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Acta Clinica Belgica

Irith De Baetselier, Kara Krista Osbak, Hilde Smet, Chris Richard Kenyon, Tania Crucitti
OBJECTIVES: To investigate the efficacy of performing a pooling strategy of triple-anatomical site samples (pharyngeal, anorectal and urine samples) for simultaneous Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) nucleic acid amplification detection. METHODS: A total of 117 specimen sets (pharyngeal, anorectal and urine) were collected from 98 men between 2014 and 2016. Double sampling of pharyngeal, anorectal and urine samples allowed for pooled and unpooled analyses using a multiplex Abbott Real Time CT/NG assay, together with confirmatory PCR testing in case of CT/NG positivity...
November 12, 2018: Acta Clinica Belgica
Mahdieh-Sadat Moosavi, Hoda Barati
OBJECTIVES: Autoimmune diseases include a spectrum of disorders in which immune response to the autoantigens leads to tissue damage or dysfunction. Xerostomia, salivary gland dysfunction and lack of saliva are some common symptoms associated with many autoimmune diseases. METHODS: In this review study, the meta-analysis technique is used to objectively review the relationship between autoimmune diseases and salivary gland dysfunction. We have searched Medline and Embase and Google Scholar...
October 30, 2018: Acta Clinica Belgica
Stéphanie Note, Patrick Soentjens, Marie Van Laer, Philippe Meert, Peter Vanbrabant
 A patient presenting with fever and purpura after a stay in the tropics tempts a physician to make a differential diagnosis mainly focusing on imported diseases. Although the importance of considering a tropical disease is obvious, the fact that cosmopolitan infections account for one third of the cases in a febrile returning traveler must not be overseen. Toxic Shock Syndrome is amongst the most notorious diseases due to the high mortality when inappropriately managed and the association with necrotizing fasciitis...
October 27, 2018: Acta Clinica Belgica
Valentine Gillion, Michel Jadoul, Olivier Devuyst, Jean-Michel Pochet
Metabolic alkalosis defined by the increase of both plasma HCO3- level (>26 mmol/L) and blood arterial pH (>7.43) is quite frequent and usually accompanied by hypokalemia. Its pathogenesis requires both the generation of alkalosis and its maintenance. Generation may be due to excessive hydrogen ion loss by the gastrointestinal tract (e.g. vomiting) or by the kidney (e.g. use of loop diuretics) or may be due to exogenous base gain. Maintenance reflects the inability of the kidney to excrete the excess of bicarbonate because of hypovolemia, chloride depletion, hypokalemia, hyperaldosteronism, renal failure or a combination of these factors...
October 27, 2018: Acta Clinica Belgica
Michel P Hermans, Sofie Gevaert, Olivier Descamps, Luc Missault, Bernard Gillot, Dieuwke De Keyzer, Dominik Lautsch, Philippe Brudi, Baishali Ambegaonkar, Ami Vyas, Martin Horack, Anselm Gitt
OBJECTIVES: To document the frequency and predictors of low-density lipoprotein cholesterol (LDL-C) target value attainment among patients with coronary heart disease (CHD) in Belgium. METHODS: The second Dyslipidemia International Study (DYSIS II) was an observational study of the prevalence of dyslipidemias and lipid target value attainment. Patients in this analysis were aged ≥ 18, had documented CHD, and had a full lipid profile. Use of lipid-lowering therapy (LLT), lipid profile, and LDL-C target value attainment (< 70 mg/dL) were assessed cross-sectionally at the enrollment visit...
October 25, 2018: Acta Clinica Belgica
R Vanholder, W Van Biesen, E V Nagler
OBJECTIVES: In this publication, we review the definitions, symptoms, causes, differential diagnoses and therapies of hypokalemia and hyperkalemia. METHODS: Comprehensive tables and diagnostic algorithms are provided when appropriate. RESULTS AND CONCLUSIONS: Although both hypokalemia and hyperkalemia may be life-threatening, this is essentially the case with severe changes (serum potassium < 2.5 or > 6.5 mmol/L), the presence of symptoms or electrocardiographic deviations, the association with aggravating factors (e...
October 24, 2018: Acta Clinica Belgica
Kun-Hung Lai, Chih-Yung Chiang, Rong-Sen Yang, Kai-Chiang Yang, Chang-Chin Wu
BACKGROUND: Patients with chronic obstructive pulmonary disease have a high prevalence of osteoporosis, and different osteoporosis drugs are used to prevent fractures in these patients. Although the overall incidence of complete or incomplete, atypical femoral fracture (AFF) is low, long-term use of antiresorptive agents is associated with an increased risk of developing AFF. METHODS: We present a patient with chronic obstructive pulmonary disease with recurrent symptoms of an incomplete AFF who had been treated with glucocorticoids, and sequentially with alendronate, zoledronic acid, strontium ranelate, raloxifene, denosumab and finally with teriparatide...
