C. De Bie, J. Tournoy, M. Van Wambeke, F. Couvreur, N. Fockaert, P. Matthyssen
Artery of Percheron infarction as an unusual cause of a reduced level of consciousness An acute onset of hemiparesis, aphasia or hemianopsia will promptly lead to the diagnosis of a stroke. However, a thalamic infarction does not always manifest with these classical symptoms due to its crucial role as a relay station between cortical brain structures, subcortical areas and the brainstem. The case of an 87-year-old woman with an altered state of consciousness due to bilateral thalamic ischemia as a result of an artery of Percheron infarction is reported. This case illustrates the clinical and diagnostic challenges in patients with an altered consciousness. The differential diagnosis is broad. One has to exclude a bilateral thalamic infarction since an early diagnosis of an ischemic stroke is crucial to initiate a proper treatment and thereby prevent morbidity and mortality.
{"title":"Cerebrale ischemie als oorzaak van verminderd bewustzijn: het Percheron-infarct","authors":"C. De Bie, J. Tournoy, M. Van Wambeke, F. Couvreur, N. Fockaert, P. Matthyssen","doi":"10.47671/tvg.80.24.052","DOIUrl":"https://doi.org/10.47671/tvg.80.24.052","url":null,"abstract":"Artery of Percheron infarction as an unusual cause of a reduced level of consciousness\u0000\u0000 \u0000\u0000An acute onset of hemiparesis, aphasia or hemianopsia will promptly lead to the diagnosis of a stroke. However, a thalamic infarction does not always manifest with these classical symptoms due to its crucial role as a relay station between cortical brain structures, subcortical areas and the brainstem.\u0000\u0000 \u0000\u0000The case of an 87-year-old woman with an altered state of consciousness due to bilateral thalamic ischemia as a result of an artery of Percheron infarction is reported. This case illustrates the clinical and diagnostic challenges in patients with an altered consciousness. The differential diagnosis is broad. One has to exclude a bilateral thalamic infarction since an early diagnosis of an ischemic stroke is crucial to initiate a proper treatment and thereby prevent morbidity and mortality.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810157","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}
J. Berwouts, C. Van haecht, R.-M. Ntahonganyira, J. Stokx, T. Pilate, V. Cossey, V. Saegeman, A. Schuermans, I. Verstreken, R. Reybrouck, L. Vander Elst, M. Verelst, J.-H. Keijzer, S. Mokrane, N. Dekker, M. Goossens, O. Vanderveken, A. De Sutter, R. Mehta, C. Ducène, A. Sousa, M. Boulad, P. Van Royen, L. Heyerick, A. Verbaeys, S. Delaet, A. Deconinck, J. Dewulf, B. De Muynck, M. Bouvry, M. Falter, K. Schoonheydt, L. Henckaerts, P. Bruynseels, J. Valk, N. Van Regenmortel, O. Maleux, A. Craeynest, J. Blok, C. Politis, D. Gorlé, K. Berquin, R. Snel, S. Kalantary, S. Ongena, A. Bral, V. Lenaerts, E. Bouckaert, T. Mulier, P. Reynders, B. Eneman, M. Lembrechts, P. Willems, S. Detienne, K. Paridaens, K. Mulkens, J. Dekoninck, Y.-M. Chong
{"title":"E-book: Antibiotica(resistentie) – Uitgave 2024","authors":"J. Berwouts, C. Van haecht, R.-M. Ntahonganyira, J. Stokx, T. Pilate, V. Cossey, V. Saegeman, A. Schuermans, I. Verstreken, R. Reybrouck, L. Vander Elst, M. Verelst, J.-H. Keijzer, S. Mokrane, N. Dekker, M. Goossens, O. Vanderveken, A. De Sutter, R. Mehta, C. Ducène, A. Sousa, M. Boulad, P. Van Royen, L. Heyerick, A. Verbaeys, S. Delaet, A. Deconinck, J. Dewulf, B. De Muynck, M. Bouvry, M. Falter, K. Schoonheydt, L. Henckaerts, P. Bruynseels, J. Valk, N. Van Regenmortel, O. Maleux, A. Craeynest, J. Blok, C. Politis, D. Gorlé, K. Berquin, R. Snel, S. Kalantary, S. Ongena, A. Bral, V. Lenaerts, E. Bouckaert, T. Mulier, P. Reynders, B. Eneman, M. Lembrechts, P. Willems, S. Detienne, K. Paridaens, K. Mulkens, J. Dekoninck, Y.-M. Chong","doi":"10.47671/tvg.80.24.e006","DOIUrl":"https://doi.org/10.47671/tvg.80.24.e006","url":null,"abstract":"","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141821568","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. Dorpmans, L. Kiebooms, L. de Vries, M. Vrijens, M. Danckaerts
