Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2012
[Dutch national safety programme will not lead to a fifty per cent reduction in avoidable mortality in hospitals].
Progress in improving patient safety in hospitals has been frustratingly slow, for several reasons. There are, for example, few proven effective improvement interventions available. Evaluation of the effectiveness of safety interventions is complicated by the complexity and variability of these interventions due to local differences and preferences of care providers. ⋯ Also, problems experienced by care providers when implementing safety interventions are not being systematically addressed. For these reasons, the aim of the Dutch national safety programme in hospitals - to reduce the incidence of avoidable harm by 50% in 5 years - will not be feasible or measurable. It is necessary to identify effective safety interventions and to exchange experiences in successful implementation of these in order to support care providers in improving patient safety.
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A 14-year-old girl had a painful hip after making a splits on a trampoline. On X-ray we discovered an avulsion fracture of the spina iliaca anterior superior, which healed in 6 weeks with conservative treatment.
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A 47-year-old woman with a history of ulcerative colitis and rheumatoid arthritis presented with a large ulcer with an erythematous halo of the right lower leg. The clinical course and the histopathological results were indicative of pyoderma gangrenosum.
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A 36-week-old girl presented with an itching papulous skin eruption symmetrically on her cheeks, buttocks and limbs. Based on the specific clinical presentation she was diagnosed with Gianotti-Crosti-syndrome. This is a self-limiting cutaneous response to a viral infection.
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Ned Tijdschr Geneeskd · Jan 2012
Comment[Useful guideline for treatment of pain in vulnerable elderly people].
Forty to fifty percent of elderly people (> 70 years of age) appear to have pain that interferes with daily life. The frail elderly, described as elderly people who are vulnerable, mostly chronically ill, with physical, and psychological, as well as social, and communicative disabilities, are often inadequately treated for pain. This interdisciplinary guideline aims to improve recognition and treatment of chronic pain in frail elderly patients and is therefore very useful in clinical practice. Interventional, minimally invasive pain treatment is not described in this guideline, although for a number of pain syndromes this could be an evidence-based potential treatment.