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Nederlands Tijdschrift Voor Geneeskunde

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https://www.readbyqxmd.com/read/29241473/-chris-arie-and-piet-three-politically-active-dutch-physicians-in-the-20th-century
#1
J G J Huurman
Chris Mol, Arie Querido and Piet Muntendam were three socially and politically active medical doctors in the 20th century. Inspired by different sources (Catholicism, and the social democratic and progressive-liberal movements), these doctors strove to improve public health in the Netherlands. Up to about 1940 they were primarily traditional doctors caring for individual patients. After World War Two their scope widened, eventually to the wider society. The life histories of the three main characters are remarkably intertwined...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241472/-health-advocacy-in-medical-student-education
#2
R A M J Damoiseaux, M B M Soethout
The introduction of the CanMEDS method to qualify training and ongoing education for healthcare providers in terms of competencies has provided a clear framework for medical schools' curricula. Different roles are outlined, and one of these is health advocacy. Physicians are accountable to society to use their knowledge and expertise to improve health. Even before the introduction of CanMEDS, physicians took responsibility for improving health by tackling issues in society that negatively affected the health of many; one obvious example is the provision of clean water and sewage systems to prevent epidemics of infectious diseases such as cholera...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241471/-patients-also-have-responsibility-for-prevention
#3
C Smit
Patient organisations should be more visible in the societal debate about prevention, alongside fulfilling their more traditional tasks such as education, peer support and lobbying for their interests. Despite appreciating the medical care he received, the author also personally experienced a lack of attention for life-style interventions (e.g. a salt-free diet, exercise) in the care provided. Since 2012, awareness among European patient groups is rising about the importance of nutrition, which is evolving from being considered as a simple necessity to being an essential component of disease management...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241470/-social-issues-in-the-doctor-s-clinic
#4
H Vos
Doctors are confronted with issues that arise in society. These social issues can affect patients' health. Solving these problems requires more than just prescribing a pill, as illustrated by the cases of three patients. The first patient is a 42-year-old male with cardiac symptoms, chronic lower back pain and an excessive use of tranquillizers. The welfare worker intervened and his demand for health care and use of tranquillizers diminished. The second patient is a 53-year-old female with symptoms of chronic back pain, migraine and depression...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241469/-social-obstetrics-a-level-playing-field-when-it-comes-to-a-healthy-start
#5
E A P Steegers
Next to foetal growth, embryonic development during the first weeks of pregnancy is associated not only with the health of the newborn, but also with health and disease in later life. In the Netherlands, large disparities exist in perinatal health. These are not only related to medical risks but also to an accumulation of risks related to lifestyle and the social environment. The effects of poverty on perinatal health appear to be substantial. These new insights should lead to a renewal of pregnancy-related care in the form of the implementation of preconception care and 'social obstetrics', into which medical and social domains of care should be integrated...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241468/-addendum-to-the-dutch-guideline-for-minor-head-brain-injury
#6
C L van den Brand, J van der Naalt, G Hageman, H P Bienfait, R A van der Kruijk, K Jellema
- After introduction of the Dutch guideline for 'Care for patients with minor head/brain injury' (LTH guideline) in 2010, the number of CT scans has increased. Some of these scans were for patients with only trivial trauma and may not have been necessary.- In addition, since this guideline was implemented, there have been changes in the use of anticoagulants and platelet aggregation inhibitors. Non-vitamin-K-dependent oral anticoagulants (NOACs) and platelet aggregation inhibitors, or combinations of these, are prescribed more often...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241467/-bioresorbable-coronary-scaffolds-follow-up
#7
J Elias, J J Piek
