Health issues
Thoracic Oncology Clinic
Clinic Mission: Management of Thoracic Cancers The Thoracic Oncology Clinic at H.U.B specializes in the multidisciplinary management of patients with lung, pleural, and mediastinal cancers, including:Bronchopulmonary cancers (non-small cell and small cell)Pleural tumors (mesotheliomas and others)Mediastinal tumors (thymomas and others)Pleuro-pulmonary metastasesDiagnostic management is provided through an advanced pulmonary endoscopy unit (bronchoscopic fiberoscopy, GPS navigation, endobronchial ultrasound [EBUS], cryobiopsies, etc.) and close collaboration with a highly skilled team of pathologists and the molecular biology laboratory.The weekly multidisciplinary thoracic oncology meeting (CUB Erasme Hospital and Jules Bordet Institute) brings together top specialists in radiology, nuclear medicine, pneumology, thoracic oncology, thoracic surgery, radiotherapy, pathology, ISO, and other fields. This collaboration is the foundation for evidence-based therapeutic decisions aligned with the latest scientific research and best practice guidelines.Surgical management is provided by the Thoracic Surgery Department, in line with our institution’s long-standing integrated medical-surgical model.Radiotherapy management is provided by the Institut Jules Bordet team.Collaboration with the Gamma Knife Center of the Neurosurgery Department at Erasme Hospital and the Radiotherapy Department at Institut Jules Bordet ensures optimal management of brain metastases. Learn more about lung cancer care at the Jules Bordet Institute Academic Mission Training of medical residents in Pneumology and Internal MedicineTraining in Thoracic OncologySupervisor: CUB Erasme Hospital – J. Bordet Institute (ULB): Dr Mekinda Ngono Zita LéaOthers Research Mission Les activités de recherche clinique et fondamentale sont réalisées en collaboration avec l’Institut Jules Bordet et la faculté de médecine de l’ULB.Depuis la Création de l’Hôpital Universitaire de Bruxelles (HUB) en 2021, la prise en charge des pathologies oncologiques thoraciques se fait dans le cadre d’un projet de soins inter-inhospitalier CUB Hôpital Erasme et l’Institut Jules Bordet. Clinical and fundamental research activities are conducted in collaboration with the Jules Bordet Institute and the ULB Faculty of Medicine.Since the creation of the Brussels University Hospital (HUB) in 2021, the management of thoracic oncological diseases has been organized within an inter-hospital care project between CUB Erasme Hospital and the Jules Bordet Institute. Multidisciplinary Thoracic Oncology Team Dr Mekinda Ngono Zita: Pulmonologist, Thoracic OncologistProf. Thierry Berghmans: Medical OncologistProf. Dimitri Leduc: PulmonologistProf. Benjamin Bondue: PulmonologistDr Blandine Jelli: Pulmonologist, Thoracic OncologistDr Olivier Taton: Pulmonologist, Thoracic OncologistProf. Mariana Brandao: Medical OncologistDr Anouk Goudsmit: Medical OncologistDr Alice Carrette: Pulmonologist, Thoracic OncologistDr Bogdan Grigoriu: PulmonologistDr Youri Sokolow: Thoracic SurgeonDr Maria Ruiz: Thoracic SurgeonDr Maarten Vander Kuylen: Thoracic SurgeonDr Elena Prisciandaro: Thoracic SurgeonProf. Pia Di Campli: Thoracic SurgeonProf. Myriam Remmelink: AnatomopathologistProf. Luigi Moretti: RadiotherapistProf. Caroline Keyzer: Radiologist
Thoracic Oncology Clinic
Health issues
Interstitial and Diffuse Pneumonias Clinic
What are interstitial pneumonias? Diffuse interstitial pneumonias are a group of relatively rare lung diseases. They are disorders of the lung parenchyma (that is, of the lung itself) with a varying degree of inflammation and fibrosis resulting in a sometimes severe respiratory insufficiency.  The principal pathologies covered by this term are •    Idiopathic pulmonary fibrosis •    Sarcoidosis •    Non-specific interstitial pneumonia •    Cryptogenic organising pneumonia •    Lung disorders secondary to autoimmune diseases (connective tissue disease and vasculitis)  •    Hypersensitivity pneumonitis (farmer‘s lung, bird fancier’s lung •    Some pneumonias of occupational origin (exposure to asbestos or to mineral or metal dust) or drug induced Idiopathic pulmonary fibrosis (IPF) Idiopathic pulmonary fibrosis (IPF) is the most common disease of this group, together with sarcoidosis. The annual incidence is estimated at 10 new cases for 100,000 persons per year and this figure seems to be rising. In IPF the lung is progressively destroyed and replaced by scar tissue. This results in an irreversible and progressive respiratory insufficiency.  Causes and risk factors Its etiology is unknown but smoking, pollution, exposure to certain viruses and the presence of gastroesophageal reflux are risk factors. There are also family forms in which gene mutations have been clearly identified.  IPF affects more men than women and is generally diagnosed at around the age of 60.  Diagnosis and treatment These diseases are rare and therefore demand particular expertise. The diagnosis is complex and requires a multidisciplinary discussion.  In the case of idiopathic pulmonary fibrosis there are two possible treatments: with Esbriet or Ofev. These do not cure the diseases but do make it possible to slow its progress.  