Acta Clinica Belgica最新文献

{"title":"Effective prompt design for large language models in clinical practice.","authors":"Steven Callens","doi":"10.1080/17843286.2026.2613903","DOIUrl":"10.1080/17843286.2026.2613903","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) have emerged as transformative healthcare tools for clinical documentation, diagnostic reasoning, and medical education. However, effective utilization requires understanding prompt engineering principles-the strategic design of inputs to optimize performance while mitigating hallucination, bias, and outdated information.</p><p><strong>Methods: </strong>This narrative review synthesizes evidence from a structured PubMed search through December 2025 using terms including \"large language models,\" \"prompt engineering,\" \"clinical decision support,\" and \"retrieval-augmented generation.\" We included peer-reviewed studies and systematic reviews from 2023 onwards, supplemented by manufacturer benchmarks (acknowledged as non-peer-reviewed), informed by a Belgian Society of Internal Medicine symposium (December 2025).</p><p><strong>Results: </strong>Effective clinical prompt engineering requires four elements: role definition, context provision, task formulation, and output specification. Structured frameworks-RTF (Role-Task-Format) for routine tasks and BRAIN (Background, Role, Aim, Instructions, Next steps) for complex scenarios-provide systematic approaches. Advanced techniques including chain-of-thought reasoning, few-shot prompting, and retrieval-augmented generation (RAG) enhance performance. RAG improves accuracy by 9.8-16.3% while reducing hallucinations by 11.8-18%. A meta-analysis of 36 studies found pooled LLM accuracy of 72% on medical licensing examinations.Critical limitations persist: studies demonstrate an inverse correlation between model confidence and accuracy, with lower-performing models paradoxically exhibiting higher confidence. Independent clinical validation remains limited.</p><p><strong>Conclusions: </strong>LLMs offer efficiency gains while requiring careful implementation. Physicians must develop prompt engineering competency, combining structured frameworks, RAG grounding strategies, and persistent human oversight for safe clinical integration. Prompt engineering literacy represents an essential emerging clinical skill.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"118-129"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951074","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 comprehensive review and meta-analysis of relationship between age of onset or duration of type 2 diabetes and mortality involving more than 2.85 million patients.","authors":"Xingmu Wang, Shuping Zhong, Gangfeng Li, Xiaojie Pan","doi":"10.1080/17843286.2026.2615091","DOIUrl":"10.1080/17843286.2026.2615091","url":null,"abstract":"<p><strong>Background: </strong>The association between age of onset or diabetes duration and all-cause mortality in individuals with type 2 diabetes (T2D) remains incompletely characterized. We aimed to clarify this relationship.</p><p><strong>Methods: </strong>On February 8, 2025, we searched CINAHL, Scopus, PubMed, Cochrane Central, Embase, and Web of Knowledge for observational studies and post-hoc or subanalyses of randomized controlled trials (p-h/sa of RCTs) assessing the relationship between age of onset or diabetes duration and all-cause mortality. We pooled relative risks (RRs) using a random-effects model and assessed heterogeneity with Cochran's Q test and I² statistic. A leave-one-out sensitivity analysis confirmed the robustness of results. The protocol was not registered.</p><p><strong>Results: </strong>Thirty-seven studies involving 2,857,346 participants were included. Earlier T2D onset was associated with higher all-cause mortality (pooled RR = 1.54; 95% CI: 1.03-2.32). When adjusting for current age, later onset correlated with lower mortality (pooled RR = 0.60; 95% CI: 0.44-0.83). Longer diabetes duration was linked to increased mortality (pooled RR = 1.43; 95% CI: 1.14-1.79), regardless of adjustment.</p><p><strong>Conclusion: </strong>Earlier-onset T2D is consistently associated with higher all-cause mortality, suggesting it may serve as an important risk marker, though causality is not established. Asymmetry in funnel plots and Egger's tests suggests possible publication bias. Future well-designed studies should explore causal mechanisms to inform interventions.