Herman Depypere

Ghent University, Gand, Flanders, Belgium

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Publications (69)186.57 Total impact

  • Maturitas 01/2014; · 2.84 Impact Factor
  • Maturitas 01/2014; · 2.84 Impact Factor
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    ABSTRACT: Introduction Osteoporοtic vertebral fractures are associated with significant morbidity, excess mortality as well as health and social service expenditure. Additionally, women with a prevalent osteoporotic vertebral fracture have a high risk of experiencing a further one within one year. It is therefore important for the physician to use a diagnostic and therapeutic algorithm for early detection and effective treatment of vertebral fractures. Aims The aim of this position statement is to provide and critically appraise evidence on the management of women with a vertebral osteoporotic fracture Material and Methods Literature review and consensus of expert opinion. Results and Conclusions The management of women with osteoporotic vertebral fractures include measures to reduce pain providing early mobility, to support the affected spine ensuring fracture healing, as well as starting treatment for osteoporosis itself. Any other underlying pathology should be sought and treated. Early detection and treatment is essential as there is an increased risk of further fractures in patients with vertebral fractures. Treatment will depend on the underlying causes of bone loss, efficacy in any particular situation, cost and patient preference.
    Maturitas 01/2014; · 2.84 Impact Factor
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    ABSTRACT: Introduction Uterine fibroids (also termed leiomyomas or myomas) are the most common tumors of the female reproductive tract. Aim The aim of this position statement is to provide and critically appraise evidence on the management of women with uterine fibroids. Methods Literature review and consensus of expert opinion. Results and Conclusions Many uterine fibroids are asymptomatic and require no intervention, although it is advisable to follow up patients to document stability in size and growth. Fibroid-associated symptoms include heavy menstrual bleeding (HMB) and pain or pelvic discomfort. The association between infertility and fibroids increases with age. Fibroids do not increase the risk of malignant uterine disease and leiomyosarcomas are extremely rare (less than one in 1,000). It is unknown at present whether leiomyosarcoma represents de novo growth or malignant transformation from benign uterine fibroids. Treatment options for symptomatic fibroids include pharmacologic, surgical and radiologically guided interventions. The range of medical treatments allows flexible management of fibroid-related symptoms; the options include tranexamic acid, non-steroidal anti-inflammatory drugs, contraceptive steroids, gonadotropin-releasing hormone analogues, antiprogesterone, and selective progesterone receptor modulators. However, these medical options do not remove the tumors and symptoms may return when treatment is stopped. Surgical and radiologically guided procedures may be tailored to age, general health, and individual patient wishes. Hysterectomy is the most effective treatment, although in some cases myomectomy may be sufficient to control symptoms. Alternatives to surgery include uterine artery embolization, myolysis and ablation by high-intensity focused ultrasound (guided with magnetic resonance imaging or ultrasound). The choice of treatment depends on fibroid size, the underlying symptoms and their severity and the woman's desire for subsequent fertility and pregnancy, as well as efficacy and need for repeated interventions.
    Maturitas 01/2014; · 2.84 Impact Factor
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    ABSTRACT: The increasing incidence of malignant diseases that often require gonadotoxic treatment and the tendency to become a parent later in life result in an increased need for fertility preservation. The aim of this position statement is to provide and critically appraise evidence on available options for fertility preservation in both pre-pubertal and post-pubertal men and women. Literature review and consensus of expert opinion. Fertility preservation should be a priority when treating children or adults of reproductive age with agents that may have hazardous effects on the reproductive system. Gonadotoxicity should be kept at a minimum. If gonadotoxic treatment has to be used, methods of fertility preservation should be discussed, as early as possible.
    Maturitas 10/2013; · 2.84 Impact Factor
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    ABSTRACT: Objective: The purpose of this study was to investigate the speaking fundamental frequency (SFF) in pre- and postmenopausal women with and without hormone therapy (HT) and with low and high body mass index (BMI). Patients and Methods: The SFF of premenopausal women with low BMI (n = 22) was compared with the SFF of premenopausal women with high BMI (n = 13), postmenopausal women with HT and low BMI (n = 35), postmenopausal women with HT and high BMI (n = 19), postmenopausal women without HT and with low BMI (n = 28) and postmenopausal women without HT and with high BMI (n = 12) using ANCOVA and post hoc tests. Results: A significantly lower SFF of the voice was only found in postmenopausal women without HT and with a low BMI. Conclusion: The results of this study suggest that the menopause lowers the voice with approximately 14 Hz and that HT and adipose tissue (high BMI) might counteract the menopausal drop in SFF.
