Laurens Berton, Pieter Lottefier, Tom Claikens, Benedicte Dubois, Philippe Demaerel, Steven Vanderschueren, Liesbet Henckaerts
{"title":"Listeria monocytogenes rhombencephalitis: a case report and review of current literature.","authors":"Laurens Berton, Pieter Lottefier, Tom Claikens, Benedicte Dubois, Philippe Demaerel, Steven Vanderschueren, Liesbet Henckaerts","doi":"10.1080/17843286.2025.2570834","DOIUrl":"https://doi.org/10.1080/17843286.2025.2570834","url":null,"abstract":"<p><strong>Background: </strong><i>Listeria monocytogenes</i> Meningoencephalitis is a rare but potentially severe and lethal infectious disease caused by <i>Listeria monocytogenes</i> invading the central nervous system. The infection mainly affects the immunocompromised, neonates and older adults.</p><p><strong>Case report: </strong>A 71-year-old woman without relevant medical history was referred to the emergency department with febrile gastroenteritis. Upon admission, neurological examination was normal. Ten hours after admission, an acute neurological deterioration was observed, with the patient exhibiting incoherent speech and ocular motility abnormalities. She appeared lethargic, not oriented in time or place, and with nuchal rigidity. Cranial nerve testing revealed a left-sided internuclear ophthalmoplegia and a left-sided nervus abducens palsy. A tentative diagnosis of meningoencephalitis was made. Empirical treatment was initiated with high-dose amoxicillin, high-dose ceftriaxone, and high-dose aciclovir. Lumbar puncture was performed, and both culture and polymerase chain reaction were positive for <i>Listeria monocytogenes</i>. Antibiotic therapy was narrowed to high-dose amoxicillin. Magnetic resonance imaging showed edema within the brainstem and signs of a small abscess. The patient developed an acute kidney injury and therapy was switched to high-dose meropenem. Her neurological symptoms improved but the left internuclear ophthalmoplegia and nervus abducens palsy remained present.</p><p><strong>Conclusions: </strong><i>Listeria monocytogenes</i> Meningoencephalitis is a severe infectious disease with marked morbidity that can occur in previously immunocompetent hosts, regardless of age.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-8"},"PeriodicalIF":0.9,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yusuf Bozkurt Şahin, Veysel Ozan Tanık, Göktürk Kaan Koçu, Mehmet Taha Özkan, Murat Akdoğan, Özden Seçkin, Çağatay Tunca, Ali Sezgin, Kürşat Akbuğa, Bülent Özlek
{"title":"Pan-immune-inflammation value predicts sustained ventricular arrhythmias in NSTEMI: a novel inflammatory risk marker.","authors":"Yusuf Bozkurt Şahin, Veysel Ozan Tanık, Göktürk Kaan Koçu, Mehmet Taha Özkan, Murat Akdoğan, Özden Seçkin, Çağatay Tunca, Ali Sezgin, Kürşat Akbuğa, Bülent Özlek","doi":"10.1080/17843286.2025.2569339","DOIUrl":"https://doi.org/10.1080/17843286.2025.2569339","url":null,"abstract":"<p><strong>Background: </strong>Systemic inflammation contributes to arrhythmogenesis in acute coronary syndromes, but its role in NSTEMI-related ventricular arrhythmias remains poorly defined. The pan-immune-inflammation value (PIV) is a novel composite biomarker reflecting immune and thrombotic activity derived from routine blood counts. This study aimed to assess the association between PIV and the risk of sustained VT/VF in NSTEMI.</p><p><strong>Methods: </strong>In this retrospective cohort study, 1,788 NSTEMI patients who underwent percutaneous coronary intervention were analyzed. The primary endpoint was the occurrence of sustained VT or VF during hospitalization. PIV was calculated as (neutrophil × platelet × monocyte)/lymphocyte. Logistic regression, ROC analysis, Kaplan - Meier curves, reclassification indices (NRI, IDI), and restricted cubic spline modeling were used.</p><p><strong>Results: </strong>VT/VF occurred in 34 patients (1.9%). Those with VT/VF had significantly higher PIV values (median 1132 vs. 329, <i>p</i> < 0.001). In multivariable analysis, PIV remained an independent predictor (OR: 1.356 per 1000 unit increase; 95% CI: 1.028-1.787; <i>p</i> = 0.031). The risk of VT/VF rose progressively across PIV quartiles (Q4 vs. Q1 OR: 4.0, p for trend < 0.001). Adding PIV to conventional predictors improved risk classification (NRI: +0.089; IDI: 0.007). Kaplan - Meier analysis showed significantly reduced arrhythmia-free survival in high-PIV tertiles (log-rank <i>p</i> < 0.001), and cubic spline modeling revealed a non-linear association with increased arrhythmic risk at higher PIV levels.</p><p><strong>Conclusions: </strong>Elevated PIV is independently associated with malignant ventricular arrhythmias in NSTEMI. As an accessible biomarker, PIV may aid early arrhythmic risk stratification and guide clinical surveillance strategies.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-13"},"PeriodicalIF":0.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Clinica BelgicaPub Date : 2025-08-01Epub Date: 2025-07-30DOI: 10.1080/17843286.2025.2540287
