http://repub.eur.nl/res/aut/40272/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/32779/ 2010-07-26T00:00:00Z http://repub.eur.nl/res/pub/28241/ 2010-05-01T00:00:00Z Complex Regional Pain Syndrome (CRPS) usually develops after a noxious event, but spontaneous onsets have been described in 3-11% of the cases. The existence of spontaneous-onset CRPS is highly debated and the aim of the present study was therefore to compare the phenotypic characteristics of CRPS patients with a spontaneous onset, with those of patients with a trauma-induced onset. Data of 537 CRPS patients followed up at four departments of anesthesiology were analyzed and comprised 498 (93%) patients with and 39 (7%) patients without a known eliciting event. There where no significant differences between the two groups in gender, or in onset in upper or lower limb or left or right side of the body. Compared to CRPS patients with a trauma-induced onset, spontaneous-onset cases were on average 9 years younger at disease onset and had a 1.4 years longer median disease duration. No significant differences in frequency were found for any of the 34 compared signs and symptoms when the effect of multiple testing was controlled. In conclusion, CRPS may develop both with and without a precipitating noxious event, with both groups exhibiting a largely similar clinical presentation. Spontaneous-onset CRPS patients generally develop the syndrome at a younger age, possibly indicating a susceptibility to develop the condition. The longer disease duration in spontaneous-onset cases may reflect a more gradual disease onset, poorer prognosis, or a delay in diagnosis, possibly as a result of reluctance to make this diagnosis in the absence of a clear initiating event. http://repub.eur.nl/res/pub/37092/ 2007-04-01T00:00:00Z Aim of Study: To establish the impact of the transportation on the condition and outcome of the victims of the Volendam fire incident. Methods: Medical and logistic parameters from all victims in the Intensive Care Unit (ICU) were retrospectively collected. Physiologic parameters in the first 24 h and outcome parameters were compared between the transported and the non-transported patients. Results: The first 24 h, 105 patients were admitted to an ICU: 47 of them were relocated during that same day. The pH value was significantly lower in the transported group (p = 0.016). Systolic blood pressure, bicarbonate, carbon dioxide, temperature, APACHE II score and fluctuation during the first day, as well as condition during the second day did not differ significantly. The origin of the acidosis seemed to be mainly metabolic. The number of hospitalization days was larger in the transported group with severe burn injury (≥25% total body surface area burnt), comparing to the non-transported group (p = 0.015). Ventilation days and mortality did not differ significantly. Conclusions: The transported patients had a lower pH the first day after transportation, but condition during the second day as well as ventilation day and mortality did not differ between the transported and the non-transported group. Therefore, transportation during the unstable phase, the first day post-burn, seemed not to have had a negative impact on patient outcome.