QTc prolongation associated with antipsychotic treatment in child and adolescent psychiatry: a systematic review Antipsychotics play a significant role in the treatment of psychiatric disorders. Monitoring of metabolic dysregulation and cardiac rhythm disturbances is essential. Given that the pharmacokinetic profile of children differs from that of adults, the literature cannot be extrapolated without consideration. Therefore, a systematic review on the risk of QTc prolongation in minors receiving antipsychotic treatment was conducted. The literature review was conducted within PubMed, Embase and Web of Science, focusing on randomized controlled trials (RCTs). Antipsychotics were selected based on the Belgian and Dutch formulary for the treatment of psychiatric disorders in minors. The study included 28 RCTs that examined the effect and safety of antipsychotic treatment in minors, including cardiac risks. The occurrence of clinically relevant QTc prolongation development is relatively rare. The comparison of the results was hindered by differences in the acquisition and correction of electrocardiograms (ECGs). It is advisable to identify risk factors through history-taking and blood sampling. Current research indicates that the risk of QTc prolongation and torsade de pointes in minors receiving antipsychotic treatment is relatively rare. However, vigilance is warranted in the presence of specific risk factors, in which case ECG monitoring is recommended.
儿童和青少年精神病学中与抗精神病药物治疗相关的 QTc 延长：系统综述 抗精神病药物在治疗精神疾病中发挥着重要作用。监测代谢失调和心律紊乱至关重要。鉴于儿童的药代动力学特征不同于成人，因此不能不考虑文献的推断。因此，我们对接受抗精神病药物治疗的未成年人出现 QTc 延长的风险进行了系统性回顾。文献综述在 PubMed、Embase 和 Web of Science 中进行，重点关注随机对照试验（RCT）。抗精神病药物是根据比利时和荷兰治疗未成年人精神障碍的处方集选定的。研究共纳入了 28 项随机对照试验，这些试验研究了抗精神病药物治疗对未成年人的效果和安全性，包括心脏风险。临床相关的 QTc 延长发生率相对较低。由于心电图（ECG）的采集和校正存在差异，因此无法对结果进行比较。建议通过询问病史和抽血来确定风险因素。目前的研究表明，接受抗精神病药物治疗的未成年人发生 QTc 延长和心搏过速的风险相对较小。不过，如果存在特定的风险因素，则应保持警惕，在这种情况下建议进行心电图监测。
{"title":"QTc-verlenging door antipsychoticagebruik binnen de kinder- en jeugdpsychiatrie: een systematische literatuurstudie","authors":"B. Dorpmans, L. Kiebooms, L. de Vries, M. Vrijens, M. Danckaerts","doi":"10.47671/tvg.80.24.057","DOIUrl":"https://doi.org/10.47671/tvg.80.24.057","url":null,"abstract":"QTc prolongation associated with antipsychotic treatment in child and adolescent psychiatry: a systematic review\u0000\u0000 \u0000\u0000Antipsychotics play a significant role in the treatment of psychiatric disorders. Monitoring of metabolic dysregulation and cardiac rhythm disturbances is essential. Given that the pharmacokinetic profile of children differs from that of adults, the literature cannot be extrapolated without consideration. Therefore, a systematic review on the risk of QTc prolongation in minors receiving antipsychotic treatment was conducted.\u0000\u0000 \u0000\u0000The literature review was conducted within PubMed, Embase and Web of Science, focusing on randomized controlled trials (RCTs). Antipsychotics were selected based on the Belgian and Dutch formulary for the treatment of psychiatric disorders in minors. The study included 28 RCTs that examined the effect and safety of antipsychotic treatment in minors, including cardiac risks. The occurrence of clinically relevant QTc prolongation development is relatively rare. The comparison of the results was hindered by differences in the acquisition and correction of electrocardiograms (ECGs). It is advisable to identify risk factors through history-taking and blood sampling.\u0000\u0000 \u0000\u0000Current research indicates that the risk of QTc prolongation and torsade de pointes in minors receiving antipsychotic treatment is relatively rare. However, vigilance is warranted in the presence of specific risk factors, in which case ECG monitoring is recommended.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668500","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}
Transmediastinal migration of a Kirschner pin after fixation of a proximal humeral fracture: a case report Fractures of the proximal humerus are common lesions in the elderly population. In some cases, they are surgically stabilized via a minimally invasive technique, namely percutaneous osteosynthesis with fixation pins. Intrathoracic migration of these pins or wire is a rare complication after percutaneous osteosynthesis of a proximal humeral fracture. In this article, the authors describe an extremely rare transmediastinal migration of a Kirschner pin from the humeral head. The purpose of this case report is to call for awareness and to open a debate in which