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Biomedical subjects

L J Boomsma

Publications and source records attributed to L J Boomsma.

At least 19 recordsLinked to original sources
PubMed2006

[Summary of the practice guideline 'Problematic alcohol consumption' (second revision) from the Dutch College of General Practitioners].

Compared with the former guideline, more attention is paid to the attitude of the general practitioner towards problem drinkers (about 200 problem drinkers in a standard practice of 2350 patients) and the combined use of alcohol and drugs among young people. The five-shot questionnaire has replaced the earlier 'cutdown, annoyed, guilty, eye-opener' (CAGE) test. Laboratory tests are of little value in the diagnosis. The general practitioner is given tools with which to motivate problem drinkers to change their behaviour. Medication is of minor importance.

Alcoholism↗
PubMed2006

[Summary of the practice guideline 'Otits media with effusion' (second revision) from the Dutch College of General Practitioners].

Most children pass through a period of otitis media with effusion, which can be considered as a normal reaction of the body to viral or bacterial infections. The general practitioner provides education and advice regarding the favourable prognosis of the hearing loss and is alert to the detection of high-risk groups and an aberrant course. In most children with otitis media with effusion, the general practitioner can wait for the disease to take its natural course. Children with persistent otitis media with effusion whose development is retarded should be referred to an otorhinolaryngologist. The former screening for perceptive hearing loss in infants resulted in the detection of many children with otitis media with effusion. Children with abnormal results on the new form of neonatal auditory screening should preferably be referred to a centre for audiology.

Family Practice↗
PubMed2005

[Indicators as the basis for quality-control in the midwifery practice].

A study on the quality of primary obstetric care in uncomplicated pregnancies carried out by means of a checklist revealed substandard factors in perinatal care in 71 out of 72 pregnancies. However there are many objections to the quality-control procedure. Some items on the original checklist had to be abandoned due to lack of evidence. In other items definitions and circumstances had not been properly considered and in some cases the patient's own wishes were responsible for a change in policy. The quality of the care delivered cannot be judged only by counting items on a checklist, but requires careful consideration of the situation and of the circumstances that led to the choices in perinatal care.

Female↗
PubMed2004

[Summary of the practice guideline 'Peripheral vascular disease' (first revision) from the Dutch College of General Practitioners].

Peripheral vascular disease is a manifestation of atherosclerosis and may occur with or without signs or symptoms. The local prognosis is worse with signs or symptoms. The concomitant atherosclerosis in heart and brain is responsible for long-term morbidity and mortality. Absence of signs and symptoms almost excludes peripheral vascular disease, but for the diagnosis an ankle-brachial index is mandatory. This implies a protocol in general practice. Treatment of peripheral vascular disease consists of advice on cardiovascular risk factors, stopping smoking, walking exercises, and foot care. For peripheral vascular disease, anti-thrombotic medication is advised.

Fibrinolytic Agents↗
PubMed2004

[Summary of the practice guideline 'Dementia' (second revision) from the Dutch College of General Practitioners].

The general practitioner (GP) should be aware of clues pointing to dementia. The GP can establish the diagnosis himself or refer the patient for extended testing. The diagnosis of dementia focuses on memory impairment, other cognitive impairments and decreased functioning in daily life. For patients with dementia and their relatives, information and advice are more important than medication. The GP must take care aspects into consideration as well as the way patients' relatives cope with the dementia patient. The treatment and care of the patient with dementia and the relatives requires good coordination and collaboration with other health workers.

Activities of Daily Living↗
PubMed2000

['Number needed to screen': a tool for assessment of prevention programs].

The number needed to screen (NNS) is defined as the number of people that need to be screened for a given period to prevent one death or adverse event. The NNS is one of the criteria with which the efficacy of a screening programme can be determined. This article introduces the NNS to Dutch literature. The NNS may be calculated with mortality figures and the absolute risk reduction obtained by a prevention programme. Another method is to multiply the number needed to treat (NNT) with the number of people that have to be screened in order to find one patient with the disease. Based on published figures, the NNS's per year to prevent one death in current screening programmes within general practice in the Netherlands are approximately 2560 for cervical cancer screening, about 1000 for breast cancer screening, and circa 2340 for the detection of hypertension in patients aged 55-75 years.

Data Interpretation, Statistical↗
PubMed1998

[The frequency of hearing impairment in patients with diabetes mellitus type 2].

OBJECTIVE: To determine the prevalence of hardness of hearing in patients with diabetes mellitus type 2 and to compare the diabetes characteristics between diabetic patients with and without hardness of hearing. SETTING: Computerized general practitioners office in Nijverdal, the Netherlands. DESIGN: Descriptive, cross-sectional study. METHOD: In all patients aged 55 years and over, registered at the general practitioners (n = 1184), diabetes mellitus type 2 and hardness of hearing were determined. Hardness of hearing was defined as use of a hearing aid or an audiometrically determined hearing loss of at least 40db. RESULTS: A hearing aid was three to four times more prevalent in patients with diabetes mellitus type 2 (n = 86) than in subjects without diabetes of the same age (p < 0.001). Of the diabetic patients 48% had impaired hearing. Patients with hardness of hearing had a longer duration of diabetes than diabetic patients with a normal hearing (10.5 years (SD: 6.9) versus 6.9 years (6.8); p = 0.06, adjusted for age). They suffered less hypertension and had a lower level of glycated haemoglobin. CONCLUSION: Hardness of hearing is frequent in elderly patients with diabetes mellitus type 2. It may be due to diabetic neuropathy.

Age Distribution↗
PubMed1989

Peripartum cardiomyopathy in a rural Nigerian hospital.

In a rural hospital in Northern Nigeria in 1985 seventeen patients were admitted who met with the criteria of peripartum cardiomyopathy. Local habits played an important part in the course of the disease. Physical examination with an emphasis on bloodpressure and the condition of the heart was most reliable in establishing the diagnosis and assessing the treatment. Electrocardiography (ECG) was introduced, but proved of low value. Treatment consisted of bedrest and diuretics. One patient died, eight patients made a full clinical recovery but eight patients did not improve. Unfortunately all patients withdrew from follow-up.

Adolescent↗