Nederlands tijdschrift voor geneeskunde
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We report on 3 male patients aged 57, 47, and 53, who each sustained an unstable straddle injury during low-energy pelvic trauma while horseback riding. All 3 patients were haemodynamically stable; radiography revealed diastasis of the pubic symphysis in each case. ⋯ Fractures of the pelvic ring are relatively rare and are typically associated with high-energy trauma. Immediate surgical treatment is necessary for patients with fractures of the pelvic ring for the stabilisation of haemorrhagic shock, identification of soft-tissue injuries and fixation of the pelvis.
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We present a neonate with transient neonatal pustular melanosis, a benign skin rash seen in 0.2-2.2% of white neonates and in 4-5% of black neonates. Vesicopustular lesions are present at birth, the lesions rupture in 24-48 hours leaving hyperpigmented macules. These slowly fade in 3-10 weeks.
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Post-traumatic lung herniation due to a pathological defect in the chest wall is rare. ⋯ There is still no consensus on surgical treatment of lung herniation. It may be performed immediately (primary) or after a delay (secondary) and depends on the clinical condition of the patient.
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A 9-year-old girl complained of a sudden severe headache during skiing, there was no previous trauma. She was nauseous, vomited and had weakness of the left arm and leg. ⋯ MRI showed acute infarction of the right hemisphere caused by a dissection of the internal carotid artery. The patient recovered partially with rehabilitation.
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Ned Tijdschr Geneeskd · Jan 2012
Comment[How can breast-conserving surgery be improved even more?].
Due to population-wide screening and increased awareness of breast cancer by women, more early-stage diagnoses are being made. Breast-conserving surgery, performed according to well-established guidelines, results in the same level of local control and long-term survival as mastectomy for the same indication. ⋯ There are two provisions: the tumour and its gross delineation must be visible by ultrasound, and the breast surgeon needs to learn the technique and apply it sensibly. Generally speaking, ultrasound-guided breast-conserving resection of invasive breast cancer may well lead to more initially complete resections and better cosmetic results.