Abstract：
CASE:A 45-year-old man presented at the emergency department (ED) with stomach pain since eight days. The patient was not worried about his symptoms and requested only pain relief. The emergency physician requested a consult of the gastroenterologist. Clinical examination was unremarkable. However, 12-lead ECG and ischemic markers were suggestive of acute coronary syndrome (ACS) which led to admission at the cardiology department. Despite delayed presentation, the patient was still referred for urgent coronary angiogram after receiving heparin, ticagrelor and acetylsalicylic acid because of persistent pain. An acute occlusion of the posterior descending artery was visualized and a percutaneous coronary intervention (PCI) with implantation of a drug-eluting stent was performed. DISCUSSION:Atypical presentation of ACS can range from non-chest pain to an epileptic seizure. Risk factors for atypical presentation include female gender, old age, comorbidities and severe mental illness. Troponin testing plays a central role when confronted with ACS but has only limited added-value with non-chest pain ACS. In cohort studies 1-2.2% of diagnosis of ACS is missed by emergency physicians. Possible explanations include atypical symptoms, non-diagnostic ECG and failure to interpret subtle ECG changes. ACS without chest pain frequently gets underdiagnosed and undertreated, which leads to more complications and a higher in-hospital mortality rate.
journal_name
Acta Clin Belgjournal_title
Acta clinica Belgicaauthors
Van Damme A,Vanderheeren P,De Backer T,Desimpel Fdoi
10.1080/17843286.2018.1460019subject
Has Abstractpub_date
2018-12-01 00:00:00pages
453-459issue
6eissn
1784-3286issn
2295-3337journal_volume
73pub_type
杂志文章abstract：:Saccharomyces boulardii is widely used as a probiotic compound and is generally thought to be safe. We report one case of fungemia caused by Saccharomyces cerevisiae occurring in an elderly patient treated orally with S. boulardii in association with vancomycin for Clostridium difficile colitis. We do not recommend ad...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1179/acb.2004.033
更新日期：2004-07-01 00:00:00
abstract：:Acute severe pancreatitis is an aggressive disease with a mortality rate of up to 30 percent. In recent years therapy has shifted away from early surgery to intensive medical care. This article focuses on several issues of the management of acute severe pancreatitis emphasising evidence from recent clinical trials and...
journal_title：Acta clinica Belgica
pub_type： 社论,评审
doi：10.1179/acb.2001.023
更新日期：2001-05-01 00:00:00
abstract：:Reversible lesions of the splenium of the corpus callosum constitute a clinicoradiological syndrome that has been associated to various medical conditions. We report the case of a 47-year-old man who presented with encephalopathy associated to auto-immune thyroid disease in which a reversible splenial lesion was isola...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1179/2295333713Y.0000000002
更新日期：2014-06-01 00:00:00
abstract：:We have studied the clinical characteristics of 126 insulin-treated diabetic patients, mainly type I subjects, who regularly performed during 18 months home glucose monitoring. The numbers of strips used each month was of 60 +/- 33 (mean +/- lSD). During the study period, HbA1C levels decreased from 8.6 +/- 2.1 to 7.0...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1080/17843286.1993.11718324
更新日期：1993-01-01 00:00:00
abstract：INTRODUCTION:Improving pain management in the ED might be attained by adequate teaching of medical students. We assessed the skills in pain treatment of ED physicians who teach the students. METHODS:All physicians working in an ED who provide elective training to undergraduate medical students from the Ghent Universit...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.2143/ACB.66.6.2062603
更新日期：2011-11-01 00:00:00
abstract：INTRODUCTION:Intra-abdominal hypertension (IAH) and subsequent abdominal compartment syndrome (ACS) in burned patients is common. This sequence of events typically occurs in patients with larger burns receiving high volume fluid resuscitation. METHODS:A review of the literature was performed. The National Library of M...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1179/acb.2007.62.s1.017
更新日期：2007-01-01 00:00:00
abstract：:25 hospitalized patients, suffering from acute bronchopulmonary affections, received every 24 hours, one I.M. injection of 750 mg of tetracycline laurylsulfate (equivalent to 500 mg of tetracycline HCl). Positive clinical results were obtained in all cases. All isolated micro-organisms, sensitive in vitro to tetracycl...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1080/17843286.1972.11716815
更新日期：1972-01-01 00:00:00
abstract：OBJECTIVE:To investigate the incidence, risk factors and mortality of ventilator-associated pneumonia (VAP) in intensive care unit (ICU) patients. DESIGN:Prospective, observational, population-based study. SETTING:The medical (14-bed) and surgical ICU (26-bed) of the Ghent University Hospital. METHODS:All 1295 patie...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1179/acb.2005.022
更新日期：2005-05-01 00:00:00
abstract：:In order to demonstrate an intake of cannabis, there are a number of rapid tests, all of them being focused on urine. In this study, we evaluated the results of six tests when applied to sweat (DrugWipe), saliva and urine (Syva Rapidtest, Biomedix, Frontline, DrugWipe, Cortez Dako). Fifty regular users of cannabis and...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：:Coronary artery disease is frequently associated with disturbed blood lipids and with a deficient blood fibrinolytic capacity. In order to investigate a possible link between hypercholesterolemia and hypofibrinolysis, we have investigated the effect of simvastatin, a HMG-CoA reductase inhibitor, on blood lipids and fi...
