Acta Clinica Belgica最新文献_第3页

Post-diuretic spot urine sodium assessment in acute heart failure: a retrospective analysis 急性心力衰竭患者利尿后定点尿钠评估：回顾性分析

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2024-04-13 DOI: 10.1080/17843286.2024.2341193

Lotte Colson, Simon Vanhentenrijk, Theodoros Kalpakos, Bram Roosens, Berlinde Von Kemp, Tim Balthazar, Stijn Lochy, Frederik H. Verbrugge

引用次数: 0

Belgian 2024 guidance on the use of pre-exposure prophylaxis. 比利时 2024 年接触前预防使用指南。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2024-04-01 Epub Date: 2024-05-22 DOI: 10.1080/17843286.2024.2356337

Jens T Van Praet, Sophie Henrard, Chris Kenyon, Agnès Libois, Annelies Meuwissen, Anne-Sophie Sauvage, Anne Vincent, Jef Vanhamel, Gert Scheerder

{"title":"Belgian 2024 guidance on the use of pre-exposure prophylaxis.","authors":"Jens T Van Praet, Sophie Henrard, Chris Kenyon, Agnès Libois, Annelies Meuwissen, Anne-Sophie Sauvage, Anne Vincent, Jef Vanhamel, Gert Scheerder","doi":"10.1080/17843286.2024.2356337","DOIUrl":"10.1080/17843286.2024.2356337","url":null,"abstract":"Objectives: We aimed to develop a guidance on the use of pre-exposure prophylaxis (PrEP) for HIV tailored to the Belgian context.Methods: Different aspects of PrEP care were judged by an expert group of nine Belgian clinicians, seeking consensus for areas of controversies.Results: PrEP should be considered in HIV negative patients at high risk of acquiring HIV. Currently, only oral tenofovir/emtricitabine is available in Belgium for PrEP, which can be used daily, or also event-driven in cisgender men and trans women who are not taking exogenous estradiol-based hormones. Personal counselling directed at medication adherence and sexual health should have a central role in PrEP care. At the initial assessment clinicians should give attention to symptoms of an acute HIV infection, the patients' immunization status and renal function. A regular follow-up must be set up to diagnose HIV seroconversion, treat sexually transmitted infections, and manage side effects of PrEP.Conclusion: The Belgian guidance on the use of PrEP provides a point of reference for standard PrEP care in Belgium and will be periodically updated.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"121-129"},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074731","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

Development of quality indicators for antimicrobial stewardship in Belgian hospitals: a RAND - modified Delphi procedure. 比利时医院抗菌药物管理质量指标的制定：兰德-改良德尔菲程序。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2024-04-01 Epub Date: 2023-12-26 DOI: 10.1080/17843286.2023.2297123

Sylvie Legros, Anna Vanoverschelde, Jens van Krieken, Yves Debaveye, Ann Versporten, Diana Huis In 't Veld, Veerle Westelinck, Caroline Briquet, Christelle Vercheval, Isabel Spriet, Olivier Denis, Koen Magerman, Marc De Schepper, Franky Buyle

{"title":"Development of quality indicators for antimicrobial stewardship in Belgian hospitals: a RAND - modified Delphi procedure.","authors":"Sylvie Legros, Anna Vanoverschelde, Jens van Krieken, Yves Debaveye, Ann Versporten, Diana Huis In 't Veld, Veerle Westelinck, Caroline Briquet, Christelle Vercheval, Isabel Spriet, Olivier Denis, Koen Magerman, Marc De Schepper, Franky Buyle","doi":"10.1080/17843286.2023.2297123","DOIUrl":"10.1080/17843286.2023.2297123","url":null,"abstract":"Introduction: Inappropriate antibiotic use is a major cause of antibiotic resistance. Therefore, optimizing antibiotic usage is essential. In Belgium, optimization of antimicrobials for the fight against multidrug resistant organisms (MDROs) is followed up by national surveillance by public health authorities. To improve appropriate antimicrobial use in hospitals, an effective national Antimicrobial Stewardship (AMS) program should include indicators for measuring both the quantity and quality of antibiotic use.Objectives: The aim of this study was to develop a set of process quality indicators (QIs) to evaluate and improve AMS in hospitals.Methods: A RAND-modified Delphi procedure was used. The procedure consisted of a structured narrative literature review to select the QIs, followed by two online questionnaires and an intermediate multidisciplinary panel discussion with experts in infectious diseases from general and teaching hospitals in Belgium.Results: A total of 38 QIs were selected after the RAND-modified Delphi procedure, from which 11 QIs were selected unanimously. These QIs address compliancy of antibiotic therapy and prophylaxis with local guidelines, documentation of the rationale for antibiotic treatment in the medical record, the availability of AMS Programs and Outpatient Parenteral Antibiotic Therapy, resistance patterns and antimicrobial prescribing during focused ward rounds.Conclusion: Our study selected 38 relevant process QIs, from which 11 were unanimously selected. The QIs can contribute to the improvement of quality of antibiotic use by stimulating hospitals to present better outcomes and by providing a focus on how to intervene and to improve prescribing of antimicrobials.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"77-86"},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139037335","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

