total hip, femoral neck, and trochanter as well as lower Tt.vBMD, cortical vBMD (Ct.vBMD), Ct.Th and trabecular number (Tb.N), and higher Tb.Sp.SD at the distal tibia (p < 0.05). Men in the lowest quartile of the composite score had lower aBMD (total hip, distal radius), lower Tb.vBMD and Tb.N at the distal radius, and lower Tt.vBMD, Ct.vBMD, Ct.Th, Tb.vBMD, and Tb.N, and higher Tb.Sp.SD at the distal tibia compared with the highest quartile. In multivariables models, men reporting falls had lower total hip aBMD and lower distal tibia Ct.vBMD (p < 0.01). CONCLUSION: In older men, poor physical performance is associated with lower hip aBMD and poor bone microarchitecture (mainly at the distal tibia).

Association of bone microarchitecture with parathyroid hormone concentration and calcium intake in men: the STRAMBO study.

UNLABELLED: OBJECTVIE: In the elderly, vitamin D deficit, low calcium intake, and impaired bone microarchitecture are associated with higher risk of hip fracture. We assessed the association of bone microarchitecture with calcium intake and serum concentrations of 25-hydroxycholecalciferol (25OHD) and parathyroid hormone (PTH) in men. DESIGN: Cross-sectional analysis was performed in 1064 men aged 20-87 years not taking vitamin D or calcium supplements. METHODS: Daily calcium intake was assessed using a food frequency questionnaire. Bone microarchitecture was assessed at distal radius and tibia by high-resolution peripheral quantitative computed tomography. We measured serum and urinary levels of biochemical bone turnover markers (BTMs). Statistical models were adjusted for age, weight, height, and glomerular filtration rate. RESULTS: In 500 men aged <65 years, lower 25OHD levels and low calcium intake were associated with lower trabecular volumetric bone mineral density (Dtrab) at the distal tibia, due to lower trabecular number (Tb.N). Low calcium intake was associated with lower cortical thickness (Ct.Th). Higher PTH level was associated with higher BTM levels. In 563 men aged ≥65 years, the highest PTH quartile was associated with lower Ct.Th (tibia), lower Dtrab (both sites), and lower Tb.N (radius) compared with the lowest quartile. Low calcium intake was associated with lower Tb.N and more heterogenous trabecular distribution. BTM positively correlated with the PTH concentration. CONCLUSION: In older men, elevated PTH concentration is associated with high bone turnover, poor trabecular microarchitecture (radius and tibia), and, at the distal tibia, lower Ct.Th. Low calcium intake is associated with lower Tb.N and more heterogenous trabecular distribution.

Risk factors for peripheral fractures vary by age in older men--the prospective MINOS study.

UNLABELLED: Identification of older men at high risk of peripheral fracture can be improved by assessing prevalent fractures (men aged ≤ 65), history of falls (men aged >65), bone width, and aortic calcifications. INTRODUCTION: Low bone mineral density (BMD) identifies 20% of men who sustain osteoporotic fracture. We studied (1) if the assessment of bone width, aortic calcifications, prevalent falls and fractures improves identification of men at high risk of fracture and (2) if the predictive value of these parameters varies with age. METHODS: Among 781 men aged 50 and over, 61 men sustained 66 low-trauma peripheral fractures during 10 years. History of falls and prevalent fractures was assessed by questionnaire. BMD and bone with were measured by dual X-ray absorptiometry. Abdominal aortic calcifications were assessed on the lateral radiographs of the lumbar spine. RESULTS: Low BMD, low bone width, extended aortic calcifications, prevalent fractures (mainly multiple fractures) and frequent falls were all associated independently with higher risk of fracture. In men aged ≤ 65, prevalent fractures are associated with a significant increase in the risk of fracture (two- to threefold for one and four- to fivefold for multiple prevalent fractures). In men aged >65, history of falls is associated with a higher risk of fracture, e.g. frequent falls are associated with a sixfold increase in the risk of fracture. CONCLUSIONS: Men aged ≤ 65 with multiple prevalent fractures and frequent fallers aged >65 are at particularly high risk of peripheral fracture regardless of BMD.

[Limited-time feeding ("meal-feeding") and avitaminosis A : respiratory exchange and metabolic adaptation in rats]. / Alimentation en temps limite ("meal-feeding") et avitaminose A : échanges respiratoires et adaptation métabolique du rat.