If the patient shows no contraindications a lung transplant must be envisaged. In this particular case we work closely together with the lung transplant team. Multidisciplinary meetings are held regularly to discuss complex cases and we have a clinical research unit that permits access to an advanced research programme in this field and patients are invited to participate in international trials to test new treatments.  The Erasmus Hospital is a member of the European experts network in the field of diffuse interstitial pneumonia (ERN lung). We are active in the field of clinical research by providing the opportunity to participate in research protocols and clinical trials.  Finally, we support and participate actively in activities organised by patients’ associations, in particular the   Association Belge Francophone contre la Fibrose Pulmonaire (ABFFP). Useful documents Informations destinées aux patient(e)s Brochure : thérapie par Esbriet (pirfénidone) Brochure : Fibrose Pulmonaire Idiopathique (FPI) Brochure : traitement de votre Fibrose Pulmonaire Idiopathique (FPI) avec OFEV® Requests for opinion Téléchargez le document de demande d'avis de la part du médecin traitant ou spécialiste à destination de la Clinique des pneumopathies interstitielles diffuses. Demande d'avis Multidisciplinary team Découvrez l'équipe multidisciplinaire de la Clinique de Pneumopathies interstitielles et diffuses. Organisation chart Our specialists
Interstitial and Diffuse Pneumonias Clinic
Health issues
Horizon TransIdentity Centre (CHTI)
Our role The centre supports people who are transgender or who are questioning their gender identity, together with their loved ones, by giving them the opportunity to explain their difficulties and put their questions to  trained healthcare professionals. Our multidisciplinary team supports people of all ages, from children to adults, as part of an open and non-pathologizing approach. Our mission is also to provide information within the various health structures. Our specialities The centre has a multidisciplinary team and experts who are references in their specialities, consequently providing the most comprehensive support possible: Psychology and Sexology: Our psychologists and sexologists are at the heart of the support provided by the Horizon TransIdentity Centre. They are ready to listen to the life experiences of beneficiaries in a one-to-one, family or group context. Social service: This provides information and assistance to facilitate administrative procedures (link with the various institutions the beneficiaries are in contact with, assistance in obtaining identity documents, financial accompaniment, etc.) Paediatric endocrinology: Permits support during puberty, comprehensive health checkups and detailed information on puberty blockers as well as on the various gender-affirming hormone  treatments. When these treatments are prescribed the child endocrinologist makes regular progress checks to ensure the young person in question receives optimal care. Endocrinology: Permits detailed information on the different gender-affirming treatments. When these treatments are prescribed the endocrinologist makes a regular progress check to ensure optimal care. Gynaecology: Our Gynaecology Department has solid experience in the field of fertility preservation and medically assisted procreation. Our department ca also support beneficiaries when undergoing certain surgical procedures (hysterectomy, ovariectomy, etc.).   Urology and paediatric urology: The Urology Department permits support and follow-up before and after gender-affirming surgery  (metaidoïoplasty, phalloplasty, etc.)Child, adolescent and adult psychology: For beneficiaries who express the need, these departments permit an assessment and monitoring of a mental health problem by child psychiatrists and psychiatrists trained to be aware of and attentive to the plurality of gender expression. Plastic surgery: Our department proposes support throughout the various gender-affirming surgical procedures (torsoplasty, breast enlargement, facial surgery, etc.)Genetics: The Genetics Department is available to respond to doubts and questions, especially for intersex beneficiaries. Internal medicine: Through the HIV Reference Centre in particular, we are able to offer advice and support on sexual health.  Our team Centre :Marie Poncelet - CoordinatorSandrine Deplus – Psychologist & Case ManagerCatherine Odent – Psychologist & SexologistDenis Storme– Social worker Centre references, per speciality:Child urologist: Karim KhelifChild endocrinologist: Cécile Brachet & Alfredo VicinanzaChild psychiatry: Marie Poncelet & Véronique DelvenneEndocrinology: AglaiaKyrill i& Rebecca FischlerUrology: Thierry RoumeguereGynaeology: OraniteGoldrat& Anne DelbaerePlastic surgery: Diane Franck & Frederic UrbainGenetics: Catherine Vilain & Urielle UllmannPsychiatry: Camille PointInternal medicine – HIV Reference Centre : Jean-Christophe Goffard Contacts For beneficiaries aged under 16: child psychiatry consultation secretariat at HUDERF : +32 (0)2 477 31 80For those aged 16 and over: secretariat for child psychiatry consultations at Erasme : +32 (0)2 555 39 40
Horizon TransIdentity Centre (CHTI)
Services
Brussels University Hospital Laboratory (LHUB)
Discover the activities of the Brussels University Hospital Laboratory on their website.
