Nederlands tijdschrift voor geneeskunde
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A 11-year-old female gymnast presented with long-standing bilateral wrist pain. Radiographs showed physeal widening and irregularity of the left distal radial and ulnar metaphyses, and irregularity of the right distal radial and ulnar metaphyses without physeal widening. 'Gymnast wrist' was diagnosed and cessation of strenuous activities was advised.
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Ned Tijdschr Geneeskd · Jan 2013
Case Reports[The diagnostic benefits of lipase values in acute pancreatitis].
Serum lipase is a biochemical marker used for diagnosing acute pancreatitis. Lipase has largely replaced amylase in terms of diagnostic value, although both markers are still commonly used. ⋯ The first patient, who had recently experienced cholecystitis, presented to the emergency room with abdominal pain and high lipase levels. The second patient, who had received a renal transplant a few years earlier, visited the gastroenterological outpatient clinic with abdominal pain and only a slightly elevated lipase level.
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Ned Tijdschr Geneeskd · Jan 2013
Practice Guideline[Guideline 'Non-specific symptoms of arm, neck and/or shoulders'].
Complaints of arm, neck and/or shoulder (CANS) constitute an important health problem. Over one third of Dutch adults reported CANS in the past year, and over a quarter were suffering from CANS at the time of interview. Over 10% of sick leave days are also attributed to CANS. ⋯ A care pathway has also been developed, aimed at optimal timing of diagnosis and treatment and multidisciplinary cooperation. Through better diagnosis, patients with specific CANS get targeted treatments sooner. Better insight into treatment results will lead to the choice for effective treatments in cases of non-specific CANS, resulting in more patients receiving the most promising therapies.
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Ned Tijdschr Geneeskd · Jan 2013
[Adverse reactions to herbal remedies: analysis of reported adverse reactions in the Netherlands].
To analyse reports of suspected adverse reactions in the use of herbal remedies in the Netherlands. ⋯ Herbs can cause adverse reactions or interactions with medicinal products, but herbal remedies can also be adulterated with regular medicines or illegal - even toxic - ingredients. Reporting adverse reactions significantly contributes to our knowledge about this subject. Physicians and pharmacists should ask patients about the use of alternative medications, particularly those based on herbs.
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The use of creams is considered to be generally safe. However, systemic side effects can occur. ⋯ An overdose of EMLA cream, whether or not in combination with laser-induced skin damage, can produce a high systemic o-toluidine concentration. This can lead to methaemoglobinaemia. In such cases, the pulse oximeter is not reliable for measuring the oxygen saturation; therefore, blood gas analysis is necessary for making a diagnosis.