Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Dec 1998
Comparative Study Clinical Trial Controlled Clinical Trial[The Dutch version of 'Functional Status II(R)': a questionnaire measuring the functional health status of children].
Clinimetric evaluation of the Dutch version of the Functional Status II(R) (FS II), measuring children's behaviour and the effect of disease on it. ⋯ The parent version of the Dutch FS II is recommended as a generic measure of functional health status of children for medical research. The child version should be improved first.
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Ned Tijdschr Geneeskd · Dec 1998
Comparative Study Clinical Trial Controlled Clinical Trial[The Dutch 'Rand General Health Rating Index for Children': a questionnaire measuring the general health status of children].
Clinimetric evaluation of the Dutch version of the RAND general health rating index for children (child RAND), measuring the general health of children. ⋯ The Dutch child RAND is recommended as a generic measure of perceived health of children for medical research and may serve as a valuable addition to the measurement of functional health status by the FS II.
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Ned Tijdschr Geneeskd · Dec 1998
Review[Bronchoalveolar lavage in the diagnosis of diffuse interstitial lung disease].
Since the introduction of bronchoalveolar lavage (BAL), this technique is used both clinically and for research. Use of BAL as a diagnostic aid was introduced fairly recently. For the different steps of the procedure a standardized approach has been proposed. ⋯ Smoking and pharmacotherapy affect the results of the analysis. BAL is a safe procedure with hardly any side effects. This method may in some diseases replace more invasive diagnostic procedures such as biopsy by demonstrating characteristic cells or micro-organisms.
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Ned Tijdschr Geneeskd · Dec 1998
Comment[Kidney donation by a 'non-heart-beating' donor from an ethical perspective].
In asystolic patients, kidney donation is possible by using a non-heart-beating (NHB) donation procedure. This involves in situ perfusion of the kidneys by inserting a catheter into the femoral artery and flushing cold fluid through the kidneys. The introduction of an NHB donation programme leads to ethical questions concerning the guarantees for prudent procedure: How should death of a patient be defined in case of NHB donation? Is there a strict separation of responsibilities of the medical teams in the different phases of the procedure (patient treatment and actual donation procedure)? Are sufficient attention and care given to the relatives? Does the NHB donation procedure not interfere with the care of a patient who is expected to die soon? Extensive discussion with the Medical Ethics Committee of the University Hospital Nijmegen, the Netherlands, has led to a protocol for NHB kidney donation that meets the required guarantees.
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Ned Tijdschr Geneeskd · Dec 1998
Case Reports[Lipodystrophy and 'buffalo hump' during treatment with HIV protease inhibitors].
In three patients, a 36-year-old HIV seropositive homosexual man and two women aged 35 and 59 years who had acquired HIV infection through heterosexual contact, signs of lipodystrophy developed after prolonged anti-HIV triple therapy. The observed syndrome is seen after prolonged use of HIV protease inhibitors: it is characterized by peripheral fat wasting, central fat accumulation, hyperlipidaemia and insulin resistance. ⋯ Lipodystrophy caused by protease inhibitors is a risk factor for cardiovascular disease. Recognition of the syndrome is essential for adequate follow-up and possible treatment.