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Acta Clinica Belgica

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https://www.readbyqxmd.com/read/28816631/platypnea-orthodeoxia-syndrome-an-unusual-presentation-of-a-complex-disease
#1
Tess Van Meerhaeghe, Steven Droogmans, Shane Hanon, Jeroen Sonck
BACKGROUND: Platypnea-orthodeoxia syndrome (POS) is an uncommon disorder characterized by dyspnea (=platypnea) and desaturation (=orthodeoxia) in upright position and improvement of symptoms and blood oxygenation in supine position. Clinical presentation is heterogeneous and often confuses the clinician. OBJECTIVES: The present case report illustrates a complicated presentation of the underlying syndrome. METHODS: Description of a POS case in a 73-year-old female with thorough workup and tailored treatment...
August 17, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28805142/intravenous-immunoglobulins-modify-relapsing-membranous-glomerulonephritis-after-kidney-transplantation-a-case-report
#2
Sanne Steyaert, Jo Van Dorpe, Anne Hoorens, Wim Van Biesen, Steven Van Laecke
OBJECTIVES: Recurrence of membranous glomerulonephritis after transplant is common and is an important cause of loss of renal graft. This case supports the effect of immunoglobulins in the treatment of this disease after transplantation. It is the first report in the literature with a follow-up of more than 10 years and because of the sustained effect of the immunoglobulins, it strengthens the idea that this can alter long-term outcome. METHODS: Single case study and search of the literature...
August 14, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28768464/perception-of-belgian-nurses-about-evidence-based-clinical-practice-implementation-a-focus-group-study
#3
Benoit Pétré, Nicolas Gillain, Nadine Jacqmin, Jef Adriaenssens, Kristel Vandenbosch, Pierre Gillet, Robert Vander Stichele, Geert Thienpont, Michèle Guillaume
BACKGROUND/OBJECTIVES: Despite recommendations to integrate evidence-based practice into nursing care, evidence-based nursing (EBN) implementation is generally lacking. Strategies for developing an EBN implementation plan require an evaluation of nurses' needs and expectations. The aim of this study was to evaluate how Belgian nurses perceive EBN. METHODS: Descriptive qualitative data were obtained via focus groups. Fifty-six nurses took part in the study and were assigned to one of seven focus groups based on their work setting and the local language...
August 2, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28749752/high-anion-gap-metabolic-acidosis-induced-by-cumulation-of-ketones-l-and-d-lactate-5-oxoproline-and-acute-renal-failure
#4
Laura Heireman, Boris Mahieu, Mark Helbert, Wim Uyttenbroeck, Jan Stroobants, Marian Piqueur
INTRODUCTION: Frequent causes of high anion gap metabolic acidosis (HAGMA) are lactic acidosis, ketoacidosis and impaired renal function. In this case report, a HAGMA caused by ketones, L- and D-lactate, acute renal failure as well as 5-oxoproline is discussed. CASE PRESENTATION: A 69-year-old woman was admitted to the emergency department with lowered consciousness, hyperventilation, diarrhoea and vomiting. The patient had suffered uncontrolled type 2 diabetes mellitus, underwent gastric bypass surgery in the past and was chronically treated with high doses of paracetamol and fosfomycin...
July 27, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28738729/utility-of-a-laboratory-score-in-the-prediction-of-gastric-emptying-in-autoimmune-gastritis-patients
#5
Çağdaş Kalkan, Irfan Soykan
OBJECTIVES: Patients with autoimmune gastritis may have symptoms suggestive of delayed gastric emptying. The aim of this study was to explore the predictive value of two scoring systems in the differentiation of delayed gastric emptying in patients with autoimmune gastritis. METHODS: About 154 patients (106 women) with autoimmune gastritis whose gastric emptying test were available, were analyzed using two laboratory-based scoring systems: 'global score' (hemoglobin, mean corpuscular volume, gastrin, vitamin B12, and chromogranin A) and 'simple score' (hemoglobin, mean corpuscular volume, and gastrin) in order to discriminate delayed and normal gastric emptying...
July 24, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28693379/incidence-of-osteonecrosis-of-the-jaw-in-patients-with-bone-metastases-treated-sequentially-with-bisphosphonates-and-denosumab
#6
Tine Loyson, Thomas Van Cann, Patrick Schöffski, Paul M Clement, Oliver Bechter, Isabel Spriet, Ruxandra Coropciuc, Constantinus Politis, Raf O Vandeweyer, Joseph Schoenaers, Herlinde Dumez, Patrick Berteloot, Patrick Neven, Kristiaan Nackaerts, Feng J S H Woei-A-Jin, Kevin Punie, Hans Wildiers, Benoit Beuselinck
OBJECTIVES: Osteonecrosis of the jaw (ONJ) is a serious adverse event of bone resorption inhibitors (BRIs), such as bisphosphonates and denosumab. Bisphosphonates and denosumab inhibit osteoclast function through different pharmacological effects and bisphosphonates are retained in bone for several months to years. Sequential treatment with bisphosphonates and denosumab might lead to an overlapping treatment effect, due to the addition of the effect of denosumab on the residual bisphosphonate effect...
