References of "Acta Clinica Belgica"
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See detailMyelofibrosis patients in Belgium: disease characteristics
Devos, Timothy; Zachée, Pierre; Bron, Domonique et al

in Acta Clinica Belgica (in press)

Objective: To date, only a small number of epidemiological studies on myelofibrosis have been performed. The current study aimed to characterize the myelofibrosis patient population in Belgium according ... [more ▼]

Objective: To date, only a small number of epidemiological studies on myelofibrosis have been performed. The current study aimed to characterize the myelofibrosis patient population in Belgium according to predefined disease parameters (diagnosis, risk categories, hemoglobin ,10 g/dl, spleen size, constitutional symptoms, platelet count, myeloblast count), with a view to obtaining a deeper understanding of the proportion of patients that may benefit from the novel myelofibrosis therapeutic strategies. Methods: A survey was used to collect data on prevalence and disease parameters on all myelofibrosis patients seen at each of 18 participating hematologic centers in 2011. Aggregated data from all centers were used for analysis. Analyses were descriptive and quantitative. Results: A total of 250 patients with myelofibrosis were captured; of these, 136 (54%) were male and 153 (61%) were over 65 years old. One hundred sixty-five (66%) of myelofibrosis patients had primary myelofibrosis and 85 (34%) had secondary myelofibrosis. One hundred ninety-three myelofibrosis patients (77%) had a palpable spleen. About a third of patients (34%) suffered from constitutional symptoms. Two hundred twenty-two (89%) myelofibrosis patients had platelet count§50 000/ml and 201 (80%) had platelet count §100 000/ml. Of 250 patients, 85 (34%) had a myeloblast count §1%. Six (2%) patients had undergone a splenectomy. Thirteen (5.2%) patients had undergone radiotherapy for splenomegaly. Conclusions: The results of this survey provide insight into the characteristics of the Belgian myelofibrosis population. They also suggest that a large proportion of these patients could stand to benefit from the therapies currently under development. [less ▲]

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See detailBlood alcohol concentration in drivers of Liege aera (Belgium) : a 5-year analysis
DEVILLE, Marine ULg; Charlier, Corinne ULg

in Acta Clinica Belgica (2015), 00

Objectives: The objective of the present study was to describe the results of the blood alcohol determinations made on drivers from the Liege area between July 2007 and December 2012. Methods: The results ... [more ▼]

Objectives: The objective of the present study was to describe the results of the blood alcohol determinations made on drivers from the Liege area between July 2007 and December 2012. Methods: The results were interpreted according to the sex, to the age, to the circumstances and temporal variation of the blood test. Statistical analysis was performed using R® software. Results: During this 5-years period, 2725 determinations were done, mainly in the context of road crashes. The mean blood alcohol concentration (BAC) was 1.69 g/L, and 2132 drivers were above the legal threshold. A large majority of offenders (77%) were men, but the mean BAC did not differ significantly between men (1.69 g/L) and women (1.67 g/L). A statistically significant correlation between age and mean BAC can be observed, if we only consider the positive cases. Concerning the temporal variation of the results, lowest mean BACs are observed during the daytime while highest mean BACs are measured during the night. In both cases, no statistically significant difference can be observed if we compare the week and the weekend. Finally, no statistically significant difference in BAC was observed over years. [less ▲]

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See detailSafety and efficacy of azacitidine in Belgian patients with high-risk myelodysplastic syndromes, acute myeloid leukaemia, or chronic myelomonocytic leukaemia: results of a real-life, non-interventional post-marketing survey
Beguin, Yves ULg; Selleslag, Dominik; Meers, Stef et al

in Acta Clinica Belgica (2015), 70

Objectives: We evaluated azacitidine (VidazaH) safety and efficacy in patients with myelodysplastic syndrome (MDS), acute myeloid leukaemia (AML), and chronic myelomonocytic leukaemia (CMML), in a real ... [more ▼]

