Nederlands tijdschrift voor geneeskunde
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According to the practice guideline of the Dutch Workingparty on Infection Prevention (WIP) sterile gloves have to be worn during minor surgery by the general practitioner. This is based on the microbiological principles of Spaulding and is not supported by other evidence. ⋯ Also, in daily practice, only 24% of general practitioners actually wear sterile gloves. We therefore propose to modify the guideline: using clean, nonsterile gloves during minor surgery is sufficient.
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Charles Bonnet syndrome is characterised by complex visual hallucinations in patients who have visual disturbances but no cognitive disorders. The diagnosis is often missed. ⋯ This patient had Charles Bonnet syndrome. If visual hallucinations occur for the first time after the 40th year of life, a somatic cause should first be ruled-out. Refraining from treating Charles Bonnet syndrome with pharmacological agents is advised in light of their many side effects and little evidence of being beneficial for this condition.
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Ultrasound guidance has made it possible to carry out an anterior approach to sciatic nerve block. This technique can be performed as fast and as successfully as the posterior or subgluteal approach. A major advantage of this technique is that the patient can remain comfortable in a neutral supine position.
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A 42-year-old woman came to the emergency department with acute abdominal pain. CT-scan showed an isolated dissection of the A. mesenterica superior and signs of ischaemic colitis. The patient was treated with endovascular stent placement in the artery and partial small bowel resection.