Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2014
Review[Pain relief in lumbosacral radicular syndrome: the role of transforaminal epidural injections with glucocorticoids].
Lumbosacral radicular syndrome is characterized by radiating pain into a part of the leg typically served by one nerve root in the lumbar or sacral spine. The most common cause of radicular syndrome is a herniated disk. The estimated annual incidence of radicular syndrome in The Netherlands is 9 cases per 1000 adults per year. ⋯ Besides pain medication, transforaminal, fluoroscopic injections with corticosteroids can be chosen. Transforaminal, fluoroscopic injections with glucocorticoids are safe and effective compared to placebo. The position within the treatment protocol for radicular pain of epidural steroid injections has yet to be determined based upon further scientific knowledge.
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Ned Tijdschr Geneeskd · Jan 2014
Review[What do you think of Thuisarts.nl? Experiences after 3 years of www.Thuisarts.nl].
Many people need information on health and disease, but the internet is a maze of medical information. In order to offer patients reliable medical information, and to support general practitioners, the Dutch College of General Practitioners (NHG) set up the public website Thuisarts.nl in 2011, which was later followed by an app. The NHG members survey amongst general practitioners from June 2013 showed that 90% of the general practitioners used Thuisarts.nl. ⋯ Information is also available from questionnaires filled in by the NIVEL Health Care Consumer Panel (n = 2846) and participants in a study on information technology and independence (n = 25). Thuisarts.nl meets an important need and is highly valued by doctors and patients. There are plans for the further development of Thuisarts.nl including short videos, illustrations, searchable anatomical structures and information from other reliable organisations such as associations of specialist doctors.
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The human gut microbiota, formerly known as 'gut flora', may be regarded as an external organ with many physiological functions in metabolism, development of the immune system and defense against pathogens. The adult gut microbiota consist of 1013-1014 micro-organisms. The aggregate genome of these, known as the microbiome, is 100 times larger than the human genome. ⋯ It should be noted that until now most of the studies conducted have been association studies, without proof of causality. This increasing insight has led to identification of new therapeutic strategies, which are currently being investigated in clinical studies. Although the implications of this knowledge for individual patients have yet to become clear, various interventions are conceivable, such as supplementation of nutritional elements, prebiotics or probiotics and feces transplantation.
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Ned Tijdschr Geneeskd · Jan 2014
Review[Dromedary camels and Middle East respiratory syndrome: MERS coronavirus in the 'ship of the desert'].
Middle East respiratory syndrome coronavirus (MERS-CoV) is a novel coronavirus, identified in patients with respiratory symptoms in the Middle East. Accumulating evidence points to dromedary camels as being reservoirs. MERS-CoV has been isolated from dromedaries, and dromedary MERS-CoV is nearly identical to human MERS-CoV. ⋯ This means that the risk of human infection may be higher in camel breeding season (spring) when more naïve camels are present. Antibodies appeared to be present in dromedaries as early as 1992, while the first case in humans was recognised in 2012. Underdiagnosis, differences in risk profile, or subtle differences in the genetic make-up of MERS-CoV may explain the absence of MERS in humans before 2012, and in Africa.
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Ned Tijdschr Geneeskd · Jan 2014
Review Case Reports[Burn injuries during MR scanning: a case report].
In this paper we report one case of skin burns in MRI caused by induced electrical currents. Two second degree skin burns occurred during imaging, while operating within all current safety guidelines. The currents are induced by the magnetic-gradient field, as well as the radiofrequency pulses. ⋯ When a loop originates within the patient for a longer time, the current can resonate and dissipate high local energy through a rise in temperature. While rare, clinicians need to be aware of this possible event. By avoiding focal skin-to-skin contact of the extremities in this case, the adverse event could have been avoided.