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[A redesign of the acute care chain: evaluation of acute care in Den Helder, The Netherlands]. [急症护理链的重新设计：荷兰登海尔德急症护理评估]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-07-24
Milou A van Goor, Tanca C Minderhoud, Emma Hengeveld, Bo Schouten, Cynthia G Kleppe, Marjolein N T Kremers, Floor Haak-van der Lely, Prabath W B Nanayakkara
{"title":"[A redesign of the acute care chain: evaluation of acute care in Den Helder, The Netherlands].","authors":"Milou A van Goor, Tanca C Minderhoud, Emma Hengeveld, Bo Schouten, Cynthia G Kleppe, Marjolein N T Kremers, Floor Haak-van der Lely, Prabath W B Nanayakkara","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study researches the quality of care of the newly redesigned Department of Acute Care (AAZ), at the Noordwest Hospital in Den Helder. It is a multi-methodological study. Quality indicators were descriptively compared with a conventional Emergency Department (ED) at the location in Alkmaar. Moreover, focus groups were held among nurses employed in the AAZ and patient experiences were recorded by the Picker Institute with a validated questionnaire. The study shows that the quality of acute care in the harmonica model of the AAZ achieves comparable results compared to the conventional ED design at Alkmaar. These results imply that it is feasible to provide acute care near the patient, with efficient staffing through a redesign of the acute care chain.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Persistent dermatomycosis due toTrichophyton indotineae]. [indotineae 毛癣菌引起的顽固性皮霉病]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-07-23
Jochem B Buil, Eelco F J Meijer, Martijn den Reijer, Manon E J Zeeuwen-Franssen, Willem J G Melchers, Paul E Verweij
{"title":"[Persistent dermatomycosis due toTrichophyton indotineae].","authors":"Jochem B Buil, Eelco F J Meijer, Martijn den Reijer, Manon E J Zeeuwen-Franssen, Willem J G Melchers, Paul E Verweij","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><i>Trichophyton indotineae</i> is a recently identified dermatophyte that frequently causes extensive and persistent dermatomycosis, particularly tinea corporis, tinea cruris, and tinea faciei. The infection is frequently encountered in countries of the Indian subcontinent and surrounding areas. In Europe, <i>T. indotineae</i> has mainly been detected in patients with an epidemiological link to the aforementioned regions. Unlike dermatomycoses caused by other dermatophyte species, infections caused by <i>T. indotineae</i> often exhibit treatment failure with commonly prescribed antifungal drugs. Reduced susceptibility to terbinafine is often observed in <i>T. indotineae</i>. In addition, reduced susceptibility to itraconazole has also been reported. Due to the extensive and persistent nature of the infection, as well as the reduced susceptibility to antifungal drugs, international experts recommend aggressive treatment of <i>T. indotineae</i> using a combination of oral and topical antifungals. Susceptibility testing may be warranted to guide treatment decisions. Early recognition of <i>T. indotineae</i> infections is crucial to prevent prolonged recurrences.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Obesity as structural injustice: towards a radically different social contract for a healthier society]. [作为结构性不公正的肥胖症：为建立一个更健康的社会而建立一个完全不同的社会契约]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-07-23
Marcel F Verweij, Marcel F M Canoy
{"title":"[Obesity as structural injustice: towards a radically different social contract for a healthier society].","authors":"Marcel F Verweij, Marcel F M Canoy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The prevalence of obesity in the Netherlands has been on the rise for decades and recent preventive efforts of government and other societal actors appear insufficient to reverse this trend. The development of food technologies neutralizing the impact of fat and sugar, and medicines that might help individuals losing weight could be seen as part of a solution. We argue however that these also reinforce three fundamental societal problems underlying the obesity crisis: a vicious market cycle, the framing of overweight as a problem of individuals, and an epistemological dilemma in science. Together these problems constitute a vicious circle that is especially harmful for socioeconomically disadvantaged groups. Many societal actors are involved in these problems and share moral responsibility for taking away the causes of injustice, including food industry, retailers, health care, and government. Effective prevention of obesity may require developing avenues to legally enforce these responsibilities.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Isolated pancreatic injury after blunt abdominal trauma: severe pathology in initially asymptomatic patient]. [腹部钝伤后孤立性胰腺损伤：最初无症状的患者出现严重病变]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-07-18
Thijs O Verhagen, Irene Aanen, Sarah van den As, Roeland F de Wilde, Jan H Allema, Fatma Cetin
{"title":"[Isolated pancreatic injury after blunt abdominal trauma: severe pathology in initially asymptomatic patient].","authors":"Thijs O Verhagen, Irene Aanen, Sarah van den As, Roeland F de Wilde, Jan H Allema, Fatma Cetin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Isolated pancreatic injury after blunt abdominal trauma is rare but unreliably excludable based on clinical symptoms. A CT-abdomen is the golden standard in diagnosing. Undiagnosed pancreatic injury can result in severe complications as abscesses and fistulas.</p><p><strong>Case description: </strong>A sixteen-year old patient was brought to the Emergency Department (ED) with epigastric pain, two days after a low-energy scooter accident. No (abdominal) alarming symptoms were objectified during direct assessment by the general practitioner. However, a complete pancreatic transection was diagnosed after assessment at the ED, eventually resulting in a distal pancreatectomy with postoperative associated complications.</p><p><strong>Conclusion: </strong>In all traumas, the mechanism of injury should be judged critically for the possibility of abdominal injury (as pancreatic damage) and thus the need for imaging. An initially harmless clinical condition can mask extensive injury. This case illustrates the importance of thoughtful expectant policies with return instructions or demarcated follow-up when no CT-scan is performed.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[How do we make society less obesogenic? Lessons from the political and complexity sciences]. [我们如何让社会减少肥胖？政治科学和复杂性科学的启示]
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-07-16
Luc L Hagenaars, Fleur Ter Ellen, Karien Stronks
