Patients and healthcare practitioners' perspective on the development of a digital interprofessional intervention for COPD.

Background: Chronic obstructive pulmonary disease (COPD) patients often have poor health literacy, leading to non-adherence to treatment and poor inhalation technique. Technological solutions can help manage COPD, but adherence tends to be low due to various factors.

Objectives And Methods: We conducted a qualitative study to determine the needs of COPD patients and healthcare practitioners (HCPs) towards a mobile application and a web platform.

Surgery for massive splenomegaly.

Background: Splenectomy for massive splenomegaly (spleen weight more than 1·5 kg) is commonly believed to be hazardous and to provide poor palliation. The aim of this cohort study was to investigate these issues and examine the many definitions of massive splenomegaly to see whether a better tool might be proposed for preoperative evaluation of these patients.

Methods: Morbidity and long-term outcomes were assessed in consecutive patients.

Post-Chernobyl incidence of papillary thyroid cancer among Belgian children less than 15 years of age in April 1986: a 30-year surgical experience.

Objective: We raised the question of a possible relationship in Belgium between the occurrence of papillary thyroid carcinoma (PTC) and age of children (<15 years) at the time of the Chernobyl nuclear plant accident in April 1986.

Setting: Referral university centre for endocrine surgery.

Material And Methods: Thirty-year prospective study of the experience of a surgical team with PTC since the Chernobyl accident, taken out of 2349 patients operated on for any thyroid lesions from April 1986 to April 2015, comparing the incidence of PTC by age groups.

Making Surgical Care Safer: A Survey on the Implementation of the Checklist by Belgian Surgeons.

Background: The operating theatre (OT) is a complex environment. The purpose of this survey was to evaluate the implementation of the surgical checklist (SC) at individual level by Belgian Surgeons.

Methods: A Surgical Checklist Questionnaire (SCQ) related to the use of the SC by individual surgeons was attached to the registration website for the 2015 Belgian Surgical Week.

The rationale for performing MR imaging before surgery for primary hyperparathyroidism.

Objective: The purpose of this study was to evaluate prospectively Magnetic Resonance Imaging (MRI) for the preoperative localization of hyperfunctioning parathyroid glands.

Design: Prospective study of 58 consecutive patients with biochemically confirmed primary hyperparathyroidism who underwent preoperative MRI.

Setting: The setting is a referral centre.

Misleading diagnosis of renal artery stenosis by magnetic resonance angiography in a patient with primary aldosteronism.

A 24-year-old woman presented with severe hypertension. A diagnostic evaluation for secondary hypertension was undertaken. A duplex ultrasonography followed by a magnetic angiography suspected fibromuscular dysplasia.

Management of common bile duct stone late after laparoscopic Roux-en-Y gastric bypass for obesity.

Rapid weight loss following Roux-en-Y gastric bypass (RYGBP) for the treatment of obesity can increase the incidence of cholelithiasis formation. Nevertheless, routine simultaneous cholecystectomy at the time of bariatric surgery remains controversial. However, in case of delayed occurrence of common bile duct (CBD) stones, the difficulty to reach endoscopically the biliary tract after RYGBP should be kept in mind.

Diabetes mellitus as a primary manifestation of multiple endocrine neoplasia type 2B.

A 22-year-old-man presenting with diabetes mellitus was found to suffer from multiple endocrine neoplasia type 2B (MEN B). The characteristic phenotype including mucosal neuromas, musculoskeletal abnormalities and a marfanoid habitus led us to suspect this diagnosis, which was confirmed by the genetic analysis showing the typical mutation in the RET proto-oncogene at codon 918. Subsequently, diagnoses of bilateral phaeochromocytoma and medullary thyroid carcinoma were made.

[A-leukemic caecal myeloid sarcoma: a difficult diagnosis].

Myeloid sarcoma is a malignant neoplasia composed of abnormal myeloid or monocytic cells, often localized in bones, but also rarely in extra-medullary sites such as lymph nodes, skin and soft tissue. We report a case of caecal myeloid sarcoma, diagnosed in a 60 year old woman who complained from abdominal pain and weight loss, in absence of any medullary disorder. Initially misdiagnosed as a B lymphoma because of a weak positivity for CD79a, the diagnosis of primitive caecal myeloid sarcoma was eventually established after further investigations showing a positivity for lysozyme and myeloperoxidase.

