{"title":"De huid: een orgaan met eigen ziekten, maar ook een spiegel van interne pathologie","authors":"J. Gutermuth","doi":"10.47671/tvg.79.23.109","DOIUrl":"https://doi.org/10.47671/tvg.79.23.109","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"407 17","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135112211","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":"Blauwlichtfilters in brillen hebben geen aantoonbaar effect","authors":"M. Finoulst, P. Vankrunkelsven","doi":"10.47671/tvg.79.23.112","DOIUrl":"https://doi.org/10.47671/tvg.79.23.112","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"2022 32","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135768662","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 november 2023","authors":"","doi":"10.47671/tvg.79.23.111","DOIUrl":"https://doi.org/10.47671/tvg.79.23.111","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"84 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136018880","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}
Rituximab for autoimmune bullous diseases For a long time, the treatment of autoimmune blistering diseases consisted of classical immunosuppressants. Recently, biologicals, including rituximab, directed against the pan B-cell marker CD20, are used. Currently, practical guidelines for the optimal use of rituximab in the treatment of autoimmune blistering diseases are still under discussion. This literature review provides an overview of the efficacy, side effects, indication, optimal dosage and administration interval of rituximab in this population. In total, 37 publications were included, based on a systematic search strategy and selection procedure. The reported efficacy of rituximab in pemphigoid, expressed as complete remission without further therapy, ranges from 20% to 79%. For pemphigus, this amounts to 89% in the RITUX-3 study, which formed the basis for approval as first-line therapy. Side effects occur in 24% to 85% of the cases. The most important are infusion-related reactions and infections. In general, the safety profile corresponds to the known side effects of rituximab in other indications. The evidence for the practical guidelines is mainly built around pemphigus. Currently, the ‘high-dose rheumatoid arthritis protocol’ is preferred, although randomised, comparative studies are lacking. The high relapse rate justifies the need for repeated administrations. Further research should clarify whether repeated administration should be done systematically or based on different parameters. Rituximab is an effective and relatively safe therapy in autoimmune blistering diseases in both first and second line. In terms of practical use, further research is recommended.
{"title":"Rituximab bij auto-immune blaarziekten","authors":"A. Lambert, T. Hillary, P. De Haes","doi":"10.47671/tvg.79.23.083","DOIUrl":"https://doi.org/10.47671/tvg.79.23.083","url":null,"abstract":"Rituximab for autoimmune bullous diseases For a long time, the treatment of autoimmune blistering diseases consisted of classical immunosuppressants. Recently, biologicals, including rituximab, directed against the pan B-cell marker CD20, are used. Currently, practical guidelines for the optimal use of rituximab in the treatment of autoimmune blistering diseases are still under discussion. This literature review provides an overview of the efficacy, side effects, indication, optimal dosage and administration interval of rituximab in this population. In total, 37 publications were included, based on a systematic search strategy and selection procedure. The reported efficacy of rituximab in pemphigoid, expressed as complete remission without further therapy, ranges from 20% to 79%. For pemphigus, this amounts to 89% in the RITUX-3 study, which formed the basis for approval as first-line therapy. Side effects occur in 24% to 85% of the cases. The most important are infusion-related reactions and infections. In general, the safety profile corresponds to the known side effects of rituximab in other indications. The evidence for the practical guidelines is mainly built around pemphigus. Currently, the ‘high-dose rheumatoid arthritis protocol’ is preferred, although randomised, comparative studies are lacking. The high relapse rate justifies the need for repeated administrations. Further research should clarify whether repeated administration should be done systematically or based on different parameters. Rituximab is an effective and relatively safe therapy in autoimmune blistering diseases in both first and second line. In terms of practical use, further research is recommended.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"20 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136376276","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. Vertommen, L. Janssen, S. Van Ierssel, E. Vlieghe
Mycotic thoracic aortic aneurysm caused by Listeria monocytogenes An 85-year-old male patient with hoarseness and constitutional symptoms was diagnosed with Listeria monocytogenes aortitis. Given his comorbidities and age, open surgery was not indicated. A thoracic endovascular aortic repair (TEVAR) was chosen and oral antibiotics were given for 6 months after the intervention, with the goal of lifelong suppressive therapy to prevent a flare-up. The patient died 59 months later of an unrelated cause. Listeria monocytogenes is a rare cause of thoracic aortic aneurysm. Open surgical treatment is considered the golden standard for mycotic aortic aneurysms (MAAs). If open surgical repair is not feasible (because of comorbidities), an endovascular approach can be considered. Since no large trials and high-quality data on long-term outcomes are available, the use of endovascular techniques is limited to patients with a lot of comorbidities (where it is considered a palliative intervention) or as a bridge to definitive open surgery. Survival on both short and middle-long term is better with an endovascular aneurysm repair (EVAR) compared to open surgery. However, more infectious complications are seen with EVAR, which have a high mortality rate. When treated with an endovascular technique, the best results are seen in patients presenting without rupture, who are afebrile at the time of surgery and who are on antibiotics 3-7 days prior to and minimal 6 months after the intervention. There is no consensus on the ideal duration of the antibiotic treatment, but a minimum of 6 months improves the survival significantly. Nevertheless, it remains important to adjust the therapy to each individual patient.