Charlotte Delrue, Reinhart Speeckaert, Marijn M Speeckaert
{"title":"The role of intermittent fasting and ketogenic diet in metabolic syndrome and type 2 diabetes.","authors":"Charlotte Delrue, Reinhart Speeckaert, Marijn M Speeckaert","doi":"10.1080/17843286.2025.2540287","DOIUrl":"10.1080/17843286.2025.2540287","url":null,"abstract":"<p><strong>Objectives: </strong>To review the current evidence on intermittent fasting (IF) and ketogenic diet (KD) as dietary interventions for the management of metabolic syndrome (MetS) and type 2 diabetes mellitus (T2D), including their mechanisms of action, clinical benefits, and potential when used in combination.</p><p><strong>Methods: </strong>A narrative review of recent scientific literature examining the physiological mechanisms, clinical outcomes, and practical implementation of IF and KD in patients with MetS and T2D. The focus is on studies evaluating glycemic control, body weight, lipid profiles, and inflammation, as well as the proposed shared biochemical pathways involving AMPK activation and mTOR inhibition.</p><p><strong>Results: </strong>Both IF and KD independently show clinically significant benefits in improving metabolic parameters in MetS and T2D, including reductions in HbA1c, fasting glucose, body weight, and triglycerides. Mechanistically, both approaches enhance insulin sensitivity, promote autophagy, reduce inflammation, and activate energy-regulating pathways (AMPK) while inhibiting mTOR. Emerging evidence suggests that combining IF and KD may offer synergistic metabolic effects, although data on long-term safety, adherence, and patient-specific suitability remain limited.</p><p><strong>Conclusions: </strong>IF and KD represent promising, non-pharmacologic strategies for improving metabolic health in patients with MetS and T2D.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"100-114"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Clinica BelgicaPub Date : 2025-06-01Epub Date: 2025-06-14DOI: 10.1080/17843286.2025.2519712
Inès Van Rossem, Sander Deridder, Aline Beckwée, Dirk Devroey, Johan Vansintejan
{"title":"Elevated blood eosinophil counts in stable COPD patients in Belgian primary care: prevalence and clinical characteristics.","authors":"Inès Van Rossem, Sander Deridder, Aline Beckwée, Dirk Devroey, Johan Vansintejan","doi":"10.1080/17843286.2025.2519712","DOIUrl":"10.1080/17843286.2025.2519712","url":null,"abstract":"<p><strong>Objectives: </strong>Recently, eosinophilic Chronic Obstructive Pulmonary Disease (COPD) has been identified as a clinically relevant phenotype, as patients with elevated blood eosinophil counts (BEC) demonstrate a better response to maintenance inhaled corticosteroids (ICS). This real-world study in Belgian primary care describes the distribution of BECs and the ICS use in stable COPD patients.</p><p><strong>Methods: </strong>This study retrospectively analysed data from two primary care practices using the most recent values retrievable from the electronic health record. Patients were dichotomized based on BEC GOLD thresholds of 100 and 300 cells/µL.</p><p><strong>Results: </strong>Eighty stable COPD patients (60% male, mean (SD) age of 70.7 (9.7)years, mean FEV1 (SD) of 65.4 (17.5) % Predicted) were included. Amongst them, 46% used ICS maintenance therapy. BEC values ranged from 0 to 667 cells/µL with a median (IQR) of 182 (80-291) cells/µL. 71% and 23% of patients presented BEC > 100 and ≥ 300 cells/µL, respectively. The mean age in the BEC<sup>≥300</sup> group was significantly higher than in the BEC<sup><300</sup> group (MD = 7.2 y; <i>p</i> = 0.005). No other significant differences in demographic characteristics, dyspnea, FEV1 % Predicted, ≥1 moderate/severe exacerbations in the previous year, current maintenance ICS use, number of comorbidities or Charlson Comorbidity Index were detected between groups.</p><p><strong>Conclusion: </strong>In this primary care population in Belgium, elevated BECs and maintenance ICS use are prevalent. Besides age, clinical characteristics were comparable between eosinophil-based groups whether the 100 or 300 cells/µL threshold was used.</p><p><strong>Trial registration: </strong>Not applicable given the retrospective nature of the study.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"29-34"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Clinica BelgicaPub Date : 2025-02-01Epub Date: 2025-05-19DOI: 10.1080/17843286.2025.2506472
