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Acta Clinica Belgica

Elodie Degroote, Halil Yildiz, Frederic Lecouvet, Alexia Verroken, Leila Belkhir
OBJECTIVE AND IMPORTANCE: New methods of microbiology identification as MALDI-TOF MS increased the rate of Aerococci detection in microbiological samples making this germ an emerging pathogen. The purpose of this case report and literature review is to highlight the role of A. urinae in spine infection and discuss the management of this type of infection. CLINICAL PRESENTATION AND INTERVENTION: A 32-year-old man, with a medical history of paraplegia secondary to a relapsing form of multiple sclerosis, was admitted because of lower back-pain following complaints suggestive of urinary tract infection...
March 2, 2018: Acta Clinica Belgica
Semi Ozturk, Ahmet Seyfeddin Gurbuz, Suleyman Cagan Efe, Raim Iliaz, Mutse Banzragch, Kadir Demir
Background Neurologic and liver involvement in Wilson's disease (WD) is well-documented, however, few reports demonstrated cardiac involvement. Tpe and Tpe/QT are new measures of ventricular repolarization which were recently suggested as predictor of arrythmogenesis. We aimed to evaluate ventricular depolarization and repolarization parameters including QT, QTc, Tpe intervals, Tpe/QT, Tpe/QTc ratios, and QT dispersion (QTd) in patients with WD. Materials and methods Thirty-five patients with WD and 30 healthy controls were included in the study...
March 1, 2018: Acta Clinica Belgica
Stefan Andric, Dragica Tesic, Dalibor Somer, Ilija Srdanovic, Tatjana Miljkovic, Djordje G Jakovljevic, Lazar Velicki
OBJECTIVE AND IMPORTANCE: Endless loop tachycardia or pacemaker-mediated tachycardia, and atrioventricular desynchronization arrhythmia or repetitive non-reentrant ventriculoatrial synchrony (RNRVAS) are two forms of reverse impulse conduction - ventriculoatrial (VA) synchrony. Although VA synchrony can theoretically cause aggravation of heart failure, clinical cases describing severe consequential heart failure are lacking. CLINICAL PRESENTATION AND INTERVENTION: We describe a case of a 60-year-old patient who underwent primary percutaneous coronary intervention and mitral valve surgery...
February 21, 2018: Acta Clinica Belgica
Paul-Emile Claus, Anne-Sophie Ceuppens, Mike Cool, Gudrun Alliet
OBJECTIVES:  The roundworm Ascaris lumbricoides is one of the most prevalent parasites belonging to the class of the soil-transmitted helminths. Infections are most common in developing countries with a tropical climate where sanitation and hygiene are poor. However, prevalence of ascariasis in industrialized countries is increasing because of immigration and increasing number of refugees. METHODS:  We report a case of ascariasis in a female patient who was admitted to our hospital after she had left the informal refugee camp of Calais in the north of France...
February 19, 2018: Acta Clinica Belgica
Nicoleta Răcătăianu, Sorana Daniela Bolboacă, Adela-Viviana Sitar-Tăut, Smaranda Mârza, Daniela Moga, Ana Valea, Cristina Ghervan
Objective The study's objective was to evaluate the thyroid parameters in obese insulin-resistant patients with euthyroid diffuse or nodular goiter, following Metformin treatment. Patients and methods The study was experimental, open, and prospective. Fifty-three patients aged 18-68 were enrolled for two years. Obese insulin-resistant patients (cut-off Homeostasis-Model-Assessment of Insulin Resistance-HOMA-IR ≥ 2.5) with euthyroid nodular/diffuse goiter were included. Subjects with diabetes, hypo-/hyper-thyroidism, autoimmune thyroiditis, psychiatric disorders, liver or heart failure were excluded...
February 16, 2018: Acta Clinica Belgica
Karel Decaestecker, Nicolaas Lumen, Christel Van Camp, Willem Oosterlinck
Objectives To explore the effect of electromotive drug administration of mitomycin C (EMDA-MMC) using a single dose of intravesical mitomycin C (MMC) to avoid transurethral resection (TURBT) for small non-muscle-invasive bladder cancer. Material and methods All patients presenting small (<2 cm), single or multiple papillary bladder tumors were proposed to undergo a single EMDA-MMC instillation with 60 mg MMC before planning TURBT. The end point is complete disappearance of all papillary tumors at 2-4 weeks after EMDA-MMC...
February 16, 2018: Acta Clinica Belgica
Martin Vanden Eede, Matthew Schroyens
OBJECTIVE AND IMPORTANCE: Late postpartum eclampsia is characterized by pre-eclampsia and tonic-clonic seizures presenting more than 48 hours postpartum. It is a rare, frightening and dangerous complication that requires rapid recognition and adequate treatment. CLINICAL PRESENTATION: We present a case of late postpartum eclampsia, initially diagnosed as right-sided heart failure, 10 days postpartum.Two days after the delivery she developed mild swelling of both feet, progressive shortness of breath on exertion and orthopnea...
