Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2009
Review[Vaccination against chickenpox, shingles and rotavirus-infection].
The Dutch National Immunisation Programme (NIP) has been very successful over the past 50 years. In future, this programme shall not include all new vaccines. Such vaccines can, however, be individually administered. ⋯ More than 95% of children experience one or more episodes of rotavirus gastroenteritis before their 5th birthday. In the Netherlands about 3400 children are hospitalised each year for rehydration following rotavirus infection. The vaccine is given orally.
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Ned Tijdschr Geneeskd · Jan 2009
Review[Dengue: a growing risk to travellers to tropical and sub-tropical regions].
Dengue is currently the most common arboviral infection worldwide. Due to global climate change and other factors, the vector of the virus - the Aedes mosquito - has spread considerably over the past decades. ⋯ Considering the limited possibilities of prevention it is anticipated that the incidence of dengue will increase in the future. It is expected that health-care providers in non-endemic regions will encounter dengue-infected patients with increasing frequency in their practices.
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Ned Tijdschr Geneeskd · Jan 2009
[Neuraminidase inhibitors and high risk of influenza complications: considered and widely-supported recommendations].
It has been suggested that it is unwise to employ neuraminidase inhibitors in order to diminish the risk of influenza-related complications in cases of infection with the new influenza A(H1N1). However, the major argument, i.e. that the beneficial effects shown in the published evidence may be due to age differences between treatment and placebo groups, can easily be refuted. The Netherlands' policy to limit treatment to those patient groups who are considered at high risk of influenza complications is a sound one. In addition, it is endorsed by recent guidelines of the WHO and CDC.
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A 54-year-old man was admitted with fever following a trip to St. Maarten in the Dutch Antilles, from where he had returned 6 days earlier. One year prior to this he had been treated on an Intensive Care Unit for a severe influenza A infection. ⋯ Neither IgG nor IgM antibodies against dengue were found, but PCR on dengue virus RNA was positive. Over past decades there has been a strong increase in the number of dengue virus infections in travellers returning from Southeast Asia, Central and South America, the Caribbean and Africa. Whilst in general a primary dengue virus infection does not result in severe disease, this case illustrates the potentially fatal consequences of dengue in travellers.
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Ned Tijdschr Geneeskd · Jan 2009
Case Reports[Hyperchloraemic metabolic acidosis in a patient with an ureteroileostomy according to Bricker].
A 79-year-old male with a Bricker loop and chronic renal failure was admitted to hospital because progressive dyspnoea. This was due to severe hyperchloraemic metabolic acidosis. Hyperchloraemic acidosis can occur if urinary diversions are constructed from the colon or ileum. ⋯ A loopogram is necessary to investigate the cause. In our patient the loopogram showed that the incorporated bowel segment was too long. After shortening of the Bricker loop, the patient recovered from the hyperchloraemic metabolic acidosis.