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Nederlands Tijdschrift Voor Geneeskunde

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https://www.readbyqxmd.com/read/27900928/-is-transcatheter-aortic-valve-implantation-superior-to-surgical-valve-replacement
#1
Y Schoon
Severe aortic valve stenosis is treated traditionally with surgical valve replacement. Transcatheter aortic valve implantation (TAVI) has experienced a rapid development in the last decade. Indications for TAVI have been broadened from inoperable and high surgical risk patients to intermediate-risk patients. Mortality rates are identical after TAVI compared with surgical valve replacement in intermediate-risk patients. However, mortality is not an appropriate outcome measure for a frail older person. Quality of life, autonomy and functioning independently are probably more suitable outcomes in this frail older population...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27900927/-a-woman-with-skin-dimpling-of-the-breast
#2
S A Hiddink, C A Smorenburg
Physical examination of a 68-year-old woman showed dimpling of the left breast, which was only visible when she lifted her arms. Dimpling of the skin of the breast is an important sign of breast cancer that can easily be missed.
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27900926/-corneal-cross-linking-as-a-treatment-for-progressive-keratoconus
#3
R P L Wisse, N Soeters, D A Godefrooij, N G de Koning-Tahzib
Keratoconus is a corneal disease with onset typically occurring during puberty or early adulthood. The cornea progressively thins and acquires a cone-like shape which negatively affects visual acuity. In the early stages, visual acuity can be corrected with glasses or contact lenses. In more advanced cases, a corneal transplant is ultimately indicated to restore visual acuity. Corneal cross-linking (CXL) is a treatment given at a relatively early stage that protects patients against deterioration of visual acuity and further corneal deformation in progressive cases of keratoconus...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27900925/-a-young-man-with-green-urine
#4
J van Rosmalen, J A H van Oers
A 37-year-old male was admitted to the Intensive Care Unit with severe traumatic brain injury. Propofol, midazolam and sufentanil were administered. Two days after admittance, we observed a green discoloration of the urine. This is a rare and benign side effect of propofol.
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27900924/-persistent-shoulder-symptoms-in-calcific-tendinitis-clinical-and-radiological-predictors
#5
P B de Witte, R A van Adrichem, J W Selten, J Nagels, M Reijnierse, R G H H Nelissen
OBJECTIVE: We assessed the most important demographics and radiological characteristics at the time of diagnosis of rotator cuff calcific tendinitis (RCCT), and their associations with long-term clinical outcome. DESIGN: Observational study. METHOD: Baseline characteristics and treatment were evaluated in 342 patients in whom RCCT had been diagnosed. Interobserver agreement of the radiological investigations was analysed. Patients were sent a general questionnaire and 2 shoulder questionnaires, the "Western Ontario rotator cuff" (WORC) and the "Disabilities of the arm, shoulder and hand" (DASH) for evaluation of long-term clinical outcome...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27900923/-the-infection-risk-scan-in-clinical-practice-improving-infection-prevention-and-antibiotic-use-through-transparency
#6
I Willemsen, J A J W Kluytmans
OBJECTIVE: The increase in Highly Resistant Micro-Organisms (HRMO) in hospitals and nursing homes requires an intensification of infection prevention measures. This paper describes a new, standardised approach to infection prevention and monitoring of antibiotic use. DESIGN: Cross-sectional, observational study. METHOD: The Infection RIsk Scan (IRIS) measures a number of objectifiable variables in the field of infection prevention, including the dissemination of HRMO, the use of antibiotics and indwelling medical devices, environmental contamination, hand hygiene and personal hygiene of healthcare workers, and various infection control preconditions...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27900922/-extracorporeal-life-support-for-legionella-pneumonia
#7
W A C Koekkoek, C Savelkoul, P R Wijnandts, M Platenkamp, D W Donker, D H T Tjan
BACKGROUND: Legionella species cause 5% of all community acquired pneumonias. However, Legionella pneumonia results relatively often in admission to the intensive care unit (ICU). A significant complication is the development of acute respiratory distress syndrome (ARDS). The ICU mortality rate for Legionella pneumonia is > 30% with conventional treatments. CASE DESCRIPTION: A 64-year-old male was admitted to the ICU with respiratory failure due to Legionella pneumonia complicated by ARDS...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27900921/-a-fixed-drug-eruption-caused-by-paracetamol