Laboratoire Hospitalier Universitaire de Bruxelles
Health issues
Raynaud’s disease
What is Raynaud’s disease? Raynaud’s disease is a disorder that affects the blood circulation, principally in the fingers and toes but sometimes in the ears, nipples, knees or nose.  It is characterised by a vasospasm – sudden constrictions of the blood vessels that considerably reduce the blood flow to the extremities – most often triggered by an exposure to cold but also by emotional stress. It can exist as an isolated  condition (primary Raynaud’s disease), in which case it is observed more frequently in women and people living in colder climates. The exact cause of primary Raynaud’s disease is not known.      Raynaud’s disease also occurs in men and women with autoimmune diseases, diseases of the conjunctive tissue and also other diseases, most notably:  Systemic scleroderma  Disseminated lupus erythematosis Sjögren’s disease  Rheumatoid polyarthritis  Polymyositis  Pulmonary hypertension Buerger’s disease (thromboangiitis obliterans) In these cases one speaks of secondary Raynaud’s disease. What are the risk factors?  Although we don’t know why certain persons develop Raynaud’s disease, certain risk factors are known:  Pre-existing connective tissue Autoimmune disease Smoking Repetitive pressure exercised on the hands, by using vibrating tools for example (electric tools)  Injuries or traumas Exposure to chemical products Side effects of certain medicines (beta blockers)  Etc. Symptoms and diagnosis There are some very frequent symptoms encountered in Raynaud’s disease patients but each patient can experience different symptoms. The fingers and toes turn white, then blue – generally after having been exposed to cold air or cold objects, or after having suffered stress – and then turn red when warmed up again. In serious cases, sores develop at the ends of the fingers or toes. In rare cases the fingers or toes can become infected or gangrenous, requiring amputation in the absence of treatment.  How to diagnose Raynaud’s disease ? Patients in our medical clinic are initially assessed by a rheumatologist and, depending on the severity, they can also be examined by a vascular specialist.  A large part of the diagnosis will focus on assessing the symptoms. In addition to a complete medical history and a medical examination, our team will generally order at least one type of blood test. A patient may also undergo a cold provocation test to highlight the colour changes in the hands or feet. With secondary Raynaud’s disease it is also important to identify - and treat- the underlying autoimmune disease that may be at the origin of the Raynaud’s disease (for example systemic sclerodermia: see the Erasmus Hospital’s systemic sclerodermia reference centre).  An examination by capillaroscopy is carried out. This non-invasive and painless examination makes it possible to visualise the capillaries in the nail bed. In the case of secondary Raynaud’s disease, as in the case of systemic sclerodermia, a reduction in the number of capillaries is observed as well as  the presence of dilated capillaries.       Treatment After an in-depth evaluation the team of doctors will draw up a treatment plan based on the type and extent of the disease, the general health status of the patient and the patient’s preferences.   Although there is no cure for Raynaud’s disease, it can normally be managed with appropriate treatment, such as:  Lifestyle changes: Limit exposure to the cold by dressing warmly: gloves, socks, scarf, hat and several layers  Stop smoking to improve circulation and your health in general Avoid the use of vibrating tools. Medical treatment Alpha blockers suppress the response of the sympathetic nervous system that leads to vasoconstriction (narrowing of the blood vessels)  Other medicines improve the blood flow to the fingers and toes by dilating the blood vessels. These include  calcium channel inhibitors and phosphodiesterase  inhibitors. Avoid using beta blockers, generally used for treating high blood pressure and that slow the heart rate and reduce the blood flow to extremities For patients who do not show a sufficient response to the aforementioned medicines there can be experimental medicine options - medicines that can be used in clinical trials. 
Raynaud’s disease
Health issues
Sjögren’s disease
What is Sjögren’s disease?  Sjögren’s disease (also known as Sjögren’s syndrome) is a chronic autoimmune disease characterised by the infiltration of the salivary and lachrimal glands by immune system cells (lymphocytes). This disorder of the exocrine glands explains the appearance of dry syndrome characterised by dry eyes and mouth.  Sjögren’s disease is characterised by the dysfunctioning of the exocrine glands (one speaks of “exocrinopathy”), which is the cause of the dry eyes and mouth but also dryness of the nose, throat, bronchi, skin and vaginal mucosa. This generalised dryness is very debilitating, having a negative impact on quality of life and can be the source of local complications: dry keratoconjunctivitis, oral mycosa, infection of the salivary glands, etc. Sjögren’s disease is also a systemic autoimmune disease that can affect virtually all the organs. These so-called extraglandular manifestations can result from three different mechanisms: 1/ The appearance of a lymphocytic infiltration in other tissues than the exocrine glands (primary biliary cirrhosis, renal tubular impairment, bronchial damage) 2/ autoimmune  impairment linked to the presence of immune complexes or specific autoantibodies and 3/ an uncontrolled proliferation of chronically stimulated B lymphocytes (lymphocytic interstitial pneumonia, lymphoma). Epidemiology After rheumatoid arthritis,  Sjögren’s disease is the most common connective tissue disease with a prevalence of    0.1-0.6% in the general population. It is a disease that affects primarily women (9 women for 1 man), generally aged between 40 and 50. Its appearance around the time of the menopause in women and its relatively unspecific manifestations (dryness, pain, tiredness) explain why it is often late in being diagnosed.  