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Naesens R, Mertes H, Clukers J, Herzog S, Brands C, Vets P, De laet I, Bruynseels P, De Schouwer P, van der Maas S, Bervoets K, Hens N, Van Damme P. SARS-CoV-2 seroprevalence survey among health care providers in a Belgian public multiple-site hospital. Epidemiol Infect 2021; 149:e172. [PMID: 34372955 PMCID: PMC8365049 DOI: 10.1017/s0950268821001497] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/03/2021] [Accepted: 06/29/2021] [Indexed: 11/22/2022] Open
Abstract
Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is lasting for more than 1 year, the exposition risks of health-care providers are still unclear. Available evidence is conflicting. We investigated the prevalence of antibodies against SARS-CoV-2 in the staff of a large public hospital with multiple sites in the Antwerp region of Belgium. Risk factors for infection were identified by means of a questionnaire and human resource data. We performed hospital-wide serology tests in the weeks following the first epidemic wave (16 March to the end of May 2020) and combined the results with the answers from an individual questionnaire. Overall seroprevalence was 7.6%. We found higher seroprevalences in nurses [10.0%; 95% confidence interval (CI) 8.9-11.2] than in physicians 6.4% (95% CI 4.6-8.7), paramedical 6.0% (95% CI 4.3-8.0) and administrative staff (2.9%; 95% CI 1.8-4.5). Staff who indicated contact with a confirmed coronavirus disease 2019 (COVID-19) colleague had a higher seroprevalence (12.0%; 95% CI 10.7-13.4) than staff who did not (4.2%; 95% CI 3.5-5.0). The same findings were present for contacts in the private setting. Working in general COVID-19 wards, but not in emergency departments or intensive care units, was also a significant risk factor. Since our analysis points in the direction of active SARS-CoV-2 transmission within hospitals, we argue for implementing a stringent hospital-wide testing and contact-tracing policy with special attention to the health care workers employed in general COVID-19 departments. Additional studies are needed to establish the transmission dynamics.
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Affiliation(s)
- Reinout Naesens
- Department of Medical Microbiology, ZiekenhuisNetwerk Antwerpen, B-2020Antwerpen, Belgium
- Department of Infection Prevention and Control, ZiekenhuisNetwerk Antwerpen, B-2020Antwerpen, Belgium
| | - Helena Mertes
- Department of Infectious Disease, ZiekenhuisNetwerk Antwerpen, B-2020Antwerpen, Belgium
| | - Johan Clukers
- Department of Respiratory Medicine, ZiekenhuisNetwerk Antwerpen, B-2020Antwerpen, Belgium
| | - Sereina Herzog
- Centre for Health Economics Research and Modelling of Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, B-2610Wilrijk, Belgium
| | - Christiane Brands
- Department of Infectious Disease, ZiekenhuisNetwerk Antwerpen, B-2020Antwerpen, Belgium
| | - Philippe Vets
- Department of Intensive Care and Anesthesiology, ZiekenhuisNetwerk Antwerpen, Antwerpen, Belgium
| | - Inneke De laet
- Department of Intensive Care and Anesthesiology, ZiekenhuisNetwerk Antwerpen, Antwerpen, Belgium
| | - Peggy Bruynseels
- Department of Medical Microbiology, ZiekenhuisNetwerk Antwerpen, B-2020Antwerpen, Belgium
- Department of Infection Prevention and Control, ZiekenhuisNetwerk Antwerpen, B-2020Antwerpen, Belgium
| | - Pieter De Schouwer
- Department of Medical Microbiology, ZiekenhuisNetwerk Antwerpen, B-2020Antwerpen, Belgium
| | - Sanne van der Maas
- Hospital and Medical Directory Board, ZiekenhuisNetwerk Antwerpen, B-2020Antwerpen, Belgium
| | - Katrien Bervoets
- Hospital and Medical Directory Board, ZiekenhuisNetwerk Antwerpen, B-2020Antwerpen, Belgium
| | - Niel Hens
- Centre for Health Economics Research and Modelling of Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, B-2610Wilrijk, Belgium
- Data Science Institute, I-BioStat, UHasselt, B-3500Hasselt, Belgium
| | - Pierre Van Damme
- Centre for Health Economics Research and Modelling of Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, B-2610Wilrijk, Belgium
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, B-2610Wilrijk, Belgium
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De Bruijn S, Galloo X, De Keulenaer G, Prihadi EA, Brands C, Helbert M. A special case of hypertrophic cardiomyopathy with a differential diagnosis of isolated cardiac amyloidosis or junctophilin type 2 associated cardiomyopathy. Acta Clin Belg 2021; 76:136-143. [PMID: 31478477 DOI: 10.1080/17843286.2019.1662572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Differential diagnosis between hypertrophic cardiomyopathy (HCM) and cardiac amyloidosis (CA) is mandatory since the prognosis is very different, but not always possible as both diseases present with increased myocardial thickness and mass. Despite better knowledge of the pathophysiology of both HCM and CA, and new developments in diagnosis, many patients with cardiac involvement in systemic amyloidosis are still only diagnosed in an advanced stage. Improvements in non-invasive diagnostic methods such as ultrasound techniques and cardiac magnetic resonance imaging will eventually obviate the need for invasive studies in order to prove amyloid cardiomyopathy. Nevertheless, today, an endomyocardial biopsy still remains the golden standard. We present an 86-year-old man, diagnosed with hypertrophic cardiomyopathy, in whom echocardiography and cardiac magnetic resonance imaging strongly suggested amyloidosis to be the underlying cause. Interestingly, a new variant of the junctophilin 2 (JPH2) gene, related to hypertrophic cardiomyopathies, was found in our patient.
