Nederlands tijdschrift voor geneeskunde
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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.
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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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An 82-year-old woman presented with dyspnoea and palpitations. The patient was admitted to the cardiology ward on suspicion of atrial fibrillation and reduced cardiac output. Examination revealed position-dependent deoxygenation. ⋯ Curative treatment consisted of percutaneous closure of the foramen ovale. A persistent asymptomatic foramen ovale is common and can be revealed in later life. Platypnea-orthodeoxia syndrome is a relatively unfamiliar disorder.
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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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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.