Objectives: We evaluated azacitidine (VidazaH) safety and efficacy in patients with myelodysplastic syndrome (MDS), acute myeloid leukaemia (AML), and chronic myelomonocytic leukaemia (CMML), in a real-life setting. Treatment response, dose, and schedule were assessed. Methods: This non-interventional, post-marketing survey included 49/50 patients receiving azacitidine at 14 Belgian haematology centres from 2010–2012. Treatment-emergent adverse events (TEAEs), including treatment-related TEAEs, and serious TEAEs (TESAEs) were recorded throughout the study. Treatment response [complete response (CR), partial response (PR), haematological improvement (HI), stable disease (SD), treatment failure (TF)) and transfusion-independence (TI) were evaluated at completion of a 1-year observation period (1YOP) or at treatment discontinuation, and overall survival (OS), at study conclusion. Results: The median age of patients was 74.7 (range: 43.9–87.8) years; 69.4% had MDS, 26.5% had primary or secondary AML, and 4.1% had CMML. Treatment-related TEAEs, grade 3–4 TEAEs, and TESAEs were reported in 67.3%, 28.6%, and 18.4% of patients, respectively. During 1YOP, patients received a median of 7 (1–12) treatment cycles. Treatment response was assessed for 38/49 patients. Among MDS and CMML patients (n529), 41.4% had CR, PR, or HI, 41.4% had SD, and 17.2% had TF. Among AML patients (n59), 44.4% had CR or PR, 33.3% had SD, and 22.2% had TF. TI was observed in 14/32 (43.8%) patients who were transfusion-dependent at baseline. Median (95% confidence interval) OS was 490 (326–555) days; 1-year OS estimate was 0.571 (0.422–0.696). Conclusions: Our data support previous findings that azacitidine has a clinically acceptable safety profile and shows efficacy. [less ▲]

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See detailRetrospective analysis of a suburban out-ofhours clinic in Belgium
Belche, Jean-Luc ULg; Berrewaerts, Marie-Astrid ULg; Burette, Philippe ULg et al

in Acta Clinica Belgica (2014), 69(5), 341-347

Introduction: In many countries, out-of-hours medical care is under scrutiny. The aim of this article is to study the activities recorded by the first out-of-hours clinic that has been opened, as a pilot ... [more ▼]

Introduction: In many countries, out-of-hours medical care is under scrutiny. The aim of this article is to study the activities recorded by the first out-of-hours clinic that has been opened, as a pilot study, in two Walloon communes. Material and method: A retrospective analysis of anonymized data was conducted for 2009. Coding of diagnoses was conducted using the International Classification of Primary Care (ICPC-2). Results: A total of 3949 contacts were recorded in 2009 with the out-of-hours clinic, 3294 related to inhabitants of the two communes covered, which was equivalent to 13% of the total population in question. Compared to 7.2% of contacts between midnight and 8 a.m., 82.9% of contacts took place between 8 a.m. and 9 p.m., and 91.6% of contacts were handled locally, with only 8.4% resulting in hospitalization. In addition, 52% of contacts were with patients aged between 25 and 65; 29.9% of contacts were with paediatric patients (,15 years). Patients over the age of 65 made up 18% of contacts. The most common pathologies were respiratory (R). Analysis of flu diagnoses identified two epidemic peaks. Discussion: The suburban out-of-hours clinic studied fulfilled an important role in managing the demand for health care. The large majority of health problems were resolved locally, and the inhabitants did not need to go to hospital. Appointments between midnight and 8 a.m. were in the minority, which points towards adjusting the organization of the out-of-hours service during the night. The geriatric population is not highly over-represented contrary to what might be expected considering its largest number of pathologies. The on-call doctor’s skills profile should take account of the populations and morbidities encountered. Out-ofhours clinics could possibly play a sentinel role in terms of flu epidemics. Conclusion: This study describes a pilot suburban out-of-hours clinic which met three of recommendations set by the KCE in its report on out-of-hours care in general medicine: the organization of an out-of-hours clinic with logistical support, the use of a single telephone number and merging out-of-hours areas. While debate exists on the management of out-of-hours care, this study provides evidence on the role of the physician during these hours. [less ▲]