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"137-163"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145958497","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":"Predicting the unpredictable: unveiling hidden patterns of emergency department unexpected deaths - a retrospective study.","authors":"Raphael Gontier, Sophie Klenkenberg, Mario Ambrozic, François Stifkens, Marine Bastide, Alexandre Ghuysen, Méryl Paquay","doi":"10.1080/17843286.2025.2594469","DOIUrl":"10.1080/17843286.2025.2594469","url":null,"abstract":"<p><strong>Objectives: </strong>Unexpected deaths in the emergency department (ED) are rare but may indicate missed opportunities to detect clinical deterioration. This study aimed to identify risk factors associated with unexpected deaths and to better characterize patients at risk during their ED stay.</p><p><strong>Methods: </strong>A retrospective study was conducted in the two EDs of CHU Liège between 2019 and 2023. All adult deaths (≥16 years) were extracted from the hospital's electronic health records and classified as expected or unexpected based on predefined criteria. Demographic data, triage levels, vital signs, Early Warning Scores (EWS), Glasgow Coma Scale (GCS), care location, and timing of death were analyzed using R software.</p><p><strong>Results: </strong>Among 461,958 ED admissions, 823 adult patients died. Of these, 42 (5.1%) were classified as unexpected. These cases were more frequently transported by non-medicalized ambulance (40.5% vs. 27.5%, <i>p</i> = 0.006), assigned lower triage levels (<i>p</i> < 0.001), and less often admitted to the resuscitation room (73.8% vs. 49.8%, <i>p</i> = 0.002). They also presented lower EWS (0-4: 77.4% vs. 48.5%, <i>p</i> = 0.006) and higher initial GCS scores (<i>p</i> = 0.002). In multivariate analysis, a high EWS (≥7) and an altered GCS were both associated with a lower likelihood of unexpected death (OR 0.10, <i>p</i> = 0.03, and OR 0.32, <i>p</i> = 0.05, respectively), indicating that these factors were more frequent among expected deaths.</p><p><strong>Conclusion: </strong>Unexpected deaths represented 5.1% of ED fatalities and were often preceded by subtle signs such as behavioral changes or mildly abnormal vital signs. Many occurred after initial stabilization, particularly in short-stay areas, underscoring the need to reflect on the organization and role of these units within the hospital system.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"18-27"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145585856","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":"Navigating complexities: differential diagnosis of thrombotic microangiopathies in pregnancy - a case report.","authors":"Maxim Bobbaerts, Lore Lannoo, Daan Dierickx, Ann Mertens, Anke Van Mellaert, Kathleen J Claes","doi":"10.1080/17843286.2025.2589256","DOIUrl":"10.1080/17843286.2025.2589256","url":null,"abstract":"<p><strong>Background: </strong>Thrombotic microangiopathy (TMA) during pregnancy is most commonly due to hypertensive disorders such as the hemolysis, elevated liver, low platelet (HELLP) syndrome and preeclampsia (PE). In these cases, delivery is the primary therapeutic intervention. However, distinguishing these pregnancy-related TMAs from other etiologies is critical, as alternative or coexisting causes may necessitate additional diagnostic and therapeutic strategies.</p><p><strong>Case report: </strong>We report a complex and unique case of a pregnant patient with prior bariatric surgery who developed a severe early-onset HELLP. The clinical course was further complicated by posterior reversible encephalopathy syndrome (PRES). Laboratory evaluation demonstrated severe vitamin B12 deficiency and glucose-6-phosphate dehydrogenase deficiency. Due to the rapid maternal deterioration, pregnancy termination was necessary to prevent further maternal morbidity.</p><p><strong>Conclusions: </strong>This case highlights the complexity of diagnosing and managing TMA during pregnancy. It emphasizes the need for clinical vigilance and a multidisciplinary approach to identify coexisting metabolic or genetic conditions that may influence both maternal and fetal outcomes.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"33-38"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627565","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":"Community pharmacists' experiences with the new tapering program for benzodiazepines and Z-drugs in Belgium.","authors":"Florian Stul, Lies Vanderbeken, Laura Lejeune, Els Mehuys, Mirko Petrovic, Koen Boussery, Thierry Christiaens, Ellen Van Leeuwen","doi":"10.1080/17843286.2025.2572344","DOIUrl":"10.1080/17843286.2025.2572344","url":null,"abstract":"<p><strong>Introduction: </strong>Long-term use of benzodiazepines and Z-drugs (BZRA) remains widespread, despite guidelines recommending short-term use and highlighting the harms. On 1 February 2023, a tapering pilot program was launched in Belgium to facilitate deprescribing BZRA by enabling community pharmacists (CPs) to compound capsules with stepwise gradual dose reductions.