Acta Clinica Belgica最新文献_第5页

RSV induced rhabdomyolysis: a case report. RSV诱导横纹肌溶解1例。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-08-01 DOI: 10.1080/17843286.2022.2121364

Stijn Arnaert, Thomas Malfait, Astrid Deruyck, Farah Desoete, Maria Nersisjan, Inge Matthijs, Bart Maes

引用次数: 0

Association between admission biomarkers and clinical outcome in older adults diagnosed with an infection in the emergency department. 急诊科诊断为感染的老年人入院生物标志物与临床结果之间的关系

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-08-01 DOI: 10.1080/17843286.2022.2146929

Lucas Flamant, Guillaume Giordano Orsini, Laurent Ramont, Marion Gornet, Sebastien De Ruffi, Pierre Leroux, Lukshe Kanagaratnam, Stéphane Gennai

{"title":"Association between admission biomarkers and clinical outcome in older adults diagnosed with an infection in the emergency department.","authors":"Lucas Flamant, Guillaume Giordano Orsini, Laurent Ramont, Marion Gornet, Sebastien De Ruffi, Pierre Leroux, Lukshe Kanagaratnam, Stéphane Gennai","doi":"10.1080/17843286.2022.2146929","DOIUrl":"https://doi.org/10.1080/17843286.2022.2146929","url":null,"abstract":"Introduction: In older adults, prognostic performances of admission biomarkers have been poorly investigated. This study aims to compare the prognostic abilities of usual admission biomarkers, especially PCT and CRP, for major clinical outcomes, comparing older to younger adults diagnosed with an infection in the ED, and to investigate the prognostic abilities of PCT and CRP depending on the glomerular filtration rate (GFR).Methods: It was an observational, single-center, retrospective study, conducted in the Reims University Hospital, France. Endpoints were bacteremia, septic shock, and in-hospital mortality, related to the same ED visit.Results: Over 1 year, 852 patients were included with 291 (34.2%) ≥75 years, and 127 (15.3%) patients had a GFR <30 mL.min-1.1.73 m2. Overall, 74 bacteremia, 56 septic shock and 82 in-hospital deaths have been observed. Prognostic abilities of admission biomarkers tended to be systematically lower in older compared to younger adults (PCT and CRP AUROC for bacteremia were, respectively, 0.71 and 0.62 in older adults vs 0.75 and 0.70 in younger adults; PCT and CRP AUROC for septic shock were, respectively, 0.71 and 0.66 in older adults vs 0.82 and 0.68 in younger adults). PCT showed a significant discriminating power for septic shock and in-hospital mortality only for GFR ≥ 30, and CRP showed a significant discriminating power for bacteremia and septic shock only for GFR ≥60.Conclusion: Caution must be taken when interpreting admission biomarkers, as their prognostic abilities are lower in older adults or in patients with renal insufficiency diagnosed with an infection.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9958710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

HOMA-IR and HOMA2-IR estimation based on glycated hemoglobin as an alternative for fasting glucose. 基于糖化血红蛋白的HOMA-IR和HOMA-IR估计可替代空腹血糖。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-08-01 DOI: 10.1080/17843286.2022.2160889

Joris R Delanghe, Evelyn Verlinde, Marijn M Speeckaert, Thomas Maenhout

{"title":"HOMA-IR and HOMA2-IR estimation based on glycated hemoglobin as an alternative for fasting glucose.","authors":"Joris R Delanghe, Evelyn Verlinde, Marijn M Speeckaert, Thomas Maenhout","doi":"10.1080/17843286.2022.2160889","DOIUrl":"https://doi.org/10.1080/17843286.2022.2160889","url":null,"abstract":"Background: Diabetes mellitus is a major global public health problem. Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) is a key laboratory index in the assessment of insulin resistance. The calculation of HOMA-IR and its updated version HOMA2-IR are partly based on plasma glucose determinations, which are prone to important pre-analytical errors. As glycated hemoglobin (Hb) fractions strongly correlate with fasting glucose levels and are more stable analytes, we explored the possibilities of using glycated Hb fractions for calculating HOMA-IR.Methods: Labile Hb and HbA1c fractions were simultaneously assayed on a Tosoh G8 analyzer and expressed as %. Fasting glucose was measured in fluoride plasma using a hexokinase method. A Lumipulse G1200 luminescence immunoassay was used to measure serum insulin. The HOMA-IR and HOMA2-IR values were compared to corresponding indices calculated using glucose and glycated Hb fractions.Results: Labile Hb could be measured with between-run CVs of 2.2-2.3%. Labile Hb correlated with both glycemia (r = 0.80) and HbA1c results (r = 0.73). HbA1c-derived estimated average glucose (eAG)-based HOMA calculation correlated very well with HOMA-IR (r2 = 0.9972). Based on eAG calculations, HOMA2-IR (%B, %S, and IR) gave comparable results, as compared to labile Hb-based calculations, in particular for fasting plasma glucose values between 4.44 and 6.67 mmol/L.Conclusions: HbA1c and eAG are practical alternatives for glucose for estimating HOMA-IR. The use of glycated Hb enables home sampling for HOMA-IR and HOMA2-IR calculation.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9958733","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

