5 results on '"van den Berg, Jan"'
Search Results
2. Diagnostische delay bij longembolie
- Author
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Walen, Stefan, Damoiseaux, R A M J, and Van Den Berg, Jan Willem K
- Subjects
Journal Article ,English Abstract - Abstract
OBJECTIVE: To quantify the different stages of diagnostic delay of pulmonary embolism (PE) in patients and to identify other clinical factors associated with this delay. DESIGN: Case series. METHOD: Medical records were reviewed for all patients diagnosed with PE in the period 1 January 2008 and 31 December 2009 in Isala Hospital in Zwolle (the Netherlands), and data was collated for: the dates of symptom onset, presentation to a GP, referral to secondary care, and diagnosis respectively. The relationship between diagnostic delay and other clinical parameters such as gender, age, risk factors, symptoms and co-morbidities was tested using multivariate logistic regression analysis. RESULTS: For the 261 patients included in the analysis, the average total delay was 8.6 days. Patient delay (4.2 days average) and delay in primary care (3.9 days) were the major contributors to this delay. Chest pain and symptoms of deep venous thrombosis were associated with an early diagnosis. Patient delay was shorter in patients with chest pain and longer in patients with dyspnoea. In primary care, chest pain and rales were associated with an early referral, whereas the presence of co-morbidity led to a delayed referral. Delay in secondary care was shorter when the patient presented with dyspnoea. CONCLUSION: The diagnostic delay of PE is substantial, especially patient delay and delays originating in primary care. Further research is needed to identify clinical factors that raise suspicion of PE in primary care, to aid the development of improved diagnostic models.
- Published
- 2016
3. [Chronic cough in adults].
- Author
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Kooistra LA, van den Berg JWK, and Patberg KW
- Subjects
- Chronic Disease, Cough etiology, Humans, Quality of Life, Drug-Related Side Effects and Adverse Reactions, Hypersensitivity
- Abstract
Cough is a physiological defense mechanism. However, excessive cough is known to have a great impact on quality of life. Cough is considered to be chronic when it lasts longer than 8 weeks. In the Netherlands, the prevalence is 10.9%. The concept as a whole is called 'cough hypersensitivity' in which there is a hypersensitivity of the cough reflex to aspecific stimuli. Specific treatment of the phenotype is important. If no specific phenotype is found it is called 'unexplained chronic cough' (UCC) and if symptoms persist despite treatment it is called 'chronic refractory cough' (CRC). Neuromodulating drugs are the main treatment in CRC. However, a suitable condition often cannot be achieved because of severe side effect and great interindividual variability in pharmacokinetics. New drugs, P2X3-antagonists, are being developed. These drugs mediate in a late phase of the cough reflex and are thereby considered to have fewer side effects.
- Published
- 2021
4. [Terminal care in patients with amyotrophic lateral sclerosis].
- Author
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van Leeuwen PW, van den Berg JP, de Goeijen NJ, Martens M, and Kampelmacher MJ
- Subjects
- Amyotrophic Lateral Sclerosis psychology, Caregivers, Humans, Hypercapnia etiology, Palliative Care, Respiration, Artificial methods, Amyotrophic Lateral Sclerosis therapy, Terminal Care
- Abstract
Patients with amyotrophic lateral sclerosis (ALS) often fear of dying from suffocation. This fear is also common in relatives and caregivers. Research has, however, shown that ALS patients seldom die from suffocation. More than 90% of all ALS patients die peacefully. Death is mostly preceded by a peracute decrease in consciousness due to hypercapnia caused by alveolar hypoventilation. Mechanical ventilation, especially at night, can reduce the symptoms caused by hypoventilation. However, little by little, the effectiveness of ventilation may decrease to such an extent that it is no longer useful or desirable. Termination of long-standing ventilation requires careful preparation. Intensive guidance of the relevant medical, practical and ethical aspects are necessary. Particularly in the pre-terminal and terminal phases, support given to an ALS patient requires a pro-active attitude on the part of the treating physician. To this end, physicians may seek advice from the Dutch ALS Center, a palliative care consultation team, a hospice physician or a center for home mechanical ventilation.
- Published
- 2013
5. [Guideline "Cancer rehabilitation"].
- Author
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van den Berg JP, Velthuis MJ, Gijsen BC, Lindeman E, van der Pol MA, and Hillen HF
- Subjects
- Humans, Neoplasms therapy, Netherlands, Patient Satisfaction, Societies, Medical, Medical Oncology standards, Neoplasms rehabilitation, Practice Patterns, Physicians', Quality of Health Care, Quality of Life
- Abstract
Initiated by IKNL (Integraal Kankercentrum Nederland), a multidisciplinary guideline for cancer rehabilitation for adult oncology patients has been developed. The guideline describes the rehabilitation care of adult patients with cancer, during and after treatment. The guideline focuses on (a) prevalence of complaints either resulting from cancer or the treatment, (b) detection of these complaints and indicated referral, (c) the intake procedure before cancer rehabilitation, (d) intervention and evaluation within cancer rehabilitation and (e) the importance of patient empowerment. The guideline is directed at all professionals giving care to patients with cancer. It concerns those (such as medical specialists, general practitioners and nurses) who are responsible for detecting cancer-related complaints and for referral to cancer rehabilitation, as well as health care professionals involved in cancer rehabilitation care (such as consultants in rehabilitation medicine, physiotherapists and psychologists). The main goal of the guideline is that every cancer patient or ex-cancer patient with (residual) complaints resulting from cancer or its treatment receives timely and appropriate cancer rehabilitation.
- Published
- 2011
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