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Affiliation(s)
- Sévérine De Bruijn
- Cardiology Department, ZNA Hartcentrum - ZNA Middelheim, Antwerpen, Belgium
| | - Xavier Galloo
- Cardiology Department, ZNA Hartcentrum - ZNA Middelheim, Antwerpen, Belgium
| | | | - Edgard A. Prihadi
- Cardiology Department, ZNA Hartcentrum - ZNA Middelheim, Antwerpen, Belgium
| | | | - Mark Helbert
- Nephrology Department, ZNA Middelheim, Antwerpen, Belgium
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Verbeke K, Verbuyst R, Brands C, Slabbynck H. Dyspnea in homosexual male patients: throwback to an occasionally forgotten but severe clinical presentation of HIV/AIDS. Acta Clin Belg 2020; 75:411-415. [PMID: 31130106 DOI: 10.1080/17843286.2019.1622880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Pneumocystis jirovecii pneumonia (PJP) can be a severe indicator disease of acquired immunodeficiency syndrome (AIDS). We present two cases of homosexual male patients who came to the emergency unit of a Belgian hospital because of shortness of breath. Both men had been sent back home, initially diagnosed with a benign viral infection. Because of worsening symptoms and gradually evolving hypoxemia, both patients came back and were admitted to the hospital with a diagnosis of (microbiology proven) Pneumocystis jirovecii pneumonia. HIV serology in both men was tested and was clearly positive, indicating a new diagnosis of HIV infection. In this article, we provide an overview of this possibly severe AIDS defining condition. First, we give an introduction of the history of HIV/AIDS and its occurrence in homosexual males in Europe. Secondly, we provide an overview of the diagnosis and treatment of Pneumocystis jirovecii pneumonia. Finally, since the first case reports of Pneumocystis jirovecii pneumonia at the beginning of the AIDS epidemic also included homosexual men, we emphasize the potential importance of a sexual anamnesis in young male patients with an initial complaint of dyspnea.
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Affiliation(s)
- Koen Verbeke
- Department of Pulmonology, ZNA Middelheim, Antwerp, Belgium
| | - Roel Verbuyst
- Department of Pulmonology, ZNA Stuyvenberg, Antwerp, Belgium
| | | | - Hans Slabbynck
- Department of Pulmonology, ZNA Middelheim, Antwerp, Belgium
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Krusche-Mandl I, Decramer A, Boltuch-Sherif J, Vlieghe E, Brands C, Vandenberghe D. Nicht-tuberkulöse mykobakterielle Infektionen an Hand und Handgelenk: Eine retrospektive Analyse von fünf Fällen. HANDCHIR MIKROCHIR P 2009; 41:283-7. [DOI: 10.1055/s-0029-1238280] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ebels J, Van Eist F, Vanderveken M, Van Cauwelaert P, Brands C, Declercq* S, Willemsen P. Splenic abscess complicating infective endocarditis: three case reports. Acta Chir Belg 2007; 107:720-3. [PMID: 18274196 DOI: 10.1080/00015458.2007.11680158] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We present three case-reports of splenic abscess in patients who were initially diagnosed with bacterial endocarditis. In all cases the diagnosis of splenic abscess was based on the findings of abdominal CT scan or MRI. All patients were treated by laparotomy and splenectomy. Two patients fully recovered and one patient, who suffered from splenic rupture and massive blood loss before surgery, died. Splenic abscess is a well-described but rare complication of infective endocarditis. Rapid diagnosis and treatment are essential as its course can prove fatal. Abdominal CT scan or MRI should be performed if there is clinical suspicion of splenic abscedation. Immediate splenectomy combined with appropriate antibiotics and valve replacement surgery is the treatment of choice. Splenic tissue is very fragile--especially if the abscess is located subcapsular--and a splenic rupture can result from minimal trauma. If the patient's general state allows it, it is best to perform splenectomy prior to valve replacement surgery to prevent re-infection of the valve prosthesis. A combined one-stage procedure is also an option.