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See detailManagement of the neonate at risk for early-onset Group B streptococcal disease (GBS EOD): new paediatric guidelines in Belgium
MAHIEU, Ludo; LANGHENDRIES, Jean Paul; COSSEY, Veerle et al

in Acta Clinica Belgica (2014), 69(5), 313-319

Despite group B streptococcal (GBS) screening in late pregnancy and intrapartum antimicrobial prophylaxis, early onset sepsis in neonates remains a common source of neonatal morbidity and mortality ... [more ▼]

Despite group B streptococcal (GBS) screening in late pregnancy and intrapartum antimicrobial prophylaxis, early onset sepsis in neonates remains a common source of neonatal morbidity and mortality especially in preterm neonates. The identification of neonates with early onset sepsis is usually based on perinatal risk factors. Clinical signs are aspecific and laboratory tests not sensitive. Therefore, many clinicians will overtreat at risk infants. Inappropriate treatment with antibiotics increases the risk for late onset sepsis, necrotizing enterocolitis, mortality and prolongs hospitalisation and costs. In 2003, the Belgian Health Council (BHC), published guidelines for the prevention of perinatal GBS infections. This report presents the Belgian paediatric management guidelines, which have been endorsed by the Belgian and Flemish societies of neonatology and paediatrics. The most imported changes in the 2014 guidelines are the following: · recommendations for a lumbar puncture, · clarification of normal spinal fluid parameters and blood neutrophil indices corrected for gestation age, · specific timing for diagnostic testing after birth, · no indication for diagnostic testing in asymptomatic newborns unless additional risk factors, · a revised algorithm for management of neonates according to maternal and neonatal risk factors, · premature infants described as those below 35 weeks instead of 37 weeks The guidelines were made on the basis of the best evidence and on expert opinion when inadequate evidence exists. [less ▲]

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See detailLiege City Parade 2013: evaluation of the preventive plan.
BRASSEUR, Edmond ULg; MASTRODICASA, Adrian ULg; GILLARD, Florence ULg et al

in Acta Clinica Belgica (2014), 69(S1), 15

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See detailAn unusual cervicalgy.
PIAZZA, Justine ULg; BRASSEUR, Edmond ULg; GHUYSEN, Alexandre ULg et al

in Acta Clinica Belgica (2014), 69(S1), 23

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See detailSomething in the air
TAMBWE RAMAZANI, Willy ULg; BRASSEUR, Edmond ULg; JOHNSON, S et al

in Acta Clinica Belgica (2014), 69(S1), 28

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See detailA quick high before immersion into the deep blue: the fall of Icarus revised.
LOPEZ RODRIGUEZ, Alicia ULg; BRASSEUR, Edmond ULg; GHUYSEN, Alexandre ULg et al

in Acta Clinica Belgica (2014), 69(S1), 21

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See detailSimultaneous determination of seven azole antifungal drugs in serum by ultra-high pressure liquid chromatography and diode array detection
MISTRETTA, Virginie ULg; DUBOIS, Nathalie ULg; DENOOZ, Raphael ULg et al

in Acta Clinica Belgica (2014), 69(1), 53-61

Azole antifungals are a group of fungistatic agents that can be administered orally or parenterally. The determination of the concentrations of these antifungals (miconazole, fluconazole, ketoconazole ... [more ▼]

