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F A Klijn

Publications and source records attributed to F A Klijn.

4 recordsLinked to original sources
PubMed2000

[Reflex sympathetic dystrophy vs. a factitious disorder].

Three women aged 18, 30 and 21, were admitted with complaints of reflex sympathetic dystrophy. These patients were caught at inducing their symptoms. Factitious disorders may be more common and serious than expected. It is suggested to include this diagnosis routinely in the differential diagnosis when dealing with inexplicable complaints, symptoms or therapy resistance. If factitious disorders are diagnosed it is advised to confront the patients. This is important in order to limit further iatrogenic damage to the patient. It also allows the physician to inform other doctors. After confrontation quite a few patients will stop inducing their symptoms. Most of them become angry, deny self-induction and refuse psychiatric help. Sometimes patients will withdraw from treatment. Despite these negative reactions patient confrontation is mandatory.

Adolescent↗
PubMed2000

[Ethanol for treatment of delirium in alcohol dependent patients on intensive care units in the Netherlands: efficacy not proven].

OBJECTIVE: To determine the use of ethanol in Dutch intensive care departments (ICUs) for the treatment of deliriant symptoms in alcohol-dependent patients, and to study the literature data concerning this use. DESIGN: Literature search and questionnaire. METHOD: In Medline a search was performed from 1993 onward with keywords 'intensive care' and 'alcohol'/'alcohol withdrawal syndrome'/'delirium'. All Dutch ICUs received a written questionnaire (n = 247) concerning the use of ethanol in this patient group. RESULTS: According to the literature the syndrome is characterized by autonomous hyperactivity, resulting in tachycardia, tachypnoea, hypertension, perspiration, fever, tremors en fear. In delirium caused by alcohol withdrawal benzodiazepines are advised, sometimes in combination with haloperidol. ICUs sometimes use ethanol, although the effectiveness in preventing or treating withdrawal symptoms has never been ascertained in scientific investigations: in a meta-analysis the conclusion is drawn that the studies are too small and insufficiently objective to determine the effectiveness. The response to the questionnaire was 55% (96/176). From all ICUs, 15 (16%) used ethanol occasionally, and treated an estimated 17% of the admitted alcohol-dependent patients. There was a tendency for large ICUs to use ethanol in these patients more frequently. Each ICU used its own method to calculate the required ethanol dosage. Calculation on the basis of these dosages indicated a plasma ethanol concentration of at most 0.5 promille. CONCLUSION: Because only a small percentage of deliriums on ICUs are caused by alcohol withdrawal, and the effectiveness of ethanol in alcohol-dependent patients with a delirium has never been proven, the use of ethanol in such cases is discouraged.

Alcohol Withdrawal Delirium↗