Nederlands tijdschrift voor geneeskunde
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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.
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Ned Tijdschr Geneeskd · Jan 2013
Multicenter Study Meta Analysis[Improved end-of-life care for patients with dementia: greater family satisfaction and possibly greater end-of-life comfort].
To analyse possible trends in families' evaluations of the quality of end-of-life care and the quality of dying in dementia. ⋯ We found a positive trend of increased satisfaction with end-of-life care. Families also reported a possible increase in residents' end-of-life comfort. Ongoing surveillance of outcomes measuring end-of-life quality is important in view of the increasing healthcare budget constraints.
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Ned Tijdschr Geneeskd · Jan 2012
Randomized Controlled Trial Multicenter Study[Direct total body CT scan in multi-trauma patients].
Immediate total body computed tomography (CT) scanning has become important in the early diagnostic phase of trauma care because of its high diagnostic accuracy. However, literature provides limited evidence whether immediate total body CT leads to better clinical outcome then conventional radiographic imaging supplemented with selective CT scanning in trauma patients. The aim of the REACT-2 trial is to determine the value of immediate total body CT scanning in trauma patients. ⋯ The REACT-2 trial is the first multicenter randomized clinical trial that will provide evidence on the value of immediate total body CT scanning during the primary survey of severely injured trauma patients.
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Ned Tijdschr Geneeskd · Jan 2012
Multicenter Study[Breast-conserving surgery for breast cancer: still much to be gained].
To conduct qualitative research into breast-conserving surgery for palpable and non-palpable breast tumours and the various methods of excising these, measured by the volume exised and surgical radicality. ⋯ Breast-conserving surgery is associated with an average of a 2 to 4-fold removal of excessive tissue. Nevertheless, 1 out of 5 excisions are not radical. Ultrasound-guided surgery for non-palpable breast cancer is the most effective method for achieving radical excision. A multicentre, prospective, randomised trial has been started to assess whether ultrasound-guided lumpectomy for palpable breast cancer can lead to optimisation of the excision volume and radicality.
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Ned Tijdschr Geneeskd · Jun 2009
Multicenter Study[Hospital mortality after emergency surgery for perforated diverticulitis].
To assess which factors predict in-hospital mortality after emergency surgery for acute perforated diverticulitis. ⋯ The type of surgery did not appear to be a risk factor for high postoperative mortality. As well as patient-related risk factors, including age, ASA and severity of disease scores, such as Hinchey score and MPI, the absence of a specialist gastrointestinal surgeon during surgery was found to be a factor associated with high mortality risk.