Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Apr 2007
Case Reports[Three patients with a paraneoplastic neurological syndrome: the significance of paraneoplastic antibodies].
Establishing the presence of paraneoplastic antibodies is important in identifying an often severe neurological syndrome as paraneoplastic and hence directing the search for an underlying neoplasm. A paraneoplastic neurological syndrome was diagnosed in 3 patients. The first was a 64-year-old woman in whom paraneoplastic encephalomyelitis was diagnosed. ⋯ Biopsy from a paraaortic mass was positive for undifferentiated carcinoma. The patient had a high titre ofanti-Ma2 antibodies and was subsequently tested positive for serum alpha-foetoprotein (AFP) and beta-human-chorionic gonadotrophin (bta-HCG). During chemotherapy for a non seminoma testicular cancer, the limbic encephalitis improved both clinically and radiologically, but the patient died as a result of the toxicity of the treatment.
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Ned Tijdschr Geneeskd · Apr 2007
Case Reports[Abdominal gunshot wounds: possibilities for selective conservative management].
Two men aged 45 and 26 years, respectively, presented with abdominal gunshot wounds and were treated successfully using a nonsurgical approach. Normally, abdominal gunshot wounds are treated surgically in the Netherlands. This policy produces negative laparotomy findings in 22-41% of procedures. ⋯ Physical examination, adequate CT investigation and possibly additional radiological evaluation play a pivotal role in this approach. Therefore, assessment by a multidisciplinary trauma team is crucial at the time of presentation and during further treatment for abdominal gunshot wounds. Ned Tijdschr Geneeskd.