Metropolitaan Kustlandschap 2100. Verkennende en methodologische analyse van de Belgische Kust

De urgentie om op een doordachte manier met ruimte om te gaan is groot. Want de wereld verandert razendsnel. Daarom is het zaak dat de verschillende ruimtelijke entiteiten, zoals wonen, bedrijvigheid, natuur en water, die van belang zijn voor deze maatschappelijke standaarden, op een zo goed mogelijke manier met elkaar in verbinding zijn. Productieve interactie! Vraag is of het huidige planningsinstrumentarium toereikend is om deze urgenties aan te pakken en zo innovatieve ruimtelijke ontwikkelingen tot stand te brengen. Kan het via participatieve processen, of moeten effectievere beleidsinstrumenten worden ontwikkeld? Ontwerpend onderzoek zal in deze ruimtelijke transformaties een grote rol spelen

Clinical and molecular epidemiological features of critically ill patients with invasive group A Streptococcus infections: a Belgian multicenter case-series.

peer reviewed[en] BACKGROUND: Recent alerts have highlighted an increase in group A streptococcal (GAS) infections since 2022 in Europe and the United States. Streptococcus pyogenes can cause limited skin or mucosal disease, but can also present as severe invasive disease necessitating critical care. We performed a multicenter retrospective study of patients with GAS infections recently admitted to Belgian intensive care units (ICUs) since January 2022. We describe patient characteristics and investigate the molecular epidemiology of the S. pyogenes strains involved. RESULTS: Between January 2022 and May 2023, a total of 86 cases (56 adults, 30 children) with GAS disease were admitted to critical care in the university hospitals of Leuven, Antwerp and Liège. We noted a strikingly high incidence of severe community-acquired pneumonia (sCAP) (45% of adults, 77% of children) complicated with empyema in 45% and 83% of adult and pediatric cases, respectively. Two-thirds of patients with S. pyogenes pneumonia had viral co-infection, with influenza (13 adults, 5 children) predominating. Other disease presentations included necrotizing fasciitis (23% of adults), other severe skin/soft tissue infections (16% of adults, 13% of children) and ear/nose/throat infections (13% of adults, 13% of children). Cardiogenic shock was frequent (36% of adults, 20% of children). Fifty-six patients (65%) had toxic shock syndrome. Organ support requirements were high and included invasive mechanical ventilation (77% of adults, 50% of children), renal replacement therapy (29% of adults, 3% of children) and extracorporeal membrane oxygenation (20% of adults, 7% of children). Mortality was 21% in adults and 3% in children. Genomic analysis of S. pyogenes strains from 55 out of 86 patients showed a predominance of emm1 strains (73%), with a replacement of the M1global lineage by the toxigenic M1UK lineage (83% of emm1 strains were M1UK). CONCLUSIONS: The recent rise of severe GAS infections (2022-23) is associated with introduction of the M1UK lineage in Belgium, but other factors may be at play-including intense circulation of respiratory viruses and potentially an immune debt after the COVID pandemic. Importantly, critical care physicians should include S. pyogenes as causative pathogen in the differential diagnosis of sCAP

Anticoagulation practices in total pancreatectomy with autologous islet cell transplant patients: an international survey of clinical programs

Diabetes mellitus: pathophysiological changes and therap