38,133 results match your criteria Nederlands Tijdschrift voor Geneeskunde [Journal]


[Ocular symptoms associated with dupilumab in atopic dermatitis].

Ned Tijdschr Geneeskd 2019 Mar 21;163. Epub 2019 Mar 21.

UMC Groningen, afd. Dermatologie.

Background: Dupilumab, the first registered biological for the treatment of atopic dermatitis, frequently causes adverse ocular events. These often take the form of mild conjunctivitis or blepharoconjunctivitis, however, more serious adverse ocular events have also been reported, including limbal stem cell insufficiency.

Case Description: A 56-year-old man was treated with dupilumab for severe atopic dermatitis. Read More

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March 2019
1 Read

[Treatment of appendicitis with antibiotics only; still a bridge too far].

Ned Tijdschr Geneeskd 2019 Mar 14;163. Epub 2019 Mar 14.

Amsterdam UMC, locatie AMC, afd. Chirurgie.

Antibiotic treatment instead of surgery for uncomplicated appendicitis seems attractive since it may lead to fewer complications. Moreover, patients who have surgery after failed initial antibiotic treatment have comparable complication rates to those undergoing immediate appendectomy. There are caveats, since patients treated with only antibiotics have a 40% chance of recurrent appendicitis within the following years. Read More

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[A girl with 16p11.2 deletion syndrome].

Ned Tijdschr Geneeskd 2019 Mar 21;163. Epub 2019 Mar 21.

Amsterdam UMC, Universiteit van Amsterdam, Klinische Genetica.

16p11.2 deletion syndrome is one of the most prevalent microdeletion syndromes in the world. Nevertheless, many doctors are not (yet) familiar with this syndrome. Read More

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March 2019
2 Reads

[Robot-assisted transaxillary thyroid surgery; 5 years later].

Ned Tijdschr Geneeskd 2019 Mar 14;163. Epub 2019 Mar 14.

UMC Utrecht, afd. Heelkunde.

Five years ago, robot-assisted transaxillary thyroidectomy (RATT) was introduced in the Netherlands. The major advantage of this technique, when compared to the conventional approach, is the prevention of a potentially disfiguring scar in the neck. In recent years, multiple large cohort studies have demonstrated that the quality of the resection, postoperative complications and functional and oncological outcomes are similar in patients treated with RATT when compared to the open procedure. Read More

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March 2019
3 Reads

[An airy feeling].

Ned Tijdschr Geneeskd 2019 Mar 18;163. Epub 2019 Mar 18.

Haaglanden Medisch Centrum, afd. Interne Geneeskunde, Den Haag.

A 65-year-old man, diagnosed with bronchus cancer metastasized to the brain and lymph nodes, was seen at the emergency department. He complained of 'an airy feeling' within the left side of his thorax. Imaging revealed a pneumopericardium, probably caused by a fistula between the primary tumour and the pericardium. Read More

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March 2019
1 Read

[Loss is gain? Discarding TNF-α inhibitors].

Ned Tijdschr Geneeskd 2019 Mar 21;163. Epub 2019 Mar 21.

Erasmus Universiteit, Institute for Medical Technology Assessment, Rotterdam.

According to a recent study, stopping the prescription of TNF inhibitors is a cost-effective decision at various willingness-to-accept thresholds. Discontinuing the prescription of the drug may lead to a minor loss in health - expressed in quality adjusted life years - but results in significant societal savings. In our commentary, we stress that willingness-to-pay thresholds should not be completely replaced by the willingness-to-accept threshold, also when it concerns health losses. Read More

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[Towards 'the best DOAC'?]

Ned Tijdschr Geneeskd 2019 Mar 21;163. Epub 2019 Mar 21.

UMC Utrecht, Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde.

Direct oral anticoagulants (DOACs) are increasingly being prescribed for stroke prevention in patients with atrial fibrillation or for treating venous thromboembolism. In this short overview, we provide some guidance on possible differences between available DOACs as well as a comparison with traditional treatments using vitamin K antagonists. In the absence of head-to-head trials comparing different DOACs with each other, this is predominantly based on indirect meta-analysis and observational evidence. Read More

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March 2019
3 Reads

[Conservative treatment of scaphoid fractures].

