Nederlands tijdschrift voor geneeskunde
-
Ned Tijdschr Geneeskd · Nov 1990
[Criteria for differential diagnosis in cardial symptoms; left- or right-sided chest pain?].
We studied the localization of pain in the acute phase of myocardial infarction in comparison with localization in non-cardiac chest pain. Myocardial infarction patients could not be differentiated from patients with non-cardiac chest pain in localization of pain on mid-chest, left side of the chest and left arm. ⋯ Results are similar when patients indicated the localization of the pain symptoms on attending the Emergency Coronary Care Unit, or when asked five days later. Pain symptoms on the right side of the chest and the right arm differentiate better between myocardial infarction and non-cardiac chest pain than the 'classical' symptom pattern.
-
Ned Tijdschr Geneeskd · Oct 1990
[Epidemiology of melanoma of the skin in The Netherlands: a descriptive study].
A study of the mortality rates of cutaneous malignant melanoma over the period 1950-1985 in The Netherlands showed a fourfold increase of mortality. An analysis by birth cohort suggests a cohort effect: age-specific mortality rates increase with successively younger generations. ⋯ Data on the trend in incidence are restricted, but indicate an increase. This descriptive study allows no conclusions about the cause of the rise in incidence and mortality rates.
-
Critical illness polyneuropathy is a syndrome of neuromuscular complications after artificial respiration. The authors present the data of their own 22 patients all suffering from severe flaccid tetraparesis, areflexia and muscle atrophy, after an average of two weeks on artificial respiration. ⋯ The role of plasma factors such as cachectin, which is identical to tumour necrosis factor (TNF), is described. Attention is drawn to this important illness which occurs especially in patients in the intensive care unit with problems in the weaning from artificial respiration.
-
A 61-year-old woman was admitted because of colchicine intoxication. After a period with gastrointestinal symptoms multiple organ failure and secondary septicaemia developed. The patient died of irreversible shock. The pharmacology of colchicine and the clinical manifestations and therapy of colchicine intoxication are discussed.