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Molecular algorithms may estimate the risk of recurrence and death for patients with endometrial cancer (EC) and may impact treatment decisions. To detect microsatellite instabilities (MSI) and p53 mutations, immunohistochemistry (IHC) and molecular techniques are used. To select the most appropriate method, and to have an accurate interpretation of their results, knowledge of the performance characteristics of these respective methods is essential. The objective of this study was to assess the diagnostic performance of IHC versus molecular techniques (gold standard). One hundred and thirty-two unselected EC patients were enrolled in this study. Agreement between the two diagnostic methods was assessed using Cohen’s kappa coefficient. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of the IHC were calculated. For MSI status, the sensitivity, specificity, PPV and NPV were 89.3%, 87.3%, 78.1% and 94.1%, respectively. Cohen’s kappa coefficient was 0.74. For p53 status, the sensitivity, specificity, PPV, and NPV were 92.3%, 77.1%, 60.0% and 96.4%, respectively. Cohen’s kappa coefficient was 0.59. For MSI status, IHC presented a substantial agreement with the polymerase chain reaction (PCR) approach. For the p53 status, the moderate agreement observed between IHC and next generation sequencing (NGS) methods implies that they cannot be used interchangeably.

Background Overweight and obesity are major public health problems of growing concern. Few studies have investigated the representations and perceptions of subjects with overweight and obesity, especially in the general population, as compared to people in a medical weight loss process. The objective of this study was to fill this gap by enabling participants to express their feelings and experience about their overweight, and to assess the extent of the body mass index (BMI) as a determinant of these perceptions. Methods A total of 4155 persons participated in an exploratory study conducted in Wallonia (Belgium). Data were collected by means of a web-based questionnaire. This study investigated the following parameters: sociodemographic and anthropometric factors, perceived health, quality of life, diet perception, enrolment in a weight loss process and weight loss target. The influence of BMI was considered, on one hand, looking at how the above variables evolve according to BMI category, secondly, as a mediation factor in the relationship between socioeconomic level and these same variables. Results A large majority (87.5%) of subjects were overweight (32.2%) or obese (obese class I 29.9%, class II 14.8%, class III 10.6%). Perceived health was found to deteriorate with the BMI (P

Background Metabolic syndrome (MetS) and migraine are known to be associated. This study assessed the risk of MetS and its clinical characteristics in migraine with aura (MA) and without aura (MO) based on a large-scale cross-sectional survey. Methods The study material consisted of 751 participants in the Nutrition, Environment and CardioVascular Health (NESCaV) survey. Diagnosis of migraine was based on the ef-ID migraine questionnaire and MetS was defined according to the Revised-Adult Treatment Panel III criteria. Sociodemographic and risk factors were also recorded. Weighted logistic regression was used to assess the risk of MetS. Results After adjusting for stratification (gender, age, district) and other factors (smoking status, sedentary lifestyle, family history of stroke, myocardial infarction and hypertension), MA subjects were at higher risk of MetS (OR 3.45; 95% CI: 1.63–7.29) while MO individuals were not, when compared to non-migraineurs. When considering MetS components, MA was positively associated with low HDL-cholesterol (OR 2.26; 95% CI: 1.08–4.74), hyperglycemia (OR 2.77; 95% CI: 1.30–5.88) and abdominal obesity (OR 2.03; 95% CI: 1.07–3.86). Conclusion Migraineurs with aura are at higher risk of MetS, suggesting that these subjects, already more exposed to stroke, may benefit from a systematic screening for the metabolic syndrome.

Introduction Migraine has a considerable social, economic, physical and emotional burden but remains underdiagnosed and undertreated. A specific migraine screening tool could help remove barriers to health care and be an attractive instrument for epidemiological studies. The objective of this work was to assess the validity of an extended French version of ID Migraine™ as a migraine-screening tool. Methods Sixty-seven subjects from the NESCaV study (2010–2012) completed the migraine screen and were diagnosed by a neurologist specializing in headache medicine using the International Classification of Headache Disorders, 2nd edition criteria (gold standard). Agreement between the two diagnoses was evaluated by Cohen kappa coefficient (κ). Sensitivity, specificity and predictive values of the migraine screen were calculated. Results Migraine was diagnosed in 21 (31.3%) of the 67 subjects according to the screening tool and in 24 (35.8%) by the neurologist (κ = 0.90). The prevalence of migraine was unrelated to age, gender, education and perception of financial resources. Sensitivity and specificity of the screen were 87.5% and 100%, respectively. The screen prevalence of migraine with aura was 10.4% (sensitivity and specificity: 83.3% and 96.7%, respectively). Conclusion The extended French version of ID Migraine™ (ef-ID Migraine) is a validated tool to screen migraine in French-speaking countries.

