Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Sep 2000
Case Reports[Severe lactic acidosis due to metformin therapy in a patient with contra-indications for metformin].
A 52-year-old woman with a medical history of diabetes mellitus type 2, chronic alcoholism and liver function disorders was hospitalized because of complaints of haematemesis, abdominal complaints and dyspnoea. This was due to a severe lactic acidosis caused by acute alcohol intoxication and the use of metformin. ⋯ Almost all patients described had contraindications to the drug, like renal failure, liver disease, alcohol abuse, and intercurrent conditions causing hypoxia or ischaemia. It is important to be aware of the circumstances in which metformin should not be prescribed.
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Ned Tijdschr Geneeskd · Sep 2000
[Incidence of traumatic head or brain injuries in catchment area of Academic Hospital Maastricht in 1997].
To measure the incidence of traumatic head or brain injury in the catchment area of the Academic Hospital Maastricht (AZM), the Netherlands. ⋯ Most patients with head or brain injury had mild injuries (99%, sole head injury or mild brain injury). Compared with other studies, the annual frequency of hospital admissions was low.
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Ned Tijdschr Geneeskd · Sep 2000
[Assessment of day surgery in a district training hospital: safety, efficacy and patient's satisfaction].
To assess the quality of day surgery in the St. Antonius Hospital in Nieuwegein, the Netherlands. ⋯ After 854 planned day cases 823 patients (96.4%) returned home the same day. Reasons for clinical admission following day surgery were pain and/or nausea (n = 8), an operation late in the afternoon (n = 7), haemorrhage (n = 6), more extensive surgery than expected (n = 3), others (n = 7). Of all patients who returned home the same day and about whom the interview yielded adequate information (n = 656; 80%) 54 (7%) suffered from a complication (wound infection (n = 28), haemorrhage (n = 7), haematoma (n = 5), seroma (n = 3), phlebitis (n = 2), infection skin (n = 2), wound dehiscence (n = 2), others (n = 5)). Six patients were re-admitted. In the hospital and outpatient clinic 40 patients were seen without an appointment (6%) and 91 patients visited their general practitioner (14%). After surgery 84 (13%) patients were helped at home by friends or family. Of the group of patients who were successfully treated in day care 14% would have preferred an overnight stay.
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A 48-year-old man had high fever and paralysis of the left leg, caused by an infectious endocarditis from which Staphylococcus aureus was cultured.