Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Apr 2003
[The value of the pulmonary-artery catheter: not ruled out, but not proven either].
A number of prospective, randomized trials have recently been published on the effects of using the pulmonary artery (Swan-Ganz) catheter in the peri-operative management of high-risk patients and in the treatment of critically ill patients on the intensive-care unit. These studies show that using the pulmonary-artery catheter does not lead to increased survival. It cannot be excluded that more beneficial effects would have been found with other treatment goals, or if different populations had been studied. However, based on the present evidence from the literature, the routine use of the pulmonary-artery catheter can no longer be defended.
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Ned Tijdschr Geneeskd · Apr 2003
[Asylum seekers in the Pacific Ocean: high prevalence of psychiatric disorders due to camp conditions].
Australia deports its asylum seekers to poor neighbouring islands like Nauru in the Pacific. The asylum seekers are kept in detention on these islands, with serious consequences for their mental health and a high incidence of psychiatric disorders. ⋯ Detention is unnecessary and inhumane. The International Organization for Migration, responsible for running these camps, should reconsider its mission as the world's leading organisation for migration issues.
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Ned Tijdschr Geneeskd · Apr 2003
Review[New developments in the treatment of nausea and vomiting caused by chemotherapy].
With the advent of the 5HT3-receptor antagonists in the 1990s and their combination with dexamethasone, complete emesis protection during the first 24 hours after administration of an emetogenic cytostatic agent became possible in 70% of the patients. Despite acute emesis protection through the use of 5HT3-receptor antagonists and dexamethasone, 40% of the patients do have symptoms during the following days. 5HT3-receptor antagonists and dexamethasone are modestly effective in this delayed phase and the antiemetic protection decreases progressively with multiple cycles. ⋯ The effectiveness of this triple therapy is sustained during subsequent cycles. The chance that an individual patient will be completely protected from severe nausea and vomiting during the entire course of chemotherapy (often 6 cycles) consequently increases significantly (from 34% in the placebo group to 59% in the aprepitant group).