{"title":"Uit de oude doos: Praatjes in de wind - juni 1947","authors":"B. Vandekerkhove","doi":"10.47671/tvg.77.21.182","DOIUrl":"https://doi.org/10.47671/tvg.77.21.182","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138963224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Lingier, N. Naessens, E. Ranschaert, K. Verstraete
The need for data for artificial intelligence in medicine In recent decades, there has been a digital revolution in medicine, with an increasing integration of innovative technologies across different disciplines in the medical world. Artificial intelligence (AI), in particular, has the potential to have a groundbreaking impact on the healthcare of the future. However, the core of this promising technology heavily relies on data. Relevant literature was systematically and structurally searched through the databases of PubMed and Embase. Interviews were conducted with experts based on the insights and considerations from the literature. These interviews formed the foundation of this paper. Finally, the interviews were supported by relevant websites and literature found through Google Scholar. To develop a generalizable algorithm, the used data should not only have a high quality, but must also be numerous and diverse. However, there is not necessarily a need for more data, but rather for accessibility of the data. In clinical practice, a standardized format to store data is lacking. Furthermore, the data are scattered across different centres, with data-sharing heavily protected by the GDPR. There is a need for uniform and linkable data that can be collected from multiple healthcare institutions in a structured and protected manner using a centralized data platform. This data should have a high quality and must be sufficient in number to develop a robust and representative algorithm. The entire process must comply with the strict obligations imposed by the GDPR, ensuring the protection of the patients’ privacy.
{"title":"De noodzaak aan data voor artificiële intelligentie in de geneeskunde","authors":"M. Lingier, N. Naessens, E. Ranschaert, K. Verstraete","doi":"10.47671/tvg.79.23.110","DOIUrl":"https://doi.org/10.47671/tvg.79.23.110","url":null,"abstract":"The need for data for artificial intelligence in medicine In recent decades, there has been a digital revolution in medicine, with an increasing integration of innovative technologies across different disciplines in the medical world. Artificial intelligence (AI), in particular, has the potential to have a groundbreaking impact on the healthcare of the future. However, the core of this promising technology heavily relies on data. Relevant literature was systematically and structurally searched through the databases of PubMed and Embase. Interviews were conducted with experts based on the insights and considerations from the literature. These interviews formed the foundation of this paper. Finally, the interviews were supported by relevant websites and literature found through Google Scholar. To develop a generalizable algorithm, the used data should not only have a high quality, but must also be numerous and diverse. However, there is not necessarily a need for more data, but rather for accessibility of the data. In clinical practice, a standardized format to store data is lacking. Furthermore, the data are scattered across different centres, with data-sharing heavily protected by the GDPR. There is a need for uniform and linkable data that can be collected from multiple healthcare institutions in a structured and protected manner using a centralized data platform. This data should have a high quality and must be sufficient in number to develop a robust and representative algorithm. The entire process must comply with the strict obligations imposed by the GDPR, ensuring the protection of the patients’ privacy.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"15 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139173637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute tubular necrosis following zoledronic acid for the treatment of osteoporosis: case report and literature review Zoledronic acid is a potent intravenous bisphosphonate widely used in the treatment of osteoporosis, amongst others. Bisphosphonate nephrotoxicity has been described for a long time, is dose-dependent and is more common when used in oncologic indications. A case of acute tubular necrosis following a treatment with zoledronate in a patient with osteoporosis is described. An 88-year-old male patient was admitted with general weakness and recurrent falls, 10 days after the fourth, annual administration of 5 mg of zoledronic acid. Acute on chronic kidney injury with a creatinine of 6.77 mg/dL compared to the baseline of 1.7 mg/dL was established. There was a temporary requirement for dialysis because of metabolic complications. The diagnosis of toxic acute tubular necrosis was made. After 6 weeks, there was a gradual improvement to a creatinine of 2.64 mg/dL. The case description is followed by a description of the mechanisms of nephrotoxicity of zoledronic acid and by a literature overview about its prevention in osteoporosis. Measurement of the serum creatinine before the infusion of zoledronic acid, awareness of possible nephrotoxicity and preventive measures are important to prevent acute kidney failure in patients with osteoporosis treated with zoledronic acid. Given the clearly proven effect of zoledronic acid on the fracture risk, the very low risk of renal side effects is certainly not a reason to avoid zoledronic acid in patients with a creatinine clearance above 35 ml/min according to the Cockcroft-Gault equation (CG).
