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J J van Binsbergen

Publications and source records attributed to J J van Binsbergen.

13 recordsLinked to original sources
PubMed2005

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

The new practice guideline of the Dutch College of General Practitioners on the management of patients with a TIA resembles the first version, but there are some important changes: The concept TIA has been narrowed to a neurological deficit that has resolved spontaneously by the time the patient consults the doctor. The indications for referral of patients with a TIA in the area supplied by the carotid artery for investigation of a possible carotid stenosis and carotid surgery have been broadened. Auscultation of the internal carotid artery is no longer necessary. The daily amount of acetylsalicylic acid to be taken by a patient with a TIA has been increased from 30 mg to 80 mg. The prescription of dipyridamol following a TIA remains controversial.

Aspirin↗
PubMed2005

Nutritional deficiency in general practice: a systematic review.

OBJECTIVE: Nutritional deficiency is an independent risk factor for mortality. Despite its clinical relevance, the prevalence in a primary care setting is poorly documented. We performed a systematic review of reported prevalence and clinical assessment of nutritional deficiency in general practice. METHODS: From MEDLINE, Current Contents and EMBASE, we derived articles and checked the initially included ones for references on prevalence data. Of the eligible articles, we assessed the quality of research and results. RESULTS: We finally included eight studies. The prevalence ranged from 0 to 13%. However, the study populations were heterogeneous and all studies contained methodological flaws, especially selection bias. In addition, the clinical assessment differed between studies. CONCLUSION: Literature on the prevalence of nutritional deficiency within general practice is rare and provides disputable prevalence assessments.

Adult↗
PubMed2005

How can a proposed Cochrane diet and nutrition field work effectively?

The Cochrane Database currently provides relatively little evidence-based guidance about nutrition relevant to general practitioners. This situation could be improved by the establishment of a new Cochrane Field to identify relevant studies, prioritize topics to include nutrition, work with Cochrane methodologists on the inclusion of observational studies, and disseminate results of Cochrane reviews to general practitioners and their patients. A Diet and Nutrition Field could be established as a separate entity or as a Subgroup of the existing Primary Health Care (PHC) Field. The Field would be appropriate if the intent is to immediately cover nutritional interventions of all sorts, in all settings. However, if the focus is nutritional evidence for use by primary care clinicians, organization as a subField would provide a simpler registration process, allow Cochrane activities to begin sooner, and would allow members to focus on primary-care-relevant nutritional issues, conserving their resources and energy. A mechanism exists for conversion to a freestanding Field if the scope later expands. Of the core Field functions, identification and assembly of relevant trials into a specialized register would be among the most important. Special registers are generated by focused literature searches augmented by hand-searching of key journals. Given the importance of studies with observational designs, a nutrition field register will require some additional work on search strategies and inclusion criteria. Other key functions would include ensuring effective communication both with members of other Cochrane entities and with the scientific and clinical community with interests in diet and nutrition.

Communication↗
PubMed2005

The Cochrane Library: more systematic reviews on nutrition needed.

The knowledge and relevance of nutrition as well as the demand for well-funded advices increase. The Cochrane Collaboration plays a leading role within the evidence-based medicine and practice. We advocate therefore more specialized nutritional interest within the Cochrane Collaboration. In case 'Nutrition' needs more attention within the Cochrane Library, one of the first priorities is deciding about whether to include non-randomized studies into the Specialized Register and generating lists of journals to handsearch for such a Specialized Register. Preparatory to these activities an inventory of Nutritional content within the Cochrane Library is needed. We estimate that reviews directly related to nutrition and those of borderline interest to nutrition represent less than 4% of all published reviews in The Cochrane Library.

Databases, Bibliographic↗
PubMed2005

Nutritional deficiency in Dutch primary care: data from general practice research and registration networks.

OBJECTIVE: To explore incidence and prevalence rates of nutritional deficiency in adults in general practice. METHODS: Six Dutch general practice research and registration networks supplied incidence and prevalence rates of nutritional deficiency by the International Classification of Primary Care (ICPC) or 'E-list' labels ('loss of appetite, feeding problem adult, iron, pernicious/folate deficiency anaemia, vitamin deficiencies and other nutritional disorders, weight loss'). In case of disease-related nutritional deficiency, we asked whether this was labelled separately ('co-registered') or included in the registration of the underlying disease. RESULTS: 'Iron deficiency anaemia' had highest incidence (0.3-8.5/1000 person years), and prevalence rates (2.8-8.9/1000 person years). Nutritional deficiency was mostly documented in the elderly. In two networks 'co-registration' was additional, two only documented the underlying disease and two did not specify 'co-registration'. No clear difference was found between networks considering the difference in 'co-registration'. CONCLUSION: Nutritional deficiency is little documented in general practice, and generally is not registered separately from the underlying disease.

