Acta Clinica Belgica最新文献_第4页

Mycobacterium abscessus felon complicated with osteomyelitis: not an ordinary nail salon visit. 重脓分枝杆菌合并骨髓炎:不是一个普通的美甲沙龙访问。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2020-12-01 Epub Date: 2019-06-28 DOI: 10.1080/17843286.2019.1637390

Jose Armando Gonzales Zamora, Abelardo Villar Astete

引用次数: 1

When clozapine appears at a dance event…. 当氯氮平出现在舞会上....

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2020-12-01 Epub Date: 2019-06-14 DOI: 10.1080/17843286.2019.1630068

Lisbeth Patteet, Kristof Maudens, Sarah Wille, Peter Blanckaert, Hugo Neels, Paul Calle

{"title":"When clozapine appears at a dance event….","authors":"Lisbeth Patteet, Kristof Maudens, Sarah Wille, Peter Blanckaert, Hugo Neels, Paul Calle","doi":"10.1080/17843286.2019.1630068","DOIUrl":"https://doi.org/10.1080/17843286.2019.1630068","url":null,"abstract":"Objectives: The content of substances sold and consumed as party drugs is often unknown. They may contain inactive, contaminated or unexpected ingredients, and the dosage of the active components may vary considerably. Obviously, these phenomena increase the chances of a wrong or delayed therapy. To illustrate this point, we report 3 cases of clozapine intoxication at a dance event where most likely clozapine tablets were sold as party drugs.Methods: The three cases were part of a prospective toxicology study at a nocturnal indoor dance event.Results: One patient had to be intubated after obstructive breathing with desaturation and bradycardia, while the 2 other patients presented with syncope and altered mental status. All patients recovered after 20 minutes to 8 hours. Systematic toxicological analysis of the blood samples revealed the presence of clozapine (73-244 ng/ml) and its metabolite norclozapine (9-59 ng/ml). A pill, found in a pocket of one patient, was identified as Leponex® 100 mg (clozapine). This neuroleptic drug is mainly prescribed for treatment-resistant schizophrenia. In clozapine-naive subjects, orthostatic hypotension, bradycardia and syncope have been reported with a single 25 mg oral dose. Serum clozapine concentrations of the 3 cases were below the defined therapeutic range (350-600ng/ml) and the clozapine:norclozapine ratios were suggestive for recent drug intake.Conclusion: Routine drug screening may be unable to detect the toxic agent(s) involved. Whenever unusual symptoms are observed in an intoxicated patient, blood and urine samples should be sent to a reference toxicology laboratory.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 6","pages":"416-420"},"PeriodicalIF":1.6,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1630068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37055522","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}

引用次数: 5

A case report of successful eradication of new isolates of Burkholderia cenocepacia in a child with cystic fibrosis. 成功根除新分离的伯克霍尔德菌囊性纤维化儿童的病例报告。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2020-12-01 Epub Date: 2019-06-15 DOI: 10.1080/17843286.2019.1630585

V Sputael, G Van Schandevyl, L Hanssens

引用次数: 3

Application of the GheOP³S-tool in nursing home residents: acceptance and implementation of pharmacist recommendations. gheop3s工具在养老院居民中的应用:药师建议的接受与实施。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2020-12-01 Epub Date: 2019-06-26 DOI: 10.1080/17843286.2019.1634323

Katrien Foubert, Peter Muylaert, Els Mehuys, Annemie Somers, Mirko Petrovic, Koen Boussery