Ned Tijdschr Geneeskd 2019 Mar 21;163. Epub 2019 Mar 21.

Luzerner Kantonsspital, afd. Orthopedie en Traumatologie, Luzern, Zwitserland.

Considering that pseudoarthrosis, or non-union, often occurs in patients with scaphoid fractures it is very important to start adequate treatment as soon as possible. On the basis of the literature, we advise immobilisation in a below-elbow cast, whereby the thumb is not immobilised and the wrist is in a slightly extended position. Despite the fact that non-dislocated fractures, at the very least, are usually consolidated within 4 weeks, we advise an immobilisation period of 6 weeks followed by clinical or radiological evaluation. Read More

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March 2019
5 Reads

[Coeliac disease in children: a changing clinical spectrum].

Ned Tijdschr Geneeskd 2019 Mar 19;163. Epub 2019 Mar 19.

Tergooi ziekenhuis, afd. Kindergeneeskunde, Blaricum.

Over the past decades the clinical spectrum of paediatric coeliac disease has profoundly changed, from a classical presentation with distended abdomen, diarrhoea and failure to thrive to more atypical symptoms. These days, children commonly present with symptoms such as recurrent abdominal pain, fatigue, iron deficiency anaemia and constipation. Age at diagnosis has also increased over the past few years. Read More

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March 2019
5 Reads

[Valsartan contamination].

Ned Tijdschr Geneeskd 2019 Mar 28;163. Epub 2019 Mar 28.

Rijnstate, afd. Interne Geneeskunde, Arnhem.

In early July 2018, it became known that a number of generic preparations containing the active substance valsartan could be carcinogenic. This news took caregivers and patients by surprise. Initially, a recall was initiated at the pharmacy level. Read More

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March 2019
4 Reads

[A patient with leg numbness and micturition symptoms].

Ned Tijdschr Geneeskd 2019 Mar 18;163. Epub 2019 Mar 18.

Martini Ziekenhuis, afd. Radiologie, Groningen.

A 37-year-old man presented with an acute loss of sensibility and a gait disorder, caused by a vitamin B12 deficiency due to nitrous oxide use. A spinal cord MRI showed an inverted V sign. Repeated use of nitric oxide blocks the remethylation of homocysteine to methionine, which, in turn, leads to demyelination. Read More

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March 2019
5 Reads

[A man with abdominal pain and nausea].

Ned Tijdschr Geneeskd 2019 Mar 21;163. Epub 2019 Mar 21.

Noordwest Ziekenhuisgroep, locatie Alkmaar, afd. Heelkunde.

A 63-year-old man with a history of orthotopic liver transplantation was presented to the emergency department with progressive right flank pain and nausea. On physical examination, we found a hernia cicatricalis that was painful on palpation. An abdominal CT scan showed acute perforated appendicitis, located in a hernia cicatricalis. Read More

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March 2019
2 Reads

[TOETVA: thyroid surgery without permanent scar].

Ned Tijdschr Geneeskd 2019 Mar 14;163. Epub 2019 Mar 14.

UMC Utrecht, afd. Heelkunde.

Transoral endoscopic thyroidectomy using a vestibular approach (TOETVA) is the first thyroid surgery that leaves no permanent visible external scar. 3 scopes are placed via the mouth, passing the front of the teeth. The thyroid is then reached and removed by passing over the chin. Read More

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March 2019
10 Reads

[Zoledronic acid; useful in osteopenia?]

Ned Tijdschr Geneeskd 2019 Mar 14;163. Epub 2019 Mar 14.

Amsterdam UMC, locatie VUmc, afd. Interne Geneeskunde.

A randomised, double-blind, placebo-controlled trial assessing the effect of zoledronic acid on osteopenia in 2000 women aged 65 years and older over a 6-year treatment period has revealed a statistically significant reduction of fracture incidence. Although the treatment effect seen in this study may have been somewhat overestimated due to selection, the implications for clinical practice could be considerable, as half of all women aged over 65 years are osteopenic and most fractures in the general population occur in this group. However, treatment with zoledronic acid is relatively expensive and the impact on health care costs of treating all older women with osteopenia would be dramatic. Read More

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March 2019
1 Read

[Why psychotherapy works].

