Philippe Burette

Influenza outbreak in a well-vaccinated nursing home population in Belgium.

Abstract Elderly people in nursing home communities are vulnerable to contagious infections, including the influenza virus. Systematic anti-influenza vaccination is an important preventive measure; however, vaccination does not provide absolute protection. We report an outbreak of influenza A infection in a well-vaccinated nursing home population. Several factors can facilitate the occurrence of this type of outbreak. This report mainly addresses the discrepancy between the circulating viral strain and strains present in the recommended vaccine.

Enfants à haut potentiel: attitude du médecin traitant

Points essentiels Les enfants a haut potentiel intellectuel representent environ 2 % de la population, mais ne sont pas toujours identifies. Ils peuvent souffrir de dyssynchronie interne et sociale , et leurs relations scolaires et familiales peuvent etre perturbees. Les medecins sont consultes principalement pour des troubles de l’humeur ou du comportement, des somatisations. Si des troubles du comportement ou de l’humeur semblent pouvoir etre rapportes a une inadaptation scolaire , il importe de faire pratiquer un bilan psychologique et psychometrique rapidement. Le diagnostic differentiel avec le trouble de deficit de l’attention avec hyperactivite est essentiel en raison de ses implications therapeutiques. Une partie substantielle de la prise en charge du phenomene releve des pedagogues et du milieu scolaire en general. Le medecin est un acteur privilegie dans le soutien de l’enfan t et de sa famille, dans le traitement des troubles associes: depression, anxiete, troubles du sommeil, somatisations. Le traitement medicamenteux n’a qu’une place tres limitee .

Retrospective analysis of a suburban out-of-hours clinic in Belgium

Abstract 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-of-hours 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.

Quatre ans d’application de la loi de dépénalisation de l’euthanasie en Belgique

Legislation decriminalizing euthanasia came into effect in Belgium in 2002. Its application is monitored by a federal Commission, which submitted 2 reports to the Parliament, one covering the first 15 months of application and the other the years 2004 and 2005. This article analyzes and comments on the contents of these 2 documents, which provide interesting information on the medical practice of euthanasia in Belgium.