{"title":"mRNA-Covid-vaccins en borstvoeding: twijfel over de veiligheid is ongegrond","authors":"M. Finoulst, P. Vankrunkelsven","doi":"10.47671/tvg.79.23.123","DOIUrl":"https://doi.org/10.47671/tvg.79.23.123","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":" 43","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139207060","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}
Performance of AI in fracture detection on radiography and its effect on the performance of physicians: a systematic review This systematic review has a twofold objective regarding the evaluation of the use of artificial intelligence (AI) for fracture detection on radiography. The first is to examine the performance of the current AI algorithms. The second concerns an evaluation of the effect of AI support on the performance of physicians in fracture detection. A systematic literature search was performed in 4 databases: PubMed, Embase, Web of Science and CENTRAL. Fourteen studies met the inclusion and exclusion criteria. The studies were divided into 2 categories: a first group in which a comparison was made between the performance of AI and the performance of physicians and a second group comparing the performance of physicians with and physicians without AI aid. Seven studies reported a comparable or superior fracture detection performance for AI compared to physicians, including radiologists. One study established a comparable performance on the internal test. On the external test, a lower AI performance was found compared to physicians. The second group of 6 studies reported a positive effect on the fracture detection performance of physicians when aided by AI. The current AI algorithms have a fracture detection performance comparable with physicians. At present, AI can be used as an aid in fracture detection. The potential impact of AI as an aid is greater with regard to less experienced doctors. The biggest hurdle of the current AI algorithms is the lack of large quantities of high-quality training data. Prospective studies, as well as further development and training of detection algorithms are needed in the future, in addition to larger datasets.
{"title":"Performantie van AI bij fractuurdetectie en effect op de prestaties van artsen: een systematische review","authors":"Y.-H. Tang, E. Ranschaert, K. Verstraete","doi":"10.47671/tvg.79.23.076","DOIUrl":"https://doi.org/10.47671/tvg.79.23.076","url":null,"abstract":"Performance of AI in fracture detection on radiography and its effect on the performance of physicians: a systematic review This systematic review has a twofold objective regarding the evaluation of the use of artificial intelligence (AI) for fracture detection on radiography. The first is to examine the performance of the current AI algorithms. The second concerns an evaluation of the effect of AI support on the performance of physicians in fracture detection. A systematic literature search was performed in 4 databases: PubMed, Embase, Web of Science and CENTRAL. Fourteen studies met the inclusion and exclusion criteria. The studies were divided into 2 categories: a first group in which a comparison was made between the performance of AI and the performance of physicians and a second group comparing the performance of physicians with and physicians without AI aid. Seven studies reported a comparable or superior fracture detection performance for AI compared to physicians, including radiologists. One study established a comparable performance on the internal test. On the external test, a lower AI performance was found compared to physicians. The second group of 6 studies reported a positive effect on the fracture detection performance of physicians when aided by AI. The current AI algorithms have a fracture detection performance comparable with physicians. At present, AI can be used as an aid in fracture detection. The potential impact of AI as an aid is greater with regard to less experienced doctors. The biggest hurdle of the current AI algorithms is the lack of large quantities of high-quality training data. Prospective studies, as well as further development and training of detection algorithms are needed in the future, in addition to larger datasets.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"277 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139228870","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}
A comprehensive geriatric assessment for elderly cancer patients: who, what and why? Advanced age is often accompanied by the development of a certain level of frailty. This can pose important challenges to the treatment of older patients with cancer. In this regard, a comprehensive geriatric assessment (CGA) allows physicians to sketch a clear picture of the functional, cognitive and social situation of an individual patient. This article provides an overview of the essential elements of a CGA and discusses the screening tools that facilitate the selection of patients for whom a CGA truly has added value. An overview of clinical trials evaluating the impact of a CGA-based treatment strategy in the management of elderly cancer patients is also provided. A CGA allows physicians to assess whether a patient has sufficient functional reserve to undergo a specific anticancer therapy. Based on a CGA, the anticancer treatment can be tailored to the individual needs and capabilities of a given patient. Furthermore, targeted, non-oncological interventions can be deployed to optimize one’s functional, cognitive and social status. Clinical studies evaluating such a CGA-based treatment strategy in older cancer patients indicate a lower incidence of high-grade toxicity and a better quality of life, without a detrimental impact on the survival rate. There is a broad consensus on the added value of a CGA-based treatment strategy in older cancer patients. However, the implementation of such a dedicated oncogeriatric management into the daily clinical practice of busy clinics can be challenging. In this regard, a close collaboration between oncologists and geriatric specialists proves to be essential.
