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Acta Clinica Belgica

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https://www.readbyqxmd.com/read/29792121/abcg2-polymorphism-rs2231142-and-hypothyroidism-in-metastatic-renal-cell-carcinoma-patients-treated-with-sunitinib
#1
Emilie Werbrouck, Julie Bastin, Diether Lambrechts, Annelies Verbiest, Thomas Van Brussel, Evelyne Lerut, Jean-Pascal Machiels, Vincent Verschaeve, Vincent Richard, Philip R Debruyne, Brigitte Decallonne, Patrick Schöffski, Oliver Bechter, Pascal Wolter, Benoit Beuselinck
Background and aim Vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) cause significant adverse events including thyroid dysfunction, mainly hypothyroidism, in a considerable proportion of patients. In a series of metastatic renal cell carcinoma (mRCC) patients treated with sunitinib, we aimed to study the correlation between hypothyroidism and single nucleotide polymorphisms (SNPs) in genes involved in sunitinib pharmacokinetics and pharmacodynamics. Patients and methods We included 79 mRCC patients who started sunitinib between November 2005 and March 2016...
May 23, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29783885/pneumomediastinum-revisited-we-should-reconsider-usual-classification
#2
Melanie Dechamps, Lieven De Smedt, Said Hachimi Idrissi
Pneumomediastinum work-up should focus on differentiating mediastinal organ injuries from alveolar rupture since these two causative mechanisms have a different management and prognosis. After an admission at our Emergency Department, we wanted to challenge the current classification into 'spontaneous' or 'secondary' pneumomediastinum, which reflects the clinical rather than the pathophysiological circumstances and is therefore confusing and inappropriate to our view. We propose a new work-up algorithm based on clinical risks factors and chest CT findings...
May 21, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29783881/lemierre-s-syndrome-a-case-study-with-a-short-review-of-literature
#3
Ken De Smet, Paul-Emile Claus, Gudrun Alliet, An Simpelaere, Geert Desmet
Objective and Importance Lemierre's syndrome (LS) is a rare condition that typically starts with a bacterial oropharyngeal infection complicated by a thrombophlebitis of the internal jugular vein and septic emboli to the lungs or other organs. The most common organism isolated is Fusobacterium necrophorum, although other causative organisms are isolated in rare cases. Case presentation We discuss a case of LS in a 44-year-old, previously healthy man presenting with an oropharyngeal infection. F. necrophorum was isolated from blood cultures and Computed tomography of the chest demonstrated septic emboli in the lungs...
May 21, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29774795/prospective-evaluation-of-hypogonadism-in-male-metastatic-renal-cell-carcinoma-patients-treated-with-targeted-therapies
#4
Julie Bastin, Emilie Werbrouck, Annelies Verbiest, Kevin Punie, Oliver Bechter, Sherida Feng Woei-A-Jin, Pascal Wolter, Hans Wildiers, Evelyne Lerut, Herlinde Dumez, Brigitte Decallonne, Paul Clement, Dirk Vanderschueren, Maarten Albersen, Raymond Oyen, Patrick Schöffski, Benoit Beuselinck
Objectives To study the prevalence of hypogonadism in male patients with metastatic renal cell carcinoma (mRCC) starting with targeted therapies and the impact of the vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) sunitinib and pazopanib on the luteinizing hormone (LH)/testosterone (TT)-axis. Methods Male mRCC patients starting with targeted therapies were prospectively included in this study. TT- and LH-levels were sampled at start as well as during systemic therapy. Endpoints of the study were gonadal status (TT- and LH-levels) at start of targeted therapy and TT- and LH-evolution during targeted therapy...
May 18, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29770734/post-transfusion-hemoglobin-values-and-patient-blood-management
#5
Jan Moerman, Edith Vermeulen, Mia Van Mullem, Anne-Mie Badts, Peter Lybeert, Veerle Compernolle, Jørgen Georgsen
Objectives The objective of this retrospective study was to evaluate the added value of communicating post-transfusion hemoglobin values to clinicians as a strategy to improve RBC utilization in a 500-bed hospital. Methods The total number of RBC transfusions, the mean number of RBC units transfused per patient, the mean pre- and post-transfusion hemoglobin values, the ratio of patients transfused and the ratio of patients with a post-transfusion hemoglobin > 10.5 g/dL were calculated per service and per department for six months...
