Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2012
Case Reports[Lucio's phenomenon in a patient with leprosy on Aruba].
Lucio's phenomenon is a rare leprosy reaction characterised by bizarrely-shaped, purpuric skin lesions and ulceration. It occurs in diffuse lepromatous leprosy and it is mainly reported in patients from Mexico and the Caribbean. ⋯ Lucio's phenomenon led to a diagnosis of leprosy. Leprosy is still endemic in Aruba.
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A 2-month-old boy with an congenital herniation of the umbilicus presented with a painful swelling of the umbilicus since 1 day, lower intake of food and vomiting. He had an incarcerated umbilical hernia. Eventually emergency surgery was needed.
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This article describes the history and significance of the eponym 'Wegener'. After the American College of Chest Physicians awarded Wegener with the Master Clinician Award, discussion about his Nazi past arose. Should the eponym 'Wegener' be maintained?
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Ned Tijdschr Geneeskd · Jan 2012
Comment[The 'paper-based' preoperative evaluation: non-optimal health care].
A nationwide preoperative assessment guideline was introduced in the Netherlands in 1997 at the advice of the Health Council of the Netherlands. The preoperative assessment should entail an appropriate interview, a physical examination, additional tests, risk assessment and informing the patient. Dutch and several international guidelines recommend a complete assessment under the responsibility of the anaesthesiologist. ⋯ A complete assessment may reduce health care costs by reducing the number of consultations by other specialists, additional tests, cancellations and length of stay. The assessment also reduces patient anxiety and improves patient satisfaction. In conclusion, a complete preoperative assessment is required by guidelines and law and does offer many advantages.
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Ned Tijdschr Geneeskd · Jan 2012
[Endoscopic versus surgical treatment of infected necrotising pancreatitis: the TENSION study].
In patients with infected necrotising pancreatitis there is a significant risk (40%) of complications and mortality with the surgical step-up approach. This approach consists of percutaneous retroperitoneal drainage, if necessary followed by video-assisted retroperitoneal débridement. ⋯ The Dutch Pancreatitis Study Group has recently started the nationwide randomized TENSION-trial, in which in 98 patients the endoscopic step-up approach is compared with the surgical method. The primary endpoint is a composite of mortality and major morbidity (new onset organ failure, bleeding, perforation of a hollow organ or incisional hernia for which intervention is needed).