Adolescent↗
PubMed1999

[Nutrition science and disease in the medical history of the 20th century].

In the twentieth century Dutch physicians provided major contributions to the development of the science of nutrition. Before the Second World War research was centred around vitamins and infant food, while at the same time the people's nutrition became a topic. Shortage of foodstuffs and nutrients had characterized the Dutch diet in the beginning of the century, but in the fifties the balance shifted towards an abundance of choice, nutrients and energy intake. Improvement of the optimum nutrient concentration pro energy unit became the main scientific challenge in order to prevent chronic degenerative diseases. Today, an unbalanced nutrition pattern is once more an issue as a relative nutrient shortage occurs in case of low energy intake and a limited variation of foodstuffs leading to chronic degenerative diseases. In addition, the difference between food components and medical drugs is decreasing by the advent of 'nutriceuticals'. Considering the variety of nutrition-related diseases the science of nutrition needs a more prominent place in medical academic education.

Diet Therapy↗
PubMed1999

ICPC-code approach of nutritional questions in general practice: a look at the future.

The Dutch College of General Practitioners is developing a computerised consult supporting system on nutrition that is integrated in the widely used GP Information System. Connected to every ICPC-code (International Code of Primary Care) for diagnosis relevant nutritional information is available. Short items simple sentences with respect to the content-provide the main nutritional information, needed to inform the patient within the limited consultation time. Background information is the second level and is reachable by clicking on the coloured items in the first part. After all the patients' practical advice is the last part of this so-called: 'P-module of nutrition'.

Decision Support Systems, Clinical↗
PubMed1997

[The role of the consulting physician in situations of active euthanasia].

The cases are reported of two patients, a man aged 69 with a metastasized bronchial carcinoma and a woman aged 65 with a frontotemporal glioblastoma no longer responding to irradiation. Both requested active euthanasia. In both cases, euthanasia was performed by injection, after a general practitioner from the same locum group had acted as consultant. The requirements of meticulousness in handling a request for active euthanasia are concerned with the request (which has to be voluntary, thoroughly considered and constant), the suffering (which has to be protracted, unbearable and incurable), consultation and the written report. The consulting or second physician in cases of active euthanasia confirms that the requirements of meticulousness have been met. In addition, the second physician may assist the general practitioner in the detection of factors that may impair correct decision-making by the doctor or the patient. The second physician will be aided in performing these tasks if he is a member of the same locum group as the treating physician. However, if he considers himself too involved, a physician outside the locum group should be available at all times.

Aged↗
PubMed1997

Nutritional factors in Dutch family medicine: an inventory.

By 1995 the Dutch College of General Practitioners (Nederlands Huisartsen Genootschap, or NHG) had developed 53 standards that spell out the preferred policy of detection, treatment, and control of different clinical conditions in general practice. In 35 of these NHG standards nutrition is of some significance. Each of them is briefly discussed. Eighteen conditions, not yet in the set of standards, have specific pathologies with nutritional factors. Each is briefly explained. Last, 17 groups of diseases or background conditions are discussed in which nutritional advice is especially important. The science of nutrition ought to have an established place in the vocational training of general practitioners. To help general practitioners give adequate nutritional advice, they should have regular consultations with dietitians.

Family Practice↗
PubMed1992

Indicators of iodine status among adults. Dutch Nutrition Surveillance System.

To evaluate the iodine status of Dutch adults we used three different iodine status indicators, namely urinary 24-hour iodide excretion (I/24 h), iodide/creatinine ratio in 24-hour urine samples (I/Cr) and 24-hour iodide excretion per kilogram body weight (I/kg). Additionally, the habitual daily iodine intake was calculated. Men had higher mean I/24 h and mean iodine intake than women. No differences between men and women were found for mean I/Cr and mean I/kg. Relatively high (greater than or equal to 18%) prevalences of low values for the different iodine status indicators were found, especially for I/24 h. The intraindividual variance for all three indicators was high. Risk assessment regarding iodine supply, based on urinary iodide excretion, depends on the indicator used, and therefore caution is called for when drawing conclusions. Our results do not argue against the usage of I/24 h as iodine status indicator. More research is needed to solve the question whether iodine requirement depends on such factors as body size, body composition and physical activity.

Adult↗