Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2011
Review[Transfusion policy in trauma involving massive blood loss].
Severe haemorrhage is a significant cause of death in trauma patients. In the case of massive blood loss a combination of coagulation defects, acidosis and hypothermia arise, which are accompanied by high morbidity and mortality rates unless properly corrected. ⋯ Unnecessary FFP transfusions in trauma patients without imminent severe haemorrhage increase the risk of complications such as multi-organ failure and acute respiratory distress syndrome. Additional research is required into the accuracy of diagnosis of acute coagulation disorders.
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Ned Tijdschr Geneeskd · Jan 2011
Case Reports[Pitfalls in the treatment of neuropathic pain in patients with cancer].
Three patients with cancer experienced severe side-effects after starting anti-neuropathic pain therapy. All patients, 1 woman and 2 men aged between 69 and 71, fell or had problems with balance. ⋯ There is little research into the treatment of neuropathic pain in patients with cancer. In this patient group it is advisable to monitor the patient at least once a week for an optimal treatment and to prevent severe side-effects, especially in the first weeks after starting the treatment.
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Ned Tijdschr Geneeskd · Jan 2011
Case Reports[Popliteal artery entrapment syndrome: suggestions for diagnostic and therapeutic clues].
The popliteal artery entrapment syndrome (PAES) is a rare cause of lower-leg claudication due to an anatomic anomaly along the course of the popliteal artery and sometimes, the vein. In the absence of an anatomic anomaly, it is termed 'functional entrapment'. We present 3 patients: a 13-year-old boy with PAES caused by an anomaly of a tendon, a 46-year-old soldier with functional PAES and a 36-year-old male with venous entrapment. ⋯ In healthy individuals, however, vascular occlusion or stenosis on imaging during provocation testing is considered a physiological finding. Surgery is justified in symptomatic as well as asymptomatic patients with an anatomic anomaly. Surgical exploration of the popliteal fossa should also be considered in patients with functional entrapment, since continuing entrapment may lead to damage of the arterial wall.
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Alzheimer's disease (AD) is neuropathologically characterized by the presence of senile plaques. The formation of these plaques is caused by the accumulation of amyloid-beta protein (Aβ), a process that begins decades before the onset of the first clinical symptoms. ⋯ Such 'amyloid imaging' can contribute significantly to both early and differential diagnosis of Alzheimer's disease. In the future, amyloid imaging could also be useful for selecting patients for clinical trials and in evaluating the effects of disease modifying agents tailored at lowering Aβ burden.
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The Amsterdam Historical Museum has a large collection of paintings of anatomy lessons, painted when surgeons followed the popular sixteenth century trend for group portraits. The very first, a painting of an anatomy lesson given by Sebastiaen Egbertsz de Vrij, was painted by Aert Pietersz in 1601-1603.