Nederlands tijdschrift voor geneeskunde

Description

De lange historie en de grote degelijkheid en leesbaarheid van het tijdschrift maken het tot een bolwerk van medische wetenschap in druk, voortdurende dialoog over het medisch ambt. Het tijdschrift wordt gelezen door artsen en aankomend artsen van velerlei signatuur. Het NTVG staat bekend als een wetenschappelijk algemeen medisch tijdschrift.

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  • Website
    Nederlands Tijdschrift voor Geneeskunde website
  • Other titles
    Nederlands tijdschrift voor geneeskunde
  • ISSN
    1876-8784
  • OCLC
    1642618
  • Material type
    Periodical
  • Document type
    Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the neonatal outcomes of the policy for the prevention of vertical HIV transmission in a non-university HIV centre. Retrospective, descriptive study. We analysed the HIV status of newborns of HIV-positive mothers during pregnancy in the period between 1 January 1995 and 31 December 2010 in St. Elisabeth Hospital, Tilburg, the Netherlands and compared these results with the Dutch HIV monitoring foundation (SHM) registration data. Eighty-seven children from 84 pregnancies and their 71 HIV-positive mothers were included. Compared with SHM data, more women were African, younger at HIV diagnosis and had less resistance to the usual combination antiretroviral therapy (cART). In line with SHM data, the percentage of elective caesarean sections declined in the study period. There were fewer preterm births than in SHM data. There were no significant differences between preterm birth (p = 0.18), SGA (p = 0.25) or congenital abnormality (p = 0.45) and detectable HIV-RNA or cART use during pregnancy. During 10 (12%) pregnancies the mother presented to the HIV centre too late. At the age of 18 months, all 72 tested children were HIV negative. Of the 15 children lost to follow-up, 8 (9%) left to an unknown destination. All newborns of HIV-positive mothers were HIV negative, 12% of the HIV-positive mothers presented too late and 9% of the children disappeared from medical control. These results emphasize the importance of better communication between HIV centres, medical services of asylum centres and first-line obstetric care for female asylum seekers and their children.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158(6):A6508.
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    ABSTRACT: It is important that junior doctors in training conduct research for a number of years, culminating in a PhD. This is crucial to their development as critical and versatile doctors, which is exactly what is required now, in 2014. Hospitals are keen to have doctors with a broad education, and conducting scientific research is an enrichment for the investigators themselves. It is not necessarily undesirable that they do this principally to increase their chances of trainee posts; even those who have almost completed a PhD can be rejected for trainee positions if they do not seem to be competent.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158:A7633.
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    ABSTRACT: Governments can influence healthy dietary choices of populations by taxing relatively unhealthy foods and drinks and/or subsidizing relatively healthy options. Experimental and modelling studies have shown that such fiscal policies can contribute to the prevention of diseases such as obesity.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158:A7590.
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    ABSTRACT: In this article, we discuss possible explanations for the discrepancy in results between urine and blood pregnancy tests. The first patient, a 26-year-old woman, had breast tenderness, was tired and suffered from abdominal pain. A urine pregnancy test was negative, but blood human chorion gonadotropin (hCG) concentration was 455 U/l (reference value < 6 U/l). It was concluded that the patient was pregnant and she was followed in the outpatient clinic. Three days later she suffered blood loss and her hCG levels returned to normal. The diagnosis was a spontaneous abortion. The second patient, a 45-year-old woman, complained of abdominal pain, nausea and more blood loss than with a normal period. The urine pregnancy test was negative, but the hCG level in her blood was 470.000 U/l. Echography showed a thickened, irregular endometrium. A molar pregnancy was suspected and curettage was performed. The hCG level dropped initially but had increased at follow-up. Persistent trophoblastic disease was suspected and the patient underwent additional treatment.
    Nederlands tijdschrift voor geneeskunde 01/2014; 157:A6336.
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    ABSTRACT: The way we classify somatic diseases changes rapidly. Whereas at one time examination by the naked eye was used as a guide and then microscopy was used to view a tissue's properties, diseases are increasingly being classified according to their molecular properties. Due to this 'molecular revolution' the diagnostic classification is increasingly predictive. Parallel to this development the boundaries between clinical disciplines are disappearing.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158:A7364.
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    ABSTRACT: A 38-year-old woman presented with nail abnormalities on both of the halluces, consisting of overlapping growth of nail plate fragments, diagnosed as onychomadesis. The onychomadesis was provoked by trauma.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158:A8014.
