Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Aug 2008
Case Reports[Fatal case of sepsis with Capnocytophaga canimorsus after a minor dog bite].
A healthy 54-year-old man presented at the emergency department with signs of sepsis. Four days prior he was bitten and scratched by his dog. Microscopy of the blood smear showed intracellular Gram-negative rods. ⋯ A risk factor is often present, such assplenectomy, alcohol abuse or immunosuppression. Immediate antibiotic treatment may influence the course of infection. Antibiotic prophylaxis has also been proposed for high-risk patients with dog bites.
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Ned Tijdschr Geneeskd · Aug 2008
Review[Umbilical cord blood from an unrelated donor as source for stem cell transplantations in inborn errors of metabolism].
In certain inborn errors of metabolism, an allogeneic stem cell transplantation is able to prevent disease progression. This is only possible when the stem cell transplantation (SCT) is performed early in life, before cerebral involvement has occurred. In addition to bone marrow and peripheral blood, unrelated umbilical cord blood appears to be an effective stem cell source as well. ⋯ There are also potential disadvantages attached to the use of umbilical blood as stem cell source: the possibility of only one donation per donor and less adaptive immunity following umbilical blood SCT with an increased risk of reactivation of a previous viral infection. However, these disadvantages are less applicable to young children with inborn errors of metabolism. The improvement of transplantation techniques and the availability of this new stem cell source could improve the success rate of this procedure and consequently the prognosis of these severely affected patients.
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Ned Tijdschr Geneeskd · Jul 2008
Case Reports[Percutaneous vertebroplasty for vertebral fractures caused by multiple myeloma, an aggressive vertebral haemangioma and in a traumatic burst fracture].
Percutaneous vertebroplasty (PVP) using polymethylmethacrylate bone cement is frequently used in the treatment of painful osteoporotic vertebral compression fractures in the Netherlands. In three patients there was another indication. A 44-year-old woman suffering from vertebral pain due to an osteolytic lesion caused by multiple myeloma was treated with vertebroplasty of 4 vertebral levels. ⋯ Vertebroplasty is a minimal invasive procedure resulting in most patients in rapid diminishment of the pain caused by pathological vertebral fractures, which may be present for a longer period and may have different causes. The indication triad for vertebroplasty consists of localised back pain, pain when pressure is applied to the processus spinosus of the fractured level and MRI bone oedema, findings suggestive of microfractures in a pathologically changed vertebral body. The procedure is also suitable in patients with extensive comorbidity or a short life expectancy.
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Ned Tijdschr Geneeskd · Jul 2008
Case Reports[Diagnostic image (382). A man with a painful knee and black cartilage].
A 56-year-old man presented with a painful knee with black pigmentation of synovium and cartilage due to ochronosis caused by alkaptonuria.