Nederlands tijdschrift voor geneeskunde
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Two infants, a girl, aged four weeks, and a boy, aged three weeks, came to our attention with poor feeding and weight loss. Later the typical cough of pertussis appeared. Serological testing confirmed that both patients' mothers had recently had pertussis. ⋯ They then become contagious for unvaccinated infants. Pertussis during the neonatal period is an insidious disease with sometimes severe complications. If pertussis is suspected in mothers with new-born infants or pregnant women towards the end of the pregnancy, they should be treated with antibiotics to prevent pertussis in the new-born infant.
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Ned Tijdschr Geneeskd · Nov 2001
Comment Case Reports[Lump in the neck: 4 patients with a medullary thyroid carcinoma].
In a 25-year-old man, medullary thyroid carcinoma (probably a solitary sporadic form) was diagnosed following investigation of a small lump in the patient's neck. This was removed and followed up with further treatment. In a 27-year-old man, episodes of headache, palpitations and excessive perspiration (due to a pheochromocytoma) and a positive family history of thyroid problems led to further investigations and the subsequent diagnosis of multiple endocrine neoplasia (MEN) type 2A. ⋯ The results of DNA tests determine the course of treatment and the need for family testing. In families with a hereditary form, there is a clear genotype-phenotype correlation. Early diagnosis and treatment can improve life expectancy.
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Ned Tijdschr Geneeskd · Nov 2001
Review Case Reports[Resection of the sciatic nerve with preservation of leg function].
Four patients, three women aged 32, 65 and 77 years and one man aged 51 years, had a soft tissue tumour of the upper dorsal thigh or gluteal region. They were treated by resection of both the sciatic nerve and the tumour. This resulted in a good functional outcome with limited functional disturbances. ⋯ The man was treated on several occasions for local recurrences of the malignancy. Patients with soft tissue sarcomas involving the sciatic nerve are often treated by amputating the affected limb. Nerve resection is a good alternative for complete tumour resection whilst still preserving the limb.
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Ned Tijdschr Geneeskd · Nov 2001
Comment Review[Preoperative examination: anamnesis and physical examination mandatory].
Preoperative assessment has been subject to discussion for many years. What should be done and by whom? Fortunately there is a general consensus that routine laboratory and function tests are not only of no benefit to the patient but are also wasteful of resources. ⋯ Efforts to validate this questionnaire have demonstrated that in practice it was not helpful. Therefore it seems justified to conclude that preoperative screening should not fundamentally differ from that performed during a basic clinical examination.
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Ned Tijdschr Geneeskd · Nov 2001
Review['Caring always'; physicians' expression of condolences to the relatives of patients].
According to the WHO definition, palliative care does not end with the death of the patient, but also includes supporting the family members in dealing with the loss. A recent article refers to the importance of physicians writing letters of condolences. The letter of condolences marks the end of the treatment relationship. ⋯ The letter can also remove any distrust that may exist towards the medical profession. Reasons for not writing a letter of condolences include an own feeling of failure, administrative difficulties, indifference or incapacity. Nevertheless, writing a letter of condolences is an integral part of the care provided by the physician to the patient and his/her relatives.