February 16, 2018: Acta Clinica Belgica
Eva De Backer, Heidi Hannon
Objective and importance Flucloxacillin is a narrow-spectrum beta-lactam antibiotic with activity against penicillinase producing staphylococci and streptococci. Severe hypokalaemia is an uncommon, but serious adverse effect in patients treated with penicillin derivates. Clinical presentation We report a case of severe hypokalaemia in a patient treated with high dose intravenous flucloxacillin. Conclusion This case report highlights the importance of monitoring electrolytes during treatment with high dose flucloxacillin...
February 15, 2018: Acta Clinica Belgica
Bernard Peene, Annick Van den Bruel, Carolien Moyson, Brigitte Decallonne
Objective Thyroid cancer incidence is increasing. The rise is most pronounced for microcancers (≤10 mm, T1a). In 2006, landmark European and American guidelines for the management of thyroid cancer were published. We studied thyroid cancer characteristics and initial management before and after 2006. Methods We conducted a retrospective observational study of non-medullary thyroid cancer patients that underwent thyroidectomy in two Belgian referral centres comparing pre-, per- and post-operative management in a cohort before and after 2006...
February 12, 2018: Acta Clinica Belgica
Peter Vermeir, Sophie Degroote, Hanne Van Tiggelen, Dominique Vandijck, Renaat Peleman, Rik Verhaeghe, An Mariman, Hubert Vermeersch, Dirk Vogelaers
Objectives To explore patient perceptions on personal comfort with participation in their own care process and on support of this patient participation through electronic health record (EHR) accessibility. Methods Explorative quantitative questionnaire study in ambulatory patients visiting the departments of General Internal Medicine or Head, Neck and Maxillo-Facial Surgery of a Belgian tertiary referral center. Results Patients were recruited by convenience sampling of 438 out of the total of 1270 patients visiting either one of these departments within a time period of two weeks...
February 12, 2018: Acta Clinica Belgica
Agnès Libois, Eric Florence, Inge Derdelinckx, Jean Cyr Yombi, Sophie Henrard, Françoise Uurlings, Stefaan Vandecasteele, Sabine D Allard, Rémy Demeester, Filip Van Wanzeele, Nathalie Ausselet, Stéphane De Wit
We present the updated Belgian guidelines for the use of non-occupational HIV post-exposure prophylaxis (NONOPEP). This document is inspired by UK guidelines 2015, adapted to the Belgian situation and approved by all AIDS reference centers in Belgium. When recommended, NONOPEP should be initiated as soon as possible, preferably within 24 h of exposure but can be offered up to 72 h. The duration of NONOPEP should be 28 days. These current guidelines include epidemiologic estimations, which can be used to calculate the risk of infection after a potential exposure and help to decide whether or not to start prophylaxis...
February 12, 2018: Acta Clinica Belgica
Tine Kold Olesen, Marie-Astrid Denys, Johan Vande Walle, Karel Everaert
Background Evidence of diagnostic accuracy for proposed definitions of nocturnal polyuria is currently unclear. Purpose Systematic review to determine population-based evidence of the diagnostic accuracy of proposed definitions of nocturnal polyuria based on data from frequency-volume charts. Methods Seventeen pre-specified search terms identified 351 unique investigations published from 1990 to 2016 in BIOSIS, Embase, Embase Alerts, International Pharmaceutical Abstract, Medline, and Cochrane. Thirteen original communications were included in this review based on pre-specified exclusion criteria...
February 6, 2018: Acta Clinica Belgica
Annick Smismans, Astrid Vantrappen, Freija Verbiest, Christophe Indevuyst, Bea Van den Poel, Sandrina von Winckelmann, Annelore Peeters, Sara Ombelet, Peter Lybeert, Andre Heremans, Eric Frans, Erwin Ho, Johan Frans
Since its introduction in the 1970s in the United States, outpatient parenteral antibiotic/antimicrobial therapy (OPAT) has been adopted internationally for long-term intravenous (IV) treatment of stable infectious diseases. The aim is to provide a safe and successful completion of IV antimicrobial treatment at the ambulatory care center or at home without complications and costs associated with hospitalization. OPAT implementation has been accelerated by progress in vascular access devices, newly available antibiotics, the emphasis on cost-savings, as well as an improved patient comfort and a reduced incidence of health care associated infections with a similar outcome...
