Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jul 1997
[Health Council Report'Preoperative evaluation: reconsideration of basic assumptions].
In February 1997 the Health Council of the Netherlands published the report 'Preoperative evaluation'; it contains recommendations about the content and organization of preoperative evaluation. The aim is to reduce expenses and to increase efficiency. For a preoperative assessment of an otherwise healthy patient history taking and physical examination will do; minimal additional examination is necessary only in certain cases. ⋯ The surgeon and the anaesthesiologist share the responsibility for the preoperative evaluation, but the anaesthesiologist collects the data. Outpatient facilities for anaesthesiologist contribute to improvement in quality. The report is well-documented; it deserves attention of the medical staff and implementation in the hospitals.
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Ned Tijdschr Geneeskd · Jun 1997
Case Reports[Acute pulmonary histoplasmosis as an imported disease].
A previously healthy 44-year-old male traveller presented with a dry cough, fever and an abnormal chest X-ray after a stay in Guatemala, where he had explored bat caves. Acute pulmonary histoplasmosis was diagnosed after culture of Histoplasma capsulatum from bronchial washings. A favourable response was seen upon treatment with itraconazole for six weeks. Acute pulmonary histoplasmosis should be considered in a healthy traveller returning with fever from the USA or subtropical areas.
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Ned Tijdschr Geneeskd · May 1997
Case Reports[Malignant pleural mesothelioma in general practice; complex pain problems].
In three patients, men aged 67, 57 and 69 years, malignant pleural mesothelioma was diagnosed. All three had worked as coal miners and were presented with thoracic pain. They were among seven cases of malignant pleural mesothelioma diagnosed in a period of five years in one suburban general practice (adherence: 5600 patients) in the former mining area in the province of Limburg. ⋯ High doses of opioids and adjuvants were necessary to achieve acceptable pain relief. It is suggested that step one of the 'analgesic ladder for cancer pain management' of the WHO (non-opioids) should be followed soon by step three (strong opioids). Because the incidence of pleural mesothelioma is not yet decreasing, it is important to know that pain management remains a serious problem.
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Ned Tijdschr Geneeskd · May 1997
[Better postoperative pain management in children by introduction of guidelines; a prospective study].
To investigate the influence of recommendations on the quality of postoperative pain management in children. ⋯ Pain scores in children improved after the introduction of recommendations on postoperative pain. However, the improvement could not be attributed to factors like medication. Factors like a change in attitude towards pain could be responsible for this change.
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Ned Tijdschr Geneeskd · May 1997
Comparative Study[Reading children's temperatures with the tympanic infrared thermometer and the rectal mercury thermometer: equally good results in the emergency room].
To compare the results of reading body temperatures with a tympanic infrared thermometer and a rectal mercury thermometer in children in an emergency department. ⋯ The tympanic infrared measurement in children in an emergency department gave the same results as rectal measurement using a mercury thermometer.