Acta Clinica Belgica最新文献

{"title":"Clinical characteristics and outcomes of patients receiving outpatient parenteral antibiotic therapy in a Belgian setting: a single-center pilot study.","authors":"Caroline Briquet, Olivier Cornu, Valerie Servais, Chloe Blasson, Bernard Vandeleene, Halil Yildiz, Annabelle Stainier, Jean Cyr Yombi","doi":"10.1080/17843286.2019.1608396","DOIUrl":"https://doi.org/10.1080/17843286.2019.1608396","url":null,"abstract":"<p><strong>Background: </strong>Outpatient parenteral antibiotic therapy (OPAT) was not used in Belgium before 2013, except for patients with cystic fibrosis. Thus, we have performed a pilot study to evaluate clinical characteristics and outcomes of patient receiving OPAT in a Belgian setting.</p><p><strong>Methods: </strong>The study was a prospective observational single-center study of patients receiving OPAT between 1 September 2013 and 31 December, 2017.</p><p><strong>Results: </strong>We included 218 OPATs. The median age was 58 years and 71% were men. At the end of the treatment, 92% of the patients on OPAT were cured. Risk factors for treatment failure were obesity, diabetes and diabetic foot infections, longer duration of hospitalization before OPAT, and duration of OPAT >16 days. An average of 24 days of hospitalization per patient discharge was saved, which amounted to 5205 days saved during the project. During the OPAT and 30 days thereafter, 71 (32.6%) of patients were readmitted, but only 26 (12%) readmissions were directly related to OPAT. Risk factors for readmissions were diabetes and diabetic foot infections, endovascular infections, longer duration of hospitalization before OPAT, duration of OPAT >30 days, and history of hospitalizations in the year before OPAT. There were 2.3 intravenous catheter-related events per 1000 days of catheter use. Patients' level of satisfaction was high (99.5%).</p><p><strong>Conclusions: </strong>In this pilot study, OPAT is found to be efficacious in saving hospitalization's days, with a low rate of readmissions and complications and a high patients' level of satisfaction. We therefore conclude that OPAT is feasible and safe.</p><p><strong>Background: </strong>Outpatient parenteral antibiotic therapy (OPAT) was not used in Belgium before 2013, except for patients with cystic fibrosis. Thus, we have performed a pilot study to evaluate clinical characteristics and outcomes of patient receiving OPAT in a Belgian setting.</p><p><strong>Methods: </strong>The study was a prospective observational single-center study of patients receiving OPAT between 1 September 2013 and 31 December, 2017.</p><p><strong>Results: </strong>We included 218 OPATs. The median age was 58 years and 71% were men. At the end of the treatment, 92% of the patients on OPAT were cured. Risk factors for treatment failure were obesity, diabetes and diabetic foot infections, longer duration of hospitalization before OPAT, and duration of OPAT >16 days. An average of 24 days of hospitalization per patient discharge was saved, which amounted to 5205 days saved during the project. During the OPAT and 30 days thereafter, 71 (32.6%) of patients were readmitted, but only 26 (12%) readmissions were directly related to OPAT. Risk factors for readmissions were diabetes and diabetic foot infections, endovascular infections, longer duration of hospitalization before OPAT, duration of OPAT >30 days, and history of hospitalizations in the year bef","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 4","pages":"275-283"},"PeriodicalIF":1.6,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1608396","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37183931","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}

{"title":"How dyspepsia led to the diagnosis of Morbus Crohn.","authors":"A Maertens,&nbsp;D Persyn,&nbsp;W Van Moerkercke","doi":"10.1080/17843286.2019.1590497","DOIUrl":"https://doi.org/10.1080/17843286.2019.1590497","url":null,"abstract":"<p><strong>Background: </strong>It is well known that Crohn's disease can involve the stomach. However, most often this upper gastrointestinal tract involvement is asymptomatic. Typically, there is involvement of the small intestine with the typical associated symptoms of Crohn's disease: abdominal cramps, diarrhoea and weight loss.</p><p><strong>Methods: </strong>We report a case of a young woman with complaints of dyspepsia since 2 months.</p><p><strong>Results: </strong>Gastroscopy revealed severe aphthous pangastritis with biopsies showing a focal active and chronic gastritis with presence of granulomas. We therefore performed a coloscopy showing an aphthous terminal ileum. The pathologic report indicated granulomatous reaction concordant with a slightly active, mildly chronic terminal ileitis typical for Crohn's disease.</p><p><strong>Conclusion: </strong>The incidence of upper gastrointestinal tract involvement of Crohn's disease is still underestimated, partially due to the asymptomatic nature in two thirds of patients. IBD gastritis should always be included in the differential diagnosis of gastritis, considering the increased risk of a more severe disease course and complications.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 4","pages":"293-295"},"PeriodicalIF":1.6,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1590497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37065884","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}

