Acta Clinica Belgica最新文献

{"title":"Unusual disseminated <i>Talaromyces marneffei</i> infection presenting with fever and diarrhea in an AIDS patient: a case report and literature review.","authors":"Yuting Tan,&nbsp;Zhihan Zhang,&nbsp;Mengmeng Wu,&nbsp;Shi Zou,&nbsp;Wei Guo,&nbsp;Ke Liang","doi":"10.1080/17843286.2022.2067957","DOIUrl":"https://doi.org/10.1080/17843286.2022.2067957","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal symptoms are not uncommon in patients infected with <i>Talaromyces marneffei</i> (<i>T. marneffei)</i>. However, the reports on intestinal <i>T. marneffei</i> infection were rare. We report a case of disseminated <i>T. marneffei</i> infection with intestine involvement.</p><p><strong>Case presentation: </strong>A 41-year-old female with acquired immune deficiency syndrome (AIDS) was admitted to our hospital for long-term fever, followed by abdominal pain and diarrhea. The colonoscopy performed in our hospital revealed ulcerative lesions in the colon and terminal ileum. Periodic acid-Schiff (PAS) staining of intestinal ulcer revealed that the small dots distributed inside and outside of the macrophages were yeast microorganisms. Further culture of bone marrow sample was confirmed <i>T. marneffei</i> positive. A diagnosis of disseminated <i>T. marneffei</i> infection was made, with intestine involvement. We also summarized the clinical characteristics, endoscopic findings and histopathological features of intestinal <i>T. marneffei</i> by literature review.</p><p><strong>Conclusion: </strong>In HIV-infected and other immunocompromised patients with gastrointestinal symptoms and/or associated abdominal imaging abnormalities, intestinal <i>T. marneffei</i> infection should be taken into consideration. Serious manifestations such as intestinal obstruction and intestinal perforation may occur. Early diagnosis is of great significance to prevent the deterioration of the illness and improve the prognosis. Histopathological examination and culture of intestinal lesions are helpful to improve the diagnosis of intestinal <i>T. marneffei</i> infection.</p><p><strong>Abbreviations: </strong>AIDS: acquired immune deficiency syndrome; ART: antiretroviral therapy; ESR: erythrocyte sedimentation rate; PPD:purified protein derivative; HE: Hematoxylin and eosin; PAS: Periodic acid-Schiff; CMV: cytomegalovirus; GMS:Gomori's methenamine silver nitrate.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"67-70"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10531587","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":"Palliative profile, one-year mortality and quality of life in older inpatients according to Be-PICT: a multicenter prospective cohort study.","authors":"Isabelle De Brauwer,&nbsp;Séverine Henrard,&nbsp;Hilde Baeyens,&nbsp;Nele Van Den Noortgate,&nbsp;Marie De Saint-Hubert,&nbsp;Ruth Piers","doi":"10.1080/17843286.2022.2053812","DOIUrl":"https://doi.org/10.1080/17843286.2022.2053812","url":null,"abstract":"<p><strong>Background: </strong>A palliative care approach (PCA), including advanced care planning (ACP), should be considered for patients with limited life expectancy. The Belgian Palliative Care Indicators Tool (Be-PICT) has been released to help identify patients who may benefit from such approach. This study aimed at measuring 1-year mortality and describe the quality of life in older inpatients, according to baseline Be-PICT results.</p><p><strong>Methods: </strong>Prospective multicentre cohort study in older patients (≥ 75 years) admitted at geriatrics and cardiology wards of four Belgian hospitals. The palliative profile was defined as a positive Be-PICT.1, defined by the presence of its three criteria, i.e. a negative physician's answer to the surprise question '<i>would you be surprised if this patient dies in the 6-12 next months?</i>', ≥ 1 poor health indicator and ≥ 1 life-limiting condition.