journal_title：Acta clinica Belgica
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1080/17843286.1992.11718214
更新日期：1992-01-01 00:00:00
abstract：AIM:To investigate the correlation between liver echogenicity and serum C-peptide levels in type 2 diabetic patients treated with oral hypoglycaemic agents. PATIENTS AND METHODS:The study included 231 type 2 diabetic patients (114 men) with a mean age of 64.3 +/- 6.9 years and a mean diabetes duration of 8.5 +/- 3.2 y...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1179/acb.2006.002
更新日期：2006-01-01 00:00:00
abstract：:Elevated intra-abdominal pressure (IAP) exerts effects not only on intra-abdominal organs, but also on organs distant to the abdominal compartment. Abdomino-thoracic interaction during intra-abdominal hypertension (IAH) or abdominal compartment syndrome (ACS) interferes with pulmonary, cardiovascular and cerebral func...
journal_title：Acta clinica Belgica
pub_type： 杂志文章,评审
doi：
更新日期：2007-01-01 00:00:00
abstract：:In Belgium, individual laboratory and treatment data of all HIV-infected patients seen in the 9 AIDS Reference Centres and 7 AIDS Reference Laboratories are collected prospectively since 2006. We present here an analysis of patients recorded in the cohort database between 1st of January 2006 and 31st of December 2008....
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.2143/ACB.67.5.2062686
更新日期：2012-09-01 00:00:00
abstract：:We report the case of a 25 year old male who presented with a well-circumscribed mass in the infratemporal fossa, without intracranial localisation. On histological examination, this tumor was a transitional type of meningioma. We review the literature and discuss the pathogenesis and the differential diagnosis. ...
journal_title：Acta clinica Belgica
pub_type： 杂志文章,评审
doi：10.1080/17843286.1998.11754176
更新日期：1998-08-01 00:00:00
abstract：:In the past 2 decades, IgE-mediated NRL allergy has become a well-defined condition with recognised risk groups, established diagnostic tools, and adequate prevention strategies (1-3). Furthermore, molecular biology and biochemical techniques have significantly improved our knowledge of the proteins responsible to cau...
journal_title：Acta clinica Belgica
pub_type： 杂志文章,评审
doi：10.1179/acb.2002.015
更新日期：2002-03-01 00:00:00
abstract：:The National Institute for Insurance of Disease and Disablement (RIZIV/INAMI) in Belgium reimburses the costs of long term oxygen therapy (LTOT) by concentrators since 1984 and by liquid oxygen since 1988 for specific categories of patients supervised by approved medical centers. Since then we prescribed these therapi...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1080/17843286.1995.11718439
更新日期：1995-01-01 00:00:00
abstract：:The objective of this study was to investigate, through a patient chart analysis, the average and the variation in the medical resource use in pulmonary embolism (PE) patients in Belgium, and to find explanatory variables for the possible variation. A sample of patients with confirmed PE (n = 54) from 5 centres was se...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1179/acb.2002.004
更新日期：2002-01-01 00:00:00
abstract：:A 12-year-old African girl presented with multiple, sharply bordered hyperpigmented patches predominantly on the dorsal, tip and lateral aspects of the tongue since 1 year (Figs 1 and 2). On clinical examination, we found an obese adolescent girl with a BMI: 26.5 kg/m(2) ( > P97) with acanthosis nigricans of the neck....
