Nederlands tijdschrift voor geneeskunde
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Lung volume recruitment can improve peak cough flows and respiratory compliance in patients who either do or do not require mechanical ventilation. There are several lung volume recruitment techniques: air stacking, glossopharyngeal breathing and mechanical insufflation-exsufflation with cough assist devices. The principle of lung volume recruitment is based on the insufflation of air in the lungs after maximal inspiration. ⋯ These techniques may prevent pulmonary complications, hospital admission and tracheotomy in patients with a reduced ability to cough, a proclivity towards atelectasis and recurrent airway infections. The combination of long-term mechanical ventilation with lung volume recruitment has led to further improvement in the prognosis of chronic respiratory failure. More patients may potentially benefit from lung volume recruitment than only those being converted from short-term to long-term mechanical ventilation.
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The Hajj, the pilgrimage to Mecca, is the largest mass migration in the world. Each year, 2.5 million Muslims from over 160 countries travel to the same place, 5000-6000 of these being from the Netherlands. ⋯ The chance of transmission of infective disease is also high and rapid contagion of Hajj pilgrims could cause a pandemic. It is therefore important that the responsible doctor is aware of the health risks to the Hajj pilgrim and his environment.
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Ned Tijdschr Geneeskd · Jan 2011
Review[Ethical review of biobanks in The Netherlands: lessons from the String of Pearls Initiative].
Ethical and legal aspects of biobanking continue to be a topic of concern. The String of Pearls Initiative (PSI) helped establish new norms for biobank governance in The Netherlands. This article gives an overview of issues that emerged from the medical-ethical review processes of PSI. ⋯ Key issues included the legal status of prospective research-dedicated biobanks, informed consent, monitoring of the use of biobanks, and alignment of biobanking policies both within and between research departments. The article calls on all actors involved in biobanking to continue to strive for the harmonization of biobanking policies. A certain degree of central coordination is crucial in order to improve on collaborative biobanking initiatives.
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Screening with low-dose computed tomography reduces lung cancer mortality. However, the high incidence of false positive screening results, the uncertainty of the duration of screening and the lack of a cost-effectiveness analysis should be overcome before introduction in a daily clinical practice.
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A 42-year-old woman came to the emergency department with acute abdominal pain. CT-scan showed an isolated dissection of the A. mesenterica superior and signs of ischaemic colitis. The patient was treated with endovascular stent placement in the artery and partial small bowel resection.