</p><p><strong>Aim: </strong>This study aims to explore the CPs' role in this program and the barriers and facilitators they encounter within the program.</p><p><strong>Methodology: </strong>A cross-sectional survey study evaluating barriers and facilitators was conducted. Participants were randomly selected from the National Database of Community Pharmacies. Results were analyzed descriptively using the Theoretical Domains Framework to identify influences on behaviour change.</p><p><strong>Results: </strong>Out of 2000 CPs contacted, 328 participants (16.4%) completed the survey. CPs rated their overall satisfaction with the program with a mean score of 7.4/10. Key facilitators identified included the relationship of trust between the patient, CP and general practitioner (GP), the patient's confidence in the CP's role in the program and the specific program elements. The most significant barriers were the CPs' perceived lack of interest from GPs and patients.</p><p><strong>Conclusion: </strong>The Belgian pilot program has been positively received by CPs. Success factors are the interdisciplinary collaboration (social influences) and the specific elements of the program itself (environmental context and resources). To better understand the factors influencing participation, a qualitative in-depth exploration of CPs, GPs and patients perspectives of the tapering program is recommended. Furthermore, implementation outcomes, the sustainability of BZRA cessation and the benefits patients experience from discontinuation need to be investigated.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"175-185"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145487346","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":"Enhanced CT image classification for kidney stones using pruned ConvNeXt and two-tier optimization.","authors":"B Reuben, C Narmadha, C Rajanandhini","doi":"10.1080/17843286.2025.2586626","DOIUrl":"10.1080/17843286.2025.2586626","url":null,"abstract":"<p><strong>Background: </strong>In this work, an innovative two-tier feature-optimized deep learning model is proposed for kidney stone detection in CT images. The framework uses a new modified ConvNeXt learning model to capture complex image patterns from CT images, along with the use of a LightGBM classifier.</p><p><strong>Methods: </strong>A two-tier optimization strategy is implemented to refine the detection process. Initially, Dynamic Channel Pruning is used within the ConvNeXt architecture to identify and retain the most informative channels during feature extraction. By dynamically evaluating the importance of each channel, this step processes the most relevant channels, reducing computational complexity and highlighting critical features. Then, the Pufferfish Optimization Algorithm (POA) is applied for optimal feature selection. This optimization helps isolate the most discriminative features for kidney stone detection. Additionally, POA is applied to adjust the hyperparameters of the LightGBM classifier to increase classification accuracy and efficiency.</p><p><strong>Results: </strong>The proposed model achieves the highest accuracy of 97.8%, compared with other models.</p><p><strong>Conclusion: </strong>The proposed model achieves enhanced detection accuracy and efficiency through the use of Dynamic Channel Pruning and Pufferfish Optimization. This model offers a promising solution for kidney stone detection in CT images.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"208-225"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494244","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":"Assessing ciliary function in polycystic kidney disease: beyond the kidney.","authors":"Beyza Doğan, Fatih Ergül, Mikail Dağ, Süleyman Karaköse, Latif Emre Özdemir, Abitter Yücel, İbrahim Güney","doi":"10.1080/17843286.2025.2581284","DOIUrl":"10.1080/17843286.2025.2581284","url":null,"abstract":"<p><strong>Background: </strong>This study sought to investigate the effects of polycystic kidney disease and tolvaptan administration on mucociliary clearance.