The Netherlands journal of medicine
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Prostate cancer is one of the most common cancers in men. When metastasised (40% of patients), classic anti-androgen therapy is the first-line treatment. Usually, this treatment becomes ineffective when castration-resistant prostate cancer (CRPC) develops. ⋯ In North America, immune therapy (sipuleucel-T) became available for a subgroup of CRPC patients. These new treatment options will change the treatment paradigm of patients with metastatic castration resistant prostate cancer. A multidisciplinary approach by both medical oncologists and urologists seems mandatory.
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In recent years solid organ transplantation has been rapidly developed as a therapeutic intervention that is life-saving and greatly contributes to a better quality of life in organ recipients. The rapid development has been made possible because of a drastic expansion in the immunosuppressive repertoire. ⋯ In this review manuscript we will discuss current and future immunosuppressive strategies that are employed in solid organ transplantation. Expanding our understanding of the human immune system will hopefully provide us with newer, smarter drugs that promote immunotolerance without the side effects observed today.
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Case Reports
Disappearance of epilepsy after resection of catecholamine secreting extra-adrenal paragangliomas: a case report.
Epileptic seizures have been associated with increased catecholamine levels, however, direct proof is lacking. We report a case with catecholamine secreting extra-adrenal paragangliomas and a continuous state of epilepsy not responding to therapy. The epileptic seizures resolved after resection of the paragangliomas and normalization of catecholamine excretion.
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Observational Study
An observational cohort study on geriatric patient profile in an emergency department in the Netherlands.
Currently, Dutch emergency care systems focus on rapid emergency department (ED) patient management with short completion times, which may not meet specific geriatric care needs. ⋯ In this study, fall-related injuries were the most frequent presenting complaint during weekday peak presentation times in 70-plus patients. Of these, one in five discharged from the ED returned within 30 days. Our emergency care system may not adequately cover comprehensive ED geriatric assessment, or provide sufficient outpatient care after ED home discharge. We believe that EPs should be more aware of the complex problems encountered in acute geriatric patients and address follow-up care pathways such as geriatric outpatient services, more often in frail elderly patients discharged home.