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Dive into the research topics where Danny De Looze is active.

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Featured researches published by Danny De Looze.


Endoscopy | 2008

Small-bowel neoplasms in patients undergoing video capsule endoscopy : a multicenter European study

Emanuele Rondonotti; Marco Pennazio; Ervin Toth; P Menchen; Maria Elena Riccioni; G.D. De Palma; F Scotto; Danny De Looze; T Pachofsky; Ilja Tachecí; Troels Havelund; G Couto; Anca Trifan; A Kofokotsios; R Cannizzaro; E Perez-Quadrado; R. de Franchis

BACKGROUND AND STUDY AIMnSmall-bowel tumors account for 1% - 3% of all gastrointestinal neoplasms. Recent studies with video capsule endoscopy (VCE) suggest that the frequency of these tumors may be substantially higher than previously reported. The aim of the study was to evaluate the frequency, clinical presentation, diagnostic/therapeutic work-up, and endoscopic appearance of small-bowel tumors in a large population of patients undergoing VCE.nnnPATIENTS AND METHODSnIdentification by a questionnaire of patients with VCE findings suggesting small-bowel tumors and histological confirmation of the neoplasm seen in 29 centers of 10 European Countries.nnnRESULTSnOf 5129 patients undergoing VCE, 124 (2.4%) had small-bowel tumors (112 primary, 12 metastatic). Among these patients, indications for VCE were: obscure gastrointestinal bleeding (108 patients), abdominal pain (9), search for primary neoplasm (6), diarrhea with malabsorption (1). The main primary small-bowel tumor type was gastrointestinal stromal tumor (GIST) (32%) followed by adenocarcinoma (20%) and carcinoid (15%); 66% of secondary small-bowel tumors were melanomas. Of the tumors, 80.6% were identified solely on the basis of VCE findings. 55 patients underwent VCE as the third procedure after negative bidirectional endoscopy. The lesions were single in 89.5% of cases, and multiple in 10.5%. Retention of the capsule occurred in 9.8% of patients with small-bowel tumors. After VCE, 54/124 patients underwent 57 other examinations before treatment; in these patients enteroscopy, when performed, showed a high diagnostic yield. Treatment was surgery in 95% of cases.nnnCONCLUSIONSnOur data suggest that VCE detects small-bowel tumors in a small proportion of patients undergoing this examination, but the early use of this tool can shorten the diagnostic work-up and influence the subsequent management of these patients.


Gut | 1997

Achalasia: outcome of patients treated with intrasphincteric injection of botulinum toxin.

C Cuillière; Philippe Ducrotté; F. Zerbib; E.H. Metman; Danny De Looze; F Guillemot; H Hudziak; H Lamouliatte; J C Grimaud; Alain Ropert; Michel Dapoigny; Richard Bost; Marc Lemann; M A Bigard; Philippe Denis; J L Auget; Jp Galmiche; S. Bruley des Varannes

BACKGROUND: To evaluate the safety and clinical efficacy of botulinum toxin (BT) in patients with achalasia followed up for six months. METHODS: Fifty five symptomatic patients with manometrically proven achalasia were included in a multicentre prospective trial. Before and two weeks and two months after intrasphincteric injection of BT, symptoms of dysphagia, regurgitation, and chest pain were scored on a 0-3 scale, and lower oesophageal sphincter pressure (LOSP) was assessed. The symptom score was determined again at six months, clinical improvement being defined by < or = 3, relapse by > 3, and failure as a relapse after two injections or loss to follow up. RESULTS: Except for transient chest or epigastric pain (22%), no side effects were observed. There was a significant decrease in LOSP after treatment. Symptom scores were significantly improved at two weeks (2.0 (SD 1.6)), two months (1.7 (1.8)), and six months (1.9 (2.0)) compared with pretreatment values (5.1 (1.8), p < 0.001). At six months, 33 patients had clinical improvement (27 after one injection), 17 were considered failures, and five had just relapsed. Although there was a trend for age (older patients being more responsive), age, sex, prior duration of symptoms, initial symptom score, weight loss, LOSP, magnitude of oesophageal contractions, vigorous or non-vigorous achalasia, previous dilatations, and radiological features were not predictive of results. CONCLUSIONS: This multicentre series confirms that intrasphincteric injection of BT is a safe procedure, resulting in clinical improvement in 60% of patients with achalasia at six months. The therapeutic role of BT in achalasia needs further evaluation with regard to other alternatives.