{"title":"Standardized approach to idiopathic retroperitoneal fibrosis: a comprehensive review of the literature.","authors":"Eduard Roussel,&nbsp;Jasper Callemeyn,&nbsp;Wouter Van Moerkercke","doi":"10.1080/17843286.2019.1609152","DOIUrl":"https://doi.org/10.1080/17843286.2019.1609152","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic retroperitoneal fibrosis (iRPF) is a rare fibro-inflammatory disease, characterized by inflammation of the abdominal aorta and its surrounding structures. The exact pathophysiology remains unclear. Diagnosis is often troublesome due to the non-specific and highly variable clinical presentation. Standardized treatment protocols are lacking.</p><p><strong>Objective: </strong>This article presents a review on iRPF, addressing clinical and diagnostic modalities as well as its pathophysiology and the possible inclusion within the IgG4-related disease (IgG4-RD) spectrum. Finally, a diagnostic-therapeutic algorithm for a standardized approach to iRPF is proposed.</p><p><strong>Methods: </strong>The PubMed Internet database was searched. Articles were selected based on the relevance of abstract, article type and impact of the journal.</p><p><strong>Results: </strong>iRPF and IgG4-RD share a common autoimmune aetiology. Diagnostics are multimodal and based on imaging. Ruling out malignancy should be of primary concern. Complications are mostly of renal or vascular origin due to compression of retroperitoneal structures. Corticosteroids remain the first-line treatment regimen and are mostly successful, but evidence supporting alternative immunosuppressive and anti-inflammatory treatments is growing. Long-term therapy, as well as follow-up, is paramount in this chronic and often relapsing disease.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 4","pages":"239-244"},"PeriodicalIF":1.6,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1609152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37194014","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}

{"title":"Shifting specialized oncological care from hospital- to home-setting: is there support among patients, specialists and general practitioners?","authors":"Lieselot Cool,&nbsp;Celine Brewaeys,&nbsp;Stefaan Viaene,&nbsp;Jana Missiaen,&nbsp;Michelle Lycke,&nbsp;Tessa Lefebvre,&nbsp;Laura Tack,&nbsp;Veerle Foulon,&nbsp;Hans Pottel,&nbsp;Philip Debruyne,&nbsp;Dominique Vandijck,&nbsp;Koen Van Eygen","doi":"10.1080/17843286.2019.1605467","DOIUrl":"https://doi.org/10.1080/17843286.2019.1605467","url":null,"abstract":"<p><strong>Objectives: </strong>Oncological home-hospitalization (OHH) might be a patient-centred approach to deal with the increasing burden of cancer on health-care facilities and finances. Before implementation into practice, its feasibility, costs and support among stakeholders should be evaluated. The purpose of this trial was to explore patients', specialists' and general practitioners' (GPs) perspectives towards the opportunities of implementing OHH within the Belgian health-care system.</p><p><strong>Methods: </strong>A regional cross-sectional survey study was launched in order to investigate the stakeholders' views on OHH and the current cancer care focusing on integration of primary care and continuous care.</p><p><strong>Results: </strong>Of the responders, 37 out of 163 patients (23%), 45 of 62 GPs (73%) and 10 of 15 specialists (67%) feel positive about the opportunities for OHH. Nevertheless, 11/15 specialists (73%) and 51/62 GPs (82%) feel primary care might currently be (too) little involved in order to ensure continuous care for cancer patients. Opportunities for improved continuous care are seen in better communication between primary care and hospital, and more patient contacts for primary care during the cancer treatment process.</p><p><strong>Conclusion: </strong>The results of this local survey study demonstrated there is support among different stakeholder groups for the implementation of OHH within the Belgian health-care context. However, some barriers impeding transmural continuous care should be tackled before implementing such model into practice. Better communication between health-care professionals and more patients contacts are suggested, and an adjusted legal and financial framework is required.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 4","pages":"250-257"},"PeriodicalIF":1.6,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1605467","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37168274","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}