{"title":"Een geriatrisch assessment voor oudere kankerpatiënten: wie, wat en waarom?","authors":"J. Delaere, B. Vandervennet","doi":"10.47671/tvg.79.23.113","DOIUrl":"https://doi.org/10.47671/tvg.79.23.113","url":null,"abstract":"A comprehensive geriatric assessment for elderly cancer patients: who, what and why? Advanced age is often accompanied by the development of a certain level of frailty. This can pose important challenges to the treatment of older patients with cancer. In this regard, a comprehensive geriatric assessment (CGA) allows physicians to sketch a clear picture of the functional, cognitive and social situation of an individual patient. This article provides an overview of the essential elements of a CGA and discusses the screening tools that facilitate the selection of patients for whom a CGA truly has added value. An overview of clinical trials evaluating the impact of a CGA-based treatment strategy in the management of elderly cancer patients is also provided. A CGA allows physicians to assess whether a patient has sufficient functional reserve to undergo a specific anticancer therapy. Based on a CGA, the anticancer treatment can be tailored to the individual needs and capabilities of a given patient. Furthermore, targeted, non-oncological interventions can be deployed to optimize one’s functional, cognitive and social status. Clinical studies evaluating such a CGA-based treatment strategy in older cancer patients indicate a lower incidence of high-grade toxicity and a better quality of life, without a detrimental impact on the survival rate. There is a broad consensus on the added value of a CGA-based treatment strategy in older cancer patients. However, the implementation of such a dedicated oncogeriatric management into the daily clinical practice of busy clinics can be challenging. In this regard, a close collaboration between oncologists and geriatric specialists proves to be essential.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139245848","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":"Uit de oude doos: Praatjes in de wind - april 1947","authors":"B. Vandekerkhove","doi":"10.47671/tvg.77.21.164","DOIUrl":"https://doi.org/10.47671/tvg.77.21.164","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139250270","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}
D. Verstegen, I. Malfait, M. Moyaert, M. Bultheel, K. Vermeersch, K. Peers
Tingling and decreased strength in the right hand of a 23-year-old man: differential diagnosis The medical history of a 23-year-old man with loss of strength and tingling in the right hand is described. The patient presented to the physical medicine consultation with decreased strength at extension and spread position of digit 4 and 5 and at dorsiflexion of the right wrist, as well as impaired fine motor skills. This arose for no apparent reason and progressively increased over the last 2 months. The electromyographic examination and ultrasound of the n. ulnaris were abnormal. Despite treatment (conservative and surgical), there was no improvement. Later, following an epileptic seizure, the diagnosis of a tumoral process in the brain was made. N. ulnar neuropathy of the elbow is the second most common pressure neuropathy in the upper limb, after the carpal tunnel syndrome. Over its course, the n. ulnaris can be affected at different localisations, the most common ones being the elbow (cubital tunnel) and the wrist (Guyon’s canal). The treatment is primarily conservative and, in case of insufficient improvement, surgical. During the diagnostic process, it is important to establish a good differential diagnosis. This requires a thorough history, a rigorous clinical examination and additional technical examinations if necessary. Good clinical reasoning taking into account the possible pathologies of the peripheral and central nervous system is paramount. If there is no evolution as to be expected with a given therapy, the tentative diagnosis should be reconsidered.
