Nederlands tijdschrift voor geneeskunde
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Groin pain in young athletes is a common problem, accounting for significant downtime in sports participation. It can be difficult to make the correct diagnosis as groin pain has a wide differential diagnosis, which encompasses acute as well as chronic causative factors. ⋯ However, after further investigation the patients were diagnosed with three very different types of injury: sportsman's hernia; hip labral tear; and pubic osteitis. This emphasises the need for every general practitioner and medical specialist to understand that there is a wide differential diagnosis for groin pain in athletes, in order to be able to implement specific therapy targeting the actual cause of groin pain.
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Ned Tijdschr Geneeskd · Jan 2014
Review Case Reports[Resuscitation for myocardial infarction and head injury: first the heart or first the head?].
Loss of circulation in a patient results in collapse and therefore possible head injury. After percutaneous coronary intervention (PCI) including anticoagulation, comatose patients are sedated for mild therapeutic hypothermia. Recognised or unrecognised head trauma may have dramatic clinical consequences. ⋯ In a 55-year-old male with neurological abnormalities after mild head trauma, the PCI was postponed for a (negative) head CT which might have increased cardiac muscle damage. Nowadays more patients reach hospital after being resuscitated for cardiac arrest and possible head trauma should be considered in all these patients. This could lead to adjustments being made in the treatment protocol.
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Ned Tijdschr Geneeskd · Jan 2014
Review[What do you think of Thuisarts.nl? Experiences after 3 years of www.Thuisarts.nl].
Many people need information on health and disease, but the internet is a maze of medical information. In order to offer patients reliable medical information, and to support general practitioners, the Dutch College of General Practitioners (NHG) set up the public website Thuisarts.nl in 2011, which was later followed by an app. The NHG members survey amongst general practitioners from June 2013 showed that 90% of the general practitioners used Thuisarts.nl. ⋯ Information is also available from questionnaires filled in by the NIVEL Health Care Consumer Panel (n = 2846) and participants in a study on information technology and independence (n = 25). Thuisarts.nl meets an important need and is highly valued by doctors and patients. There are plans for the further development of Thuisarts.nl including short videos, illustrations, searchable anatomical structures and information from other reliable organisations such as associations of specialist doctors.
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Ned Tijdschr Geneeskd · Jan 2014
[Practice guideline 'Management of patients with mild traumatic head/brain injury' in the Netherlands].
To evaluate the effect of the revised practice guideline 'Management of patients with mild traumatic head/brain injury' (MHI) in the Netherlands using the number of CT scans of the cerebrum, number of hospital admissions, and the number of intracranial traumatic findings on CT scan. ⋯ After introduction of the current MHI guideline in the Netherlands, percentages of both hospitalization and CT of cerebrum have increased significantly. It was expected that the guideline would result in decreases of this percentages. This increase does not seem to be related to more or serious head/brain injury.
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Ned Tijdschr Geneeskd · Jan 2014
Multicenter Study[Suspected allergy to a local anaesthetic: how often is allergy proven?].
To determine the percentage of proven allergy for local anaesthetics (LA) in patients who were tested because of a clinical suspicion of LA allergy. ⋯ IgE-mediated and delayed-type allergic reactions are rarely caused by LA. IgE-mediated reactions can be proven by provocation testing. Patch testing is used when a delayed type reaction is suspected.