</p><p><strong>Results: </strong>Of the 379 patients (50% aged ≥85 years; 51% female), 52 (14%) presented a palliative profile and 83 (23%) died within 1 year. Be-PICT.1 showed the following characteristics to predict 1-year mortality: sensitivity 0.54, specificity 0.83, positive and negative predictive values 0.48 and 0.86, positive and negative likelihood ratios 3.22 and 0.55. The patients with a palliative profile were at higher mortality risk (hazard ratio 4.79 p < 0.001) and 1-year mortality rate (45%). Not using the SQ allowed to improve sensitivity to include a larger number of patients who may benefit from ACP and PCA.</p><p><strong>Conclusions: </strong>Be-PICT.1 is a simple case-finding tool to identify older inpatients being at high mortality risk and candidates for ACP and PCA.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"16-24"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10523132","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":"Transferring nursing home residents to emergency departments by emergency physician-staffed emergency medical services: missed opportunities to avoid inappropriate care?","authors":"Sabine E E Lemoyne,&nbsp;Peter Van Bogaert,&nbsp;Paul Calle,&nbsp;Kristien Wouters,&nbsp;Dennis Deblick,&nbsp;Hanne Herbots,&nbsp;Kg Monsieurs","doi":"10.1080/17843286.2022.2042644","DOIUrl":"https://doi.org/10.1080/17843286.2022.2042644","url":null,"abstract":"<p><strong>Background: </strong>The decision to transfer a nursing home (NH) resident to an emergency department (ED) is multifactorial and challenging but many of the emergency physician-staffed emergency medical service (EP-EMS) interventions and ED transfers are probably inappropriate.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional study in three EP-EMSs in Belgium over a period of three years. We registered indicators that are potentially associated with inappropriate transfers: patient characteristics, availability of written do not resuscitate (DNR) orders or treatment restrictions, involvement of a general practitioner (GP) and availability of transfer notes. We also explored the association between age, the Charlson Comordity Index (CCI), polypharmacy, dementia, and the availability of DNR documents.</p><p><strong>Results: </strong>We registered 308 EP-EMS interventions in NH residents. In 98% the caller was a health-care professional. In 75% there was no GP present and 40% had no transfer note. Thirty-two percentage of the patients had dementia, 45% had more than two comorbidities and 68% took five medications or more. In 6% cardiopulmonary resuscitation was performed. DNR orders were available in 25%. Eighty-eight percentage of the NH residents were transferred to the ED. Forty-four percent had a CCI >5. In patients of ≥90 years, with a CCI >5, with dementia and with polypharmacy, DNR orders were not available in 81%, 67%%,and 69%, respectively.</p><p><strong>Conclusions: </strong>Improved EMS dispatch centre-NH caller interaction, more involvement of GP's, higher availability of DNR orders and better communication between GPs/NHs and EP-EMS could prevent inappropriate interventions, futile prehospital aactions,and ED transfers.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"3-10"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10536511","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":"Appropriateness of alert antibiotics measured by repeated prevalence surveys and impact of direct prescriber interaction and feedback.","authors":"Elise Willems,&nbsp;Hannah Min Jou,&nbsp;Franky Buyle,&nbsp;Veroniek Saegeman,&nbsp;Steven Callens","doi":"10.1080/17843286.2022.2059981","DOIUrl":"https://doi.org/10.1080/17843286.2022.2059981","url":null,"abstract":"<p><strong>Objectives: </strong>Hospital point prevalence surveys (PPS) are shown to help identifying determinants for inappropriate antimicrobial therapy (AMT) and create feedback opportunities to optimize AMT.</p><p><strong>Methods: </strong>PPS were performed at the AZNikolaas hospital, on four wards with high consumption rates of three alert antibiotics (AB) to judge their appropriateness. The impact of a multidisciplinary interaction between a medical microbiologist, a clinical pharmacist and the prescriber on inappropriate AMT, hospital costs and intravenous AMT days, was analyzed.