E. Vanbelleghem, J. Werbrouck, S. Verstraete, L. Libbrecht, F. D’heygere, B. Heymans, W. Meersseman, K. Timmermans, M. Nachtergaele, C. Vanfraechem, A.-M. Bogaert, M. Vermandere, D. Verstegen, D. De Wulf, J. Dewyspelaere, N. Van Moorter, J. Jaekers, E. André, A. Wilmer, L.J.M. Heyens, J. Bauer, G.H. Koek, M. Finoulst, P. Vankrunkelsven, E. Van Cutsem
{"title":"E-book: Gastro-enterologie - Uitgave 2023","authors":"E. Vanbelleghem, J. Werbrouck, S. Verstraete, L. Libbrecht, F. D’heygere, B. Heymans, W. Meersseman, K. Timmermans, M. Nachtergaele, C. Vanfraechem, A.-M. Bogaert, M. Vermandere, D. Verstegen, D. De Wulf, J. Dewyspelaere, N. Van Moorter, J. Jaekers, E. André, A. Wilmer, L.J.M. Heyens, J. Bauer, G.H. Koek, M. Finoulst, P. Vankrunkelsven, E. Van Cutsem","doi":"10.47671/tvg.79.23.e017","DOIUrl":"https://doi.org/10.47671/tvg.79.23.e017","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136235181","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 - februari 1947","authors":"B. Vandekerkhove","doi":"10.47671/tvg.77.21.134","DOIUrl":"https://doi.org/10.47671/tvg.77.21.134","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135015065","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}
Pott’s disease: rare but not extinct In a 78-year-old woman with a history of colon diverticulitis, an incidental finding of spondylodiscitis T12-L2 was found on the CT scan to evaluate the diverticulitis. The finding was confirmed on an MRI, showing multifocal involvement of T12-L2 and the intervertebral discs with alongside an intraspinal abscess collection and a psoas abscess. Further investigations (hemocultures and cultures of the abscess) remained negative. Empirical antibiotic therapy was initiated with intravenous ceftriaxone and metronidazole for 6 weeks. The patient was discharged after the antibiotic treatment. One week later, the patient presented at the emergency department due to abnormal liver function values. Because of the multifocal lytic lesions, she received a pedicle screw fixation T11-L2 with a biopsy of L2 at the same time. The biopsy sample showed a positive PCR for Mycobacterium tuberculosis. The patient was diagnosed with tuberculous spondylitis. Multidrug anti-tubercular therapy was initiated with a 4-drug regimen (rifampicine, isoniazide, ethambutol and pyrazinamide).
{"title":"Ziekte van Pott: zeldzaam, maar niet uitgestorven","authors":"A. Bilge, B. Depreitere, F. Van Calenbergh","doi":"10.47671/tvg.79.23.059","DOIUrl":"https://doi.org/10.47671/tvg.79.23.059","url":null,"abstract":"Pott’s disease: rare but not extinct In a 78-year-old woman with a history of colon diverticulitis, an incidental finding of spondylodiscitis T12-L2 was found on the CT scan to evaluate the diverticulitis. The finding was confirmed on an MRI, showing multifocal involvement of T12-L2 and the intervertebral discs with alongside an intraspinal abscess collection and a psoas abscess. Further investigations (hemocultures and cultures of the abscess) remained negative. Empirical antibiotic therapy was initiated with intravenous ceftriaxone and metronidazole for 6 weeks. The patient was discharged after the antibiotic treatment. One week later, the patient presented at the emergency department due to abnormal liver function values. Because of the multifocal lytic lesions, she received a pedicle screw fixation T11-L2 with a biopsy of L2 at the same time. The biopsy sample showed a positive PCR for Mycobacterium tuberculosis. The patient was diagnosed with tuberculous spondylitis. Multidrug anti-tubercular therapy was initiated with a 4-drug regimen (rifampicine, isoniazide, ethambutol and pyrazinamide).","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135010758","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}
B. Janssens, C. Mathieu, J. Lambert, P. Meersseman
Diabetic ketoacidosis: still a life-threatening disease. This report details a rare occurrence of cerebral edema as a complication of diabetic ketoacidosis (DKA) in an 18-year old male. The patient presented with headache, and on further inquiry typical symptoms of DKA (polyuria, polydipsia and weight loss). During treatment his condition rapidly deteriorated resulting in neurological collapse and coma. A CT-scan revealed signs of cerebral edema. Although the exact pathophysiology is not fully understood, it is believed that both DKA-related (cytotoxic and vasogenic) and treatment-related factors play a role. Cerebral edema caused by DKA can be fatal, or result in persisting neurologic deficits. Proper use of intravenous (IV) resuscitation fluids and avoidance of IV bicarbonate and IV insulin bolus is necessary to avoid exacerbation of pre-existing cerebral edema, as described in this case report. Neurological monitoring, before and during treatment, is essential, as early detection and treatment of cerebral edema improves outcome. If clinical signs of cerebral edema, mannitol 20% or hypertonic salt IV should be administered immediately. This case emphasizes the importance of careful metabolic and neurological monitoring and adherence to appropriate treatment principles in DKA to reduce the risk of cerebral edema. Increasing awareness of this complication among healthcare providers can help intervene in a timely manner and improve outcome for the patient.