Authors:
H L R Van

Ned Tijdschr Geneeskd 2019 Mar 21;163. Epub 2019 Mar 21.

Arkin, Amsterdam.

All psychotherapies are rooted in a theory about how psychological symptoms can be changed. However, to date the scientific evidence for specific working mechanisms has been very limited. What is certain is that a good working relationship leads to a better treatment outcome. Read More

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March 2019
1 Read

[Psychiatric symptoms in a child with gluten sensitivity].

Ned Tijdschr Geneeskd 2019 Mar 14;163. Epub 2019 Mar 14.

LUMC, afd. Kindergeneeskunde, Leiden.

Background: Non-celiac gluten sensitivity (NCGS) is a diagnosis that is increasingly being reported. Psychiatric symptoms can be a rare but serious manifestation of this new clinical entity.

Case Report: A 13-year-old girl consulted the paediatrician with abdominal pain, diarrhoea, bloating, and compulsive thoughts and fears; these disappeared on a gluten-free diet. Read More

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[A man with a skin lesion on the big toe].

Ned Tijdschr Geneeskd 2019 Mar 11;163. Epub 2019 Mar 11.

Streekziekenhuis Koningin Beatrix, afd. Chirurgie, Winterswijk.

We present a 48-year-old man who had developed a skin lesion on his big toe. In 2 years' time, the lesion had evolved from melanonychia striata to an erratic, erosive, granulomatous plaque of approximately 3,0 x 3,0 cm. Histopathological examination of 2 skin biopsies revealed a nodular melanoma. Read More

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March 2019
6 Reads

[Chest pain after angiography without anomalies].

Ned Tijdschr Geneeskd 2019 Mar 1;163. Epub 2019 Mar 1.

Zaans Medisch Centrum, afd. Cardiologie, Zaandam.

Background: Myocardial infarction can be categorized based on ECG-findings (presence or absence of ST-elevations on STEMI/NSTEMI) or on the results from coronary angiography (CAG) (presence or absence of obstructive atherosclerosis). Myocardial infarction without significant obstruction on CAG (Myocardial Infarction with Non-Obstructive Coronary Arteries/Atherosclerosis; MINOCA) occurs in up to a quarter of patients with myocardial infarcts. These patients have a higher risk of future heart diseases; up to a quarter of MINOCA patients suffer from heart diseases during a median follow-up of four years. Read More

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[A real fear of voodoo spirits].

Ned Tijdschr Geneeskd 2019 Mar 1;163. Epub 2019 Mar 1.

Equator Foundation, Arq Psychotrauma Expert Groep, Diemen.

Nigerian victims of human trafficking often fear revenge of voodoo spirits after escaping from their offenders. Human traffickers usually tell them that voodoo spirits will disturb their sleep and their peace of mind and eventually drive them crazy in case the victim would break the contract. In the Nigerian context, this fear is real and threatening. Read More

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[Respectful ethnic profiling in the care sector].

Ned Tijdschr Geneeskd 2019 Mar 1;163. Epub 2019 Mar 1.

Amsterdam UMC, afd. Inwendige geneeskunde, Endocrinologie en Metabolisme, locatie UvA-AMC.

Physicians sometimes use ethnicity as part of their clinical reasoning. Using ethnicity can sometimes, however, lead to bias and may lead to discrimination or racial discrimination. In this article we discuss some examples of wrongful medical profiling based on ethnicity, but also show how ethnic profiling can be performed respectfully. Read More

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[How do I come across like an authentic doctor?]

Authors:
David Engelhard

Ned Tijdschr Geneeskd 2019 Mar 7;163. Epub 2019 Mar 7.

Leiden: drs. D. Engelhard, sinoloog en bestuurskundige.

'The more my patient looks like a real patient, the more I will look like a real doctor.' Certain young medical professionals may think that way, as they widen the gap between themselves as 'trained professionals' and their patients as 'ignorant laymen'. Medical doctors and patients have a relationship with each other. Read More

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March 2019
3 Reads

[Hacking into a pacemaker; risks of smart healthcare devices].

