Nederlands tijdschrift voor geneeskunde
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Patient handover is of major importance for continuity of care and contributes to patient safety. According to Joint Commission International (JCI), an American quality institute, 67% of medical errors result from miscommunication. More than half of these errors appear to be attributable to poor medical handover. ⋯ Little attention is paid to handover as an essential medical competence during training to become a doctor or medical specialist. Many hospitals lack either training or a standardised format for handover. In this paper we discuss 10 tips for improving the quality of intradisciplinary handover.
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In recent decades, enormous progress has been made in the development of intraocular lenses (IOLs) and cataract surgery. Before the development of the IOL, a cataract would cause impairment or loss of vision. ⋯ The current cataract procedure is associated with a very low incidence of intra- and postoperative complications and satisfactory postoperative visual outcomes. Due to the increasing number of cataract surgeries performed annually, and an ageing population, development of IOLs and surgical techniques continues apace.
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Ned Tijdschr Geneeskd · Jan 2015
Comment[Unannounced simulation of obstetric emergencies: safe for medical staff?].
Management of obstetric emergencies is difficult to learn in real life due to the rarity of emergency events. Simulation-based medical education (SBME) has been shown to be a useful training method. A safe learning environment is a crucial condition for successful, applicable SBME. ⋯ However, the number of staff who viewed the simulation as stressful also increased, especially among midwives. Although this study had some limitations, these results should be taken seriously. Randomised trials are warranted to explore the perceptions of healthcare professionals with regard to SBME.
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Ned Tijdschr Geneeskd · Jan 2015
Comment[Central arteriovenous anastomosis: the solution for patients with treatment-resistant hypertension?].
New non-pharmacological therapies for the treatment of resistant hypertension, such as baroreflex stimulation, renal denervation and barostenting, have recently been introduced. The latest development is lowering blood pressure by creating an arteriovenous anastomosis between the common iliac vein and artery by means of a metal coupler device. The randomised, non-blinded ROX CONTROL HTN study showed that office systolic blood pressure was reduced by 27 mmHg in patients assigned to arteriovenous coupler therapy, compared with a reduction of 4 mmHg in patients assigned to normal care. ⋯ The most common complication was venous stenosis. Questions remain regarding the exact working mechanism, size and duration of the effects on blood pressure. There are also concerns about adverse effects.
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A 2-year-old boy showed itchy papules and wheals, which were diagnosed as papular urticaria. Papular urticaria are a hypersensitivity reaction after insect bites. The condition can relapse even without the presence of insects or new bites. Topical steroids or antihistamines diminish the symptoms in some cases.