Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jul 2003
Case Reports[Testicular torsion can also be present in adult men].
Five adult men, aged 34, 33, 31, 56 and 52 years respectively, were admitted with acute scrotal pain. Testicular torsion was eventually diagnosed in all the patients. Two of the patients were initially treated with antibiotics due to a suspected epididymitis. ⋯ Using a physical examination to distinguish epididymitis from testicular torsion can be difficult. Doppler ultrasound is a reliable diagnostic tool for confirming testicular ischaemia. If the intratesticular flow is diminished or absent, then testicular torsion should be considered and this should be followed by immediate surgical exploration.
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Ned Tijdschr Geneeskd · Jul 2003
Review[Nutrition and health--potential health benefits and risks of vegetarianism and limited consumption of meat in the Netherlands].
In the latest Dutch national food consumption survey (1998) just over 1% of subjects (about 150,000 persons) claimed to be vegetarians; however, a much larger group (6% or approximately 1 million persons) ate meat < or = once a week. Vegetarianism can be subdivided into lacto-vegetarianism (a diet without meat and fish) and veganism (a diet without any animal foods whatsoever, including dairy products and eggs). A recent meta-analysis showed that vegetarians had a lower mortality from ischaemic heart disease than omniovorous subjects; however, cancer mortality and total mortality did not differ. ⋯ In medical practice, the possibility of vitamin B12 deficiency in subjects consuming meat or fish < or = once a week deserves serious consideration. In case of doubt, evaluation is indicated using sensitive and specific deficiency markers such as the levels of methylmalonic acid in plasma or urine. Alternative dietary sources of vitamin B12 instead of meat are fish (especially fatty fish is a good source of vitamin B12), or a vitamin-B12-supplement.
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Ned Tijdschr Geneeskd · Jun 2003
Case Reports[Diagnostic image (145). A girl with striae. Irreversible striae due to longterm use of corticosteroids].
A 9-year-old girl presented with irreversible striae, due to prolonged local corticosteroid use.
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A detailed anamnesis and a complete physical examination are essential for establishing the cause of recurrent abdominal pain in a child. Often no medical abnormalities will be found and additional diagnostic procedures may be limited. ⋯ The recently established Rome II criteria for the classification of functional abdominal pain in children can be used to diagnose this disorder. The literature provides little evidence for the effectiveness of medication in treating functional recurrent abdominal pain.