S. Mokrane, N. Dekker, Č. Martin, D. Van Beckhoven, S. Swannet, E. Florence, R. Koeck, T. Cornelissen, L. de Coninck, J. Laermans, V. Borra, S. Cordyn, M. Goossens, P. Van Royen
The management of people living with HIV in primary care: summary of a multidisciplinary guideline HIV infection has evolved from a lethal to a chronic condition thanks to antiretroviral therapy (ART). General practitioners (GPs) provide care to patients with chronic conditions in collaboration with specialist care and are thus supposed to integrate, together with the HIV reference centre (HRC), certain aspects of the medical follow-up of patients living with HIV into their daily practice. This article is a summary of the recent guideline for the care of people living with HIV in primary care. It describes, besides the context and the conditions for the post-test counselling interview after the confirmation of the positive HIV diagnosis and during the follow-up consultations, the 3 main components in the care of patients with HIV: linkage to care, retention in care and adherence to ART, and how GPs can support patients in this. In addition, GPs have the task to monitor the overall health of patients living with HIV (basic vaccinations, comorbidities, risk factors, screening programmes, drug interactions with ART), as well as the HIV-specific aspects, such as vaccinations to prevent the risk of co-infections (hepatitis A virus, hepatitis B virus) and avoid infections (pneumococcal, influenza, COVID-19, HPV) where they are at a higher risk of complications. The sexual and reproductive health of patients with HIV can be monitored in primary or secondary care, according to the patient’s preference. The care of patients living with HIV is a joint responsibility of the GP and the HRC. The guideline clearly indicates when referral to the HRC is necessary.
{"title":"Zorg voor mensen met hiv in de eerste lijn: samenvatting van een multidisciplinaire richtlijn","authors":"S. Mokrane, N. Dekker, Č. Martin, D. Van Beckhoven, S. Swannet, E. Florence, R. Koeck, T. Cornelissen, L. de Coninck, J. Laermans, V. Borra, S. Cordyn, M. Goossens, P. Van Royen","doi":"10.47671/tvg.80.24.026","DOIUrl":"https://doi.org/10.47671/tvg.80.24.026","url":null,"abstract":"The management of people living with HIV in primary care: summary of a multidisciplinary guideline\u0000\u0000 \u0000\u0000HIV infection has evolved from a lethal to a chronic condition thanks to antiretroviral therapy (ART). General practitioners (GPs) provide care to patients with chronic conditions in collaboration with specialist care and are thus supposed to integrate, together with the HIV reference centre (HRC), certain aspects of the medical follow-up of patients living with HIV into their daily practice.\u0000\u0000 \u0000\u0000This article is a summary of the recent guideline for the care of people living with HIV in primary care. It describes, besides the context and the conditions for the post-test counselling interview after the confirmation of the positive HIV diagnosis and during the follow-up consultations, the 3 main components in the care of patients with HIV: linkage to care, retention in care and adherence to ART, and how GPs can support patients in this. In addition, GPs have the task to monitor the overall health of patients living with HIV (basic vaccinations, comorbidities, risk factors, screening programmes, drug interactions with ART), as well as the HIV-specific aspects, such as vaccinations to prevent the risk of co-infections (hepatitis A virus, hepatitis B virus) and avoid infections (pneumococcal, influenza, COVID-19, HPV) where they are at a higher risk of complications. The sexual and reproductive health of patients with HIV can be monitored in primary or secondary care, according to the patient’s preference.\u0000\u0000 \u0000\u0000The care of patients living with HIV is a joint responsibility of the GP and the HRC. The guideline clearly indicates when referral to the HRC is necessary.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141006331","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. Depover, G. Serry, E. Degrande, P. Wilmes, E. Steenkiste, V. Van Damme
Thoracic lymphadenopathies and neutropenia: an unexpected diagnosis A 68-year-old patient, known with rheumatoid arthritis (RA) and treated with TNF-alpha antagonists, presents with a persistent cough with coloured sputum. Further examination reveals neutropenia and thoracic adenopathies. Histopathologic examination shows non-necrotizing granulomas in the thoracic lymph nodes and bone marrow. After infectious and malignant evaluation, the diagnoses of sarcoidosis and sarcoidosis-like granulomatosis by TNF-alpha antagonists are made. The clinic, imaging, laboratory findings and histopathology do not allow the doctors to distinguish between the 2 diagnoses. Several arguments point in the direction of sarcoidosis-like granulomatosis due to TNF-alpha antagonists. First, there is a temporal relationship between the initiation of the antagonists and the finding of granulomas. Additionally, the association of RA and sarcoidosis is extremely rare. Sarcoidosis-like granulomatosis due to TNF-alpha antagonists may be considered as a form of drug-induced sarcoidosis.