Clinical manifestations The trio of dryness - tiredness - pain (Sicca Asthenia Polyalgia) The trio of dryness – tiredness – pain, known by some as SAP (Sicca-Asthenia-Polyalgia) syndrome, are the main complaints expressed by patients with Sjögren’s disease. As the disease appears in the exocrine glands, it is not surprising that almost 96% of patients present eye and mouth dryness that is often very debilitating. This dryness can be more general and affect the respiratory tracts (cough) and vaginal mucosa (intimate dryness in women). More than 50% of  Sjögren’s disease patients report tiredness as a symptom. Finally, almost 1 in 2 patients have chronic joint and muscular pain without any clear anatomical cause, making it similar to fibromyalgia syndrome. These “SAP” manifestations can be very debilitating, preventing the patient from working and considerably reducing the quality of life of patients with Sjögren’s syndrome. Extraglandular manifestations of autoimmune origin Although often reduced to its symptomatic trio as set out above,  Sjögren’s disease nevertheless remains a systemic rheumatological disease of autoimmune origin that can affect any organ of the body, sometimes very seriously. In regard to this dimension, it is close to its cousin: disseminated lupus erythematosus. Sjögren’s disease can thus manifest through a Raynaud phenomenon, constitutional manifestations (fever of unexplained origin, weight loss), glandular manifestations (major swelling of the  protid and submaxillary saliva glands), ganglionary manifestations (swollen glands known as adenopathies), joint manifestations (inflammatory pain with morning stiffness for more than 30 minutes, polyarthritis),   muscular manifestations (inflammatory myositis), neurological problems (polyneuropathies, brain vasculitis, symptoms miming  multiple sclerosis), bronchial lung damage or damage to lung tissue, kidney damage (proteinuria, renal failure, glomerular lesions, tubulointerstitial lesions complicated by tubular acidosis or osteomalacia), autoimmune haematological manifestations (anaemia, thrombocytopenia, leukopenia) and biological haematological manifestations (cryoglobulinemia, complement consumption, hypergammaglobulina). Non-Hodgkin’s lymphoma The intense activation of the immune system can lead to a major increase in B lymphocytes. If these lose their regulating mechanism, a B cell sub-population will continue to proliferate without limit: this is a cancer of the immune system, known as non-Hodgkin’s lymphoma. It is a complication found in between 5 and 10% of Sjögren’s disease patients. Generally slow to develop and quite discreet, it should be sought in the case of a chronic unilateral swelling of a salivary gland, adenopathies or an unexplained fever, for example. The rheumatologist may screen persons at risk of developing a lymphoma subsequent to  Sjögren’s disease by searching for clinical and biological anomalies reflecting the appearance of an excessive B-cell proliferation and monitor them more closely.  Diagnosis Due to its frequent non-specific manifestations  - tiredness, pain and dryness – and its systemic manifestations that can be polymorphous (neurological, kidney, lung, skin disorders, etc.) Sjögren’s disease can be complicated to diagnose.  In addition, there is not at present any single test that permits a diagnosis. The diagnosis is based on a set of clinical and biological arguments:  Subjective dryness of the eyes and mouth; Objectification of an impaired functioning of the salivary and lachrimal glands   - Establishing of damage to the surface of the eye by an ophthalmologist ; - Establishing of a reduced lachrimal flow by the Schirmer test; - Establishing of a reduced salivary flow by a sialometry; - Establishing of a malfunctioning of the salivary glands by a scintigraphy; - Establishing of MRI or ultrasound anomalies in the salivary glands. Lymphocytic Infiltration on a biopsy of accessory salivary glands; Establishment of anti-Ro/SSA and/or anti-La/SSB autoantibodies in the blood. Treatment There is not at present any curative treatment for Sjögren’s disease. Treatment is based on 3 dimensions: The dryness syndrome, tiredness and chronic pain (evaluated by the ESSPRI score) are treated on a  symptomatic and multidisciplinary basis in cooperation with the Departments of Ophthalmology and Physiotherapy and the Pain Clinic. The initial evaluation aims to exclude the involvement of certain manifestations systemic to tiredness and pain  (hypothyroidism, osteomalacia, lymphoma) as well as to identify persistent limiting factors (sleeping problems, depression, kinesiophobia, etc.) before proposing a multimodal treatment.  These interventions include prescribing artificial tears or saliva and the use of eye drops based on an autologous serum.  Pilocarpin is also a medication commonly prescribed to permit an increase in tear or saliva secretions. Sjögren’s disease is recognised as a “serious pathology” that brings the entitlement to 60 physiotherapy sessions a year. Following a diagnosis by your rheumatologist your mutual insurance company can also grant you monthly financial assistance to purchase eye drops and other medicines against dryness. Extraglandular manifestations of an autoimmune origin (evaluated with the aid of the ESSDAI score) can be present to very variable degrees. Depending on the organs affected and the seriousness of the inflammation, an immune suppression / immune modulator treatment may be prescribed by the rheumatologist: corticoids (Médrol), hydroxychloroquine (Plaquenil), méthotrexate, azathioprine, mycophenolate mofetil, rituximab or cyclophosphamide. Within our institution, the multidisciplinary treatment of complex systemic diseases   - of which Sjögren’s disease is one – is one of the missions  of the  MISIM (Immuno-Mediated Systemic Inflammatory Diseases) platform that includes rheumatologists, general internists, nephrologists, pneumologists, dermatologists... with a penchant for and expertise in autoimmune diseases. Sjögren’s  disease – apart from the intense activation of B lymphocytes – can be complicated in certain patients by a non-Hodgkin’s lymphoma (cancerous proliferation of the lymphocytes). This risk is the reason for at least an annual clinical and biological follow up in patients with Sjögren’s disease. If a lymphoma appears  in a patient being monitored for Sjögren’s disease, the patient will be monitored in cooperation with our hospital’s Department of Haematology.   
