Rhabdomyolysis: some clinical and etiological aspects and prevention by dantrolene sodium

Contains fulltext : mmubn000001_161439586.pdf (publisher's version ) (Open Access)Promotor : F. Gabreëls168 p

Traagheid, langzaam doen en langzaam denken

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Office spirometry: to refer or not to refer?

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Posterior dislocation fractures of the shoulder in seizure disorders—two case reports and a review of literature

AbstractWe present two patients with complaints of shoulder pain after an epileptic seizure. Both patients had a posterior dislocation fracture of the shoulder. After reviewing the literature the following conclusions can be drawn: (1) A posterior shoulder dislocation fracture is rare. (2) One should not underestimate the muscular forces in seizure disorders and be alert for dislocation fractures of the shoulder and/or other joints. (3) The diagnosis is frequently missed, but an axillary radiograph or a CT scan always reveals the fracture

Combining vocational and research training.

Contains fulltext : 70619.pdf (publisher's version ) (Open Access)BACKGROUND: The gap between research and clinical practice can be bridged by strengthening the position of the clinician-researcher with appropriate research training and protected time for research. METHODS: A Dutch program combines vocational training in family medicine with research training. This article describes the scientific output of registrars following this combined program. RESULTS: Forty family physician registrars who undertook the combined program from 2000-2006 produced 138 publications in both international and national journals. Most of these registrars participated in scientific committees and expert groups in the field of family medicine. DISCUSSION: Combining vocational training with research training in general practice has proven to be feasible and has resulted in considerable scientific output and professional participation

Variation in spirometry utilization between trained general practitioners in practices equipped with a spirometer.

Contains fulltext : 51151.pdf (publisher's version ) (Open Access)OBJECTIVE: To explore spirometry utilization among general practitioners and identify practitioner and practice-related factors associated with spirometry utilization. DESIGN: Multivariate multilevel cross-sectional analysis of a questionnaire survey. SETTING: Some 61 general practices involved in a spirometry evaluation programme in the Netherlands. All practices owned a spirometer and were trained to perform spirometry. SUBJECTS: A total of 144 general practitioners and 179 practice assistants. MAIN OUTCOME MEASURES: Extent of spirometry utilization for five indications from national COPD/asthma guidelines, practitioner and practice-related factors associated with spirometry utilization. RESULTS: The response rate was 97%. General practitioners used spirometry mostly to evaluate treatment with inhaled steroids (58%). Significant practitioner-related factors associated with spirometry utilization were: general practitioners' job satisfaction, general practitioners' general interest in research, and prior participation in spirometry training. Practice-related factors associated with spirometry utilization were: presence of a practice nurse, delegation of medical tasks to practice assistants, use of spirometry in different rooms, and use of protocols in practice. CONCLUSION: Practitioner- as well as practice-related factors were associated with the extent of spirometry utilization. In particular, it is essential to improve practice-related factors (e.g. presence of a practice nurse, more delegation of medical tasks to the practice assistant)

The effect of dantrolene sodium in Very Long Chain Acyl-CoA Dehydrogenase Deficiency.

Contains fulltext : 48177.pdf (publisher's version ) (Closed access)We present a patient, who experienced recurrent episodes of rhabdomyolysis. Her beneficial response to treatment with dantrolene sodium was previously reported. Adult onset Very Long Chain Acyl-CoA Dehydrogenase (VLCAD) deficiency has been diagnosed only recently. In adults, VLCAD deficiency results in recurrent fasting-, exercise-, or infection-induced muscle stiffness, muscle pain and myoglobinuria caused by rhabdomyolysis. This case illustrates for the first time the beneficial effect of dantrolene in VLCAD deficiency. We discuss the therapeutic mechanism of dantrolene sodium and its possible role as additional treatment modality for patients with VLCAD deficiency

Subnormale vitamine-B6-spiegels bij theofyllinegebruik

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Applicability of diagnostic recommendations on dementia in family practice

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