Acta Clinica Belgica最新文献

{"title":"Systemic mastocytosis with myeloid sarcoma and B-CLL: molecular and clonal heterogeneity in a rare case of SM-AHN with review of literature.","authors":"Philippe Decruyenaere,&nbsp;Dominiek Mazure,&nbsp;Ine Moors,&nbsp;Jo Van Dorpe,&nbsp;Malaïka Van der Linden,&nbsp;Barbara Denys,&nbsp;Mattias Hofmans,&nbsp;Fritz Offner","doi":"10.1080/17843286.2022.2033919","DOIUrl":"https://doi.org/10.1080/17843286.2022.2033919","url":null,"abstract":"<p><strong>Background: </strong>Systemic mastocytosis (SM) is a rare myeloproliferative disease that results from a clonal proliferation of abnormal mast cells in one or more extra-cutaneous organs. Systemic mastocytosis with an associated hematological neoplasm (SM-AHN) is the second most common subgroup and is diagnosed when WHO criteria for both SM and a hematological neoplasm of non-mast cell lineage are met. The SM-AHN category as currently proposed is highly heterogeneous in terms of pathogenesis, clinical presentation, and prognosis.</p><p><strong>Case presentation: </strong>We present the first reported case of SM-AHN associated with two hematological malignancies of different lineages, a monocytic myeloid sarcoma and a B-cell chronic lymphatic leukemia. Cytogenetic and molecular analyses revealed a distinct clonal origin of the two associated malignancies. The SM-myeloid sarcoma clone demonstrated an abnormal karyotype, trisomy 8 and del(13)(q12.3q14.3), as well as mutations in <i>KITD816V, DNMT3A</i> and <i>RUNX1</i>. The <i>DNMT3A</i> mutation could be detected years before disease onset, supporting its potential role as early driver of leukemogenesis. No genetic aberrations could be identified in the CLL clone, which is assumed to present coincidentally.</p><p><strong>Conclusions: </strong>This report highlights the importance of full diagnostic work-up in SM patients in whom an associated hematological malignancy is suspected. Moreover, the importance of genetic analysis is highlighted, as it provides additional insights in the underlying clonal pathogenesis of different phenotypes, can aid in risk stratification, and may help identify potential therapy targets.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"58-66"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9095449","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":"Success of the acute renal angina index in the early prediction of acute kidney injury in the emergency department.","authors":"Raziye Merve Yaradilmiş,&nbsp;Betül Öztürk,&nbsp;Ali Güngör,&nbsp;İlknur Bodur,&nbsp;Muhammed Mustafa Güneylioğlu,&nbsp;Aytaç Göktuğ,&nbsp;Aysun Tekeli,&nbsp;Can Demir Karacan,&nbsp;Nilden Tuygun","doi":"10.1080/17843286.2022.2031667","DOIUrl":"https://doi.org/10.1080/17843286.2022.2031667","url":null,"abstract":"<p><strong>Introduction: </strong>It is mentioned that the acute renal angina index (aRAI), a new concept, can be used in emergency departments to calculate and accurately predict the risk of developing acute kidney injury (AKI). The aims of the study included: to evaluate the predictive performance of the aRAI (AKI risk classification tool) in predicting AKI in the pediatric emergency department.</p><p><strong>Method: </strong>Patients who met the criteria for systemic inflammatory response syndrome were examined. AKI was defined with creatinine N1.5× baseline 24-72 hours after hospitalization. aRAI and original RAI scores were calculated for patients and were shown as renal angina positive (RA+) above a population-derived threshold. The performance of aRAI in predicting AKI compared to changes in creatinine and original RAI was evaluated.</p><p><strong>Results: </strong>In total, 241 eligible subjects were enrolled. The median age of the patients was 17 months (min-max 1-192). AKI developed in 60 (24.8%) of the patients. According to the aRAI, 76 (31.5%) of 241 patients were RA(+). The aRAI had an NPV of 1.00 and an AUC of 0.948 (0.914-0.983) for the prediction of AKI. Sensitivity was 95% for the aRAI as compared to 48% for an elevation in SCr noted to be at least two times greater than the baseline while in the PED and 61% for original RAI.</p><p><strong>Conclusions: </strong>The aRAI is easily computable, does not depend on complex computational or derivation methods, and is universally accessible. We confirm and extend the findings of previous study reporting the performance of RAI for early prediction of AKI.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"51-57"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9095452","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":"Rat bite fever: some comments on a case report review.","authors":"Wim L C Van Hooste","doi":"10.1080/17843286.2022.2028113","DOIUrl":"https://doi.org/10.1080/17843286.2022.2028113","url":null,"abstract":"Dear Editor, I like to make some comments on a case report review with the focus on the rare zoonotic infection rat bite fever (RBF) written by Coessens and De Laere [1]. Firstly, I agree with the authors that the literature on RBF is sparse for a zoonosis that has been recognized since ancient times [2]. By only summarizing 20 articles about European case reports, some points of view could have been overlooked. Moreover, a thorough PubMed database search strategy and performing a backward citation search could have yield twice as many interesting papers about European case reports published in English or Dutch in the last 20 years (2001–2020) [3,4]. So, there are several limitations to Coessens et al. review that are related to the breadth and depth of information, half of the cases may be missed (I retrieved other case reports from France, Germany, The Netherlands, also nonmentioned cases from Denmark, Poland, Spain, and Switzerland, n = 40). For instance, only 4/20 were cases among children, although RBF is a growing pediatric issue, as mentioned by Coessens and De Laere themselves. Secondly, rat bites account for approximately 1% of animal bites, with the risk of Streptobacillus moniliformis infection following a bite is about 10% [4]. RBF incidence must be largely underestimated due to frequent misdiagnoses (e.g. viral illness or rheumatologic