Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2012
Comparative Study[Surgery in patients with centrally-situated non-small cell lung carcinoma: lung-parenchymal sparing procedure versus pneumonectomy].
To examine if lung-parenchymal sparing resection ('sleeve' resection) is a safe and oncologically responsible alternative to pneumonectomy in patients with central tumours. Further, to evaluate in how far this technique is being used in the Netherlands. ⋯ Patients with centrally-situated NSCLC who undergo a lung-parenchymal sparing procedure have lower mortality and better survival than patients who undergo pneumonectomy.
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Ned Tijdschr Geneeskd · Jan 2012
[Determining burn depth: clinical assessment and laser Doppler imaging].
Early accurate determination of burn depth is important to determine the optimal treatment of burns. The method most used to determine burn depth is clinical assessment. ⋯ It is hypothesised that the introduction of LDI will lead to quicker decisions as to whether or not to operate, possibly leading to a shorter length of hospital stay and lower medical costs. To test this hypothesis, a multicentre randomized controlled trial is presently being conducted in the Dutch burn centres.
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Ned Tijdschr Geneeskd · Jan 2012
Comment[Role of secondary care too small in Dutch College of General Practitioners' (NHG) practice guideline 'Dementia'].
The third revision of the Dutch College of General Practitioners' practice guideline 'Dementia' is a major improvement and stimulates the general practitioner by providing concrete advice on stepped care in dementia diagnostics and organizing care management in order to obtain improvement in the quality and realization of dementia care in the primary care setting. However, this practice guideline does not address more effective and efficient dementia care by collaboration between primary and secondary care as it discourages the prescription of cholinesterase inhibitors and recommends limiting further diagnostic procedures to patients in whom a treatable condition is likely. Although, this new practice guideline strengthens the central role of the general practitioner in Dutch dementia care, this role would be further reinforced if general practitioners were to adopt integrated diagnostics of dementia and relevant additional diseases burden as the starting point.
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Ned Tijdschr Geneeskd · Jan 2012
[Dutch military casualties of the war in Afghanistan--quality of life and level of participation after rehabilitation].
To describe the distribution of injuries and the quality of life and functioning at activity and participation level of rehabilitated Dutch military personnel who were wounded during the mission to Afghanistan. ⋯ The quality of life and functional level of Dutch military personnel who were injured in combat in Afghanistan seemed to be lower than in the general population after 2.3 years. For a large part this could be explained by the level of mobility and occupation.
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An 85-year-old woman with a severe kyphosis presented at the emergency room because of progressive dyspnea and cough, without other complaints. During auscultation, peristaltic sounds were heard over the thorax. A massive diaphragmatic hernia with intrathoracic stomach, small intestine and colon, was seen on CT-scan.