January 31, 2018: Acta Clinica Belgica
Audrey Cambier, Delphine Martiny, Marie Hallin, Magali Wautier, Jean-Baptiste Giot, Myriam Z Khaldi, Jacques Cambier, Philippe Léonard
Campylobacter coli is a major pathogen rarely responsible for extra-intestinal infections. We report a case of Campylobacter coli bacteremia and meningitis in a 57-year-old immunocompetent Belgian man. The strain, isolated from cerebrospinal fluid, belonged to the unusual sequence type 8418 (ST8418). The patient fully recovered after meropenem treatment.
January 31, 2018: Acta Clinica Belgica
Francesc Formiga, David Chivite, Ariadna Brasé, Irene Petit, Rafael Moreno-Gonzalez, Jose Carlos Arévalo-Lorido, Xavier Corbella
Objective Admission hyponatremia is related to poor outcomes in patients with heart failure (HF). Few studies have examined the influence of hyponatremia in the prognosis of HF patients without previous admissions. Our aim is to determine whether baseline hyponatremia predicts worse outcomes in a cohort of real-world HF patients admitted because of a first episode of acute HF. Methods We reviewed the medical records of 985 patients >50 years of age admitted within a two-year period for a first episode of decompensation of HF...
January 25, 2018: Acta Clinica Belgica
Robin de Putter, Karen Geboes, Marc De Man, Simon Van Belle
Background Anemia is frequent in patients with cancer and is often multifactorial. Treatment depends on etiology and can consist of transfusions, intravenous iron (IV Fe), and/or erythropoiesis-stimulating agents (ESA). Several studies have shown that cancer-related anemia is undertreated. The aim of this study is to compare usual practice in a university hospital with the international guidelines. Methods Using the hospital and pharmacy informatics all adults (≥18 years), who received a treatment for anemia (transfusion, IV Fe, ESA) from February to August 2016 during palliative chemotherapy, were identified...
January 16, 2018: Acta Clinica Belgica
Griet Buyck, Veronique Devriendt, Anne-Marie Van den Abeele, Christian Bachmann
Objective and importance Listeria monocytogenes is a rare foodborne pathogen, causing both outbreaks and sporadic infections. Severe, systemic infections are more prevalent in at-risk populations, such as pregnant women, but occur mostly in older people and immunocompromised individuals. In this case report, we describe the presentation, diagnosis, and treatment of Listeria monocytogenes sepsis in an older patient, and we briefly review the literature about listeriosis and the importance of safe food practices...
January 9, 2018: Acta Clinica Belgica
Martin Lucien Tonglet, Jean-Louis Poplavsky, Laurence Seidel, Jean Marc Minon, Vincenzo D'Orio, Alexandre Ghuysen
Introduction Evidence supporting the use of Thromboelastography (TEG®) and rotational thromboelastometric (ROTEM®) in the trauma setting remains limited. We present the results of a practical evaluation of the potential interest of ROTEM® in the diagnosis of acute coagulopathy and the need for emergent blood product transfusion in the general trauma population of a non-trauma Belgian emergency department. Methods Extracting a convenience cohort from the initial prospective TICCS study, we performed a retrospective analysis to test the following hypothesis: ROTEM® might be helpful to discriminate trauma patients with or without acute coagulopathy...
January 4, 2018: Acta Clinica Belgica
Eva De Backer, Félix Gremonprez, Guy Brusselle, Pieter Depuydt, Jo Van Dorpe, Carole Van Haverbeke, Pieter C Goeminne, Eric Derom
CASE PRESENTATION:  We present a case of a 55-year-old Caucasian male with manifestations of dermatomyositis complicated with rapidly progressive interstitial lung disease (RP-ILD). Diagnosis of anti-MDA5 positive dermatomyositis was made. DISCUSSION:  Myositis specific antibodies (MSA) can be used for diagnosis and predicting prognosis in patients with polymyositis and dermatomyositis. Anti-MDA5 positive dermatomyositis should be considered in patients presenting with dermatomyositis and a disease course resembling antisynthetase syndrome in the absence of antisynthetase autoantibodies, especially if a remarkably high ferritin is noted...
December 29, 2017: Acta Clinica Belgica
Wouter Steyaert, Steven Callens, Paul Coucke, Bart Dermaut, Dimitri Hemelsoet, Wim Terryn, Bruce Poppe
INTRODUCTION: In recent decades, we witnessed a revolution in genetic technology. Some 20 years ago, analysing a single gene was quite laborious and time-consuming. In addition, diagnostic testing was only available for selected genes. Nowadays, whole exome analysis - a technique enabling sequencing of all protein coding sequences in the entire genome - is gradually introduced in a clinical setting. Whole genome sequencing forms the ultimate exponent of this evolution and offers an even broader application...
February 2018: Acta Clinica Belgica
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