Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2010
[Variations in Dutch National Medical Registration hardly affect the hospital standardised mortality rate (HSMR)].
To analyse the variation in the registration of hospital admissions across Dutch hospitals and determine how this variation affects the Hospital Standardised Mortality Rate (HSMR). ⋯ This analysis does not support the view that the HSMR is strongly affected by variation in the registration of hospital admissions and is therefore not reliable. Therefore, there is no need for restraint with regard to publication of the Dutch HSMR.
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A 60-year-old man presented with chest pain and weight loss, starting after a period of vomiting. Contrast radiography of the esophagus revealed an esophageal-pleural fistula. The patient was successfully treated by stent placement.
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Ned Tijdschr Geneeskd · Jan 2010
Biography Historical Article[Thomas Schwencke and Wolfgang Amadeus Mozart].
Thomas Schwencke (1694-1767) was Professor of Anatomy and Surgery and Lecturer in Obstetrics at the Surgical School in The Hague, the Netherlands. In 1743 he published the very first textbook on haematology. Furthermore, he described his observations on the variolation of smallpox, and published the design of a new obstetric instrument. ⋯ During his Dutch tour the young Mozart fell seriously ill, probably from typhoid fever. At the request of the court Mozart was seen for a second opinion and thereafter successfully treated by Schwencke. Mozart could continue his concert tour and Schwencke's reputation as Mozart's physician was established.
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Ned Tijdschr Geneeskd · Jan 2010
Case Reports[Haemorrhages due to vitamin C deficiency. Scurvy in the 21st century].
A 68-year-old female with an extensive history of unexplained problems presented at the Department of Internal Medicine for an analysis of painful cutaneous abnormalities of the lower legs. A systemic cause could not be found. Later on the general practitioner noted haematoma and petechiae and subsequently a hypovitaminosis C. ⋯ This patient was found to have symptomatic hypovitaminosis C, also known as scurvy, as a complication of an psychiatric disorder. Although scurvy might appear to be a disease of the past that rarely occurs nowadays, it should nevertheless be given due consideration. This requires a good history taking.
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Ned Tijdschr Geneeskd · Jan 2010
Case Reports[Resuscitation of a pregnant patient--don't hesitate to perform a perimortem caesarean section].
Cardiac arrest is a rare and life-threatening complication during pregnancy. We present the case of a 26-year-old patient in her first pregnancy who during induction of labour at 41 weeks had a cardiac arrest caused by an amniotic fluid embolism. As part of the resuscitation procedure, a perimortem caesarean section was performed in the delivery room within five minutes. ⋯ Pregnancy-induced changes in anatomy and physiology warrant a different approach during resuscitation. All medical personnel involved in the care of pregnant women should be trained to act promptly in acute situations. Training should increase knowledge of the aforementioned changes and stress the importance of performing a perimortem caesarean section, when necessary, on site and without hesitation.