Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2011
[Scientific output of orthopaedic hospitals in the Netherlands: not all hospitals meet the requirements of the Dutch orthopaedic residency programme].
To evaluate the feasibility of the requirements for scientific participation in the Dutch orthopaedic residency programme by assessing the numbers of articles published by orthopaedic teaching hospitals. ⋯ Of the 29 teaching hospitals, 9 (31%) did not meet the requirements for publication specified in the Dutch orthopaedic residency programme guidelines. The number of published articles is related to the numbers of orthopaedic surgeons and PhD students in peripheral teaching hospitals. The requirements for the minimum number of publications could therefore be revised to reflect the proportion of orthopaedic surgeons in each teaching hospital. The introduction of a weighting factor that accounts for the quality of the publications would also result in a more balanced assessment.
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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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Ned Tijdschr Geneeskd · Jan 2011
Case Reports[A young child with respiratory acidosis and hypoxia from mechanical ventilation with equipment made for adults].
During mechanical ventilation of young children, problems may arise due to the additional dead space of the ventilation circuit. This may lead to respiratory acidosis and even hypoxia in the child. ⋯ As a rule of thumb, an additional dead space of 1.5-2 ml/kg body weight is acceptable in young children. Emergency wards for young children should have specific equipment to mechanically ventilate them, and have a protocol paying explicit attention to the dead space.
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A 89-year-old woman came to the hospital with abdominal pain, vomiting and melaena. A CT-scan showed the complaints were caused by a hernia obturatoria incarcerata. After surgery the woman recovered uneventfully.
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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.