{"title":"Een mycotisch thoracaal aorta-aneurysma veroorzaakt door Listeria monocytogenes","authors":"S. Vertommen, L. Janssen, S. Van Ierssel, E. Vlieghe","doi":"10.47671/tvg.79.23.068","DOIUrl":"https://doi.org/10.47671/tvg.79.23.068","url":null,"abstract":"Mycotic thoracic aortic aneurysm caused by Listeria monocytogenes An 85-year-old male patient with hoarseness and constitutional symptoms was diagnosed with Listeria monocytogenes aortitis. Given his comorbidities and age, open surgery was not indicated. A thoracic endovascular aortic repair (TEVAR) was chosen and oral antibiotics were given for 6 months after the intervention, with the goal of lifelong suppressive therapy to prevent a flare-up. The patient died 59 months later of an unrelated cause. Listeria monocytogenes is a rare cause of thoracic aortic aneurysm. Open surgical treatment is considered the golden standard for mycotic aortic aneurysms (MAAs). If open surgical repair is not feasible (because of comorbidities), an endovascular approach can be considered. Since no large trials and high-quality data on long-term outcomes are available, the use of endovascular techniques is limited to patients with a lot of comorbidities (where it is considered a palliative intervention) or as a bridge to definitive open surgery. Survival on both short and middle-long term is better with an endovascular aneurysm repair (EVAR) compared to open surgery. However, more infectious complications are seen with EVAR, which have a high mortality rate. When treated with an endovascular technique, the best results are seen in patients presenting without rupture, who are afebrile at the time of surgery and who are on antibiotics 3-7 days prior to and minimal 6 months after the intervention. There is no consensus on the ideal duration of the antibiotic treatment, but a minimum of 6 months improves the survival significantly. Nevertheless, it remains important to adjust the therapy to each individual patient.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"45 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135368180","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.A.C. Van Averbeke, G. Leemans, V. Beckers, M. Grosber
Non-healing skin lesions in the right mammary region Although almost all dermatological conditions are visible, some patients wait a long time to consult a dermatologist. Nevertheless, an early diagnosis is important for the treatment and prognosis in case of cutaneous cancers. A 39-year-old man with skin lesions on his right chest, present for 3 years and slowly growing over time, consulted the dermatologist. The anatomopathological examination showed a diffuse-type primary cutaneous follicular B-cell non-Hodgkin lymphoma. Staging revealed a primary cutaneous lymphoma. After deliberation in a multidisciplinary oncologic consultation, radiotherapy was started. Cutaneous lymphomas are often difficult to diagnose because of their non-specific and variable clinical presentation. Skin biopsies should be performed when patients present with atypical cutaneous lesions. In case of cutaneous B-cell lymphomas, early diagnosis is important to detect and treat an underlying systemic or aggressive B-cell lymphoma. A multidisciplinary management team including dermatologists, pathologists, hematologists and radiation oncologists is necessary.
