Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jun 2004
Review[Bispectral analysis of the electroencephalogram: a new method for recording the level of consciousness during anaesthesia].
Until recently, no measure was available that provided objective and reproducible information on the level of consciousness in patients under general anaesthesia. Several decades of research to find a reliable measure for determining the depth of anaesthesia has now led to the clinical introduction of the bispectral index scale (BIS), a parameter derived from the electroencephalogram. Implementation of the BIS-monitor in anaesthetic practice leads to a reduced use of hypnotic agents, a more rapid recovery phase and possibly a reduced incidence of awareness.
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Ned Tijdschr Geneeskd · Jun 2004
Review[Valganciclovir. Oral treatment of Cytomegalovirus infections].
Valganciclovir is an orally administered prodrug of ganciclovir, the most widely used drug in the clinical management of Cytomegalovirus infections. The good bioavailability and the rapid conversion into ganciclovir provide oral valganciclovir with pharmacokinetic properties approaching those of intravenously administered ganciclovir. ⋯ Broader application of valganciclovir is to be expected in the pre-emptive treatment of organ as well as stem-cell transplant recipients. This drug also increases the potential for prophylactic applications, which may lead to the development of viral resistance.
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Ned Tijdschr Geneeskd · Jun 2004
Review[Coping with grief following perinatal death: a multifaceted and natural process].
Coping with grief following perinatal death is a natural process that every individual experiences in his own personal and unique way. Parents go through varying emotions in the months following the death of their baby. ⋯ Parents benefit from individually focused counseling and assistance in making their own choices with regard to saying goodbye and the way in which they will cope with their grief in the immediate future, as parents, within the family and in relation to the people in their surroundings. It is recommended that the attention for the parents and their lifeless child and all care behaviour be the same, as much as possible, as after the birth of a living child.
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Ned Tijdschr Geneeskd · Jun 2004
[The transport of severely ill children in the Amsterdam region; 1995-2001].
To inventory experiences of the transport of critically ill children in the Amsterdam region. ⋯ Retrieval by a specialized team did not always contribute to a favourable outcome. However, from both a logistical and a medical point of view, a retrieval system seems warranted in order to guarantee a higher level of care. There is a need for more clarity regarding the indications for retrieval by an intensive-care team.
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Ned Tijdschr Geneeskd · Jun 2004
[The initial results of fetoscopic laser treatment for severe second trimester twin-to-twin transfusion syndrome in the Netherlands are comparable to international results].
Evaluation of the initial results of selective fetoscopic laser coagulation of placental blood vessels for severe second-trimester twin-to-twin transfusion syndrome in the Netherlands. ⋯ The results of fetoscopic laser treatment for severe second-trimester twin-to-twin transfusion syndrome in the Netherlands are similar to the recent results in specialised foreign centres.