Ned Tijdschr Geneeskd 2019 Mar 8;163. Epub 2019 Mar 8.

UMC Utrecht, afd. Cardiologie.

Technological progress in healthcare offers a plethora of opportunities, but they also raise important issues, such as safety. Every year, around 18,000 electronic implants with a therapeutic function, such as pacemakers and implantable cardioverter defibrillators (ICDs), are implanted in patients in the Netherlands. Most of these devices are able to establish a wireless internet connection to share technical and diagnostic information remotely with healthcare providers. Read More

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March 2019
1 Read

[Race and racism in a medical context in the Netherlands].

Authors:
Lizzy M Brewster

Ned Tijdschr Geneeskd 2019 Mar 1;163. Epub 2019 Mar 1.

Creatine Kinase Foundation, Hart- en Vaatziekten (Cardiovascular Disease), Amsterdam.

From experiments by the Nazis in Germany, to the infamous American Tuskegee study, controversies surround racialized medical science and clinical practice. However, although 'race' is a social construct, disease patterns may cluster in groups with a common ethno-cultural ancestry. In this journal, Buckle and Achterbergh et al. Read More

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March 2019
1 Read

[Unusual findings on chest x-ray].

Ned Tijdschr Geneeskd 2019 Mar 11;163. Epub 2019 Mar 11.

Spaarne Gasthuis, afd. Radiologie, Haarlem/Hoofddorp.

We describe a 59-year-old woman, who came to the Emergency Room with fever, dyspnoea and lung abnormalities on chest x-ray. The X-ray abnormalities were not related to the clinical symptoms and could be explained by the patient's medical history, which included rib fractures and spinal compression fractures. The confined spherical structures visible on chest X-ray were indicative of previous rib fractures. Read More

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March 2019
1 Read

[Health care claims per medical specialty in the Netherlands: a 10-year overview].

Ned Tijdschr Geneeskd 2019 Mar 11;163. Epub 2019 Mar 11.

Faculty of Health, Medicine and Life Sciences.

Objective: To analyse the quantity and size of health care claims per medical specialty in the past 10 years.

Design: Descriptive, evaluative and comparative study.

Method: Anonymised damage claim data from Centramed and MediRisk were used for this study. Read More

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March 2019
1 Read

[Data-driven integrated diagnostics: the natural evolution of clinical chemistry?]

Ned Tijdschr Geneeskd 2019 Feb 28;163. Epub 2019 Feb 28.

UMC Utrecht, Laboratorium Klinische Chemie en Haematologie, Utrecht.

In the near future, making a correct medical diagnosis will be increasingly supported by artificial intelligence. The development of algorithms that integrate all data from an individual into the diagnostic process calls for a multidisciplinary approach that includes not only healthcare professionals and patients, but also data scientists. Because of the position of the clinical chemist in the current health care process, this medical specialist is naturally suited to initiate the development of self-learning diagnostic algorithms and to take the lead in the process to take big data to the next level and create value for health care. Read More

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February 2019

[Posterior shoulder dislocation; an often-missed diagnosis].

Ned Tijdschr Geneeskd 2019 Mar 8;163. Epub 2019 Mar 8.

Martini ziekenhuis, afd. Orthopedie, Groningen.

Posterior shoulder dislocation after a traumatic event is often underdiagnosed. Consequently, treatment is initiated too late and patients experience pain and loss of motion. Conventional X-ray is the standard to diagnose a posterior shoulder dislocation. Read More

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March 2019
3 Reads

[A girl with a purple chin].

Ned Tijdschr Geneeskd 2019 Mar 8;163. Epub 2019 Mar 8.

Huisartsenpraktijk Gunneweg en Groot, Ermelo.

A 9-year-old healthy girl visited the general practitioner with a recurring purple discoloration of the skin around the mouth without any other complaints. She was diagnosed with factitious purpura due to a vacuum that was caused by creating a negative pressure through placement of a plastic cup around the mouth. Read More

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March 2019
2 Reads

[BRCAmutations more frequent in people of Jewish ancestry].

Ned Tijdschr Geneeskd 2019 Mar 1;163. Epub 2019 Mar 1.