Gastrointestinal Endoscopy | 2008

Clinical impact of capsule endoscopy on further strategy and long-term clinical outcome in patients with obscure bleeding

Pieter Hindryckx; Thomas Botelberge; Martine De Vos; Danny De Looze

BACKGROUNDnCapsule endoscopy (CE) is highly effective in detecting small-bowel lesions in patients with obscure GI bleeding (OGIB). Little is known about the impact of CE on further management and outcomes in patients with OGIB.nnnOBJECTIVEnTo evaluate the impact of CE on the management and outcomes of patients with OGIB.nnnDESIGNnRetrospective cohort study.nnnSETTINGnTertiary-referral center.nnnPATIENTSnA total of 92 patients referred for obscure-overt bleeding (N = 36) or obscure-occult bleeding (N = 56).nnnINTERVENTIONSnCE was performed after a negative endoscopic examination of the upper-GI and lower-GI tract. Follow-up was performed by collecting information from the referring physicians.nnnMAIN OUTCOME MEASUREMENTSnNeed for transfusion, overt bleeding, anemia.nnnRESULTSnNinety-two patients (52 men, 40 women), with a mean age of 66.5 years (range 22-90 years) and a mean follow-up time of 635.5 days (range 81-1348 days) were studied. Relevant lesions were found in 55 of 92 patients (59.8%). After a CE, invasive small-bowel investigations were more often done in patients with a positive CE result (P = .01). Invasive endoscopic or surgical therapy was far more often performed in patients with a positive CE finding (P < .001). The outcome after a CE was favorable in 61 of 92 patients (66.3%) and was defined by the absence of overt bleeding and a normal Hb value on the latest available laboratory result. In the younger age category, a 100% resolution of OGIB was observed after long-term follow-up. On the contrary, angiodysplasia was a predictor for a less favorable clinical outcome (P = .04).nnnLIMITATIONSnRetrospective analysis.nnnCONCLUSIONSnA CE has an important impact on a further diagnostic workup, therapeutic strategy, and long-term clinical evolution in patients with OGIB, with a favorable outcome in 66.3% of patients after CE-guided therapy.


European Journal of Anaesthesiology | 2005

Propofol versus remifentanil for monitored anaesthesia care during colonoscopy

Annelies Moerman; Luc Foubert; Luc Herregods; Michel Struys; Daniël De Wolf; Danny De Looze; M. De Vos; Eric Mortier

Background and objective: We conducted an open, prospective, randomized study to compare the efficacy, safety and recovery characteristics of remifentanil or propofol during monitored anaesthesia care in patients undergoing colonoscopy. Methods: Forty patients were randomly assigned to receive either propofol (1 mg kg−1 followed by 10 mg kg−1h−1, n = 20) or remifentanil (0.5 μg kg−1 followed by 0.2 μg kg−1 min−1, n = 20). The infusion rate was subsequently adapted to clinical needs. Results: In the propofol group, arterial pressure and heart rate decreased significantly from the baseline. These variables remained unchanged in the remifentanil group, but hypoventilation occurred in 55% of patients. Early recovery was delayed in the propofol group (P < 0.002). Recovery of cognitive and psychomotor functions was faster in the remifentanil group. Fifteen minutes after anaesthesia, the Digit Symbol Substitution Test score was 28.6 ± 12.8 versus 36.2 ± 9.4 and the Trieger Dot Test score was 25.6 ± 8.1 versus 18.7 ± 4.1 in the propofol and remifentanil groups, respectively (both P < 0.05). Patient satisfaction, using a visual analogue scale, was higher in the propofol group (96 ± 7 versus 77 ± 21, P < 0.001). Conclusions: Remifentanil proved efficient in reducing pain during colonoscopy. Emergence times were shorter and the recovery of cognitive function was faster with remifentanil compared with propofol. Remifentanil provided a smoother haemodynamic profile than propofol; however, the frequent occurrence of remifentanil‐induced hypoventilation requires the cautious administration of this agent.


