Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2002
Review[Procalcitonin concentrations in the diagnosis of acute inflammatory reactions].
Procalcitonin is a calcitonin prohormone. During systemic inflammatory response it has the characteristics of an acute-phase protein. However, plasma levels rise more rapidly than those of the parameter (i.e. ⋯ This makes procalcitonin a valuable addition to the current diagnostic work-up for acutely ill patients. Procalcitonin can be used as a marker of inflammation, to differentiate serious bacterial infections from other generalised inflammatory diseases, to differentiate bacterial from viral infections, to differentiate infection from disease activity in patients with autoimmune diseases, to differentiate infection from rejection in transplant patients, and as a prognostic marker in critically ill patients. Procalcitonin may prove to be a valuable adjunct in diagnosing and treating patients with a variety of inflammatory disorders.
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Ned Tijdschr Geneeskd · Jan 2002
Review Case Reports[Complex visual hallucinations in partially sighted elderly: Charles Bonnet syndrome].
In two patients, women aged 85 and 80 years, who suffered from visual hallucinations involving living creatures, cars and buildings, Charles Bonnet syndrome was diagnosed. Both were worried that these signs were an indication of a severe psychiatric condition. ⋯ Patient education and reassurance are the cornerstones of treatment. Other possible treatments are: improving visual acuity and the general physical condition, stopping medication with hallucinogenic side effects, activating the patient, coaching the patient in avoiding hallucination-triggering situations and using stopping strategies, and (still experimental) pharmacological treatment with carbamazepine, valproate, ondansetron or cisapride.
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A 63-year-old healthy man developed acute meningitis. A Gram-stain of the cerebrospinal fluid showed Gram-negative rods, which grew slowly. They were identified by 16S ribosomal RNA sequence-analysis as Capnocytophaga canimorsus, an oral commensal found in various animal species including dogs. ⋯ Documented infections concern mainly sepsis or meningitis, with a mortality of approximately 30%. Due to its fastidious growth, C. canimorsus may be missed in standard culture methods. Therefore, in each case of unexplained sepsis or meningitis contact with animals should be enquired about.
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Paper journals--and books--will continue to exist, despite the digital revolution. Electronic media are superior for storage and retrieval of information, but far less so for intellectual digestion. ⋯ Recently, a curator and a professional librarian were appointed. Part of the Society's assets have been transferred to a special fund for the support of projects on the borderline between medicine and other disciplines, such as history, philosophy, sociology and art.