Nederlands tijdschrift voor geneeskunde
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The use of medicinal oxygen can be dangerous. The spontaneous combustion of an oxygen cylinder was the cause of a fire in an operating theatre and an emergency medical service. ⋯ Not opening the pressure reduction valve while the oxygen flow supply valve is open can prevent this type of fire. Information from the contractor shows that the probability of such an incident is 1 in a million.
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Ned Tijdschr Geneeskd · Jan 2010
Case Reports[Severe metabolic acidosis as a result of 5-oxoproline in acetaminophen use].
Acetaminophen overdose is a well known cause of liver function disorder and even hepatic failure. Less well known is that even a therapeutic dose of acetaminophen may lead to life-threatening problems. ⋯ A systematic approach can help us to determine the cause of a high anion gap metabolic acidosis. In unexplained high anion gap acidosis clinicians should consider the possibility of 5-oxoproline accumulation in patients with risk factors such as acetaminophen use, female sex, malnutrition, infection, diminished liver function or renal failure.
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We describe the clinical course of a 51-year-old woman in a vegetative state and of a 63-year-old woman in a minimally conscious state. The difference between these two states is an important one, as clinical course, prognosis and medical-ethical considerations of both are different. ⋯ The differences between these two states regarding rehabilitation, pain management and medical-ethical decisions are important. The effects of neuro-rehabilitation and the implications of a minimally conscious state for patients and their proxies need further investigation.
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Catatonia is a neuropsychiatric syndrome characterized by dysregulation of the motor system. It is associated with affective disorders, psychosis, and a number of somatic conditions. The condition tends to be undertreated due to under-recognition. ⋯ We recommend being alert for catatonia in patients with or without a psychiatric disorder. Early recognition and treatment is vital for the quality of life of these patients, and may in some cases be life-saving. In addition, we recommend a thorough analysis of possible underlying somatic disorders.