[Total body CT scan as the primary diagnostic modality in multi-trauma patients].

Radiological imaging is highly protocolized during initial assessment of severely injured trauma patients. After an initial examination, radiography and ultrasound are performed. Imaging is frequently supplemented by CT scan of selective body areas.

[Medical practitioner status subject to regular examinations].

Patients demand that their doctors receive regular certification, just like the pilots of the aircrafts they travel on. There are many arguments against regular certification: having the correct attitude and other skills are far more important than knowledge; immediate knowledge is not necessary because doctors can easily look up the knowledge they need; continuing education renders regular certification unnecessary; it is impossible to put together the right exams for doctors. This article argues that the right attitude can never be a substitute for knowledge, that immediate knowledge is essential in treating acute illnesses in busy departments, that continuing education is no guarantee that knowledge has been acquired at all and finally that it obviously should be possible, albeit difficult, to formulate suitable questions for regular doctors' exams.

[Perioperative suspension of anticoagulants: practical recommendations].

If patients being treated with anticoagulants need to undergo an operation then physicians need to consider whether to suspend the use of this medication or to allow its use to be continued. Suspending the use of anticoagulants increases the risk of thrombosis, whereas continued use may cause bleeding complications. No evidence-based scientific research has been carried out regarding best practice for the perioperative use of anticoagulants.

[Low literacy and limited health literacy require health care measures].

Health literacy is the combination of cognitive and social skills that is necessary for adequate response to information about health, illness and health care. Subjects with limited health literacy often experience difficulty in understanding the information provided by health care professionals and finding their way in the health care system, with consequent increased morbidity and mortality. Health literacy is a wider concept than literacy.

[Treatment of HIV-infected pregnant women: prevention of virus transmission and adverse effects in mother and child].

Without intervention, the probability of HIV transmission from mother to child varies from less than 10% to over 60%, dependent on the quantity of freely circulating HIV in the plasma. The prevention of HIV transmission from mother to child is based on the perinatal administration of a combination of antiretroviral drugs (highly active antiretroviral therapy; HAART) to both mother and child. The value of elective caesarean section along with an effective treatment with HAART during the pregnancy is very limited.

[Antiseptics to prevent or treat wound infections; myths and evidence].

Antiseptics are commonly applied to prevent or treat wound infections. Many common opinions about antiseptics appear not to be supported by convincing evidence. The aim of this review is to compare such traditional beliefs with currently available evidence.

[A clinically unrecognised and persistent facial folliculitis: herpes folliculitis].

A 33-year-old woman presented with a 5-year history of a relapsing erythematous, indurated plaque on the left cheek. Herpes simplex virus (HSV) immunostain revealed the presence of HSV in the follicular and perifollicular keratinocytes. After oral treatment with valaciclovir for a period of 3 months the lesion disappeared without leaving a scar.

['Rheumatoid arthritis' in a Surinamese man: leprosy].

Rheumatoid arthritis was diagnosed in a 65-year-old man from Suriname, on the basis of clinical and radiological findings. However, he was eventually diagnosed with leprosy. This emerged when the patient developed skin lesions and complained of increasing sensibility disorders during treatment for the alleged rheumatoid arthritis.

[Laparoscopic surgery for inflammatory bowel disease; an update].

Objective: To carry out a review of the literature for the short- and long-term effects of various laparoscopic operations in the inflammatory bowel diseases ulcerative colitis and Crohn's disease and to compare these operations with open surgical procedures.

Design: Review of the literature.

Method: PubMed (Medline), Embase and Cochrane databases were searched for randomised clinical trials and meta-analyses on this topic, published between January 1991 and August 2008.

[Imaging techniques in sports medicine].

Sports radiology is a new radiological subspecialty. Traumatic sports-related injuries can be acute, but are more frequently caused by over-use. Close collaboration between the treating physician and radiologist optimizes the choice of the best imaging technique to confirm the tentative diagnosis and to determine the treatment plan.

[Early treatment of Parkinson's disease with levodopa].

Parkinson's disease (PD) is a neurodegenerative disorder characterised by tremor, rigidity and bradykinesia. The current treatment, for example with levodopa or dopamine-agonists, is complicated by response fluctuations, dyskinesias and gastro-intestinal side-effects. These, and various other reasons including fear of levodopa toxicity, have led to reluctance in starting medical treatment in PD.

[Registration of ethnicity allowed with conditions].

Registration of an individual's ethnicity is, in the light of the potential risks of stigmatization and discrimination, rightfully considered a sensitive issue. Traditionally, privacy legislation offers special legal protection in the collection, registration etc. of data relating to race and ethnic background.

[Responsible care requires registration of ethnic origin].

Registration of the ethnic origin of patients in health care is subject to political and public debate. This paper is intended to contribute to that debate. We argue that registration of the ethnic origin of all patients is a necessary condition for responsible patient care.

[The coming diabetes tsunami: the Netherlands should exploit its lead].

Some authors claimed that if current trends prevail, 1.32 million people will have been diagnosed with diabetes mellitus in the Netherlands by 2025. In this commentary, the author sheds doubt on some of the underlying assumptions.

[The need for orchiopexy in the case of congenital undescended testis].

Congenital undescended testis (UDT) is a common congenital anomaly among males. Since ectopic position of the testis is considered a risk factor for the development of testicular cancer and infertility, early diagnosis and treatment are essential. Careful physical examination after birth should indicate those patients with UDT who must be followed up for possible orchiopexy at an early age.