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Nederlands Tijdschrift Voor Geneeskunde

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https://www.readbyqxmd.com/read/28537541/-earlier-weight-bearing-mobilisation-after-fracture-fixation
#1
P R G Brink, E J M M Verleisdonk, T J Blokhuis
Almost all the literature dictates a period of non-weight-bearing after surgical treatment of articular and peri-articular fractures of the pelvis and lower extremities. This is followed by partial weight-bearing which is based on the number of weeks after surgery. However, none of these recommendations are based on evidence. When taking muscle force and gravity into account, non-weight-bearing is actually impossible. In addition, lack of patient compliance, lack of muscle force in the elderly and four-fold energy expenditure make it almost impossible to ensure that patients will adhere to their surgeon's restrictions...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28537540/-e-bikers-are-more-often-seriously-injured-in-bicycle-accidents-results-from-the-groningen-bicycle-accident-database
#2
H P A M Poos, T L Lefarth, J S Harbers, K W Wendt, M El Moumni, I H F Reininga
OBJECTIVE: Analysing injury types, injury severity and mortality in victims of accidents with electric bicycles in comparison with conventional bicycles. DESIGN: Prospective cohort study. METHOD: Data of patients treated at the Accident & Emergency Department of the University Medical Center Groningen after a bicycle accident are being entered in a database since 2014. We have analysed this database for accidents with electric bicycles (e-bikes) and conventional bicycles occurring among adult patients for the period of July 2014 to May 2016...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28537539/-metal-on-metal-hip-implant-continues-to-be-a-source-of-concern
#3
J A N Verhaar, T Gosens
It has recently been suggested that patients with metal-on-metal (MOM) hip implants have an increased chance of mortality. These observations come from a meta-analysis including many small randomised controlled trials (RCTs) and cohort studies. Because of the high risk of bias there is no reason for great concern. In the Netherlands, the Dutch Orthopaedic Association (NOV) advised against the use of MOM implants in 2012, and that all patients with MOM implants should be followed up every year. There are good arguments to continue this policy because of the high risk of revision associated with MOM implants and the potential toxic effects of metal ions...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28537538/-increasing-incidence-of-thin-melanomas-in-the-netherlands
#4
J Zoutendijk, R J T van der Leest, T Nijsten, W J Mooi, J I van der Rhee, E de Vries, L M Hollestein
OBJECTIVE: In the Netherlands the incidence of melanomas in situ and thin invasive melanomas is rising more quickly than that of thicker melanomas. Our aim was to gain insight into this increase and to test the hypothesis that it is attributable to over-diagnosis. METHOD: We analysed data taken from the Netherlands Cancer Registry on all primary melanomas diagnosed between 1994 and 2010. We assessed trends in European standardised rates (ESR) using joinpoint analysis, and expressed these trends as estimated annual percentage change (EAPC)...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28537537/histopathologisch-onderzoek-van-mogelijke-metastase
#5
W J B Blox, P D Gobardhan, T Rozema, R H T Koornstra, J W B de Groot, A J Ten Tije
Histopathological examination of possible metastasis; indispensable or diagnostic excess?
