Acta Clinica Belgica最新文献

{"title":"Hepatic arterial infusion chemotherapy versus transarterial chemoembolization for patients with unresectable hepatocellular carcinoma: a systematic review and meta-analysis.","authors":"Shun-Yu Kong,&nbsp;Jiao-Jiao Song,&nbsp;Yao-Qi Jin,&nbsp;Man-Jun Deng,&nbsp;Jing-Xin Yan","doi":"10.1080/17843286.2022.2076791","DOIUrl":"https://doi.org/10.1080/17843286.2022.2076791","url":null,"abstract":"<p><strong>Background: </strong>We carried out a systematic review and meta-analysis to assess the safety and effectiveness of hepatic arterial infusion chemotherapy (HAIC) compared with transarterial chemoembolization (TACE) for patients with unresectable hepatocellular carcinoma (uHCC).</p><p><strong>Methods: </strong>Eligible studies were searched by MEDLINE, the Cochrane Library, Embase, and Web of Science from January 1995 to January 2022, investigating eligible literature comparing HAIC and TACE for patients with HCC. The main outcome measures included progression-free survival (PFS), overall survival (OS), adverse events (AEs), objective response rate (ORR), and diseases control rate (DCR).</p><p><strong>Results: </strong>Eight literature and 1028 patients were enrolled in this meta-analysis. The pooled PFS, OS, ORR, and DCR were HR = 0.89 (95% CI, 0.81-0.98), HR = 0.84 (95% CI, 0.75-0.93), OR = 2.77 (95% CI, 2.01-3.80), and OR = 4.64 (95% CI, 2.40-8.99), respectively. The adverse events of HAIC were lower than TACE.</p><p><strong>Conclusion: </strong>Our meta-analysis revealed that HAIC can achieve a better effect and survival benefits than TACE in patients with uHCC.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"171-179"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10841376","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":"Differences in antibiotic prescribing quality in Belgian out-of-hours primary care services.","authors":"Jeroen De Man,&nbsp;Roy Remmen,&nbsp;Hilde Philips","doi":"10.1080/17843286.2022.2081772","DOIUrl":"https://doi.org/10.1080/17843286.2022.2081772","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to compare trends in antibiotic prescribing behaviour for lower urinary tract infections among different out-of-hours primary care services.</p><p><strong>Methods: </strong>Cross-sectional study using routine prescription data extracted from electronic health records from six out-of-hours services. The study population included 5888 cases diagnosed with an uncomplicated lower urinary tract infection from 2016 to 2020. Prescriptions were assessed based on the national guidelines.</p><p><strong>Results: </strong>Considering the total study period, an antibiotic was prescribed in 98.9% of cases. Among these cases, 55.0% was prescribed a guideline recommended antibiotic, 21.0% was prescribed fosfomycin, 17.4% was prescribed a quinolone and 1.8% was prescribed more than one antibiotic. Guideline recommended prescribing improved substantially over time. However, there were significant differences among out-of-hours services in terms of proportion over the total study period (between 49.0% and 66.7%) as well as in terms of time-trend pattern.</p><p><strong>Conclusion: </strong>Substantial differences among out-of-hours services suggest a potential for further improvement in the quality of antibiotic prescribing. Monitoring prescribing behaviour per out-of-hours primary care service can guide focused interventions.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"122-127"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9103743","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":"Changes in lipid lowering medication and lipid levels over time in patients with stable coronary artery disease.","authors":"Clara François,&nbsp;A M Willems,&nbsp;L Van Calster,&nbsp;E Germonpré,&nbsp;Johan De Sutter","doi":"10.1080/17843286.2022.2084948","DOIUrl":"https://doi.org/10.1080/17843286.2022.2084948","url":null,"abstract":"<p><strong>Background/aim: </strong>To provide longitudinal data on the evolution of lipid levels and the intake of lipid-lowering therapies in patients with stable coronary artery disease.</p><p><strong>Methods: </strong>Single-centre retrospective study with inclusion of 350 patients with a first coronary artery event in 2014 or earlier and outpatient cardiac clinic follow-up in 2015 and 2019. Lipid levels were collected within a time frame of 3 months of their visits.This retrospective study protocol (2020.086) was approved by the ethical committee and by the Data Privacy Officer of AZ Maria Middelares Ghent. For this type of study, formal consent is not required, following local law and regulations.</p><p><strong>Results: </strong>Average LDL levels were 82 (±26) mg/dl in 2015 and 70 (±24) mg/dl in 2019 (<i>p</i> < 0.001). Most patients included were already on statin treatment before inclusion in the trial (94%), with a significant increase in high-intensity statin use (45% vs. 58%) after a 5-year follow-up. At the same time, we observed a significant increase in ezetimibe use (in combination with statin therapy or in monotherapy) (8% vs. 22%) during follow-up. LDL ≤70 mg/dl was 34% in 2015 and 53% in 2019. LDL ≤55 mg/dl was 13% in 2015 and 28% in 2019.