The Netherlands journal of medicine
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Letter Case Reports
Dapsone for the treatment of chronic IgA vasculitis (Henoch-Schonlein).
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Comparative Study
The standardised mortality ratio is unreliable for assessing quality of care in rectal cancer.
The standardised mortality ratio (SMR) for rectal or anal cancer was above average in a large tertiary referral centre for locally advanced rectal cancer in the Netherlands. The aim of this study was to investigate whether the increased SMR was indeed related to poor quality of care or whether it could be explained by inadequate adjustment for case-mix factors. ⋯ The increased SMR appeared to be caused by the admission of patients who received palliative care only. Consequently, the SMR is unreliable for the assessment of quality of care in patients with rectal or anal cancer.
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The global obesity epidemic is also affecting the Netherlands, paralleled by a proportional increase in the number of morbidly obese persons. Bariatric surgery has been included as a treatment for morbid obesity in the Dutch Guideline for Obesity (2008). Nonetheless, bariatric surgery is applied in only a limited number of morbidly obese subjects in the Netherlands. Based on the most recent literature and Dutch statistics, this review provides a summary of current knowledge on the impact of obesity on health and health care and highlights the effective role of bariatric surgery in reducing this threat to public health.