Harefuah
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A high risk of suicide was found in young drug addicts. The risk was especially serious when drug addiction was accompanied by severe personality disorder, depression, or both. ⋯ These age-adjusted rates are 5-20 times greater than for the general population. 2 cases of completed suicides by drug addicts in a psychiatric hospital, a man of 32 and a woman of 26, are presented. We recommend increased precaution in handling drug addicts, as for depressed patients with a high suicide risk.
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On Sunday, Oct. 4, 1992, an E1 A1 Boeing cargo plane crashed into a 10-story block of flats in the Bijmermeer, on the outskirts of Amsterdam. About 8 people died at the site of the disaster. 37 patients were treated in local hospitals within 90 minutes of the disaster, 16 of whom were admitted. 3 suffered severe, and 6 moderate burns (> 15% and 10-15% of body surface area, respectively). Although there were relatively few injured, a full-scale disaster response was evoked, providing an opportunity to study the effectiveness of current disaster plans. ⋯ Secondary transfer of severely burned patients to the burn center was efficient and followed current guidelines. In retrospect, while communication between the various services might be subject to minor criticism, no problems were encountered which interfered with proper execution of the rescue operation. No one who survived the immediate impact died.
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Paranasal sinusitis complicated by subdural empyema (SDE) in a 14-year-old boy is described. He presented with fever, headache and vomiting. X-rays revealed left maxillary and bilateral frontal sinusitis. ⋯ Clinical features include fever, headache, vomiting, convulsions and neurologic deficits. Modern imaging methods and combined surgical and antibiotic treatment have lowered mortality to 5-10%. A high index of suspicion is important for early diagnosis and successful treatment.
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A case of adenocarcinoma of the splenic flexure during pregnancy is reported. A 27-year-old woman was admitted at 34 weeks of pregnancy with abdominal pain and vomiting. 36 hours after normal delivery an emergency exploratory laparotomy was performed for intestinal obstruction. A huge tumor of the splenic flexure with retroperitoneal extension was found. ⋯ Delay in diagnosis and complications of colonic cancer are more prevalent in pregnancy. While colonic carcinoma during pregnancy is extremely rare, it should be included in the differential diagnosis of colonic symptoms. The 24th case of this type is reported.