Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2010
Case Reports[Diagnostic image. A man with tongue deviation following a motorcycle accident].
A 49-year-old man complained of headache, dysarthria and difficulty in swallowing following a motorcycle accident. He had a tongue deviation to the right due to a traumatic lesion of the right hypoglossal nerve which was caused by a right occipital condyle fracture.
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Ned Tijdschr Geneeskd · Jan 2010
['Advanced triage' improves patient flow in the emergency department without affecting the quality of care].
To investigate whether 'advanced triage' improved patient flow among self-referred patients in the emergency department of a level 1 trauma centre and, most importantly, whether the quality of medical care was maintained. In advanced triage, the triage nurse initiates additional diagnostic investigations independently. ⋯ The implementation of advanced triage improved patient flow for self-referred patients in the emergency department without affecting the quality of medical care. Advanced triage was successful in the Dutch system, too.
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Ned Tijdschr Geneeskd · Jan 2010
[Vertebroplasty: a treatment option for osteoporotic compression fractures].
Percutaneous vertebral augmentation, with percutaneous vertebroplasty (PVP) as its most widely used variant, is currently the only intervention for painful osteoporotic compression fractures. This procedure offers immediate and substantial pain relief in over 80% of treated patients with a low reported complication rate (< 1.6%). A large number of studies have shown promising results and the superiority of this treatment over conservative treatment has been established. ⋯ Limitations in the design of both trials prevented widespread implementation of the results. We believe that PVP cannot be regarded as an obsolete treatment as long as patients are carefully selected. Patients with persistent (over 2 months) and painful osteoporotic vertebral fractures have been shown to benefit from vertebroplasty and are therefore suitable candidates for this procedure, which, in these cases, can prevent complications due to long-term disabling pain.
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Ned Tijdschr Geneeskd · Jun 2009
Multicenter Study[Hospital mortality after emergency surgery for perforated diverticulitis].
To assess which factors predict in-hospital mortality after emergency surgery for acute perforated diverticulitis. ⋯ The type of surgery did not appear to be a risk factor for high postoperative mortality. As well as patient-related risk factors, including age, ASA and severity of disease scores, such as Hinchey score and MPI, the absence of a specialist gastrointestinal surgeon during surgery was found to be a factor associated with high mortality risk.