</p><p><strong>Methods: </strong>The cross-sectional study enrolled 30 patients with autosomal dominant polycystic kidney disease undergoing tolvaptan therapy, 30 patients with autosomal dominant polycystic kidney disease not on tolvaptan, and 30 healthy volunteers. Nasal mucociliary clearance time was determined using the saccharin transit time test, with a 1 mm diameter saccharin particle carefully placed on the anteromedial surface of the inferior nasal concha. Comparisons of mucociliary clearance time were then performed between the groups.</p><p><strong>Results: </strong>In our study, the average mucociliary clearance time for patients with polycystic kidney disease was determined to be 9, in contrast to an average of 11 in the control group. A comparative analysis of patients receiving tolvaptan and those not receiving tolvaptan revealed an identical average mucociliary clearance time of 9 for both cohorts (<i>p</i> = 0.706). Furthermore, patients treated with tolvaptan demonstrated an average urine specific gravity of 1004, significantly lower than the 1011 observed in the non-tolvaptan group (<i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>This study indicates that the administration of tolvaptan yielded a beneficial impact on hydration status; however, this improved hydration did not translate into a significant effect on mucociliary clearance. Furthermore, the mucociliary clearance times recorded in the patient group were found to be in alignment with those typically associated with chronic kidney disease cohorts.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"186-192"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385801","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":"Exploring the real-life value of first responders for out-of-hospital cardiac arrest in a Belgian urban context: a retrospective analysis.","authors":"P Van de Voorde, M Du Bois, T Tackaert, K To, N Mpotos","doi":"10.1080/17843286.2025.2573748","DOIUrl":"10.1080/17843286.2025.2573748","url":null,"abstract":"<p><strong>Aim: </strong>First Responder [FR] systems are associated with improved outcomes. However, this evidence has very low certainty. We aimed to explore - using real-life data - the reality of out-of-hospital cardiac arrest [OHCA] in a Belgian municipal region where there currently is no such system.</p><p><strong>Methods: </strong>We explored the hypothetical potential for an FR in all cases of OHCA attended by the physician-staffed emergency medical services [EMS] team of Ghent University Hospital [07/2020-06/2021].</p><p><strong>Results: </strong>Of the 200 attended cases, 76% were residential; 54% were unwitnessed. Bystander CPR occurred in 36.5%, a public-access AED was used in only three cases. Eleven patients survived beyond hospital discharge, all but one with good neurological outcomes. In 60%, we considered an FR obsolete from start (due to irreversible death, existing advance directive, resourceful setting, early EMS arrival, OHCA not recognized, or EMS witnessed). Another 10% were traumatic OHCA, a category universally excluded. Although impossible to identify those cases from the remaining 30% (<i>n</i> = 60) that would truly benefit, the actual number is likely far lower due to a.o. the likelihood of prolonged no-flow in unwitnessed residential OHCA (one-third or complicating contexts, victim accessibility, or FR availability).</p><p><strong>Conclusion: </strong>There might be added value for an FR system in selected populations, but the associated cost-effectiveness ratios and the potential for harm should not be ignored. Better identification of victims potentially benefitting at the system point of entry is crucial.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"159-165"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285309","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":"Emerging threat of WHO priority pathogens in ICU-associated CLABSI and CAUTI: an integrated analysis of resistance patterns, epidemiological trends, and stewardship strategies.","authors":"Gargee Anand, Rijhul Lahariya, Ketan Priyadarshi, Asim Sarfraz","doi":"10.1080/17843286.2025.2546420","DOIUrl":"10.1080/17843286.2025.2546420","url":null,"abstract":"<p><strong>Purpose: </strong>To unmask the alarming prevalence, intricate antimicrobial resistance patterns, and consequential clinical outcomes of World Health Organization (WHO) priority pathogens causing device-associated infections in critical care settings - a frontier analysis of silent pandemic threatening modern healthcare.