Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Dec 2004
Review[The sensitization model: a method to explain chronic pain to a patient].
Chronic pain is pain without a clear somatic substrate. As a result, patients with chronic pain often do not receive a clear diagnosis following a medical examination. In many patients, having pain without a proper explanation or diagnosis induces stress and the urge to search elsewhere for explanations and treatments. ⋯ This central sensitisation is facilitated by numerous factors that contribute to the maintenance of pain in a way that differs from individual to individual. How sensitisation may develop and persist as a result of medical, psychological and social factors calls for research from the perspective of a bio-psycho-social model. If sensitisation is used to explain chronic pain to a patient and the patient understands the relation beween pain and the factors that play a role in the maintenance of the pain, this can lead to acceptation of a treatment learning to cope with these factors.
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Ned Tijdschr Geneeskd · Dec 2004
[Results from 10 years of preimplantation-genetic diagnostics in The Netherlands].
To report the data from couples who were referred for preimplantation-genetic diagnostics (PGD) and treatment due to a significantly increased risk of offspring with a serious genetic disorder. ⋯ PGD was a reliable and successful method, with pregnancy rates similar to those of IVF or intracytoplasmatic sperm injection. PGD should be stated as an alternative during the preconception counselling of couples with an increased genetic risk, especially for disorders where PGD can be routinely applied, such as Huntington's disease, myotonic dystrophy, cystic fibrosis, spinal muscular atrophy, Fragile-X syndrome and structural chromosomal abnormalities.
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Ned Tijdschr Geneeskd · Dec 2004
[Delayed discharge of older patients from the Department of Geriatric Medicine of the Erasmus Medical Centre and factors affecting the length of stay; July 2001--June 2002].
To determine how the discharge of older patients proceeds and what factors affect it. ⋯ The average duration of admission was 9 days longer than the average duration of treatment. The discharge procedure could be accelerated by simplifying the bureaucratic process surrounding indication and referral to an additional-care facility and by accepting the recommendations of the Geriatrics Department.