Antoni van Leeuwenhoek, polikliniek Familiaire Tumoren en afd. Pathologie, Amsterdam.

Three BRCA1/BRCA2 mutations occur more frequently in the Jewish population than in the general population. In Jewish patients with breast cancer about 10% of cases are caused by one of these mutations; consequently, all patients with breast cancer and who are of Jewish ancestry, or their healthy family members, are eligible for genetic testing. Read More

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[Prospective parents with a mental impairment: is prior competency testing in this group of people who wish to have children justified?]

Authors:
A C Hendriks

Ned Tijdschr Geneeskd 2019 Feb 28;163. Epub 2019 Feb 28.

Universiteit Leiden, Faculteit der Rechtsgeleerdheid, departement Publiekrecht, Leiden.

Doctors can decide to subject individuals who wish to become parents to a test to analyse their parental competence. From a legal perspective there is no justification to subject only those individuals with a mental impairment to such a test. In fact, it could be argued that all potential parents should undergo such a test, but due to the impact this would have on the healthcare system that is simply not feasible. Read More

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February 2019

[Lifestyle medicine: effective cure or just snake oil?]

Ned Tijdschr Geneeskd 2019 Feb 19;163. Epub 2019 Feb 19.

Vrije Universiteit, Amsterdam.

Many chronic non-communicable diseases are at least partly caused by unhealthy lifestyles; an example is type 2 diabetes mellitus (T2DM). Lifestyle interventions have been shown to substantially reduce the risk of T2DM in high-risk patients. The risk reduction diminishes over time, but a long-term (> ten years) reduction is still achieved. Read More

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February 2019
3 Reads

[Subfertility in mentally disabled people who desire to have children: how to give balanced advice].

Ned Tijdschr Geneeskd 2019 Feb 19;163. Epub 2019 Feb 19.

Radboud UMC, Nijmegen, afd. Eerstelijnsgeneeskunde.

When people with a mental disability fail to conceive naturally, they also like to be considered for fertility treatment. However, the GP, gynaecologist or fertility specialist may question their parenting competence. Physicians may and can refuse fertility treatment if they have reasons to suspect that the child will have a poor quality of life. Read More

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February 2019

[What questions do adolescents have for the adolescent health care service?]

Ned Tijdschr Geneeskd 2019 Feb 12;163. Epub 2019 Feb 12.

GGD Gelderland-Midden, afd. Jeugdgezondheidszorg, Arnhem.

Objective: Gain insight in questions adolescents have about their health.

Design: Cross-sectional questionnaire-based study.

Method: During the 2015-2016 school year, all grade 3 VMBO students and grade 4 MAVO/VMBO-T, HAVO or VWO (MHV) students in schools of the mid-Gelderland region were invited for the preventive health study 'Gezond leven? Check het even!' ['Living healthily? Do the check!']. Read More

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February 2019
1 Read

[Lifestyle intervention in the consulting room: high-hanging fruit].

Authors:
Yvo M Smulders

Ned Tijdschr Geneeskd 2019 Feb 22;163. Epub 2019 Feb 22.

Amsterdam UMC, locatie VUmc, afdeling Interne Geneekunde.

The attributable risk of lifestyle factors for the development of diabetes, hypertension, and related disorders is very large. To what extent this attributable risk translates into potential for prevention and treatment in the consulting room in much less clear. Previous trials showing effects of lifestyle interventions have often been characterized by intensive patient education and stimulation programmes, which may be difficult to implement in everyday practice. Read More

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February 2019

[Blisters and skin abnormality after playing in the garden].

Ned Tijdschr Geneeskd 2019 Feb 27;163. Epub 2019 Feb 27.

Onze Lieve Vrouwe Gasthuis, afd. Dermatologie, Amsterdam.

On a sunny day, a 2-year-old boy came to the paediatric department with skin abnormalities. These had started as redness and blisters and later also included hyperpigmentation. He had played near a phototoxic plant known as 'common rue' (Ruta graveolens). Read More

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February 2019
3 Reads

[A man with nasal bleedings and blurry vision].

Ned Tijdschr Geneeskd 2019 Feb 28;162. Epub 2019 Feb 28.