</p><p><strong>Methods: </strong>This groundbreaking retrospective study analysed data from 5,398 patients at risk for central line-associated bloodstream infections (CLABSI) and 15,416 patients for catheter-associated urinary tract infections (CAUTI) spanning 2021-2024. Microbial isolates were categorized according to WHO's priority pathogen classifications. Antimicrobial susceptibility profiles were comprehensively analysed using Clinical and Laboratory Standards Institute guidelines, with statistical analyses elucidating pathogen distribution dynamics, resistance mechanisms, and mortality correlations.</p><p><strong>Results: </strong>Striking findings revealed WHO priority pathogens dominated the microbial landscape, constituting 76.47% of CLABSI and 82.14% of CAUTI isolates - with critical priority organisms overwhelmingly predominant (83.34% and 91.3%, respectively). Carbapenem-resistant Enterobacterales (CRE) emerged as the formidable leading threat (39.5% of CLABSI, 72.7% of CAUTI), while Carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB) demonstrated exceptional virulence with devastating mortality (93.33%). The study unveiled unprecedented levels of multidrug resistance, with most therapeutic options rendered ineffective; only colistin maintained universal efficacy against gram-negative isolates despite its concerning toxicity profile. Dramatic disparities in infection outcomes revealed CLABSI-associated mortality rates (71.79%) significantly eclipsed CAUTI (39.13%), establishing infection type as a critical independent predictor of survival.</p><p><strong>Conclusions: </strong>This landmark investigation exposes the crossroad between WHO priority pathogens and healthcare-associated infections, sounding an urgent alarm for global healthcare systems. Our findings provide crucial evidence-based guidance for recalibrating therapeutic approaches, optimizing antimicrobial selection, and prioritizing infection control measures in intensive care settings worldwide.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"135-145"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870809","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":"Evolution of muscle mass and strength in patients admitted for a diabetic foot ulcer.","authors":"Yenna Hulshagen, Janne Terwingen, Dorien Frings, An Verrijken, Kristof Van Dessel, Carolien Van Gils, Ilse De Peuter, Patrick Lauwers, Eveline Dirinck","doi":"10.1080/17843286.2025.2543334","DOIUrl":"10.1080/17843286.2025.2543334","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess changes in muscle mass and strength in patients hospitalized due to a diabetic foot ulcer, and to evaluate the impact of malnutrition at admission on these parameters.</p><p><strong>Methods: </strong>This prospective observational cohort study included patients from February 2021 to July 2024. Anthropometric measurements, handgrip strength tests, and impedance analyses were conducted. Diagnosis of malnutrition was based on the Global Leadership Initiative on Malnutrition criteria. All patients received nutritional support during their hospital stay.</p><p><strong>Results: </strong>Seventy-eight DFU patients (74% men, median age 72 years, median BMI 27.6 kg/m²) were recruited. Half of them was malnourished. Median hospital stay was 28 days. Overall, muscle mass and handgrip strength at admission and discharge did not differ significantly (18.31 ± 2.05 versus 18.08 ± 2.11 kg/m² and 26.02 ± 10.27 versus 26.45 ± 11.45 kg respectively). At admission, muscle mass was 17.25 ± 1.66 kg/m² in malnourished patients versus 19.37 ± 1.85 kg/m² in non-malnourished patients (<i>p</i> < 0.001), muscle strength was 24.82 ± 9.39 kg versus 27.23 ± 11.07 kg respectively (non-significant). Muscle mass change in malnourished patients was -0.039 ± 1.35 versus -0.562 ± 1.21 kg/m² for non-malnourished. Muscle strength change for malnourished patients was 0.4 (-8.3 to 15) and 0 (-2.90 to 2.70) kg for non-malnourished. Both changes were not significantly different.</p><p><strong>Conclusion: </strong>DFU Patients exhibited no significant changes in muscle mass or strength during hospitalization, regardless of nutritional status at admission. Malnutrition did not significantly affect changes in muscle mass or strength during hospitalization. These findings indicate that the current clinical approach including nutritional counselling and support, appears to stabilize muscle health in this relatively immobile and fragile population.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":" ","pages":"123-134"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938388","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}