{"title":"Diabetische ketoacidose: nog steeds een levensbedreigende ziekte","authors":"B. Janssens, C. Mathieu, J. Lambert, P. Meersseman","doi":"10.47671/tvg.79.23.097","DOIUrl":"https://doi.org/10.47671/tvg.79.23.097","url":null,"abstract":"Diabetic ketoacidosis: still a life-threatening disease. This report details a rare occurrence of cerebral edema as a complication of diabetic ketoacidosis (DKA) in an 18-year old male. The patient presented with headache, and on further inquiry typical symptoms of DKA (polyuria, polydipsia and weight loss). During treatment his condition rapidly deteriorated resulting in neurological collapse and coma. A CT-scan revealed signs of cerebral edema. Although the exact pathophysiology is not fully understood, it is believed that both DKA-related (cytotoxic and vasogenic) and treatment-related factors play a role. Cerebral edema caused by DKA can be fatal, or result in persisting neurologic deficits. Proper use of intravenous (IV) resuscitation fluids and avoidance of IV bicarbonate and IV insulin bolus is necessary to avoid exacerbation of pre-existing cerebral edema, as described in this case report. Neurological monitoring, before and during treatment, is essential, as early detection and treatment of cerebral edema improves outcome. If clinical signs of cerebral edema, mannitol 20% or hypertonic salt IV should be administered immediately. This case emphasizes the importance of careful metabolic and neurological monitoring and adherence to appropriate treatment principles in DKA to reduce the risk of cerebral edema. Increasing awareness of this complication among healthcare providers can help intervene in a timely manner and improve outcome for the patient.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134912109","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. Vercauteren, H. Van Den Steene, W. Cools, E. Campforts
Waiting times at the outpatient clinic for child and adolescent psychiatry at the University Hospital of Brussels: which factors are related to waiting times and the risk of being admitted for diagnostics? Long waiting lists are a major problem in mental health care for minors. In Flanders (Belgium), concrete data about waiting lists are limited. Gaining more insight into this problem and exploring possibilities to reduce waiting times are essential. This exploratory study of a retrospective cohort mapped the waiting times and population characteristics of all registered patients in the period of May 1, 2020 to April 30, 2021 who were placed on the waiting list for intake at the outpatient clinic for child and adolescent psychiatry of the University Hospital of Brussels. A logistic regression analysis was conducted to determine factors associated with the likelihood of rejection. Based on the data, a template for an online questionnaire was developed to help identify patients at high risk of being rejected more quickly. Half of the 382 registered patients moved on for further assessment. The median waiting time until intake was 17 weeks. The likelihood of being rejected increased as the parents’ total Strengths and Difficulties Questionnaire (SDQ) score decreased and with current involvement of psychological/psychiatric services. This study confirms the long waiting time for ambulatory multidisciplinary child psychiatric assessment within a university hospital. A significant proportion of the patients does not proceed for further assessment, which makes fast identification of these patients important. A proposal for an online questionnaire was developed for this purpose. Patients with an increased risk of rejection can be screened in the short term. Follow-up research with practical implementation and evaluation of the impact on waiting times is necessary.