Maasstad Ziekenhuis, afd. Interne Geneeskunde, Rotterdam.

A 67-year-old man, experiencing nasal bleedings and shortness of breath for months, had a blurry vision for a few days. Bone marrow biopsy and laboratory findings led to the diagnosis of Waldenström's macroglobulinaemia. Fundoscopy showed cotton wool spots and retinal haemorrhages, associated with Waldenström's retinopathy. Read More

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February 2019

[A suppurating parasternal swelling].

Ned Tijdschr Geneeskd 2019 Feb 27;163. Epub 2019 Feb 27.

Ziekenhuis Gelderse Vallei, afd. Longgeneeskunde, Ede.

A 94-year-old man with a history of colon cancer presented to the emergency department with a painful, suppurating, parasternal swelling. The swelling had been present for more than a year and its size had increased over time. However, previous diagnostic tests (CT, MRI and cytological punctures) had not led to a diagnosis. Read More

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February 2019
1 Read

[A woman with a painful elbow].

Ned Tijdschr Geneeskd 2019 Feb 27;163. Epub 2019 Feb 27.

Amsterdam UMC, afd. Radiologie, locatie AMC-UvA.

A 27-year-old woman presented to the Emergency Department with a painful right elbow after falling off a road bike. X-ray examination ruled out an elbow fracture, but showed a radiolucency in the radial tuberosity. MRI demonstrated normal bone marrow, which indicated that the radiolucency was in fact a radial tuberosity pseudolesion. Read More

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February 2019

[Cerebral imaging in a delirious patient].

Ned Tijdschr Geneeskd 2019 Feb 26;163. Epub 2019 Feb 26.

Franciscus Gasthuis, afd. Neurologie, Rotterdam.

An 80-year-old woman attended the emergency department with sub-acute confusion and fever. On examination no focal signs were found. Cerebral CT showed an area of hypodensity suspected to be an infarction, but an MRI scan carried out 10 days later showed cerebral abscesses caused by a dental infection that had occurred four weeks previously. Read More

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February 2019
1 Read

[Relapse in anxiety disorders].

Ned Tijdschr Geneeskd 2019 Feb 15;163. Epub 2019 Feb 15.

Amsterdam UMC, locatie VUmc, afd. Psychiatrie.

Because the risk of relapse is high in anxiety disorders, it is important to bear in mind long-term prospects when making treatment decisions. This means that patients may need 'booster' treatment or continuous antidepressant medication to achieve long-term positive outcomes. Preparing a patient for a possible relapse in the end phase of a successful treatment, especially when there is a desire to discontinue the use of antidepressants, or timely intervention in case of an actual relapse episode is crucial to prevent recurrence of the anxiety disorder. Read More

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February 2019
1 Read

[Communication with patients who have medically unexplained symptoms: an art and a skill].

Ned Tijdschr Geneeskd 2019 Feb 27;163. Epub 2019 Feb 27.

Radboudumc, afd. Eerstelijnsgeneeskunde, Nijmegen.

The relationship between doctors and patients often becomes tense when the patient has medically unexplained symptoms: doctors may experience frustration because they feel ill-equipped to provide their patients with a plausible explanation of the symptoms. Patients often feel that their doctor does not take them seriously and would like to understand why they are having symptoms. Research into the effect of the quality of the doctor-patient relationship and doctor-patient communication where medically unexplained symptoms are concerned has led to some recommendations for communication. Read More

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February 2019

[New antibiotics: an overview].

Ned Tijdschr Geneeskd 2019 Feb 13;163. Epub 2019 Feb 13.

Amsterdam UMC, locatie AMC, afd. Inwendige Geneeskunde.

The worldwide rapid increase in antibiotic resistance means that new therapeutic measures are urgently needed. Older antibiotics, such as colistin, fosfomycin, minocycline, mecillinam and temocillin, which had fallen from grace due to the development of more effective and less toxic drugs are now of renewed interest in the treatment of infections caused by multiresistant bacteria. Two new glycopeptides (oritavancin and dalbavancin) and a new oxazolidinone (tedizolid) are now registered for the treatment of acute skin and soft-tissue infections. Read More

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February 2019

[Tai chi reduces the number of falls].