    Folia Phoniatrica et Logopaedica 08/2013; 65(2):78-83. · 1.08 Impact Factor
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    ABSTRACT: During the last decades, couples in Europe have been delaying parenthood, mainly due to socio-demographic factors that include increased rates of university education and employment in women and poorer financial status. The aim of this position statement is to provide and critically appraise evidence on the impact of late parenthood, focusing on the pathophysiology and management of male and female infertility, pregnancy complications and long-term offspring health. Literature review and consensus of expert opinion. Advanced parental age is associated with infertility and pregnancy complications and may have an impact on long-term offspring health. All adults of reproductive age should receive counseling on the risks of advanced parental age, so they can make informed decisions about the timing of childbearing. All parents-to-be of advanced age should receive advice on the potential pregnancy, neonatal and long-term offspring health-related issues. These tasks require an interdisciplinary approach that could lead to patient-centered, informed decision-making strategies.
    Maturitas 08/2013; · 2.84 Impact Factor
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    ABSTRACT: INTRODUCTION: Invasive as well as non-invasive methods are available for assessment of the endometrium. AIMS: The purpose of this clinical guide is to provide evidence-based advice on endometrial assessment in peri and postmenopausal women. MATERIAL AND METHODS: Literature review and consensus of expert opinion. RESULTS AND CONCLUSIONS: Presuming speculum examination and cervical cytology are assessed, transvaginal ultrasound should be undertaken initially as it is non-invasive and will not only measure endometrial thickness, but will also detect other pelvic pathology such as leiomyomas and ovarian tumours. The main indication for invasive methods is to obtain endometrial tissue to diagnose or exclude the presence of endometrial cancer or pre-malignancies. Biopsy is mainly undertaken as an outpatient procedure, but sampling is 'blind'. Hysteroscopy is used when focal lesions affecting the uterine cavity are suspected such as endometrial polyps or sub-mucous fibroids. None of the available methods are perfect. Ultrasound evaluation is dependent on the experience of the examiner, the equipment and the quality of visualization. Hysteroscopy too is dependent on the examiner and fibroids may obstruct visualization. Blind endometrial biopsy procedures often miss focal lesions. Thus re-examination is necessary when symptoms persist and no explanation for these has been identified. This clinical guide will evaluate the different methods of endometrial assessment, their indications and limitations. Guidance is also given about dealing with inconclusive investigations and persistent symptoms.
    Maturitas 04/2013; · 2.84 Impact Factor
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    ABSTRACT: INTRODUCTION: Vulvar lichen sclerosus (LS) is a chronic inflammatory disease which affects genital labial, perineal and perianal areas, producing significant discomfort and psychological distress. However there may be diagnostic delay because of late presentation and lack of recognition of symptoms. AIMS: The purpose of this clinical guide is to provide advice on early recognition and treatment. MATERIAL AND METHODS: Literature review and consensus of expert opinion. RESULTS AND CONCLUSIONS: The etiology of LS in peri and postmenopausal women is unknown, although autoimmune, genetic and infectious factors have been implicated. Definitive diagnosis of non-malignant disorders depends on the histology of biopsied tissue. LS associated with cellular atypia should be classified as intraepithelial neoplasia. Topical corticosteroids are the most effective treatment, although prolonged treatment may be associated with dermal atrophy. Topical calcineurin inhibitors, such as tacrolimus or pimecrolimus, may be a safe and effective alternative treatment without risk of corticosteroid-related vulvar atrophy since they do not affect collagen synthesis. LS recurrences are frequent, and can lead to significant physical discomfort and emotional distress that affect mood and sexual relationships. Anatomical changes may require surgical management.
    Maturitas 01/2013; · 2.84 Impact Factor
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    ABSTRACT: INTRODUCTION: There is increasing evidence that life-style factors, such as nutrition, physical activity, smoking and alcohol consumption have a profound modifying effect on the epidemiology of most major chronic conditions affecting midlife health. AIMS: To provide guidance concerning the effect of diet on morbidity and mortality of the most frequent diseases prevalent in midlife and beyond. MATERIALS AND METHODS: Literature review and consensus of expert opinion. RESULTS AND CONCLUSIONS: A healthy diet is essential for the prevention of all major chronic non-communicable diseases in midlife and beyond, both directly, through the effect of individual macro- and micronutrients and indirectly, through the control of body weight. Type 2 diabetes mellitus is best prevented or managed by restricting the total amount of carbohydrate in the diet and by deriving carbohydrate energy from whole-grain cereals, fruits and vegetables. The substitution of saturated and trans-fatty acids by mono-unsaturated and omega-3 fatty acids is the most important dietary intervention for the prevention of cardiovascular disease. Obesity is also a risk factor for a variety of cancers. Obese elderly persons should be encouraged to lose weight. Diet plans can follow the current recommendations for weight management but intake of protein should be increased to conserve muscle mass. The consumption of red or processed meat is associated with an increase of colorectal cancer. Adequate protein, calcium and vitamin D intake should be ensured for the prevention of osteoporotic fractures. Surveillance is needed for possible vitamin D deficiency in high risk populations. A diet rich in vitamin E, folate, B12 and omega-3 fatty acids may be protective against cognitive decline. With increasing longevity ensuring a healthy diet is a growing public health issue.