Management of oesophageal perforation after delayed diagnosis: the merit of tissue flap reinforcement.

Oesophageal perforation remains a life-threatening situation and its management represents a challenge for the surgeon, especially if diagnosis has been delayed. In most cases, a surgical approach is indicated. Simple primary repair often result in leakage.

Size and geometry of hepatic radiofrequency lesions.

Aim: To report and compare the size and geometry of hepatic radiofrequency (RF) lesions using the currently available commercial devices.

Methods: A literature search was carried out for the period from January 1st 1990 to June 15th 2003. The commercial suppliers were asked to provide all available data.

Intraoperative gamma probe detection of insulinoma in an elderly patient with pancreatic cystic lesions.

Insulinoma is a rare endocrine tumour in the elderly. We report the case of an 81-year-old woman suffering from grand mal seizures. Insulinoma was suspected because plasma glucose and insulin levels were 1.

Occurrence of thyroid papillary carcinoma in young patients. A Chernobyl connection?

The risk of thyroid papillary carcinoma is increased by external radiation particularly in children under 15 years of age as shown by a marked increase in those exposed to radiation after Chernobyl. We were recently confronted in Belgium over a short period with four patients (3 F, 1 M) with papillary thyroid carcinoma who were aged 10 years, 2 months, 2 years and 6 years when the Chernobyl accident occurred. We thus raise the question of a possible relationship.

Spiral computed tomography with three-dimensional reconstructions for severe blunt abdominal traumas: a useful complementary tool?

Spiral computed tomography (CT) has proved to be a valuable tool by providing three-dimensional (3D) images of the studied structures. We hypothesized that a more realistic depiction of lesions by 3D CT could be of interest for surgeons who are treating blunt abdominal traumas and lead to less inappropriate triage. A good working relationship between surgeons and radiologists allowed us to perform a 3D CT examination in six patients.

Direct carbon dioxide insufflation of the retroperitoneum under laparoscopic control for renal and adrenal surgery.

Objective: Assessment of the videoscopic approach to the retroperitoneal space in the vicinity of the kidney and the adrenal gland.

Design: Open study.

Setting: University hospital, Belgium.

Blunt renal traumas: contribution of spiral CT with three dimensional reconstruction to the surgical decision process?

Spiral CT has proved to be a valuable tool by providing various kinds of three-dimensional (3D) images of the studied structures. Such 3D images, which offer a more realistic depiction of the lesions, could be of interest for surgeons who are attempting to treat conservatively blunt abdominal traumas and lead to less inappropriate triage between conservative and operative management particularly for renal trauma. A good working relationship between surgeons and radiologists allowed us to perform an early follow-up 3D spiral CT on a commercially available spiral CT scanner.

From laparoscopic training on an animal model to retroperitoneoscopic or coelioscopic adrenal and renal surgery in human.

So far, laparoscopic approaches to kidney and adrenal have been limited because of their retroperitoneal location. We here report eight renal and adrenal endoscopic procedures performed in seven patients: two adrenalectomies for hyperaldosteronism, one adrenalectomy for isolated metastasis from an adenocarcinoma of the lung; two nephrectomies for end-stage infected hydronephrosis, two partial nephrectomies for small circumscribed lesions of the kidney, and one endoscopic resection for pain relief of a voluminous cyst at the kidney. The approach was transperitoneal in two cases and retroperitoneal in five cases using the retropneumoperitoneum insufflation technique.

Early diagnosis of adult intestinal intussusception at four different locations.

Four cases of adult intestinal intussusception at four different locations (two ileocolic type, two colocolic type involving the transverse and the rectosigmoid colon) are reported. The most beneficial diagnostic procedures were emergency contrast studies of the colon or computed tomogram of the abdomen. Three cases were associated with primary malignancy.

Synchronous abdominoperineal resection without transfusion.

Blood loss and hypovolaemic shock affect the immune system significantly, and perioperative blood transfusion has been shown to be associated with a higher rate of tumour recurrence in patients with cancer and increased susceptibility to infectious complications. Data obtained from patients undergoing synchronous abdominoperineal excision of the rectum were analysed to assess whether such surgery is feasible without transfusion. Twenty-two consecutive unselected patients were studied.