</p><p><strong>Results: </strong>During this survey, 7,39% of hospitalized patients in the selected wards received one or more of three alert antibiotics. Out of 78 prescriptions, 35.90% were judged appropriate, 39.74% inappropriate and 24.36% had insufficient data for judgment. Only the oncology ward was associated with more frequent appropriate use of alert AB. In case of an unknown infection focus or a catheter-related infection, the relative risk of inappropriate use was the highest. Multidisciplinary interaction improved inappropriate AMT in 59% of cases. It resulted in a 2478€ healthcare AMT cost saving and a reduction of 30 intravenous AMT days.</p><p><strong>Conclusions: </strong>This survey shows high consumption rates and a high rate of inappropriate use of three alert AB in the observed wards. It revealed the lack of a local guideline concerning treatment of neutropenic fever of unknown origin and the need for more diagnostic information in electronical medical records. The survey demonstrated that direct feedback on inappropriate AMT to clinicians can be of added value, cost-saving and reducing length of intravenous AMT days. However, more studies are needed to confirm this.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"36-43"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9095898","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 20-valent pneumococcal conjugate vaccine (PCV20): expected added value.","authors":"Esther Janssens,&nbsp;Johan Flamaing,&nbsp;Corinne Vandermeulen,&nbsp;Willy E Peetermans,&nbsp;Stefanie Desmet,&nbsp;Paul De Munter","doi":"10.1080/17843286.2022.2039865","DOIUrl":"https://doi.org/10.1080/17843286.2022.2039865","url":null,"abstract":"<p><strong>Objectives: </strong>Currently existing pneumococcal vaccines have contributed to a major reduction in pneumococcal disease. However, there remains an unmet need for vaccine coverage of serotypes not included in PCV13 to further reduce the burden of disease. The objective of this review is to assess the potential impact of implementation of the investigational 20-valent pneumococcal conjugate vaccine (PCV20) in the childhood and adult immunization programme in Belgium and Europe.</p><p><strong>Methods: </strong>A literature search was conducted to identify publications and surveillance reports concerning the effectiveness and safety of pneumococcal vaccines, epidemiological data on pneumococcal disease or serotype distribution dynamics after introduction of systematic vaccination.</p><p><strong>Results: </strong>Serotypes included in PCV20 currently account for the majority of pneumococcal disease in Belgium and Europe. In Belgium, PCV20-serotypes accounted for 71.4% of invasive pneumococcal disease (IPD) cases across all age groups in 2019, of which 39.2% were caused by PCV20-non-PCV13-serotypes. In Europe, these seven serotypes accounted for 37,6% of IPD cases in 2018.  PCV20 has proven to be well tolerated in vaccine-naïve adults and elicits a substantial immune response against all serotypes included.</p><p><strong>Conclusion: </strong>Due to serotype replacement following the introduction of PCV7 and PCV13, a considerable proportion of pneumococcal disease is currently caused by PCV20-serotypes. PCV20 has the potential of preventing more pneumococcal disease in children and the adult population at risk than the existing conjugate vaccines. The available evidence on safety and immunogenicity of PCV20 is promising, but further research is needed to provide data about vaccine effectiveness, immune response duration and replacement phenomenon after introduction of PCV20.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"78-86"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10585558","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":"Abstracts presented at the 26th Annual Congress of the Belgian Society of Internal Medicine, 9-10 December 2022, Dolce La Hulpe, La Hulpe, Belgium","authors":"Liselot Vandenbergen, Charline Leclercq, J. D. Greef, J. Yombi, H. Yildiz, Veerle Beckers, Shula Staessens, Sabine Allard, Rik Schots, L. Pothen, Ana Strezova, Javier Diez-Domingo, Kamal Al Shawafi, Juan Carlos Tinoco, Meng Shi, Paola Pirrotta, Angnes Mwakingwe-Omari, Florence Strubbe, Hernan Valdes-Socin, O. Calvete, Javier Benitez, Edouard Louis, P. Petrossians, S. Henrard, Nicola Trotta, Tim Coolen, Delphine