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Nederlands Tijdschrift Voor Geneeskunde

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https://www.readbyqxmd.com/read/28635579/-fish-oil-in-pregnancy-can-it-prevent-asthma-in-children
#1
P L P Brand, M B Katan
Taking fish oil supplements in the third trimester of pregnancy was associated with significantly less wheezing or asthma in the child at the age of 3-5 years, according to a randomized clinical trial by Bisgaard et al., NEJM 2017. However, the results of this study should be interpreted with caution. The primary end points were modified at a late stage in the study, and two primary end points, eczema in the first 3 years of life and allergic sensitization at 18 months of age, were demoted to secondary end points, and showed no significant effect of treatment...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28635578/-healthcare-professionals-back-in-the-driving-seat
#2
P W G Elbers, A R J Girbes
This commentary discusses the increasingly observed managerilisation of healthcare. Managerilisation frequently results in a framework of rules, regulations and accompanying time-consuming forms and procedures to guide decision-making. Although likely developed with the best of intentions in mind, this framework may be of limited value and tends to leave healthcare professionals feeling frustrated and distrusted. In addition, overzealous bureaucracy and rigid adherence to protocols may be disadvantageous to patient care and outcomes...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28635577/-an-intraoral-swelling-located-in-the-buccal-mucosa
#3
J Schortinghuis, M Contini
A 69-year-old woman presented with a bony hard swelling inside her left cheek. After clinical and radiographic examination, the diagnosis sialolithiasis of the main duct of the parotid gland was made. Surgical removal relieved her complaints.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28635576/-a-man-with-an-anomaly-in-his-ear
#4
T E M van Doeveren, M Bol, W M C Klop
A 65-year-old man presented with an anomaly in his left ear. He had no complaints, but was ashamed of the lesion. On physical examination a pigmented, pedunculated, polypoid tumour of approximately 2 x 2.5 cm was seen, which filled the whole cavum conchae. After excision, histopathological examination showed a verruca seborrhoica.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28635575/-high-risk-obstetrics-in-tertiary-centres-anaesthetist-hybrid-operating-suite-and-obstetric-critical-care-unit
#5
C D van der Marel, A J Eggink, R J Stolker
The frequency of pregnancy-related morbidity has increased over recent decades, as has the number of patients with complex congenital cardiac anomalies reaching fertile age, resulting in an increasing number of high-risk pregnancies. In order to optimalise maternal and foetal outcome in these patients, not only is the availability of optimal in-hospital facilities (e.g. obstetric critical care unit, hybrid operating suite) important, but also a multidisciplinary approach which is mandatory for successful maternal and foetal outcome...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28635574/-it-is-all-about-the-form-adrenaline-in-anaphylaxis-intravenous-or-intramuscular-administration
#6
M van der Have, D Dekker, E M J Theunissen, C Snijders, K A H Kaasjager
BACKGROUND: Medication errors are a frequent problem in the accident and emergency (A&E) department. CASE DESCRIPTION: A 17-year-old boy was referred to our A&E department with an anaphylactic reaction to peanuts. Because of various shortcomings in the care process in A&E, adrenaline was administered intravenously instead of intramuscularly, resulting in a broad complex tachycardia. We analysed these shortcomings using the 'Prevention and recovery information system for monitoring and analysis' (PRISMA) method...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28635573/-colonic-ischaemia-a-condition-with-an-atypical-clinical-presentation-timely-recognition-and-treatment-improve-prognosis
#7
E J A Rondagh, S A Oei, D Goudkade, A A M Masclee, J W Kruimel
The incidence of colonic ischaemia has risen in recent decades because of the ageing population. Patients with colonic ischaemia present with mild abdominal pain, rectal blood loss and/or diarrhoea. However, no pathognomonic signs have been described. Signs of peritonitis are often absent and serum lactate may be normal. This makes prompt recognition and diagnosis difficult, while early treatment with close monitoring is important to optimise prognosis. Computed tomography may have suggestive findings and exclude other causes of abdominal pain, but endoscopy remains the gold standard for confirming the diagnosis...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28612696/-abbreviations-in-daily-language-stop-it
#8
A C Girbes, A R J Girbes