{"title":"Wachttijden op de polikliniek kinder- en jeugdpsychiatrie van het UZ Brussel: hoe sneller patiënten identificeren die minder kans hebben op doorstromen naar diagnostisch onderzoek?","authors":"S. Vercauteren, H. Van Den Steene, W. Cools, E. Campforts","doi":"10.47671/tvg.79.23.027","DOIUrl":"https://doi.org/10.47671/tvg.79.23.027","url":null,"abstract":"Waiting times at the outpatient clinic for child and adolescent psychiatry at the University Hospital of Brussels: which factors are related to waiting times and the risk of being admitted for diagnostics? Long waiting lists are a major problem in mental health care for minors. In Flanders (Belgium), concrete data about waiting lists are limited. Gaining more insight into this problem and exploring possibilities to reduce waiting times are essential. This exploratory study of a retrospective cohort mapped the waiting times and population characteristics of all registered patients in the period of May 1, 2020 to April 30, 2021 who were placed on the waiting list for intake at the outpatient clinic for child and adolescent psychiatry of the University Hospital of Brussels. A logistic regression analysis was conducted to determine factors associated with the likelihood of rejection. Based on the data, a template for an online questionnaire was developed to help identify patients at high risk of being rejected more quickly. Half of the 382 registered patients moved on for further assessment. The median waiting time until intake was 17 weeks. The likelihood of being rejected increased as the parents’ total Strengths and Difficulties Questionnaire (SDQ) score decreased and with current involvement of psychological/psychiatric services. This study confirms the long waiting time for ambulatory multidisciplinary child psychiatric assessment within a university hospital. A significant proportion of the patients does not proceed for further assessment, which makes fast identification of these patients important. A proposal for an online questionnaire was developed for this purpose. Patients with an increased risk of rejection can be screened in the short term. Follow-up research with practical implementation and evaluation of the impact on waiting times is necessary.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913707","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}
N. De Munck, J. Sterckx, D. Brackman, E. Stoop, K. Wouters, H. Tournaye
Screening for Chlamydia trachomatis in allogeneic sperm donation: is it necessary to test every donation or is periodic screening sufficient? There are several guidelines regarding the screening of sperm donors. For hepatitis B and C and HIV, these guidelines are unambiguous, but the recommendations for Chlamydia trachomatis are, on the contrary, very heterogeneous. Until 30 June 2021, a 3-monthly screening for C. trachomatis was performed at Brussels IVF (Belgium) on all sperm donors. This periodic screening has been questioned given the theoretical risk for transmission in sperm donation. The researchers collected sperm donations before 30 June 2021, when urine was not tested for C. trachomatis at each donation. Of the 1,809 untested donations, 190 donations from 42 sperm donors were randomly selected. These 190 sperm donations were tested for C. trachomatis using a nucleic acid test (NAT). For the tested 190 sperm straws, no infection with C. trachomatis was detected after NAT. These results show that the initial method of periodic testing seems sufficiently safe and cost-efficient to exclude infections with C. trachomatis. Both post-hoc testing of untested straws as well as testing at each donation seem therefore unnecessary.