Case report: diagnosis of VEXAS syndrome in a patient with therapy-resistant large vessel vasculitis. 病例报告：耐药大血管炎患者的 VEXAS 综合征诊断。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2024-04-01 Epub Date: 2024-02-05 DOI: 10.1080/17843286.2024.2312627

M Boret, T Malfait

引用次数: 0

Flatten the curve. On a new covid-19 (hit) severity. 拉平曲线在新的 covid-19（命中）严重程度上。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2024-04-01 Epub Date: 2024-02-17 DOI: 10.1080/17843286.2024.2314240

J Crombez, R H De Staelen

{"title":"Flatten the curve. On a new covid-19 (hit) severity.","authors":"J Crombez, R H De Staelen","doi":"10.1080/17843286.2024.2314240","DOIUrl":"10.1080/17843286.2024.2314240","url":null,"abstract":"Background: During the health crisis of the COVID-19 pandemic, the adagium was to 'flatten the curve'. We investigate how well countries succeeded in this aim by constructing an appropriate severity measure. It is able to distinguish between countries that, e.g., experienced identical overall (excess) mortality rates or attained equal case load peaks over a certain period of time. Concretely, this implies that an identical total number of infections or deaths over a certain period is considered relatively worse if there is a higher and/or more peaks. More classical measures (like the total number or the maximum of cases/deaths) neglect this and are therefore inappropriate to assess the resilience of a health care system nor pandemic policy ex post performance.Methods & results: We applied our new (hit) severity to a set of 32 countries, and found that the flattening didn't go equally well. The difference in severity is large, with Norway being consistently the least severely hit by the pandemic (using deaths as indicator) during the whole observation period, while Hungary comes out as eventually being hit the hardest in our sample.Conclusions: Having constructed a (hit) severity measure that enables to differentiate between countries' performances in a sound way, further research should now relate these observed differences to the pre-pandemic health care status and the sanitary measures or restrictions imposed during the pandemic; in order to reveal what measures help the most in what type of health care system and society.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"87-96"},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139897870","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

Prognostic value of geriatric and cardiac parameters for one-year mortality in older heart failure patients. A multicentre, observational, prospective study. 老年医学和心脏参数对老年心力衰竭患者一年死亡率的预测价值。一项多中心、观察性、前瞻性研究。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2024-04-01 Epub Date: 2024-05-16 DOI: 10.1080/17843286.2024.2352910

