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Biomedical subjects

R M Leclercq

Publications and source records attributed to R M Leclercq.

5 recordsLinked to original sources
PubMed1997

[Malignant pleural mesothelioma in general practice; complex pain problems].

In three patients, men aged 67, 57 and 69 years, malignant pleural mesothelioma was diagnosed. All three had worked as coal miners and were presented with thoracic pain. They were among seven cases of malignant pleural mesothelioma diagnosed in a period of five years in one suburban general practice (adherence: 5600 patients) in the former mining area in the province of Limburg. The terminal phase of the disease was characterized by intractable pain. High doses of opioids and adjuvants were necessary to achieve acceptable pain relief. It is suggested that step one of the 'analgesic ladder for cancer pain management' of the WHO (non-opioids) should be followed soon by step three (strong opioids). Because the incidence of pleural mesothelioma is not yet decreasing, it is important to know that pain management remains a serious problem.

Aged↗
PubMed1994

Reliability of C-reactive protein measurement in general practice in The Netherlands.

The aim of this study was to compare the reliability of the whole blood NycoCard C-reactive protein measurement (CRP) with the erythrocyte sedimentation rate (ESR) in four general practice centres (GPCs) in The Netherlands with 443 patients indicated for ESR. During 4 successive months in 1992 NycoCard CRP was measured in capillary (whole) blood at the GPC. A venous blood sample was then transported to the local hospital laboratory in order to determine CRP turbidimetrically in plasma. Westergren's ESR was measured at the GPC and at the laboratory. The dichotomized CRP values measured at the GPCs corresponded with the laboratory values in 88% of the cases. Kappa was 65% (p < 0.00001). Using a 20 mm cut-off point, ESR values measured at the GPCs and the laboratory corresponded in 96% of cases (Kappa = 90%, p < 0.00001). Interpractice variabilities and learning effects did not influence the results. 'False normal' rates for CRP and ESR were 8% and 1%; 'false elevated' rates were 28% and 12% respectively. The reliability of the NycoCard CRP measurement in whole blood disappointed. In particular the 'false elevated' rate is unacceptably high for daily general practice. The background of the poor reliability remains unclear.

Blood Sedimentation↗