Gauthierdean7230

Studies in more comparable populations are scarce and contradictory.Discrimination based on ethnic background and the use of terminology like 'Negro Race' in clinical practice guidelines have been criticized, also in this journal. Typical Dutch words 'allochtonen', 'non-western', 'Creools' and 'Hindostan' are unspecific or could also offend people. Nevertheless, there are health risks related to ethnic background. Healthcare improves when health professionals would consider these, contributing to person centred cultural sensitive care. Therefore, we aimed to start a discussion about which acceptable terminologies should be used to describe ethnic differences in guidelines and research. We suggest that terminologies use to describe ethnic minority groups should be as precise as possible and should not be offensive, for instance 'migration background' instead of allochtoon, and 'African-Surinamese' instead of Creool. We invite guideline developers, researchers and people of different ethnic background, to join this discussion.

To analyse the incidence, risk factors and avoidability of acute kidney injury in adult patients admitted to a Dutch hospital.

Retrospective cohort study.

We assessed all consecutive admissions in our clinic during one week for the development of acute kidney injury and its cause. We compared medical information between patients with and without acute kidney injury to identify risk factors. We reviewed whether the current advice on kidney injury was followed to estimate the avoidability of acute kidney injury.

347 patients were older than 18 years and admitted for more than 1 day. Acute kidney injury occurred in 16.4% of patients. Almost half of the patients already developed acute kidney injury at home, before admission. learn more Acute kidney damage was encountered in all medical specialties. Chronic kidney disease, diabetes mellitus and heart failure were significantly more common in patients with acute kidney injury. Patients with acute kidney injury used significantly more RAS-inhibitors and loop diuretics. The renal function completely restored in half of cases. Two thirds of acute kidney injury was probably avoidable if volume depletion had been optimized or medication with hemodynamic effects had been adjusted in time according to the guidelines.

Acute kidney injury is not only a common and underestimated problem in the daily practice of all doctors, but it is also probably avoidable. Awareness of the risk of acute kidney injury by doctors, pharmacists and patients can contribute to the reduction of acute kidney injury and its serious consequences.

Acute kidney injury is not only a common and underestimated problem in the daily practice of all doctors, but it is also probably avoidable. Awareness of the risk of acute kidney injury by doctors, pharmacists and patients can contribute to the reduction of acute kidney injury and its serious consequences.The SARS-CoV-2 pandemic presents a challenge for healthcare worldwide. In this context, rapid, correct diagnosis and early isolation of infected persons is of great importance. Pneumonia as an expression of COVID-19 is responsible for the most part of morbidity and mortality. Lung ultrasound can provide valuable information about the diagnosis of a COVID-19 pneumonia in daily practice. A normal ultrasound excludes COVID-19 pneumonia. Conversely, finding abnormalities matching with a COVID-19 pneumonia can be useful for isolation policy. Follow up lung ultrasound visualizes the development of the pneumonia and a possible alternative diagnosis can thereby be determined in the event of a deviating clinical course.In the middle of the worldwide COVID-19 crisis, the whole of Europe was alarmed about a possible side effect of the AstraZeneca vaccine against COVID-19. Consequently, the use of this AstraZeneca vaccine was temporarily suspended in many European nations including the Netherlands. In this article, we chronologically describe the decisions that were made about the use of this vaccine in the Netherlands and we discuss the risk-benefit ratios of these actions as well as possible non-medical reasons that may explain why these actions were taken.Real-world evidence is accumulating to support the idea that there are differences among the direct oral anticoagulants (DOACs). The results of the study, discussed elsewhere in the NTvG, add to the growing body of evidence that while there is almost no difference in efficacy in prevention of the thromboembolic complications of non-valvular atrial fibrillation there are significant differences in safety. Apixaban is safer than rivaroxaban, with significantly less major bleeding, any bleeding or gastro-intestinal bleeding. Apixaban is probably the safest DOAC of the four available. These differences between DOACs with almost equal half-life are probably partly due to the differences in dosing interval twice a day (BID) versus once a day (QD).This study is based on a large international survey, which collected the views of general practitioners (GPs) in 11 different countries on their respective healthcare systems in 2019. Findings show that Dutch GPs are positive about the quality of GP care and that they are satisfied with their profession. However, findings also show that there is room for improvement. (i) Work pressure and work-related stress among GPs is high in the Netherlands, which may be due to moves to substitute primary care for some hospital care. (ii) Dutch GPs are behind other high-income countries in their uptake of some digital applications (e.g. video consultations). (iii) According to Dutch GPs, pressure from patients, lack of time, and fear of complaints contributes to provision of low-value care. The COVID-19 epidemic has created opportunities to improve Dutch GP care further, for example through wider uptake of digital health applications.

Diseases of the pancreas may present with extrapancreatic symptoms, such as (poly)arthritis or necrosis of subcutaneous fat. A combination of pancreatitis, panniculitis and (poly)arthritis is referred to as the PPP syndrome, which is associated with acute and chronic pancreatitis, as well as pancreatic malignancies.

This article describes a patient which was admitted to our hospital with severe polyarthritis and panniculitis. A meticulous work-up revealed an underlying focal alcoholic pancreatitis. The clinical course in our patient illustrates the severity of the PPP syndrome and emphasizes the need of a multidisciplinary approach.

Panniculitis and/or (poly)arthritis may be the first symptom of underlying pancreatic disease. Timely recognition and diagnosis is imperative for successful treatment and outcome. The multi-organ involvement in the PPP syndrome requires close collaboration across different medical departments.

Panniculitis and/or (poly)arthritis may be the first symptom of underlying pancreatic disease.