appropriate prevention can be freely discussed. The consideration of a conservative management, the choice of alternative osteosynthesis techniques, the use of a sling bandage to restrict the shoulder movement, the use of fixation pins with a threaded tip, bending of the external free end of the pin and an appropriate time to remove the pin are possible recommendations from the literature. Furthermore, it is important to provide additional information and awareness to health care providers in rehabilitation centers, geriatricians and orthopedists concerning the possibility of such a life-threatening postoperative complication. Thus, specific policies for clinical and radiographic monitoring of the position of fixation pins should be developed in hospitals and rehabilitation centers with the aim of prevention, early detection and prompt action when this life-threatening complication is suspected.
{"title":"Transmediastinale migratie van een Kirschner-pin na fixatie van een proximale humerusfractuur: een casus","authors":"C. Sneyers, S. Hens, G. Stassijns","doi":"10.47671/tvg.80.24.049","DOIUrl":"https://doi.org/10.47671/tvg.80.24.049","url":null,"abstract":"Transmediastinal migration of a Kirschner pin after fixation of a proximal humeral fracture: a case report\u0000\u0000 \u0000\u0000Fractures of the proximal humerus are common lesions in the elderly population. In some cases, they are surgically stabilized via a minimally invasive technique, namely percutaneous osteosynthesis with fixation pins. Intrathoracic migration of these pins or wire is a rare complication after percutaneous osteosynthesis of a proximal humeral fracture. In this article, the authors describe an extremely rare transmediastinal migration of a Kirschner pin from the humeral head. The purpose of this case report is to call for awareness and to open a debate in which appropriate prevention can be freely discussed. The consideration of a conservative management, the choice of alternative osteosynthesis techniques, the use of a sling bandage to restrict the shoulder movement, the use of fixation pins with a threaded tip, bending of the external free end of the pin and an appropriate time to remove the pin are possible recommendations from the literature. Furthermore, it is important to provide additional information and awareness to health care providers in rehabilitation centers, geriatricians and orthopedists concerning the possibility of such a life-threatening postoperative complication. Thus, specific policies for clinical and radiographic monitoring of the position of fixation pins should be developed in hospitals and rehabilitation centers with the aim of prevention, early detection and prompt action when this life-threatening complication is suspected.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141685609","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}
The number of elderly in our society is increasing. Psychiatric problems are common in this population. For adults aged 18 to 65, there already is psychiatric crisis home treatment for patients experiencing a psychiatric crisis at home. However, this did not yet exist in Belgium for adults over the age of 65. Since the 1st of November 2021, people over 65 who are experiencing a psychiatric crisis in the region of the Ghent-Eeklo-Flemish Ardennes Mental Health Care Network (PAKT) can rely on psychiatric crisis home treatment. For this reason, it was investigated whether this treatment is effective and cost-effective. There are currently no studies available on this subject. For this reason, different sub-aspects were considered. The effectiveness and cost-effectiveness of long-term psychiatric home treatment teams in elderly & adults and of psychiatric crisis home treatment teams (MCT) in adults older than 18 years were assessed. Finally, we looked for the characteristics of adults who were included for psychiatric crisis care at home and whether these are present in adults older than 65 years. Since there are no studies on MCT in the elderly, it is not possible to draw conclusions on the subject. However, a general trend is noted in the studies whereby the treatment always appears to be effective and often also cost-effective. However, further research is needed to confirm that this will also be the case for MCT for the elderly in Belgium.