Ned Tijdschr Geneeskd 2019 Feb 15;163. Epub 2019 Feb 15.

Amsterdam UMC, locatie VUmc, afd. Huisartsgeneeskunde & Ouderengeneeskunde.

Falls and fall injuries among older adults are common. Exercise interventions are a safe and effective way to reduce falls. Tai chi is a form of exercise therapy aimed at improving postural control, sensory integration and anticipatory control. Read More

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February 2019
3 Reads

[Obesity cannot be solved by meal replacements].

Ned Tijdschr Geneeskd 2019 Feb 19;163. Epub 2019 Feb 19.

Erasmus MC, afd. Interne Geneeskunde, sectie Endocrinologie, en Centrum Gezond Gewicht, Rotterdam.

Finding new ways to reach sustainable weight reduction, which are suitable for daily practice, is important. In this commentary we discuss the article by Astbury et al. suggesting that a total diet replacement (TDR) programme in a primary care setting is safe and effective. Read More

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February 2019

[Sunburn of a reconstructed breast: risk of denervated tissue].

Ned Tijdschr Geneeskd 2019 Feb 15;163. Epub 2019 Feb 15.

HagaZiekenhuis, afd. Plastische en Reconstructieve Chirurgie, Den Haag.

More and more women opt for breast reconstruction with autologous tissue after breast removal. Reconstruction with a deep inferior epigastric perforator (DIEP) flap is the most common technique. In this operation, the nerves of the DIEP flap are cut. Read More

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February 2019
2 Reads

[A man with fever-dependent ECG abnormalities].

Ned Tijdschr Geneeskd 2019 Feb 27;163. Epub 2019 Feb 27.

Haaglanden Medisch Centrum, afd. Cardiologie, Den Haag.

We present a patient with fever-induced Brugada syndrome, a rare cardiac disease caused by an inherited ion channelopathy and associated with malignant arrhythmias. ECG findings normalized after the fever resolved. As Brugada syndrome can be confused with anterior myocardial ischemia, right bundle branch block and intoxication with tricyclic antidepressants, ECG recognition is important. Read More

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February 2019
1 Read

[Elderly patients and atrial fibrillation: age alone should not be a contra-indication for anticoagulant treatment].

Ned Tijdschr Geneeskd 2019 Feb 22;163. Epub 2019 Feb 22.

Amsterdam UMC, locatie AMC, afd. Huisartsgeneeskunde.

A significant proportion of elderly patients are not properly treated with anticoagulants. Here we describe the pros and cons of anticoagulant treatment in elderly patients with atrial fibrillation, illustrated by two cases. We discuss the sometimes difficult treatment decisions to be made in frail elderly patients, especially after they have suffered bleeding complications. Read More

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February 2019

[Serotin syndrome; literature overview and Lareb pharmacovigilance reports].

Ned Tijdschr Geneeskd 2019 Feb 7;163. Epub 2019 Feb 7.

Reinier van Arkel groep, 's-Hertogenbosch.

Serotonin syndrome is a medication-induced clinical syndrome, caused by an increased concentration of serotonin in the central and peripheral nervous system. An excess of serotonin can be caused by the use of one or more serotinergic substances on the one hand, or by decreased clearance of these substances on the other hand We carried out a systematic literature search to make an estimation of substances and patient-related factors that might be associated with an increased risk of serotonin syndrome. We also carried out a search for all reports of serotonin syndrome in the Lareb (Netherlands pharmacovigilance centre) database. Read More

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February 2019
2 Reads

[Acute colonic pseudo-obstruction after caesarean section; Ogilvie's syndrome].

Ned Tijdschr Geneeskd 2019 Feb 7;163. Epub 2019 Feb 7.

Ikazia Ziekenhuis, afd. Gynaecologie en Verloskunde, Rotterdam.

Background: Acute pseudo-obstruction of the colon - also known as Ogilvie's syndrome - is a rare clinical presentation in obstetrics. The syndrome is seen more often following caesarean section than vaginal delivery.

Case Description: We present a 38-year-old primigravida who developed Ogilvie's syndrome following secondary caesarean section. Read More

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February 2019
2 Reads