Nederlands tijdschrift voor geneeskunde
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A 57-year-old woman came to the dermatologist because of 'strange bumps' on her feet. The bumps were not painful. ⋯ They had the same colour as the skin and decreased in size while sitting. The diagnosis was: 'piezogenic papules'.
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Alzheimer's disease (AD) is neuropathologically characterized by the presence of senile plaques. The formation of these plaques is caused by the accumulation of amyloid-beta protein (Aβ), a process that begins decades before the onset of the first clinical symptoms. ⋯ Such 'amyloid imaging' can contribute significantly to both early and differential diagnosis of Alzheimer's disease. In the future, amyloid imaging could also be useful for selecting patients for clinical trials and in evaluating the effects of disease modifying agents tailored at lowering Aβ burden.
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Ned Tijdschr Geneeskd · Jan 2011
Comment[Practice guideline 'Medically unexplained physical symptoms (MUPS) and somatoform disorders': a step in the right direction].
The Dutch multidisciplinary practice guideline 'Medically unexplained physical symptoms (MUPS) and somatoform disorders' provides information on non-specific somatoform complaints, hypochondriasis, conversion disorders and a limited number of specific functional syndromes. Much attention is given in the guideline to the role of doctor-patient communication and empathy in the treatment of patients with somatoform complaints. ⋯ Firstly, an undesirable side-effect of the Dutch nomenclature of unexplained symptoms is that it implies a duality of body and mind. Secondly, the value of screening for depression or an anxiety disorder as a secondary step in primary care is doubtful.
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Ned Tijdschr Geneeskd · Jan 2011
Case Reports[Camphor poisoning following ingestion of mothballs 'for headache'].
Camphor is a toxic hydrocarbon, found in numerous over-the-counter medicinal products and chemist-shop items. The consequences of camphor poisoning depend on the dose, and severe poisoning can result in death. Ingestion of camphor can cause seizures, apnoea, renal insufficiency, raised hepatic enzyme levels, and vomiting resulting in chemical pneumonitis due to aspiration. ⋯ Many every-day products contain camphor. Poisoning can lead to an acute clinical picture, and immediate intensive care department treatment is obligatory. As there is no antidote available, supportive care is the only available option when poisoning occurs.
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A 19-year-old woman with a Syrian background complained of genital ulcers. Sexually transmitted disease was excluded. She was also suffering from oral aphthae and had been treated by a dermatologist for acne. ⋯ This often makes its diagnosis difficult. Its exact cause is unknown but the immune system and genetic factors may play a role. Although diagnosis is made mainly on clinical grounds, laboratory tests and pathology examination may contribute to the establishment of the differential diagnosis.