J Bekaert, M Aerts, S François, S Raevens, H Degroote, A Geerts, X Verhelst, H Van Vlierberghe, H Reynaert
{"title":"The burden of ascites in cirrhosis.","authors":"J Bekaert, M Aerts, S François, S Raevens, H Degroote, A Geerts, X Verhelst, H Van Vlierberghe, H Reynaert","doi":"10.1080/17843286.2025.2506472","DOIUrl":"10.1080/17843286.2025.2506472","url":null,"abstract":"<p><strong>Objectives: </strong>Liver cirrhosis is a leading cause of morbidity and mortality worldwide, with complications such as ascites, spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS) significantly worsening prognosis. This paper aims to review the pathophysiology, diagnostic approaches, and management strategies for ascites and the complication of it, emphasizing the role of portal hypertension.</p><p><strong>Methods: </strong>We conducted a comprehensive review of the literature on liver cirrhosis, portal hypertension, ascites formation, and related complications. Existing evidence was evaluated and ranked using the GRADE system: A (high) to D (verly low). Recommendation strength was graded 1 (strong) or 2 (weak).</p><p><strong>Results: </strong>Portal hypertension is the key factor in ascites development. Non-invasive tools such as liver stiffness measurement (LSM) have proven to be effective in identifying patients at risk for clinically significant portal hypertension (CSPH), thus guiding treatment decisions. Carvedilol, recommended over propranolol, offers superior efficacy in reducing portal pressure. Diuretics, in combination with a moderate sodium-restricted diet, are the first-line treatment for ascites. However, refractory ascites requires advanced interventions. Spontaneous bacterial peritonitis (SBP) remains a major complication in patients with ascites, while hepatorenal syndrome - acute kidney injury (HRS-AKI) demands early recognition and timely vasoconstrictor therapy.</p><p><strong>Conclusions: </strong>Liver cirrhosis and the complication of it significantly impact patient quality of life and survival. Portal hypertension is a critical driver of ascites and other complications, making early identification through non-invasive diagnostic methods essential for appropriate management. Medical treatments, including non-selective beta-blockers (NSBBs), diuretics, and advanced procedures, offer substantial benefits in controlling ascites and preventing further decompensation.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"8-16"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Clinica BelgicaPub Date : 2025-02-01Epub Date: 2025-05-14DOI: 10.1080/17843286.2025.2505864
Ode Devos, Christof Vulsteke, Emmanuelle Versele, An Deman, Heidi Hannon
{"title":"Severe hypocalcemia due to osteoblastic bone metastases in a patient with hypoparathyroidism: a case report.","authors":"Ode Devos, Christof Vulsteke, Emmanuelle Versele, An Deman, Heidi Hannon","doi":"10.1080/17843286.2025.2505864","DOIUrl":"10.1080/17843286.2025.2505864","url":null,"abstract":"<p><strong>Objectives: </strong>Bone metastases in breast cancer are typically osteolytic but can rarely be osteoblastic. While malignancy-related hypercalcemia is well-known, malignancy-related hypocalcemia is rare and often multifactorial.</p><p><strong>Case presentation: </strong>We present a case of a 48-year-old woman with metastatic breast cancer who developed severe hypocalcemia due to a combination of expanding osteoblastic bone metastases and hypoparathyroidism after total thyroidectomy. Despite oral and intravenous calcium supplementation, adequate calcium levels were not achieved until the patient responded to systemic therapy with Trastuzumab Deruxtecan (T-DXd), a HER2-directed antibody-drug conjugate.</p><p><strong>Conclusion: </strong>This case underscores the challenges in finding the cause of and managing hypocalcemia in patients with complex oncological histories and emphasizes the need for close calcium monitoring in patients with bone metastases, particularly those with additional risk factors such as hypoparathyroidism or treatment with anti-resorptive drugs.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"21-24"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Clinica BelgicaPub Date : 2025-02-01Epub Date: 2025-05-19DOI: 10.1080/17843286.2025.2506467
