Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2012
[High mortality in patients with idiopathic pulmonary fibrosis on Dutch lung transplant waiting list].
To describe patients diagnosed with idiopathic pulmonary fibrosis (IPF) registered for lung transplantation and to evaluate the current referral guidelines for lung transplantation in the Netherlands. ⋯ One-third of the IPF patients on the waiting list died before donor lungs became available. The mean diffusing capacity of 27% of predicted at the time of screening was considerably lower than advised in the international guidelines for placement on the waiting list. This study, therefore, shows that the timing of screening IPF patients for lung transplantation can be improved in the Netherlands.
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We present a neonate with transient neonatal pustular melanosis, a benign skin rash seen in 0.2-2.2% of white neonates and in 4-5% of black neonates. Vesicopustular lesions are present at birth, the lesions rupture in 24-48 hours leaving hyperpigmented macules. These slowly fade in 3-10 weeks.
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A 47-year-old woman with a history of ulcerative colitis and rheumatoid arthritis presented with a large ulcer with an erythematous halo of the right lower leg. The clinical course and the histopathological results were indicative of pyoderma gangrenosum.
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Ned Tijdschr Geneeskd · Jan 2012
Case Reports[A man with impaired consciousness after femur fractures].
A 23-year-old man presented with femur fractures after a car accident. He underwent intramedullary nail surgery. Afterwards consciousness deteriorated with concurrent respiratory distress followed by seizures. MRI-scan of the brain displayed multiple punctate lesions of restricted diffusion, a so-called starfield pattern, which confirmed the diagnosis of cerebral fat embolism syndrome.
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A 56-year-old woman presented with retrograde amnesia and confusion at the Emergency Department after falling down the stairs. Physical examination revealed a bilateral periorbital hematoma (raccoon eyes) and bilateral retroauricular ecchymosis, both strongly indicative of a basilar skull fracture.