October 19, 2018: Acta Clinica Belgica
Ivanka Perčić, Ivana Urošević, Edita Stokić, Dragana Tomić Naglić, Ivana Milošević
BACKGROUND/AIM: To determine insulin sensitivity before chemotherapy and during febrile neutropenia in patients with acute leukemia and to assess its effect on the number of documented infections, the severity of infection and the outcome of the first hospitalization. To compare insulin sensitivity in the study group to a group of patient with obesity. MATERIALS AND METHODS: The study group consisted of 30 (37% of the total number) patients with newly diagnosed acute leukemia...
October 17, 2018: Acta Clinica Belgica
Volkan Dogan, Oğuzhan Çelik, Bülent Özlek, Eda Özlek, Cem Çil, Özcan Başaran, Murat Biteker
OBJECTIVES: Allergic myocardial infarction, known as Kounis syndrome, is an acute myocardial infarction after an allergic reaction to food, drugs, or insect stings, etc. Kounis syndrome can also be caused by all kinds of seafood, such as finned fish, molluscan shellfish, cephalopods, and crustacean shellfish. METHODS: Herein, we report a case of a 67-year-old man, with hypertension, referred for itchiness, facial rash, chest pain, and palpitations developed after consumption of blue crab...
October 16, 2018: Acta Clinica Belgica
G Decaux
The differential diagnosis between hypertonic, isotonic and hypotonic hyponatremia are presented. The help of some usual serum (urea, uric acid and TCO2 ) and urine parameters (mainly osmolality and sodium concentration) are discussed and help to determine the best treatment. Morbidity associated with untreated hyponatremia and with the different treatment available is also discussed. Who to prevent and treat ODS (osmotic demyelating syndrome) is recalled. The pathophysiology and treatment of hypernatremia are also discussed...
October 12, 2018: Acta Clinica Belgica
Dimitri Stylemans, Sylvia Verbanck, Stefanie Vincken, Walter Vincken, Elke De Wachter, Eef Vanderhelst
BACKGROUND: While cystic fibrosis (CF) lung disease is generally considered to be an obstructive disorder, other pulmonary function patterns (PFP) may occur. Furthermore, little is known about possible associations between PFP and genotype or phenotypical characteristics. METHODS: Cross-sectional study including CF patients aged 16 years or more, identifying different PFP and exploring associations between PFP and genotype or phenotypical characteristics. RESULTS: Obstructive PFP was most prevalent in our population (n = 80), comprising obstructive lung disease (62...
October 12, 2018: Acta Clinica Belgica
Stien Vandendriessche, Elizaveta Padalko, Elke Wollants, Charlotte Verfaillie, Bruno Verhasselt, Liselotte Coorevits
OBJECTIVES: The Seegene AllplexTM Respiratory panel was retrospectively challenged using a collection of quality control samples (QCMD) and clinical samples previously analysed with validated routine methods. METHODS: A collection of 111 samples [43 QCMD samples, 13 bronchoalveolar lavage fluids and 55 nasopharyngeal aspirates/swabs] was tested with Seegene AllplexTM . The clinical samples were tested previously using either FTD® Respiratory Pathogens 21 qPCR assay (Fast Track Diagnostics), an in-house multiplex PCR for Bordetella, or BioGX Sample-ReadyTM Atypical pneumo panel (Becton Dickinson)...
October 11, 2018: Acta Clinica Belgica
Pei-Yu Liu, Chien-Lin Chen, Min-Chien Yu, Yu-Lin Ko, Shun-Yi Hsu, Hsin-Hua Chou, Kuan-Hung Yeh, De-Min Duan, Ming-Hsin Chen, Jeng-Feng Lin
OBJECTIVES: In patients with ST-elevation myocardial infarction (STEMI), it is not clear whether low-dose renin-angiotensin system inhibitors and beta-blockers can result in the same benefits achievable with higher target doses. This observational study aims to investigate whether higher doses of angiotensin converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARB) and beta-blockers can improve outcomes in patients with STEMI. METHODS: We recorded daily doses of ACEI, ARB, and beta-blockers in 331 patients with STEMI...