May 17, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29757121/management-of-electrolyte-disorders-also-the-method-matters
#6
Joris Richard Delanghe
INTRODUCTION: For the last few decades, electrolyte determinations in plasma or serum are carried out by reliable potentiometric methods. In recent years, a marked technical evolution has taken place, where the clinical analysis of common analytes (e.g. electrolytes) is partly moving from centralised clinical core laboratories to near-patient point-of-care testing. METHODS: As the measuring principle used by point-of-care testing markedly differs from the one used in core laboratories, sodium results are not always interchangeable in critically ill patients due to the different sensitivity of the analytical methods for the electrolyte exclusion effect...
May 14, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29757110/massive-pleural-and-pericardial-effusion-due-to-hypothyroidism-in-a-patient-with-a-surgically-treated-thyroid-stimulating-hormone-producing-pituitary-adenoma
#7
Ji-Hoon Lee, MinA Park, Myung Jae Park, Yong Suk Jo
Hypothyroidism is relatively rare etiology of serositis with effusion, but massive pleural effusion is very unusual. This is a report of massive pleural effusion in patient taking methimazole after surgical resection of thyroid-stimulating hormone (TSH)-producing pituitary adenoma (TSHoma). The patient was clinically and biochemically hypothyroid and responded well to discontinuation of methimazole and thyroid hormone replacement therapy. When assessing patients with pleural effusion, we should not rely on laboratory test results alone, as a detailed medical history and thorough physical examination could be more useful...
May 14, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29745792/neonates-are-not-just-little-children-and-need-more-finesse-in-dosing-of-antibiotics
#8
Karel Allegaert, John van den Anker
OBJECTIVES: Neonates are not just little children. They need more finesse in decisions on when to treat, which antibiotics to use and how to dose these antibiotics. METHODS: Representative compounds of three major classes of antibiotics (beta-lactams, aminoglycosides, glycopeptides) are discussed in a narrative review to illustrate the recent progress in the knowledge on PK and its covariates (how to dose). RESULTS: This knowledge can subsequently be converted to targeted exposure dosing regimens...
May 10, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29745308/conservative-treatment-of-non-aneurysmal-infectious-aortitis-a-case-report-and-review-of-the-literature
#9
Jasper Callemeyn, Kim Daenens, Inge Derdelinckx, Steven Dymarkowski, Katleen Fagard
BACKGROUND:  Non-aneurysmal infectious aortitis is a rare clinical entity with most often lethal complications when surgical intervention is delayed. OBJECTIVES:  This report describes the case of a non-aneurysmal infectious aortitis complicated with a penetrating aortic ulcer in an elderly woman, caused by a methicillin-sensitive Staphylococcus aureus. Surgery was deemed contra-indicated and treatment was limited to the administration of intravenous vancomycin (2 grams daily), followed by flucloxacillin (6 times 2 grams daily)...
May 10, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29726745/physical-activity-and-exercise-in-obstructive-sleep-apnea
#10
Van Offenwert Evelien, Vrijsen Bart, Belge Catharina, Troosters Thierry, Buyse Bertien, Testelmans Dries
OBJECTIVES: In the last decade significant research has focused on the relationship between physical activity (PA), exercise and obstructive sleep apnea (OSA). The purpose of this study is to provide an overview and interpretation of different studies regarding this subject. METHODS: PubMed, Embase and Cochrane Library databases were searched for English articles published before August 21, 2017. Search terms were 'Sleep Apnea, Obstructive' and 'Exercise'. RESULTS: Low levels of PA are associated with higher odds of OSA...
