Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2010
[Acute upper-airway obstructions in primary care. Cricothyrotomy performed by the general practitioner].
Acute upper-airway obstructions, especially epiglottitis, are being observed with increasing frequency in adults, both in the hospital situation and in general practice. Acute upper-airway obstructions are life-threatening and therefore need to be treated with the highest priority. When interventions such as manual removal of a foreign body, thoracic compression or the Heimlich manoeuvre fail, the only remaining interventions are intubation and cricothyrotomy. ⋯ Should all GPs be trained in performing life-saving interventions such as cricothyrotomy? This is a difficult question; the intervention is invasive and has a high risk of complications, but securing the airway is a critical life-saving measure. Above all, there is very limited time available to wait for more experienced help. Therefore, we believe that GPs should be trained in performing life-saving interventions such as cricothyrotomy.
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Ned Tijdschr Geneeskd · Jan 2010
[Endoscopic vein-graft harvesting for coronary bypass grafting: good results in patients at risk for surgical site infection].
To determine the clinical impact of endoscopic vein-graft harvesting in patients undergoing coronary artery bypass grafting (CABG) who are at risk for surgical site infection. ⋯ Endoscopic vein-graft harvesting resulted in a - statistically non-significant - lower incidence of surgical site infection than open harvesting, although the patients had a higher risk for infections. Infections in the endoscopic harvesting group were less severe. The hospital stay was shorter and the patient satisfaction was higher than in the open harvesting group.
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A 60-year-old man presented with chest pain and weight loss, starting after a period of vomiting. Contrast radiography of the esophagus revealed an esophageal-pleural fistula. The patient was successfully treated by stent placement.
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Ned Tijdschr Geneeskd · Jan 2010
Biography Historical Article[Thomas Schwencke and Wolfgang Amadeus Mozart].
Thomas Schwencke (1694-1767) was Professor of Anatomy and Surgery and Lecturer in Obstetrics at the Surgical School in The Hague, the Netherlands. In 1743 he published the very first textbook on haematology. Furthermore, he described his observations on the variolation of smallpox, and published the design of a new obstetric instrument. ⋯ During his Dutch tour the young Mozart fell seriously ill, probably from typhoid fever. At the request of the court Mozart was seen for a second opinion and thereafter successfully treated by Schwencke. Mozart could continue his concert tour and Schwencke's reputation as Mozart's physician was established.
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Ned Tijdschr Geneeskd · Jan 2010
[Variations in Dutch National Medical Registration hardly affect the hospital standardised mortality rate (HSMR)].
To analyse the variation in the registration of hospital admissions across Dutch hospitals and determine how this variation affects the Hospital Standardised Mortality Rate (HSMR). ⋯ This analysis does not support the view that the HSMR is strongly affected by variation in the registration of hospital admissions and is therefore not reliable. Therefore, there is no need for restraint with regard to publication of the Dutch HSMR.