Puttaert, J. Goffard, J. Vooren","doi":"10.1080/17843286.2022.2149807","DOIUrl":"https://doi.org/10.1080/17843286.2022.2149807","url":null,"abstract":"Background Dry weight is defined as the lowest tolerated post-dialysis weight at which there are minimal signs or symptoms of hypovolemia or hypervolemia. Achieving dry weight is a goal for each dialysis session. That improves blood pressure control and reduces cardiovascular risk in dialysis patients. Haemodialysis patients may experience weight loss likely related to a reduction of dry mass when catabolic reactions and inflammation occur. Our aim was to assess the impact of SARSCov-2 infection on haemodialysis patients and analyse factors associated with dry weight variations observed during the COVID-19 pandemic. Method(s): In this retrospective observational single-centre study, we analysed the clinical characteristics of all patients undergoing haemodialysis at the Pole Hospitalier Jolimont during COVID-19 pandemic from 1 March 2020 to 28 February 2022. We determined dry weight at day 1 after diagnosis of SARSCov-2 infection or at day 1 of a randomly assigned 28-days observation period and at 2, 3 and 4 weeks later. We compared infected and uninfected patients and examined the clinical features associated with SARSCov-2 infection and those associated with changes in dry weight. Result(s): Within the observation period, among the 162 haemodialysis patients, 47 patients were infected with SARSCov-2. Three patients were excluded because they have been infected before the first dialysis session and seventeen others due to missing data. Two patients were infected twice but we considered the second episodes as relevant and had therefore 144 observations. Dry weight variation ratio (dry weight variation divided by dry weight at day 1) was a continuous non normally distributed variable for which we performed Wilcoxon rank sum tests and Student's t-tests. Dry weight variations were bigger in patients infected with SARSCov-2 compared to non-infected patients: the mean dry weight variation ratio was - 2,4 +/- 2,2% (SD) in the infected dialysis patients and - 0,6 +/- 2,0% in the uninfected patients (p < 0.001). A very strong association was found between SARSCov-2 infection and loss of dry weight (0,5 kg and more) with odds ratio = 21,89;95% CI [7,17-66,85]. No difference was found whether infected patients were symptomatic or not (-2,6 +/- 2,2% vs - 2,3 +/- 2,3%;p = 0,662). Infected patients and non-infected patients significantly differ by the sex distribution (76% vs 52% males;p = 0,008). We performed a Cochran-Mantel-Haenszel stratified analysis and confirmed the association between loss of dry weight and SARSCov-2 infection after controlling for effect modification or confounding by sex. Furthermore, dry weight often varies during early haemodialysis sessions and a bias such as a short dialysis duration was also ruled out. Indeed, no correlation was found between the shortest dialysis durations (less than 2 months) and the dry weight variations observed in our population. Discussion(s): SARSCov-2 infection is associated with decreases of dry weight","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"77 1","pages":"1 - 74"},"PeriodicalIF":1.6,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42470410","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":"A novel pathogenic variant in LCAT causing FLD. A case report.","authors":"Nuria Goñi Ros,&nbsp;Ricardo González-Tarancón,&nbsp;Paula Sienes Bailo,&nbsp;Elvira Salvador-Ruperez,&nbsp;Martín Puzo Bayod,&nbsp;José Puzo Foncillas","doi":"10.1080/17843286.2021.2007598","DOIUrl":"https://doi.org/10.1080/17843286.2021.2007598","url":null,"abstract":"<p><strong>Background: </strong>Fish-eye disease (FED) is due to a partial deficiency in LCAT activity. Nevertheless, Familial lecithin-cholesterol acyltransferase deficiency (FLD), also called Norum disease, appears when the deficiency is complete. They are both rare genetic disorders inherited in an autosomal recessive manner. Clinical signs include decreased circulating HDL cholesterol and dense corneal opacity. Kidney injuries also affect patients suffering from FLD. The diagnosis of FLD is based on the presence of characteristic signs and symptoms and confirmed by genetic testing.