Nederlands tijdschrift voor geneeskunde
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Since 2009, a warning has been issued about cocaine that has been adulterated with levamisole, mainly in the USA and Canada. Agranulocytosis occurs as an idiosyncratic reaction in 3-10% of patients exposed to levamisole. ⋯ This patient had acquired agranulocytosis, due to the use of cocaine adulterated with levamisole.
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Telemedicine is a way to provide care over a distance. In teleconsultations the intensivist gives advice to his or her colleagues in a remote centre. In tele-intensive care (tele-IC) the intensivist makes medical decisions for the remote patients and is fully responsible for the treatment of the intensive care patients in a remote centre. ⋯ In a pilot setting, the OLVG hospital has implemented a tele-ICU for the 3-bed ICU in the MC Zuiderzee hospital. The tele-ICU was set up on 3 December 2010. Although the tele-ICU performed sufficiently, several aspects, such as cost analysis, need clarification before the system can be widely implemented in the Netherlands.
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Ned Tijdschr Geneeskd · Jan 2014
[Thrombosis and embolism during Diane-35 use: analysis of reports made to the Netherlands Pharmacovigilance Centre Lareb].
After media attention on the possible risks of thromboembolic complications associated with the use of cyproterone/ethinylestradiol (Diane-35 and generics), the Netherlands Pharmacovigilance Centre Lareb received a large number of reports over a short period of time. We describe in detail the reports of serious undesirable effects, also taking into account the indication, time to onset and risk factors, identification of the complication, treatment and course. ⋯ It was mentioned that cyproterone/ethinylestradiol was often used as a contraceptive drug. Some reports mentioned the fact that thrombosis and embolism were not always recognised at an early stage by users.
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Ned Tijdschr Geneeskd · Jan 2014
Case Reports[Infestation with Enterobius vermicularis mimicking appendicitis].
Gastrointestinal infestation with the parasite Enterobius vermicularis is common in humans and is usually harmless. Anal pruritus is the most characteristic symptom, but the parasites can cause severe abdominal pain mimicking appendicitis. Early recognition can prevent an unnecessary appendectomy. ⋯ Gastro-intestinal infestation with E. vermicularis is very common, especially in young children. This infestation is usually harmless, but can mimic appendicitis. This infestation is easily treatable with mebendazol.
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Ned Tijdschr Geneeskd · Jan 2014
[Potential lowering of sepsis-related mortality via screening and implementation of guidelines].
The incidence of sepsis continues to increase. However, over the past decade marked reductions in sepsis-related in-hospital mortality have been reported. Large variations in the presentation and severity of illness may be encountered in ICU patients with severe sepsis, which might preclude the success of screening and guideline programmes. ⋯ In-hospital mortality did not change in 30 non-participating hospitals. Therefore, the authors recommend implementing updated guidelines, sepsis quality indicators and programmes with a package of interventions to further reduce sepsis mortality. Furthermore, additional research on long term consequences in sepsis survivors is warranted.