Bioresorbable scaffolds have been developed as an alternative to current metal stents. Despite earlier acceptable short-term results, the recently published AIDA study found that the most-used resorbable scaffold (Absorb) presents an almost threefold increased risk of stent thrombosis than the metal XIENCE stent, short-term as well as long-term. Acute and subacute stent thrombosis probably occur because of inadequate dual antiplatelet therapy, suboptimal implantation technique or both. Late stent thrombosis is probably affected by absorption-related stent-strut discontinuity and factors affecting blood flow...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241466/-how-can-gentlemen-of-standing-grow-old-healthily-plemp-and-his-de-togatorum-valetudine-tuenda-commentatio-1670
#8
A H M Kerkhoff
In 1670, the Professor of Medicine V.F. Plemp from the Belgian University of Leuven published a book explaining in an entertaining fashion how elderly gentlemen in positions of authority could live for a long time in good health but still have enjoyable lives. In writing this book the author manifested himself as a 17th century forerunner of the modern fitness and wellness movement. Plemp was a humanist who believed in the renaissance of Antiquity, and his medical revelations originate largely from ancient Roman sources...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241465/-delayed-umbilical-cord-separation
#9
H Theeuwen, J van der Sluijs, M Nanlohy-Manuhutu
We present the case report of a preterm infant with delayed umbilical cord separation. At the age of four weeks the umbilical cord separation had still not occurred. The umbilical cord tissue sometimes seemed wet and did not dry completely. There were no signs of immunodeficiency. An ultrasound of the abdomen showed a small urachal cyst. No further intervention was indicated.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241464/-diagnostic-approach-and-treatment-of-primary-hyperparathyroidism
#10
W Y van der Plas, M E Noltes, A W M A Schaeffers, A H Brouwers, A N A van der Horst-Schrivers, S Kruijff
- Primary hyperparathyroidism (PHPT) is characterised by elevated serum calcium levels due to elevated levels, or insufficient suppression, of parathyroid hormone (PTH).- The incidence of PHPT has increased in recent years. This is mainly the result of more frequently performed routine measurements of serum calcium, e.g. as part of postmenopausal screening.- The classically described features of PHPT - bones and stones - are not always observed and most patients are asymptomatic.- Diagnosis of PHPT is only established by biochemical testing, not by imaging...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241463/-myocardial-contusion-following-trauma
#11
R T Stolmeijer, H Lameijer
BACKGROUND: Myocardial contusion is a potentially life threatening condition, which should be considered in patients with a compatible thoracic trauma. Guidelines for diagnosis and determination of management are non-existent. CASE DESCRIPTION: A 51-year-old man arrived at the accident and emergency department with thoracic trauma after being knocked down by a bus. A myocardial contusion was diagnosed based on the ECG and elevated high-sensitivity (hs) troponin levels...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29241462/-neurogenic-thoracic-outlet-syndrome
#12
J A W Teijink, N Pesser, R van Grinsven, H van Suijlekom, M R H M van Sambeek, B F L van Nuenen
Neurogenic thoracic outlet syndrome (nTOS) is a type of thoracic outlet syndrome (TOS) where compression of the brachial plexus is responsible for development of upper-extremity, head and neck symptoms. We present a 16-year-old and a 34-year-old patient with nTOS. Diagnosis in both cases was done by following the recently published reporting standards for (n)TOS. After this multidisciplinary diagnostic work-up we performed a transaxillary thoracic outlet decompression (TOD). Due to lack of literature, difficult nomenclature and complexity of diagnosis and treatment, diagnosis of nTOS is often delayed...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29219801/-a-focus-on-patients-with-the-highest-healthcare-costs
#13
W Groot
Wammes et al. (2017) showed that many of the patients who are among the 1% with the highest healthcare costs are being treated for multiple conditions. This suggests that high healthcare costs are at least partly due to treatment for multiple conditions, each of which by itself may not be excessively costly. It is the accumulation of costs for multiple conditions that cause patients to become high-cost patients, and this has implications for cost-control policies. It may be more worthwhile to focus on improving efficiency in the treatment of conditions that occur frequently but have low or medium costs than on conditions with high costs but that occur infrequently...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29219800/-social-awareness-campaign-for-a-ban-on-consumer-fireworks-10-tips-doctor-on-the-barricade