A case of Leishmania infection with focal splanchnic involvement without systemic symptoms: a potential anti-inflammatory role for vitamin D. 伴有局灶性内脏受累而无全身症状的利什曼原虫感染一例:维生素D的潜在抗炎作用

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-08-01 DOI: 10.1080/17843286.2022.2145686

I Zaghi, L Ielasi, B Stagni, A Cascavilla, S Ferri, V Ambrosini, M Riefolo, S Varani

{"title":"A case of Leishmania infection with focal splanchnic involvement without systemic symptoms: a potential anti-inflammatory role for vitamin D.","authors":"I Zaghi, L Ielasi, B Stagni, A Cascavilla, S Ferri, V Ambrosini, M Riefolo, S Varani","doi":"10.1080/17843286.2022.2145686","DOIUrl":"https://doi.org/10.1080/17843286.2022.2145686","url":null,"abstract":"Case report: We report the case of a 59 year-old woman with persistent nausea, hyporexia, fatigue and mild abdominal discomfort. The patient was hospitalized upon suspicion of malignancy due to multiple hepatic and splenic nodules found on an abdominal ultrasound. Hypercalcemia emerged at initial diagnostic workup, which was considered secondary to iatrogenic vitamin D intoxication. After an adequate management of hypercalcemia and normalization of serum calcium level, all symptoms presented by the patient completely regressed. In order to characterize splanchnic lesions, several biochemistry, microbiology and radiological tests were performed, including two bioptic specimens of a focal hepatic lesion. Eventually, a diagnosis of leishmanial infection was made. The patient started a specific anti-leishmanial treatment, and the focal hepatic and splenic lesions progressively disappeared.Conclusion: To our knowledge, this is the first reported case of asymptomatic leishmanial infection with a widespread focal splanchnic involvement. The anti-inflammatory effect of vitamin D could be related to this atypical presentation of visceral leishmaniasis without systemic symptoms.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9594636","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: 2

The effect of physical exercise on fatigue in systemic lupus erythematosus: a systematic review. 体育锻炼对系统性红斑狼疮患者疲劳的影响:一项系统综述。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-08-01 DOI: 10.1080/17843286.2022.2163751

Luna Vandenbulcke, Margot Erard, Dieter Van Assche, Ellen De Langhe

{"title":"The effect of physical exercise on fatigue in systemic lupus erythematosus: a systematic review.","authors":"Luna Vandenbulcke, Margot Erard, Dieter Van Assche, Ellen De Langhe","doi":"10.1080/17843286.2022.2163751","DOIUrl":"https://doi.org/10.1080/17843286.2022.2163751","url":null,"abstract":"Objective: Fatigue is a prominent and disabling manifestation that impairs the quality of life of Systemic Lupus Erythematosus (SLE) patients both physically and mentally. The majority of SLE patients reports fatigue as an unmet need. Physical exercise could help SLE patients to reduce fatigue and improve quality of life.Methods: A systematic review was conducted to analyse the effectiveness of physical exercise interventions to reduce fatigue in SLE patients. PubMed, EMBASE, Web of Science: Core Collection, the Cochrane Library, CINAHL via EBSCO, and PEDro were searched (March 2021 to October 2021). Studies were included if they fulfilled prespecified criteria and were assessed for quality using the PEDro risk of bias tool.Results: A total of 17 studies (11 RCTs, 3 non-RCTs, 2 one-group pretest-posttest designs, and 1 cross-sectional study) were included in this review. They compared exercise treatment with standard care, alternative treatment, or a different type of exercise. Most of the included studies reported significant improvement in fatigue after exercise therapy. However, study heterogeneity is an important methodological limitation. Exercise interventions did not cause disease flare-ups in patients with low to moderate disease activity.Conclusion: Studies are heterogeneous, precluding firm conclusions. In general, 10 out of 17 studies showed statistically significant but rarely clinically relevant improvement in fatigue after exercise treatment. However, results were not always consistent across different instruments used to assess fatigue. More multi-centred randomised controlled trials are needed to find the best type of physical activity that is both safe and effective for SLE patients.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9657354","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

