Nederlands tijdschrift voor geneeskunde
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A 89-year-old woman came to the hospital with abdominal pain, vomiting and melaena. A CT-scan showed the complaints were caused by a hernia obturatoria incarcerata. After surgery the woman recovered uneventfully.
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A 2-year-old boy had fallen at home with a pencil in his hand. On physical examination we found only some blood in the inner corner of his right eye, but MRI showed a traumatic pencil tract into his frontal lobes.
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The use of sterile gloves as part of asepsis during surgery goes back to the end of the nineteenth century, but now the preventive value of this measure during minor surgery is questioned. One randomized study showed no difference in wound infection rates whether sterile or nonsterile gloves were used for repair of uncomplicated lacerations of the skin. ⋯ However, in more complicated minor dermatological surgery, 80% less wound infections were observed when sterile gloves were used. In conclusion, the available evidence is too limited to change the recommendation to use sterile gloves for minor surgery.
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Ned Tijdschr Geneeskd · Jan 2011
Case Reports[Fractures of the hamate bone and metacarpal bone: a rare combination].
Fractures of the hamate bone are rare, but are being seen more frequently due to the increasing popularity of racket sports and golf. ⋯ On conventional X-rays, 60% of wrist fractures are missed. If the clinical picture indicates a fracture of the hamate bone but conventional X-rays reveal no abnormalities then a supplementary CT-scan is advisable. Non-displaced fractures, or fractures with little displacement, can be treated conservatively, but surgical treatment is preferred in the case of displacement or non-union.
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Ned Tijdschr Geneeskd · Jan 2011
[Thromboprophylaxis with low-molecular-weight heparin insufficient in high-risk pregnancy].
To evaluate the efficacy and safety of thromboprophylaxis with a low of low-molecular-weight heparin (LMWH) in women with an intermediate to high risk of pregnancy-related venous thromboembolism (VTE). ⋯ There was a considerable risk of pregnancy-related VTE in high-risk women despite a prophylactic dose of LMWH during pregnancy and in the post partum period. For these women thromboprophylaxis with a low, prophylactic dose of LMWH appeared to be insufficient.