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The Brussels University Hospital (H.U.B), consisting of the Erasmus Hospital, the Jules Bordet Institute and the Queen Fabiola University Children's Hospital, employs more than 800 doctors. To improve collaborations, inter-departmental communication and care pathways, at the end of December these doctors voted to set up a single Medical Council. An initiative seen as a logical next step and that respects the identities of each hospital. This form of transverse representation of the medical staff makes it possible to support both respective and common projects in the interests of medicine, both today and into the future.  All the doctors represented within the same body The attachment of each hospital to the Université Libre de Bruxelles (ULB) already enabled the three medical councils to cooperate regularly in the past. The creation of the Brussels University Hospital (H.U.B) as an academic hospital for the City of Brussels in October 2021 served to consolidate this cooperation. Common governance was therefore soon seen as the logical next step. Thus, on 20 December 2020, doctors from the Brussels University Hospital (H.U.B) came together and opted, by more than 80% of votes, to deploy a single medical council. This form of representation of the medical staff within the hospital governance aims to facilitate and improve inter-departmental cooperation and promote an efficient sharing of activities. The future doctors' representatives on this single Medical Council will be appointed when new elections are held at the start of the next academic year. Voting will be by electronic means.    Unifying while respecting the identity of each hospital The role of the Medical Council is to coordinate medical activities, promote quality care and harmonise patient pathways that are accessible to all within the hospital networks while maintaining the spirit of cooperation between the doctors. Although the Brussels University Hospital is deployed through its governance and its transversality, the desire to preserve the identity of each institution, for both staff and patients, remains a priority. Each of these constituent institutions is recognised nationally and internationally for its medical projects and innovations, whether oncological, paediatric or specialised.  The communication challenge Regular meetings of all the H.U. B doctors are needed to ensure that the deployment of a common medical project is a shared experience. The existence of two distinct hospital sites (Anderlecht and Laeken) remains the biggest challenge in terms of communication for the teams, especially when members of the medical staff must be present physically. Using the right means of communication at the right time remains a key issue in ensuring the smooth functioning of the institution.  A union in keeping with the triple mission: care, research and teaching As a university structure with many researchers and research physicians, the Brussels University Hospital offers a stimulating environment that permits the continuous recruitment of young specialists. A youth that has a vital place within the institution and to which established staff are always attentive. The medical staff also interact very closely both with the paramedical teams and support services (data processing, human resources, etc.) as well as with GPs, with the aim of always guaranteeing the best care for the patients.

Call +32 (0)2 555 55 55 for any department in Erasme Hospital, Jules Bordet Institute or Children's Hospital.  From today, you only need to remember one number to call all the services of the Erasme Hospital, the Jules Bordet Institute, and the Children's Hospital: +32 (0)2 555 55 55. Call this number and then simply follow our system that will send you comfortably and as quickly as possible to your wanted correspondant. 

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.   

What are sleep apnea? As the name indicates, sleep apnea is when breathing stops, for at least 10 seconds, during sleep. If this happens more than five times an hour, you are no doubt suffering from obstructive sleep apnea-hyponea syndrome (OSAHS).    OSAHS is often but not always accompanied by snoring. In any event, it affects the quality of sleep. Not only do persons with this condition wake up feeling tired, but in the longer term OSAHS has a series of physiological and/or psychological consequences that can give rise to cardiovascular, pulmonary, metabolic, haematological, psychiatric (depression) or cognitive (memory and concentration problems, etc.) complications. Far from being inconsequential, OSAHS impairs the quality of life and brings a risk of premature death.    Care Some specialist doctors at the H.U.B have particular expertise in sleep disorders. These are mainly psychiatrists, ENT specialists, pneumologists, neurologists or even stomatologists. These specialists can prescribe a polysomnography or sleep test at the H.U.B. Sleep Laboratory.    What are the procedures for a sleep test?    You generally arrive at the Sleep Laboratory at around 2 pm. A member of staff will show you to a private room. Before lying down you are fitted with a number of sensors connected to various measuring devices. Depending on the case, a video camera may record you during the night. This enables the team to detect any abnormal movements (sleepwalking,  epilepsy, etc.), to ensure you are safe in the event of nocturnal restlessness and to reconnect any sensor that may become detached during your sleep.    The next day the numerous data collected are analysed. This analysis makes it possible to confirm the OSAHS diagnosis and/or identify any other sleep disorders. A secondary assessment by another specialist doctor is sometimes necessary.    Treatment  Depending on the causes, origin and seriousness of the OSAHS, various treatment is possible:    People with OSAHS caused by sleeping on their back are offered positional therapy to correct their sleeping positions.    As being overweight or obese is the number one risk factor for OSAHS, patients are always advised to lose weight.     Alcohol, smoking and taking myorelaxant drugs (such as benzodiazepines) can also aggravate OSAHS. Patients can therefore be directed towards specialised care to help them reduce or stop the use of these substances.    The Continuous Positive Airway Pressure (CPAP) machine is a mask, usually nasal, that is worn during the night to correct apnea.      A mandibular advanced orthosis is generally indicated for a mild to moderate OSAHS (< 30 apneas/hour). This orthosis is made to measure in the Department of Stomatology   Maxillofacial surgery makes it possible to correct in apnea sufferers the position of the mandible (lower jaw) and of the maxillary (upper jaw) and is recommended for moderate to severe OSAHS  (> 30 apneas/hour).           Image Research The H.U.B Sleep Laboratory participates in a number of studies. An important line of research is the connection between sleep disorders and certain cardiovascular and neurological diseases (MS, Parkinson’s, etc.), the polysomnographic markers of certain pathologies, etc.