</p><p><strong>Case presentation: </strong>We present a case of a 63-year-old man showing an altered lipid profile with low HDL cholesterol, chronic kidney disease (CKD) and corneal disorders. He was referred to genetic counseling in order to discard genetic LCAT deficiency due to decreased visual acuity caused by corneal opacity. A massive DNA sequencing was conducted using a multigene panel associated with lipid metabolism disturbances.</p><p><strong>Results and genetic findings: </strong>Two likely pathogenic variants in <i>LCAT</i> were identified and later confirmed by Sanger sequencing. Both (c.491 G > A and c.496 G > A) were missense variants that originated an amino acid substitution (164Arginine for Histidine and 166Alanine for Threonine, respectively) modifying the protein sequence and its 3D structure.</p><p><strong>Conclusions: </strong>FLD and FED sharing common biochemical features, and the existence of other diseases with similar clinical profiles underline the need for a timely differential diagnosis aiming to address patients to preventive programs and future available therapies. This case, added to the reduced number of publications previously reported regarding FLD and FED, contributes to better understanding the genetic characteristics, clinical features, and diagnosis of these syndromes.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"77 6","pages":"970-975"},"PeriodicalIF":1.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9324982","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":"Analysis of ergonomic occupational accidents and near misses in a large Belgian university hospital.","authors":"Norbert Fraeyman,&nbsp;Dirk de Bacquer,&nbsp;Els Clays,&nbsp;Tom Fiers,&nbsp;Lode Godderis,&nbsp;Rik Verhaeghe,&nbsp;Leen Viaene,&nbsp;Eric Mortier","doi":"10.1080/17843286.2021.2015553","DOIUrl":"https://doi.org/10.1080/17843286.2021.2015553","url":null,"abstract":"<p><strong>Introduction: </strong>Health-care organizations are facing a high burden of ergonomic occupational accidents, and prevention is a continuous point of interest. In this manuscript, we describe the characteristics of ergonomic accidents in a large Belgian university hospital and discuss the value of near misses.</p><p><strong>Methods: </strong>Combining databases, we identified the frequency [number of accidents × 10⁶ hours worked per year], severity (number of days off work × 10³ hours worked per year), and profile of the victims of occupational ergonomic accidents (with absence from work) or incidents or near-misses (without absence from work). Ergonomic accidents and incidents include slips, trips, falls, injurious body movements, overexertion, and handling heavy weights.</p><p><strong>Results: </strong>In a period of 23 years, we noticed a significant decrease in the frequency of ergonomic accidents (from about 7 to about 4 standard units), without changes in the severity. The decrease in the frequency of accidents is mirrored by an increase in the frequency of incidents (from about 4 to about 6 standard units). Female and older employees are more vulnerable to accidents, and the frequency was between two and four times higher for employees mostly involved in manual tasks compared to employees mostly involved in managerial tasks. The profile of the victims and the causes of accidents and incidents were identical.</p><p><strong>Conclusion: </strong>Although it is premature to assume a cause-consequence relationship between incidents and accidents, it is tempting to speculate that the increased ratio of the frequencies of incidents over accidents might be one of the variables reflecting the adequacy of preventive measures and the growth of safety behavior.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"938-944"},"PeriodicalIF":1.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39586257","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":"Not a wild goose chase: long-lasting MRSA negative status following eradication therapy for chronic MRSA infection in patients with cystic fibrosis.","authors":"Stefanie Vincken,&nbsp;Sylvia Verbanck,&nbsp;Shane Hanon,&nbsp;Eef Vanderhelst","doi":"10.1080/17843286.2021.2012948","DOIUrl":"https://doi.org/10.1080/17843286.2021.2012948","url":null,"abstract":"<p><strong>Objectives: </strong>Prevalence of MRSA in patients with CF has risen over the past decades, and chronic infection with MRSA is associated with worse outcome in this patient group.