Nederlands tijdschrift voor geneeskunde
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A 46-year-old man had pain between the shoulders and at the sternum. Two and a half months earlier he had fallen when cycling. It appeared the pain was caused by fractures of thoracic vertebrae V and VI and a dislocation of the manubrium and body of the sternum.
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Ultrasound guidance has made it possible to carry out an anterior approach to sciatic nerve block. This technique can be performed as fast and as successfully as the posterior or subgluteal approach. A major advantage of this technique is that the patient can remain comfortable in a neutral supine position.
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A 72-year-old woman from the inlands of Surinam was admitted to the hospital because of chronic painful swelling of both legs, caused by filariasis.
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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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Examination of the active and passive range of motion of the shoulder joint is of major importance when diagnosing shoulder disorders. Abduction and external exorotation movements of the shoulder joint can be judged reliably. ⋯ Palpation of the shoulder serves no useful purpose if inspection of the joint and examination of the active range of motion reveal no abnormal signs. The value of physical examination tests that identify impingement or stability of the shoulder joint has not been reliably demonstrated.