Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2014
[Accidents involving a motorized mobility scooter: a growing problem].
To analyze injury patterns, injury severity and mortality among victims of motorized mobility scooter (MMS) crashes in relation to the trauma mechanism and patient's age. ⋯ Low-energy as well as high-energy crashes involving the MMS may result in serious injuries and sometimes death. Awareness by multidisciplinary treatment teams may help to avoid underestimation of injury severity. MMS drivers need to improve their driving skills in order to reduce the number of MMS crashes.
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Ned Tijdschr Geneeskd · Jan 2014
Case Reports[Post-injection syndrome after depot injection of olanzapine].
Olanzapine pamoate injection is an anti-psychotic depot to be administered intramuscularly once every 2-4 weeks. A post-injection syndrome may occur shortly after administration, resulting in an acute intoxication with olanzapine. ⋯ A post-injection syndrome may develop after administration of olanzapine pamoate when the entire dose olanzapine is released at once from the muscle. Therefore, the patient should be observed for at least 3 hours after every injection. The risk of a post-injection syndrome and the necessary observation period should to be taken into account when deciding to start treatment with olanzapine pamoate depot.
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Endoscopic transpapillary gallbladder drainage is a new, relatively non-invasive treatment for patients with symptomatic gallbladder disease and a high surgery risk. Placement of an internal pigtail stent is an alternative treatment for percutaneous gallbladder drainage. This procedure can be performed in patients with a temporary contra-indication - in preparatory process to a cholecystectomy - as well as in patients with a prolonged contra-indication where the pigtail stent can remain in situ for a longer period of time. This technique appears to be an effective and safe procedure for patients with acute cholecystitis or symptomatic gallbladder disease and a high surgery risk.
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Ned Tijdschr Geneeskd · Jan 2014
[Irreversible electroporation: a new form of image-guided tumour ablation].
Irreversible electroporation (IRE) is a new, non-thermal image-guided tumour ablation technique. The repeated application of high-voltage electrical pulses causes pores to form in the cell membrane, so that cells lose their homeostatic properties, and die. The advantage of IRE over other local ablation techniques is that IRE selectively destroys cells, whilst the surrounding extracellular matrix structures remain intact. ⋯ Both in the Netherlands and worldwide, various clinical studies are being run on the safety and efficacy of IRE for centrally located hepatic and pancreatic tumours, which are unsuitable for the current local therapies (surgical resection, irradiation or thermal ablation) due to their anatomic location. Although the long-term results are as yet unknown, the future of IRE appears promising. IRE may prove a valuable tool to add in the multidisciplinary treatment of cancer.
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Since 2009, a warning has been issued about cocaine that has been adulterated with levamisole, mainly in the USA and Canada. Agranulocytosis occurs as an idiosyncratic reaction in 3-10% of patients exposed to levamisole. ⋯ This patient had acquired agranulocytosis, due to the use of cocaine adulterated with levamisole.