</p><p><strong>Methods: </strong>This retrospective observational study investigated long-term eradication rate in pediatric and adult CF patients with chronic MRSA infection, using a 6-month eradication regimen containing 2 oral antibiotics, combined with topical decolonisation measures. Respiratory tract cultures were performed at least every three months, from the first MRSA-positive culture onwards.</p><p><strong>Results: </strong>A total of 24 patients with chronic MRSA infection were identified from our CF patient registry, of which 13 patients underwent an eradication attempt. The regimen consisted of 2 oral antibiotics: a combination of rifampicin, fusidic acid, clindamycin and co-trimoxazol, based on the sensitivity pattern of the MRSA strain. At the end of the study period (median 8.2 years), 12 out of 13 patients (92%) were MRSA negative. None of the patients interrupted treatment due to side-effects.</p><p><strong>Conclusions: </strong>Eradication of chronic MRSA infection is feasible, well-tolerated and highly successful, and can offer a long-lasting MRSA-negative status, obviating the need for patient segregation.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"933-937"},"PeriodicalIF":1.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39699363","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":"Treatment of patients with newly diagnosed metastatic hormone sensitive prostate cancer (mHSPC) in Belgium: a real world data analysis.","authors":"E Lambert,&nbsp;S Hollebosch,&nbsp;C van Praet,&nbsp;S Van Bruwaene,&nbsp;L Duck,&nbsp;W De Roock,&nbsp;S van Wambeke,&nbsp;C Ghysel,&nbsp;F Ameye,&nbsp;P Schatteman,&nbsp;F Vandenbroucke,&nbsp;B Sautois,&nbsp;F Baekelandt,&nbsp;D Ost,&nbsp;K Fransis,&nbsp;B Filleul,&nbsp;C Remondo,&nbsp;W Wynendaele,&nbsp;B Bamelis,&nbsp;P Logghe,&nbsp;E Vergauwe,&nbsp;E Denies,&nbsp;S Joniau,&nbsp;N Lumen","doi":"10.1080/17843286.2021.2001999","DOIUrl":"https://doi.org/10.1080/17843286.2021.2001999","url":null,"abstract":"<p><strong>Introduction: </strong>Abiraterone acetate + prednisone (AAP) and docetaxel have proven their efficacy in the treatment of patients with newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC) in clinical trials. However, real-world data are scarce. The goal of this study is to evaluate real-world data on the efficacy and safety of these therapies in mHSPC patients.</p><p><strong>Patients and methods: </strong>Records of 93 patients from 21 different centres were retrospectively reviewed. Primary and secondary endpoints were radiographic and PSA progression-free survival (RPFS - PSA-PFS) and cancer specific and overall survival (CSS - OS), respectively. Adverse events (AEs) were evaluated according to the Common Terminology Criteria for Adverse Events version 5.0. Differences in oncological outcome and AEs were evaluated between three treatment groups: ADT only (N=26) - ADT + AAP (N=48) - ADT + docetaxel (N=19). Survival analysis was performed using Kaplan-Meier statistics.</p><p><strong>Results: </strong>Median RPFS was 13 months (95% confidence interval [CI]: 9-17) for ADT only, 21 months (95% CI: 19-23) for ADT + AAP and 12 months (95% CI: 11-14) for ADT + docetaxel (p = 0.004). The 1-year PSA-PFS, CSS and OS were 73.5%, 90.7% and 88.7%, respectively, with no significant differences between the three groups. Adverse events of grade 3 or higher were not observed more frequently.</p><p><strong>Conclusion: </strong>Retrospective real-world data show a significantly longer RPFS for mHSPC patients treated with ADT + AAP compared to ADT only or ADT + docetaxel at short-term follow-up. This can aid in counselling of mHSPC patients in daily clinical practice.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"897-905"},"PeriodicalIF":1.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39899390","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}