Nederlands tijdschrift voor geneeskunde
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Appendicitis was first recognised by the American surgeon Fitts in 1886. Three years later, the New York surgeon Charles McBurney (1845-1913) described the location of greatest pain in this condition: '... between an inch and a half and two inches from the anterior spinous process of the ilium on a straight line drawn from that process to the umbilicus'. He also advocated early surgical treatment and described a variety of surgical techniques.
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A 20-year-old woman with borderline personality disorder was referred to the emergency department by a psychiatric clinic. After taking 10 g of nutmeg she complained of stomach ache and dizziness. A physical examination showed mild hypothermia and sinus tachycardia. ⋯ Symptoms disappear without sequelae after 24-48 h. Treatment consists of supportive measures. In the event of haemodynamic instability, cardiovascular monitoring is indicated.
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Ned Tijdschr Geneeskd · Jan 2010
Case Reports[Unexplained fever after exposure to rats: rat bite fever or Haverhill fever].
A 24-year old man presented himself to the emergency ward with complaints of fever, nausea, headache, muscle ache and chest pain. Two weeks before presentation he had been bitten by a pet rat. We determined that he had bacteraemia caused by a Streptobacillus moniliformis infection, which led to the development of an illness called rat bite fever. ⋯ It is the cause of two similar illnesses: rat bite fever and Haverhill fever. Clinicians should consider these infections in the work-up of unexplained fever or sepsis, certainly in the presence of known exposure to rats. Treatment consists of antibiotics.
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A medical doctor and a lawyer searched for the seven deadly sins in medical case law, the media and stories from daily practice. It appears that the temptations of the seven sins hide behind many of the minor and major malpractice incidents in medical care. These sins are considered worse when not conceded. Patients, but also colleagues, the judiciary and society are more forgiving if medical doctors recognize and admit to their sins.
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The Dutch parliament has recently accepted a tax law in which certain groups of alternative therapists can be exempt from VAT. To be eligible for this VAT exemption, the disciplines to which the therapists belong have to meet certain training requirements. ⋯ It legitimizes harmful therapies. This is illustrated by two serious accidents, previously described in this journal, caused by a chiropractor and a craniosacral therapist.