[The post-traumatic stress disorder].

Many people experience a potentially traumatic event during their lives, which can result in brief periods of post-traumatic stress symptoms; this is a normal reaction. Most people can deal with a traumatic event when supported by significant others, but 10% of them develop post-traumatic stress disorder (PTSD). The nature of the traumatic event, the duration of exposure and the age at which one experiences such an event partly determine whether a person will develop PTSD.

[Ethnic origin of patients remains important].

The ethnic diversity in medical practices is increasing rapidly. In the Netherlands, ethnic groups are predominantly defined on the basis of their geographical origin, e.g.

[Trust of Turkish and Arabic ethnic minority patients in their Dutch oncologist].

Objective: To examine the nature of the trust that Turkish and Arabic ethnic minority patients suffering from cancer have in their oncologist, and to explore how this trust is established.

Design: We interviewed 9 cancer patients with Turkish and Arabic backgrounds about the trust they have in their oncologist. Semi-structured qualitative interviews.

[Low health literacy in ethnic minority patients: understandable language is the beginning of good healthcare].

In order to provide adequate healthcare to ethnic minority patients, healthcare professionals must use professional interpreter services to effectively overcome language barriers. Many ethnic minority patients have low health literacy, i.e.

[Transfusion-related acute lung injury].

Transfusion-related acute lung injury (TRALI) is a major complication of blood transfusions. The pathogenesis of TRALI is thought to occur in 2 phases: the 'double-hit theory'. The first phase is an underlying condition present in the patient, such as a surgical procedure or sepsis, which leads to priming, i.

[The 'multimorbidity generalist' is the future].

The 'multimorbidity generalist' is the future. Such doctors will prove to be key to sustainable healthcare systems in the 21st century. The multimorbidity generalist combines preventive, generalist (i.

[Exercise-promoting interventions for encouraging people with schizophrenia to take physical exercise].

Background: Physical activity is of therapeutic value for people with schizophrenia. However, only a small percentage of them is physically active.

Aim: To provide an overview, based on scientific evidence, of effective aspects of exercise-promoting interventions that can be used to induce patients with schizophrenia to engage in and continue with physical activity.

[Public healthcare occupations--insight into size and composition is limited].

Objective: To gain insight into the size and composition of the various groups of professionals operating in the Dutch public health sector in order to steer development within these groups and to improve quality and efficiency in public healthcare.

Design: Document analysis.

Method: Analysis of data from 7 reports published between 2003 and 2010, focussing on descriptions of working fields, (definitions of) professions and roles and total numbers.

[Diabetes mellitus].

Currently there are over 740,000 patients with diabetes mellitus in the Netherlands, and this number will increase further in the coming years. Approximately 90% of patients has type 2 diabetes, a metabolic disorder that is often associated with obesity, hypertension and increased cholesterol levels. Treatment of diabetes mellitus is essential to reduce the risk of severe complications with irreversible organ damage in the long-term.

[Balancing between hope and hype in biomarker research].

Biomarkers have become a popular topic in medicine, and investigations of putative molecular indicators of a specific biological state have started to occupy a considerable part of health research. Yet only a small number of biomarkers are being used in routine clinical practice. Many biomarker studies have major methodological shortcomings, in particular in the selection of appropriate study groups.

[Lyme disease].

Lyme disease, or Lyme borreliosis, is the most prevalent vector-borne illness in the United States of America and Europe. In the Netherlands, the disease is endemic with an estimated yearly incidence of 133 cases per 100.000 inhabitants.

[Hypertension in Dutch and English ethnic minorities. Blood pressure better controlled in English groups than in Dutch groups].

Objective: To compare blood pressure and the prevalence of hypertension in white Dutch and Dutch of Suriname-hindustani and Suriname-creole ethnic derivation with corresponding ethnic minority groups in England and to assess the quality of hypertension treatment in these groups.

Design: Retrospective; comparison of cross-sectional studies.