{"title":"Application of the GheOP3S-tool in nursing home residents: acceptance and implementation of pharmacist recommendations.","authors":"Katrien Foubert, Peter Muylaert, Els Mehuys, Annemie Somers, Mirko Petrovic, Koen Boussery","doi":"10.1080/17843286.2019.1634323","DOIUrl":"https://doi.org/10.1080/17843286.2019.1634323","url":null,"abstract":"ABSTRACT Background and objective: The prevalence of potentially inappropriate prescribing (PIP) among nursing home (NH) residents is high. This study aimed to investigate the acceptance and implementation of pharmacist recommendations based on a screening tool for PIP, the Ghent Older People’s Prescriptions community Pharmacy Screening (GheOP3S)-tool. Setting and method: Prospective observational study in NH residents (≥ 70 years, using ≥ 5 medications) with a 3-month follow-up period. A pharmacist screened the medication lists using the GheOP3S-tool and formulated recommendations to reduce PIP. The acceptance of recommendations discussed during face-to-face pharmacist-general practitioner (GP) meetings was recorded. Implementation was examined by comparing baseline and follow-up medication lists. A pre-post comparison of the number of chronic medications and GheOP3S-criteria; the anticholinergic and sedative burden quantified by the Drug Burden Index (DBI); and medication costs was performed. Results: Screening with the GheOP3S-tool resulted in 168 pharmacist recommendations for 50 NH residents, mainly to stop (78.0%) and to substitute (14.3%) medications. Ninety-three % (156/168) of recommendations were considered relevant. GPs acceptance rate was 44.9%. Fifty-four % of all accepted recommendations were implemented. At follow-up, the number of chronic medications (p = 0.007), and DBI scores (p = 0.004) significantly differed from baseline. There was no significant decrease in the number of GheOP3S-criteria (p = 0.075) and medication costs (p > 0.05). Conclusion: The acceptance and implementation of pharmacist recommendations were relatively low. Future studies should increase the involvement of patients and all health-care providers. Interdisciplinary collaboration with sufficient education for all disciplines and patients is essential.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 6","pages":"388-396"},"PeriodicalIF":1.6,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1634323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37363440","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}

引用次数: 10

Necrotizing myositis case report and brief literature study. 坏死性肌炎1例报告及简要文献研究。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2020-12-01 Epub Date: 2019-07-03 DOI: 10.1080/17843286.2019.1637388

Arthur Basso, Filip Moerman, Christophe Ronsmans, Martine Demarche

引用次数: 1

Survival prediction in patients with cutaneous melanoma by tumour lymphangiogenesis. 通过肿瘤淋巴管生成预测皮肤黑色素瘤患者的生存。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2020-12-01 Epub Date: 2019-06-18 DOI: 10.1080/17843286.2019.1629076

Zorica Špirić, Milka Vještica, Mirela Erić

{"title":"Survival prediction in patients with cutaneous melanoma by tumour lymphangiogenesis.","authors":"Zorica Špirić, Milka Vještica, Mirela Erić","doi":"10.1080/17843286.2019.1629076","DOIUrl":"https://doi.org/10.1080/17843286.2019.1629076","url":null,"abstract":"Objectives: Melanoma induces lymphangiogenesis by secreting lymphangiogenic growth factors. The aim of this study was to examine the role of tumour lymphangiogenesis in survival of patients with cutaneous melanoma. Methods: Immunostaining of one hundred melanoma specimens was done with lymphatic-specific antibody D2-40. The quantification of tumour lymphangiogenesis - lymphatic vessel density (LVD) and lymphatic vessel area (LVA) - was calculated by computer-assisted morphometric analysis. Results: High intratumoural LVD, high peritumoural LVD, male gender, greater tumour thickness and Clark level IV/V were significantly associated with shorter disease-free survival (p= 0.001, p= 0.004, p= 0.004, p= 0.000 and p= 0.008, respectively) and melanoma-specific survival (p= 0.002, p= 0.002, p= 0.001, p= 0.000 and p= 0.017, respectively), while the trunk melanoma site was significantly associated only with shorter disease-free survival (p= 0.033). No significant association of LVA with survival was found. At multivariate analysis, peritumoural LVD [hazard ratio (HR) = 2.143, 95% confidence interval (CI) 1.097-4.189, p= 0.026)] and melanoma thickness (HR = 1.276, 95%CI 1.106-1.473, p= 0.001) were independent predictors of disease-free survival, while intratumoural LVD (HR = 3.446, 95%CI 1.465-8.109, p= 0.005), peritumoural LVD (HR = 2.742, 95%CI 1.313-5.725, p= 0.007) and gender (HR = 2.880, 95%CI 1.304-6.362, p= 0.009) were independent predictors of melanoma-specific survival. Conclusion: Тhis study shows that LVD enables better prediction of survival than melanoma thickness and other clinical-pathological parameters. Intratumoural LVD is the most significant predictor of melanoma-specific survival, while only peritumoural LVD has a significant impact on both, a disease-free survival and a melanoma-specific survival.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 6","pages":"379-387"},"PeriodicalIF":1.6,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1629076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37065106","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}