disease), specialized techniques required to recover the microorganism from cultures, and lack of obligatory reporting of RBF infections [5]. Recently, various publications have suggested that Streptobacillus spp. might be far more common than previously thought [6]. The recent findings of Kache et al. (2020) of all cases reported in the period 2001–2015 in the United States reinforce that rat bite fever is rare, yet suggest it occurs more frequently than previously demonstrated in the review of 65 cases by Elliott in 2007 [6,7]. Thirdly, RBF may indeed be a misnomer, approximately 30% of patients do not report having been bitten or scratched by rodents [6]. Transmission occurs by a bite or scratch of a rodent or a predator of rats; mucocutaneous contact with the saliva, urine, or feces of a rat; as well as by ingestion of food or water contaminated by a rat. The infection may be acquired by handling rats, without any apparent breach of intact skin or with a portal of entry, such as varicella lesions. So, non-traumatic transmission has been reported more frequently, e.g. via mucous membranes (kissing a rat) [8]. The cases without clear rat bite or scratch exposure highlight the need for a thorough history before removing RBF from the differential diagnosis [9]. Ingestion leads to the gastrointestinal form of disease known as ‘Haverhill fever’, characterized by pharyngitis and vomiting. Fourthly, RBF is a diagnostic dilemma due to missing notice of a rodent bite (or contact), non-specific clinical symptoms, fastidious growth of the widely unknown microorganism and broad chemotherapeutic susceptibility, ","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"1-2"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10523129","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":"Vitamin D in patients with COVID-19: is there a room for it?","authors":"Gülistan Bahat,&nbsp;Duygu Erbas Sacar,&nbsp;Mirko Petrovic","doi":"10.1080/17843286.2021.2018832","DOIUrl":"https://doi.org/10.1080/17843286.2021.2018832","url":null,"abstract":"<p><p>Vitamin-D receptors are found in a variety of cells with the potential to regulate many cellular functions. Higher COVID-19 severity has been reported in individuals, which are known to have lower vitamin-D levels. The relation between vitamin-D and COVID-19 has been analysed with a number of studies but only few met high standards. Studies revealed discordant findings. There is no data from interventional trials clearly indicating that vitamin-D supplementation may prevent against COVID-19. An increasing number of observational studies put forward the preventive feature of adequate vitamin-D status for COVID-19 mortality. Yet, there are again conflicting findings. This narrative review summarizes the current evidence and provides a practical advice to lessen the impact of COVID-19 by ensuring recommended vitamin-D intakes. This approach would not be harmful, but potentially useful. Vitamin-D is safe especially if it does not exceed the upper-tolerable-limit. Daily doses are recommended over the weekly or monthly higher doses. Mega-doses are not recommended because of its potential to lead adverse events. The target level of vitamin-D is proposed above 30 ng/mL in majority of the studies. Nonetheless, one should consider that the benefit is foreseen to be small, and some time (months) may be needed for such effect.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"71-77"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8726006/pdf/YACB_0_2018832.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10536508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of antenatal magnesium sulfate with reduced late-onset sepsis in extreme preterm infants.","authors":"Sophie Vanhaesebrouck,&nbsp;Alexandra Zecic,&nbsp;Linde Goossens,&nbsp;Annelies Keymeulen,&nbsp;Lara Garabedian,&nbsp;Julie De Meulemeester,&nbsp;Pauline Naessens,&nbsp;Kris De Coen,&nbsp;Koenraad Smets","doi":"10.1080/17843286.2022.2048531","DOIUrl":"https://doi.org/10.1080/17843286.2022.2048531","url":null,"abstract":"<p><strong>Objectives: </strong>Neonatal intensive care has changed extensively over the last decades resulting in improved survival of extreme preterm infants. However, improved survival is associated with prolonged hospitalization, mechanical ventilation and use of invasive devices, which are all predisposing factors for LOS. LOS is known to increase short- and long-term morbidities resulting in impaired neurodevelopmental outcome. Besides treatment with antibiotics and supportive care, there is an unmet need for adjunctive therapies to prevent neonatal sepsis and hereby improve outcome.</p><p><strong>Methods: </strong>In a retrospective single-center design, we explored underlying pre-, peri- and postnatal factors in extreme preterm infants with and without LOS to potentially identify future strategies in the prevention of LOS in these infants.</p><p><strong>Results: </strong>Associations formerly published could be confirmed, such as lower birth weight, longer duration of respiratory support, parenteral nutrition and NICU stay and a higher incidence of almost all neonatal morbidities. A new interesting finding was the fact that infants with LOS received more antenatal magnesium sulfate (p = 0.002). After nearest neighbor matching based on birth weight, gestational age, gender and multiplicity increased duration of parenteral nutrition and NICU stay, the incidence of PVL remained significantly different between the two groups (LOS/no LOS), but also the association between antenatal magnesium sulfate administration and less LOS held true (p = 0.004).</p><p><strong>Conclusion: </strong>In this study, extreme preterm infants receiving antenatal magnesium sulfate developed less LOS. Whether this is merely an associative factor reflecting illness severity or an interesting link for new preventive strategies for LOS, should be further explored.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"11-15"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10536514","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":"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}