L Kestens, S Billet, L Hens, A Velghe, R Piers

{"title":"Prognostic value of geriatric and cardiac parameters for one-year mortality in older heart failure patients. A multicentre, observational, prospective study.","authors":"L Kestens, S Billet, L Hens, A Velghe, R Piers","doi":"10.1080/17843286.2024.2352910","DOIUrl":"10.1080/17843286.2024.2352910","url":null,"abstract":"Purpose: Heart failure is prevalent among older people and has a poor prognosis. The aim of this study is to identify potential prognostic, geriatric, and cardiac parameters which could help clinicians identify older heart failure patients at high risk for one-year mortality.Methods: The multicentre, observational cohort study which included 147 heart failure patients aged ≥75 years, hospitalized in the cardiac or geriatric department in two hospitals. One-year survival was the outcome measure. For univariate analysis Chi-square test and independent sample T-test were used; for multivariate analysis Logistic regression and Cox regression for time-dependent analysis.Results: One-year mortality was 28% (41/147). One-year survivors and non-survivors did not differ in the following characteristics: age, gender, sodium level at hospital discharge, ejection fraction, NYHA Class, basic and instrumental activities of daily living, and the presence of a geriatric risk profile. There was a significant lower systolic blood pressure at discharge in non-survivors compared to one-year-survivors (mean 125.26 mmHg vs. 137.59 mmHg). Non-survivors had more severe underlying comorbidities according to the age adjusted Charlson Comorbidity index (CCI) (mean 8.80 vs. 7.40).Both logistic and Cox regression showed a higher risk and rate of mortality with decreasing systolic blood pressure at discharge (OR 0.963, p=0.001 and HR 0.970, p<0.001) and with increasing CCI (OR 1.344, p=0.002 and HR 1.269, p=0.001); the other variables were not significantly related.Conclusion: Lower blood pressure and more severe comorbidities, but not functionality nor the presence of a geriatric risk profile, are related to one-year mortality in older, in-hospital heart failure patients.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"113-120"},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943660","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

The development of the Belgian paediatric clinical trial network. 比利时儿科临床试验网络的发展。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2024-02-01 Epub Date: 2024-01-02 DOI: 10.1080/17843286.2023.2283664

E Degraeuwe, L Persijn, L Nuytinck, K Allegaert, L De Taeye, E Gasthuys, D Christiaens, S Karamaria, A Raes, M Turner, J Vande Walle

{"title":"The development of the Belgian paediatric clinical trial network.","authors":"E Degraeuwe, L Persijn, L Nuytinck, K Allegaert, L De Taeye, E Gasthuys, D Christiaens, S Karamaria, A Raes, M Turner, J Vande Walle","doi":"10.1080/17843286.2023.2283664","DOIUrl":"10.1080/17843286.2023.2283664","url":null,"abstract":"Paediatric clinical trials are critical to ensure that medications prescribed to children are safe and effective. However, evidence-based dosing and labelling of such medications remain limited, and most clinical trials in paediatrics fail. Factors for lack of trial completion include performance at site level (limited patient recruitment, limited site staff experience and lack of infrastructure), the sponsor team (limited paediatric specific expertise in design, uncertainties on robustness of biomarkers or outcome variables) as well as regulatory and administrative burdens. As a result of the growing demand for site support, the Belgian Paediatric Clinical Research Network (BPCRN) established in 2009 has been relaunched in 2018 to improve paediatric clinical trials, with the support of innovative-medicines-initiative 2 (IMI2) pan-European network conect4children (c4c) and the transatlantic network I-ACT for Children (US).This paper highlights the formation of the BPCRN and the practical insights it offers for advancing paediatric clinical trials through national networks. A national network can improve trial quality, safety and efficiency, provide clinical research expertise, identify suitable sites, and help with troubleshooting of common trial issues. The BPCRN's centralized approach has advanced paediatric clinical trials by streamlining communication and standardizing trial conduct. Challenges and opportunities have arisen, including a relaunch in 2018, orphan medicine trials, and network sustainability. Collaboration between network activities, government support, site-level improvements, efficient communication, and interaction with industry are key to achieve lasting transformation in paediatric medicine research.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"34-45"},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138486444","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

Belgian atopic dermatitis guidelines. 比利时特应性皮炎指南。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2024-02-01 Epub Date: 2024-01-02 DOI: 10.1080/17843286.2023.2285576

Hilde Lapeere, Reinhart Speeckaert, Marie Baeck, Bita Dezfoulian, Julien Lambert, Pierre-Paul Roquet-Gravy, Annelies Stockman, Jonathan White, Francisca Castelijns, Jan Gutermuth

引用次数: 0

The Belgian physiotherapy reimbursement criteria for fall prevention fails in screening appropriately fall-prone community-dwelling older adults. 比利时预防跌倒的物理治疗报销标准未能筛选出适合跌倒的社区老年人。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2024-02-01 Epub Date: 2024-01-02 DOI: 10.1080/17843286.2023.2268916

