Nederlands tijdschrift voor geneeskunde
-
Ned Tijdschr Geneeskd · Jan 2016
[When should notification of an infectious disease be mandatory? A decision aid to determine whether mandatory notification is justified].
In the Netherlands, all physicians are required to report cases of certain infectious diseases to the public health services, to allow appropriate control measures. In recent years, various requests have been submitted to add certain infectious diseases to the list of notifiable diseases. ⋯ In this article, we describe the development of this decision aid and illustrate its use in the mandatory notification application reviews for Vibrio vulnificus infection and tularaemia respectively. Based on the decision aid outcomes, mandatory notification for V. vulnificus infection was advised as not necessary whereas notification is considered mandatory for tularaemia.
-
Ned Tijdschr Geneeskd · Jan 2016
Review[Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension].
Chronic thromboembolic pulmonary hypertension (CTEPH) is characterised by an elevated average blood pressure in the pulmonary artery (≥ 25 mmHg). This increase is secondary to fibrous organization of thromboembolic obstructions in the pulmonary arteries. CTEPH is associated with significant morbidity and mortality due to right-sided heart failure and ventilation-perfusion discrepancy. ⋯ BPA is associated with improvements in functional status and haemodynamic profile. Initially procedural complications often occurred, but improvements in procedural technique have ensured that BPA is used increasingly worldwide. In this article, we discuss the history, procedural aspects and outcomes of BPA, and present our first experiences with BPA in a patient with CTEPH.
-
Ned Tijdschr Geneeskd · Jan 2016
Historical Article[The entrance to the guild chamber of the Amsterdam Guild of Surgeons].
In the 17th and 18th centuries the entrance to the guild chamber of the Amsterdam Guild of Surgeons was located in the right corner-tower of the Waag on the Nieuwmarkt in Amsterdam. The surgeons entered their guild chamber through this door for guild meetings or to take surgical exams. The entrance also gave access to the anatomy theatre, the 'Theatrum Anatomicum', where anatomical dissections - anatomy lessons - took place. ⋯ The series of 'anatomy lessons' reminds us of the famous paintings that were commissioned by the Surgeons' Guild. At the beginning of the 17th century, a skeleton was painted on the door in the gateway, and this marked the entrance to the Surgeons' Guild for almost 200 years. We examined, from a historical perspective, how the gateway to the guild chamber of the Amsterdam Guild of Surgeons was transformed over time.
-
Ned Tijdschr Geneeskd · Jan 2016
[The Amsterdam wrist rules: the multicenter prospective derivation and external validation of a clinical decision rule for the use of radiography in acute wrist trauma].
Although only 39% of patients with wrist trauma have sustained a fracture, the majority of patients is routinely referred for radiography. The purpose of this study was to derive and externally validate a clinical decision rule that selects patients with acute wrist trauma in the Emergency Department (ED) for radiography. ⋯ The Amsterdam Wrist Rules is a clinical prediction rule with a high sensitivity and negative predictive value for fractures of the wrist. Although external validation showed low specificity and 100 % sensitivity could not be achieved, the Amsterdam Wrist Rules can provide physicians in the Emergency Department with a useful screening tool to select patients with acute wrist trauma for radiography. The upcoming implementation study will further reveal the impact of the Amsterdam Wrist Rules on the anticipated reduction of X-rays requested, missed fractures, Emergency Department waiting times and health care costs.
-
Ned Tijdschr Geneeskd · Jan 2015
Review Case Reports[Treatment of breakthrough pain in cancer patients].
Pain is common in patients with cancer (33-64%) and can be divided into background and breakthrough pain (BTP). BTP is a passing, acute pain that occurs despite the use of analgesia to control background pain. BTP may arise spontaneously or be provoked by certain movements or activities. ⋯ Both patients had to wait too long before they received their BTP medication, causing the BTP to have passed its peak. After consultation with their nurses, both patients were allowed to have one dose of breakthrough medication in advance, which resulted in better treatment of their BTP. Every hospitalized patient with BTP should have one dose of breakthrough medication ready for taking in advance.