Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2012
Case Reports[A woman with fever and a painful hip and lower back].
A 66-year-old woman presented with fever and acute pain in her lower back and left hip. She used prednison for arteritis temporalis. Abdominal radiography revealed no signs of free intraperitoneal gas, but instead a radiolucent area below the spleen suggesting free retroperitoneal gas. This was confirmed by CT-scan of the abdomen and surgery, when a diverticulitis of the colon descendens with retroperitoneal perforation was diagnosed.
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Ned Tijdschr Geneeskd · Jan 2012
[Lung cancer staging by endobronchial ultrasound with transbronchial needle aspiration].
To determine the diagnostic yield of endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) and to investigate the number of cervical mediastinoscopies that could be avoided when this technique was used as the initial modality in the invasive mediastinal staging of lung cancer. ⋯ In more than 50% of lung cancer patients with suspected mediastinal lymph node metastases, cervical mediastinoscopy can be avoided when EBUS-TBNA is used. This examination is the technique of first choice for the invasive staging of the mediastinum in lung cancer, but it can not replace mediastinoscopy completely.
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Ned Tijdschr Geneeskd · Jan 2012
[High mortality in patients with idiopathic pulmonary fibrosis on Dutch lung transplant waiting list].
To describe patients diagnosed with idiopathic pulmonary fibrosis (IPF) registered for lung transplantation and to evaluate the current referral guidelines for lung transplantation in the Netherlands. ⋯ One-third of the IPF patients on the waiting list died before donor lungs became available. The mean diffusing capacity of 27% of predicted at the time of screening was considerably lower than advised in the international guidelines for placement on the waiting list. This study, therefore, shows that the timing of screening IPF patients for lung transplantation can be improved in the Netherlands.
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Improved aquarium techniques are enabling sea aquariums to imitate reality even better. This means that they sometimes contain known and unknown marine toxins. Aquarium keepers and their families may then develop potentially severe poisoning. ⋯ Manipulation of certain soft corals found in sea aquariums can cause emission of palytoxin. This may cause a potentially severe episode of poisoning. When working in a sea aquarium protective measures should be taken. There is no specific therapy for or antidote to palytoxin poisoning and for this reason, treatment is supportive.
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Heinrich Irenaeus Quincke (1842-1922), the son of a physician, was born in Frankfurt but was educated in Berlin where he also completed his medical studies in 1864. After a 'grand tour' that took him to Paris, Vienna and London, he was trained in Berlin, first in surgery and later in internal medicine, under Von Frerichs (1819-1885). In 1878, he became a professor of internal medicine in Berne; from 1883 he held the chair of medicine in Kiel, which he would hold for the next 30 years. ⋯ Quincke accurately described the clinical features and distinguished the familial from the sporadic forms. He was correct in attributing the condition to increased vascular permeability, but he surmised the causal factors were neurogenic rather than humoral, according to current insights (excess of bradykinin due to external factors or hereditary deficiency of C1-esterase inhibitor). Quincke not only contributed to several other clinical observations, but also pioneered the lumbar puncture, initially not for diagnostic purposes, but to relieve headache in hydrocephalic children.