May 4, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29726743/opinion-paper-the-role-of-work-in-the-management-of-medically-unexplained-physical-symptoms
#11
Els Tobback, An Mariman, Lies Clauwaert, Lode Godderis, Stefan Heytens, Patrick Ruppol, Daniel Spooren, Rita Tytgat, Martine De Muynck, Dirk Vogelaers
OBJECTIVES: Patients with medically unexplained physical symptoms suffer from chronic fatigue and/or pain in combination with a variety of other symptoms. A flexible, biopsychosocial approach is needed for diagnostic screening and global management. It is crucial to involve the direct patient environment, including family, friends, colleagues as well as health providers, evaluation, and reintegration sector. The aim of this paper is to review the importance of work in the management of medically unexplained physical symptoms...
May 4, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29718781/long-term-treatment-with-atazanavir-atv-in-real-life-in-belgium-a-retrospective-observational-cohort-of-2264-hiv-patients
#12
Stéphane De Wit, Eric Florence, Linos Vandekerkhove, Jean-Christophe Goffard, Bernard Vandercam, Eric Van Wijngaerden, Michel Moutschen, Rémy Demeester, Patrick Lacor, Marc Delforge, Maartje van Frankenhuijsen, Paul Lacante
Objectives This 5-year follow-up study aimed to assess clinical outcomes of HIV-1 infected adults treated with atazanavir (ATV) in clinical practice in Belgium, to describe patient profiles and characteristics, as well as treatment safety. Methods A multicenter, non-interventional, non-comparative, retrospective cohort study was performed in HIV-1 positive adult patients treated with ATV between 2006 and 2012. Data were collected from 8 AIDS reference centers' databases. All analyses were on-treatment. Sub-analyses were carried out in unboosted ATV treated patients and in females...
May 2, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29717636/importance-of-cardiovascular-examination-in-patients-with-multiple-lentigines-two-cases-of-leopard-syndrome-with-hypertrophic-cardiomyopathy
#13
Tomas Jurko, Alexander Jurko, Jana Krsiakova, Alexander Jurko, Milan Minarik, Michal Mestanik
Introduction LEOPARD syndrome is a rare genetic disorder characterised by lentigines, electrocardiographic conduction abnormalities, ocular hypertelorism, pulmonary stenosis, abnormal genitalia, retardation of growth and sensorineural deafness. Clinical manifestations are often mild, which may result in difficult and late diagnosis. Cardiac involvement may have a significant impact on the prognosis, however, appearance of severe abnormalities such as hypertrophic cardiomyopathy usually precedes the occurrence of multiple lentigines and may be asymptomatic...
May 2, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29708056/development-of-clinical-pharmacy-in-belgian-hospitals-through-pilot-projects-funded-by-the-government
#14
A Somers, A Spinewine, I Spriet, S Steurbaut, P Tulkens, J D Hecq, L Willems, H Robays, M Dhoore, H Yaras, I Vanden Bremt, M Haelterman
Objectives The goal is to develop clinical pharmacy in the Belgian hospitals to improve drug efficacy and to reduce drug-related problems. Methods From 2007 to 2014, financial support was provided by the Belgian federal government for the development of clinical pharmacy in Belgian hospitals. This project was guided by a national Advisory Working Group. Each funded hospital was obliged to describe yearly its clinical pharmacy activities. Results In 2007, 20 pharmacists were funded in 28 pilot hospitals; this number was doubled in 2009 to 40 pharmacists over 54 institutions, representing more than half of all acute Belgian hospitals...
April 30, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29694303/cannabinoid-receptor-2-a-potential-novel-therapeutic-target-for-sepsis
#15
Qianwen He, Fei Xiao, Qinghong Yuan, Jingjing Zhang, Jia Zhan, Zongze Zhang
OBJECTIVE: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. It is the most common cause of death among critically ill patients in non-coronary intensive care units and the incidence continues to rise. Although advanced management was applied, the prognosis of sepsis patients remains poor. As a G-protein coupled receptor, cannabinoid receptor 2 (CB2R) was implicated in a wide variety of diseases. In this study, we aimed to investigate the role of CB2R in sepsis...
