Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jul 2005
Case Reports[Diagnostic image (243). A woman with an epigastric mass and vomiting].
An 87-year-old woman presented with epigastric pain and vomiting. Abdominal examination revealed an epigastric mass of 10 by 15 cm. Computed tomography of the abdomen demonstrated protrusion of peritoneal contents through a large defect in the linea alba.
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Ned Tijdschr Geneeskd · Jul 2005
[The polypill: optimal strategy for reduction of cardiovascular disease].
Treating all persons above 55 years of age with a polypill for primary and secondary cardiovascular-disease prevention may reduce cardiovascular events by more than 80%. This strategy is expected to be cost-effective and the associated risk of side effects is estimated to be low.
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Ned Tijdschr Geneeskd · Jul 2005
Comment[The polypill: not an effective strategy for reduction of cardiovascular disease].
The implementation of the intriguing concept of the polypill to prevent cardiovascular events remains doubtful due to a lack of evidence, expected adherence problems, the inevitable overtreatment and undertreatment of individuals, and potential side effects. Lifestyle changes and individual interventions are more preferable strategies.
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Ned Tijdschr Geneeskd · Jul 2005
Letter[The level of first aid and basic life support for the next generation of physicians].
According to Dutch medical-education guidelines junior doctors are expected to be able to carry out first aid and basic life support. We determined the level of first aid and basic life support of junior doctors at the Radboud University Nijmegen Medical Centre, The Netherlands. Of the 300 junior doctors 54 (18%) were submitted to a theoretical test, consisting of 52 multiple-choice questions on first aid and basic life support. ⋯ The first-aid scenario was performed correctly in 11% of the cases. According to the examiners the CPR situation was performed correctly by 30% of the junior doctors but when assessed by Berden's international criteria only 6% of the junior doctors had performed CPR correctly. The level of first aid and basic life support amongst junior doctors was low and so the majority of them did not meet the required level as stated in the guidelines for practice of medical education in The Netherlands on this subject.
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Ned Tijdschr Geneeskd · Jul 2005
Case Reports[Physostigmine for the immediate treatment of a patient with the central anticholinergic syndrome induced by cocaine cut with atropine].
A 34-year-old man was admitted in a coma after a nightlong abuse of cocaine and alcohol, whereupon he fell and convulsed at home. There was a fracture of the nose, hyperpyrexia, tachycardia and hypertension. Dry mouth and mydriasis were suggestive of anticholinergic poisoning. ⋯ Cocaine and atropine were found in the patient's urine. Several users of cocaine in various European countries have recently developed a central anticholinergic syndrome due to adulteration of cocaine with atropine. In the presence of indications for such an intoxication, physostigmine is the antidote of first choice.