Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2014
[Hand injuries caused by fireworks and treated by plastic surgeons].
To make an inventory of the number and nature of hand injuries caused by private firework use in the Netherlands during the New Year celebrations 2013-2014 and that were seen and treated by plastic surgeons. ⋯ The number of victims with serious hand injuries caused by fireworks was high during the New Year celebrations 2013-2014 and had increased in comparison with the preceding year. The majority of victims were aged < 18 years and were injured while setting off illegal fireworks by themselves.
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Antimicrobial resistance is an increasing health care problem, both abroad and in the Netherlands, and its main driving force is antibiotic use. In patients with pneumonia or sepsis, appropriate antibiotic use has been associated with improved clinical outcome, shorter length of hospital stay, decreased bacterial resistance and reduced costs. ⋯ A social and behavioural scientific approach with different intervention strategies - restrictive and persuasive - is required if antibiotic prescription in hospitals is to be improved. As a part of this antimicrobial stewardship programme, antibiotic teams (A-teams) must be introduced in all hospitals in 2014.
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Ned Tijdschr Geneeskd · Jan 2014
[Accidents involving a motorized mobility scooter: a growing problem].
To analyze injury patterns, injury severity and mortality among victims of motorized mobility scooter (MMS) crashes in relation to the trauma mechanism and patient's age. ⋯ Low-energy as well as high-energy crashes involving the MMS may result in serious injuries and sometimes death. Awareness by multidisciplinary treatment teams may help to avoid underestimation of injury severity. MMS drivers need to improve their driving skills in order to reduce the number of MMS crashes.
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Sepsis is a major cause of death worldwide. In recent years it has become clear that most septic patients do not die from an overwhelming initial pro-inflammatory immune response, but die in the subsequent immunosuppressive phase, called 'immunoparalysis', which is characterized by increased susceptibility to secondary and opportunistic infections. ⋯ Hitherto, whereas research into sepsis therapies predominantly focused on suppression of the immune system (for example with anti-cytokine therapies or glucocorticoids), recent studies increasingly concentrate on immunostimulatory treatment. Promising immunostimulatory compounds such as interferon-γ (IFN-γ) and granulocyte-macrophage colony stimulating factor (GM-CSF) have already shown promising results in experimental settings, and are currently studied in clinical trials.
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Ned Tijdschr Geneeskd · Jan 2014
Case Reports[Post-injection syndrome after depot injection of olanzapine].
Olanzapine pamoate injection is an anti-psychotic depot to be administered intramuscularly once every 2-4 weeks. A post-injection syndrome may occur shortly after administration, resulting in an acute intoxication with olanzapine. ⋯ A post-injection syndrome may develop after administration of olanzapine pamoate when the entire dose olanzapine is released at once from the muscle. Therefore, the patient should be observed for at least 3 hours after every injection. The risk of a post-injection syndrome and the necessary observation period should to be taken into account when deciding to start treatment with olanzapine pamoate depot.