Abbreviations are used more and more in physician common parlance and it seems they are on the way to becoming a new jargon. However, identical abbreviations may have different meanings, especially in different medical specialties. Moreover, many physicians do not know the meaning of specific abbreviations or are attributing the wrong meaning to the abbreviation. This will lead to misunderstanding and therefore danger to the patient. The authors are calling for a stop on the use of spoken abbreviations and for minimising the use of abbreviations in clinical notes and medical prescriptions...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28612695/-peritoneal-tuberculosis
#9
M Koning, L M van der Pol, E F Schippers
Peritoneal tuberculosis was diagnosed in a 38-year-old man from Curaçao, a 42-year-old Dutch man and a 38-year-old woman from Surinam. All patients had been living in the Netherlands for over a decade at the time of diagnosis. Time to diagnosis and treatment varied between patients. Factors contributing to delayed diagnosis were nonspecific symptoms, failure to consider tuberculosis exposure, consulting of more than one physician and delay in obtaining adequate material for histopathologic and microbiologic tests...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28612694/-anticholinergic-syndrome-caused-by-contaminated-herbal-tea-acting-swiftly-to-identify-the-source
#10
C Oerlemans, I de Vries, A J H P van Riel
BACKGROUND: Despite good manufacturing practice and quality control, consumer products can become contaminated. In some cases, this can result in severe and life-threatening intoxication with potentially fatal consequences. CASE DESCRIPTION: A 27-year-old man and a 28-year-old pregnant woman presented to the Emergency Department with severe anticholinergic syndrome after using a marshmallow root (Althaea officinalis) herbal remedy, mixed into hot chocolate drink, to reduce symptoms of common cold...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28612693/-a-man-with-hypoxaemia-after-a-femoral-fracture
#11
T D Koster, M van Dijk, D J Slebos
A 25-year-old male presented with fever and dyspnoea after a femoral fracture, which was treated with intramedullary nail fixation. Based on clinical criteria and a CT scan, the diagnosis fat embolism was made. He was treated conservatively and made a full recovery.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28612692/-fosfomycin-an-old-antibiotic-with-new-possibilities
#12
A C Dijkmans, S G Kuiper, J Burggraaf, J W Mouton, E B Wilms, D J Touw, J Stevens, C van Nieuwkoop, I M C Kamerling
- Fosfomycin is a broad-spectrum antibiotic agent used orally for uncomplicated cystitis. The intravenous form of administration has recently been authorised in the Netherlands.- Thanks to its broad spectrum and extensive tissue penetration, fosfomycin offers possibilities for the treatment of infections in different organs.- Infections with multidrug-resistant bacteria pose a significant threat to public health. Many of these multidrug-resistant bacteria are sensitive to fosfomycin, which means fosfomycin may be an option for the treatment of infections with multidrug-resistant bacteria...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28612691/-smoking-and-young-people-effectiveness-of-smoking-prevention-and-cessation-programmes
#13
K Monshouwer, S Onrust, E Rikkers-Mutsaerts, J Lammers
- In this article, we discuss the scientific knowledge on the effects of interventions that help young people to quit smoking and interventions that should prevent young people from starting to smoke.- We also describe the interventions in the Netherlands that, after a quality assessment, have been included in the database of the National Institute for Public Health and the Environment (RIVM) Centre for Healthy Living.- Interventions have varying degrees of success in helping young people to quit smoking. There are only indications of a modest effect of behavioural interventions...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28589870/-making-better-use-of-the-clinical-geneticist-s-expertise-treating-physician-could-request-a-dna-test-for-most-cancer-patients
#14
C M Aalfs, A M Westermann, C G van El
Eight university medical centres in the Netherlands have established clinical genetic services. Patients receive intensive, and therefore costly, genetic counselling before genetic testing takes place. In recent years the number of patients referred to clinical genetic services has risen dramatically, creating waiting-list backlogs. Knowing your carrier status in hereditary cancers, for instance for a BRCA1/2 mutation, can have consequences for surveillance, treatment, and prevention; however, 90% of patients with breast cancer do not have a mutation...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28589869/-hepatopulmonary-syndrome-a-consideration-in-patients-with-liver-disease-accompanied-by-dyspnoea-and-hypoxaemia