Sjögren’s disease
Health issues
Early arthritis and rheumatoid arthritis
What is it about? Rheumatoid arthritis is a chronic and progressive inflammatory disease that affects many people in Belgium, most often at a young age. At Hôpital Erasme, this condition is treated by a specialized team within the Rheumatology department. The Early Arthritis Clinic Rheumatoid arthritis is the most common systemic autoimmune disease and affects approximately 0.5% of the population. If the disease is not correctly diagnosed and treated within the first months after the onset of symptoms, it can lead to irreversible joint damage. Early treatment of the disease can positively influence its course and thereby prevent disability.The HERA early arthritis clinic rapidly receives patients in whom inflammatory arthritis is suspected and uses advanced techniques to establish a diagnosis as quickly as possible. Tailored toolsThe traditional approach based on systematic history-taking and clinical examination is complemented by joint ultrasound, which can visualize intra-articular inflammation and detect joint erosions even before they become visible on X-rays.A blood test, performed by your general practitioner before the consultation or prescribed during the first visit, provides additional information to support the diagnosis. In addition, X-rays of the affected joints are performed in all patients.If necessary, a more in-depth examination using MRI is proposed to further clarify the cause of the pain. All of this information makes it possible to establish a diagnosis of polyarthritis within one week and to start the necessary treatment to relieve pain, control inflammation, and improve joint function.The clinic’s physicians then ensure effective treatment and close follow-up of the disease, and provide you with all necessary information regarding your condition. In parallel, the early arthritis clinic offers access to a specialized rheumatology nurse, a team of physiotherapists and occupational therapists specialized in rheumatoid arthritis, as well as rapid access to studies of new medications if needed. How to request a consultationYour general practitioner can use this form to refer you to the clinic; you will then be seen within 15 days. The Rheumatoid Arthritis Clinic What is rheumatoid arthritis?Rheumatoid arthritis (RA) is a chronic inflammatory disease that causes pain, stiffness, and swelling (inflammation) of the joints. Joints that remain inflamed can become damaged and deformed, which may lead to disability. The synovial membrane can thicken, and the surrounding ligaments, cartilage, and bone may also be affected.Rheumatoid arthritis typically affects joints in a symmetrical pattern: if, for example, one hand is affected, the other is likely to be affected as well. Causes of rheumatoid arthritisThe exact cause of rheumatoid arthritis is unknown. It is an autoimmune disease, meaning that the patient’s immune system attacks its own healthy cells and tissues. This causes inflammation in the joints and surrounding tissues. Often, this inflammation is also systemic and may affect other organs such as the lungs and the heart.Heredity is a risk factor for developing rheumatoid arthritis, and smoking is also recognized as a factor that promotes its onset.The disease most commonly affects adults between 30 and 50 years of age, and more often women, but it can occur at any age and in both sexes. Symptoms of rheumatoid arthritisRA most commonly affects the hands, wrists, ankles, feet, knees, shoulders, and elbows. The onset of the disease may be gradual and slow or sudden and rapid. Each patient may experience different symptoms, including:PainJoint stiffness, especially in the morningJoint swellingReduced joint mobilityDifficulty with daily activities (opening a jar, buttoning a shirt, etc.)Difficulty grasping or pinching objectsFatigue and lack of energyOccasional feverThis list is not exhaustive, and these symptoms can also occur in other conditions. A medical consultation with a rheumatologist is necessary to establish a diagnosis. Diagnosis of rheumatoid arthritisThe initial diagnosis of RA is often challenging: symptoms are usually mild, and abnormalities in blood tests or X-rays may not yet be visible. The rheumatologist will perform a full medical history and a detailed clinical examination. Several diagnostic tests may be carried out:Bone X-raysJoint aspiration and synovial fluid analysis to detect infection, signs of inflammation, or crystalsBlood tests for inflammatory markers such as CRP, and diagnostic markers such as rheumatoid factor and anti-citrullinated protein antibodies (anti-CCP)Joint ultrasound and MRI: specialized imaging studies to detect joint inflammation and damage to bone and cartilage. Duration of the diseaseMost people with polyarthritis face a chronic disease, often with alternating periods of severe pain (inflammatory flare-ups) and periods of symptom improvement. In rare cases, symptoms disappear completely, known as spontaneous remission. Fortunately, thanks to currently available treatments, most patients are able to return to a normal life, something that would be impossible without medical treatment. Treatments for rheumatoid arthritisTreatment is usually medication-based, but physiotherapy and a balanced approach between rest and physical activity can also help. At present, there is no cure for polyarthritis, but treatment helps control symptoms and prevent inflammatory flare-ups and disease-related damage.Treatment varies from person to person depending on disease severity, comorbidities, other medications, and patient preferences. The goal is to allow patients to maintain their lifestyle, reduce joint pain, and prevent permanent joint damage and disability.The mainstay of treatment consists of so-called DMARDs (disease-modifying antirheumatic drugs), which aim to control inflammation and prevent joint damage. These include classic drugs such as methotrexate, leflunomide, and sulfasalazine, as well as biological agents (anti-TNFα, anti-IL6, CTLA4 agonists, and rituximab) and small synthetic molecules (JAK inhibitors), which are second-line treatments.These medications are often combined with systemic anti-inflammatory drugs (NSAIDs and corticosteroids) and local treatments (intra-articular corticosteroid injections). These are needed as a “bridge” between the start of DMARD therapy and the time it takes for them to become effective, which can sometimes take several months. The Rheumatoid Arthritis Clinic At Hôpital Erasme, the rheumatoid arthritis team provides comprehensive care in a single location, ranging from medical imaging to physiotherapy, including treatment follow-up and pain management.
