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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
Jean-Philippe Riga, Attilio Leone, Frédéric Lambot, Olivier Cappeliez, Alain Friart
OBJECTIVE AND IMPORTANCE: The antiphospholipid syndrome can manifest itself by silent (or not) myocardial infarction. CLINICAL PRESENTATION: We report the case of a 16-year-old girl who presented a myocardial infarction for whom a coronary-computer tomography did not reveal any coronary abnormalities or obstruction. She had a livedo reticularis on her physical exam. INTERVENTION: The echocardiography showed a normal left ventricular function and a mild eccentric mitral regurgitation...
August 30, 2018: Acta Clinica Belgica
Rene Westhovens, Isabelle Ravelingien, Klaas Vandevyvere, Ingrid Pansar, Oana Purcaru, Thomas Kumke, Lieve Gyselbrecht
OBJECTIVES: To report changes in productivity and social participation - alongside clinical and patient-reported outcomes (PROs) - in patients with rheumatoid arthritis (RA) receiving certolizumab pegol (CZP) during routine clinical practice in Belgium. METHODS: This was a prospective, non-interventional study, in which patients were prescribed CZP at their physicians' discretion and followed during routine clinical visits. The primary outcomes were household productivity and social participation at the last visit (~52 weeks), measured through responses to the Work Productivity Survey...
August 30, 2018: Acta Clinica Belgica
Charlotte De Vloo, Tom Matton, Wouter Meersseman, Geert Maleux, Sabrina Houthoofd, Katya Op de Beeck, Wim Laleman, Hannah Van Malenstein, Frederik Nevens, Len Verbeke, Schalk Van der Merwe, Chris Verslype
OBJECTIVES: Portal vein aneurysm is an unusual vascular dilatation of the portal vein. The etiology, diagnosis and management are ill-defined. METHODS: A case of a portal vein aneurysm complicated with complete thrombosis is presented with a literature review providing an overview of the etiology, clinical presentation and management. RESULTS: Portal venous aneurysms represent approximately 3% of all venous aneurysms with a reported prevalence of 0...
August 27, 2018: Acta Clinica Belgica
Anja Huion, Veerle Decalf, Candy Kumps, Nico De Witte, Karel Everaert
OBJECTIVES: The objective of the study is to evaluate the use of an experimental smart diaper as an indicator of saturation for diaper change in persons with dementia living in nursing homes. METHODS: A multicenter prospective study was conducted in 3 nursing homes amongst 18 residents with dementia. For each resident, a frequency-volume urine chart (FVUC) was kept for 24 h including voided volume and diaper weights, wearing smart diapers. A comparative study was set up between results obtained by smart diapers and data registered in FVUCs...
August 27, 2018: Acta Clinica Belgica
Alex Heyse, Florence Anne, Beatrice Lagae, Hilde Van Haver, Frederik Van Durme
We report a case of takotsubo syndrome (TTS) triggered by herpes encefalitis in the presence of significant triple vessel coronary artery disease (CAD). The typical ECG abnormalities, moderately elevated cardiac enzymes with disproportionally elevated brain natriuretic peptide (BNP) as well as the typical wall motion abnormalities on echocardiography and left ventricular (LV) angiography, were consistent with the diagnosis of TTS with concomitant CAD rather than an acute coronary syndrome. The normalization of the wall motion abnormalities, ejection fraction and longitudinal strain on serial echocardiography all support the diagnosis of takotsubo syndrome, especially in challenging cases...
August 27, 2018: Acta Clinica Belgica
Julia Bini Viotti, Monica Corzo-Pedroza, Jose Armando Gonzales Zamora
BACKGROUND: Candida prosthetic joint infection (PJI) is a rare complication of total knee arthroplasty (TKA). The literature regarding its diagnosis and management is scarce. CASE SUMMARY: We present the case of a 79-year-old woman with history of TKA and femoral intramedullary nailing, who developed PJI caused by Candida lusitaniae. A two-stage exchange arthroplasty was performed. She underwent implant removal, debridement and placement of temporary antibiotic impregnated spacer...
August 23, 2018: Acta Clinica Belgica
Zdenko Killinger, Lenka Gajdarova, Martin Kuzma, Anna Krajcovicova, Kristina Brazdilova, Peter Jackuliak, Juraj Payer
INTRODUCTION: Biologic treatment may influence activity of rheumatoid arthritis (RA), as well as areal bone mineral density (aBMD). Decreased aBMD explains the fracture risk in RA patients only partially. The trabecular bone score (TBS), novel texture parameter reflects degradation of trabecular bone and therefore could be used as a further parameter to predict the risk of fragility fracture. OBJECTIVE: To compare the effects of biological disease-modifying antirheumatic drugs (bDMARDs) and conventional synthetic (cs) DMARDs (methotrexate) on aBMD and TBS in patients suffering from active RA...