</p><p><strong>Conclusion: </strong>This study shows significant intensification of lipid-lowering therapy use during follow-up, and a significant lipid level lowering after 5-year follow-up, in an outpatient cardiac clinic follow-up. Further improvement in lipid control is still desirable, especially after the European Society of Cardiology recommend stricter lipid levels in the 2021 Prevention Guidelines.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 2","pages":"135-139"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454871","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":"Organization, feasibility and patient appreciation of a follow-up consultation in surgical critically ill patients with favorable baseline quality of life and prolonged ICU-stay: a pilot study.","authors":"Sofie F M Vanderhaeghen,&nbsp;Johan M Decruyenaere,&nbsp;Dominique D Benoit,&nbsp;Sandra G Oeyen","doi":"10.1080/17843286.2022.2050003","DOIUrl":"https://doi.org/10.1080/17843286.2022.2050003","url":null,"abstract":"<p><strong>Objectives: </strong>Intensive care unit (ICU) survivors are often left with impairments in physical, mental and cognitive functioning (Post-Intensive Care Syndrome (PICS)). We evaluated the organization, the feasibility for caregivers and patients and the patients' appreciation of a post-ICU consultation aiming to detect these PICS-symptoms.</p><p><strong>Methods: </strong>A single-center prospective observational pilot study was conducted during an 18 month-period in the surgical ICU of a tertiary care hospital. Consecutive adult patients with an ICU-stay of ≥8 days and a favorable baseline quality of life (utility index ≥0.6 on EQ-5D-3 L) were eligible for inclusion. A post-ICU follow-up consultation consisting of a structured interview was scheduled 3 months after hospital discharge. Characteristics of the consultation (CG) and no consultation group (NCG) were compared. P-values <0.05 were considered significant.</p><p><strong>Results: </strong>Of 133 eligible patients, 85 (64%) consented for the study and 42 (49%) attended the consultation. A total of 148 phone calls were made to schedule the consultations. Consultations took a median of 68 (61-74) minutes. Compared to CG-patients, NCG-patients were more often discharged to a care facility (P = 0.003) and had more problems with mobility (P = 0.014), self-care (P < 0.001) and usual activities (P = 0.005) after 3 months. At least one PICS-related problem was documented in all patients in the CG and NCG. Thirty-four CG-patients (81%) appreciated the initiative.</p><p><strong>Conclusion: </strong>Organizing an ICU-follow-up consultation was difficult and feasibility was low, but most attending patients appreciated the initiative. Better developed structures for ICU-follow-up are needed in view of the high number of PICS-related problems documented.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"25-35"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10529960","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":"Identifying vulnerable older adults at risk for functional decline in cardiac care wards: time to shift the paradigm.","authors":"Anthony Jeuris,&nbsp;Bastiaan Van Grootven,&nbsp;Lisa Geyskens,&nbsp;Koen Milisen,&nbsp;Johan Flamaing,&nbsp;Mieke Deschodt","doi":"10.1080/17843286.2022.2031374","DOIUrl":"https://doi.org/10.1080/17843286.2022.2031374","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether routine screening with the Flemish version of the Triage Risk Screening Tool (fTRST) is a valid approach to determine which patients on cardiac care wards are at risk for inhospital functional decline and would benefit from geriatric expertise consultation.</p><p><strong>Methods: </strong>A secondary data-analysis of the G-COACH before-cohort, describing patient profiles and routine care processes, in 189 older adults on two cardiac care wards in the University Hospitals Leuven between September 2016 and June 2017. Inhospital functional decline was defined as an increase of at least one point on the Katz Index of Activities of Daily Living or death between hospital admission and discharge.</p><p><strong>Results: </strong>Nine in 10 patients had at least one geriatric syndrome and one-third developed functional decline. Based on the fTRST proposed cut-off of ≥2, 156 (82.5%) patients were at risk for functional decline (sensitivity of 95.2%, specificity of 23.8%, negative predictive value of 90.9% and Area Under the Curve of 0.60). Of the 156 'at risk' patients, 43 (27.6%) received a consultation by the geriatric consultation team after a median of four hospitalization days. A positive fTRST was not significantly related to geriatric consultations (x² = 0.57; p = 0.45).</p><p><strong>Conclusion: </strong>The fTRST has a low discriminative value in identifying older cardiology patients at risk for functional decline. Given the high prevalence of geriatric syndromes, we propose a new paradigm were all older adults on cardiac care wards undergo a needs assessment upon hospital admission.</p>","PeriodicalId":7086,"journal":{"name":"Acta Clinica Belgica","volume":"78 1","pages":"44-50"},"PeriodicalIF":1.6,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9095448","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":"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}