{"title":"Preoperative joint aspiration culture results and causative pathogens in total hip and knee prosthesis infections: mind the gap.","authors":"Peter Declercq,&nbsp;Jeroen Neyt,&nbsp;Melissa Depypere,&nbsp;Stefanie Goris,&nbsp;Eric Van Wijngaerden,&nbsp;Jan Verhaegen,&nbsp;Joost Wauters,&nbsp;Isabel Spriet","doi":"10.1080/17843286.2019.1611718","DOIUrl":"https://doi.org/10.1080/17843286.2019.1611718","url":null,"abstract":"<p><strong>Objectives: </strong>In prosthetic joint infections (PJIs), there is no consensus about the utility of the preoperative joint aspiration culture to guide antimicrobial treatment. The main objective of this retrospective study was to investigate the value of these preoperative samples to narrow immediate postoperative empirical antimicrobial treatment in patients with a knee or hip PJI.</p><p><strong>Methods: </strong>Adult patients admitted for an exchange procedure between June 2007 and July 2016 for whom a preoperative joint aspiration within 6 months prior to the procedure was available and with an antibiotic-free interval before sampling, were eligible. Per PJI, taking both preoperative joint aspiration and intraoperative deep samples into account, causative pathogen(s) were assessed by the current Infectious Diseases Society of America (IDSA) guidelines. Per PJI, agreement of preoperative joint aspiration cultures corresponding to the causative pathogen(s) was investigated both on species and on Gram/fungi level.</p><p><strong>Results: </strong>From the 85 PJIs, on species level, the total agreement was found in 58 (68%) PJIs. On Gram/fungi level, when preoperative joint aspiration cultures yielded exclusively Gram-positive microorganisms (n = 61), a 100% predictive value for Gram positive causing pathogens was attained. Insufficient predictive value was observed in PJIs with preoperative joint aspiration yielding Gram-negative microorganisms (n = 4), a fungus (n = 1) or with sterile results (n = 19).</p><p><strong>Conclusion: </strong>In the immediate postoperative setting, the treating team might consider a broad spectrum empirical antibiotic regime, guided by the local epidemiology and susceptibility, which can be narrowed to Gram-positive coverage if preoperative joint aspiration cultures yield exclusively Gram-positive microorganisms.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 4","pages":"284-292"},"PeriodicalIF":1.6,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1611718","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37389677","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}

{"title":"Left atrium size and red cell distribution width predict atrial fibrillation progression from paroxysmal or persistent to permanent.","authors":"Ivana Jurin,&nbsp;Irzal Hadžibegović,&nbsp;Ivan Durlen,&nbsp;Sandra Jakšić Jurinjak,&nbsp;Domagoj Mišković,&nbsp;Marko Ajduk,&nbsp;Helena Jerkić,&nbsp;Tomislav Letilović","doi":"10.1080/17843286.2019.1599173","DOIUrl":"https://doi.org/10.1080/17843286.2019.1599173","url":null,"abstract":"<p><p><b>Objective</b>: Stratifying patients with paroxysmal or short-term persistent atrial fibrillation (AF) who are at greater risk of developing permanent AF is challenging. Aim of our prospective study was to evaluate association of laboratory parameters (biochemistry and complete blood count (CBC)) together with standard demographic, clinical and echocardiography parameters, with AF progression.<b>Methods</b>: We prospectively recruited 579 patients with AF and divided them into two groups at index hospitalization: paroxysmal or persistent (non-permanent AF), and long-term persistent or permanent AF patients (permanent AF). Clinical, echocardiographic, and relevant CBC parameters were collected. Non-permanent AF patients were selected for follow-up, with a median follow-up time of 21 months. Endpoint was progression to permanent AF.<b>Results</b>: Out of 409 patients with non-permanent AF, 109 (26.6%) progressed within follow-up. In a multivariate Cox regression model only increased left atrium (LA) diameter (HR 2.16, 95% CI 1.20-3.87, <i>p</i> = 0.010), and increased red cell distribution width (RDW; HR 1.19, 95% CI 1.03-1.39, <i>p</i> = 0.022) showed significant independent association with progression. There were 221/409 patients with both LA ≤45 mm and RDW level ≤14.5% who progressed at a rate of only 17.6%, and showed relative risk of AF progression of 0.47 (95% CI 0.34-0.67; p < 0,001).<b>Conclusion</b>: Together with LA size, RDW was independently associated with AF progression. Patients with both LA size ≤45 mm and RDW level ≤14.5% are most probably the best candidates for rhythm control strategies.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 3","pages":"205-211"},"PeriodicalIF":1.6,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1599173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37286220","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}