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Affiliation(s)
- J. Ebels
- Departments of General Surgery ZNA Middelheim, Antwerp, Belgium
| | - F. Van Eist
- Departments of General Surgery ZNA Middelheim, Antwerp, Belgium
| | - M. Vanderveken
- Departments of General Surgery ZNA Middelheim, Antwerp, Belgium
| | - P. Van Cauwelaert
- Departments of Cardiovascular Surgery ZNA Middelheim, Antwerp, Belgium
| | - C. Brands
- Departments of Internal Medicine ZNA Middelheim, Antwerp, Belgium
| | - S. Declercq*
- Departments of Pathology, ZNA Middelheim, Antwerp, Belgium
| | - P. Willemsen
- Departments of General Surgery ZNA Middelheim, Antwerp, Belgium
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della Faille D, Hartoko T, Vandenbroucke M, Brands C, Schmelzer B, de Deyn PP. [Fixation of nasogastric tubes in agitated and uncooperative patients]. Rev Laryngol Otol Rhinol (Bord) 1998; 119:59-61. [PMID: 9770046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
To prevent extubation, nasogastric tubes (NGT) were attached to a fine bore polyurethane tube, which loops loosely around the nasal septum. In a prospective study 180 cases were evaluated concerning the efficacy and possible complications related to this techniques. On average, a nasal septal loop (NSL) remained 20.1 +/- 1.3 days and a NGT 14 +/- 0.9 days. Complications were rare. In 45 of the cases NGT had to be replaced after self extubation and in 2.2% extubation presented more than twice. We think NSL is an easy and useful technique to secure NGT in non-cooperative and/or agitated patients for a relatively short term enteral nutrition or gastric decompression.
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Wynants H, Van den Ende J, Randria J, Van Gompel A, Van den Enden E, Brands C, Coremans P, Michielsen P, Verbist L, Colebunders R. Diagnosis of amoebic infection of the liver: report of 36 cases. Ann Soc Belg Med Trop 1995; 75:297-303. [PMID: 8669977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The classical clinical picture of amoebic infection of the liver consists of fever, right upper quadrant pain and hepatomegaly. In recent years, the widespread availability of ultrasound and serology made an early diagnosis possible, which could result in less prominent clinical pictures. Thirty six cases of liver amoebiasis diagnosed in Antwerp between 1985 and 1992, were reviewed. Three patients acquired their infection in Belgium. For the other patients, the average delay between arrival in Belgium and the first symptoms was 5.64 months. The classical triad of clinical signs (fever, right upper quadrant pain and hepatomegaly), was observed in only 13.9% of the patients, whereas it was much more frequent in earlier studies (68-75%). The right lobe was the most frequently affected (94%). The colour of the liquid, obtained by puncture, was brown in 61% of patients in whom it was reported. Amoebic cysts were found in the stools of only one patient. Amoebic serology was initially negative in only one patient, but became positive on second testing. Chest X-rays were abnormal in 34% of the patients. All patients who develop unexplained fever during the year after a stay in tropical countries should undergo an abdominal ultrasound examination and serological testing for Entamoeba histolytica.
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Affiliation(s)
- H Wynants
- Instituut voor Tropische Geneeskunde, Antwerpen, Belgium
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Saxena VK, Brands C, Crols R, Moens E, Marien P, de Deyn PP. Multiple cerebral infarctions in a young patient with secondary thrombocythemia due to iron deficiency anemia. Acta Neurol (Napoli) 1993; 15:297-302. [PMID: 8249673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A 30-year-old woman developed multiple cerebral infarctions. In the absence of other risk factors, thrombocythemia secondary to iron deficiency anemia due to polymenorrhoea was considered to underlie the cerebral infarctions. Platelet count was normalized after iron therapy. The importance of vigorous treatment of iron deficiency anemia in preventing complications of secondary thrombocythemia is emphasized.
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Affiliation(s)
- V K Saxena
- Dept. of Neurology, General Hospital Middelheim, Belgium
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Claeys M, Brands C, Delvigne C. [Anaphylaxis induced by exertion]. Ned Tijdschr Geneeskd 1991; 135:1410-2. [PMID: 1865953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 44-year-old man with a two-year history of episodes of exercise-related urticaria and facial angioedema was admitted to our department because of vascular collapse during an athletic activity. The diagnosis of exercise-induced anaphylaxis was established after excluding other causes of shock. This clinical syndrome was described recently; it consists of urticaria, local angioedema and/or cardiorespiratory failure following exercise. Factors possibly associated with or predisposing to attacks include personal and family histories of atopy, food ingestion and weather conditions. Not every effort evokes these reactions, indicating the presence of other, still unknown variables and therefore complicating the diagnosis because provocation tests often have false-negative results. With reference to this case, the clinical syndrome, its pathophysiology and its treatment are discussed.
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Affiliation(s)
- M Claeys
- Algemeen Ziekenhuis Middelheim, afd. Interne Geneeskunde, Antwerpen
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