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28537536/-7-tesla-mri-for-visualisation-of-small-cerebral-vessels
#6
R P Kloppenborg
Due to its higher resolution, MRI in which a magnet with a field strength of 7 Tesla (7T MRI) is used, is able to image smaller abnormalities. 7T MRI is a promising tool for research into the causes of cerebral small vessel disease. Originally this technique was aimed at imaging the small perforating brain vessels and in particular at the micro-thrombi present there. Although 7T MRI has not proved effective in showing thrombi in small blood vessels, it has proved itself to be effective on other fronts. Functional measurements of the small brain vessels can be reliably determined and abnormalities of the vessel wall can be imaged...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513414/-prehospital-triage-in-trauma-patients-ambulance-care-and-deployment-of-a-mobile-medical-team
#7
M van Heijl, D den Hartog
- The prehospital trauma triage system consisting of regional ambulance services and overarching availability of mobile medical teams, the level criteria for trauma centres and in-hospital care for trauma patients are well-organised in the Netherlands.- However, the quality of prehospital triage in the Netherlands is inadequate at the moment, with an average under-triage rate of more than 30%. There is, thus, much room for improvement in the quality of prehospital triage.- Research in this area is now taking off, partly because of the arrival of a new quality indicator from the Netherlands National Health Care Institute, which states that at least 90% of multiple-trauma patients should be primarily taken to a level 1 trauma centre...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513413/-nhg-traumatic-wounds-and-bite-wounds-treatment-guideline
#8
I M Wichers, M Bouma
- The 'Traumatic wounds and bite wounds' treatment guideline by the NHG (Dutch College of General Practitioners) has recommendations for treating traumatic wounds, bite wounds and wound infection.- It is important to distinguish between traumatic wounds and bite wounds because treatment of lacerations and cuts differs from treatment of bites.- Clean a wound under a lukewarm water tap; avoid using disinfectants.- Preferably close traumatic wounds within 12 hours, provided that the wounds have been carefully cleaned and that there are no referral indications...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513412/-multidisciplinary-approach-of-facial-injuries
#9
L Dubois, R Schreurs, O Lapid, P Saeed, G F Adriaensen, F M Hoefnagels, V M de Jong
BACKGROUND: Approximately one quarter of polytrauma patients has facial injuries, which usually lead to loss of form and function. Several specialties are involved in the acute and reconstructive phases of facial injuries, such as oral and maxillofacial surgery, otorhinolaryngology, plastic surgery, ophthalmology and dentistry. CASE DESCRIPTION: A 25-year-old man with severe facial injuries was brought to the shock room after sustaining high-energy trauma. He had a panfacial fracture that required reconstruction...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513411/-injuries-resulting-from-accidents-and-violence-in-the-netherlands-results-of-an-emergency-department-register
#10
E F van Beeck, M J M Panneman, S Polinder, B Blatter
- Injuries from accidents and violence are amongst the most important public health issues in the world, including in Europe and the Netherlands.- Using the Dutch Injury Surveillance System and the Dutch Burden of Injury Model, we describe the incidence and costs associated with injuries in the Netherlands that are registered via Emergency Departments (ED). We also map the main causes of injury by age category.- Annually, 700,000 patients attend the ED of a hospital with an injury; 1 in 6 attendees is admitted...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513410/-what-if-the-sperm-donor-has-a-hereditary-disease-informed-consent-needed-for-sharing-medical-information
#11
J J van der Smagt, L C Govaerts, S G M Frints
There are no regulations in the Netherlands regarding the exchange of important genetic information that has become available after the birth of a child conceived with donor gametes. This may lead to difficult situations such as when the gamete donor is found to suffer from a genetic cancer-predisposition disorder. Genetic information about the donor that becomes available later may be of great importance to donor offspring. Genetic information uncovered in the donor child may likewise be of importance to legal offspring of the gamete donor...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513409/-a-woman-with-acute-bilateral-vision-loss
#12
N Meijer, H T Nguyen, R Wolff
A 46-year-old woman presented to the emergency department with progressive bilateral loss of vision followed by headache. She had been taking topiramate 25 mg daily for eight days before presentation. In the end, she was diagnosed with topiramate-induced acute glaucoma for which she received appropriate treatment.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513408/-legally-capable-care-refuser-has-rights-as-well-as-responsibilities
#13
L J du Perron, A Maat, A C Hendriks