Vandemaele N, Stragier B, Tamsin A, De Bock M
{"title":"Asymptomatic hypercalcemia, caused by sarcoid-like granulomatosis, induced by checkpoint inhibition.","authors":"Vandemaele N, Stragier B, Tamsin A, De Bock M","doi":"10.1080/17843286.2025.2506467","DOIUrl":"10.1080/17843286.2025.2506467","url":null,"abstract":"<p><strong>Objectives: </strong>To illustrate the diagnostic challenges, as well as the importance of early recognition of rare immunotherapy-induced complications, presenting a case and literature of sarcoid-like granulomatous reaction.</p><p><strong>Methods: </strong>This report presents a case of asymptomatic hypercalcemia, revealing a sarcoid-like granulomatosis in a patient with metastatic melanoma, treated with an immune checkpoint inhibitor (ICI). In the discussion, an overview of the existing literature is provided through a PubMed search.</p><p><strong>Results: </strong>Thorough investigations are essential to rule out disease progression and other possible explanations. Ultimately, biopsy with extensive staining led to the diagnosis of sarcoid-like granulomatosis. As there is no consensus in treatment, we suggest a case-by-case assessment, if possible by discussion within the multidisciplinary treatment team, to decide discontinuation of the causal ICI-therapy or the use of systemic steroids as supportive therapy.</p><p><strong>Conclusion: </strong>This case demonstrates the importance of a broad differential diagnosis when identifying an asymptomatic hypercalcemia as well as new CT-graphic lesions, since the diagnosis of sarcoid-like granulomatosis can avoid not only unnecessary changes in treatment plans, avoiding toxicity, but also be a sign of good prognosis.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"1-7"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Clinica BelgicaPub Date : 2024-12-01Epub Date: 2025-02-21DOI: 10.1080/17843286.2025.2469906
K Ferdinande, S Raevens, J Decaestecker, C De Vloo, L Seynhaeve, L Hoof, X Verhelst, A Geerts, K M J Devreese, H Degroote, H Van Vlierberghe
{"title":"Unravelling the coagulation paradox in liver cirrhosis: challenges and insights.","authors":"K Ferdinande, S Raevens, J Decaestecker, C De Vloo, L Seynhaeve, L Hoof, X Verhelst, A Geerts, K M J Devreese, H Degroote, H Van Vlierberghe","doi":"10.1080/17843286.2025.2469906","DOIUrl":"10.1080/17843286.2025.2469906","url":null,"abstract":"<p><p>Patients with liver disease experience complex haemostatic changes leading to a state of 'rebalanced haemostasis' that may shift towards bleeding or thrombosis due to complications like kidney dysfunction, bacterial infection, or acute-on-chronic liver failure. Traditional coagulation tests inadequately capture haemostasis in cirrhosis, whereas advanced assays like thrombin generation assay and viscoelastic testing offer better insights but remain limited in clinical outcome prediction or guiding pre-procedural prophylaxis.Contrary to the traditional view of cirrhosis as a bleeding disorder, recent evidence highlights a paradox of higher venous thromboembolism incidence in hospitalised cirrhotic patients. Misconceptions about 'auto-anticoagulation' and concerns about anticoagulation safety hinder consistent thromboprophylaxis. Emerging data suggest that low molecular weight heparin is safe and effective in cirrhotic patients, supporting more evidence-based thromboprophylaxis. For thrombotic events or conditions like atrial fibrillation, therapeutic anticoagulation is recommended, and may offer additional benefits, such as attenuating liver fibrosis and portal hypertension. However, anticoagulation is not established as a core therapy in cirrhosis, given safety concerns in advanced disease.Bleeding remains a significant challenge in cirrhosis, with management focusing on specific aetiologies, including portal hypertension or procedural injuries. In pre-procedural planning, there is a trend of unnecessary blood product use, often based on an assumed bleeding risk. Rational pre-procedural planning should minimize unnecessary transfusions, optimise modifiable risks, and include a plan for managing potential bleeding.This review aims to clarify the 'coagulation paradox' in cirrhosis, promoting a nuanced, individualized approach to managing bleeding and thrombosis in chronic liver disease.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"451-461"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Clinica BelgicaPub Date : 2024-12-01Epub Date: 2025-03-04DOI: 10.1080/17843286.2025.2465674