    Maturitas 11/2012; · 2.84 Impact Factor
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    ABSTRACT: Vaginal atrophy is common in postmenopausal women. This clinical guide provides the evidence for the clinical use of vaginal estrogens for this condition focussing on publications since the 2006 Cochrane systematic review. Use after breast cancer, before assessment of cervical cytology and prolapse surgery is also discussed.
    Maturitas 07/2012; 73(2):171-4. · 2.84 Impact Factor
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    ABSTRACT: The main purpose of this study was to investigate the impact of hormone therapy (HT) on vocal characteristics in postmenopausal women by comparing postmenopausal women with HT (n=59) and postmenopausal women without HT (n=46). The second purpose was to investigate the differences in vocal characteristics between two types of HT: estrogen therapy (ET) and estrogen-progestogen therapy (E-PT). To determine the vocal characteristics in both groups, objective (aerodynamic measurements, vocal range measurements, acoustic analysis, and a determination of the dysphonia severity index) and subjective assessment techniques (perceptual evaluation, videostroboscopic evaluation, and voice handicap index) were used. The postmenopausal women without HT showed a significantly lower speaking fundamental frequency and were able to phonate lower compared with postmenopausal women with HT. No differences in vocal characteristics were found between postmenopausal women with ET and postmenopausal women with E-PT. HT seems to counteract the vocal changes caused by menopause. The type of HT did not affect the outcome in this study.
    Journal of voice: official journal of the Voice Foundation 05/2012; 26(5):671.e1-7. · 0.95 Impact Factor
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    ABSTRACT: The purpose of this study was to investigate the impact of menopause and hormone therapy on nasal resonance by comparing premenopausal women and postmenopausal women with and without hormone therapy. A total of 147 middle-aged Flemish (Dutch)-speaking women participated in the study and were divided into three groups: premenopausal women (n =42), and postmenopausal women with (n =63) and without (n =42) hormone therapy. Nasal resonance scores of isolated sounds and connected speech were measured using the Nasometer. For the isolated sounds as well as for the reading texts, no differences were found in nasal resonance scores between the three groups (ANCOVA). The results of this study indicate that menopause and hormone therapy do not have an impact on the nasal resonance in middle-aged women.
    Logopedics, phoniatrics, vocology 03/2012; 37(2):69-74.
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    ABSTRACT: In an initial study it was shown that (without hormonal influences) middle-aged (premenopausal) women show a smaller frequency and intensity range and a lower fundamental frequency of the voice compared to young women. To investigate the impact of menopause on voice and nasal resonance a cross-sectional non-randomized study design was used. Vocal characteristics and nasal resonance in premenopausal and postmenopausal women without hormone therapy (HT) were compared. Postmenopausal women without HT showed a significantly lower speaking fundamental frequency (SFF) and were able to phonate lower compared to postmenopausal women with HT. The mean difference in SFF was 14 Hz. HT can also counteract the menopausal changes in SFF. The lower SFF did not result in vocal complaints. Further research about the impact of menopause and HT on voice should concentrate on elite professional voice users.
    Facts, views & vision in ObGyn. 01/2012; 4(1):38-41.