{"title":"Niet-genezende huidletsels van de borst","authors":"A.A.C. Van Averbeke, G. Leemans, V. Beckers, M. Grosber","doi":"10.47671/tvg.79.23.052","DOIUrl":"https://doi.org/10.47671/tvg.79.23.052","url":null,"abstract":"Non-healing skin lesions in the right mammary region Although almost all dermatological conditions are visible, some patients wait a long time to consult a dermatologist. Nevertheless, an early diagnosis is important for the treatment and prognosis in case of cutaneous cancers. A 39-year-old man with skin lesions on his right chest, present for 3 years and slowly growing over time, consulted the dermatologist. The anatomopathological examination showed a diffuse-type primary cutaneous follicular B-cell non-Hodgkin lymphoma. Staging revealed a primary cutaneous lymphoma. After deliberation in a multidisciplinary oncologic consultation, radiotherapy was started. Cutaneous lymphomas are often difficult to diagnose because of their non-specific and variable clinical presentation. Skin biopsies should be performed when patients present with atypical cutaneous lesions. In case of cutaneous B-cell lymphomas, early diagnosis is important to detect and treat an underlying systemic or aggressive B-cell lymphoma. A multidisciplinary management team including dermatologists, pathologists, hematologists and radiation oncologists is necessary.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"100 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135513762","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 - maart 1947","authors":"B. Vandekerkhove","doi":"10.47671/tvg.77.21.153","DOIUrl":"https://doi.org/10.47671/tvg.77.21.153","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135729741","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}
Retinal detachment in the perspective of insurance medicine The purpose of this guideline is to support the insurance medical advisor in the check-up and guidance towards the return to work of patients suffering from retinal detachment. This guideline, based on the current state of science, may help the medical advisor to anticipate on a possibly delayed or prolonged recovery and to promote timely reintegration. A flowchart was designed to support the evaluation process by recognizing alarm signals for a delayed recovery.
{"title":"De retinaloslating in verzekeringsgeneeskundig perspectief","authors":"L. Wellens, M. Du Bois","doi":"10.47671/tvg.79.23.061","DOIUrl":"https://doi.org/10.47671/tvg.79.23.061","url":null,"abstract":"Retinal detachment in the perspective of insurance medicine The purpose of this guideline is to support the insurance medical advisor in the check-up and guidance towards the return to work of patients suffering from retinal detachment. This guideline, based on the current state of science, may help the medical advisor to anticipate on a possibly delayed or prolonged recovery and to promote timely reintegration. A flowchart was designed to support the evaluation process by recognizing alarm signals for a delayed recovery.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135995213","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}
L. Daniels, T. Vandersteegen, W. Marneffe, N. Braeckman, E. Dejans, A. Van Tongel, K. Ponnet, N. De Baets, L. De Wilde, L. Ravez, Z. Claesen, A. Ravelingien, K. Solhdju, P. Borry, J. De Lepeleire, J. Lisaerde, C. Tobback, I. Verhaeverbeke, G. Ghijsebrechts, K. Herweyers, I. Pattyn, N. Van den Noortgate, L. Moureau, A. Tansens, L. Desimpele, T. Verdée, M. De Hert, S. Loos, K. Van Assche, P. De Mulder, P. Desmet, M. Bollaert, S. Desnouck, B. Verbrugghe, L. Harlet, P. Pattyn
{"title":"E-book: Ethiek en gezondheidsrecht - Uitgave 2023","authors":"L. Daniels, T. Vandersteegen, W. Marneffe, N. Braeckman, E. Dejans, A. Van Tongel, K. Ponnet, N. De Baets, L. De Wilde, L. Ravez, Z. Claesen, A. Ravelingien, K. Solhdju, P. Borry, J. De Lepeleire, J. Lisaerde, C. Tobback, I. Verhaeverbeke, G. Ghijsebrechts, K. Herweyers, I. Pattyn, N. Van den Noortgate, L. Moureau, A. Tansens, L. Desimpele, T. Verdée, M. De Hert, S. Loos, K. Van Assche, P. De Mulder, P. Desmet, M. Bollaert, S. Desnouck, B. Verbrugghe, L. Harlet, P. Pattyn","doi":"10.47671/tvg.79.23.e018","DOIUrl":"https://doi.org/10.47671/tvg.79.23.e018","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135854973","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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