引用次数: 4

Dyspnea in homosexual male patients: throwback to an occasionally forgotten but severe clinical presentation of HIV/AIDS. 男同性恋患者的呼吸困难:倒退到偶尔被遗忘但严重的HIV/AIDS临床表现。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2020-12-01 Epub Date: 2019-05-25 DOI: 10.1080/17843286.2019.1622880

Koen Verbeke, Roel Verbuyst, Christiane Brands, Hans Slabbynck

{"title":"Dyspnea in homosexual male patients: throwback to an occasionally forgotten but severe clinical presentation of HIV/AIDS.","authors":"Koen Verbeke, Roel Verbuyst, Christiane Brands, Hans Slabbynck","doi":"10.1080/17843286.2019.1622880","DOIUrl":"https://doi.org/10.1080/17843286.2019.1622880","url":null,"abstract":"Pneumocystis jirovecii pneumonia (PJP) can be a severe indicator disease of acquired immunodeficiency syndrome (AIDS). We present two cases of homosexual male patients who came to the emergency unit of a Belgian hospital because of shortness of breath. Both men had been sent back home, initially diagnosed with a benign viral infection. Because of worsening symptoms and gradually evolving hypoxemia, both patients came back and were admitted to the hospital with a diagnosis of (microbiology proven) Pneumocystis jirovecii pneumonia. HIV serology in both men was tested and was clearly positive, indicating a new diagnosis of HIV infection. In this article, we provide an overview of this possibly severe AIDS defining condition. First, we give an introduction of the history of HIV/AIDS and its occurrence in homosexual males in Europe. Secondly, we provide an overview of the diagnosis and treatment of Pneumocystis jirovecii pneumonia. Finally, since the first case reports of Pneumocystis jirovecii pneumonia at the beginning of the AIDS epidemic also included homosexual men, we emphasize the potential importance of a sexual anamnesis in young male patients with an initial complaint of dyspnea.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 6","pages":"411-415"},"PeriodicalIF":1.6,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1622880","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37273919","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}

引用次数: 0

Efficacy and toxicity of sorafenib in patients with adenoid cystic carcinoma of the head and neck: a case series of five patients. 索拉非尼治疗头颈部腺样囊性癌的疗效和毒性:5例患者的病例系列。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2020-10-01 Epub Date: 2019-06-23 DOI: 10.1080/17843286.2019.1633490

Karen Couvreur, Jacobs Celine, Bock Marlies, D'Hondt Randal, Deron Philippe, Duprez Frederic, Rottey Sylvie

{"title":"Efficacy and toxicity of sorafenib in patients with adenoid cystic carcinoma of the head and neck: a case series of five patients.","authors":"Karen Couvreur, Jacobs Celine, Bock Marlies, D'Hondt Randal, Deron Philippe, Duprez Frederic, Rottey Sylvie","doi":"10.1080/17843286.2019.1633490","DOIUrl":"https://doi.org/10.1080/17843286.2019.1633490","url":null,"abstract":"Introduction: Adenoid cystic carcinoma (ACC) of the head and neck is a rare malignancy of the salivary glands that accounts for approximately 10% of salivary gland carcinoma. Despite aggressive local therapy, local recurrence and distant metastases occur frequently. Response rates (RR) to potential curative and palliative chemotherapy are limited, so new strategies are needed.Case reports: We describe five case reports of patients with unresectable locally advanced or metastatic ACC of the head and neck who have been treated with sorafenib, a multi-tyrosine kinase inhibitor (mTKI).Results: In this case series, we found that three out of five patients treated with sorafenib survived, respectively, 16, 35 and 35 months. Two patients showed a partial response (PR) and one patient had a prolonged stable disease (SD) for almost three years. Grade 3 adverse events (AE) occur under sorafenib so adequate toxicity management is essential. This retrospective case series hints towards the possibility of clinical benefit for treating ACC patients with sorafenib. Efficacy of sorafenib should be studied in a prospective-randomized clinical trial which is a challenging task due to the rarity of the disease.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 5","pages":"362-369"},"PeriodicalIF":1.6,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1633490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37355745","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}

引用次数: 3

Orthostatic blood pressure drop and cardiovascular and psychotropic medication dosages in acutely ill geriatric inpatients. 老年急性病住院患者体位血压下降与心血管和精神药物剂量的关系。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2020-10-01 Epub Date: 2019-05-29 DOI: 10.1080/17843286.2019.1623516