April 25, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29663861/amyloid-cardiomyopathy-a-hidden-heart-failure-cause-that-is-often-misdiagnosed
#16
Yale Tung-Chen, Miguel-Ángel Arnau
BACKGROUND: Congestive heart failure (CHF) is a very common condition, especially in the elderly, characterized by dyspnea, orthopnea, nocturnal paroxysmal dyspnea, and peripheral edema. CLINICAL PRESENTATION AND INTERVENTION: We report the case of a 76-year-old with CHF symptoms for the last 3 months. The ECG and transthoracic echocardiogram were suggestive of CHF due to amyloid cardiomyopathy. After cardiac MRI, a positive Congo red staining of subcutaneous fat aspiration and a negative genetic testing for mutant transthyretin, senile amyloid cardiomyopathy (ATTRw) was expected...
April 17, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29623779/long-term-use-of-darunavir-ritonavir-containing-regimens-in-daily-practice-in-belgium-retrospective-observational-cohort-data-of-1701-hiv-patients
#17
Stéphane De Wit, Eric Florence, Linos Vandekerckhove, Bernard Vandercam, Jean-Christophe Goffard, Eric Van Wijngaerden, Michel Moutschen, Remy Demeester, Pushpike Thilakarathne, Hilde Piryns
Background Once daily (QD) ritonavir or cobicistat-boosted darunavir (DRV/b), in combination with other antiretrovirals (ARVs), is recommended as a first-line option for human immunodeficiency virus-infected patients in European and USA guidelines. The objective of this study was to analyse the outcomes of DRV/r QD-based antiretroviral therapy (ART) regimens in real-life settings. Methods This is an observational, non-interventional, non-comparative, retrospective, multicentre cohort study. Data were collected from the databases of eight Belgian AIDS Reference Centres...
April 6, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29623770/atypical-presentation-of-acute-coronary-syndrome-acs-a-case-report
#18
Axel Van Damme, Philippe Vanderheeren, Tine De Backer, Françine Desimpel
Case A 45-year-old man presented at the emergency department (ED) with stomach pain since eight days. The patient was not worried about his symptoms and requested only pain relief. The emergency physician requested a consult of the gastroenterologist. Clinical examination was unremarkable. However, 12-lead ECG and ischemic markers were suggestive of acute coronary syndrome (ACS) which led to admission at the cardiology department. Despite delayed presentation, the patient was still referred for urgent coronary angiogram after receiving heparin, ticagrelor and acetylsalicylic acid because of persistent pain...
April 6, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29609529/video-recording-consultations-for-educational-purposes-in-out-of-hours-primary-care-patients-and-physicians-are-willing-to-participate
#19
Bertwin Krug, Annelies Colliers, Jan Matthys, Sibyl Anthierens, Hilde Philips, Jorn Damen, Samuel Coenen, Roy Remmen
Background Video-recordings of consultations are used by general practitioner (GP) trainees to enable reflection on aspects of knowledge, skills and attitudes. Typically, these recordings are made during office hours in general practice, but little is known about using video-recording during out of hours (OOH) care, which is an important and distinct part of a GP's work. To be able to record consultations during OOH care (i.e. at the emergency department (ED) and at the General Practitioner Cooperative (GPC)), patients must be willing to cooperate and give informed consent...
April 2, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29595095/hospital-networks-how-to-make-them-work-in-belgium-facilitators-and-barriers-of-different-governance-models
#20
Kaat De Pourcq, Melissa De Regge, Koen Van den Heede, Carine Van de Voorde, Paul Gemmel, Kristof Eeckloo
Objectives This study aims to identify the facilitators and barriers to governance models of hospital collaborations. The country-specific characteristics of the Belgian healthcare system and legislation are taken into account. Methods A case study was carried out in six Belgian hospital collaborations. Different types of governance models were selected: two health systems, two participant-governed networks, and two lead-organization-governed networks. Within these collaborations, 43 people were interviewed...
March 29, 2018: Acta Clinica Belgica
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