Early arthritis and rheumatoid arthritis
Article
Feeding tube: a tool to take care of yourself when your body needs it
When a patient can no longer eat by mouth, either temporarily or on a more permanent basis, another route must be found... What exactly is a feeding stoma?When a patient can no longer eat by mouth, either temporarily or on a more permanent basis, another route must be found. A gastrostomy is one of these alternatives: it consists of creating a small opening that connects the stomach to the skin through a tube. The procedure is performed endoscopically, using a simple technique that avoids major surgery and allows the tube to be placed safely.Who is concerned?People who require a gastrostomy have very different profiles, but they share the same reality: their body can no longer meet their nutritional needs on its own.“This may be related to neurological diseases that affect swallowing, established malnutrition, certain cancers that weaken the body, or lung diseases that use up all the available energy,” explains Ms Ballarin.When oral feeding is no longer possible or is insufficient, and this situation is expected to last, gastrostomy becomes an appropriate and safe option to ensure a reliable and continuous nutritional intake for the patient.Is it risky?“As with any medical procedure, complications can occur, but they are rare, often mild and, above all, largely preventable,” reassures the head nurse.Everything begins well before the procedure: the team meets with the patient and their relatives, explains each step, answers questions and prepares the return home. Anaesthesia or sedation may be offered to ensure the procedure takes place under the best possible conditions. This preparation phase is not a minor detail: it reduces stress and limits risks for the patient.In the long term: manageable inconveniences“Following good practices reduces the risk of complications, which is why therapeutic support for patients and their caregivers is so important. Education and training have three objectives: ensuring effective tube feeding, preventing complications and improving the patient’s comfort,” stresses Ms Ballarin.The most common complications are skin-related issues, such as inflammation, granulomas, fungal infections or local infections. These skin problems are generally mild and can usually be treated easily with appropriate care.Digestive intolerances may also occur, such as nausea, bloating, diarrhoea or constipation. Although these symptoms can be unsettling, they are usually easy to understand and, above all, can be corrected through adjustments to the way the feeding is administered.The most frequent late complications are skin irritations around the tube (redness, inflammation, fungal infections), which can also be treated easily. Digestive problems (a sensitive abdomen, altered bowel movements or constipation) may appear when enteral nutrition is started, meaning when liquid nutrition is delivered through the tube. These symptoms can sometimes worry patients, but they have explanations and, most importantly, can be treated.The right daily habits?Two simple steps every day: clean the area with water and dry it thoroughly. Clean and dry skin helps prevent irritation and limits most complications. The second step is less obvious but just as essential: gently move the tube every day with a small back-and-forth movement. This simple action prevents the tube from becoming embedded in the stomach wall, a rare but serious complication that can largely be prevented thanks to the advice provided to patients.“Each patient leaves with a clear information booklet and a detailed care protocol. Consultations take place twice a week, on Monday afternoons and Wednesday mornings. A full assessment is organised every six months. And if there is any doubt, a direct helpline is available at any time. Often, a simple phone call or a photo sent from a smartphone is enough to reassure the patient and solve the problem, sometimes without the need to come to the hospital,” explains Ms Ballarin. Discover the nursing team When should you contact us?“It is essential to inform us as soon as an adverse event occurs, whether or not it is related to the tube. Some signs, even if they seem minor at first, can quickly become troublesome for the patient and compromise the continuation of nutritional treatment. Our role is precisely to intervene early to prevent these small problems from becoming more serious,” she explains.Any redness, irritation, discharge or unusual pain around the tube should be reported immediately. These problems are common but can be treated easily when managed quickly.Digestive discomfort is often misunderstood. A bloated abdomen, nausea, constipation or pain does not necessarily mean that “the nutrition is not being tolerated”. In most cases, it simply means that an adjustment is needed: the feeding rate may be too fast, the timing may not be suitable, hydration may be insufficient, or there may sometimes be a cause unrelated to the tube itself (gastroenteritis, medication, stress, etc.).Difficulty flushing the tube and/or an inability to administer the nutrition should be reported without delay. An early blockage can usually be resolved easily; a later obstruction may require the tube to be replaced.What about the patient’s social life?A gastrostomy never occurs in isolation. It enters lives that have already been disrupted by illness. A stroke that changes everything overnight, motor neurone disease that progresses, cancer that gradually drains the body. In these challenging journeys, every new medical step can feel like an additional burden. This is precisely where the healthcare team plays a key role: helping transform a tube that may initially be perceived as a burden into a genuine source of support.A feeding stoma cannot replace what a meal represents, because eating is about much more than nutrition: it is about sharing a moment, sitting at the table with the people we love. For some patients who can no longer eat by mouth, this loss creates a deep sense of absence that can sometimes be difficult to express.“It is essential to acknowledge this loss, to listen to it and to provide support. Tube feeding does not claim to fill this void. However, it can provide the energy needed to continue experiencing these moments in a different way: being present, taking part, and staying connected with others. Feeding is not only about calories: it is also about meaning, connection and dignity,” emphasises Ms Ballarin.A word for someone who has just learned they will need a gastrostomy?For many people, gastrostomy can feel like one more difficult step in an already challenging journey with an underlying illness. These are diseases that disrupt everything: the body, independence, social life and identity. So yes, hearing that a feeding tube will be placed can be frightening. This is a normal reaction. The aim is to help patients find meaning where there is fear, and to restore a sense of perspective when everything seems to be becoming more complicated.A gastrostomy is not a failure. It is a treatment. Just as a broken leg requires rehabilitation, a weakened body may need support to receive adequate nutrition. It is not giving up; it is providing help.In an already difficult journey, being told that a gastrostomy is needed may feel like another sign that things are getting worse. This reaction deserves to be heard and acknowledged, not dismissed.And then, the way we see it changes.“A gastrostomy is not a defeat but a form of support. It is a practical way to take care of yourself when your body needs it,” concludes Ms Ballarin. Asuncion Ballarin Head Nurse, Stoma Care Nurse, Head of the Clinical Nutrition, Wound Care and Stoma Therapy Unit at H.U.B Contact our stomatherapy team Read also... “With a stoma, my body is different, but life is still possible.”It is often imagined as something impossible to overcome. A “hole in the abdomen,” a distressing image, a life turned upside down, intimacy forever changed. And yet…Read more