{"title":"Tintelingen en krachtsverlies in de rechterhand bij een 23-jarige man: differentiaaldiagnose","authors":"D. Verstegen, I. Malfait, M. Moyaert, M. Bultheel, K. Vermeersch, K. Peers","doi":"10.47671/tvg.79.23.107","DOIUrl":"https://doi.org/10.47671/tvg.79.23.107","url":null,"abstract":"Tingling and decreased strength in the right hand of a 23-year-old man: differential diagnosis The medical history of a 23-year-old man with loss of strength and tingling in the right hand is described. The patient presented to the physical medicine consultation with decreased strength at extension and spread position of digit 4 and 5 and at dorsiflexion of the right wrist, as well as impaired fine motor skills. This arose for no apparent reason and progressively increased over the last 2 months. The electromyographic examination and ultrasound of the n. ulnaris were abnormal. Despite treatment (conservative and surgical), there was no improvement. Later, following an epileptic seizure, the diagnosis of a tumoral process in the brain was made. N. ulnar neuropathy of the elbow is the second most common pressure neuropathy in the upper limb, after the carpal tunnel syndrome. Over its course, the n. ulnaris can be affected at different localisations, the most common ones being the elbow (cubital tunnel) and the wrist (Guyon’s canal). The treatment is primarily conservative and, in case of insufficient improvement, surgical. During the diagnostic process, it is important to establish a good differential diagnosis. This requires a thorough history, a rigorous clinical examination and additional technical examinations if necessary. Good clinical reasoning taking into account the possible pathologies of the peripheral and central nervous system is paramount. If there is no evolution as to be expected with a given therapy, the tentative diagnosis should be reconsidered.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"35 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139252590","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}
Two patients with toxic hepatitis after tea ingestion Drug-induced liver injury (DILI) is common and can manifest in various degrees: from asymptomatic increased transaminases to hepatocellular jaundice with an elevated total and direct bilirubin to acute liver failure. When accompanied by jaundice, there is a mortality rate of 10%. In acute liver failure, referral to a tertiary centre is necessary. This article emphasizes the consideration of herbal and dietary supplements (HDS). The use of HDS in Europe and the US is rising. Some studies state that 1 out of 3 to 1 out of 2 Americans take dietary supplements, which raises concerns about HDS-related toxic hepatitis. HDS involve any supplement that could cause liver damage, including herbs, vitamins, minerals, amino acids and proteins. The prevalence of hepatotoxicity is underestimated. DILI is a diagnosis of exclusion. Diseases that should be excluded, are viral hepatitis, non-alcoholic steatohepatitis (NASH), alcoholic steatohepatitis (ASH), hereditary hemochromatosis, autoimmune hepatitis, Wilson’s disease and alpha-1 antitrypsin deficiency. If there is an increased total and direct bilirubin with or without cholestasis, bile duct stones and hepatobiliary malignancies should be excluded. A liver biopsy may be necessary if the diagnosis is unclear or when several diagnoses are plausible. Liver damage usually occurs within 1 to 6 months after starting the product and is usually reversible. It is important to bear in mind HDS when considering DILI as the incidence of HDS is clearly increasing.
{"title":"Twee patiënten met acute toxische hepatitis na recente inname van thee","authors":"P. Deyaert, E. Colpaert, A. Pieters, A. Vonck","doi":"10.47671/tvg.79.23.074","DOIUrl":"https://doi.org/10.47671/tvg.79.23.074","url":null,"abstract":"Two patients with toxic hepatitis after tea ingestion Drug-induced liver injury (DILI) is common and can manifest in various degrees: from asymptomatic increased transaminases to hepatocellular jaundice with an elevated total and direct bilirubin to acute liver failure. When accompanied by jaundice, there is a mortality rate of 10%. In acute liver failure, referral to a tertiary centre is necessary. This article emphasizes the consideration of herbal and dietary supplements (HDS). The use of HDS in Europe and the US is rising. Some studies state that 1 out of 3 to 1 out of 2 Americans take dietary supplements, which raises concerns about HDS-related toxic hepatitis. HDS involve any supplement that could cause liver damage, including herbs, vitamins, minerals, amino acids and proteins. The prevalence of hepatotoxicity is underestimated. DILI is a diagnosis of exclusion. Diseases that should be excluded, are viral hepatitis, non-alcoholic steatohepatitis (NASH), alcoholic steatohepatitis (ASH), hereditary hemochromatosis, autoimmune hepatitis, Wilson’s disease and alpha-1 antitrypsin deficiency. If there is an increased total and direct bilirubin with or without cholestasis, bile duct stones and hepatobiliary malignancies should be excluded. A liver biopsy may be necessary if the diagnosis is unclear or when several diagnoses are plausible. Liver damage usually occurs within 1 to 6 months after starting the product and is usually reversible. It is important to bear in mind HDS when considering DILI as the incidence of HDS is clearly increasing.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957351","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}
Patient-reported care for the greater trochanteric pain syndrome The greater trochanteric pain syndrome (GTPS) is a condition that mostly affects middle-aged women. At the University Hospitals Leuven (Belgium), many patients consult a physician for this problem. This retrospective cohort study evaluated the technical investigations and treatment options women with GTPS went through before presenting to a university hospital. Despite the fact that GTPS is described as a clinical diagnosis, most patients already underwent technical investigations. In literature, an MRI of the pelvis is often considered the gold standard for the differential diagnosis, but only a minority already got one. The most performed technical investigation was a hip radiography, followed by an ultrasound of the hip. Less than half of the patient population reported they already had physiotherapy with an active exercise program. About 25% received a corticosteroid injection. Both the proposed diagnostic examinations and treatment options for GTPS seem to differentiate among caregivers. This type of descriptive study makes them reflect critically about the care provided.