Method: Secondary analyses were performed on data from 3 population-based studies with 13,999 participants in total of European, African of South-Asian origin from England and the Netherlands.

[Vasculitis associated with Churg-Strauss syndrome].

A 52-year-old man was admitted to hospital with abdominal pain, erythema and mild eosinophilia. Medical history revealed fatigue and dyspnoea on exertion after returning from the Gambia a year previously, and allergic rhinitis with nasal polyps that were surgically excised. Before a cause of the abdominal symptoms was determined he developed mononeuropathy, severe eosinophilia and arthralgia in combination with positive anti-neutrophil cytoplasmic antibodies (ANCA) against myeloperoxidase, which lead to the diagnosis of 'Churg-Strauss syndrome'.

[Endarterectomy in asymptomatic carotid stenosis: not worth the risk].

A recent trial revealed a reduction in ischaemic infarcts after carotid endarterectomy in patients with asymptomatic carotid stenosis. However, the number needed to treat (NNT) was 22 to prevent 1 stroke in 10 years (including perioperative death as a primary outcome measurement). This is a modest effect in comparison to the trials with symptomatic patients with a 70-99% stenosis (NNT: 6).

[Removing a patient from the practice list].

There are boundaries to what a physician can be expected to tolerate from a patient in terms of behaviour. If a patient approaches or oversteps these boundaries the physician is entitled to take action. Article 460 of the Dutch Medical Treatment Act states that a physician may unilaterally end an agreement to treat if there are important grounds to do so.

[Endoscopic vein-graft harvesting for coronary bypass grafting: good results in patients at risk for surgical site infection].

Objective: To determine the clinical impact of endoscopic vein-graft harvesting in patients undergoing coronary artery bypass grafting (CABG) who are at risk for surgical site infection.

Design: Retrospective cohort study.

Method: Of patients undergoing elective CABG between March 1st 2006 and March 1st 2007, 335 were eligible for analysis.

[Amyotrophic lateral sclerosis and frontotemporal dementia: overlapping characteristics].

There is an overlap between amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Some 5-10% of ALS patients show changes in their behaviour and personality that are characteristic of FTD and about 10% of FTD patients develop ALS. Mild cognitive impairment occurs in 30% of ALS patients.

[Airplane crash near Schiphol Airport 25 February 2009: injuries and casualty distribution].

Objective: To describe the injuries and distribution of casualties resulting from the crash of Turkish Airlines flight TK 1951 near Schiphol Airport on 25 February 2009.

Design: Retrospective, descriptive.

Method: We reviewed the hospital case notes of all casualties of the airplane crash and scored triage at the scene, time to emergency department, Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS), mortality, length of hospital stay and surgical procedures.

[Guideline 'Diagnosis and treatment of abdominal aortic aneurysm'].

The evidence-based guideline 'Diagnosis and treatment of abdominal aortic aneurysm' is applicable to all patients with an atherosclerotic fusiform or ruptured aneurysm of the abdominal aorta (AAA) and can be found on www.vaat-chirurgie.nl, click on Richtlijnen.

[Preconceptual care should include looking at the effect of working conditions on pregnancy].

Working conditions are amongst the exogenous factors that can lead to pregnancy complications. Attention within preconceptual care to the working conditions experienced by women who plan to become pregnant can change this, by influencing exposure to harmful working conditions. Until now, relatively little attention has been given to working conditions within preconceptual care, and the subject is often not discussed in daily midwifery practice.

[Patient with relapsed hyperparathyroidism and neck swelling].

72-year-old woman with a history of primary hyperparathyroidism, for which she underwent surgery years previously, went to see her general practitioner because of a swelling in her neck that had been present for a few months and was growing in size. Other than this she had no symptoms. During the physical examination a solid elastic, non-fixed swelling with a diameter of about 3 cm was palpable on the right of the neck, medially to the sternocleidomastoid muscle.