Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Sep 2007
Review[Influenza vaccination in health-care workers: an effective method to reduce the consequences of influenza in health care users].
Only few usable studies into the effect of influenza vaccination of health-care workers on sick leave and influenza among their patients are available in the literature. However, together these studies provide consistent evidence that this vaccination is effective and cost effective, reducing the death rate from all causes of residents of nursing homes for the elderly by 27-44%. Therefore, measures to raise the vaccination rate among health-care workers, which is at present under 25%, are highly recommended. However, more studies in this field are needed.
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Ned Tijdschr Geneeskd · Sep 2007
[Multicentre clinical study into the optimal blood transfusion policy in patients with postpartum haemorrhage: the 'Wellbeing of obstetric patients on minimal blood transfusions' (WOMB) study].
Postpartum haemorrhage is a common and potentially serious complication of delivery. In clinical obstetrics, exact measurement of blood loss is often difficult. Red blood cell (RBC) transfusion is the most important intervention to treat the complications of this sustained blood loss. ⋯ The total follow-up period is 6 weeks. Currently, the study is ongoing in 10 hospitals in the Netherlands. The goal of this study is to develop a new transfusion policy based on Hb-levels as well as HRQoL criteria.
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Ned Tijdschr Geneeskd · Sep 2007
Meta Analysis[Relationship between volume and quality of care for surgical interventions; results of a literature review].
To examine the relationship between the number of procedures performed per hospital or per surgeon and health care outcomes. ⋯ Volume appears to be related to quality for some surgical procedures. The magnitude of the relationship differs depending on the procedure. For technically less complex procedures, organisation within the hospital appears to have a greater influence on the differences between hospitals than the performing surgeon.
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Ketamine is a new party drug, which is easy to obtain. For this reason, it is possible that physicians will be increasingly confronted with users that have medical problems. Relatively few cases of ketamine intoxication with a fatal outcome have been reported thus far. ⋯ As a result, the chance of untoward effects is increased. Anaesthetists use ketamine for short surgical procedures, sedation and analgesia. It is also used more and more often as an analgesic in patients who do not respond well to opioids.