{"title":"Patiëntgerapporteerde zorgverlening voor het grote-trochanterpijnsyndroom","authors":"J. Croes, F.-R. Dusar, S. Bogaerts","doi":"10.47671/tvg.79.23.077","DOIUrl":"https://doi.org/10.47671/tvg.79.23.077","url":null,"abstract":"Patient-reported care for the greater trochanteric pain syndrome The greater trochanteric pain syndrome (GTPS) is a condition that mostly affects middle-aged women. At the University Hospitals Leuven (Belgium), many patients consult a physician for this problem. This retrospective cohort study evaluated the technical investigations and treatment options women with GTPS went through before presenting to a university hospital. Despite the fact that GTPS is described as a clinical diagnosis, most patients already underwent technical investigations. In literature, an MRI of the pelvis is often considered the gold standard for the differential diagnosis, but only a minority already got one. The most performed technical investigation was a hip radiography, followed by an ultrasound of the hip. Less than half of the patient population reported they already had physiotherapy with an active exercise program. About 25% received a corticosteroid injection. Both the proposed diagnostic examinations and treatment options for GTPS seem to differentiate among caregivers. This type of descriptive study makes them reflect critically about the care provided.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"4 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136348014","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. Hellebaut, F. Vanden Meerschaut, F. Vandekerckhove, Y. Jacquemyn, C. De Bruyn, A. Van Hoyweghen, S. Van den Broeck, A. Dierick, A. Vermandel, H. Neels, A. Verest, D. De Neubourg, J. Illegems, N. Komen, N. Jacquemyn, O. Zemtsova, R. Verhofstede, A.-S. Page, J. Van De Walle, S. De Smedt, S. Vandamme, N. Willers, S. Han, C. Ghysbrecht, F. Claerhout, M. Boogaerts, H. Joos, K. Wuyts
{"title":"E-book: Gynaecologie - Uitgave 2023","authors":"S. Hellebaut, F. Vanden Meerschaut, F. Vandekerckhove, Y. Jacquemyn, C. De Bruyn, A. Van Hoyweghen, S. Van den Broeck, A. Dierick, A. Vermandel, H. Neels, A. Verest, D. De Neubourg, J. Illegems, N. Komen, N. Jacquemyn, O. Zemtsova, R. Verhofstede, A.-S. Page, J. Van De Walle, S. De Smedt, S. Vandamme, N. Willers, S. Han, C. Ghysbrecht, F. Claerhout, M. Boogaerts, H. Joos, K. Wuyts","doi":"10.47671/tvg.79.23.e019","DOIUrl":"https://doi.org/10.47671/tvg.79.23.e019","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":" 37","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135292122","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. Beck, E. Ali, L. Wauters, K. Bronselaer, S. Verelst
Telephone triage by the 112 emergency center versus physical triage at the emergency department: a comparison Operators of the 112 emergency center (EC 112) use medical protocols to convert a request for help into a severity level and thus a specific resource. At the emergency department (ED), a physical triage is performed by the triage nurse. The primary goal was to compare the severity level assigned by EC 112 with the ED triage score. The secondary goal was to compare the activated medical protocol by EC 112 with the main complaint registered by the triage nurse. A retrospective cohort study was performed with data collected from the database of the EC 112 Flemish Brabant (Belgium) of all adult patients (≥ 18 years) referred to the ED of the University Hospital Leuven via the mobile urgency group (MUG), the paramedical intervention team (PIT) or the ambulance in 2019. A matched severity level determined by EC 112 was compared to an a priori matched emergency triage score. For the 5,519 included patients, the severity level assigned by EC 112 for the MUG, PIT and ambulance corresponded in respectively 91.5%, 86.7% and 53.9% of the cases with the severity level according to the ED triage score. For the MUG, PIT and ambulance, the activated medical protocol corresponded in respectively 60.9%, 62.1% and 58.8% of the cases with the main complaint registered by the triage nurse. This study showed a high degree of correspondence between the resources MUG and PIT sent out by the operators of EC 112 and the ED triage score. A higher PIT deployment may lead to time and efficiency gains.