#8
L van Zogchel, T Hendriks, S Adriaens, I Diederen, E Herremans
BACKGROUND: Fixed drug eruption is a hypersensitive skin response to drugs, which can present itself in different ways. The skin lesions are usually solitary, but can also appear as a maculopapular rash, Stevens-Johnson syndrome or toxic epidermal necrolysis. While fixed drug eruptions can be caused by various drugs, paracetamol is responsible in 1.5% of cases. CASE DESCRIPTION: A 58-year-old man was seen in general practice with a five-year-old exanthema on his torso, arms and legs...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27900920/-sudden-loss-of-consciousness-during-labour
#9
L T van Genugten, L P Morssink, E L van der Kooi
This case describes a 36-year-old woman, gravida 4 para 2 at 41 weeks and 3 days gestation, who appeared unconscious during labour for 75 minutes. After excluding physical disorders, it transpired that she was having a conversion disorder. A patient with a decreased level of consciousness in childbirth must be assessed using the ABCDE method, positioned in left lateral tilt to prevent inferior vena cava compression. After stabilization of the vital functions and establishing the patient's history, physical examination and laboratory tests are components of the initial clinical assessment...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27879186/-to-reimburse-or-not-evaluating-expensive-drugs-differently
#10
J Stolk
Health insurance organisations grant reimbursement for drug treatment on the basis of results of placebo-controlled randomised clinical trials showing a clinically meaningful and statistically significant effect over placebo. This often proves problematic in rare diseases as well as in many chronic diseases that are difficult to treat. Clinical scientists may address the issue by testing the drug on surrogate outcome parameters and ask for post-marketing studies conducted by expert reference centres as expediency research, using budgets provided by the government to show that the drug really works in terms of real-life patient experience...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27879185/-an-integrated-approach-including-paediatric-and-forensic-medical-expertise-on-suspicion-of-child-abuse
#11
M C M Schouten, W A Karst, H F van der Stel, A H Teeuw, E M van de Putte
A false accusation of child abuse has a major impact on child and family. Conversely, a missed diagnosis of child abuse may have significant and lifelong consequences for the child. For health professionals the assessment of the nature of the injury and differentiating between accidental and inflicted injury, disease manifestation or a physiological phenomenon can be challenging. For adequate determination of the cause of injury, an integrated approach including paediatric knowledge and forensic medical expertise is essential...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27879184/-myopia-a-growing-health-problem
#12
J W L Tideman, J R Polling, A van der Schans, V J M Verhoeven, C C W Klaver
- Myopia is the eye disorder with the most rapid increase in prevalence worldwide. It develops in childhood, with a peak incidence between the ages of 13 to 15 years. - Especially high myopia, i.e. a refractive error of -6 diopters or more, increases the risk of permanent visual impairment during adulthood due to structural abnormalities of the retina and optic nerve.- The cause of myopia is complex. Lifestyle factors in childhood, such as limited time spent outdoors and close work - such as reading and smartphone usage - are risk factors...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27879183/-supporting-patients-in-self-management-moving-to-a-personalised-approach
#13
N Eikelenboom, J van Lieshout, A Jacobs, F Verhulst, J Lacroix, A van Halteren, M Klomp, I Smeele, M Wensing
OBJECTIVE: The aim of this research was to assess the effect of providing personalised self-management support on patient activation (knowledge, skills, self-efficacy) and self-management behaviour. DESIGN: Cluster randomised trial in 15 general practices (Dutch Trial Register No.: NTR 3960). METHOD: Patients aged 18 years or older with a chronic condition were invited to participate in the study. The Self-Management Screening (SeMaS) questionnaire - which illustrates barriers to self-management - was used as a tool for personalised self-management support...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27879182/-acute-respiratory-failure-caused-by-minocycline
#14
B Kok, M J T van de Ven, H J van Leeuwen
