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A recent analysis using family history weighting and co-observation classification modeling indicated that BRCA1 c.594-2A > C (IVS9-2A > C), previously described to cause exon 10 skipping (a truncating alteration), displays characteristics inconsistent with those of a high risk pathogenic BRCA1 variant. We used large-scale genetic and clinical resources(More)
PURPOSE To describe patient, tumor, and family histories of cancer in a hospital-based cohort of patients with ovarian cancer and to identify the predictive value of these characteristics for (non)carrying a BRCA1 or BRCA2 mutation. METHODS Women diagnosed with invasive ovarian cancer between 1999 and 2003 in the west region of The Netherlands and(More)
One in every 7 pregnancies ends with meconium-stained amniotic fluid and approximately 5% of these infants develop the meconium aspiration syndrome (MAS). MAS is a severe disease of the (mainly) term neonate, characterized by respiratory distress, pulmonary inflammation, persistent pulmonary hypertension and chronic hypoxia. The pathophysiology of MAS is(More)
BACKGROUND Due to emergency care overcrowding, right care at the right place and time is necessary. Uniform triage of patients contacting different emergency care settings will improve quality of care and communication between health care providers. OBJECTIVE Validation of the computer-based Netherlands Triage System (NTS) developed for physical triage at(More)
BACKGROUND Although fever in children is often self-limiting, antibiotics are frequently prescribed for febrile illnesses. GPs may consider treating serious infections by prescribing antibiotics. AIM To examine whether alarm signs and/or symptoms for serious infections are related to antibiotic prescription in febrile children in primary care. DESIGN(More)
OBJECTIVES To assess whether the flowcharts and discriminators of the Manchester Triage System (MTS) can be used as indicators of alarming signs of serious febrile illness to predict the risk of hospitalization for febrile children who present at the emergency department (ED). STUDY DESIGN Observational study, which included 2455 children (<16 years) who(More)
BACKGROUND Clinical prediction rules (CPRs) to identify children with serious infections lack validation in low-prevalence populations, which hampers their implementation in primary care practice. AIM To evaluate the diagnostic value of published CPRs for febrile children in primary care. DESIGN AND SETTING Observational cohort study among febrile(More)
OBJECTIVE The goal of this study was to evaluate parents' capability to assess their febrile child's severity of illness and decision to present to the emergency department. We compared children referred by a general practitioner (GP) with those self-referred on the basis of illness-severity markers. METHODS This was a cross-sectional observational study(More)
BACKGROUND The diagnostic value of alarm features of serious infections in low prevalence settings is unclear. AIM To explore to what extent alarm features play a role in referral to the emergency department (ED) by GPs who face a febrile child during out-of-hours care. DESIGN AND SETTING Observational study using semi-structured, routine clinical(More)
CONTEXT Febrile children in primary care have a low risk for serious infection. Although several alarming signs and symptoms are proposed to have predictive value for serious infections, most are based on research in secondary care. The frequency of alarming signs/symptoms has not been established in primary care; however, in this setting differences in(More)