{"title":"MCT bij ouderen","authors":"S. Stoop, A. Nobels, G. Heylens","doi":"10.47671/tvg.80.24.010","DOIUrl":"https://doi.org/10.47671/tvg.80.24.010","url":null,"abstract":"The number of elderly in our society is increasing. Psychiatric problems are common in this population. For adults aged 18 to 65, there already is psychiatric crisis home treatment for patients experiencing a psychiatric crisis at home. However, this did not yet exist in Belgium for adults over the age of 65. Since the 1st of November 2021, people over 65 who are experiencing a psychiatric crisis in the region of the Ghent-Eeklo-Flemish Ardennes Mental Health Care Network (PAKT) can rely on psychiatric crisis home treatment. For this reason, it was investigated whether this treatment is effective and cost-effective. There are currently no studies available on this subject. For this reason, different sub-aspects were considered. The effectiveness and cost-effectiveness of long-term psychiatric home treatment teams in elderly & adults and of psychiatric crisis home treatment teams (MCT) in adults older than 18 years were assessed. Finally, we looked for the characteristics of adults who were included for psychiatric crisis care at home and whether these are present in adults older than 65 years. Since there are no studies on MCT in the elderly, it is not possible to draw conclusions on the subject. However, a general trend is noted in the studies whereby the treatment always appears to be effective and often also cost-effective. However, further research is needed to confirm that this will also be the case for MCT for the elderly in Belgium.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695846","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":"Evidentie als onderbouwing voor ethisch verantwoorde, kwaliteitsvolle zorg","authors":"J. De Lepeleire","doi":"10.47671/tvg.80.24.068","DOIUrl":"https://doi.org/10.47671/tvg.80.24.068","url":null,"abstract":"","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709196","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, W. Gyselaers, M. Finoulst, P. Vankrunkelsven, E. De Waele, J. Gabriels, Y. Sluyts, H. De Cauwer, S. Dockx, M.-P. Assoignon, P. Deyaert, E. Colpaert, A. Pieters, A. Vonck, D. De Looze
{"title":"E-book: De impact van voeding(ssupplementen) - Uitgave 2024","authors":"S. Vos, B. Van den Bergh, H. Roels, D. Martens, H. Kindermans, T.S. Nawrot, W. Gyselaers, M. Finoulst, P. Vankrunkelsven, E. De Waele, J. Gabriels, Y. Sluyts, H. De Cauwer, S. Dockx, M.-P. Assoignon, P. Deyaert, E. Colpaert, A. Pieters, A. Vonck, D. De Looze","doi":"10.47671/tvg.80.24.e004","DOIUrl":"https://doi.org/10.47671/tvg.80.24.e004","url":null,"abstract":"","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140964875","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}
G. Vos, K. Vrancken, H. Van Veer, P. Verbrugghe, P. Nafteux, F. Rega, L. Depypere
How to diagnose and manage atrio-esophageal fistulas occurring after atrial fibrillation ablation procedures? An atrio-esophageal fistula (AEF) is a rare complication occurring after an ablation procedure for atrial fibrillation, associated with a high mortality. The aim of this study is to provide a practical flowchart for first-line healthcare professionals on the diagnostics and management of these patients. A literature search was performed, resulting in the inclusion of 100 AEF cases after atrial fibrillation ablation procedures (85 reports). The documentation on these 100 patients was analyzed to compose the flowchart. All patients presented within 2 months after the ablation procedure (23 ± 11 days). Neurologic symptoms (75%), fever (73%) and both symptoms (57%) occurred in the majority. A CT scan of the chest was performed in 78% of the cases. In 30% of the patients, an AEF was observed. In other patients, the diagnosis was suspected based on air in the left cardiac circulation or the mediastinum. An esophagogastroscopy resulted in an infaust deterioration in 14/26 of the cases. In total, 41 patients received esophageal surgery (76% survival) versus 9 with only stenting (22% survival). In 27 patients, the diagnosis or treatment was not obtained in time. An AEF should be suspected in patients presenting with fever or neurological symptoms after a recent ablation procedure. CT scans of the chest and head can support the diagnosis. Once diagnosed, one should proceed to emergency surgery to prevent further complications. An esophagogastroscopy should be avoided. The authors hope to provide a practical management guide, allowing an earlier diagnosis, a faster treatment and thus an improved survival in these patients.
