Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2015
Case Reports[Spontaneous, atraumatic rupture of the spleen in a young man].
A spontaneous, atraumatic splenic rupture is a splenic rupture without a history of trauma. Rupture of this type may occur in a healthy patient but may also be seen in the context of an underlying neoplastic, haematological, infectious or local inflammatory condition. ⋯ It is clinically difficult to diagnose a spontaneous, atraumatic rupture of the spleen due to the overlap in presentation with other, more common abdominal and thoracic conditions. A CT scan is essential to detect such a rupture promptly in order to provide appropriate surgical intervention.
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Ned Tijdschr Geneeskd · Jan 2015
[Effect of pelvic floor muscle training compared with watchful waiting in older women with symptomatic mild pelvic organ prolapse: randomised controlled trial in primary care].
To compare the effect of pelvic floor muscle training (PFMT) and watchful waiting on pelvic floor symptoms in women aged 55 years and over with symptomatic mild pelvic organ prolapse in primary care. ⋯ Although PFMT led to a significantly greater improvement in PFDI-20 score, the difference between groups was below the presumed level of clinical relevance (15 points). Nevertheless, 57% of the participants in the PFMT group reported an overall improvement of symptoms.
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Childhood melanoma is a rare disorder which is often associated with a diagnostic delay. Worldwide, the incidence of cutaneous melanoma is rising in both adults and children. ⋯ The epidemiology of childhood melanoma in the Netherlands is discussed. In reviewing the literature, we wish to draw attention to important clinical aspects which may contribute to the early recognition of melanoma in children.
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Ned Tijdschr Geneeskd · Jan 2015
[Cognitive aid for emergencies in the OR--AMC bundle helps ensure that no steps are left out].
Crucial management steps in unexpected perioperative emergencies are frequently omitted by OR teams because of the suboptimal performance of the brain under stress. A cognitive aid is a tool that will help care providers to perform and speed up all the necessary management steps of a critical event. ⋯ Their use has furthermore, been standard practice in other high-risk industries for many years. Further research should therefore mainly focus on the implementation and optimisation of these tools.
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Ned Tijdschr Geneeskd · Jan 2015
Biography Historical Article[Sir Geoffrey Marshall, anaesthetist before the term existed].
At the start of World War I, relatively inexperienced physicians were responsible for administering anaesthesia to severely injured soldiers in shock. Lack of knowledge, experience and proper equipment led to high mortality rates. Based on his pre-war experience in the department of respiratory physiology at Guy's Hospital in London, the British physician Geoffrey Marshall was ordered to investigate the high mortality rates. ⋯ Marshall's main achievement was his design of a machine which could be used to reliably administer a mixture of ether, oxygen and nitrous oxide. This led to much more stable anaesthesia and a substantial decrease in mortality. After World War I, his invention became known as Boyle's machine, providing a template for all subsequent anaesthetic machines.