Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jul 2002
Case Reports[Diagnostic image (98). A woman with a vanished intra-uterine device].
A 36-year-old woman suffered from abdominal pain immediately after placement of an intra-uterine device (IUD). Abdominal X-ray revealed that the IUD had perforated the uterus and lay in the peritoneal cavity.
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A 15-year-old boy presented with 20-nail dystrophy, a self-limiting childhood condition.
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Ned Tijdschr Geneeskd · Jun 2002
Historical Article[One hundred years of the Association of Surgeons in the Netherlands. VI. The training].
Over the last 25 years the organisation and content of the residency training program for general surgeons have been adapted to meet the needs of changing surgical practice. Recently more profound changes have been dictated by the Dutch Working Hours Act, which has strictly limited the working hours of resident physicians. ⋯ Because of the limiting working hours resident physicians will have a smaller role in patient care. These changes will require a huge effort from both the teaching surgeons and the resident physicians, as well as substantial financial investments from the government and healthcare providers.
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Ned Tijdschr Geneeskd · Jun 2002
Review[Oral fluoropyrimidines registered for the treatment of metastatic colorectal carcinoma: a possible gain].
Up until now the standard treatment for metastasized colorectal carcinoma has been fluorouracil (5-FU) in combination with folonic acid in low doses administered intravenously, even after the recent registration of a number of new intravenously administered cytostatics, such as irinotecan and oxaliplatin. Meanwhile there are oral alternatives for 5-FU: capecitabine and the combination of tegafur and uracil with folonic acid. In four randomised studies it was shown that these drugs were globally just as effective as the combination of 5-FU with folonic acid (in accordance with the 'Mayo Clinic' scheme). ⋯ An examination of the serious side effects (grade 3 and 4) revealed that the total incidence was generally comparable. These data, together with the ease of oral administration, form the basis for the registration of capecitabine and tegafur-uracil-folonic acid. The definitive place of these drugs in the treatment of metastasized colorectal carcinoma is not yet clear.
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Ned Tijdschr Geneeskd · Jun 2002
[The benefit of population screening for breast cancer; an advisory report from the Health Council of the Netherlands].
A recent Cochrane review does not nullify the evidence supporting the practice of mammographic population screening for breast cancer for women aged 50 years and over. Thus concludes the Health Council of the Netherlands in an advisory report to the Dutch Government. ⋯ The Health Council does agree with the view that the use of disease-specific mortality as the only endpoint renders cancer-screening trials subject to bias. Therefore, careful attention should be paid to total cancer mortality, other important causes of death, and overall mortality.