Nederlands tijdschrift voor geneeskunde
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Bariatric surgery is becoming popular as treatment of morbid obesity. With this popularity there is a danger that it surpasses or even replaces conservative medical therapy. ⋯ There is a new Dutch practice guideline on the treatment of morbid obesity in which conservative treatment is hardly covered. There is little evidence of the highest level to support the recommendations in this guideline.
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Many experimental studies in mammals, and increasingly also in primates, have shown that almost all anaesthetic agents when administered during a young animal's brain-development phase cause increased neuroapoptosis and changes in dendritic morphology at short term, and later, learning disorders. These findings are being confirmed in increasing numbers of retrospective cohort studies in humans. ⋯ These study results will only provide information on relatively short procedures and will not be available until the first reliable neuropsychological evaluation at age 5 in 2018. Pending this additional data, we should discuss with our surgical colleagues the indications, timing and duration of surgery and - if possible - postpone elective surgery until the child is more mature.
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Ned Tijdschr Geneeskd · Jan 2013
[Revised NHG practice guideline 'Acute coronary syndrome': a strong link in the chain of treatment].
This Dutch College of General Practitioners' (NHG) practice guidelines an important component in the care for patients with an acute coronary syndrome. In this commentary, the role of acute pre-hospital triage and percutaneous coronary intervention, high-sensitivity troponins, pharmacological therapy and automatic external defibrillators is reflected upon.
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A 43-year-old woman came to the Emergency Room with acute abdominal pain during the night. CT examination of the abdomen showed ventral herniation of the stomach and parts of the small intestine and colon in the right hemithorax. We made the diagnosis 'symptomatic Morgagni hernia', a rare congenital defect that is usually diagnosed soon after birth.
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New biomedical technologies make it possible to replace parts of the human body or to substitute its functions. Examples include artificial joints, eye lenses and arterial stents. Newer technologies use electronics and software, for example in brain-computer interfaces such as retinal implants and the exoskeleton MindWalker. ⋯ Second, because in western thought the human mind, and not the body, is considered to be the seat of personhood. However, it has been argued by phenomenological philosophers that the body is more than just an object but is also a subject, important for human identity. From this perspective, we can appreciate that a bionic body does not make one less human, but it does influence the experience of being human.