{"title":"Atrio-oesofageale fistels na ablatie bij voorkamerfibrillatie: diagnose en aanpak voor de eerste lijn","authors":"G. Vos, K. Vrancken, H. Van Veer, P. Verbrugghe, P. Nafteux, F. Rega, L. Depypere","doi":"10.47671/tvg.80.24.032","DOIUrl":"https://doi.org/10.47671/tvg.80.24.032","url":null,"abstract":"How to diagnose and manage atrio-esophageal fistulas occurring after atrial fibrillation ablation procedures?\u0000\u0000 \u0000\u0000An atrio-esophageal fistula (AEF) is a rare complication occurring after an ablation procedure for atrial fibrillation, associated with a high mortality. The aim of this study is to provide a practical flowchart for first-line healthcare professionals on the diagnostics and management of these patients.\u0000\u0000 \u0000\u0000A literature search was performed, resulting in the inclusion of 100 AEF cases after atrial fibrillation ablation procedures (85 reports). The documentation on these 100 patients was analyzed to compose the flowchart.\u0000\u0000 \u0000\u0000All patients presented within 2 months after the ablation procedure (23 ± 11 days). Neurologic symptoms (75%), fever (73%) and both symptoms (57%) occurred in the majority.\u0000\u0000 \u0000\u0000A CT scan of the chest was performed in 78% of the cases. In 30% of the patients, an AEF was observed. In other patients, the diagnosis was suspected based on air in the left cardiac circulation or the mediastinum. An esophagogastroscopy resulted in an infaust deterioration in 14/26 of the cases.\u0000\u0000 \u0000\u0000In total, 41 patients received esophageal surgery (76% survival) versus 9 with only stenting (22% survival). In 27 patients, the diagnosis or treatment was not obtained in time.\u0000\u0000 \u0000\u0000An AEF should be suspected in patients presenting with fever or neurological symptoms after a recent ablation procedure. CT scans of the chest and head can support the diagnosis. Once diagnosed, one should proceed to emergency surgery to prevent further complications. An esophagogastroscopy should be avoided. \u0000\u0000 \u0000\u0000The authors hope to provide a practical management guide, allowing an earlier diagnosis, a faster treatment and thus an improved survival in these patients.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140969177","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}
Incapacity for work after inguinal hernia repair: survey of general practitioners’ and surgeons’ prescribing behaviour Inguinal hernia surgery is a very frequently performed procedure. Since this pathology often presents in professionally active patients, the procedure and resulting incapacitation have socio-economic repercussions. Additionally, a laparoscopic repair has become the standard procedure, a technique that involves significant additional costs. The aim of this study was to investigate the period of incapacity after a uni- or bilateral, open or laparoscopic repair, prescribed by GPs and surgeons, as well as their main motivations. A survey was sent to 17 GP associations in the province of Limburg (Belgium) with the request to distribute it to their members. Additionally, 73 abdominal surgeons were asked to complete the same survey. The prescription behaviour with regard to the incapacity period was evaluated as a function of the surgical technique used and the type of physical exertion required during professional practice or sports. The motivation for this prescribing behaviour was also surveyed. 107 GPs and 35 surgeons fully completed the survey. It demonstrated a wide variation in the prescribing behaviour. There was no correlation with the years of professional experience. The average prescribed incapacity period was significantly higher among GPs than surgeons. Hardly any distinction was made between a uni- and bilateral recovery. Avoidance of recurrences was the most frequently mentioned factor determining the prescribing behaviour among both GPs (89.9%) and surgeons (79.4%). The survey reveals a lack of consensus regarding the prescribing behaviour in primary and secondary care. This is mainly based on fear of recurrence, which is unfounded. Developing evidence-based postoperative guidelines for the return to work and to the normal activities is recommended.
