Nederlands tijdschrift voor geneeskunde
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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.
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(68)Gallium (Ga)-PSMA PET/CT (PSMA stands for "prostate-specific membrane antigen") is a new diagnostic tool for patients with prostate cancer or with prostate cancer metastases. PET/CT is a combination scan which uses the physiological information of the PET scan and the anatomic information of the CT scan. The radioligand (68)Ga-PSMA is a radioactively labelled peptide that binds to the membrane protein PSMA. ⋯ In the same patient, (68)Ga-PSMA PET/CT detects more metastases in an earlier phase, i.e. at a lower PSA level, than fluorine-18 choline PET/CT. Furthermore, the (68)Ga-PSMA can be produced in the investigating hospital with a gallium generator. The expectation is that the use of (68)Ga-PSMA PET/CT will increase to a major extent over the coming years in patients with prostate cancer.