Azole antifungals are a group of fungistatic agents that can be administered orally or parenterally. The determination of the concentrations of these antifungals (miconazole, fluconazole, ketoconazole, posaconazole, voriconazole, itraconazole, and its major active metabolite, hydroxy-itraconazole) in serum can be useful to adapt the doses to pharmacological ranges because of large variability in the absorption and metabolism of the drugs, multiple drug interactions, but also potential resistance or toxicity. A method was developed and validated for the simultaneous determination of these drugs in serum utilizing ultra-high pressure liquid chromatography and diode array detection (UHPLC-DAD). After a simple and rapid liquid– liquid extraction, the pre-treated sample was analysed on an UHPLC-DAD system (Waters CorporationH). The chromatographic separation was carried out on an Acquity BEH C18 column (Waters Corporation) with a gradient mode of mobile phase composed of acetonitrile and aqueous ammonium bicarbonate 10.0 M pH10. The flow rate was 0.4 ml/min and the injection volume was 5 ml. The identification wavelength varied according to the drug from 210 to 260 nm. The method was validated by the total error method approach by using an analytical validation software (eNnoval V3.0 ArlendaH). The seven azole antifungals were identified by retention time and specific UV spectra, over a 13-minute run time. All calibration curves showed good linearity (r2.0.99) in ranges considered clinically adequate. The assay was linear from 0.05 to 10 mg/l for voriconazole, posaconazole, itraconazole, hydroxy-itraconazole, and ketoconazole, from 0.3 to 10 mg/l for fluconazole, and from 0.1 to 10 mg/l for miconazole. The bias and imprecision values for intraand inter-assays were lower than 10% and than 15%, respectively. In conclusion, a simple, sensitive, and selective UHPLC-DAD method was developed and validated to determine seven azole antifungal drugs in human serum. This method is applicable to patient samples, and can be applied successfully to clinical applications and therapeutic drug monitoring. [less ▲]

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See detailCowden Syndrome: a novel PTEN mutation description and how to recognize a not so rare hereditary cancer syndrome
Delannoy, Pauline; DEBRAY, François-Guillaume ULg; BECKERS, Albert ULg et al

in Acta Clinica Belgica (2014), 69(suppl 3), 16

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See detailRefractory hypercalcemia and ectopic calcitonin secretion in a malignant pancreatic neuroendocrine tumor: hypocalcemic effects on cinacalcet
VALDES SOCIN, Hernan Gonzalo ULg; rubio almanza, Matilde; LOLY, Jean-Philippe ULg et al

in Acta Clinica Belgica (2013), 68(6), 42

Introduction: Paraneoplastic hypercalcemia is a sign of poor prognosis, as it is particularly resistant to the usual hypocalcemic treatments. Observation: In 2009, a well differentiated pancreatic ... [more ▼]

Introduction: Paraneoplastic hypercalcemia is a sign of poor prognosis, as it is particularly resistant to the usual hypocalcemic treatments. Observation: In 2009, a well differentiated pancreatic neuroendocrine tumor (Ki-67= 2%) is diagnosed in a 52-year-old diabetic man. The tumor is revealed with a splenic and hepatic carcinomatosis. Plasmatic calcium was: 3.54 mmol/L (2.15 - 2.6). Biology showed hypophosphatemia, PTH < 4 ng/ml, high 1-25 OH VitD, calcitonin: 1016 ng/ml (< 12 ng/ml). He had hypercalciuria and hypophosphaturia. He received for two years several cycles of Streptozotocin-ADRIAMYCIN and FOLFOX, with partial control of the tumor mass and calcium levels. In 2012, calcitonin levels are 29 ng/ml whereas calcemia is 3.17 mmol/L. Hypercalcemia is refractory to hyperhydration, diuretics, corticosteroids, and bisphosphonates therapy. Cinacalcet (Mimpara) is prescribed up to 120 mg/day (PO). Calcemia decreases gradually from 3 to 2.87 and then 2.76 mmol/L. PTH and calcitonin-the tumor mass remain unchanged. After two months of Cinacalcet treatment, Sunitinib (Sutent) 37.5 mg per day was added. During the third month, calcium levels dropped to 2.09 mmol/L and PTH raised to 78 pg/ml, requiring discontinuation of Mimpara. Calcitonin normalized, with a further improvement over pancreatic and metastatic lesions. Conclusion: Cinacalcet is a Calcium Sensing Receptor oral agonist. Cinacalcet hypocalcemic effects have not been previously documented in pancreatic paraneoplastic hypercalcemia. In our patient, Cinacalcet has significantly improved cancer prognosis: this drug could be a new alternative in paraneoplastic hypercalcemia. [less ▲]

