Life-sustaining treatment preferences in older patients when referred to the emergency department for acute geriatric assessment: a descriptive study in a Dutch hospital.

Background: In many cases, life-sustaining treatment preferences are not timely discussed with older patients. Advance care planning (ACP) offers medical professionals an opportunity to discuss patients' preferences. We assessed how often these preferences were known when older patients were referred to the emergency department (ED) for an acute geriatric assessment.

Proactive palliative care for patients with COPD (PROLONG): a pragmatic cluster controlled trial.

Background And Aim: Patients with advanced chronic obstructive pulmonary disease (COPD) have poor quality of life. The aim of this study was to assess the effects of proactive palliative care on the well-being of these patients.

Trial Registration: This trial is registered with the Netherlands Trial Register, NTR4037.

[Hallucinations and vivid dreams by use of metoprolol].

A 71-year-old man had had visual hallucinations and vivid dreams for two years after starting to take metoprolol. When metoprolol was replaced by atenolol the patient's symptoms disappeared within five days. Side-effects of beta-blockers on the central nervous system are relatively uncommon.

Diagnostic strategy using a modified clinical decision rule and D-dimer test to rule out pulmonary embolism in elderly in- and outpatients.

Excluding or confirming pulmonary embolism remains a diagnostic challenge. In elderly patients pulmonary embolism is associated with substantial co-morbidity and mortality, and many elderly patients with suspected pulmonary embolism are inpatients. The safety and efficacy of the combination of a clinical probability (CDR) and d-dimer test in excluding pulmonary embolism in this group is unclear.

Sensorineural hearing impairment in patients with Pmp22 duplication, deletion, and frameshift mutations.

Objective: To characterize and distinguish the types of sensorineural hearing impairment (SNHI) that occur in hereditary motor and sensory neuropathy Type 1a (HMSN-1a) and hereditary neuropathy with liability to pressure palsies (HNPP), which are caused by deletion or frameshift mutation.

Study Design: Prospective study.

Setting: Ambulatory patients in a university hospital.

Recurrent staphylococcal bacteraemia and subhepatic abscess associated with gallstones spilled during laparoscopic cholecystectomy two years earlier.

This is the first report of Staphylococcus aureus bacteraemia and subhepatic abscess in association with intraperitoneal gallstones spilled during laparoscopic cholecystectomy two years earlier. Spilled gallstones can lead to abscess formation in the late postoperative period by acting as foreign bodies that can become infected during bacteraemia and then become a source of recurrent bacteraemia.