Inconsistencies in laboratory investigations of hypertension in a young woman taking ethinylestradiol/drospirenone association. 一名服用炔雌醇/屈螺酮联合剂的年轻女性高血压的实验室调查不一致。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-08-01 DOI: 10.1080/17843286.2022.2132764

Patrice Dufour, Laurent Vroonen, Etienne Cavalier, Caroline Le Goff

{"title":"Inconsistencies in laboratory investigations of hypertension in a young woman taking ethinylestradiol/drospirenone association.","authors":"Patrice Dufour, Laurent Vroonen, Etienne Cavalier, Caroline Le Goff","doi":"10.1080/17843286.2022.2132764","DOIUrl":"https://doi.org/10.1080/17843286.2022.2132764","url":null,"abstract":"Case presentation: A 34-year-old woman presented to the emergency department for arterial hypertension. Blood analysis requested by the endocrinologist showed very high level of aldosterone (1805 ng/L, normal values: <264 ng/L) and high level of renin activity (2.8 ng/mL/h, normal values: 0.1-2.0 ng/mL/h). The patient reported the use of Yasmin® (ethinylestradiol 30 µg/drospirenone 3 mg) continuously (without hormone-free week between cycles) as oral contraception. Medical imaging examinations revealed no anomaly in the kidneys and the adrenal glands. On the endocrinologist advice, patient stopped the intake of Yasmin®. Aldosterone and renin levels were measured several times after the discontinuation of the oral contraception and a diminution of these levels was observed with a complete normalization of both levels 26 days after the synthetic hormones discontinuation.Discussion: The literature shows that ethynilestradiol/drospirenone association can interfere with the renin-angiotensin-aldosterone system and increase the levels of aldosterone and/or renin. We reported here a clinical case illustrating the significant impact of this medication on the renin-angiotensin-aldosterone axis of a young woman. However, this association is not listed among the drugs interfering with the aldosterone and renin-level measurements.Conclusion: Considering the data in the literature and our clinical case, we suggest adding drospirenone and the ethinylestradiol/drospirenone association in the list of drugs interfering with aldosterone and renin level determination.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9602957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Meningococcal pericarditis caused by the MenW:cc11 strain in an older adult. 老年人脑膜炎球菌性心包炎由MenW:cc11菌株引起。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-06-01 DOI: 10.1080/17843286.2022.2107315

Gaëlle Moerman, D Verleyen, Ph Rogiers, J Hoste, W Mattheus, K Floré

{"title":"Meningococcal pericarditis caused by the MenW:cc11 strain in an older adult.","authors":"Gaëlle Moerman, D Verleyen, Ph Rogiers, J Hoste, W Mattheus, K Floré","doi":"10.1080/17843286.2022.2107315","DOIUrl":"https://doi.org/10.1080/17843286.2022.2107315","url":null,"abstract":"Introduction: Invasive meningococcal disease (IMD) caused by Neisseria meningitidis is a disease with a high mortality and morbidity rate. Serogroup W meningococci (MenW) used to be associated with sporadic disease worldwide. In recent years, a surge in MenW incidence is being observed.Report: An older adult presenting with acute onset shortness of breath, chest pain and fever, was diagnosed with pericarditis with meningococcemia due to MenW:ST11 strain. MenW infections are reported to have a higher case fatality rate and atypical clinical presentations: MenW has been identified in patients presenting with pneumonia, gastro-intestinal symptoms, arthritis, and pericarditis.Discussion: In Belgium, the National Reference Laboratory is also noticing an increase in serogroup Wmeningococcal disease. Recent epidemiological data for Belgium is reported in the article. MenW infections are reported to have a higher case fatality rate and atypical clinical presentations: MenW has been identified in patients presenting with pneumonia, gastro-intestinal symptoms, arthritis, and pericarditis.Conclusion: When factors for poor prognosis are present in patients with pericarditi clinicians should be vigilant and search for the underlying aetiology .","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9381023","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

In-hospital end-of-life care in the old: a retrospective study of intensive care unit use and do-not-resuscitate forms in patients deceased in a Belgian university hospital. 在医院临终关怀在老年人:回顾性研究重症监护病房使用和不复苏形式的病人在比利时大学医院死亡。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-06-01 DOI: 10.1080/17843286.2022.2097408