J Paul, F Vaillant, O Vanden Bossche, T Pepersack, S Henrard, B Boland

{"title":"Orthostatic blood pressure drop and cardiovascular and psychotropic medication dosages in acutely ill geriatric inpatients.","authors":"J Paul, F Vaillant, O Vanden Bossche, T Pepersack, S Henrard, B Boland","doi":"10.1080/17843286.2019.1623516","DOIUrl":"https://doi.org/10.1080/17843286.2019.1623516","url":null,"abstract":"Objectives: . To investigate the dose-response relationship between cardiovascular or psychotropic medication dosages and falling orthostatic blood pressure in geriatric inpatients.Methods: . This cross-sectional study included 100 consecutive geriatric inpatients of a Belgian hospital. The end points were the maximum changes of systolic (sBP) and diastolic (dBP) blood pressure in a standing up position at one or three minutes. The dosages of six classes of vascular and five classes of psychotropic medications were expressed in terms of a proportion of defined daily doses (DDD). Bivariate and multivariate linear regression models were used.Results: . The 100 geriatric patients (85 ± 5 years, 58 % women) received 7.7 ± 4 medications (mean DDD: vascular = 1.0, psychotropic = 0.74) on the day of an orthostatic test (lying sBP: 136 ± 21; dBP: 72 ± 14 mm Hg). In a standing position, sBP and dBP fell by 12 ± 17 and 11 ± 5 mmHg, respectively. At the individual level, BP change was not correlated with vascular DDD (sBP: p = 0.07, r2 = 0.04; dBP: p = 0.59; r2 = 0.004) nor with psychotropic DDD (sBP: p = 0.14, r2 = 0.02; dBP: p = 0.82; r2 = 0.0). In multivariate analysis, sBP drop was positively associated with age, diabetes, falls history, and number of medications, but not with the DDD of any of the medication classes, while dBP drop was positively associated with age, diabetes, stroke and anaemia, but again with the DDD of any of the medication classes.Conclusion: . No correlation was found between vascular and psychotropic medication dosages and the orthostatic blood pressure drop expressed as a continuous variable.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 5","pages":"313-320"},"PeriodicalIF":1.6,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1623516","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37288674","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}

引用次数: 1

Dissatisfaction and Burnout among Flemish emergency physicians: a qualitative study. 佛兰德急诊科医师的不满与倦怠:一项质性研究。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2020-10-01 Epub Date: 2019-06-11 DOI: 10.1080/17843286.2019.1629077

Ine Van Bogaert, Catheline Depuydt, Said Hachimi-Idrissi

{"title":"Dissatisfaction and Burnout among Flemish emergency physicians: a qualitative study.","authors":"Ine Van Bogaert, Catheline Depuydt, Said Hachimi-Idrissi","doi":"10.1080/17843286.2019.1629077","DOIUrl":"https://doi.org/10.1080/17843286.2019.1629077","url":null,"abstract":"Objectives: Emergency physicians have shown difficulties to combine their private and professional life. In addition to a very stressful environment, they have to deal with multiple sources of uncertainty. These factors may lead to psychological distress. The aim of this study is to determine the factors leading to dissatisfaction and burnout among Flemish emergency physicians (EPs). Which are the barriers hindering EPs to seek help and what are the potential solutions for this problem? Methods:This is a prospective, explorative qualitative study where seven Flemish EPs were interviewed. These were in-depth semi-structured interviews. The information from the interviews was analyzed using NVivo 12. Results:The common contributors were the working schedule, the increasing number of patients, the mental and physical impact of the job and the relatively low income. The most important barrier to seek help is the existence of an unforgiving medical culture. The solutions provided by the EPs are less patients and a better financing. Conclusion:Dissatisfaction and burnout are common among the EP profession. There is a need for awareness and a change in the unforgiving medical culture to a 'no shame no blame culture'. Improvement of EPs' work schedule and income to the level of other medical specialties are other important needs. Finally, reducing the number of patient contact at the emergency department, by highlighting the difference between medical urgency rather than personal convenience.","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 5","pages":"329-333"},"PeriodicalIF":1.6,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1629077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37319948","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}

引用次数: 1