Nederlands tijdschrift voor geneeskunde
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A 62-year-old man fell from a ladder, after which he could not lower his right arm. X-ray and CT-scan showed inferior luxation of his shoulder (luxatio erecta). A reduction procedure was performed.
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Ned Tijdschr Geneeskd · Jan 2011
Case Reports[Obesity hypoventilation syndrome--serious but reversible providing weight is lost].
Obesity hypoventilation syndrome (OHS) is a condition in which obesity and chronic hypoventilation during waking hours are combined. Patients with OHS are more likely to be hospitalized and to require intensive-care monitoring compared with patients with similar degrees of obesity without hypoventilation. ⋯ In the second case, a 31-year-old man, we show that if a patient with OHS and chronic NPPV looses a significant amount of weight NPPV can be discontinued. Patients with OHS should be treated in a multidisciplinary team in order to achieve significant weight loss, so NPPV could be a temporary treatment or even be avoided.
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Ingestion of certain Cortinarius species may lead to renal failure. In the Netherlands, this type of poisoning has not been previously described. ⋯ This case is the first description of mushroom poisoning by a species of the genus Cortinarius in the Netherlands.
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Ned Tijdschr Geneeskd · Jan 2011
Case Reports[Pitfalls in the treatment of neuropathic pain in patients with cancer].
Three patients with cancer experienced severe side-effects after starting anti-neuropathic pain therapy. All patients, 1 woman and 2 men aged between 69 and 71, fell or had problems with balance. ⋯ There is little research into the treatment of neuropathic pain in patients with cancer. In this patient group it is advisable to monitor the patient at least once a week for an optimal treatment and to prevent severe side-effects, especially in the first weeks after starting the treatment.
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Ned Tijdschr Geneeskd · Jan 2011
Review[Perioperative 3D fluoroscopy of intra-articular fractures of the extremities].
During operative treatment of intra-articular fractures of the extremities, 2D fluoroscopy is often used for assessing the quality of fracture reduction and fixation and for making any necessary corrections. Post-operative radiographs or CT scans, however, frequently reveal suboptimal reduction or fixation of the fracture. To help prevent this, a 3D-fluoroscopy technique that can be used during surgery has been developed. ⋯ The diagnostic value of 3D fluoroscopy is comparable to that of CT scanning. Extra corrections were performed during a considerably high percentage of operations (11-39%) using 3D fluoroscopy; it is unknown, however, whether corrections are required of all the defects detected. In a randomised clinical trial, we are currently investigating the added value of 3D fluoroscopy in terms of the quality of procedures involving the reduction and fixation, as well as patient-relevant outcomes such as pain and joint function in the long term.