Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Aug 2004
Case Reports[Fever, coughing and/or wheezing in young children: consider the possibility of foreign body aspiration].
Three children, 2 girls aged 1.5 and 3 years and a 2-year-old boy, experienced coughing, wheezing and/or fever for several days or weeks. The first girl was treated for asthma, the other two children for pneumonia. ⋯ Thereafter, all the children recovered completely. In children with persistent coughing, wheezing or fever despite treatment for pneumonia or asthma and in absence of a characteristic acute incident, foreign body aspiration should be considered.
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Ned Tijdschr Geneeskd · Aug 2004
Case Reports[Accelerated elimination using hemoperfusion in a patient with phenobarbital intoxication].
A 44-year-old female was found comatose after attempting suicide. Toxicological screening showed phenobarbital intoxication. The patient was treated symptomatically. ⋯ Multiple-dose activated charcoal effects the elimination of phenobarbital. If elimination needs to be speeded up, then hemoperfusion can be considered. If this technique is unavailable, hemodialysis is a good alternative.
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Ned Tijdschr Geneeskd · Aug 2004
[Unnatural and unexplained death in a paediatric intensive-care unit, 1993-2002].
To analyse the causes of unnatural death in a general paediatric intensive-care unit. ⋯ In 16% of the children who died of unnatural causes there was a suspicion of child battery. A forensic autopsy was useful in all cases to confirm or refute the suspicion of child battery, but was not carried out in all cases.
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Ned Tijdschr Geneeskd · Aug 2004
Case Reports[A long-distance runner with a painful sesamoid bone in the forefoot].
A 38-year-old long-distance runner presented with pain in the left medial forefoot. In the presence of such symptoms, consideration should be given to a disease of or injury to a sesamoid bone. Radiology revealed a fracture line through the medial sesamoid bone under the first metatarsophalangeal joint. ⋯ Besides reduction of weight-bearing pressure on the affected sesamoid, NSAIDs and ice massage, special attention should be paid to the foot (postural deformities), the shoe (inlays, sesamoid pad, shock absorption, stiff sole) and running on a soft surface. Insufficient therapeutic results may be due to osteonecrosis or non-union. These and persistent pain may, as a last resort, require surgical intervention such as screw fixation in case of a fracture or sesamoidectomy.
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Ned Tijdschr Geneeskd · Jul 2004
Case Reports[Successful treatment of three elderly patients suffering from prolonged delirium using the cholinesterase inhibitor rivastigmine].
Delirium is commonly encountered in elderly patients in general hospitals. Most patients with delirium respond well within 12 days of commencement of treatment with haloperidol. A significant number of patients, however, does not improve. ⋯ There is some evidence, both from animal and human experiments, that cholinergic deficiency plays a role in certain types of delirium. Therefore treatment of delirium with a cholinesterase-inhibitor seems logical. Controlled studies are needed to evaluate the effects of these types of drugs in patients with prolonged delirium.