Ellis Rommers, Mirko Petrovic, Robby de Pauw, Anke Van Bladel, Dirk Cambier

{"title":"The Belgian physiotherapy reimbursement criteria for fall prevention fails in screening appropriately fall-prone community-dwelling older adults.","authors":"Ellis Rommers, Mirko Petrovic, Robby de Pauw, Anke Van Bladel, Dirk Cambier","doi":"10.1080/17843286.2023.2268916","DOIUrl":"10.1080/17843286.2023.2268916","url":null,"abstract":"Objectives: The incidence of falling in older adults has remained unchanged over the past decades, despite evidence-based prevention initiatives. Therefore, it is appropriate to reflect on the current screening approach for preventive initiatives. The objective of this study was to determine whether the multifactorial algorithm proposed by Lusardi et al. (2017) exhibits superior predictive validity compared to the currently employed algorithm by the Belgian National Institute for Health and Disability Insurance (NIHDI).Methods: The current study includes a secondary analysis of data collected from a falls-related study in the Department of Rehabilitation Sciences at Ghent University to compare the predictive validity of the two algorithms. Sensitivity, specificity, positive and negative predictive value and area under the curve (AUC) were calculated to ascertain which algorithm is more accurate.Results: The database included a total of 94 community-dwelling older adults (mean age 76 years ±7.4, 35% male). Thirty-nine participants experienced at least one fall in the 8 month follow up. Lusardi's approach has a higher sensitivity score (89.7% compared to 10.3%) and negative predictive value (89.9% compared to 61.1%), but a lower specificity score (61.8% compared to 100%) and positive predictive value (62.2% compared to 100%) than the NIHDI approach. The AUC is 0.76 for Lusardi's approach and 0.55 for the NIHDI approach.Conclusion: The use of the multifactorial algorithm proposed by Lusardi et al. may be significant and more accurate in identifying adults at risk to falls. Further research is needed particularly with a larger, more heterogenous group of older adults.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"5-11"},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181764","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

The prevalence, risk factors and clinical implications of dehydration in older patients: a cross-sectional study. 老年患者脱水的患病率、危险因素和临床意义：一项横断面研究。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2024-02-01 Epub Date: 2024-01-02 DOI: 10.1080/17843286.2023.2275922

Kubra Atciyurt, Cihan Heybeli, Lee Smith, Nicola Veronese, Pinar Soysal

{"title":"The prevalence, risk factors and clinical implications of dehydration in older patients: a cross-sectional study.","authors":"Kubra Atciyurt, Cihan Heybeli, Lee Smith, Nicola Veronese, Pinar Soysal","doi":"10.1080/17843286.2023.2275922","DOIUrl":"10.1080/17843286.2023.2275922","url":null,"abstract":"Objectives: Adequate hydration is essential for the maintenance of physiological functions. Older adults may not be able to maintain adequate hydration, which is often not recognized. Our aim was to investigate the prevalence, risk factors and clinical implications of dehydration in older adults.Methods: This cross-sectional study included 964 older adults in one geriatric outpatient clinic in Turkey. Dehydration was defined as a calculated [1,86 × (Na+K)+1,15×glucose+urea +14] plasma osmolarity of ≥ 295 mOsm/L. Clinical characteristics and measures of comprehensive geriatric assessments of patients with dehydration and normohydration were compared. Predictors of dehydration were assessed using logistic regression analysis.Results: Mean age was 79.9 ± 7.7 years, (71.7% female). The prevalence of dehydration was 31%. Female patients, diabetes mellitus (DM), chronic renal failure (CKD), a higher risk of falling (based on Timed Up and Go test), probable sarcopenia, dependence based on basic and instrumental daily living activities (BADL and IADL) were more common in the dehydrated group (p < 0.05). After adjusting for age and gender, dependency on BADL and IADL, the risk of falling were still higher in the dehydrated group (p < 0.05). There were significant relationships between dehydration and risk of falling (OR 1.38, 95% CI 1.00-1.90; p < 0.05), after adjustment for age, gender, DM, CKD.Conclusion: Dehydration is common among older adults and is associated with a dependency, probable sarcopenia, and an increased risk of falling. Screening for dehydration and taking preventive measures may be beneficial in avoiding the negative consequences associated with dehydration.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"12-18"},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71410106","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