CardioVascular and Interventional Radiology | 2008

Therapeutic Decision-Making in Endoscopically Unmanageable Nonvariceal Upper Gastrointestinal Hemorrhage

Luc Defreyne; Ignace De Schrijver; Johan Decruyenaere; Georges Van Maele; Wim Ceelen; Danny De Looze; Peter Vanlangenhove

The purpose of this study was to identify endoscopic and clinical parameters influencing the decision-making in salvage of endoscopically unmanageable, nonvariceal upper gastrointestinal hemorrhage (UGIH) and to report the outcome of selected therapy. We retrospectively retrieved all cases of surgery and arteriography for arrest of endoscopically unmanageable UGIH. Only patients with overt bleeding on endoscopy within the previous 24xa0h were included. Patients with preceding nonendoscopic hemostatic interventions, portal hypertension, malignancy, and transpapillar bleeding were excluded. Potential clinical and endoscopic predictors of allocation to either surgery or arteriography were tested using statistical models. Outcome and survival were regressed on the choice of rescue and clinical variables. Forty-six arteriographed and 51 operated patients met the inclusion criteria. Univariate analysis revealed a higher number of patients with a coagulation disorder in the catheterization group (41.4%, versus 20.4% in the laparotomy group; pxa0=xa00.044). With multivariate analysis, the identification of a bleeding peptic ulcer at endoscopy significantly steered decision-making toward surgical rescue (ORxa0=xa05.2; pxa0=xa00.021). Taking into account reinterventions, hemostasis was achieved in nearly 90% of cases in both groups. Overall therapy failure (no survivors), rebleeding within 3xa0days (ORxa0=xa03.7; pxa0=xa00.042), and corticosteroid use (ORxa0=xa05.2; pxa0=xa00.017) had a significant negative impact on survival. The odds of dying were not different for embolotherapy or surgery. In conclusion, decision-making was endoscopy-based, with bleeding peptic ulcer significantly directing the choice of rescue toward surgery. Unsuccessful hemostasis and corticosteroid use, but not the choice of rescue, negatively affected outcome.


eLife | 2015

Impact of a decade of successful antiretroviral therapy initiated at HIV-1 seroconversion on blood and rectal reservoirs

Eva Malatinkova; Ward De Spiegelaere; Pawel Bonczkowski; Maja Kiselinova; Karen Vervisch; Wim Trypsteen; Margaret Johnson; Chris Verhofstede; Danny De Looze; Charles Murray; Sabine Kinloch-de Loes; Linos Vandekerckhove

Persistent reservoirs remain the major obstacles to achieve an HIV-1 cure. Prolonged early antiretroviral therapy (ART) may reduce the extent of reservoirs and allow for virological control after ART discontinuation. We compared HIV-1 reservoirs in a cross-sectional study using polymerase chain reaction-based techniques in blood and tissue of early-treated seroconverters, late-treated patients, ART-naïve seroconverters, and long-term non-progressors (LTNPs) who have spontaneous virological control without treatment. A decade of early ART reduced the total and integrated HIV-1 DNA levels compared with later treatment initiation, but not reaching the low levels found in LTNPs. Total HIV-1 DNA in rectal biopsies did not differ between cohorts. Importantly, lower viral transcription (HIV-1 unspliced RNA) and enhanced immune preservation (CD4/CD8), reminiscent of LTNPs, were found in early compared to late-treated patients. This suggests that early treatment is associated with some immunovirological features of LTNPs that may improve the outcome of future interventions aimed at a functional cure. DOI: http://dx.doi.org/10.7554/eLife.09115.001


Digestive and Liver Disease | 2008

Capsule endoscopy findings in cirrhosis with portal hypertension: a prospective study.

Daniel Urbain; S. Vandebosch; Pieter Hindryckx; Isabelle Colle; Herwig Reynaert; F. Mana; S. Vanden Branden; H. Van Vlierberghe; M. De Vos; Danny De Looze

1] Jacobson IM, Gonzalez SA, Ahmed F, Lebovics E, Min AD, Bodenheimer Jr HC, et al. A randomized trial of pegylated interferon alpha-2b plus ribavirin in the retreatment of chronic hepatitis C. Am J Gastroenterol 2005;100:2453–62. 2] Taliani G, Gemignani G, Ferrari C, Aceti A, Bartolozzi D, Blanc PL, et al., Nonresponder Retreatment Group. Pegylated interferon alfa-2b plus ribavirin in the retreatment of interferon-ribavirin nonresponder patients. Gastroenterology 2006;130:1098–106. 3] Sherman M, Yoshida EM, Deschenes M, Krajden M, Bain VG, Peltekian K, et al., Canadian Pegasys Study Group. Peginterferon alfa-2a (40 KDa) plus ribavirin in chronic hepatitis C patients who failed previous interferon therapy. Gut 2006;55:1631–8. 4] Shiffman ML, Di Bisceglie AM, Lindsay KL, Morishima C, Wright EC, Everson GT, et al., Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis Trial Group. Peginterferon alfa-2a and ribavirin in patients with chronic hepatitis C who have failed prior treatment. Gastroenterology 2004;126:1015–23. 5] Krawitt EL, Ashikaga T, Gordon SR, Ferrentino N, Ray MA, Lidofsky SD, et al., New York New England Study Team. Peginterferon alfa2b and ribavirin for treatment-refractory chronic hepatitis C. J Hepatol 2005;43:243–9.