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See detailPersistent low levels of serum hCG: please do not miss phantom hCG! (pseudohypergonadotropinemia syndrome)
VALDES SOCIN, Hernan Gonzalo ULg; SYRIOS, Petros ULg; GADISSEUR, Romy ULg et al

in Acta Clinica Belgica (2013), 68(6), 465

Introduction: Beyond pregnancy, persistent low levels of hCG may be associated with various benign and malignant conditions, i.e. quiescent gestational trophoblastic disease (QTD), raised pituitary hCG or ... [more ▼]

Introduction: Beyond pregnancy, persistent low levels of hCG may be associated with various benign and malignant conditions, i.e. quiescent gestational trophoblastic disease (QTD), raised pituitary hCG or false positive elevation caused by circulating heterophilic antibodies. This situation requires a clinico-biological approach in order to avoid misunderstandings that could lead to inappropriate diagnostic or therapeutic attitudes. Observation: A 23 years old woman (GOPO status) consulted his gynaecologist because of persistent abdominal pain. She was diagnosed of having trophoblastic disease on the basis of persistently positive human chorionic gonadotropin (hCG) test (Roche Modular) results, in the absence of pregnancy. Persistent low levels of hCG (around 10 U/L) were detected in her plasma. The patient underwent a trial with methotrexate chemotherapy. Abdominal pain was unrelieved whereas plasma hCG was 8.9 U/L. A serology test for Chlamydia indicated persistent infection and a course of antibiotic treatment was underwent without any relief. A laparoscopic exploration ruled out any trophoblastic residue or pelvic adherences. The patient was referred to the Endocrine Unit for further pituitary and hormonal investigations. Plasma and urine samples were sent to Biology Service to exclude a false hCG positive value. While low levels of hCG were detected in serum by assay, no significant hCG was detected in the urine (0,1 U/L). When serum was treated with HBT tube for the detection of heterophilic antibodies, hCG levels were 0.98 U/L. After mouse serum treatment, hCG was not further detected in our patient, indicating the presence of phantom hCG due to the presence of human anti mouse heterophilic antibodies. Conclusions: Textbooks on obstetrics and gynecology emphasize the importance of plasma hCG testing in patients with trophoblastic diseases. The ability of laboratory measurements to guide the clinician appropriately in every circumstance is limited. Caution should be exercised when clinical findings and laboratory results are discordant. Current protocols for the diagnosis and treatment of trophoblastic disease should include a compulsory test for hCG in urine and a test for heterophilic antibodies when appropriate. In this case report, we demonstrated that phantom hCG, was caused by heterogenous human anti mouse antibodies. [less ▲]

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See detailInvestigation olfactive de la mort
Focant, Jean-François ULg; Stefanuto, Pierre-Hugues ULg; Brasseur, Catherine ULg et al

in Acta Clinica Belgica (2013, October), 68-6

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See detailQuantitative determination of non persistent endocrine disruptors in human urine
Dewalque, Lucas ULg; PIRARD, Catherine ULg; DUBOIS, Nathalie ULg et al

in Acta Clinica Belgica (2013), 68(6),

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See detailEvaluation de l'exposition professionnelle aux cytostatiques des travailleurs de deux services du CHU de Liège
Rusu, Dorina; DUBOIS, Nathalie ULg; Surleraux, Cécile et al

in Acta Clinica Belgica (2013), 68(6), 472

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See detailProspective study of an advanced nurse triage for a target pathology at the admission in the emergency department
JOBE, Jérôme ULg; VANDERCLEYEN, C; Ghuysen, Alexandre ULg et al

in Acta Clinica Belgica (2013), 68(6), 2

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See detailValidation of analytical method for the determination in serum of psychotropic drugs commonly prescribed in Rwanda by HPLC-DAD
Hahirwa, Innocent; Charlier, Corinne ULg; DENOOZ, Raphael ULg et al

in Acta Clinica Belgica (2013), 68(6), 479

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