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51.
Rudy R.F. Kuiters Geert Douma Ruben E.M. Hekster 《Clinical neurology and neurosurgery》1987,89(4):255-260
The case histories of two patients with an acute spinal epidural abscess are reported. When presented with a patient suffering from a spinal cord syndrome, the physician must keep in mind the possibility of a spinal epidural abscess. A rapid diagnostic procedure, prompt laminectomy, and medical treatment are particularly essential to total recovery in such cases. 相似文献
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Hemodynamic and Arterial Stiffness Parameters in Ambulatory Blood Pressure Phenotypes and the Clinical Scenario of Polypharmacy and Comorbidities
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Edgar JG. Peters Didier Collard Sander Van Assen Martijn Beudel Marije K. Bomers Jacqueline Buijs Lianne R. De Haan Wouter De Ruijter Renée A. Douma Paul WG. Elbers Abraham Goorhuis Niels C. Gritters van den Oever Lieve GHH. Knarren Hazra S. Moeniralam Remy LM. Mostard Marian JR. Quanjel Auke C. Reidinga Roos Renckens Jonne J. Sikkens 《Clinical microbiology and infection》2021,27(2):264-268
ObjectiveTo compare survival of individuals with coronavirus disease 2019 (COVID-19) treated in hospitals that either did or did not routinely treat patients with hydroxychloroquine or chloroquine.MethodsWe analysed data of COVID-19 patients treated in nine hospitals in the Netherlands. Inclusion dates ranged from 27 February to 15 May 2020, when the Dutch national guidelines no longer supported the use of (hydroxy)chloroquine. Seven hospitals routinely treated patients with (hydroxy)chloroquine, two hospitals did not. Primary outcome was 21-day all-cause mortality. We performed a survival analysis using log-rank test and Cox regression with adjustment for age, sex and covariates based on premorbid health, disease severity and the use of steroids for adult respiratory distress syndrome, including dexamethasone.ResultsAmong 1949 individuals, 21-day mortality was 21.5% in 1596 patients treated in hospitals that routinely prescribed (hydroxy)chloroquine, and 15.0% in 353 patients treated in hospitals that did not. In the adjusted Cox regression models this difference disappeared, with an adjusted hazard ratio of 1.09 (95% CI 0.81–1.47). When stratified by treatment actually received in individual patients, the use of (hydroxy)chloroquine was associated with an increased 21-day mortality (HR 1.58; 95% CI 1.24–2.02) in the full model.ConclusionsAfter adjustment for confounders, mortality was not significantly different in hospitals that routinely treated patients with (hydroxy)chloroquine compared with hospitals that did not. We compared outcomes of hospital strategies rather than outcomes of individual patients to reduce the chance of indication bias. This study adds evidence against the use of (hydroxy)chloroquine in hospitalised patients with COVID-19. 相似文献
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Ellen M.A. Smets Marij A. Hillen Kirsten F.L. Douma Lukas J.A. Stalpers Caro C.E. Koning Hanneke C.J.M. de Haes 《Patient education and counseling》2013
Objective
We investigated whether the content of information provided by radiation oncologists and their information giving performance increase patients’ trust in them.Methods
Questionnaires were used to assess radiotherapy patients (n = 111) characteristics before their first consultation, perception of information giving after the first consultation and trust before the follow-up consultation. Videotaped consultations were scored for the content of the information provided and information giving performance.Results
Patients mean trust score was 4.5 (sd = 0.77). The more anxious patients were, the less they tended to fully trust their radiation oncologist (p = 0.03). Patients’ age, gender, educational attainment and anxious disposition together explained 7%; radiation oncologists’ information giving (content and performance) explained 3%, and patients’ perception of radiation oncologists’ information-giving explained an additional 4% of the variance in trust scores.Conclusion
It can be questioned whether trust is a sensitive patient reported outcome of quality of communication in highly vulnerable patients.Practice implications
It is important to note that trust may not be a good patient reported outcome of quality of care. Concerning radiation oncologists’ information giving performance, our data suggest that they can particularly improve their assessments of patients’ understanding. 相似文献60.
Josien van Es Paul L. den Exter Ad A. Kaptein Cornelie D. Andela Petra M.G. Erkens Frederikus A. Klok Renee A. Douma Inge C.M. Mos Danny M. Cohn Pieter W. Kamphuisen Menno V. Huisman Saskia Middeldorp 《Thrombosis research》2013