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    S Bolca, M Bracke, H Depypere
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    ABSTRACT: In developed countries, the life expectancy of women is currently extending more than 30 years beyond the age of menopause. The menopausal transition is often associated with complaints. The conflicting results on the effectivity of phytoestrogens to alleviate menopausal symptoms. This discrepancy in treatment effect may be due to the large interindividual variation in isoflavone bioavailability in general and equol production in particular. Equol, a microbial metabolite of daidzein, has been hypothesized as a clue to the effectiveness of soy and its isoflavones, but only about 30-50% of the population harbor an intestinal microbial ecosystem supporting the conversion of daidzein into equol. There is much concern on breast cancer, since this incidence of this disease increases with age. There is indication that soy phytoestrogens may decrease this breast cancer incidence. In order to evaluate the estrogenic potential of these exposure levels, we studied the isoflavone-derived E2α- and E2β-equivalents (i.e. 17β-estradiol (E2)-equivalents towards ERα and ERβ, respectively) in human breast tissue. Total isoflavones showed a breast adipose/glandular tissue distribution of 40/60 and their derived E2β-equivalents exceeded on average 21 ± 4 and 40 ± 10 times the endogenous E2 concentrations in corresponding adipose and glandular biopsies, respectively, whereas the E2α/E2 ratios were 0.4 ± 0.1 and 0.8 ± 0.2 in adipose and glandular breast tissue, respectively. These calculations suggest that, at least in this case, soy consumption could elicit partial ERβ agonistic effects in human breast tissue. We are currently characterizing the differential activation of estrogen-responsive genes between dietary isoflavones, the chemopreventive selective ER modulators tamoxifen and raloxifene and exogenous estrogens in a controlled dietary intervention trial that integrates data on the exposure to estrogenically active compounds, expression of isoflavone and estrogen target genes, and epigenetic events. During the menopause, there is a close relation between the drop in serum estrogen and negative metabolic changes such as the increase in bone resorption and negative change in the serum lipid profile. Randomized controlled trials measuring bone turnover markers in menopausal women revealed that soy isoflavone supplements significantly but moderately decrease the bone resorption marker urinary deoxypyridinoline without significant effects on the bone formation markers serum bone alkaline phosphatase and osteocalcin.
    Facts, views & vision in ObGyn. 01/2012; 4(1):30-7.
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    ABSTRACT: Aging influences several speech characteristics in middle-aged women. However, the effect of aging on nasal resonance has not been widely investigated, and findings are contradictory. The purpose of this study was to investigate the effect of aging on nasal resonance by comparing young women (between 20 and 28 years of age) with middle-aged women (between 45 and 55 years of age). Thirty-one middle-aged women with a mean age of 48 years participated in the subject group. The control group consisted of 22 young women with a mean age of 23 years. To investigate nasal resonance, we used a multiparameter approach by means of the Nasal Severity Index (NSI). Objective acoustic (nasal resonance scores of sounds and connected speech measured with the Nasometer) and aerodynamic measurements (maximum duration time of /s/, vital capacity, and mirror fogging test), as well as perceptual evaluations (Gutzmann /a/-i/test), were performed. The results of this study showed no differences in aerodynamic measurements and nasal resonance scores of connected speech and the sounds /i/, /u/, and /m/. Only the mean nasal resonance score of /a/ and the Gutzmann /a/ test were significantly different between the young and middle-aged women. The mean (+/- SD) NSI scores of the young women (12.93 +/- 17.9) and the middle-aged women (-1.49 +/- 14.4) both corresponded to normal nasal resonance. The results of this study indicate that both young and middle-aged women show a normal nasal resonance. Differences in objective and subjective measurements of nasal resonance were only found in isolated vowels, and not in connected speech.
    The Annals of otology, rhinology, and laryngology 09/2011; 120(9):575-80. · 1.21 Impact Factor
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    ABSTRACT: The purpose of this study was to investigate the association between body mass index (BMI) and speaking fundamental frequency (SFF) in premenopausal and postmenopausal women with and without hormone therapy (HT). A total of 105 middle-aged women participated and were divided into three groups: premenopausal women (n = 41), postmenopausal women without HT (n = 26), and postmenopausal women with HT (n = 38). The mean SFF (in hertz) of connected speech was measured using the Real-Time Pitch program from Computerized Speech Lab (Kay). Correlation coefficients were calculated using partial correlation between BMI and SFF, controlling for age. A positive correlation was apparent between BMI and SFF in the group of postmenopausal women without HT (P = 0.021). In the group of premenopausal women and the group of postmenopausal women with HT, no correlation was found between BMI and SFF. In postmenopausal women without HT, increasing BMI is associated with increasing SFF. This correlation is possibly related to the higher amount of estrogen production in adipose tissue in women with a higher BMI.
    Menopause (New York, N.Y.) 02/2011; 18(7):754-8. · 3.08 Impact Factor
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    ABSTRACT: Human MCF-7/6 breast cancer cells differ from their MCF-7/AZ counterparts by their invasiveness in a number of assays in vitro, such as invasion of MCF-7 spheroids into embryonic chick heart fragments or type I collagen gels. Comparative proteomic analysis of these two variants revealed an identical pattern, except for a 230 kDa protein present in the invasive MCF-7/6 variant, but hardly detectable in the non-invasive MCF-7/AZ one. This protein appeared to be the non-muscle myosin IIA heavy chain (NMIIA), also coined MYH9. Experimental inhibition of NMIIA by reducing either its expression (via stable shRNA transduction) or its function (via the specific ATPase inhibitor blebbistatin) underpinned the decisive role of NMIIA in MCF-7 cell invasion. Inhibition of NMIIA indeed blocked the invasion of MCF-7/6 cells in three-dimensional invasion substrata such as embryonic chick heart fragments and type I collagen gels. Invasiveness of MCF-7/6 cells has been related to poor formation and compaction of aggregates, due to a functionally defective E-cadherin/catenin complex. Both genetic and pharmacological inhibition of NMIIA stimulated MCF-7/6 cell aggregation. Together, these data indicate that NMIIA is a decisive protein for MCF-7 cells to invade, indicating that this molecule is a candidate for targeted anti-invasive treatment.