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1179/2295333715Y.0000000067
更新日期：2016-04-01 00:00:00
abstract：:Allogeneic hematopoietic stem cell transplantation (HSCT) is used for the treatment of selected hematological malignancies. Its curative potential is based on two very different mechanisms, involving the conditioning regimen and the graft-versus-host reactions, respectively. The high-dose chemo-radiotherapy conditioni...
journal_title：Acta clinica Belgica
pub_type： 杂志文章,评审
doi：10.1179/acb.2003.58.1.005
更新日期：2003-01-01 00:00:00
abstract：:The in vitro activity of cefepime has been compared with that of cefotaxime, ceftazidime, aztreonam, and piperacillin against 1826 Enterobacteriaceae including 537 inducible Enterobacteriaceae (Enterobacter spp., Serratia spp., Citrobacter spp,. Morganella morganii) and 572 non-fermenters, including 401 Pseudomonas ae...
journal_title：Acta clinica Belgica
pub_type： 杂志文章,多中心研究
doi：
更新日期：1996-01-01 00:00:00
abstract：:Despite the high prevalence of malnutrition among elderly patients, nutritional problems are still not recognized as a priority forthem by health professionals. The need for nutritional assessment and intervention is particularly crucial in this age group, in whom the incidence of chronic illness is high and a myriad ...
journal_title：Acta clinica Belgica
pub_type： 杂志文章,评审
doi：10.1179/acb.2009.017
更新日期：2009-03-01 00:00:00
abstract：OBJECTIVES:Acquired thrombotic thrombocytopenic purpura (aTTP) is a rare autoimmune disorder characterized by auto-antibodies to Willebrand factor (vWF) cleaving enzyme (ADAMTS13), resulting in unusually large vWF multimers that lead to platelet aggregation, microthrombi formation and microangiopathic hemolytic anemia....
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1080/17843286.2019.1608395
更新日期：2020-10-01 00:00:00
abstract：:Ketamine is an anaesthetic used in human medicine and veterinary practice, synthesised on 1962 and marketed on 1970 in France. Recreational uses were described during 1992 in the medical community and in 1996 in the dance settings. The chemical name of ketamine is 2--(2chlorophenyl)2-(methylamine)-cyclohexanone, an ar...
journal_title：Acta clinica Belgica
pub_type： 杂志文章,评审
doi：
更新日期：2002-01-01 00:00:00
abstract：OBJECTIVE:To assess the diagnostic performance of the CAGE and AUDIT (Alcohol Use Disorder Identification Test) and its derivatives, and laboratory tests for screening alcohol abuse or dependence in a male medical hospital population. DESIGN:A diagnostic cross-sectional prevalence study. SETTING:Three general hospita...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1179/acb.2002.048
更新日期：2002-09-01 00:00:00
abstract：:The frequency of neurologic involvement in sarcoidosis is about 5%. When the clinical picture presents with only neurological manifestations, as it did in our patient, the diagnosis at presentation is often difficult. Involvement of other tissues must therefore be actively searched. We describe a case of neurosarcoido...
journal_title：Acta clinica Belgica
pub_type： 杂志文章,评审
doi：10.1080/17843286.1992.11718250
更新日期：1992-01-01 00:00:00
abstract：:We report the findings in 21 Belgian patients (12 males and 9 females, median age 61 years) with LGLPD. Symptoms at presentation included infection (n = 9), weight loss (n = 5), asthenia (n = 9), pruritus (n = 2) and arthralgia (n = 7). Four patients were asymptomatic. The main clinical findings were hepatomegaly (n =...
journal_title：Acta clinica Belgica
pub_type： 杂志文章,评审
doi：10.1080/17843286.1992.11718206
更新日期：1992-01-01 00:00:00
abstract：:Sepsis is characterized by disturbances in liver perfusion and alterations in intrahepatic cellular functions and interactions. This provokes structural and functional liver damage as well as hepatocellular activation that is believed to perpetuate the immuno-inflammatory response. Changes in hepatic perfusion during ...
journal_title：Acta clinica Belgica
pub_type： 杂志文章,评审
doi：
更新日期：1999-08-01 00:00:00
abstract：:The development of secondary leukemia in donor cells after allogeneic stem cell transplantation is a rare event. We describe the occurrence of acute myeloid leukemia in donor cells 4 years after a stem cell transplantation for multiple myeloma. The multiple myeloma was relapsing at the time of the onset of acute myelo...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1179/acb.2006.016
更新日期：2006-03-01 00:00:00
abstract：:Temocillin, a methoxy-derivative of the broad-spectrum penicillin, ticarcillin, has been introduced into clinical practice in Belgium in 1988. Since then, not many surveys of its in vitro activity have been published. This study addresses this issue in a prospective collection of 300 consecutive Gram-negative isolates...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1179/acb.2001.053
更新日期：2001-11-01 00:00:00
abstract：:After notification of a case of fulminant hepatitis B virus (HBV) infection in a 83-year-old female resident of a nursing home to the Flemish Health Inspectorate, a seroepidemiological study and a retrospective cohort study were conducted among the 94 residents and 47 nursing staff to assess the extent of HBV transmis...
journal_title：Acta clinica Belgica
pub_type： 杂志文章
doi：10.1179/acb.2005.012
更新日期：2005-03-01 00:00:00