Background Cluster analysis is a data-driven method used to create clusters of individuals sharing similar dietary habits. However, this method requires specific choices from the user which have an influence on the results. Therefore, there is a need of an objective methodology helping researchers in their decisions during cluster analysis. The objective of this study was to use such a methodology based on stability of clustering solutions to select the most appropriate clustering method and number of clusters for describing dietary patterns in the NESCAV study (Nutrition, Environment and Cardiovascular Health), a large population-based cross-sectional study in the Greater Region (N = 2298). Methods Clustering solutions were obtained with K-means, K-medians and Ward’s method and a number of clusters varying from 2 to 6. Their stability was assessed with three indices: adjusted Rand index, Cramer’s V and misclassification rate. Results The most stable solution was obtained with K-means method and a number of clusters equal to 3. The “Convenient” cluster characterized by the consumption of convenient foods was the most prevalent with 46% of the population having this dietary behaviour. In addition, a “Prudent” and a “Non-Prudent” patterns associated respectively with healthy and non-healthy dietary habits were adopted by 25% and 29% of the population. The “Convenient” and “Non-Prudent” clusters were associated with higher cardiovascular risk whereas the “Prudent” pattern was associated with a decreased cardiovascular risk. Associations with others factors showed that the choice of a specific dietary pattern is part of a wider lifestyle profile. Conclusion This study is of interest for both researchers and public health professionals. From a methodological standpoint, we showed that using stability of clustering solutions could help researchers in their choices. From a public health perspective, this study showed the need of targeted health promotion campaigns describing the benefits of healthy dietary patterns. Electronic supplementary material The online version of this article (doi:10.1186/s12937-017-0226-9) contains supplementary material, which is available to authorized users.

Data on the vitamin D status of the population of Wallonia (Belgium, 51°30' North) are scarce. This study was carried out to estimate vitamin D deficiency, identify potential determinants, and analyze their relationship with vitamin D supplementation. We tested the hypothesis that vitamin D deficiency is common in the general population, particularly among subjects without supplementation. Vitamin D deficiency was defined as a serum level of 25-hydroxyvitamin D (25(OH)D) concentration less than 50nmol/L. Data were analyzed from 915 participants of the Nutrition, Environment and Cardio-Vascular Health cross-sectional survey. The median (interquartile range) 25(OH)D level was 53.1 (37.8-69.9) nmol/L, and 44.7% of the subjects were vitamin D deficient. Subjects without vitamin D supplementation were more concerned by vitamin D deficiency than those with supplementation (odds ratio [OR], 3.35; P < .0001). From a multivariate standpoint, the potential determinants of vitamin D deficiency among subjects without vitamin D supplementation were season, specifically spring and winter (OR, 7.36 and 6.44, respectively), obesity (OR, 2.19), low household income (OR, 1.73), and lack of solarium use (OR, 1.79). For subjects with supplementation, the only determinant observed for vitamin D deficiency was obesity (OR, 5.00). This work evidenced the high prevalence of 25(OH)D deficiency in the general population, especially among nonsupplemented subjects with obesity, low household income, and/or lack of light. Vitamin D supplementation looks effective in our population, especially via a stabilization of vitamin D coverage throughout the seasons. The best dietary strategy to achieve optimal 25(OH)D concentrations all year round in the general population requires more research.

Country-specific prevalence data on migraine and comorbidities are vital to assess the public health burden of migraine and the corresponding resources required for proper management. Considering the absence of reliable statistics, this study aimed to estimate the one-year prevalence of migraine in Wallonia (Belgium) in relation to socio-demographic factors and several health indicators.Among the 1071 people aged 20-69 years who participated in the NESCaV survey, 751 (70.1%) were screened for one-year migraine attacks using the "ef-ID Migraine", a validated, extended French version of the self-administered ID Migraine™ questionnaire. Socio-demographic and health data were collected with a self-administered questionnaire and a physical examination.The overall one-year prevalence of migraine was 25.8%; 40.8% of migraineurs reported visual symptoms compatible with an aura. The prevalence was higher in women than in men (33.9% vs. 17.9%, P0.0001) and declined markedly after the age of 50 (P=0.005). Importantly, migraine was associated with the subjective feeling of poorer health (P=0.0004). No other socio-demographic factor or health indicator studied was significantly correlated with migraine.High prevalence of migraine and strong association with feeling of poor health should incite health authorities to institute more active public health and management policies with regards to the migraine problem.