{"title":"Overlooked guide wire: a multicomplicated Swiss Cheese Model example. Analysis of a case and review of the literature.","authors":"Henri Thonon,&nbsp;Florence Espeel,&nbsp;Ficart Frederic,&nbsp;Frédéric Thys","doi":"10.1080/17843286.2019.1592738","DOIUrl":"https://doi.org/10.1080/17843286.2019.1592738","url":null,"abstract":"<p><p><b>Objectives</b>: Central venous catheter (CVC) implementation is now usual in emergency department. The most common complications are misplacement, bleeding, pleural perforation, thrombosis and sepsis. Forgetting a guide wire in the patient's body after catheterization is an underestimated complication of this procedure; only 76 cases are described. Even if the majority of patients remained asymptomatic, severe complications can happened even years later. This article's aim is to identify the sequence of elements that led to the event occurrence and to suggest recommendations of good practice to minimize complications related to central catheter placement.<b>Method</b>: After reviewing all the complications related to central venous catheterization and their frequencies, we analyse from a case report and a review of the literature the sequence of elements that led to the medical error. We use an Ishikawa diagram to show our results and the links between them.<b>Results</b>: Our Ishikawa diagram shows that material, human resources, procedural and radiological involvement factors are the main elements on which we can act to reduce the complications rate after central venous catheterization. We advocate for the establishment of standardized procedures before, during and after the technical gesture.<b>Conclusions</b>: Because of human nature, errors will always be possible when taking care of a patient. However, we propose good practice recommendations to avoid the repetition of a forgetting guide wire after central venous catheterization.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 3","pages":"193-199"},"PeriodicalIF":1.6,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1592738","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37108759","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}

{"title":"An important problem in an aging country: identifying the frailty via 9 Point Clinical Frailty Scale.","authors":"Cemile Özsürekci,&nbsp;Cafer Balcı,&nbsp;M Cemal Kızılarslanoğlu,&nbsp;Hatice Çalışkan,&nbsp;Rana Tuna Doğrul,&nbsp;Gözde Şengül Ayçiçek,&nbsp;Fatih Sümer,&nbsp;Erdem Karabulut,&nbsp;Burcu Balam Yavuz,&nbsp;Mustafa Cankurtaran,&nbsp;Meltem Gülhan Halil","doi":"10.1080/17843286.2019.1597457","DOIUrl":"https://doi.org/10.1080/17843286.2019.1597457","url":null,"abstract":"<p><strong>Objectives: </strong>Frailty is a geriatric syndrome which develops as a result of cumulative decline in many physiological systems and results in an increased vulnerability and risk of adverse outcomes. The Clinical Frailty Scale (CFS) was validated as a predictor of adverse outcomes in community-dwelling older people and evaluates items such as comorbidity, cognitive impairment and disability. We aimed to study the concurrent and construct validity and reliability of the 9 point CFS in Turkish Population.<b>Methods</b>: This study was designed as a cross-sectional study. Participants, who were admitted to a geriatric medicine outpatient clinic, were included. Validity of 9 point CFS was tested by its correlation with the assessment and opinion of an experienced geriatric medicine specialist and Fried frailty phenotype. Test-retest and inter-rater reliability analyses were also performed.<b>Results</b>: Median age of the 118 patients was 74.5 years (min: 65 max: 88) and 64.4 % were female. The concordance of CFS and experienced geriatric medicine specialist's opinion was excellent (Cohen's <i>K</i>: 0.80, <i>p</i> < 0.001).The concordance of CFS and Fried Frailty phenotype was moderate (Cohen's <i>K</i>: 0.514, <i>p</i> < 0.001).CFS inter-rater reliability and test-retest reliability was very strong (Cohen's <i>K</i>: 0.811, <i>p</i> < 0.001 and Cohen's <i>K</i>: 1.0, <i>p</i> < 0.001, respectively).<b>Conclusions</b>: CFS appears to be a quick, reliable and valid frailty screening tool for community-dwelling older adults in the Turkish population.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 3","pages":"200-204"},"PeriodicalIF":1.6,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1597457","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37097323","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}

