Nederlands tijdschrift voor geneeskunde
-
Effective intra-operative anaesthesia and peri-operative analgesia are important aspects of patient care in orthopaedic surgery. The interscalene regional anaesthetic block technique, performed with the patient lying in a lateral decubitus position, is new for arthroscopic shoulder surgery conducted in the Netherlands. The combination of the interscalene block (without general anaesthesia) and the lateral decubitus position results in better peri-operative conditions for the patient. Better analgesia, increased patient satisfaction and fewer complications in comparison to general anaesthesia have been reported for these types of surgery.
-
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.
-
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.
-
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.
-
A 57-year-old woman came to the dermatologist because of 'strange bumps' on her feet. The bumps were not painful. ⋯ They had the same colour as the skin and decreased in size while sitting. The diagnosis was: 'piezogenic papules'.