Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Apr 2004
Case Reports[Diagnostic image (186) A man with abdominal pain in the left upper quadrant. Acute appendicitis with malrotation of the colon].
A 54-year-old man presented with abdominal pain in the left upper quadrant due to acute appendicitis with a malrotation of the colon.
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Orf was diagnosed in three patients: a 16-year-old Moroccan girl who had cut her finger in a butcher's shop, a 47-year-old Dutch woman who had allowed a lamb to suck on her finger on a children's farm, and a 50-year-old Dutch farm woman. Orf or ecthyma contagiosum is a well-known viral disease among sheep and goats. Transmission to humans as a zoonosis is rare but can take place via direct contact with infected animals or animal products. ⋯ Early clinical recognition and knowledge of this benign, self-limiting viral condition is vital to avoid unnecessary surgical intervention. Proper information and reassurance of the infected patient are very important. All three patients recovered.
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Codes of medical practice forbid a doctor to have sex with a patient. Still, practice and attitudes turn out to be unruly, so there is a need for (public) discussion and education. Moreover, other professional limitations in the doctor-patient relationship (e.g., 'non-medical' physical contact, dating a patient, accepting gifts from a patient, and treating partners, family-members and friends) require more attention to facilitate the reverification of the impermissibility of a sexual relationship with a patient. The need for such reverification is underlined by the expected changes in the balance between engagement and detachment in the doctor-patient relationship due to the influences on medical practice of technology, protocols and the discontinuity of personal care.
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Ned Tijdschr Geneeskd · Apr 2004
Practice Guideline Guideline[Summary of the practice guideline 'Acute cough' from the Dutch College of General Practitioners].
In most cases acute cough has an infectious, often viral, cause. When the coughing lasts longer than 3 weeks, the diagnosis has to be reconsidered. The effectiveness of cough medicines has not been proven. ⋯ Specific management has to be considered in the case of: whooping cough, bronchiolitis and croup. In the case of pneumonia, antimicrobial therapy is indicated; follow-up is necessary. In the case of moderate to severe croup, a single dose of corticosteroids is recommended.