Nederlands tijdschrift voor geneeskunde
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In 2008, approximately 1,559,000 Dutch patients consulted their GP because of back pain. One out of 20 back pain patients is ultimately referred to a specialist, most often to a neurologist. ⋯ Scientific evidence in systematic reviews is scarce for the treatments we investigated because of small patient groups and a lack of randomised research. We made an infographic to show the numbers of patients with back pain who visit their GP or a specialist.
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Ned Tijdschr Geneeskd · Jan 2014
Review Case Reports[Diagnostic evaluation of β-lactam antibiotic allergy].
Many patients report a β-lactam allergy or hypersensitivity without actually having this allergy. Targeted questioning, in combination with an accurate description of the nature of the symptoms, leads to rejection of a large number of these presumed allergies. In a suspected allergic reaction one has to distinguish between the potentially life-threatening, acute type I mediated allergy and delayed type IV skin reaction. ⋯ Patient B was a 58-year-old man with anaphylaxis triggered by amoxicillin/clavulanate as a result of a selective allergy to amoxicillin. Patient C was a 50-year-old man who had had a possible reaction to a penicillin in his childhood. Analysis in an allergology department can be useful for further treatment.
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Ned Tijdschr Geneeskd · Jan 2014
Multicenter Study[Suspected allergy to a local anaesthetic: how often is allergy proven?].
To determine the percentage of proven allergy for local anaesthetics (LA) in patients who were tested because of a clinical suspicion of LA allergy. ⋯ IgE-mediated and delayed-type allergic reactions are rarely caused by LA. IgE-mediated reactions can be proven by provocation testing. Patch testing is used when a delayed type reaction is suspected.
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Ned Tijdschr Geneeskd · Jan 2014
Review[Chemotherapy-induced peripheral neuropathy; impact on quality of life].
Peripheral neuropathy is a frequently occurring side-effect of chemotherapy as a cancer treatment. The incidence of chemotherapy-induced peripheral neuropathy (CIPN) is increasing as a consequence of better treatment of cancer becoming available and increasing use of chemotherapy, and because CIPN occurs more frequently with use of new chemotherapeutics. The diagnosis 'CIPN' is made principally on clinical grounds, and it is characterized by predominantly sensory symptoms. ⋯ If CIPN occurs, the only effective strategies are dose reduction or discontinuation of chemotherapy. CIPN impairs quality of life. It is important to evaluate the symptoms of CIPN, as well as the impact on daily living.
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Groin pain in young athletes is a common problem, accounting for significant downtime in sports participation. It can be difficult to make the correct diagnosis as groin pain has a wide differential diagnosis, which encompasses acute as well as chronic causative factors. ⋯ However, after further investigation the patients were diagnosed with three very different types of injury: sportsman's hernia; hip labral tear; and pubic osteitis. This emphasises the need for every general practitioner and medical specialist to understand that there is a wide differential diagnosis for groin pain in athletes, in order to be able to implement specific therapy targeting the actual cause of groin pain.