{"title":"[How do we make society less obesogenic? Lessons from the political and complexity sciences].","authors":"Luc L Hagenaars, Fleur Ter Ellen, Karien Stronks","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The adoption of prevention policies that address our obesogenic society remains deficient. We investigated how to overcome policy inertia, using qualitative literature review and theories and concepts from the political and complexity sciences. Our findings indicate that multiple self-reinforcing processes buttress the assumption that obesity is an individual problem, strengthening the biomedical and commercial weight-loss sectors' claim to ownership over solutions. 'Focusing events' can draw political attention to societal cause and consequences of obesity. The more attention such events generate and the clearer the failure of current policies, such as the failure to achieve goals set out in the Dutch 2018 Prevention Agreement, the more pressure builds for alternative policies. Collaboration with groups that emphasize societal aspects of obesity, such as anti-weight stigma activists, can help reframe obesity as a societal problem. Addressing our obesogenic society requires cooperation with policy organizations that influence obesogenic environments, like urban planning.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Allergy and anaphylaxis]. [过敏和过敏性休克]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-07-15
Chantal Smeding, Laila E Gamadia, Jeroen Heidt
{"title":"[Allergy and anaphylaxis].","authors":"Chantal Smeding, Laila E Gamadia, Jeroen Heidt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Allergy is a medical condition of frequent occurrence. In the Netherlands approximately 20% of the population has some kind of respiratory allergy, due to pollen and dust mites. The occurrence of allergy on foods, antibiotics, other medications, contrast fluid and insect poison is estimated to be 2% in the adult population. Because of this large and diverse group of allergy triggers it is very likely that physicians, regardless of background or medical specialty, will come across questions regarding allergy at some point in their career. The severity of an allergic reaction can vary, with anaphylaxis as one of the most severe and potentially life-threatening reactions (among DRESS, SJS, TEN and acute FPIES). This article describes the backgrounds of IgE-mediated allergy and anaphylaxis, like pathophysiology, diagnostics and treatment.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Spurious hypertension in an athletic young man]. [运动型年轻人的假性高血压]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-07-11
Stieneke Doornweerd, B J H van den Born, Didier Collard, Erik H Serné, Yvo M Smulders
{"title":"[Spurious hypertension in an athletic young man].","authors":"Stieneke Doornweerd, B J H van den Born, Didier Collard, Erik H Serné, Yvo M Smulders","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Isolated systolic hypertension is typical for the elderly, but also occurs in younger adults. Increased pulse wave amplification between the elastic aorta and arteries to the arm can result in a higher peripheral (brachial) blood pressure, while central (aortic) systolic blood pressure is normal. A 21-year-old athletic man was referred because of an arterial blood pressure of 160/85 mmHg. Diagnostic work-up did not reveal secondary hypertension or organ damage such as left ventricular hypertrophy or microalbuminuria. Pulse wave analysis by arterial tonometry showed central blood pressure to be 29 mmHg lower than blood pressure at the brachial artery. This finding suggests 'spurious' or pseudohypertension. Isolated systolic hypertension in athletic young adults can reflect a discrepancy between a blood pressure measured at the upper limb and the 'true' central blood pressure at the central arteries, i.e. pseudohypertension.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Treatment of Dupuytren's disease; limited fasciectomy versus percutaneous needle fasciotomy]. [杜普伊特伦氏病的治疗；局限性筋膜切除术与经皮针式筋膜切开术]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-07-11
Dieuwke C Broekstra, Bente A van den Berge
{"title":"[Treatment of Dupuytren's disease; limited fasciectomy versus percutaneous needle fasciotomy].","authors":"Dieuwke C Broekstra, Bente A van den Berge","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>We estimated retreatment risk following limited fasciectomy (LF) or percutaneous needle fasciotomy (PNF) for Dupuytren's disease.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Method: </strong>Using frailty models, we estimated retreatment risk within 1,3,5,10 and 20 years.</p><p><strong>Results: </strong>LF showed a 10-year retreatment risk of 8% (95%CI: 3-13%) for men and 4% (95%CI: 1-8%) for women without an affected first-degree relative, initially treated at 60 years. PNF showed higher risks at 69% (95%CI: 52-86%) and 46% (95%CI: 16-77%). Younger age at initial treatment increased retreatment risk, sex and first-degree relative had no influence.</p><p><strong>Conclusion: </strong>LF gives a longer-lasting treatment effect than PNF.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A man with swelling of the shoulder]. [一个肩膀肿胀的男人]
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-07-10
Marijke C De Vries, Theo R Zijlstra
{"title":"[A man with swelling of the shoulder].","authors":"Marijke C De Vries, Theo R Zijlstra","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 64-year-old male with a history of gout was seen with a swelling of het left acromioclavicular joint. Microscopic examination revealed monosodium urate crystals, confirming the diagnosis of tophaceous gout.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Unattended automatic office blood pressure measurement: the new standard?] [无人值守的办公室自动血压测量：新标准？］
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-07-08
Mark C van der Wel
{"title":"[Unattended automatic office blood pressure measurement: the new standard?]","authors":"Mark C van der Wel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Unattended automatic office blood pressure measurement (uAOBP) is starting to become recognised as the preferred method of blood pressure measurement in practice. The body of evidence to support this position is growing. uAOBP decreases intra- and interobserver variability by reducing measurement error. In addition it reduces the white coat effect. Currently three protocols are validated and used the most, with different countries and/or settings preferring different protocols: BpTRU protocol, SPRINT protocol and 30-minute OBP protocol. In this overview all three protocols are discussed extensively based on current available evidence including pro and con's, accuracy and prognostic value.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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