Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2017
Review[Injuries resulting from accidents and violence in the Netherlands; results of an Emergency Department register].
- Injuries from accidents and violence are amongst the most important public health issues in the world, including in Europe and the Netherlands.- Using the Dutch Injury Surveillance System and the Dutch Burden of Injury Model, we describe the incidence and costs associated with injuries in the Netherlands that are registered via Emergency Departments (ED). We also map the main causes of injury by age category.- Annually, 700,000 patients attend the ED of a hospital with an injury; 1 in 6 attendees is admitted.- The societal costs of these injuries totals 3.2 billion euro per year. ⋯ Injuries occur relatively more often in children and the elderly.- The key underlying causes differ per age category. Common causes in all ages are cycling accidents, falls from heights, and other fall-related incidents.- The government should continue to deliver the public health interventions for prevention of fall injuries and cycling accidents.
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Ned Tijdschr Geneeskd · Jan 2017
Review[Are nail polish, artificial nails and piercings allowed outside the surgical area?Recommendations for the perioperative policy].
- An increasing number of patients wear nail polish, artificial nails or have piercings.- There is uncertainty about the perioperative management of these items, especially when located outside the surgical area.- In the majority of hospitals, patients are urged to remove these items preoperatively, under the assumption that they might cause problems.- Frequently, however, these items cannot be removed straightforwardly.- Nail polish and artificial nails only very rarely cause perioperative problems and therefore do not need to be removed pre-operatively.- The same applies to most piercings, except when located in or near the respiratory tract, if they have sharp endings or if they might cause problems as a result of the perioperative positioning of the patient.- Providing adequate information to the patient, knowledge about removal of these items and documentation of agreed arrangements are all important.- A national guideline concerning perioperative policy is urgently required.
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Ned Tijdschr Geneeskd · Jan 2017
[E-bikers are more often seriously injured in bicycle accidents: results from the Groningen bicycle accident database].
Analysing injury types, injury severity and mortality in victims of accidents with electric bicycles in comparison with conventional bicycles. ⋯ E-bikers who had a bicycle accident had more severe injuries, more frequently had multiple injuries and had more severe head injuries than conventional cyclists. This resulted in a greater need for care. Preventive measures such as riding lessons and helmet use should be encouraged. Care providers should pay extra attention to the possibility of severe injuries when a patient had a bicycle accident with an e-bike.
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Ned Tijdschr Geneeskd · Jan 2017
[Is dementia preventable through intensive vascular care? The preDIVA trial].
To assess whether intensive vascular care in GP practices can prevent dementia in a population of community-dwelling older people. ⋯ Long-term intensive vascular care for community-dwelling elderly patients, provided in a primary care setting, does not result in a reduced incidence of dementia, functional limitations or mortality. There is, however, possibly an effect in elderly patients with untreated or sub-optimally treated hypertension; this warrants further research.
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Carotid sinus massage for diagnosis and termination of supraventricular tachycardia (SVT) is still a widely used vagal manoeuvre in the A&E department. However, itsefficacy is limited (termination of the SVT in approximately 20%) and carotid sinus massage may be complicated by (potentially devastating) neurologic complications in 0.2-1% of the patients. ⋯ Carotid sinus massage remains an important diagnostic method in patients with unexplained syncope in whom, based on the clinical history, carotid sinus hypersensitivity is suspected. It should be avoided in patients with previous TIA or stroke within the past 3 months, or those with carotid bruits, except if carotid Doppler studies have excluded significant stenosis (≥ 70%).