{"title":"The effect of selenium and zinc on CD4(+) count and opportunistic infections in HIV/AIDS patients: a randomized double blind trial.","authors":"Azar Hadadi,&nbsp;Afshin Ostovar,&nbsp;Behnaz Edalat Noor,&nbsp;Mehrnaz Rasoolinejad,&nbsp;Mahboobeh Haji Abdolbaghi,&nbsp;Sahar Yousefi,&nbsp;Hossein Khalili,&nbsp;Gita Manshoori,&nbsp;Patricia Khashayar,&nbsp;Zahra Alipour,&nbsp;Narges Safari","doi":"10.1080/17843286.2019.1590023","DOIUrl":"https://doi.org/10.1080/17843286.2019.1590023","url":null,"abstract":"<p><p><b>Objectives</b>: We assessed the effect of selenium and zinc supplementation on CD4 cell count and the risk of developing opportunistic infections.<b>Methods</b>: In a double blind clinical trial, 146 HIV(+) patients receiving combination antiretroviral therapy with CD4(+) >200/cubic millimeter were screened for comorbidities and opportunistic infections, and randomized to receive daily selenium (200 µg), zinc (50 mg) or placebo for 6 months, before a 3-month follow-up period. CD4 cell counts were measured in the 3^th, 6^th and 9^th months. The serum selenium and zinc were measured in the 6^th month. The incidence of opportunistic infection was assessed monthly for 6 months and at the end of the 9^th month.<b>Results</b>: The final incidence of supplement deficiency for placebo, zinc and selenium were 46.7%, 44.7% and 50.0%, respectively. Overall compliance with supplementation was 99.42%. Although the changes from baseline were not statistically significant, zinc supplementation was significantly associated with reduced risk of opportunistic infections.<b>Conclusion</b>: Development of the opportunistic infections after zinc supplementation significantly decreased; however, significant improvement in CD4 count was not observed in this group.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 3","pages":"170-176"},"PeriodicalIF":1.6,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1590023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37070248","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}

{"title":"Past, present and future of university hospitals.","authors":"Kasper Raus,&nbsp;Eric Mortier,&nbsp;Kristof Eeckloo","doi":"10.1080/17843286.2019.1590024","DOIUrl":"https://doi.org/10.1080/17843286.2019.1590024","url":null,"abstract":"<p><p><b>Objectives</b>: Health care systems worldwide are changing and taking new forms. The old, more hierarchically oriented, model with individual institutional and bilateral interactions between primary, secondary, tertiary and quaternary care is being replaced by an integrated and dynamic network model. We aim to look at what role university hospitals will play in this future organization of health care.<b>Method</b>: In this paper, we look at the relevant literature on the history of academic medicine and university hospitals. Subsequently, we look at the challenges university hospitals are facing according to contemporary literature on the topic.<b>Results</b>: Our current model of academic medicine with its university hospitals finds its origin in the institutionalization of the academic mission in the late 18^th century. Currently, the sustainability of the model is under immense pressure. University hospitals are facing economic challenges, teaching challenges and research challenges. However, there is reason to believe that they can continue to play a role of importance in tomorrow's medicine. The organization of health care is undergoing two important changes. The first is the evolution towards a more dynamic and integrated network model. University hospitals can become an important hub within this network. The second change is an evolution towards evidence based medicine and translational research.<b>Conclusion</b>: Due to their unique tripartite mission, we argue that university hospitals can continue to play an important and critical role in promoting evidence-based medicine and speedy translation of new evidence.</p>","PeriodicalId":48865,"journal":{"name":"Acta Clinica Belgica","volume":"75 3","pages":"177-184"},"PeriodicalIF":1.6,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17843286.2019.1590024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37077408","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}