{"title":"Thoracale adenopathieën en neutropenie: een onverwachte diagnose","authors":"A. Depover, G. Serry, E. Degrande, P. Wilmes, E. Steenkiste, V. Van Damme","doi":"10.47671/tvg.80.24.025","DOIUrl":"https://doi.org/10.47671/tvg.80.24.025","url":null,"abstract":"Thoracic lymphadenopathies and neutropenia: an unexpected diagnosis\u0000\u0000 \u0000\u0000A 68-year-old patient, known with rheumatoid arthritis (RA) and treated with TNF-alpha antagonists, presents with a persistent cough with coloured sputum. Further examination reveals neutropenia and thoracic adenopathies. Histopathologic examination shows non-necrotizing granulomas in the thoracic lymph nodes and bone marrow.\u0000\u0000 \u0000\u0000After infectious and malignant evaluation, the diagnoses of sarcoidosis and sarcoidosis-like granulomatosis by TNF-alpha antagonists are made. The clinic, imaging, laboratory findings and histopathology do not allow the doctors to distinguish between the 2 diagnoses. Several arguments point in the direction of sarcoidosis-like granulomatosis due to TNF-alpha antagonists. First, there is a temporal relationship between the initiation of the antagonists and the finding of granulomas. Additionally, the association of RA and sarcoidosis is extremely rare. Sarcoidosis-like granulomatosis due to TNF-alpha antagonists may be considered as a form of drug-induced sarcoidosis.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141016009","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":"Ethiek: brandstof voor de dagelijkse praktijk","authors":"J. De Lepeleire","doi":"10.47671/tvg.80.24.004","DOIUrl":"https://doi.org/10.47671/tvg.80.24.004","url":null,"abstract":"","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141024267","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 rights 2.0: patient participation with respect The Belgian Law on Patients’ Rights was modernized to align with the developments towards a more high-quality, patient-oriented healthcare. The 7 patient rights continue to exist, but will be adapted accordingly. This reform is based on 3 pillars: patient rights in the interest of the patient, patient rights in collaboration with the patient and patient rights by the patient. Each of these pillars ensures that patient rights can guarantee the relationship of trust between the healthcare provider and the patient. This article provides an overview of the changes to the Law on Patients’ Rights within the 3 pillars.
{"title":"Patiëntenrechten 2.0: patiëntparticipatie met respect","authors":"T. Goffin","doi":"10.47671/tvg.80.24.028","DOIUrl":"https://doi.org/10.47671/tvg.80.24.028","url":null,"abstract":"Patient rights 2.0: patient participation with respect\u0000\u0000 \u0000\u0000The Belgian Law on Patients’ Rights was modernized to align with the developments towards a more high-quality, patient-oriented healthcare. The 7 patient rights continue to exist, but will be adapted accordingly. This reform is based on 3 pillars: patient rights in the interest of the patient, patient rights in collaboration with the patient and patient rights by the patient. Each of these pillars ensures that patient rights can guarantee the relationship of trust between the healthcare provider and the patient. This article provides an overview of the changes to the Law on Patients’ Rights within the 3 pillars.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140674441","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 - juli 1947","authors":"B. Vandekerkhove","doi":"10.47671/tvg.78.22.011","DOIUrl":"https://doi.org/10.47671/tvg.78.22.011","url":null,"abstract":"","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140682379","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. Verheye, D. Neves Ramos, A. Taelman, K. Goffart, A. Van Dijck, J. Lebeer, W. Gyselaers, M. Finoulst, P. Vankrunkelsven, S. Vercauteren, H. Van Den Steene, W. Cools, E. Campforts, I. Gybels, F.-L. De Winter, Y. Meuffels, J. Haas, J. Steyaert, M. Danckaerts
{"title":"E-book: Ontwikkelingsstoornissen – Uitgave 2024","authors":"B. Verheye, D. Neves Ramos, A. Taelman, K. Goffart, A. Van Dijck, J. Lebeer, W. Gyselaers, M. Finoulst, P. Vankrunkelsven, S. Vercauteren, H. Van Den Steene, W. Cools, E. Campforts, I. Gybels, F.-L. De Winter, Y. Meuffels, J. Haas, J. Steyaert, M. Danckaerts","doi":"10.47671/tvg.80.24.e003","DOIUrl":"https://doi.org/10.47671/tvg.80.24.e003","url":null,"abstract":"","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140682615","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 right to an ethical consultation: a necessary patient’s right? The law on patients’ rights of 22 August 2002 describes 7 important patients’ rights which healthcare professionals must guarantee and respect towards their patients. In 2002, the aim of the law was to recognize the patient’s autonomy or right to self-determination and to strengthen the patient’s legal position. The clarity that this law creates in the treatment relationship between a patient and a healthcare professional, is often unclear in practice. Frequently, this legal framework turns out to be too black and white for a concrete and nuanced application in practice. At the same time, the law pays too little attention to the joint decision-making model, which is a necessary condition for the relationship of trust between a patient and a healthcare professional. Consultation between the patient and the care professional, between care professionals and between care professionals and ethical experts is insufficiently present or almost absent in the Law on Patients’ Rights. However, this consultation is necessary to provide high-quality care and, moreover, to realize a feasible translation of the law into practice. The question of a right to ethics and ethical consultation as a necessary patient right is in fact the question of consultation as an essential part of considering patients’ rights as a means to realize a patient-oriented, quality healthcare based on trust.