The aim of this study was to evaluate the interest in the Internet and its usage for health-related issues among people eligible for osteoporosis screening. Self-administered questionnaires have been distributed to subjects who were screened for osteoporosis and to menopausal women. 177 patients have responded to the survey (64.5 ± 10.1 years, 88.1 % of women). There are 78.5 % of Internet users. Among them, 67.2 % said searching information about their health and 74.5 % said using the Internet for this purpose. All respondents attributed an average score, out of 10, of 5.7 ± 2.3 regarding the reliability of information that they could find on the Internet. The use of the Internet differs significantly depending on age: those who use the Internet are younger (62.1 ± 8.91 years) than those who do not use it (73.3 ± 9.42 years). The socioeconomic status also has an impact on the Internet use: Internet users have a higher education, are more professionally active and have a higher net monthly household income compared to the group of non-users. Even if age and socioeconomic status appear to be determining factors in the use of the Internet for the search of health information in patients eligible for osteoporosis screening, almost 75 % of the study population use the Internet for this purpose. Action to promote health through an Internet platform must therefore take these parameters into account.

Background Overweight and obesity are significant and growing public health concerns. In Belgium, the rates of overweight (Body Mass index (BMI) ≥ 25 kg/m2) and of obesity (BMI ≥ 30 kg/m2) amount 33% and 14%, respectively. While physiopathological processes subtending obesity are well documented, this is not the case for the representations and perceptions of subjects with overweight and obesity. One of the objectives of EDUDORA2 program intends to fill this gap by enabling concerned subjects to express their feeling and …

Background The prevalence of obesity has increased dramatically over the past three decades in industrialized societies. Unbalanced eating habits with high macronutrient and poor micronutrient intakes are known to augment the risk of obesity. Furthermore, various studies have shown that socioeconomically disadvantaged groups have a higher prevalence of obesity than more advantaged groups, especially among women. The purpose of the study was to assess the importance of …

Background In the interregional cross-sectional study NESCAV (Nutrition, Environment and Cardiovascular Health), a modified semi-quantitative Food frequency questionnaire (FFQ) was used to assess dietary habits of the “Greater Region” (Luxembourg, Wallonia in Belgium and Lorraine in France) and to explore the relationship between diet and cardiovascular risk factors (CVRF). Validation of the FFQ is essential since incorrect information may lead to erroneous associations between …

The assessment of nutritional problems is vital to support patients undergoing radiotherapy. Poor nutritional status may occur as a result of preexisting problems, older age, the cancer itself, or treatment side effects. Malnutrition impairs the outcome of the disease and affects patients. This prospective study aimed at developing two simple tools to screen malnutrition before radiotherapy and to assess, prior to treatment, the risk of malnutrition after radiotherapy. Forty-seven lung cancer patients treated with curative intent were evaluated before radiotherapy and after completion of the treatment. To assess patient’s malnutrition, two well-known screening tools (PG-SGA and NRS-2002) were used, complemented by patient-specific characteristics, yielding a 59-item questionnaire. Malnutrition status was defined using Thoresen’s criteria. The two screening tools derived by multivariate analyses were validated by comparing anthropometric, biological, and nutritional variables between patients at risk of malnutrition and those who are not. Malnutrition detection prior to radiotherapy was based on the equation “MDS = 5.88 − 0.20 × BMI + 0.05 × (percent weight loss over past 6 months),” while malnutrition prediction after radiotherapy was given by “MPS = 3.67 + 0.98 × (age ≥70) − 0.12 × BMI + 1.20 × edema.” Agreement between observed and estimated outcomes was quite high for the two scores (kappa coefficient 0.80 and 0.85, respectively). The two assessment tools were found parsimonious and easy to use. Further studies are needed to validate them in larger lung cancer groups and in other cancer populations.