{"title":"Arbeidsongeschiktheid na liesbreukherstel: onderzoek naar het voorschrijfgedrag van huisartsen en chirurgen","authors":"A. Dams, M. Du Bois","doi":"10.47671/tvg.80.24.031","DOIUrl":"https://doi.org/10.47671/tvg.80.24.031","url":null,"abstract":"Incapacity for work after inguinal hernia repair: survey of general practitioners’ and surgeons’ prescribing behaviour\u0000\u0000 \u0000\u0000Inguinal hernia surgery is a very frequently performed procedure. Since this pathology often presents in professionally active patients, the procedure and resulting incapacitation have socio-economic repercussions. Additionally, a laparoscopic repair has become the standard procedure, a technique that involves significant additional costs. The aim of this study was to investigate the period of incapacity after a uni- or bilateral, open or laparoscopic repair, prescribed by GPs and surgeons, as well as their main motivations.\u0000\u0000 \u0000\u0000A survey was sent to 17 GP associations in the province of Limburg (Belgium) with the request to distribute it to their members. Additionally, 73 abdominal surgeons were asked to complete the same survey. The prescription behaviour with regard to the incapacity period was evaluated as a function of the surgical technique used and the type of physical exertion required during professional practice or sports. The motivation for this prescribing behaviour was also surveyed.\u0000\u0000 \u0000\u0000107 GPs and 35 surgeons fully completed the survey. It demonstrated a wide variation in the prescribing behaviour. There was no correlation with the years of professional experience. The average prescribed incapacity period was significantly higher among GPs than surgeons. Hardly any distinction was made between a uni- and bilateral recovery. Avoidance of recurrences was the most frequently mentioned factor determining the prescribing behaviour among both GPs (89.9%) and surgeons (79.4%).\u0000\u0000 \u0000\u0000The survey reveals a lack of consensus regarding the prescribing behaviour in primary and secondary care. This is mainly based on fear of recurrence, which is unfounded. Developing evidence-based postoperative guidelines for the return to work and to the normal activities is recommended.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140981919","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}
C. Boels, R. Schoonjans, D. Fonck, B. Van Imschoot, A. Van Driessche
Hepatic portal venous gas in combination with pneumatosis intestinalis based on small-bowel ischemia: a case-report A 76-year-old man presented with complaints of abdominal pain and vomiting. An urgent CT scan showed pneumatosis intestinalis of the small intestine with air in the portal vein and the portal venules of the left hepatic lobe. Hepatic portal venous gas is a rare radiological finding: gas is found in the portal venous branches. This can be seen in both benign and life-threatening conditions. In most cases, it is accompanied by underlying intestinal ischemia, which was also the case in this patient. The patient underwent urgent surgery with a partial resection of the small intestine. After a brief admission to the intensive care unit, the man recovered well and was able to leave the hospital in good health.
{"title":"Hepatisch portaal veneus gas in combinatie met pneumatosis intestinalis op basis van dunnedarmischemie","authors":"C. Boels, R. Schoonjans, D. Fonck, B. Van Imschoot, A. Van Driessche","doi":"10.47671/tvg.80.24.027","DOIUrl":"https://doi.org/10.47671/tvg.80.24.027","url":null,"abstract":"Hepatic portal venous gas in combination with pneumatosis intestinalis based on small-bowel ischemia: a case-report\u0000\u0000 \u0000\u0000A 76-year-old man presented with complaints of abdominal pain and vomiting. An urgent CT scan showed pneumatosis intestinalis of the small intestine with air in the portal vein and the portal venules of the left hepatic lobe.\u0000\u0000 \u0000\u0000Hepatic portal venous gas is a rare radiological finding: gas is found in the portal venous branches. This can be seen in both benign and life-threatening conditions. In most cases, it is accompanied by underlying intestinal ischemia, which was also the case in this patient.\u0000\u0000 \u0000\u0000The patient underwent urgent surgery with a partial resection of the small intestine. After a brief admission to the intensive care unit, the man recovered well and was able to leave the hospital in good health.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140993511","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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