{"title":"Recht op ethisch overleg: een noodzakelijk patiëntenrecht?","authors":"T. Goffin","doi":"10.47671/tvg.80.24.018","DOIUrl":"https://doi.org/10.47671/tvg.80.24.018","url":null,"abstract":"A right to an ethical consultation: a necessary patient’s right?\u0000\u0000 \u0000\u0000The law on patients’ rights of 22 August 2002 describes 7 important patients’ rights which healthcare professionals must guarantee and respect towards their patients. In 2002, the aim of the law was to recognize the patient’s autonomy or right to self-determination and to strengthen the patient’s legal position.\u0000\u0000 \u0000\u0000The clarity that this law creates in the treatment relationship between a patient and a healthcare professional, is often unclear in practice. Frequently, this legal framework turns out to be too black and white for a concrete and nuanced application in practice. At the same time, the law pays too little attention to the joint decision-making model, which is a necessary condition for the relationship of trust between a patient and a healthcare professional.\u0000\u0000 \u0000\u0000Consultation between the patient and the care professional, between care professionals and between care professionals and ethical experts is insufficiently present or almost absent in the Law on Patients’ Rights. However, this consultation is necessary to provide high-quality care and, moreover, to realize a feasible translation of the law into practice.\u0000\u0000 \u0000\u0000The question of a right to ethics and ethical consultation as a necessary patient right is in fact the question of consultation as an essential part of considering patients’ rights as a means to realize a patient-oriented, quality healthcare based on trust.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140690117","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}
Ethics consultation at a regional level: the experience of the forum for ethical reflection of the Île-de-France region Referring to experiences in healthcare ethics, we seek to better understand and assume our moral and political responsibilities in a democratic society. One of the reference points is ‘Espace éthique AP-PH’, the ethics forum of the public hospital network in Paris. Its creation in 1995 dovetailed with the upheavals of the ‘AIDS years’, in which the patient’s voice increasingly penetrated public life and spurred political mobilisation. In 2014, it was expanded into the Île-de-France region’s forum for ethical reflection. The forum for ethical reflection is a place where the art of dialogue and discussion is elevated to a normative level, which is indispensable for understanding, deliberation and joint endorsement of an ethical approach that implies responsibility. France now has 15 regional forums for ethical reflection that contribute to the development of a genuine ethical culture among healthcare providers and the general public in their region.