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    ABSTRACT: A young woman was diagnosed with SAPHO syndrome. She presented with retrosternal pain and lumbar stiffness in combination with hidradenitis. DXA scan indicated secondary osteoporosis of the lumbar spine caused by chronic inflammation. Bone scintigraphy showed increased sternal uptake. Treatment with immunosuppressive agents was started after which the stiffness improved.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158:A7857.
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    ABSTRACT: Postoperative infections with non-tuberculous mycobacteria (NTM) are rare. Early diagnosis is important so tailored antibiotic therapy can be started. This can prevent unnecessary radiological and surgical interventions.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158:A7926.
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    ABSTRACT: Gender differences play an important role in coronary heart disease (CHD). Not only in the presentation of symptoms, but also in their underlying pathophysiology. Women with persistent angina without obstructive coronary artery disease (CAD) pose a diagnostic and therapeutic challenge. Half of these women have microvascular coronary dysfunction (MCD). The 2013 guidelines on management of stable angina now acknowledge this condition, but our understanding of MCD is still limited. In this clinical case presentation we elaborate on contemporary methods of diagnosing and managing microvascular angina based on the cases of two women who attended our outpatient clinic. The availability of non-invasive tools to diagnose MCD is still limited. Current treatment is based on reduction of cardiovascular risk factors but physicians and patients should be aware that although therapy usually reduces symptoms, they do not completely disappear. More research on diagnostic methods and effective therapy for MCD is eagerly awaited.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158:A7185.
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    ABSTRACT: The practice guideline 'Diagnosis and treatment of the subacromial pain syndrome' provides a thorough overview of the treatment possibilities that a doctor has when a patient with a painful shoulder presents. This guideline recognizes the importance of occupational exposure and functioning in the development, maintenance and treatment of health problems too. As is the case with so many multidisciplinary guidelines, it can be seen as an appeal to doctors to inquire about work and an appeal to occupational physicians to become active in the functional recovery of patients with a subacromial pain syndrome.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158:A7061.
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    ABSTRACT: - In children < 6 years characteristic asthma patterns are often lacking and the diagnosis cannot be objectified. For this reason 'episodic expiratory wheezing' is the preferred diagnosis.- In children ≥ 6 years asthma is diagnosed on the basis of symptoms; if there is doubt spirometry may be helpful.- The treatment goal is complete asthma control, i.e. daytime symptoms < 2/week, no nocturnal symptoms, no limitation of activities, rescue treatment ≤ 2/week, normal spirometry.- Smoking by children or relatives is strongly discouraged.- In children < 1 year, a monitored trial with short-acting beta-agonist (SABA) is recommended. Controller medication (inhaled corticosteroids (ICS)) is not recommended.- In children aged 1 to 6 years, a SABA is recommended, with additional ICS if symptoms persist. Incompletely controlled asthma is an indication for referral.- In children ≥ 6 years ICS are recommended in incomplete asthma control. If the normal daily dosage of ICS and adequate coping fail to achieve complete control of the asthma, then referral is recommended.- Patients on ICS should be monitored regularly.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158:A7935.
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    ABSTRACT: An 8-year-old boy presented with a fever, headache, maculopapular rash and painful joints after a vacation in Morocco. He had an eschar on his arm. Under the presumed diagnosis of rickettsiosis he was treated with doxycycline after which his fever subsided. Serology became positive for Rickettsia conorii 2 weeks later.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158:A7238.
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    ABSTRACT: Multiple epiphyseal dysplasia (MED) is a clinically and genetically heterogenous skeletal dysplasia. MED is usually inherited as a dominant trait, however, in a quarter of patients it is a recessive trait. Common symptoms of MED are pain and stiffness of joints. However, MED also can present as a neuromuscular disorder with hypotonia and muscle weakness, particularly in childhood. We saw a 7-year-old boy with abnormal gait and slight weakness of the upper legs at our outpatient clinic. Because of his short stature and other skeletal anomalies, skeletal dysplasia was considered. The diagnosis of MED was confirmed by DNA analysis. A mutation in the cartilage oligomeric matrix protein (COMP) gene was found. Skeletal dysplasia should be included in the differential diagnosis of children with unexplained neuromuscular symptoms.
    Nederlands tijdschrift voor geneeskunde 01/2014; 158(2):A6604.