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Geriatrics Symposium
The must-attend event for anyone and all healthcare professionals interested in geriatric care and care pathways that support healthy ageing for older adults. Preliminary Programme 6:00 PM – Welcome and registration 6:30 PM – Keynote: Geriatrics – Helping People Continue Living What Matters MostDr Pierre Hanotier, Head of the Department of Geriatrics, H.U.B 6:40 PM – 7:00 PM | Flash Talks – One Expertise, One Message, Five Minutes 6:40 PM – Cardiogeriatrics: From Organ-Based Medicine to Person-Centred CareDr Véronique Lesage, Geriatrician specialised in cardiogeriatrics and palliative care, Erasmus Hospital, H.U.B 6:45 PM – Orthogeriatrics: The Care Model That Improves Outcomes for Older PatientsDr Laetitia Beernaert, Geriatrician specialised in orthogeriatrics, Erasmus Hospital, H.U.B 6:50 PM – Oncogeriatrics: When Age No Longer Determines TreatmentDr Julie Caillet, Geriatrician specialised in oncogeriatrics, Jules Bordet Institute, H.U.B and Dr Nathalie Compté, Geriatrician, CHU Helora 6:55 PM – Sexual Health: Pleasure Has No Expiry DateDr Nathan Franceschi, Geriatrician, Erasmus Hospital, H.U.B 7:00 PM – Geriatric Rehabilitation: Regaining Abilities, Preserving Life GoalsDr Anne Mergam, Geriatrician, Geriatric Rehabilitation Centre (GRC), Erasmus Hospital, H.U.B 7:10 PM – Healthy Aging Keynote: Supporting Health and Independence for as Long as Possible!Dr Pierre Hanotier 8:00 PM – Networking Dinner 9:30 PM – End of the Symposium Register Practical Information Date: Thursday, 12 November 2026Venue: Jules Bordet Institute, 90 Rue Meylemeersch, 1070 Brussels, Tagnon Auditorium (1st floor). DirectionsThis symposium is open to everyone: healthcare professionals, people interested in geriatric care, anyone wishing to learn more about healthy ageing, and general practitioners who would like to strengthen collaboration with geriatricians.Participation is free of charge, but registration is mandatory. Registration deadline: 6 November 2026.Participating physicians will receive accreditation points. Accreditation points will only be awarded to physicians who attend the symposium in its entirety.The symposium will be held in French. Contact Image
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Symposium on Interventional Radiology in Gynaecology
Interventional radiology in gynecology: minimally invasive innovations to preserve health and fertility Interventional radiology is playing an increasingly important role in the management of gynecological conditions. Thanks to image-guided minimally invasive techniques, it provides alternatives or complements to conventional treatments, with potential benefits including organ preservation, reduced complications and improved patients’ quality of life.This symposium will provide a multidisciplinary overview of the latest advances in interventional radiology applied to gynecology. Gynecologists, interventional radiologists and specialists involved in the management of pelvic pathologies will come together to discuss current indications, clinical outcomes and future perspectives of these approaches.Therapeutic innovations at the heart of gynecological careTargeted embolization: a conservative approach for uterine conditionsArterial embolization allows precise targeting of the blood supply of certain gynecological lesions, offering an alternative or complement to conventional treatments while preserving the uterus.This session will address in particular:Uterine fibroids (fibromyomas): indications, clinical outcomes and the role of embolization within today’s therapeutic options.Pelvic adenomyosis: new perspectives for managing a condition often responsible for chronic pain and menstrual disorders.Thermal ablation: new minimally invasive strategies for deep endometriosisThermal ablation opens up new perspectives in the management of certain deep endometriosis lesions through a targeted approach that limits the impact on surrounding tissues. This session will present the indications, available outcomes and the role of this technique within a personalized therapeutic strategy.Pelvic vascular conditions: diagnosing and treating differentlySome chronic pelvic pain conditions may be related to vascular abnormalities. Experts will present recent advances in:Pelvic varices embolization: a targeted approach to treating pelvic congestion syndrome in selected patients.Management of varicoceles: with particular focus on indications and outcomes.Restoring fertility: the potential of selective tubal recanalizationIn certain cases of proximal tubal obstruction, selective tubal recanalization is a minimally invasive approach that may restore tubal patency. This session will explore its role within infertility care pathways and its integration into individualized patient management.A comprehensive reflection on interventional radiology in gynecologyCross-cutting challenges: responsible practice of interventional radiology in gynecologyBeyond technical innovations, the development of these approaches raises essential questions:What ethical challenges will accompany the evolution of these practices?How can economic considerations be integrated into therapeutic decision-making?How can radiation protection for patients and healthcare professionals be optimized?A comprehensive reflection is essential to ensure innovative, responsible and patient-centered medicine.A symposium to strengthen collaboration between specialistsThis symposium is aimed at gynecologists wishing to deepen their knowledge of available interventional techniques in gynecology and better identify situations in which these approaches can be offered to their patients.It provides an opportunity to exchange with specialists in interventional radiology and gynecology through clinical cases, practical experiences and discussions on future developments.Practical informationDate: Saturday, 21 November 2026Time: 08:00 AM to 03:00 PMLocation: Museum of Medicine, Erasme Campus – Place Facultaire. Route de Lennik 808, 1070 Anderlecht. AccessTarget audience: gynecologists, interventional radiologists and specialists involved in the management of pelvic pathologiesAccredited symposium organized under the direction of Dr Salvatore Murgo and Dr Arnaud Bourguignon.Free registration required (registration deadline: 14/11/2026)Contact: Interventional Radiology Angiography Coordination, coordination [dot] RI [at] hubruxelles [dot] be Registration
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“With a stoma, my body is different, but life is still possible.”
