Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · May 2006
Comment Letter Historical Article[Those who cannot remember the past are condemned to repeat it].
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A 34-year-old bodybuilder presented at the emergency room with fever, vomiting and muscle cramps that had started during a bodybuilding session. Several days before he started training he had used tablets and intramuscular injections containing the anabolic steroids: dehydro-chloro-methyltestosterone, boldenone and trenbolone. In addition, he had taken clenbuterol tablets, liothyronine tablets and subcutaneous injections of phosphatidylcholine. ⋯ He recovered quickly and his renal function remained unaffected. 'Doping' among amateur athletes in the Netherlands occurs frequently. Apart from long term side-effects, doping can also cause acute health problems. Therefore it is important to ask about doping use during history taking in amateur athletes.
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Ned Tijdschr Geneeskd · May 2006
[Nitrous-oxide sedation indispensable in the dental care of anxious people and the mentally impaired].
The long-term occupational exposure to high concentrations of nitrous oxide in health-care workers in a Dutch hospital, with probable adverse effects on their offspring, has triggered a discussion about the benefits and risks of nitrous oxide. In Dutch dentistry, nitrous-oxide sedation is a valuable and indispensable aid in the treatment of patients with challenging behaviour, such as those with mental impairment or in extremely-anxious adults and children. Nitrousoxide sedation can be used without risk to the dental team, provided that measures are taken for sufficient scavenging and room ventilation. A possible ban on nitrous oxide would be a major setback for specialty-care dentistry in the Netherlands.
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In the Netherlands and elsewhere there is ongoing debate about the potential of nitrous oxide (used as a medical gas for more than 150 years), to cause spontaneous abortion, malignancies and renal and hepatic disease in health-care workers. Although nitrous oxide has been shown to have teratogenic properties in rodents, there is no evidence for such an effect in humans. The number of indications for the application of nitrous oxide in the Netherlands are diminishing. Therefore it is proposed to use nitrous oxide on strict indication only, and to strictly adhere to policies to reduce exposure to the drug for health-care workers.
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Ned Tijdschr Geneeskd · Apr 2006
Case Reports[Simple diagnostics of patellofemoral instability point to tailored treatment].
Three patients presented with patellar instability. On physical examination, the first patient, a 20-year-old male soccer player, reported pain at the medial insertion ofthe medial patellofemoral ligament (MPFL) after a traumatic patella luxation. He was successfully treated by MPFL reconstruction. ⋯ Patients with patellofemoral instability must be distinguished from patients with patellofemoral-pain syndrome. Simple physical examination and conventional X-rays usually suffice to make this distinction. The treatment is tailored to the pathology found.