August 23, 2018: Acta Clinica Belgica
Laurens Doucet, Ruben Lammens, Sarah Hendrickx, Phillipe Dewolf
BACKGROUND: The importance of early cardiopulmonary resuscitation (CPR) during an out-of-hospital cardiac arrest (OHCA) cannot be emphasized enough and has a major impact on survival. Unfortunately, CPR education in schools is often inadequate or non-existing due to lack of educators and financial resources. The introduction of application-based teaching could facilitate education as no instructor is needed. The aim of present study is to compare app-based self-teaching (intervention group) with a traditional instructor-led course (control group)...
August 14, 2018: Acta Clinica Belgica
Chloé Wyndham-Thomas, Violette Dirix, Jean-Christophe Goffard, Sophie Henrard, Maryse Wanlin, Steven Callens, Françoise Mascart, Jean-Paul Van Vooren
OBJECTIVES: To review the current knowledge on screening for latent tuberculosis infection (LTBI) in HIV-infected adults and provide specific guidelines for Belgium. Focus is given to who to test, which testing method to use, timing of screening and choice of LTBI treatment. METHODS: Expert review by the members of the Belgian LTBI group, in consultancy with the ARC College. RESULTS: Target population, timing of screening, testing method, active TB exclusion, treatment of LTBI and guideline implementation are all reviewed...
July 23, 2018: Acta Clinica Belgica
Michèle Geys, Roy Remmen, Ludwig Apers
Background Antiretroviral treatment has turned HIV infection into a chronic condition with a near normal life expectancy and an ageing patient population. For a well-defined proportion of these patients, HIV-care could pass from specialty care to primary care, especially for prevention and treatment of additional chronic diseases. A better understanding of the complex health needs of this particular proportion is needed to determine the optimal way to integrate specialist and primary care. Objectives Our objective was to examine the health-seeking behaviour of ageing HIV patients...
July 20, 2018: Acta Clinica Belgica
Lien Cattoir, Anne Vankeerberghen, An Boel, Kristien Van Vaerenbergh, Hans De Beenhouwer
OBJECTIVES: Respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are important respiratory pathogens. Both viral pathogens have similar clinical manifestations. The epidemiology of RSV is well known, that of hMPV is less clear. We reviewed the results of 10 consecutive years of molecular testing for RSV and hMPV in respiratory samples of Flemish patients. METHODS: In the laboratory of the OLV hospital Aalst, Belgium, multiplex RT-PCR assays are used for the detection of RSV and hMPV...
July 20, 2018: Acta Clinica Belgica
Judith Baert, Stephanie Van Biervliet, Jean-Pierre Van Biervliet, Johan Vande Walle, Felicia Bentin, Liesl De Graeve, Doris Vandenbossche, Ann De Guchtenaere
OBJECTIVE: Evaluate the effect of a 1-year standardized residential slimming program on exercise-induced dehydration in children with obesity. METHOD: At the start (T1 ) and end (T2 ) of the program, urine samples, weight, blood pressure and pulse were collected before (TR ) and after a Cooper test (TE ). Urinary samples were analyzed for volume, Na (UNa ), Cl, K (UK ), urea, creatinine (Ucreat ), protein and osmolality (Uosm ). RESULTS: All 66 children (15 ± 1 years) starting the program were included after informed consent (28 stopped prematurely)...
July 20, 2018: Acta Clinica Belgica
Mony Hing, Dorien Van Den Bossche, Tinne Lernout, Christel Cochez, Jean-Paul Pirnay, Walter Heuninckx
Ticks are vectors for a broad range of pathogens of medical and veterinary importance, such as Borrelia spp., Babesia spp., Anaplasma spp., Rickettsia spp., Bartonella spp. and the tick-borne encephalitis virus. The Gram-negative bacterium Anaplasma phagocytophilum is present worldwide, including Belgium where numerous patients were shown to harbour antibodies against this pathogen as recorded by the Belgian National Reference Center (NRC) for Anaplasma. The clinical presentation of human granulocytic anaplasmosis is an acute, febrile, nonspecific, flu-like illness...
July 20, 2018: Acta Clinica Belgica
Justin C Cikomola, Antoine S Kishabongo, Marijn M Speeckaert, Joris R Delanghe
Diabetes mellitus is an increasing public health problem in sub-Saharan Africa with a substantial socioeconomic burden. Although laboratory medicine has been recognized as one of the six key public health functions, there are still gaps in strengthening of laboratory services in developing countries. In the last decades, a lot of progress has been made in the diagnostic field of infectious diseases, whereas the diagnosis of noncommunicable diseases is still insufficient and uneven. This article analyses the challenges encountered in diagnosing and monitoring of diabetes mellitus in sub-Saharan Africa and explores new alternative diagnostic tools...
July 20, 2018: Acta Clinica Belgica
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