#14
J T H N de Faber, M van Zuilen, M Snouck Hurgronje, J Keunen
- Describe the problem, and show why a social awareness campaign is needed- Know what you are talking about, and explain the medical jargon in plain language- Collect data and facts- Create support among colleagues- Get the media involved- Get support from the community- Create a coalition of supporters via a website- You will discover who the opposition is when you are on the barricade- Offer a safe and healthy alternative - Draw up a long-term roadmap, and persevere.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29219799/-characteristics-and-healthcare-utilization-of-patients-with-highest-costs-of-care
#15
J J G Wammes, M Tanke, W Jonkers, G P Westert, P J van der Wees, P P T Jeurissen
OBJECTIVE: To determine characteristics and healthcare utilization of high-cost patients in the Netherlands. DESIGN: Cross-sectional study, using claim data for 2013 from one Dutch health insurer. Analyses were limited to the curative health system (care that falls under the Health Insurance Act), including voluntary supplementary insurance. METHOD: We established total healthcare costs per beneficiary by summing all claims with a starting date in 2013...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29219798/-guideline-organ-donation-following-euthanasia
#16
H Mulder, G Olthuis, M Siebelink, R Gerritsen, E van Heurn
- The multidisciplinary guideline 'Organ donation following euthanasia' was published in March 2017 at request of the Minister of Health, Welfare and Sport.- This guideline provides recommendations for the organisation and implementation of a request to donate organs expressed by a patient who asks for euthanasia.- It is vital to avoid any conflict of interest while the patient requesting organ donation following euthanasia is still alive.- The person who carries out the euthanasia procedure is responsible for assessing the degree of unbearable suffering and for guaranteeing that potential organ donation is well-considered and voluntary...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29219797/-timing-of-the-care-internship-in-the-medical-curriculum-when-should-students-make-acquaintance-with-older-patients
#17
W P Achterberg, J Lindenberg
A care internship in the first year of medical school is an effective way to help students learn to reflect and to acquire professional behaviour. Research has shown, however, that the impressions young medical students have of older people were not very positive before the care internship, and actually worsen afterwards. The care internship has now been adapted as result of these findings and on the basis of evidence in existing literature. Scientific evaluation of educational programmes, and studying potential side effects, are necessary to keep the medical curriculum effective and appropriate...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29219796/-an-infant-with-moaning-breathing
#18
M S M Zijderveld, M Ruige
A girl of 3.5 months old was presented at the emergency department because of sudden onset of moaning breathing. Clinical examination and imaging showed a congenital diaphragmatic hernia.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29219795/-platelet-function-tests-tailored-antiplatelet-therapy-for-vascular-patients
#19
A R T Brand, S J A Korporaal, R T Urbanus, G Pasterkamp, G J de Borst
- Platelet aggregation inhibitors, also known as antiplatelet therapy (APT), are prescribed for the prevention of secondary cardiovascular events (CVE) after endovascular revascularization procedures.- Platelet aggregation inhibitors are not equally effective in all patients. The phenomenon of high residual platelet reactivity despite APT is called 'high on-treatment platelet reactivity' (HTPR); it bears an increased risk of secondary CVE.- Platelet function tests (PFT) can be used to diagnose HTPR. There are various tests available; of those, light transmission aggregometry (LTA) is considered the gold standard...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29219794/-a-brown-red-papule
#20
N A Ipenburg, W J Mooi, R van Doorn
A 44-year-old woman was referred with a brown-red papule on the back. Histopathologic examination showed a melanocytic BAP1-associated intradermal tumour. A germline mutation in the BAP1 gene confirmed a diagnosis of BAP1 tumour predisposition syndrome. This syndrome is associated with various tumour types. Early diagnosis is essential for counselling and screening.
2017: Nederlands Tijdschrift Voor Geneeskunde
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