M P van Vliet, A Boudewyns, A Keymeulen, E Vlieghe, K Vanden Driessche
{"title":"Screening frequency for congenital cytomegalovirus in Flanders, Belgium - a multicentre retrospective study.","authors":"M P van Vliet, A Boudewyns, A Keymeulen, E Vlieghe, K Vanden Driessche","doi":"10.1080/17843286.2025.2465674","DOIUrl":"10.1080/17843286.2025.2465674","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the screening practices for congenital cytomegalovirus (cCMV) in Flanders, Belgium, with the aim of determining the frequency of neonatal screening and the number of diagnoses resulting from it.</p><p><strong>Methods: </strong>Flemish hospitals with maternity facilities were asked for data on the number of infants screened for cCMV (PCR-CMV on saliva or urine), and diagnosed with cCMV (positive PCR-CMV on urine before the age of 3 weeks). Screening and diagnosis rates were compared across geographic regions and screening policies. We defined that at least 3% of neonates should be screened, given the prevalence of common screening indications (i.e. microcephaly and IUGR), and evaluated whether the empirical incidence of cCMV (0.5%) was approached.</p><p><strong>Results: </strong>Fifty of 57 eligible hospitals participated. Overall, 1.65% of infants were screened and 0.12% were diagnosed with cCMV. Few hospitals screened 3% or more of infants (14/50), and measured an incidence of 0.5% or more (6/50). Hospitals using targeted screening policies conducted fewer screenings (median 1.5% vs 94.2%, <i>p</i> < 0.001) and diagnosed fewer infants (median 0.10% vs 0.54%, <i>p</i> < 0.001) compared to hospitals that screened universally.</p><p><strong>Conclusion: </strong>There was important variability in cCMV screening practices across Flanders. Most hospitals screened fewer than 3% of infants, i.e. lower than the prevalence of microcephaly, a clinical feature that warrants testing for cCMV. Failure to diagnose cCMV in a timely manner limits the opportunities for early treatment with valganciclovir (secondary prevention) and morbidities such as hearing loss (tertiary prevention). There is a pressing need to enhance the knowledge and vigilance of perinatal healthcare professionals in Flanders, ensuring infants at risk of cCMV are appropriately identified and receive timely care.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"403-412"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Clinica BelgicaPub Date : 2024-12-01Epub Date: 2025-01-15DOI: 10.1080/17843286.2025.2451429
Helena Degroote
{"title":"Cirrhosis and complications hepatocellular carcinoma - expanding indications for immunotherapy.","authors":"Helena Degroote","doi":"10.1080/17843286.2025.2451429","DOIUrl":"10.1080/17843286.2025.2451429","url":null,"abstract":"<p><p>The incidence of hepatocellular carcinoma (HCC) is rising, with a shift towards Metabolic Dysfunction-associated Steatotic Liver Disease becoming the dominant risk factor in Western countries. Significant advances in treatment have broadened the range of available therapeutic options. For this reason, clinical decision-making, along with a multidisciplinary team approach, plays a crucial role in improving patient outcomes. Following several landmark trials, immune checkpoint inhibitor-based therapy has now become the established first-line standard of care for advanced HCC. Additionally, the application of immunotherapy is shifting to include patients with earlier stages of HCC. Research on the combination with locoregional therapies for intermediate-stage HCC has recently reported positive results, and other phase III trials in the same patient population and early-stage HCC are currently in progress. Furthermore, a growing number of reports support the safety and efficacy of immunotherapeutic agents as potential adjuncts for downstaging of HCC, thus facilitating successful liver transplantation. We will discuss the published and ongoing trials in the expanding field of immune checkpoint inhibitor-based therapy for different stages of HCC.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"434-440"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}