{"title":"Telefonische triage door de Noodcentrale 112 versus fysieke triage op de spoedgevallendienst: een vergelijking","authors":"S. Beck, E. Ali, L. Wauters, K. Bronselaer, S. Verelst","doi":"10.47671/tvg.79.23.072","DOIUrl":"https://doi.org/10.47671/tvg.79.23.072","url":null,"abstract":"Telephone triage by the 112 emergency center versus physical triage at the emergency department: a comparison Operators of the 112 emergency center (EC 112) use medical protocols to convert a request for help into a severity level and thus a specific resource. At the emergency department (ED), a physical triage is performed by the triage nurse. The primary goal was to compare the severity level assigned by EC 112 with the ED triage score. The secondary goal was to compare the activated medical protocol by EC 112 with the main complaint registered by the triage nurse. A retrospective cohort study was performed with data collected from the database of the EC 112 Flemish Brabant (Belgium) of all adult patients (≥ 18 years) referred to the ED of the University Hospital Leuven via the mobile urgency group (MUG), the paramedical intervention team (PIT) or the ambulance in 2019. A matched severity level determined by EC 112 was compared to an a priori matched emergency triage score. For the 5,519 included patients, the severity level assigned by EC 112 for the MUG, PIT and ambulance corresponded in respectively 91.5%, 86.7% and 53.9% of the cases with the severity level according to the ED triage score. For the MUG, PIT and ambulance, the activated medical protocol corresponded in respectively 60.9%, 62.1% and 58.8% of the cases with the main complaint registered by the triage nurse. This study showed a high degree of correspondence between the resources MUG and PIT sent out by the operators of EC 112 and the ED triage score. A higher PIT deployment may lead to time and efficiency gains.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":" 18","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135242042","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}
K. Devloo, J. Toelen, C. Cassiman, M. Danckaerts, E. Van Roie
Looking ahead: case report of functional oscillopsia in an adolescent A conversion disorder or functional neurological disorder (FND) is a rare condition with disturbances in voluntary body functions, sensory or motor, unexplained by any known somatic condition. This case report describes intermittent horizontal oscillopsia with normal neuro-ophthalmic findings in a 14-year-old girl. ‘Oscillopsia’ refers to the perception of unstable vision, i.e. an oscillating image. This is usually caused by a newly acquired eye movement disorder type nystagmus, ocular flutter or myokymia. Clinical examination showed positive symptoms of a conversion disorder. During a pediatric admission with multidisciplinary assessment, the diagnosis of FND was made. A multidisciplinary treatment plan was established, starting with psychoeducation about the diagnosis to arrive at a shared perspective of disease theory. This article aims to demonstrate the need for multidisciplinary collaboration in the diagnostic phase of particular symptom presentations with attention to a functional mechanism. This approach contributes to a more rapid and integrated conclusion and reduces the likelihood of an exclusionary diagnosis. The authors provide some examples for communicating with patients, as this is crucial to achieve shared meaning.
{"title":"Een blik vooruit: casusbespreking van functionele oscillopsie bij een adolescente","authors":"K. Devloo, J. Toelen, C. Cassiman, M. Danckaerts, E. Van Roie","doi":"10.47671/tvg.79.23.099","DOIUrl":"https://doi.org/10.47671/tvg.79.23.099","url":null,"abstract":"Looking ahead: case report of functional oscillopsia in an adolescent A conversion disorder or functional neurological disorder (FND) is a rare condition with disturbances in voluntary body functions, sensory or motor, unexplained by any known somatic condition. This case report describes intermittent horizontal oscillopsia with normal neuro-ophthalmic findings in a 14-year-old girl. ‘Oscillopsia’ refers to the perception of unstable vision, i.e. an oscillating image. This is usually caused by a newly acquired eye movement disorder type nystagmus, ocular flutter or myokymia. Clinical examination showed positive symptoms of a conversion disorder. During a pediatric admission with multidisciplinary assessment, the diagnosis of FND was made. A multidisciplinary treatment plan was established, starting with psychoeducation about the diagnosis to arrive at a shared perspective of disease theory. This article aims to demonstrate the need for multidisciplinary collaboration in the diagnostic phase of particular symptom presentations with attention to a functional mechanism. This approach contributes to a more rapid and integrated conclusion and reduces the likelihood of an exclusionary diagnosis. The authors provide some examples for communicating with patients, as this is crucial to achieve shared meaning.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"11 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135431524","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}
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