{"title":"Screening naar Chlamydia trachomatis bij allogene spermadonoren: is het noodzakelijk om elke donatie te testen of volstaan periodieke tests?","authors":"N. De Munck, J. Sterckx, D. Brackman, E. Stoop, K. Wouters, H. Tournaye","doi":"10.47671/tvg.79.23.035","DOIUrl":"https://doi.org/10.47671/tvg.79.23.035","url":null,"abstract":"Screening for Chlamydia trachomatis in allogeneic sperm donation: is it necessary to test every donation or is periodic screening sufficient? There are several guidelines regarding the screening of sperm donors. For hepatitis B and C and HIV, these guidelines are unambiguous, but the recommendations for Chlamydia trachomatis are, on the contrary, very heterogeneous. Until 30 June 2021, a 3-monthly screening for C. trachomatis was performed at Brussels IVF (Belgium) on all sperm donors. This periodic screening has been questioned given the theoretical risk for transmission in sperm donation. The researchers collected sperm donations before 30 June 2021, when urine was not tested for C. trachomatis at each donation. Of the 1,809 untested donations, 190 donations from 42 sperm donors were randomly selected. These 190 sperm donations were tested for C. trachomatis using a nucleic acid test (NAT). For the tested 190 sperm straws, no infection with C. trachomatis was detected after NAT. These results show that the initial method of periodic testing seems sufficiently safe and cost-efficient to exclude infections with C. trachomatis. Both post-hoc testing of untested straws as well as testing at each donation seem therefore unnecessary.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135878603","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. Ravelingien, S. Desnouck, B. Verbrugghe, L. Harlet, P. Pattyn
Back to basics: information needs of patients after rectal surgery The past decades, there has been increased attention for the ‘educative attitude’ of caregivers. It appears to be quite a challenge to provide good education: many patients need support to understand, evaluate and apply relevant health information. Also, there is no ‘one size fits all’ method. In this qualitative research, the authors investigated what patients experienced as useful or obstructive in the education they were provided with during a complex care path. As a pilot study, they focused on oncological patients who had received rectal surgery. This subpopulation was chosen because of the many education moments and methods they had been confronted with. The authors conducted semi-structured interviews with oncological patients (n = 8) who had undergone (ultra)low anterior resection surgery in the general hospital AZ Delta in Roeselare (Belgium) from February 2020 to May 2022. The interviews focused on their patient information journeys. The information preferences and needs were very diverse. Some respondents wanted very detailed information, while others put faith in the doctor. Nonetheless, these interviews drew attention to the importance of personal relationships with the caregiver(s) and the use of basic education methods: verbal explanations and clarifications through images and the show-me method. Many forms of innovative formats are now available to make sure that patients receive all appropriate information in an accessible manner. While these efforts are crucial and appreciated, this research complements other studies that re-emphasize the importance of some ‘basics’ in communication, as well as the quality of the patient-provider relationship.
{"title":"Back to basics: informatienoden van zorgvragers na endeldarmchirurgie","authors":"A. Ravelingien, S. Desnouck, B. Verbrugghe, L. Harlet, P. Pattyn","doi":"10.47671/tvg.79.23.089","DOIUrl":"https://doi.org/10.47671/tvg.79.23.089","url":null,"abstract":"Back to basics: information needs of patients after rectal surgery The past decades, there has been increased attention for the ‘educative attitude’ of caregivers. It appears to be quite a challenge to provide good education: many patients need support to understand, evaluate and apply relevant health information. Also, there is no ‘one size fits all’ method. In this qualitative research, the authors investigated what patients experienced as useful or obstructive in the education they were provided with during a complex care path. As a pilot study, they focused on oncological patients who had received rectal surgery. This subpopulation was chosen because of the many education moments and methods they had been confronted with. The authors conducted semi-structured interviews with oncological patients (n = 8) who had undergone (ultra)low anterior resection surgery in the general hospital AZ Delta in Roeselare (Belgium) from February 2020 to May 2022. The interviews focused on their patient information journeys. The information preferences and needs were very diverse. Some respondents wanted very detailed information, while others put faith in the doctor. Nonetheless, these interviews drew attention to the importance of personal relationships with the caregiver(s) and the use of basic education methods: verbal explanations and clarifications through images and the show-me method. Many forms of innovative formats are now available to make sure that patients receive all appropriate information in an accessible manner. While these efforts are crucial and appreciated, this research complements other studies that re-emphasize the importance of some ‘basics’ in communication, as well as the quality of the patient-provider relationship.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135033631","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 augustus 2023","authors":"","doi":"10.47671/tvg.79.23.075","DOIUrl":"https://doi.org/10.47671/tvg.79.23.075","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135601762","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 juli 2023","authors":"","doi":"10.47671/tvg.79.23.063","DOIUrl":"https://doi.org/10.47671/tvg.79.23.063","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135967505","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":"Schisis in Vlaanderen","authors":"G. De Pauw","doi":"10.47671/tvg.79.23.022","DOIUrl":"https://doi.org/10.47671/tvg.79.23.022","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136161914","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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