BACKGROUND: In the case of pneumonia an infectious cause is always considered first. However, toxic agents and medicines can also be the cause of pneumonia. CASE DESCRIPTION: A 54-year-old woman was referred to the emergency department because of progressive dyspnoea, a non-productive cough, headache, and fever. She was admitted with the diagnosis community acquired pneumonia. Despite treatment with antibiotics and oxygen she developed hypoxic respiratory failure, which necessitated invasive mechanical ventilation...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27879181/-integral-obstetrics-impeded-by-history-midwives-and-gynaecologists-through-the-ages
#15
N van der Lee, F Scheele
There is a long and complicated history concerning the interprofessional collaboration between midwives and gynaecologists, which is still evident in current practice. Yet, in the analysis of collaborative problems, history and its lessons are often overlooked. Consequently, less effective solutions to problems may be found, because the root cause of a problem is not addressed. In this historical perspective we show how policies of the respective professions have often focused on self-preservation and competition, rather than on effective collaboration...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27879180/-web-based-interventions-targeting-cardiovascular-risk-factors-in-older-people-a-systematic-review-and-meta-analysis
#16
C R L Beishuizen, W A van Gool, W B Busschers, R J G Peters, E P Moll van Charante, E Richard
OBJECTIVE: To evaluate whether web-based interventions for cardiovascular risk factor management reduce the risk of cardiovascular disease in older people. DESIGN: Systematic review and meta-analysis. METHOD: Embase, Medline, Cochrane Library and CINAHL were systematically searched from January 1995 to 3 November 2014. We included all randomised controlled trials for web-based interventions targeting cardiovascular risk factors in populations with a mean age of 50 and older...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27879179/-two-sisters-with-lung-emphysema
#17
I Piscaer, F M E Franssen, N H T Ten Hacken, E F M Wouters, R Janssen
BACKGROUND: α1-antitrypsin is an antiprotease that is mainly produced in the liver; it plays a crucial role in the protection of lung parenchyma against the destructive effects of proteases. Mutations in the α1-antitrypsin gene can cause α1-antitrypsin deficiency. Individuals homozygous for the Z-genotype have drastically lowered serum α1-antitrypsine concentrations and often develop lung emphysema at an early age. CASE DESCRIPTION: A 38-year-old woman and her 43-year-old sister both developed lung emphysema at an early age; this could be attributed to severe α1-antitrypsin deficiency...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27879178/-minocycline-induced-hyperpigmentation-not-uncommon-but-nonetheless-important-to-recognise
#18
P J G M Voets, D Blommaert, R R M C Keijsers, H A C Alkemade
BACKGROUND: Minocycline, a broad-spectrum antibiotic from the group of tetracyclins, is frequently prescribed for acne vulgaris and rosacea. Hyperpigmentation is a relatively common side effect of this drug and can lead to multiple unsightly skin lesions, which are not always reversible. It can take a long period, from a few months to several years, before the lesions have completely vanished. CASE DESCRIPTION: A 24-year-old male was seen in our outpatient clinic because of slowly progressive pigmented lesions on his shins...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27879177/-retinal-haemorrhages-as-a-symptom-of-child-abuse
#19
C M L van den Hoven, F M C van Berkestijn, I M B Russel-Kampschoer, W A Karst, E S M Voskuil-Kerkhof
Inflicted traumatic brain injury (ITBI) - a possible result of child abuse - is difficult to diagnose, yet the diagnosis bears great impact on patients and their relatives. The purpose of this paper is to describe ophthalmologic findings that can be seen in relation to ITBI. For exemplification, three different cases are described in detail. ITBI is diagnosed through a multidisciplinary approach by exclusion of other causes that could explain the clinical findings, and by linking factors that together raise a high suspicion of ITBI...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27848910/-the-pitfalls-of-necrotising-soft-tissue-infection-a-wake-up-call-for-surgeons
#20
V M de Jong, J C Goslings
Necrotising soft tissue infections require early consultation of an experienced surgeon, regardless of what time of day they occur. Delays in diagnosis and treatment should not occur. Necrotectomy should be skin-sparing when possible. A low threshold for consultation with a tertiary referral center is recommended.
2016: Nederlands Tijdschrift Voor Geneeskunde
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