General Hospital Middelheim

Antwerpen, Belgium

General Hospital Middelheim

Antwerpen, Belgium

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Docx M.K.F.,Queen Paola Childrens Hospital | Vandenberghe P.,Queen Paola Childrens Hospital | Van De Broek D.,General Hospital Middelheim | Govaert P.,General Hospital Middelheim
Journal of Nepal Paediatric Society | Year: 2015

A one day old Moroccan boy was admitted to our neonatal unit with a giant tuberous right abdominal haemangioma. The clinical examination revealed no other vascular tumours. There was no evidence of heart failure. Ultrasound and MRA documented a giant vascular structure suggestive of haemangioma. The tumor responded well to propranolol treatment. © 2015, Nepal Paediatric Society (NEPAS). All rights reserved.


De Block C.E.M.,University of Antwerp | Gios J.,University of Antwerp | Verheyen N.,University of Antwerp | Manuel-Y-Keenoy B.,University of Antwerp | And 4 more authors.
Diabetes Technology and Therapeutics | Year: 2015

Background and Objective: Hyperglycemia occurs commonly in patients admitted to medical intensive care units (MICUs). Whether real-time (RT) continuous glucose monitoring (CGM) improves glycemic control and variability and reduces hypoglycemia in severely ill MICU patients with an Acute Physiology and Chronic Health Evaluation II (APACHE-II) score of ≥20 has not been studied. Subjects and Methods: Thirty-five patients (66 ± 10 years of age; APACHE-II score, 28 ± 6) were randomly assigned to RT-CGM (n = 16) using the GlucoDay®S (A. Menarini Diagnostics, Florence, Italy) device or to blinded CGM. Insulin was infused using a modified Yale protocol targeting a blood glucose level between 80 and 120 mg/dL. Outcome measures were percentage of time in normoglycemia (80-110 mg/dL) and in hypoglycemia (<60 mg/dL), glycemic variability (SD, coefficient of variation, mean amplitude of glucose excursions, and mean of daily differences), and CGM accuracy (error grid analyses, Bland-Altman bias plot, and mean absolute relative deviation). Results: During 96 h of monitoring, glycemia reached target (80-110 mg/dL) in 37 ± 15%, was between 70 and 180 mg/dL in 91 ± 10%, and <60 mg/dL in 2 ± 2% of the time. In the RT-CGM group glycemia averaged 119 ± 17 mg/dL versus 122 ± 11 mg/dL in the control group. Parameters of glucose variability and percentages of time at target glycemia and in hypoglycemia were similar between groups. GlucoDayS values and arterial glycemia correlated well, with 98.6% of data falling in Zones A and B of the error grid analysis. Mean absolute relative devation was 11.2%. Conclusions: RT-CGM did not ameliorate glucose control or variability; neither did it reduce the number of hypoglycemic events, but our insulin infusion protocol led to overall good glucose control without a significant hypoglycemia risk, making further improvement difficult. © Copyright 2015, Mary Ann Liebert, Inc. 2015.


PubMed | A. Menarini Diagnostics, General Hospital Middelheim and University of Antwerp
Type: Journal Article | Journal: Annals of intensive care | Year: 2016

Achieving good glycemic control in intensive care units (ICU) requires a safe and efficient insulin infusion protocol (IIP). We aimed to compare the clinical performance of two IIPs (Leuven versus modified Yale protocol) in patients admitted to medical ICU, by using continuous glucose monitoring (CGM). This is a pooled data analysis of two published prospective randomized controlled trials. CGM monitoring was performed in 57 MICU patients (age 6412years, APACHE-II score 287, non-diabetic/diabetic: 36/21). The main outcome measures were percentage of time in normoglycemia (80-110mg/dl) and in hypoglycemia (<60mg/dl), and glycemic variability (standard deviation, coefficient of variation, mean amplitude of glucose excursions, mean of daily differences).Twenty-two subjects were treated using the Leuven protocol and 35 by the Yale protocol; >63,000 CGM measurements were available. The percentage of time in normoglycemia (80-110mg/dl) was higher (3715 vs. 2611%, p=0.001) and percentage of time spent in hypoglycemia was lower (0[0-2] vs. 5[1-8]%, p=0.001) in the Yale group. Median glycemia did not differ between groups (118[108-128] vs. 128[106-154]mg/dl). Glycemic variability was less pronounced in the Yale group (median SD 28[21-37] vs. 47[31-71] mg/dl, p=0.001; CV 23[19-31] vs. 36[26-50]%, p=0.001; MODD 35[26-41] vs. 60[33-94] mg/dl, p=0.001). However, logistic regression could not identify type of IIP, diabetes status, age, BMI, or APACHE-II score as independent parameters for strict glucose control.The Yale protocol provided better average glycemia, more time spent in normoglycemia, less time in hypoglycemia, and less glycemic variability than the Leuven protocol, but was not independently associated with strict glycemic control.


PubMed | General Hospital Middelheim, 6 A. Menarini Diagnostics and University of Antwerp
Type: Journal Article | Journal: Diabetes technology & therapeutics | Year: 2015

Hyperglycemia occurs commonly in patients admitted to medical intensive care units (MICUs). Whether real-time (RT) continuous glucose monitoring (CGM) improves glycemic control and variability and reduces hypoglycemia in severely ill MICU patients with an Acute Physiology and Chronic Health Evaluation II (APACHE-II) score of 20 has not been studied.Thirty-five patients (6610 years of age; APACHE-II score, 286) were randomly assigned to RT-CGM (n=16) using the GlucoDay()S (A. Menarini Diagnostics, Florence, Italy) device or to blinded CGM. Insulin was infused using a modified Yale protocol targeting a blood glucose level between 80 and 120mg/dL. Outcome measures were percentage of time in normoglycemia (80-110mg/dL) and in hypoglycemia (<60mg/dL), glycemic variability (SD, coefficient of variation, mean amplitude of glucose excursions, and mean of daily differences), and CGM accuracy (error grid analyses, Bland-Altman bias plot, and mean absolute relative deviation).During 96h of monitoring, glycemia reached target (80-110mg/dL) in 3715%, was between 70 and 180mg/dL in 9110%, and <60mg/dL in 22% of the time. In the RT-CGM group glycemia averaged 11917mg/dL versus 12211mg/dL in the control group. Parameters of glucose variability and percentages of time at target glycemia and in hypoglycemia were similar between groups. GlucoDayS values and arterial glycemia correlated well, with 98.6% of data falling in Zones A and B of the error grid analysis. Mean absolute relative devation was 11.2%.RT-CGM did not ameliorate glucose control or variability; neither did it reduce the number of hypoglycemic events, but our insulin infusion protocol led to overall good glucose control without a significant hypoglycemia risk, making further improvement difficult.

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