Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2009
Case Reports[Takotsubo cardiomyopathy; reversible cardiomyopathy induced by stress].
Takotsubo cardiomyopathy was diagnosed in a 79-year-old woman. She visited her husband who had been admitted for primary percutaneous coronary intervention, and during her visit she developed acute chest pain. Further investigation revealed transient left ventricular apical ballooning, diagnosed as takotsubo cardiomyopathy. ⋯ Especially in elderly women presenting with the clinical features of an ST-elevation myocardial infarction, takotsubo cardiomyopathy should be considered as an alternative diagnosis. Regarding the exact aetiology and pathophysiology many questions remain unanswered. With supportive treatment the prognosis is favourable.
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Ned Tijdschr Geneeskd · Jan 2009
[Mild therapeutic hypothermia following resuscitation; experience and results in the first two years after introduction].
To describe the results of mild therapeutic hypothermia (MTH) following resuscitation in the 'Gelderse Vallei' hospital, Ede, the Netherlands. ⋯ The introduction of MTH in the intensive care department of the "Gelderse Vallei" has taken place without major problems. Although the mortality rate following cardiopulmonary resuscitation was relatively high, the neurological outcome in those patients who were discharged from hospital alive was good.
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Ned Tijdschr Geneeskd · Jan 2009
[Total body CT scan as the primary diagnostic modality in multi-trauma patients].
Radiological imaging is highly protocolized during initial assessment of severely injured trauma patients. After an initial examination, radiography and ultrasound are performed. Imaging is frequently supplemented by CT scan of selective body areas. ⋯ Recent research on TBCT in multi-trauma patients shows promising results and several large European trauma centers have already protocolized this strategy. These studies lack a good study design, so more prospective research on clinical outcomes, cost effectiveness and radiation exposure is necessary. As part of a pilot study in preparation for a randomized multicenter study, the University Medical Centre in Amsterdam in the Netherlands is performing TBCT in severely injured trauma patients.
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Ned Tijdschr Geneeskd · Jan 2009
Review[Efficiency of human papillomavirus vaccination--estimates based on Dutch cost effectiveness analyses].
Up to now the turnout for the human papillomavirus (HPV) vaccination programme implemented this year in the Netherlands has been lower than expected. This may be the result of negative publicity and doubts about the efficacy of the vaccination programme. To provide some clarity about the efficacy, this article gives an overview of the cost effectiveness analyses carried out on the introduction of HPV vaccination in the Netherlands. ⋯ It has also been shown that HPV vaccination is a cost effective strategy and that about 1000 girls must be vaccinated to prevent 1 death. The actual health benefits gained by HPV vaccination are strongly dependent on vaccination coverage. It is therefore important that this remains high (85-100%).
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Ned Tijdschr Geneeskd · Jan 2009
Review[Changes in the duty of notification of infectious diseases via the Dutch Public Health Act].
The Dutch Public Health Act, which came into force on 1 December 2008, replaces the existing laws concerning the combating of infectious diseases. Important changes have been incorporated in the new Public Health Act in comparison with the previous law on infectious diseases. ⋯ The Centre for Infectious Disease Control Netherlands at the Dutch National Institute for Public Health and the Environment (RIVM) has issued a booklet for all Dutch physicians and laboratories providing background information on notifiable diseases. This can be useful in daily practice for helping to decide whether a disorder or cluster of infections is notifiable.