It is hard to determine how a doctor should act when a patient with a somatic condition refuses medical care. The Dutch law obliges a doctor to inform a patient about his condition and the possible treatment options. This includes an effort to reach out and make contact with the patient. But how far should a doctor's responsibility reach when a patient refuses contact? We point out that refusal of medical care can also be seen in the light of a patient's autonomy. We thereby propose that falling ill gives responsibilities to a patient too, which include making the effort to seek medical care and cooperate with treatment...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513407/-cardiac-resynchronization-therapy-who-is-a-candidate-and-who-is-not
#14
M Kloosterman, A H Maass, M Rienstra, I C Van Gelder
- Cardiac resynchronisation therapy (CRT) is a treatment for patients with impaired cardiac pump function (left ventricular ejection fraction ≤ 35%) and a wide QRS complex who, despite maximum tolerated medical therapy, remain symptomatic.- In addition to reducing symptoms, CRT can reduce hospital admissions and improve survival.- Selection of patients for CRT remains difficult. Despite the fact that predicting and influencing success of CRT has improved, ~30% of patients do not respond to the therapy.- Optimizing therapy and follow-up of patients after implantation requires a multidisciplinary approach tailored to the individual patient...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513406/-the-court-physician-the-clergyman-a-learned-society-and-smallpox
#15
H F P Hillen
Variolation was introduced in England in the first half of the 18th century. The positive effects of this new method for preventing smallpox were already known in the Netherlands around 1720, one of whom was the Dutch physician Boerhaave. In spite of this, it took another 30 years before variolation was used in the Netherlands. Despite receiving positive advice and information from his learned English friends Sloane and Sherard, Boerhaave did not apply nor advise the use of variolation. There were various arguments for this restrained approach...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513405/-a-football-player-with-an-evident-knee-trauma
#16
W A Goudriaan, R Huis In 't Veld, R A G Hoogeslag
A 22-year-old male presented with medial sided instability of the right knee three days after shooting a blocked ball. Physical examination, which is usually feasible in the acute phase, showed grade 3 laxity of the superficial medial collateral ligament. MRI confirmed a distal rupture, which needs repair within 2 weeks after onset.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28513404/-a-bomb-attack-in-the-netherlands-how-would-we-provide-hospital-care
#17
J J M Haverkort, M B de Jong, L L van Spengler, L P H Leenen
- There is an ever-present threat of large-scale incidents and disasters, such as terrorism and natural disasters.- Preparation and planning are the key to successful response to major incidents and disasters, which is why education, training sessions and exercises take place in the Netherlands.- Analysis of recent large-scale incidents in Europe and the USA emphasises the importance of adequate distribution of the wounded to centres where the correct care can be provided.- A major step has been taken in the Netherlands to provide for such an eventuality with the introduction of distribution plans for the wounded, and other initiatives such as a regional hospital disaster plan...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28488560/-the-effects-of-severe-and-very-severe-injuries
#18
H R Holtslag, E F van Beeck, J A Haagsma, M Olff
- The effects of severe injuries can be charted using the International Classification of Functioning, Disability and Health (ICF) model and the burden of disease model, in which the burden of disease is expressed in 'disability-adjusted life years' (DALYs). - Severe accidents cause 10 DALYs per 1000 people, which is comparable with the burden of disease of mood disorders and lung cancer.- In the Netherlands, severe injury victims are often males aged < 40 years, who are often injured in road traffic accidents...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28488559/-hip-fracture-in-elderly-patients-additional-value-of-a-multidisciplinary-approach-and-concentration-of-care
#19
P van der Vet, J Kussen, M van Dijk, R M Houwert, E J M M Verleisdonk, D van der Velde
Management of elderly patients with a proximal femoral fracture is an increasing challenge for the Dutch healthcare system. Proximal femoral fractures in the elderly have high morbidity and mortality rates. Furthermore, healthcare costs for this group of patients are rising. Referral, operation and postoperative care demand efficient collaboration between healthcare professionals. Every step in this chain of events is crucial for optimal treatment results. Multidisciplinary orthogeriatric trauma care shows promising results...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28488558/-identifying-mild-traumatic-brain-injury-clinical-signs-and-consequences
#20
J van der Naalt, W L Draijer, C A M van Bennekom
Identification of patients with mild traumatic brain injury (TBI) is important since 85,000 patients visit the emergency department with a head trauma annually. Although most patients recover well, 15-20% of the patients with head trauma develop persistent symptoms that interfere with resumption of daily activities. It is particularly important to identify the clinical signs that define mild TBI. Presence of anterograde amnesia after the injury, for example, is an important clinical diagnostic sign to establish the diagnosis of TBI...
2017: Nederlands Tijdschrift Voor Geneeskunde
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