Acta Chirurgica Belgica | 2018

High post-operative pain scores despite multimodal analgesia in ambulatory anorectal surgery: a prospective cohort study

Aline Ceulemans; Danny De Looze; Dirk Van de Putte; Eline Stiers; Marc Coppens

Abstract Background: Ambulatory surgery for anorectal procedures has become widely accepted. Recent reviews recommend a multimodal approach to pain management. However, these recommendations are largely based on single intervention studies. Our goal was to evaluate post-operative pain in patients receiving a multimodal analgesic regimen. Methods: All patients undergoing an ambulatory anorectal procedure between December 2015 and September 2016 received a pain diary. Mean pain throughout the day and pain during defecation where recorded on day 0–14 and day 21 postoperatively using a numeric rating scale-11. Use of oral analgesics was also recorded. Results: Forty-two patients completed the pain diary. The use of local anesthetic infiltration did not result in a significant difference in pain scores in this study. Patients who received written information on postoperative pain management and hygienic measures had higher intake of oral analgesics. Despite receiving multimodal analgesic treatment, patients undergoing surgery for hemorrhoids or anal fissures reported pain scores ≥4 and used analgesics longer. Conclusion: A multimodal analgesic approach consisting of local anesthetic infiltration, multiple oral analgesics and written information seems to be insufficient for certain patient groups after ambulatory anorectal surgery. Especially patients undergoing surgery for hemorrhoids or an anal fissure should receive adequate analgesia. Pain during defecation is problematic and finding a solution for this problem remains challenging. Further research into the combined use of different analgesic modalities is recommended.


Gut | 2017

PWE-001 Anal problems during pregnancy and postpartum: a prospective cohort study

K Ferdinande; Y Dorreman; Kristien Roelens; Wim Ceelen; Danny De Looze

Introduction Many pregnant women have anal symptoms during pregnancy and postpartum. The most common proctological problems reported are haemorrhoids, anal fissures and anal incontinence. Literature about this problem is scarce. The aim of this study is to determine the prevalence of anal problems and constipation during the second and third trimester of pregnancy, in the immediate postpartum and up to three months after childbirth. We also want to identify the risk factors for the development of anal symptoms. Method This is a prospective cohort study. Women between their 19th and 25th week of pregnancy are included. High-risk pregnancy and non-Dutch speaking are exclusion criteria. Ninety-four women were followed with a symptom questionnaire in the second and third trimester, in the immediate postpartum (within 3 days) and three months postpartum. Descreptive data were obtained from the patient files. A specific proctological diagnosis was presumed on the basis of combined symptoms (rectal bleeding, anal pain and swelling). Constipation was defined by the Rome III criteria. Statistical analysis was performed with SPSS and risk factors were identified using multivariate analysis with binary logistic regression. Results Sixty-eight percent of the women developed anal symptoms during the whole study period. Anal symptoms occured in 50% of the women during pregnancy, in 56,2% in the immediate postpartum and in 62,9% during the three months postpartum. The most prevalent symptom was anal pain. Constipation was reported by 60,7% during the whole study period. The most prevalent diagnoses were: hemorrhoidal thrombosis (immediate postpartum), hemorrhoidal prolaps (3rd trimester and immediate postpartum) and anal fissure (not episode-related). Anal incontinence was only reported in 2% during the postpartum. Multivariate analysis identified constipation and a history of anal problems as significant risk factors for the development of anal complaints pre-and postpartum. Conclusion Two thirds of pregnant womed deal with anal symptoms during pregnancy and/or postpartum, especially hemorrhoidal complications and anal fissure. This high prevalence emphasises the clinical importance of this problem. The most important risk factor is constipation. Therefore, prevention of constipation pre-and postpartum is recommended. Disclosure of Interest None Declared


Endoscopy | 2006

Video capsule endoscopy in small-bowel malignancy: A multicenter Belgian study

Daniel Urbain; Danny De Looze; I. Demedts; Edouard Louis; O. Dewit; Elizabeth Macken; A. Van Gossum

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Daniel Urbain

Free University of Brussels

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Martine De Vos

Ghent University Hospital

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A. Van Gossum

Université libre de Bruxelles

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F. Mana

Université libre de Bruxelles

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