July 10, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28689471/the-scope-pc-instrument-for-assessing-patient-safety-culture-in-primary-care-a-psychometric-evaluation
#7
Melissa Desmedt, Jochen Bergs, Benjamin Willaert, Annemie Vlayen, Johan Hellings, Ward Schrooten, Neree Claes, Dominique Vandijck
INTRODUCTION: Primary healthcare differs from hospitals in terms of - inter alia - organisational structure. Therefore, patient safety culture could differ between these settings. Various instruments have been developed to measure collective attitudes of personnel within a primary healthcare organisation. However, the number of valid and reliable instruments is limited. OBJECTIVES: Psychometric properties of the SCOPE-Primary Care instrument were tested to examine the instrument's applicability in home care services in Belgium...
July 9, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28679322/prevalence-and-co-prevalence-of-comorbidities-in-belgian-patients-with-type-2-diabetes-mellitus-a-transversal-descriptive-study
#8
Michel P Hermans, Nicolas Dath
OBJECTIVES: Most patients with type 2 diabetes mellitus (T2DM) have at least one comorbid chronic disease. These comorbidities increase disease burden and costs and may impact the selection of glucose-lowering therapies. The aim of our study was to describe the prevalence and co-prevalence of comorbidities in patients with T2DM in Belgium. METHODS: This was a single centre, transversal, descriptive study performed at Saint-Luc University Hospital, Brussels, Belgium...
July 5, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28673201/health-and-budget-impact-of-combined-hiv-prevention-first-results-of-the-belhivprev-model
#9
Sebastian Vermeersch, Steven Callens, Stéphane De Wit, Jean-Christophe Goffard, Marie Laga, Dominique Van Beckhoven, Lieven Annemans
OBJECTIVES: We developed a pragmatic modelling approach to estimate the impact of treatment as prevention (TasP); outreach testing strategies; and pre-exposure prophylaxis (PrEP) on the epidemiology of HIV and its associated pharmaceutical expenses. METHODS: Our model estimates the incremental health (in terms of new HIV diagnoses) and budget impact of two prevention scenarios (outreach+TasP and outreach+TasP+PrEP) against a 'no additional prevention' scenario. Model parameters were estimated from reported Belgian epidemiology and literature data...
July 3, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28659007/pancarditis-an-unusual-complication-of-a-group-b-streptococcal-infection
#10
Elisa Larrieu-Ardilouze, Luc Christiaens, Nicolas Varroud-Vial, Coralie Madico, Jamil Hajj-Chahine, Michaela B Rehman
Pancarditis is a rare condition with a poor prognosis combining endocarditis, myocarditis with abscess formation, and purulent pericarditis. Diagnosis is often delayed and the clinical signs are predominantly those of the embolic complications. Literature is scarce. We present a unique and rare case of pancarditis, complicating a Streptococcal B infection in an immunocompetent, healthy, 54 year-old woman. The evolution was favourable under medical therapy alone and thanks to multimodality cardiac imaging diagnosis and follow-up...
June 28, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28629305/evaluation-of-cost-and-length-of-stay-linked-to-complications-associated-with-major-surgical-procedures
#11
M Pirson, F Dehanne, J Van den Bulcke, P Leclercq, D Martins, A De Wever
INTRODUCTION: A lot of studies have demonstrated the possibility of reducing the number of post-operative complications in the domain of major surgical procedures with the use of medical preventive techniques. However, complications following surgical procedures are unfortunately frequent and are a major problem, not only because of the impact for the patient, but also because of economic consequences that they provoke. The aim of the present study is to evaluate the extra length of stay and the extra cost, born by the hospital and the social security, linked to complications, incurring after major surgical procedures...
June 19, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28629255/hemophagocytic-lymphohistiocytosis-associated-to-haemophilus-parainfluenzae-endocarditis-a-case-report
#12
D I Costescu Strachinaru, M Chaumont, D Gobin, L Sattar, M Strachinaru, E Karakike, A Roman, D Konopnicki
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare but severe and potentially fatal syndrome that is characterized by increased proliferation and activation of benign macrophages with hemophagocytosis throughout the reticuloendothelial system. This syndrome is classified as primary (genetic) or secondary when acquired in the context of infections (usually viral), malignancies, rheumatologic and metabolic diseases. CASE SUMMARY: We report a case of HLH complicating a Haemophilus parainfluenzae mitral valve endocarditis and resolving under antibiotic and surgical treatment alone...
June 19, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28622754/prevalence-of-non-infectious-comorbidities-in-the-hiv-positive-population-in-belgium-a-multicenter-retrospective-study
#13
Jessie Gunter, Steven Callens, Stephane De Wit, Jean-Christophe Goffard, Michel Moutschen, Gilles Darcis, Christelle Meuris, Charlotte van den Bulcke, Karine Fombellida, Marc Del Forge, Homie Razavi, Chloe Wyndham-Thomas
OBJECTIVES: In Belgium, eleven AIDS Reference Centers (ARCs) and seven AIDS Reference Laboratories diagnose and treat HIV-positive individuals and track patients under care. As AIDS-related deaths are avoided and the HIV-positive population ages, non-infectious comorbidities (NICMs), such as cardiovascular disease, renal disease and certain cancers, play a larger role in the quality and length of patients' lives. This study aims to characterize the HIV-positive population in Belgium in terms of the prevalence of key NICMs...