It is often imagined as something impossible to overcome. A “hole in the abdomen,” a distressing image, a life turned upside down, intimacy forever changed. And yet… A hole in the abdomen... Interview with Agathe Ducrocq, Clinical Nurse Specialist, Stoma Care Nurse and Wound Care Specialist at Erasmus Hospital – H.U.BTo begin with, what exactly is a stoma?A stoma is a surgically created opening that connects a hollow organ (such as the intestine or ureter) to the surface of the skin, allowing stool or urine to be diverted outside the body. Instead of passing through the usual route, stool or urine exits through the abdomen and is collected in a pouch attached to the skin. Image Why might someone need a stoma? There are many medical reasons, including cancer, inflammatory bowel disease, neurological disorders or an intestinal blockage. In these situations, surgeons may need to divert the normal pathway. A stoma can be life-saving or restore quality of life to people who had lost it.How do patients react when they are told they need a stoma?The news is delivered by the doctor or surgeon and, in most cases, it comes as a shock. By the time we meet patients before surgery, they have usually had some time to begin processing the information. The pouch is often what frightens people the most. It can trigger feelings of disgust towards the stoma and the way they imagine their body will look. Seeing urine or stool leaving the body through the abdomen is understandably difficult to accept. As stoma care nurses, our role is to address these fears and show patients that it is entirely possible to live well with a stoma.What does the support provided in hospital look like?Once surgery has been scheduled, we meet patients before the surgery. We explain what a stoma is, why it is needed and how to care for it. At this stage, our goal is to reassure them, answer their questions, guide them and provide education.During the hospital stay, we provide daily follow-up alongside the nursing team. We help find the pouching system that best suits the patient's body shape, balancing comfort, safety and ease of use. We teach stoma care and, above all, take the time to answer every question, respecting each patient's pace.Our goal is for patients to feel confident and comfortable living with their pouch. In the beginning, body image is often the greatest challenge. We explain what to expect, assess how each patient is coping according to their abilities, and discuss possible complications as well as the warning signs they should be aware of.Family members are also involved in this education. They are not caregivers, but their support is invaluable, particularly if problems arise at home. We therefore maintain close communication with relatives and caregivers throughout the patient's journey: before surgery, during the hospital stay and after discharge.  Image Going home is often the most stressful moment… When patients are ready to leave the hospital, we help prepare them for their return home. We provide the necessary supplies, contact the medical equipment provider and coordinate with the home care nurse. Even when patients are independent, a home care nurse visits during the first few days to help them adapt to caring for their stoma in their own environment. This provides reassurance during an important transition.The golden rule we always repeat is simple: it is always better to call with a small question than to wait several days and return with a serious complication.What are the most common problems after discharge?The most frequent issues involve the skin: the pouch coming loose or leakage due to incorrect application. Persistent itching, repeated leaks or skin irritation are all signs that patients should contact their stoma care nurse to arrange an appointment. Sometimes, simply switching to a different pouching system solves the problem.What warning signs should patients know?For a digestive stoma: if there is no stool output accompanied by vomiting and/or abdominal pain, patients should seek urgent medical attention. Conversely, very high stool output may lead to dehydration.For a urinary stoma: dark, foul-smelling urine, especially if accompanied by a fever, requires prompt medical assessment. Image What misconception would you most like to dispel? "I'm going to have a hole in my abdomen. I'll never be able to leave the house again." This is by far the most common concern we hear. A stoma is not a wound. Daily care is clean rather than sterile: simply wash the skin with water, dry it thoroughly and that's it. Together, we will find the pouch that suits you best and give you the tools you need to live confidently with it. Modern pouches are secure, odour-proof and discreet under clothing. Going to a restaurant, flying, swimming—everything remains possible. Many patients also worry about their intimate relationships. This is a subject we always address openly and without taboo. Body image and self-confidence are just as much a part of our care as the practical aspects of stoma management.And what about psychological support?We often find ourselves listening to concerns that go beyond our own professional expertise. When a patient feels overwhelmed, we suggest meeting with a psychologist. We also try to normalise psychological support, although this is not always easy. Many people still associate seeing a psychologist with mental weakness. In reality, being able to speak freely and openly can make an enormous difference. Having a psychologist specialised in supporting people through this type of care pathway as part of our multidisciplinary team is a real benefit for our patients. Image Finally, what would you say to someone who has just learned they will need a stoma? The news will undoubtedly come as a shock. But please know that a dedicated multidisciplinary team will be there for you—from your first consultation, throughout your hospital stay, when you return home and for as long as you need us afterwards. Nurses, stoma care specialists, surgeons, psychologists and medical equipment providers work closely together, communicate regularly and adapt to your individual needs. Each professional has a specific role, but everyone is working towards the same goal: your well-being.You do not have to face this alone. Agathe Ducrocq Clinical Nurse Specialist, Stoma Care Nurse and Wound Care Specialist at Erasmus Hospital – H.U.B Contact the stomatherapy team Read also... Feeding tube: a tool to take care of yourself when your body needs itWhen a patient can no longer eat by mouth, either temporarily or on a more permanent basis, another route must be found...Read more
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Episode 16 of Hôp'Voices: how to select the right embryo?
Catherine takes us through the major innovations that have transformed fertility medicine and discusses the key challenges facing medically assisted reproduction (MAR) today. MAR: How do you select the right embryo? Join us as we explore the major innovations that have revolutionised fertility medicine: IVF, ICSI, vitrification, preimplantation diagnosis, genetic screening, and more.Thanks to these advances, thousands of families have been able to fulfil their dream of having a child.Yet technology is never an end in itself, and it does not work the same way for every patient.It is the expertise, experience and compassionate support of multidisciplinary teams that make it possible to identify, together with each patient, the most appropriate treatment pathway.In this new episode of Hôp'Voices, Dr Catherine Houba, Director of the H.U.B. Fertility Clinic, discusses the techniques used in medically assisted reproduction and explains the challenges they present today.She also revisits the fundamentals of fertility and shares insightful stories that highlight both the successes and the limitations of fertility treatments, while dispelling some of the common misconceptions surrounding assisted reproduction.Finally, she looks ahead to the future of reproductive medicine: what will medically assisted reproduction look like tomorrow, particularly with the growing role of artificial intelligence?Listen now (in French) on:Spotify : Hôp'Voices | Podcast on SpotifyDeezer : #16 Catherine | PMA : Comment sélectionner le bon embryon ? Image