Richard L. Braam

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BACKGROUND The focus of the diagnostic process in chest pain patients at the emergency department is to identify both low and high risk patients for an acute coronary syndrome (ACS). The HEART score was designed to facilitate this process. This study is a prospective validation of the HEART score. METHODS A total of 2440 unselected patients presented with(More)
How Would You Manage This Patient? Acute dissection of the ascending aorta is often lethal. Even when emergency surgery can be performed, associated morbidity and mortality are high. To prevent dissection of the aorta, timely operation on a patient with a known dilatation of the ascending aorta (for normal values, see Table 1) is advised, along with other(More)
BACKGROUND It is uncertain whether a diagnostic strategy supplemented by early coronary computed tomography angiography (CCTA) is superior to contemporary standard optimal care (SOC) encompassing high-sensitivity troponin assays (hs-troponins) for patients suspected of acute coronary syndrome (ACS) in the emergency department (ED). OBJECTIVES This study(More)
Several methods have been described to measure adherence to prescribed drug therapy. However, most of these have been shown to be inaccurate. Bromide is an anion that is readily absorbed in the gut and has an elimination half-life of about 12 days. In the present study, we investigated the pharmacokinetic properties of bromide with the objective to use it(More)
INTRODUCTION Evaluating the pre-morbid functional status in critically ill patients is important and frequently done using the physical component score (PCS) of the Short Form 36, although this approach has its limitations. The Academic Medical Center Linear Disability Score (ALDS) is a recently developed generic item bank used to measure the disability(More)
BACKGROUND Congenital coronary-pulmonary fistulas (CPFs) are commonly unilateral, but bilateral and multilateral fistulas may occur. In multilateral CPFs, the value of a multidetector computed tomography (MDCT) imaging technique as an adjuvant to coronary angiography (CAG) is eminent. The purpose of this study was to describe the clinical presentation,(More)
BACKGROUND In validation studies reporting on the accuracy of blood pressure measuring devices (ambulatory and non-ambulatory systems), it is frequently stated that the accuracy of blood pressure devices seems to decrease at increasing blood pressure levels. This has been shown for several ambulatory devices in the past. Whether more recently validated(More)
An 80-year-old man was admitted to our hospital because of complaints of dizziness and palpitations. His medical history revealed an anteroseptal myocardial infarction 26 years earlier. The patient was hemodynamically stable with a blood pressure of 95/60 mm Hg and a heart rate of 120 bpm. The ECG (Figure 1A) showed a wide QRS complex tachycardia, 120 bpm.(More)
OBJECTIVE To determine the accuracy of the Omron RX-M, a device measuring blood pressure oscillometrically at the wrist. METHODS In 89 subjects (mean age 55+/-14 years) blood pressure measurements at the wrist with the Omron RX-M were compared to sequential blood pressure measurements with a mercury sphygmomanometer at the (same) upper-arm and to(More)