October 8, 2018: Acta Clinica Belgica
Nathalie Berghen, Jean-Baptiste Vulsteke, Rene Westhovens, Jan Lenaerts, Ellen De Langhe
OBJECTIVES: To review the therapeutic option of Rituximab, a chimeric anti-CD20 antibody, in systemic autoimmune rheumatic diseases (SARDs) such as systemic lupus erythematosus, systemic sclerosis, primary Sjögren syndrome and idiopathic inflammatory myopathy. METHODS: A non-systematic review was conducted. RESULTS: The specific role and indication of rituximab in SARDs has been the subject of multiple trials in recent years. Evidence supports the use of rituximab in moderate-to-severe refractory systemic lupus erythematosus, diffuse skin involvement in systemic sclerosis and systemic involvement in primary Sjögren syndrome...
September 26, 2018: Acta Clinica Belgica
Soetkin Kennes, Dirk Van de Putte, Jo Van Dorpe, Vanessa Van Hende, Tessa Kerre, Philip Vlummens
OBJECTIVES: Since primary intestinal aspergillosis is a severe infectious complication with a high morbidity and mortality in immunocompromised patients, we want to draw attention to this rare entity and the importance of early recognition. METHODS: We report a case of documented primary intestinal aspergillosis in a patient receiving an autologous stem cell transplantation (SCT). Furthermore, this article gives a short reflection on the occurrence of invasive aspergillosis in autologous SCT and the value of serum galactomannan levels based on literature search and linked with the case...
September 21, 2018: Acta Clinica Belgica
Katrien Foubert, Els Mehuys, Leen Claes, Dirk Van Den Abeele, Marleen Haems, Annemie Somers, Mirko Petrovic, Koen Boussery
BACKGROUND AND OBJECTIVE: An accurate medication scheme may be a useful tool to improve medication safety in primary care. This study aimed to identify (1) pharmacists' alterations to nurse medication schemes and (2) potential improvements to the contribution of the community pharmacist to a shared medication scheme within a multidisciplinary collaboration. Dosing frequency, potentially incorrect moments of intake, drug-drug interactions and medication complexity (quantified by the Medication Regimen Complexity Index, MRCI) were investigated...
September 20, 2018: Acta Clinica Belgica
Oguz Abdullah Uyaroglu, Abdulsamet Erden, Levent Kilic, Bora Peynircioğlu, Omer Karadag, Umut Kalyoncu
OBJECTIVES: Behçet's disease (BD) is a multi-systemic inflammatory disorder which can affect all types and sizes of vessels.The usage of TNF-α antagonists is increasing in different involvements of BD that is inadequately controlled by standard immunosuppressive regimens. METHODS: Here we reported a rare BD case that is controlled by only infliximab (IFX) treatment. RESULTS: A 24-years-old male patient was diagnosed as BD with recurrent oral and genital ulcerations,uveitis,femoral vein thrombosis and HLA-B5 positivity...
September 17, 2018: Acta Clinica Belgica
Steven Van Laecke
INTRODUCTION: Magnesium is an essential element which also has pleiotropic effects in humans. Recent studies have altered our interpretation of a disturbed magnesium balance both leading to hypomagnesemia and hypermagnesemia. METHODS: a narrative review of their clinical relevance is presented. RESULTS: Although magnesium balance is strictly controlled by the kidneys, hypomagnesemia is fairly common, especially in people with comorbid conditions...
September 17, 2018: Acta Clinica Belgica
Nathalie Van Tittelboom, Dan Devos, Bové Thierry, Michel De Pauw, Els Vandecasteele
BACKGROUND: Pulmonary arterial hypertension (PAH) is a devastating, life-threatening disease with poor prognosis when left untreated. The long-term prognosis is definitely influenced by the natural progression of PAH but late disease-specific complications may also contribute. CASE SUMMARY: We present a patient with a long-standing idiopathic PAH in whom progressive dilatation of pulmonary trunk and pulmonary arteries leads to compression of the left main coronary artery and the left atrium with hemodynamic compromise...
September 14, 2018: Acta Clinica Belgica
Toine Mercier, Griet Deslypere, Kristiaan Nackaerts
OBJECTIVES: Ramsay Hunt syndrome (RHS) is a rare complication of varicella zoster virus (VZV) reactivation with high morbidity, requiring swift and specific treatment. METHODS: We discuss the epidemiology, diagnosis and treatment of RHS using a case report of a cancer patient who presented with disseminated VZV reactivation, including RHS. RESULTS: A 68-year old man with stage IV lung adenocarcinoma, for which he received pemetrexed maintenance chemotherapy, presented to the emergency department with a progressive skin rash despite broad spectrum antibiotics, vertigo, and diminished hearing...
September 6, 2018: Acta Clinica Belgica
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