Felicia Bentin, Nele Van Den Noortgate, Ruth Piers

{"title":"In-hospital end-of-life care in the old: a retrospective study of intensive care unit use and do-not-resuscitate forms in patients deceased in a Belgian university hospital.","authors":"Felicia Bentin, Nele Van Den Noortgate, Ruth Piers","doi":"10.1080/17843286.2022.2097408","DOIUrl":"https://doi.org/10.1080/17843286.2022.2097408","url":null,"abstract":"Objectives: To explore the quality of in-hospital end-of-life care in adult patients with special attention to those 75 years and older and to make a comparison with the situation 10 years ago.Methods: Data were retrospectively collected on adult patients who deceased at Ghent University Hospital between September 2018 and December 2019. The main outcome measures were 'ICU use' and 'presence of DNR forms on non-ICU units' in the final hospitalization. In order to identify possible risk factors for ICU use, logistic regression was performed.Results: In total, 762 people died, of whom 35% were 75 or older. Just as 10 years ago, one-third (31%) died in the ICU versus 49% of those younger than 75 years (p < 0.001). Of people ≥75 years, 38%, compared to 42% 10 years ago, received an ICU treatment during their final hospitalization. The median length of an ICU stay was 4 versus 3 days 10 years ago. After adjusting for gender, comorbidities and the Charlson Comorbidity Index, factors associated with less ICU use were higher age, active malignancy and dementia (OR 0.838, 0.116 and 0.098 respectively). Seventy-nine percent of older patients on non-ICU wards died with a DNR form (versus 87% 10 years ago).Conclusion: Although there was an increase in the presence of DNR forms in the final hospitalization, no significant differences were seen in actual ICU use compared to 10 years ago. Factors associated with less ICU use were higher age, active malignancy and dementia.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9385609","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

Safety of direct oral anticoagulants in patients with liver disease: a systematic review and meta-analysis. 肝病患者直接口服抗凝剂的安全性:一项系统综述和荟萃分析

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-06-01 DOI: 10.1080/17843286.2022.2108259

Yan Zhao, Liyao Zhu, Yang Yang, Han Gao, Rui Zhang

{"title":"Safety of direct oral anticoagulants in patients with liver disease: a systematic review and meta-analysis.","authors":"Yan Zhao, Liyao Zhu, Yang Yang, Han Gao, Rui Zhang","doi":"10.1080/17843286.2022.2108259","DOIUrl":"https://doi.org/10.1080/17843286.2022.2108259","url":null,"abstract":"Background: Direct oral anticoagulants (DOACs), such as apixaban, edoxaban, rivaroxaban, or dabigatran, are an effective treatment for atrial fibrillation (AF) and deep venous thromboembolism. We hope to evaluate the safety of DOACs versus warfarin/low molecular weight heparin (LMWH) in improving bleeding events in patients with different severity of the liver disease.Methods: We systematically searched the Cochrane Library, PubMed, and Embase databases for studies reporting the effects of DOACs in patients with liver cirrhosis. A random-effects model or fixed-effects model was selected to pool risk ratios (RR) and 95% confidence intervals (CI).Results: A total of 18 studies involving 41,447 participants was included in this meta-analysis. Compare with warfarin/ LMWH, the use of DOACs significantly reduced the incidence of all bleeding (RR: 0.76; 95%CI: 0.66 to 0.87), major bleeding (RR: 0.51; 95%CI: 0.28 to 0.91), intracranial hemorrhage (RR: 0.50; 95%CI: 0.31 to 0.81), and gastrointestinal bleeding (RR: 0.76, 95% CI: 0.60 to 0.97), and all-cause death in patients with liver disease (RR: 0.77; 95%CI: 0.62 to 0.95). Similar results were observed in atrial fibrillation patients with liver disease and cirrhosis subgroups. Furthermore, the pooled estimates of the Child-Turcotte-Pugh (CTP) class indicated that DOACs reduced the incidence of all bleeding (RR: 0.61; 95%CI: 0.45 to 0.82), gastrointestinal bleeding (RR 0.55; 95%CI: 0.37 to 0.83), and all-cause death (RR: 0.62; 95%CI: 0.49 to 0.79) in patients with mild to moderate cirrhosis.Conclusions: Our study demonstrates that DOACs significantly reduce the risk of bleeding in patients with liver disease compared with warfarin/LMWH.","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9385618","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

Shunt Nephritis: A Case of Mistaken Identity. 分流性肾炎:误诊一例。

IF 1.6 4区医学

Acta Clinica Belgica Pub Date : 2023-06-01 DOI: 10.1080/17843286.2022.2095490

Tim Van Damme, Nic Veys, Marijn M Speeckaert, Sigurd E Delanghe

引用次数: 0