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
[Using the SETQ system to evaluate and improve teaching qualities of clinical teachers].
To determine (a) the feasibility of implementing a system for the evaluation of teaching qualities (SETQ) of faculty in an academic medical centre, (b) the psychometric qualities of the questionnaires that are used for the generation of feedback and (c) how residents evaluate the teaching qualities of faculty members and how faculty rated themselves. ⋯ Implementing a system for the evaluation of teaching qualities (SETQ) of faculty in an academic hospital was proven feasible. The psychometric qualities of the underlying instruments was sufficient to good. Teaching faculty were evaluated positively, although interdepartmental variations existed.
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Ned Tijdschr Geneeskd · Jan 2010
Case Reports[Haemorrhages due to vitamin C deficiency. Scurvy in the 21st century].
A 68-year-old female with an extensive history of unexplained problems presented at the Department of Internal Medicine for an analysis of painful cutaneous abnormalities of the lower legs. A systemic cause could not be found. Later on the general practitioner noted haematoma and petechiae and subsequently a hypovitaminosis C. ⋯ This patient was found to have symptomatic hypovitaminosis C, also known as scurvy, as a complication of an psychiatric disorder. Although scurvy might appear to be a disease of the past that rarely occurs nowadays, it should nevertheless be given due consideration. This requires a good history taking.
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Ned Tijdschr Geneeskd · Jan 2010
Case Reports[Unexplained fever after exposure to rats: rat bite fever or Haverhill fever].
A 24-year old man presented himself to the emergency ward with complaints of fever, nausea, headache, muscle ache and chest pain. Two weeks before presentation he had been bitten by a pet rat. We determined that he had bacteraemia caused by a Streptobacillus moniliformis infection, which led to the development of an illness called rat bite fever. ⋯ It is the cause of two similar illnesses: rat bite fever and Haverhill fever. Clinicians should consider these infections in the work-up of unexplained fever or sepsis, certainly in the presence of known exposure to rats. Treatment consists of antibiotics.
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A 20-year-old woman with borderline personality disorder was referred to the emergency department by a psychiatric clinic. After taking 10 g of nutmeg she complained of stomach ache and dizziness. A physical examination showed mild hypothermia and sinus tachycardia. ⋯ Symptoms disappear without sequelae after 24-48 h. Treatment consists of supportive measures. In the event of haemodynamic instability, cardiovascular monitoring is indicated.