Published in Nederlands tijdschrift voor geneeskunde
There was considerable disagreement between the classifications of individual delirium experts, based on exactly the same information, indicating the difficulty of the diagnosis. Furthermore, the sensitivity of the delirium screening tools used by the clinical nurses was poor. Further research should focus on the development of objective methods fo...
Published in Nederlands tijdschrift voor geneeskunde
When patients are transferred from the hospital to other health care settings, responsibility for the patient is transferred from the treating physician, nurse, paramedic or pharmacist at the hospital to the next health care provider. Good patient handovers from hospital to other healthcare settings are essential to ensure continuity of care. Howev...
Published in Nederlands tijdschrift voor geneeskunde
Due to its higher resolution, MRI in which a magnet with a field strength of 7 Tesla (7T MRI) is used, is able to image smaller abnormalities. 7T MRI is a promising tool for research into the causes of cerebral small vessel disease. Originally this technique was aimed at imaging the small perforating brain vessels and in particular at the micro-thr...
Published in Nederlands tijdschrift voor geneeskunde
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disease, with a global prevalence of 10 per 10,000. It is characterized by the formation of numerous cysts in both kidneys, and leads to renal function loss; the majority of patients will eventually need renal replacement therapy. It is possible to screen patie...
Published in Nederlands tijdschrift voor geneeskunde
In October 2016, the Health Council of the Netherlands has published the 'Research that makes you better' report. This report gives an overview of a future scenario in which UMCs (university medical centres) are investing more in research into quality and efficiency of care and prevention. This scenario is based on interviews and a review of the li...
Published in Nederlands tijdschrift voor geneeskunde
Almost all the literature dictates a period of non-weight-bearing after surgical treatment of articular and peri-articular fractures of the pelvis and lower extremities. This is followed by partial weight-bearing which is based on the number of weeks after surgery. However, none of these recommendations are based on evidence. When taking muscle for...
Published in Nederlands tijdschrift voor geneeskunde
Conjunctivitis is a frequently diagnosed disease, usually caused by a virus. A less well-known cause is a chlamydia infection. This may result in missed diagnoses, delay of treatment and several complications. We present two cases of a persistent, therapy-resistant conjunctivitis in patients who were over 70 years of age. One patient had conjunctiv...
Published in Nederlands tijdschrift voor geneeskunde
Transient monocular vision loss (TMVL) caused by temporary disturbance of blood flow to the retina is a harbinger of future vascular complications. The diagnosis may be difficult, not only because it is solely dependent on history taking, but also because the range of monocular visual symptoms a patient may experience is wide. The classic pattern o...
Published in Nederlands tijdschrift voor geneeskunde
The latest criteria for delirium (DSM-5) still encompass a very heterogeneous group of patients, as both risk factors and causes differ greatly between patients. This makes it unlikely that a single biomarker (e.g. an EEG signal) can be a valid and reliable diagnostic tool in clinical practice. Researchers should be very aware of this heterogeneity...
Published in Nederlands tijdschrift voor geneeskunde
A 4-year-old boy was referred to the emergency department with four days of nightly vomiting after ingestion of a marble. Abdominal X-ray showed the marble in the antrum of the stomach. The marble was successfully removed by endoscopy. X-rays detect 86% of all glass objects and should therefore be considered as diagnostic option by ingestion of a m...