Weanling male rats were fed ad libitum for 6 weeks with a normal or vitamin-A-deficient diet and then meal-fed 1 1/2 hours per 24 hours a 65 p. 100 glucose diet for not less than 3 weeks. The stomach of meal-fed rats develop and food intake is sufficient to ensure a normal rate of growth until deficients reached a plateau of weight. After the single daily meal the respiratory quotients are remaining high (QR greater than 1) all throught the day and decreases during the night (0,8) with all the animals. Fasting glycemia, insulinemia and liver glycogen of meal-feds are higher than ad libitum rats ones, but lower in deficients than in controls. Activities of NADPH2-linked enzymes (G6PDH, 6PGDH and NADP malate DH) are increased in meal-feeding, but avitaminosis A reduces by half this increase.

[New aspect of carbohydrate metabolism in vitamin A deficient rats: absorption of glucose during intestinal perfusions in vivo]. / Nouvel aspect du métabolisme glucidique du rat en avitaminose A: absorption du glucose au cours de perfusions intestinales in vivo.

24 hour fasting rats are anaesthetized and the small intestines are perfused in situ with a Tyrode solution at 37 degrees C, 1 ml/min., containing 0,5 to 15 g of glucose per liter. Larger amounts of glucose and water are absorbed by the intestine of vitamin A-deficient rats at all oncentrations of glucose. Intestines of meal fed rats absorbed more glucose than ad libitumnes. Plasma glucose and insulin levels are measured both before and during the perfusions everal higher values of hyperglycemia are noted in deficient rats which developed a particular lower insulinemia (these results are detailed in a further article).

[Glycemia and insulinemia of vitamin A deficient rats after administration of glucose]. / Glycémie et insulinémie du rat carencé en vitamine A aprés surcharge glucosée.

We have studied the variations of the blood glucose and insulin concentrations of control and vitamin A-deficient rats after administration of glucose by various ways. The avitaminosis decreases the initial glycaemia and insulinaemia in fasting rats. It seems that the insulin release from the pancreas of the deficient rats is normal after a moderate treatment: for example after a single injection of glucose 0,5 g/kg in the carotide, or during the digestion of a mixed meal (rats trained to eat their day's food in a short time), or during an intestinal perfusion in vivo of weak concentrated glucose solutions (0,5 to 2 g/l). But after meal feeding a glucose rich diet (65 p. cent) or during intestinal perfusions of solutions with a higher glucose content (up to 15 g/l) the hyper-insulinaemia is fleeting in the deficient rats and its appeared highest hyperglycaemia in some perfused animals. The endocrine regulations of the vitamin A-deficient rats are considered in the discussion.

[Adrenal cortex and avitaminosis A: II. Complementary in vivo and in vitro studies on inhibition of corticoidogenesis in moderate deficiency in the rat. III. In vivo criterion for activity: glycemic response to ACTH]. / Corticosurrénale et avitaminose A: II. Compléments a l'étude in vivo et in vitro; modalités d'inhibition de la corticoidogenèse en carence modérée chez le rat. III. Recherche d'un critère d'activité utilisable in vivo; réponse glycémique a l'ACTH

II. We set up new experiments, both in vivo and in vitro, in order to explain the impaired adrenal response to stress, of vitamin A middly deficient, male Wistar rats. Injections of progesterone, 6 mg s.c. or i.p. every other day, did not improve the deficiency curse in our rats. In agreement with these results, we have found that, in vitro, the delta5-3beta hydroxysteroide dehydrogenase is not altered in deficient glands; we confirmed it histochemically. On the other hand, the 11beta and 18 hydroxylase activities are lowered in vitro (and presumably in vivo). When conditions of hyperactivity are established, the conversion of deoxycorticosterone (DOC) to 18 OH-DOC or to corticosterone is reduced and DOC accumulates in the incubation medium. III. When middly deficient intact rats are injected with ACTH i.p. (2UI p. 100 g of body weight), only some of them are found to have normoglycemia or hyperglycemia, 45 or 60 minutes after injection, as the controls do. Many deficient rats become hypoglycemic as the adrenalectomised animals do. We think that the changes in the glycemia after ACTH injection could be used to discriminate between the more or less deficient rats.