Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Dec 1997
Review[Revision consensus hemophilia: treatment and responsibility. Nederlandse Vereniging van Hemophilia Patients].
Haemophilia is an X-linked clotting disease occurring in 1400 men in the Netherlands. As the result of factor VIII or IX deficiency, haemophilia patients suffer from severe bleedings, spontaneous or caused by trauma. Bleedings mostly occur in major joints and muscles. ⋯ Over the last 20 years haemophilia treatment has improved much. This has resulted in a decrease of the number and of the duration of hospitalization, and a decrease in days lost at school or work. This has led to great improvement of the social life of haemophilia patients.
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In two boys aged 4 months and one girl aged 2 months one or two toes were red and oedematous, while in one boy aged 3 weeks one toe had become necrotic. In the first-mentioned three children the affected toes were encircled by a hair, the hair was removed under anaesthesia, after which the children recovered. In the last-mentioned child, amputation through the proximal phalanx was necessary. ⋯ Strangulation of the toes by circular foreign material. such as hair or fibre, causes oedema and increasing constriction. Timely treatment is followed by good recovery. Delayed or incomplete treatment can lead to necrosis which may necessitate amputation.
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Ned Tijdschr Geneeskd · Dec 1997
Case Reports[Cerebral hyperperfusion syndrome following carotid endarterectomy].
Three patients with a severe symptomatic carotid stenosis developed headache, epileptic seizures and focal neurologic deficits several days after carotid endarterectomy. CT of the brain revealed hypodensities, indicative of cerebral oedema with haemorrhagic components. ⋯ Dysfunction of the cerebral autoregulation believed to be the cause of this hyperperfusion. Sometimes these complications are incorrectly attributed to one of the better known types of stroke.