Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Nov 2005
Review[Preventive surgical prcedures for inherited risk of breast cancer].
Preventive surgical procedures for inherited risk of breast cancer Forwomen with a demonstrated BRCA1 or BRCA2 mutation, the cumulative risk of developing invasive breast cancer before the age of 70 years is about 50-85% and the risk of developing invasive epithelial ovarian cancer is 20-60%. Regular surveillance including physical examination and imaging is offered to mutation carriers and the options for risk-reducing surgery are discussed. ⋯ Prophylactic bi- or contralateral mastectomy after previous treatment for unilateral breast cancer reduces the incidence of contralateral breast cancer, but has no impact on survival. The complexity of the problem demands a multidisciplinary approach within the context of a family cancer clinic.
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Ned Tijdschr Geneeskd · Nov 2005
[Dutch authors in international medical journals are also authors of publications in the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine)].
To determine whether Dutch medical scientists who frequently publish in international journals with high impact factors also publish in Dutch in the Nederlands Tijdschrit voor Geneeskunde (NTvG). ⋯ Authors that publish many articles in frequently cited international journals also write articles for the NTvG and, vice versa, the authors of articles in the NTvG also publish in international journals.
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Ned Tijdschr Geneeskd · Nov 2005
Review[Differences in folic-acid policy and the prevalence of neural-tube defects in Europe; recommendations for food fortification in a EUROCAT report].
The European Registration Of Congenital Anomalies and Twins (EUROCAT), a network of 40 European registries of congenital anomalies, has published a special report on the prevention of neural-tube defects by, periconceptional folic-acid supplementation in Europe. This report reviews the progress made in 17 European countries since i99I in terms of developing and implementing public health policies to raise periconceptional folate status. Data on the prevalence of neural-tube defects in 1980-2000 were also analysed. - At the beginning of 2002, 10 of the 17 countries had an official government recommendation that women planning a pregnancy should take folic-acid supplementation daily. ⋯ Even in the Netherlands, where the percentage of planned pregnancies is estimated at 85%, only 36% of women take folic-acid supplements during the advised period. - Overall, the number of neural-tube defects has not decreased in Europe. A slight decrease was seen in those countries with an official policy regarding periconceptional folic-acid supplementation. - It is clear from the report that more effective prevention of neuraltube defects could be achieved with folic-acid fortification of staple foods; this approach has led to a reduction in the prevalence of neuraltube defects in the US and Canada. This approach can also prevent the majority of neural-tube defects in unplanned pregnancies and reduce the socioeconomic differences in prevalence.
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Ned Tijdschr Geneeskd · Nov 2005
Practice Guideline[Guideline 'Diagnosis and treatment of community-acquired pneumonia' from the Dutch Thoracic Society].
Community-acquired pneumonia (CAP) is associated with considerable morbidity and mortality. The incidence of CAP in the Netherlands is estimated to be 5-10 per 1000 per year. This guideline can be used for the scientifically-based diagnosis and antibiotic treatment of adults with CAP. ⋯ Parapneumonic effusion frequently occurs in cases of CAP. Drainage is indicated if the pleural fluid contains bacteria or yields a pH < 7.0. Influenza vaccination is recommended in the elderly to prevent CAP.