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allergology (12)
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cardiac differentiation (1)
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cell cycle (1)
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children (12)
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clinical epidemiology (2)
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Clinical retrospective patient outcome study (1)
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coagulation (1)
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cochlear implants (1)
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cognition and outcome (2)
cognitive function (1)
cognitive impairment (1)
colonic stenting (1)
colonisation (1)
colonoscopy (2)
colorectal (1)
colorectal cancer (2)
colorectal livermetastases (1)
colorectal surgery (2)
Community Mental Health (1)
comorbidity (1)
comorbidity: anxiety, aggression, emotion regulation problems, depression (1)
compensatory movements (2)
competency development (1)
complement (3)
compliance (3)
complications (4)
Comprehensice geriatric assessment (1)
Comprehensive geriatric assessment (1)
Congenital anomalies (1)
congenital heart disease (3)
connective tissue disease (1)
continue glucose monitoring (3)
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COPD (16)
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coronary artery bypass grafting (1)
Coronary Artery Disease (1)
coronary calcium score (2)
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Crohn's disease (2)
Crohn's disease (3)
Crohn's disease (1)
crosscultural (1)
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crystallography (4)
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data management (1)
database (3)
database registry (2)
Deep brain stimulation (DBS) (3)
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delirium (1)
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dementia (6)
dementie / cognitie (1)
depressie (1)
depression (5)
Depression, (1)
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dermatology (2)
Descriptive and retrospective study with clinical results (1)
development (1)
Developmental coordination disorder (1)
developmental disorder (1)
developmental disorders (1)
Developmental Dysplasia of the Hip (DDH) (2)
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diabetes (9)
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diffuse Large B-cell lymphoma (DLBCL) (1)
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endothelial cells (2)
endoveneuze laser behandeling (1)
energy metabolism (3)
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epidemiology (10)
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epinephrine auto-injector (1)
epithelial cells (1)
epithelial disorders (1)
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esophageal carcinoma (1)
esophagus surgery (2)
Essential tremor (1)
ethical issues (1)
ethics (3)
evidence-based medicine (2)
EVLT (1)
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exercise testing (2)
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exome sequencing (1)
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First Episode Psychosis (1)
first trimester anomaly scan (1)
first trimester ultrasound (1)
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fluid administration, hemodynamic monitoring (2)
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functional genetics (2)
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Gender (1)
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gene enrichment (1)
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general practice (4)
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genetic testing (1)
genetics (8)
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hematology, cancer, critical care, outcome (2)
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hospital Deventer (14)
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imaging (8)
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laboratory animals (5)
laparoscopy (2)
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late effects of treatment (1)
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liver diseases (1)
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liver transplantation (7)
local recurrence (2)
locally advanced rectal caner (1)
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Long non-coding RNAs (1)
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lung (1)
lung cancer (3)
Lung function (2)
lung mechanics (2)
lung nodules (1)
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multidisciplinairy regional team meetings (1)
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Multimorbidity (5)
multiple myeloma (1)
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myocardial perfusion (2)
myoclonus (1)
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NaF PET/CT (1)
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NASH (2)
nasopharyngeal carcinoma (1)
Near-Infrared Spectroscopy (1)
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necrotising enterocolitis (1)
nefropathie (1)
neglected diseases (1)
Neglected Tropical Diseases (1)
neoadjuvant chemoradiotherapy (1)
Neonatal hypoxic-ischaemic encephalopathy (1)
Neonatal outcome (1)
neonates (2)
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neuroblastoma (1)
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neurodegenerative diseases (1)
neurodevelopmental outcome (1)
neuroendocrine tumor (1)
Neuroimaging (4)
neuroinflammation (1)
neurological development (1)
neurology (1)
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neuropathy (2)
neuropsychiatric symptoms (1)
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neutropenia (1)
nier (1)
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novel cancer drug (1)
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nutrient addiction (1)
nutrition (7)
nutritional status (1)
nutritition (1)
obesitas (1)
obesity (6)
observational scale (1)
obstetrics (1)
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oesofaguscarcinoom (1)
oesophagectomy (1)
Older adults (1)
oligodendrocytes (2)
Oncologic emergencies (1)
oncological epidemiology (2)
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oncology (8)
onderwijskunde (1)
ongeplande heropname (1)
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ontwikkelen (reken)model (1)
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opthalmologic problems (1)
Organ failure (1)
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ototoxicity (1)
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outcome (3)
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Outcome measurement (4)
Outcomes (2)
ovarian cancer (6)
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overweight (2)
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Patients with self inflicted burn injuries; how do they fare?
