Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2015
[3D bioprinting of cartilage: challenges concerning the reconstruction of a burned ear].
Reconstruction of a severely maimed ear is a major challenge. The ear is highly flexible yet tough, and has a very complex three-dimensional shape. Reconstruction of a patient's burned ear is even more complex due to surrounding tissue damage. ⋯ However, 3D bioprinting is a tool to facilitate the reconstruction, and not by itself the Holy Grail. The clinical application of this technique is still at a very early stage. Nevertheless, we expect that 3D bioprinting can be utilised for facial reconstruction following burns come 2020.
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Ned Tijdschr Geneeskd · Jan 2015
[Psychotropic drug prescription to people with intellectual disability in GP practices].
Antipsychotic drugs are more often prescribed in primary care to people with intellectual disability (ID) with challenging behaviour, sometimes even without a diagnosis, than to those with a diagnosed mental illness. This is shown in a large cohort study in the United Kingdom in primary care and in a Dutch study in three residential care facilities. This prescription behaviour is undesirable. ⋯ The Dutch study showed that antipsychotic drug reduction in people with ID with challenging behaviour led to improved behaviour and improvement of physical parameters. A skilled multidisciplinary team of professionals can help with alternative management strategies for challenging behaviour. These teams should be made available for primary care services.
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Patient handover is of major importance for continuity of care and contributes to patient safety. According to Joint Commission International (JCI), an American quality institute, 67% of medical errors result from miscommunication. More than half of these errors appear to be attributable to poor medical handover. ⋯ Little attention is paid to handover as an essential medical competence during training to become a doctor or medical specialist. Many hospitals lack either training or a standardised format for handover. In this paper we discuss 10 tips for improving the quality of intradisciplinary handover.
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In recent decades, enormous progress has been made in the development of intraocular lenses (IOLs) and cataract surgery. Before the development of the IOL, a cataract would cause impairment or loss of vision. ⋯ The current cataract procedure is associated with a very low incidence of intra- and postoperative complications and satisfactory postoperative visual outcomes. Due to the increasing number of cataract surgeries performed annually, and an ageing population, development of IOLs and surgical techniques continues apace.
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Ned Tijdschr Geneeskd · Jan 2015
Comment[Unannounced simulation of obstetric emergencies: safe for medical staff?].
Management of obstetric emergencies is difficult to learn in real life due to the rarity of emergency events. Simulation-based medical education (SBME) has been shown to be a useful training method. A safe learning environment is a crucial condition for successful, applicable SBME. ⋯ However, the number of staff who viewed the simulation as stressful also increased, especially among midwives. Although this study had some limitations, these results should be taken seriously. Randomised trials are warranted to explore the perceptions of healthcare professionals with regard to SBME.