#15
P V van Hirtum, G P Bootsma, R A de Man, C Th B M van Deursen, P I Bonta, M D de Kruif
BACKGROUND: Hepatopulmonary syndrome is a severe complication of liver disease, with greatly increased mortality. The syndrome is characterized by increased blood-flow, intrapulmonary vasodilatation and angiogenesis, leading to effects including the formation of shunts. This leads to a decrease in arterial oxygen pressure. Liver transplantation is the only effective treatment. CASE DESCRIPTION: A 74-year-old woman with cirrhosis of the liver attended the pulmonary outpatients' clinic with progressive dyspnoea, which worsened if she sat upright from a lying position (platypnoea)...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28589868/-two-year-follow-up-of-infants-born-at-24-weeks-gestation-first-outcomes-following-implementation-of-the-new-guideline-for-perinatal-policy-in-cases-of-extreme-prematurity
#16
C S H Aarnoudse-Moens, M Rijken, R M Swarte, P Andriessen, H J Ter Horst, S M Mulder-de Tollenaer, C Koopman-Esseboom, A R C Laarman, K Steiner, A H B M van der Hoeven, R F Kornelisse, J J Duvekot, N Weisglas-Kuperus
OBJECTIVE: Since 2010 the guideline 'Guideline for perinatal policy in cases of extreme prematurity' has advised an active policy in infants born at 24 weeks gestation. We investigated how infants born at 24 and 25 weeks gestation in the first year following the implementation of the guideline had developed by the age of 2 years. DESIGN: Retrospective national cohort study. METHOD: The study population consisted of all surviving infants born in the Netherlands at 24 or 25 weeks gestation in the period from 1 October 2010 to 1 October 2011...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28589867/-a-motorcyclist-with-hematomas-and-tingling-in-his-leg
#17
B F Kingma, B A S Knobben, M P Somford
A 30-year-old man presented with recurrent hematomas and tingling in his left leg, caused by a large femoral neck osteochondroma that induced multiple muscle ruptures and compressed the ischiadic nerve. There were no radiological signs of malignant transformation and symptoms disappeared without intervention. Hence, we chose a 'wait and see' approach instead of surgical removal of the osteochondroma.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28558853/-effectiveness-of-influenza-vaccine-in-the-netherlands-predominant-circulating-virus-type-and-vaccine-match-are-important-conditions
#18
E van Doorn, M Darvishian, F Dijkstra, M J Bijlsma, G A Donker, M M A de Lange, L M Cadenau, E Hak, A Meijer
OBJECTIVE: To investigate the relationship between circulating influenza virus A types and subtypes and influenza B lineages, their match with the vaccine and the effectiveness of the influenza vaccine (IVE). DESIGN: Test negative case control study. METHOD: We used data from the Dutch Sentinel Practices of the Netherlands Institute for Health Services Research (NIVEL) Primary Care Database. Participating general practitioners took nose and throat swabs for viral studies from patients with influenza-like illness or another acute respiratory infection...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28558852/-no-glucocorticoids-for-treatment-of-sepsis-unless%C3%A2
#19
M J A Kamps, D Kiers, P Pickkers
Steroids influence the immune response and blood pressure in patients with septic shock. Many trials have evaluated a putative positive effect of steroids as an adjuvant therapy in patients with sepsis and septic shock, with contradictory outcomes. As a consequence, the use of steroids in sepsis patients varies widely. A recently published randomized clinical trial has demonstrated that treatment with hydrocortisone does not delay or prevent progress to septic shock in patients with sepsis. Based on the current available data, the use of steroids in sepsis should be reserved for those patients who remain severely hemodynamic unstable after fluid resuscitation and vasopressor therapy, or those with a separate indication for steroid therapy...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28558851/-new-biopsy-at-lung-cancer-progression-rational-treatment-of-resistant-lung-cancer
#20
L B M Hijmering-Kappelle, A J van der Wekken, T J N Hiltermann, H J M Groen
Nowadays, patients with advanced non-small cell lung cancer harbouring a driver mutation undergo targeted treatment. This results in profound tumour responses but inevitably induces resistance after approximately 9 to 12 months. In this article we consider the importance and clinical implications of taking new biopsies to retrieve information regarding resistance mechanisms. There is a shift in the use of other modalities such as radiotherapy and surgery in patients with oligometastatic disease, producing long-lasting responses...
2017: Nederlands Tijdschrift Voor Geneeskunde
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