Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · May 1997
Randomized Controlled Trial Clinical Trial[Surgical treatment of carpal tunnel syndrome: endoscopic or classical (open)? A prospective randomized trial].
To compare the results of open with endoscopic release of the carpal tunnel in patients with the carpal tunnel syndrome. ⋯ Endoscopic release of the carpal tunnel is as effective as the open release but it gives less postoperative pain. Because of the risk of complications and the additional costs, the endoscopic release is not the preferred method for treatment of the carpal tunnel syndrome, however.
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To determine the prevalence of constipation and the use of laxatives in terminal patients. ⋯ Present laxative policy in terminal patients is ineffective. Monotherapy with fixed lactulose doses is not effective as a laxative in either users or non-users of opioids.
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Ned Tijdschr Geneeskd · Apr 1997
[Rwanda, a retrospective to aid rendered following the 1994 genocide].
Some 700,000 Tutsi were killed in Rwanda in 1994, and 1.2 million Hutu fled to neighbouring countries. The United Nations and the non-governmental organizations recently issued a document assessing the aid given. Several matters could have been better. ⋯ Relief organizations resorted too quickly to import of goods that were available locally, thereby making the aid unnecessarily expensive. The refugees themselves were involved too little in establishing relief priorities. Life of the original population round the camps was disrupted, a fact that received hardly any attention.
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Ned Tijdschr Geneeskd · Apr 1997
Review[Clinical application of albumin: a closer look at indications].
Albumin infusions are given far from always on the correct indications, and often there are alternatives that are cheaper and equally suitable. In septic or hypovolaemic shock, crystalline fluids are cheaper and equally efficacious for volume therapy. ⋯ In decompensated hepatic cirrhosis with ascites, it appears useful to combine paracentesis with albumin infusion, to prevent renal insufficiency and hyponatraemia, but other colloidal fluids are probably equally suitable. Combating hypoalbuminemia as such is not useful in seriously ill patients; it is the underlying disease that should be treated.
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Ned Tijdschr Geneeskd · Mar 1997
Review[Malignant hyperthermia as a complication of anesthesia: predisposition is hereditary].
The frequency of malignant hyperthermia in the Netherlands is about 1 in 200,000 anaesthesias. Five times a year, an anaesthetic procedure will be complicated by a malignant hyperthermic metabolic disturbance, which can cause death if treatment is not instituted rapidly, by the administration of dantrolene. Suxamethonium and all the anaesthetic vapours can trigger such a reaction. ⋯ So far a genetic malignant hyperthermia test is not available because of genetic heterogeneity. The in-vitro contracture test in skeletal muscle is currently used as a diagnostic test for malignant hyperthermia. Patients who are likely to be at risk based on a clinical grading score, and family members with at least a 25% chance of inheriting malignant hyperthermia, are eligible for this test.