Introduction La facon dont les patients (soignes) percoivent leur diabete est mal connue des medecins (soignants). Ce travail compare les representations individuelles des patients et les representations attribuees aux patients par les medecins a propos du diabete de type 2 (DT2). Patients et methodes Une collecte standardisee de donnees a ete realisee en 2011–2012 a l'aide de deux questionnaires auto-administres aupres de 1 764 patients DT2 (32 questions semi-ouvertes) et aupres de 113 medecins generalistes (18 questions semi-ouvertes). Les 2 questionnaires se sont interesses au vecu du diabete par les patients (causes du DT2, domaines de vie modifies, difficultes dans la prise en charge). Resultats Les patients (63,4±8,9 ans, 55,5 % hommes, 30,3±5,8kg/m 2 , 11,5±8,9 annees de DT2) sont sous traitement oral (63 %), sous injection (15 %) ou sous traitement combine (22 %). Les medecins ont un âge de 54,2±10,5 ans, avec 70,8 % d'hommes ; 28,9 % estiment avoir une formation specifique sur le diabete et 11,1 % en matiere d'education a la sante. Patients et medecins citent prioritairement les causes classiques du diabete (âge, heredite, obesite, alimentation), mais les patients insistent davantage sur le stress et les traumatismes. Les soignants pensent que le diabete modifie plus considerablement les differents domaines de la vie des patients que les soignes eux-memes (9/9 items cites par > 40 % des medecins versus 3/9 items cites par > 40 % des patients). Les medecins pensent egalement que leurs patients rencontrent davantage de difficultes dans la prise en charge de leur diabete que les patients eux-memes (6/7 items cites par > 25 % des medecins versus 1/7 items cites par > 25 % des patients). Conclusion Les patients ont une opinion plus favorable de leur diabete que les medecins. Non exprimees, les discordances entre les representations des soignants et des soignes constituent un frein pour une collaboration constructive et pour une veritable education therapeutique.

Introduction Le diabete de type 2 (DT2) et la qualite de vie (QoL) des patients entretiennent une influence reciproque encore mal connue. La presente enquete a interroge la QoL des patients avec le DT2. Patients et methodes Une collecte standardisee de donnees a ete realisee en 2011-2012 avec un questionnaire auto-administre aupres de 1 764 patients DT2 recrutes via differents reseaux (63,4±8,9 ans ; 55,5 % hommes ; 30,3±5,8kg/m 2 11,5±8,9 annees de DT2). Les 32 questions semi-ouvertes se sont essentiellement interessees au vecu du diabete par les patients (causes du DT2, domaines de vie modifies, difficultes dans la prise en charge). La QoL a ete evaluee sur une echelle de 0 a 10. Les resultats ont ete compares entre les patients avec une QoL basse (score ≤ 6) et une QoL elevee (score ≥ 7). Resultats 64,6 % des patients estiment que leur QoL reste elevee (moyenne 8,2, venant de 8,4 avant le DT2). Les patients avec une QoL basse (moyenne 4,7, venant de 7,5 avant DT2) incriminent plus frequemment, comme responsables du DT2, des facteurs ineluctables (stress, heredite, traumatismes). Les domaines de vie sont plus souvent modifies negativement par le diabete chez les patients avec une QoL basse (7/9 items cites par > 40 % vs. 0/9 chez les patients avec une QoL ≥ 7) et des difficultes sont davantage rencontrees dans la prise en charge du DT2 (7/9 items cites par > 15 % vs. 7/9 items cites par Conclusion Chez les patients relatant une QoL basse, la chute depuis le DT2 semble liee a des modifications negatives de divers domaines de vie et a un moins bon vecu de la maladie. Les resultats de cette enquete plaident en faveur d'une meilleure connaissance du sens de ces relations.

Introduction L'exces de poids represente un probleme de sante publique majeur. En Belgique, 33 % de la population sont en surpoids (IMC≥25kg/m 2 ) et 14 % obeses (IMC≥30kg/m 2 ). Si les processus physiopathologiques sous-tendant l'exces de poids sont mieux connus, les representations et perceptions des personnes concernees par celui-ci le sont moins. Un des objectifs de l'etude Edudora 2 etait de donner la parole a ces personnes pour apprehender leurs ressentis et experiences de la maladie. Patients et methodes 4 155 personnes ont participe volontairement, en 2012, a une etude exploratoire menee en Wallonie (Belgique) grâce a un questionnaire specifiquement dedicace disponible sur internet (46±14 ans, 69 % femmes, IMC 31,7±6,7kg/m 2 ). Resultats 87,5 % des participants rapportent un exces de poids (surpoids 32,2 %, obesite moderee 29,9 %, severe 14,8 %, morbide 10,6 %) et 94,5 % d'entre eux estiment avoir un probleme de poids. Ce probleme est juge « tres important » pour 46,3 % des individus et « important » pour 42,4 %. Neanmoins, trois quarts des repondants percoivent leur sante comme bonne ou tres bonne ; cependant, plus l'IMC est eleve, plus la sante est consideree comme mauvaise (p Conclusion Cette etude montre l'influence du degre de l'exces de poids (IMC) sur les perceptions en termes de sante et les representations des personnes concernees. Une prise en charge adaptee doit tenir compte de ce constat.