{"title":"Acute tubulusnecrose na zoledronaat voor de behandeling van osteoporose: casusbespreking en literatuurstudie","authors":"K. Denewet, M. Dejaeger, E. Gielen","doi":"10.47671/tvg.79.23.101","DOIUrl":"https://doi.org/10.47671/tvg.79.23.101","url":null,"abstract":"Acute tubular necrosis following zoledronic acid for the treatment of osteoporosis: case report and literature review\u0000\u0000 \u0000\u0000Zoledronic acid is a potent intravenous bisphosphonate widely used in the treatment of osteoporosis, amongst others. Bisphosphonate nephrotoxicity has been described for a long time, is dose-dependent and is more common when used in oncologic indications.\u0000\u0000 \u0000\u0000A case of acute tubular necrosis following a treatment with zoledronate in a patient with osteoporosis is described. An 88-year-old male patient was admitted with general weakness and recurrent falls, 10 days after the fourth, annual administration of 5 mg of zoledronic acid. Acute on chronic kidney injury with a creatinine of 6.77 mg/dL compared to the baseline of 1.7 mg/dL was established. There was a temporary requirement for dialysis because of metabolic complications. The diagnosis of toxic acute tubular necrosis was made. After 6 weeks, there was a gradual improvement to a creatinine of 2.64 mg/dL.\u0000\u0000 \u0000\u0000The case description is followed by a description of the mechanisms of nephrotoxicity of zoledronic acid and by a literature overview about its prevention in osteoporosis. Measurement of the serum creatinine before the infusion of zoledronic acid, awareness of possible nephrotoxicity and preventive measures are important to prevent acute kidney failure in patients with osteoporosis treated with zoledronic acid. Given the clearly proven effect of zoledronic acid on the fracture risk, the very low risk of renal side effects is certainly not a reason to avoid zoledronic acid in patients with a creatinine clearance above 35 ml/min according to the Cockcroft-Gault equation (CG).","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"51 S12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138999900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Van Den Eede, C. Pinto, D. Peeters, M. van Schijndel
At least 30 medical-psychiatric units in The Netherlands: what is Flanders waiting for? The medical-psychiatric unit (MPU) constitutes an important integrated health service for the diagnostic assessment and the treatment of patients with co-occurring somatic and psychiatric morbidity when the somatic problems are too complex for the psychiatric department or the psychiatric disorder complicates or prevents treatment at a medical ward. There are different types of MPU based on the level of acuity, as well as on the objectives and the service providing the actual care. As yet and in contrast to The Netherlands, the United States and many other countries, no similar combined health service is operational in Flanders (Belgium). With the aim to improve the quality of care in case of any such moderate to severe comorbidity and to ensure the safety of care and the staff, the authors deem it advisable to set up MPUs in Flemish general and/or university hospitals. Indisputably, any MPU is a challenging and multifaceted endeavour. Their efficiency and treatment outcomes require further research, most preferably studies evaluating views and findings obtained in clinical practice. Also, funding and management frameworks need to be developed to facilitate the organisation and operation of such complex care units.
{"title":"Al minstens 30 medisch-psychiatrische units in Nederland: waarop wacht Vlaanderen nog?","authors":"F. Van Den Eede, C. Pinto, D. Peeters, M. van Schijndel","doi":"10.47671/tvg.79.23.115","DOIUrl":"https://doi.org/10.47671/tvg.79.23.115","url":null,"abstract":"At least 30 medical-psychiatric units in The Netherlands: what is Flanders waiting for?\u0000\u0000 \u0000\u0000The medical-psychiatric unit (MPU) constitutes an important integrated health service for the diagnostic assessment and the treatment of patients with co-occurring somatic and psychiatric morbidity when the somatic problems are too complex for the psychiatric department or the psychiatric disorder complicates or prevents treatment at a medical ward. There are different types of MPU based on the level of acuity, as well as on the objectives and the service providing the actual care.\u0000\u0000 \u0000\u0000As yet and in contrast to The Netherlands, the United States and many other countries, no similar combined health service is operational in Flanders (Belgium). With the aim to improve the quality of care in case of any such moderate to severe comorbidity and to ensure the safety of care and the staff, the authors deem it advisable to set up MPUs in Flemish general and/or university hospitals.\u0000\u0000 \u0000\u0000Indisputably, any MPU is a challenging and multifaceted endeavour. Their efficiency and treatment outcomes require further research, most preferably studies evaluating views and findings obtained in clinical practice. Also, funding and management frameworks need to be developed to facilitate the organisation and operation of such complex care units.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"13 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139010147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
How truthful are statements about substance use in the fitness to drive examination? In Belgium, the court can order a fitness to drive examination on indication. One is not fit to drive if there has been excessive alcohol and/or drug use in the past 6 months. Chronic excessive alcohol use corresponds to an average consumption of ≥ 6 units per day or ≥ 42 units per week over several months. Toxicologically, 30 pg/mg ethylglucuronide (direct alcohol marker) in scalp hair strongly suggests this. For drugs, it is sufficient to demonstrate this substance in one of the samples. The anamnesis and toxicology were compared with a McNemar test. The sensitivity, specificity and positive/negative predictive value of the anamnesis as a diagnostic test were calculated. People are more likely to be unfit to drive based on the toxicological analysis than based on the anamnesis (respectively 60% versus 40%). The greatest discrepancy is seen regarding alcohol consumption. In addition, toxicologically more cases of drug use were detected. This study shows that statements regarding alcohol and drug use within the fitness to drive examination are not reliable.