    The International journal of developmental biology 01/2011; 55(7-9):835-40. · 2.16 Impact Factor
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    ABSTRACT: The purpose of this study was to measure and describe the effect of menopause on vocal characteristics by comparing premenopausal and postmenopausal women (not taking hormone therapy [HT]). Thirty-eight postmenopausal women (mean age, 58 y) not taking HT participated in the study. The control group consisted of 34 premenopausal women (mean age, 48 y). To determine the vocal characteristics in both groups, objective (aerodynamic measurements, vocal range measurements, acoustic analysis, electroglottography, and a determination of the Dysphonia Severity Index) and subjective (perceptual evaluation, videostroboscopic evaluation, and Voice Handicap Index) assessment techniques were used. Postmenopausal women showed a good overall vocal quality, with a Dysphonia Severity Index value of 3.3. Significant differences in aerodynamic parameters (vital capacity and phonation quotient), vocal range (lowest frequency), and acoustic parameters (fundamental frequency [F0] during reading, variation of F0, F0 tremor intensity index, and amplitude tremor intensity index) were found between the premenopausal and postmenopausal women. However, when controlling for age, only phonation quotient and F0 during reading were significantly lower in the group of postmenopausal women. For the perceptual evaluation, significant differences in grade of dysphonia, breathiness, and strained vocal quality were found. Postmenopausal women not taking HT had a good overall vocal quality. However, in comparison with premenopausal women, they showed a lower habitual F0 in continuous speech.
    Menopause (New York, N.Y.) 10/2010; 18(3):267-72. · 3.08 Impact Factor
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    ABSTRACT: Hop-derived products may contain xanthohumol (XN), isoxanthohumol (IX), and the potent phytoestrogen 8-prenylnaringenin (8-PN). To evaluate the potential health effects of these prenylflavonoids on breast tissue, their concentration, nature of metabolites, and biodistribution were assessed and compared with 17beta-estradiol (E(2)) exposure. In this dietary intervention study, women were randomly allocated to hop (n=11; 2.04 mg XN, 1.20 mg IX, and 0.1 mg 8-PN per supplement) or control (n=10). After a run-in of >or=4 days, three supplements were taken daily for 5 days preceding an aesthetic breast reduction. Blood and breast biopsies were analyzed using HPLC-ESI-MS/MS. Upon hop administration, XN and IX concentrations ranged between 0.72 and 17.65 nmol/L and 3.30 and 31.50 nmol/L, and between 0.26 and 5.14 pmol/g and 1.16 and 83.67 pmol/g in hydrolyzed serum and breast tissue, respectively. 8-PN however, was only detected in samples of moderate and strong 8-PN producers (0.43-7.06 nmol/L and 0.78-4.83 pmol/g). Phase I metabolism appeared to be minor (approximately 10%), whereas extensive glucuronidation was observed (> 90%). Total prenylflavonoids showed a breast adipose/glandular tissue distribution of 38/62 and their derived E(2)-equivalents were negligible compared with E(2) in adipose (384.6+/-118.8 fmol/g, p=0.009) and glandular (241.6+/-93.1 fmol/g, p<0.001) tissue, respectively. Consequently, low doses of prenylflavonoids are unlikely to elicit estrogenic responses in breast tissue.
    Molecular Nutrition & Food Research 07/2010; 54 Suppl 2:S284-94. · 4.31 Impact Factor

Publication Stats

757 Citations
186.57 Total Impact Points

Institutions

  • 1994–2014
    • Ghent University
      • • Faculty of Medicine and Health Sciences
      • • Faculty of Bioscience Engineering
      • • Medical Oncology
      • • Department of Uro-gynaecology
      • • Department of Radiotherapy and Experimental Cancer Research
      • • Faculty of Pharmaceutical Sciences
      Gand, Flanders, Belgium
  • 1993–2014
    • Universitair Ziekenhuis Ghent
      • • Department of Gynaecology
      • • Women´s Clinic
      Gand, Flanders, Belgium