Nederlands tijdschrift voor geneeskunde
-
Ned Tijdschr Geneeskd · May 2003
Case Reports[Behçet's disease in a Dutch boy with painful skin lesions].
A 14-years-old Dutch boy had pain in both calves, recurrent oral ulcers, fever, hoarseness and erythema nodosum-like skin lesions. Laryngoscopic examination revealed a vocal cord ulcer and leukocytoclastic vasculitis was visible in a skin biopsy. Based on the clinical picture, the diagnosis of 'incomplete juvenile Behçet's disease' was established. ⋯ Diagnostic criteria have been formulated, but in most cases there is a delay before these criteria are fulfilled due to the slow clinical course of the disease. All organ systems may be affected; mucocutaneous and skin lesions are the most frequent manifestations. Therapy depends on the severity and the symptoms of the disease.
-
Ned Tijdschr Geneeskd · Apr 2003
[The value of the pulmonary-artery catheter: not ruled out, but not proven either].
A number of prospective, randomized trials have recently been published on the effects of using the pulmonary artery (Swan-Ganz) catheter in the peri-operative management of high-risk patients and in the treatment of critically ill patients on the intensive-care unit. These studies show that using the pulmonary-artery catheter does not lead to increased survival. It cannot be excluded that more beneficial effects would have been found with other treatment goals, or if different populations had been studied. However, based on the present evidence from the literature, the routine use of the pulmonary-artery catheter can no longer be defended.