{"title":"Hoe waarheidsgetrouw zijn verklaringen over middelengebruik in het rijgeschiktheidsonderzoek?","authors":"B. Van Rafelghem, A. Van Goethem, W. Jacobs","doi":"10.47671/tvg.79.23.084","DOIUrl":"https://doi.org/10.47671/tvg.79.23.084","url":null,"abstract":"How truthful are statements about substance use in the fitness to drive examination?\u0000\u0000 \u0000\u0000In Belgium, the court can order a fitness to drive examination on indication. One is not fit to drive if there has been excessive alcohol and/or drug use in the past 6 months. Chronic excessive alcohol use corresponds to an average consumption of ≥ 6 units per day or ≥ 42 units per week over several months. Toxicologically, 30 pg/mg ethylglucuronide (direct alcohol marker) in scalp hair strongly suggests this. For drugs, it is sufficient to demonstrate this substance in one of the samples.\u0000\u0000 \u0000\u0000The anamnesis and toxicology were compared with a McNemar test. The sensitivity, specificity and positive/negative predictive value of the anamnesis as a diagnostic test were calculated.\u0000\u0000 \u0000\u0000People are more likely to be unfit to drive based on the toxicological analysis than based on the anamnesis (respectively 60% versus 40%). The greatest discrepancy is seen regarding alcohol consumption. In addition, toxicologically more cases of drug use were detected. This study shows that statements regarding alcohol and drug use within the fitness to drive examination are not reliable.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"9 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138587712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Vos, B. Van den Bergh, H. Roels, D. Martens, H. Kindermans, T.S. Nawrot, J. Rombaut, N. Coryn, R. Salihi, P. Tummers, Y. Biesemans, E. Roets, M. Baetens, K. Roelens, B. Menten, A. Vandewal, A. Thaens, S. Fransis, M. Finoulst, P. Vankrunkelsven, A. Van Tongerloo, H. Verdin, B. Blaumeiser, L. Polster, P. Coucke, S. Janssens
{"title":"E-book: Verloskunde - Uitgave 2023","authors":"S. Vos, B. Van den Bergh, H. Roels, D. Martens, H. Kindermans, T.S. Nawrot, J. Rombaut, N. Coryn, R. Salihi, P. Tummers, Y. Biesemans, E. Roets, M. Baetens, K. Roelens, B. Menten, A. Vandewal, A. Thaens, S. Fransis, M. Finoulst, P. Vankrunkelsven, A. Van Tongerloo, H. Verdin, B. Blaumeiser, L. Polster, P. Coucke, S. Janssens","doi":"10.47671/tvg.79.23.e020","DOIUrl":"https://doi.org/10.47671/tvg.79.23.e020","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"25 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138594475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Primary adrenal lymphoma A primary adrenal lymphoma (PAL) is a very rare extranodal lymphoma with only about 400 cases described worldwide. PAL is a rapidly progressive disease. Since the advent of rituximab, there is an improvement in the prognosis, making it comparable to a classical diffuse large B-cell lymphoma (DLBCL). This article describes the medical history of a 62-year-old woman with a bilateral adrenal incidentaloma on a CT scan. She complained of vague symptoms such as nausea, vertigo and excessive sweating with minor weight loss. Additional testing revealed primary adrenal insufficiency, for which hydrocortisone and fludrocortisone substitution was started, significantly improving the patient’s symptoms. A right adrenalectomy demonstrated the presence of a DLBCL and staging with an FDG-PET-CT scan showed no additional lesions. As the adrenals were the only location of the disease, the diagnosis of PAL could be made.
{"title":"Primair adrenaal lymfoom","authors":"S. Buyse, W. Daneels, B. Lapauw","doi":"10.47671/tvg.79.23.080","DOIUrl":"https://doi.org/10.47671/tvg.79.23.080","url":null,"abstract":"Primary adrenal lymphoma\u0000\u0000 \u0000\u0000A primary adrenal lymphoma (PAL) is a very rare extranodal lymphoma with only about 400 cases described worldwide. PAL is a rapidly progressive disease. Since the advent of rituximab, there is an improvement in the prognosis, making it comparable to a classical diffuse large B-cell lymphoma (DLBCL).\u0000\u0000 \u0000\u0000This article describes the medical history of a 62-year-old woman with a bilateral adrenal incidentaloma on a CT scan. She complained of vague symptoms such as nausea, vertigo and excessive sweating with minor weight loss. Additional testing revealed primary adrenal insufficiency, for which hydrocortisone and fludrocortisone substitution was started, significantly improving the patient’s symptoms. A right adrenalectomy demonstrated the presence of a DLBCL and staging with an FDG-PET-CT scan showed no additional lesions. As the adrenals were the only location of the disease, the diagnosis of PAL could be made.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"75 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138604453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Welkom aan onze nieuwe hoofdredactie!","authors":"J. Heyrman","doi":"10.47671/tvg.79.23.125","DOIUrl":"https://doi.org/10.47671/tvg.79.23.125","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"26 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138624840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Folia Pharmacotherapeutica december 2023","authors":"","doi":"10.47671/tvg.79.23.120","DOIUrl":"https://doi.org/10.47671/tvg.79.23.120","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139208419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：