{"title":"Ethisch overleg op regionaal niveau: ervaringen van het forum voor ethische reflectie van de regio Île-de-France","authors":"E. Hirsch","doi":"10.47671/tvg.80.24.022","DOIUrl":"https://doi.org/10.47671/tvg.80.24.022","url":null,"abstract":"Ethics consultation at a regional level: the experience of the forum for ethical reflection of the Île-de-France region\u0000\u0000 \u0000\u0000Referring to experiences in healthcare ethics, we seek to better understand and assume our moral and political responsibilities in a democratic society. One of the reference points is ‘Espace éthique AP-PH’, the ethics forum of the public hospital network in Paris. Its creation in 1995 dovetailed with the upheavals of the ‘AIDS years’, in which the patient’s voice increasingly penetrated public life and spurred political mobilisation. In 2014, it was expanded into the Île-de-France region’s forum for ethical reflection.\u0000\u0000 \u0000\u0000The forum for ethical reflection is a place where the art of dialogue and discussion is elevated to a normative level, which is indispensable for understanding, deliberation and joint endorsement of an ethical approach that implies responsibility.\u0000\u0000 \u0000\u0000France now has 15 regional forums for ethical reflection that contribute to the development of a genuine ethical culture among healthcare providers and the general public in their region.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140697801","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}
T. Pilate, V. Cossey, V. Saegeman, A. Schuermans, I. Verstreken, R. Reybrouck, L. Vander Elst, M. Verelst
Implementation of the Infection Risk Scan in a hospital network by the Hospital Outbreak Support Team The Infection Risk Scan (IRIS) assesses the quality of infection prevention and control (IPC) and antimicrobial stewardship (AMS) in a hospital ward by the standardized measurement of a broad range of quality indicators. IRIS was implemented in the geriatric wards of the 4 hospitals of the Plexus healthcare network ‘Oost-Vlaams-Brabant’ (Belgium). The goal was to compare the IPC and AMS policies of the hospitals in order to define common improvement strategies within the Hospital Outbreak Support Team (HOST), a federal project concerning IPC and AMS. In the first part of IRIS, the risk profile of the patient population is determined by a point prevalence measurement of 4 variables. In the second part, the improvement plot is created based on the measurement of 7 quality indicators. Improvement actions can be deduced from quality indicators with higher improvement potentials. The risk profiles of the 4 hospitals were highly comparable and the improvement plots showed an intermediate to high improvement potential for the use of AMT and hand hygiene compliance. There were important differences in the appropriate use of transurethral and intravascular catheters, with 2 hospitals having a low and 2 hospitals having a high improvement potential. IRIS was a useful tool in the early phase of the HOST project to benchmark the IPC and AMT policies between the Plexus hospitals and to decide what future projects could be collaborated on. As a result of IRIS, it was decided to define common care bundles for the prevention of catheter-associated urinary tract and blood stream infections and to determine hospital-specific actions with regard to the optimisation of AMS.
{"title":"Implementatie van de Infectierisicoscan in een ziekenhuisnetwerk door het Hospital Outbreak Support Team","authors":"T. Pilate, V. Cossey, V. Saegeman, A. Schuermans, I. Verstreken, R. Reybrouck, L. Vander Elst, M. Verelst","doi":"10.47671/tvg.80.24.021","DOIUrl":"https://doi.org/10.47671/tvg.80.24.021","url":null,"abstract":"Implementation of the Infection Risk Scan in a hospital network by the Hospital Outbreak Support Team\u0000\u0000 \u0000\u0000The Infection Risk Scan (IRIS) assesses the quality of infection prevention and control (IPC) and antimicrobial stewardship (AMS) in a hospital ward by the standardized measurement of a broad range of quality indicators. IRIS was implemented in the geriatric wards of the 4 hospitals of the Plexus healthcare network ‘Oost-Vlaams-Brabant’ (Belgium). The goal was to compare the IPC and AMS policies of the hospitals in order to define common improvement strategies within the Hospital Outbreak Support Team (HOST), a federal project concerning IPC and AMS.\u0000\u0000 \u0000\u0000In the first part of IRIS, the risk profile of the patient population is determined by a point prevalence measurement of 4 variables. In the second part, the improvement plot is created based on the measurement of 7 quality indicators. Improvement actions can be deduced from quality indicators with higher improvement potentials.\u0000\u0000 \u0000\u0000The risk profiles of the 4 hospitals were highly comparable and the improvement plots showed an intermediate to high improvement potential for the use of AMT and hand hygiene compliance. There were important differences in the appropriate use of transurethral and intravascular catheters, with 2 hospitals having a low and 2 hospitals having a high improvement potential.\u0000\u0000 \u0000\u0000IRIS was a useful tool in the early phase of the HOST project to benchmark the IPC and AMT policies between the Plexus hospitals and to decide what future projects could be collaborated on. As a result of IRIS, it was decided to define common care bundles for the prevention of catheter-associated urinary tract and blood stream infections and to determine hospital-specific actions with regard to the optimisation of AMS.","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140710049","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":"Hoe kunnen we de beste zorg geven aan jongeren die te maken hebben met genderincongruentie?","authors":"P. Vankrunkelsven, K. Casteels, J. De Vleminck","doi":"10.47671/tvg.80.24.030","DOIUrl":"https://doi.org/10.47671/tvg.80.24.030","url":null,"abstract":"","PeriodicalId":507632,"journal":{"name":"Tijdschrift voor Geneeskunde","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140723749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：