Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · May 2008
[The effect of specialised medical procedures on the hosptial standardised mortality ratio in cardiac centers].
To examine the impact of specialised medical procedures (SMPs) on the hospital standardized mortality ratio (HSMR) in Dutch cardiac centres. ⋯ Specialised medical procedures for heart conditions influence the HSMR of cardiac centres. The increase or decrease in HSMR is related to the relative frequency of PTCA and open heart surgery. These results can be used to help interpret the differences in HSMR among cardiac centres and other hospitals.
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Ned Tijdschr Geneeskd · May 2008
Review[Medicine is not gender-neutral: influence of physician sex on medical care].
Many studies have shown that men and women differ in communication styles. The question is whether these differences also play a role during medical consultation. Potential differences between male and female physicians that have been investigated, are differences in doctor-patient communication, the diagnostic process and treatment. ⋯ Within the medical profession, male and female medical students are socialised differently, and professional socialisation does not overcome differences in gender roles. Patients are generally more satisfied with female physicians than male physicians. Knowledge of and insight into these processes is essential for improving the quality of care.
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Ned Tijdschr Geneeskd · May 2008
[Diagnosis and treatment of patients with spinal epidural metastases].
Three patients with a medical history of malignancy were referred for back pain: two women aged 53 and 43 years respectively, with breast cancer, and a woman of 85 years with rectal carcinoma. All patients suffered from spinal metastasis. Considerable delay occurred between the initial complaint of back pain and the diagnosis. ⋯ A reliable differentiation, based on symptoms and signs, between widely occurring non-malignant back pain and back pain due to spinal metastasis is impossible. This confronts physicians with the dilemma of overexposing their patients to diagnostic tests on the one hand and the risk of missing an important diagnosis on the other. Early recognition of warning signs, i.e. previous medical history of malignancy, onset of back pain above 50 years of age, continuous pain not related to posture or movement and nocturnal pain, should alert physicians.
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Ned Tijdschr Geneeskd · May 2008
[Splenectomy in a large general hospital: often caused by iatrogenic injury, often causing multiple complications; poor adherence to post-operative guidelines for vaccination and prophylaxis].
To assess the indications, complications and mortality associated with splenectomy in a large general hospital, and to evaluate adherence to guidelines for postoperative vaccination and prophylactic antibiotics. ⋯ In this large general hospital, splenectomy was often performed due to iatrogenic injury and was associated with a relatively high complication rate. Adherence to guidelines on vaccination and prophylactic antibiotics could be improved.
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Ned Tijdschr Geneeskd · May 2008
[Helicopter-Mobile Medical Teams in The Netherlands: significant differences in deployment frequencies between different emergency room regions].
To investigate whether Helicopter-Mobile Medical Teams (H-MMTs or HEMS) are optimally deployed in all emergency dispatch centres. ⋯ By relating the deployment of H-MMTs with the number of inhabitants per region, a comparison can be made of the deployment frequencies in different emergency dispatch regions. The deployment of H-MMTs proved to differ significantly between emergency dispatch centres.