Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Feb 2005
Case Reports[The aortocaval fistula, a rare complication of an aneurysm of the abdominal aorta].
Four patients, 3 men aged 73, 60 and 81 years with hemodynamic instability and 1 man aged 80 with abdominal symptoms and breathlessness appeared to have an arteriovenous fistula secondary to spontaneous rupture of an atherosclerotic aneurysm: between the aorta and the V. cava inferior or between the A. and the left V. iliaca communis. One patient died, one patient had postoperative decompensatio cordis, one suffered a deep vein thrombosis and the 4th recovered without symptoms. ⋯ Furthermore, a fistula can be the underlying cause of therapy-resistant heart failure or acute renal dysfunction. Pre-operative identification can lead to decrease of morbidity and mortality of the phenomenon.
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Ned Tijdschr Geneeskd · Feb 2005
Review[From gene to disease; from CLN1, CLN2 and CLN3 to neuronal ceroid lipofuscinosis].
The neuronal ceroid lipofuscinoses (NCL) are worldwide the most common lysosomal storage disorders of childhood. Clinical features often include progressive visual impairment, seizures, psychomotor deterioration, dementia, and premature death. ⋯ Diagnosis at the protein level is not available for JNCL, but CLN3 mutation analysis is possible. The carrier status of healthy relatives in families with known mutations in either CLN1, CLN2, CLN3 or CLN6 can be determined with certainty by mutation analysis.
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Ned Tijdschr Geneeskd · Jan 2005
[Deliberate termination of life in newborns in The Netherlands; review of all 22 reported cases between 1997 and 2004].
To gain insight into the reporting and assessment of active termination of life in newborns in The Netherlands. DESIGN; Retrospective. ⋯ Three cases of deliberate termination of life in newborns were reported in The Netherlands annually. The public prosecutor used fixed criteria to assess the case and all cases of active termination of life reported were found to be in accordance with good practice.
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Ned Tijdschr Geneeskd · Jan 2005
Case Reports[When the treatment in children with asthma fails: first other reasons should be sought before prescribing more medication].
In 4 children with asthma symptoms increased. A 13-year-old girl suffered shortness of breath from fear of a man who was making indecent advances; an 8-year-old girl was allergic to the new cat at home; a 6-year-old boy was not inhaling the medication properly; and a 6-year-old girl had tracheomalacia and a vascular ring. ⋯ After that causes of failure can be excluded. Only when this has been done can the dosage of inhalation corticosteroids be increased or other medicines added to the medication therapy.