June 16, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28610479/quetiapine-abuse-and-dependence-is-pharmacokinetics-important
#14
Karol Grabowski
No abstract text is available yet for this article.
June 13, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28602146/impact-of-purchasing-the-cpap-device-on-acceptance-and-long-term-adherence-a-belgian-model
#15
Joke Leemans, Daniel Rodenstein, Jamila Bousata, Gimbada Benny Mwenge
RATIONALE: In Belgium, patients with moderate to severe OSA (AHI > 20) who show less than 30 micro-arousals per hour slept (MAI) cannot benefit from CPAP refund by the social security (SS). OBJECTIVES: To assess the influence of reimbursement on CPAP acceptance, and long-term adherence. METHODS: OSA patients (AHI > 20) were included regardless of MAI. All patients were offered a CPAP trial of 3-5 days for habituation. Two groups were defined and compared: «Out of pocket money» patients (OOP) with MAI < 30 that were invited to purchase their device and «reimbursed group» that were offered a CPAP reimbursed by the social security...
June 11, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28599619/a-devastating-case-of-diarrhea-associated-hemolytic-uremic-syndrome-associated-with-extensive-cerebral-infarction-why-we-need-to-do-better
#16
Werner Keenswijk, Evelyn Dhont, Ann Raes, An Bael, Johan Vande Walle
A 4-year-old girl with diarrhea-associated hemolytic uremic syndrome (D+HUS) was transferred to the PICU of our center due to deteriorating renal function and neurological involvement. On admission, a comatous child was seen with hypoventilation and she was placed on mechanical ventilation. Hemodialysis was commenced but plasma exchange was discontinued due to repeated hypersensitivity reactions. A trial of eculizumab was given in light of the worsening of her neurologic condition with development of a pyramidal syndrome and deepening of the coma...
June 9, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28587567/quality-of-care-in-oncology-quality-indicators-in-testicular-cancer-a-hospital-based-approach
#17
Hermans Barbara, Christof Vulsteke, Dekuyper Peter, Van Baelen Anthony, Huybrechts Stefan, Wulfrank Denis, Elzo-Kraemer Ximena, Van Eycken Elisabeth, Ameye Filip
INTRODUCTION: The Belgian Health Care Knowledge Centre (KCE) conducted a literature search leading to twelve quality indicators for testicular cancer. Data obtained from three nationwide databases, showed only five fully measurable quality indicators, one was partially measurable, and two could be determined using a proxy indicator. The four remaining indicators could not be assessed. In this study, we aimed to investigate if these quality indicators were registered and measurable in a medium-volume center...
June 6, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28583022/implementation-of-the-new-virtuo-blood-culture-system-evaluation-and-comparison-to-the-3d-system-using-simulated-blood-cultures
#18
Nathalie Miller, Laetitia Brassinne, Daniel Allemeersch
PURPOSE: To evaluate the performances of the newly approved BacT/ALERT VIRTUO blood culture system for the recovery of bloodstream pathogens and compare it to the BacT/ALERT 3D system. METHODS: Simulated blood cultures of eight clinically relevant microorganisms were used: Bacteroides fragilis (ATCC 25285), Escherichia coli (ATCC 25922), Haemophilus influenzae (ATCC 49247), Pseudomonas aeruginosa (ATCC 27853), Enterococcus faecalis (ATCC 29212), Staphylococcus aureus (ATCC 29213), Streptococcus pneumoniae (ATCC 49619) and Candida krusei (ATCC 6258)...
June 5, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28580858/suboptimal-palliative-sedation-in-primary-care-an-exploration
#19
Peter Pype, Inge Teuwen, Fien Mertens, Marij Sercu, An De Sutter
OBJECTIVES: Palliative sedation is a therapeutic option to control refractory symptoms in terminal palliative patients. This study aims at describing the occurrence and characteristics of suboptimal palliative sedations in primary care and at exploring the way general practitioners (GPs) experience suboptimal palliative sedation in their practice. METHODS: We conducted a mixed methods study with a quantitative prospective survey in primary care and qualitative semi-structured interviews with GPs...
June 5, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/27712511/anakinra-in-resistant-gout-a-case-report
#20
Jana Van Wabeke, Eric Dhondt, Isabelle Peene, Yves Piette
Gout is a common cause of inflammatory arthritis. The classical treatment options in an acute gout attack are non-steroidal anti-inflammatory drugs, colchicine, and corticosteroids. Interleukin-1 inhibition has been shown to be an effective alternative when non-biologic therapies are ineffective or contraindicated. Herein, we report the case of a 69-year-old female who presented with polyarticular tophaceous gout treated successfully with anakinra.
August 2017: Acta Clinica Belgica
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