Keywords: burns
self inflicted
suicide
Researchers:
dr. M.K. Nieuwenhuis
P.A. Cornet
T.W. Broersma
A.S. Niemeijer
G.I.J.M. Beerthuizen
Nature of the research:
retrospectieve studie
Fields of study:
psychiatry
Background / introduction
Achtergrond
In Europa en Amerika komen zelf toegebrachte brandwonden (self inflicted burn (SIB)) niet vaak, maar wel regelmatig voor; het betreft tussen de 2 en 14% van alle opnames van patienten met brandwonden (Laloe, 2004). Uit verschillende onderzoeken is naar voren gekomen dat patienten met SIB een slechtere outcome hebben in vergelijking met patienten die worden opgenomen na een ongeval (accidental burn (AB)) (b.v. Theodorou et al., 2011; Modjarred et al., 2007). Nu is het ook zo dat bij zelf toegebrachte brandwonden, zeker als het om een tentamen suïcide gaat, vaak sprake is van ernstiger letsel, waardoor een slechtere uitkomst (mortaliteit, opnameduur) te verklaren is. Echter, ook als rekening gehouden wordt met ernst van het letsel, en al dan niet ook leeftijd en geslacht, wordt gevonden dat de outcome van patienten met zelf toegebrachte brandwonden nog steeds slechter is in vergelijking met patienten die worden opgenomen na een ongeval (Forster et al., 2012; Varley et al., 20011; Horner et al., 2004), maar niet in alle studies (van der Does et al., 1997). Als mogelijke factoren die deze slechtere outcome verklaren kwamen onder andere slechtere therapie trouw, en vertraging in het ontslagtraject naar voren (Wisely et al., 2010). Daarnaast zijn toch ook aanwijzingen gevonden dat als niet alleen rekening gehouden wordt met de ernst van het letsel, maar ook met aanvullende demografische en gezondheidskarakteristieken (19 factoren in totaal) (Thombs et al., 2008), outcome van patienten met SIB en AB wel vergelijkbaar is.
Bij het merendeel van patienten met zelf toegebrachte brandwonden is sprake van psychiatrische stoornis(sen). Deze patienten vragen niet alleen veel zorg en begeleiding door de ernst van de brandwonden, maar ook door de psychiatrische en somatische comorbiditeit. In verschillende settings, waaronder ook brandwonden, wordt gevonden dat de psychiatrische stoornis een belangrijke factor zou kunnen zijn met betrekking tot – slechtere - outcome (Thombs et al., 2007; Bourgeois et al., 2005, Bressi et al., 2006).
Ook al is de incidentie van SIB wellicht niet hoog, de ernst van het letsel en mogelijk slechtere outcome zorgen ervoor dat dit een belangrijke subgroep is. Om de intensive en complexe zorg voor deze patienten verder vorm te kunnen geven, is het nodig meer inzicht te krijgen in het beloop en de outcome van behandeling van patienten met SIB, en factoren die hierbij een rol zouden kunnen spelen.
Research question / problem definition
Doel van het onderzoek
Inventariseren van de incidentie van zelf toegebrachte brandwonden en outcome van deze groep patienten in vergelijking met patienten met brandwonden na een ongeval.
Workplan
Studieopzet
In dit retrospectieve onderzoek worden ten eerste patienten met SIB vergeleken met patienten met AB. Ten tweede worden beloop van herstel en outcome van 30 patienten met SIB vergeleken met 30 patienten met AB, gematched op ernst van het letsel (op basis van ABSI score (Abbreviated Burn Severity Index, Tobiasen et al., 1982; Forster et al., 2011) en comorbiditeit.
Daartoe worden uit de medische status van patiënten die voldoen aan de inclusie criteria de volgende gegevens verzameld:
- datum: geboorte, ongeval, opname en ontslag - complicaties
- geslacht - comorbiditeit
- etiologie en lokalisatie brandwonden - mortaliteit
- % totaal verbrand lichaamsoppervlak (TVLO) - psychofarmaca
- inhalatieletsel - kolonisatie
- beademingsdagen - huwelijkse staat
- datum en type OK (‘s) - ontslagbestemming
References
Referenties
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