Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2014
Review[What do you think of Thuisarts.nl? Experiences after 3 years of www.Thuisarts.nl].
Many people need information on health and disease, but the internet is a maze of medical information. In order to offer patients reliable medical information, and to support general practitioners, the Dutch College of General Practitioners (NHG) set up the public website Thuisarts.nl in 2011, which was later followed by an app. The NHG members survey amongst general practitioners from June 2013 showed that 90% of the general practitioners used Thuisarts.nl. ⋯ Information is also available from questionnaires filled in by the NIVEL Health Care Consumer Panel (n = 2846) and participants in a study on information technology and independence (n = 25). Thuisarts.nl meets an important need and is highly valued by doctors and patients. There are plans for the further development of Thuisarts.nl including short videos, illustrations, searchable anatomical structures and information from other reliable organisations such as associations of specialist doctors.
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The human gut microbiota, formerly known as 'gut flora', may be regarded as an external organ with many physiological functions in metabolism, development of the immune system and defense against pathogens. The adult gut microbiota consist of 1013-1014 micro-organisms. The aggregate genome of these, known as the microbiome, is 100 times larger than the human genome. ⋯ It should be noted that until now most of the studies conducted have been association studies, without proof of causality. This increasing insight has led to identification of new therapeutic strategies, which are currently being investigated in clinical studies. Although the implications of this knowledge for individual patients have yet to become clear, various interventions are conceivable, such as supplementation of nutritional elements, prebiotics or probiotics and feces transplantation.
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Ned Tijdschr Geneeskd · Jan 2014
[Practice guideline 'Management of patients with mild traumatic head/brain injury' in the Netherlands].
To evaluate the effect of the revised practice guideline 'Management of patients with mild traumatic head/brain injury' (MHI) in the Netherlands using the number of CT scans of the cerebrum, number of hospital admissions, and the number of intracranial traumatic findings on CT scan. ⋯ After introduction of the current MHI guideline in the Netherlands, percentages of both hospitalization and CT of cerebrum have increased significantly. It was expected that the guideline would result in decreases of this percentages. This increase does not seem to be related to more or serious head/brain injury.
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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
Comment[Pill matters: targeted research into side effects necessary].
The paper by Van Hunsel et al. in this issue of the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine) describes reports of side effects among users of hormonal preparations containing cyproterone acetate (Diane-35 and generics) following reports from France of fatal venous thrombosis and subsequent regulatory action. These preparations are licensed for treatment of acne and hirsutism, but are used as oral contraceptives. ⋯ It is noteworthy that oral contraceptives containing cyproterone acetate have been known to be unsafe since 2001, and still they have been used by more than 100,000 women in the Netherlands. The information from Lareb also shows that a pharmacovigilance system based on voluntary reports by physicians and patients is not sufficient to detect increased frequencies of 'common' side effects.