Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2012
Case Reports[Pulmonary toxicity resulting from the use of nitrofurantoin].
Acute pulmonary syndrome is an uncommon but severe adverse reaction to nitrofurantoin. This syndrome is seldom recognised at the moment of presentation, which potentially subjects patients to unnecessary treatment and delays in the discontinuation of nitrofurantoin. ⋯ The diagnosis of acute pulmonary syndrome should be considered in patients presenting with fever, dyspnoea, dry cough, leukocytosis (typically with eosinophilia) and a bilateral interstitial pattern visible on the chest X-ray after having started nitrofurantoin. The prognosis is excellent if the condition is recognised early and the exposure to nitrofurantoin is discontinued.
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Ned Tijdschr Geneeskd · Jan 2012
Comparative Study[Reliability of the registration of data on complex patients: effects on the hospital standardised mortality ratio (HSMR) in the Netherlands].
To evaluate the reliability of data registration in calculating the hospital standardised mortality ratio (HSMR). ⋯ Comorbidities in patients with pancreatic carcinoma who undergo a resection are being inadequately recorded in the LMR. This results in insufficient correction in the case mix and a low score on the Charlson index, which could result in an incorrect HSMR.
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Ned Tijdschr Geneeskd · Jan 2012
Case Reports[Autoimmune limbic encephalitis: importance of early diagnosis and treatment].
Autoimmune limbic encephalitis is a rare disorder, characterised by the subacute onset of seizures, short-term memory loss, and psychiatric and behavioural symptoms. Initially, it was recognised as a paraneoplastic disorder, but recently a subgroup of patients without systemic cancer was identified. This type of limbic encephalitis is associated with voltage-gated potassium channel (VGKC) or N-methyl-D-aspartate receptor (NMDAR) antibodies. ⋯ These case descriptions emphasise the importance of timely recognition of autoimmune limbic encephalitis in order to rule out malignancy and to quickly initiate treatment. This potentially life-threatening disease responds well to immunomodulatory therapy.
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Ned Tijdschr Geneeskd · Jan 2012
Comparative Study[Surgery in patients with centrally-situated non-small cell lung carcinoma: lung-parenchymal sparing procedure versus pneumonectomy].
To examine if lung-parenchymal sparing resection ('sleeve' resection) is a safe and oncologically responsible alternative to pneumonectomy in patients with central tumours. Further, to evaluate in how far this technique is being used in the Netherlands. ⋯ Patients with centrally-situated NSCLC who undergo a lung-parenchymal sparing procedure have lower mortality and better survival than patients who undergo pneumonectomy.
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Ned Tijdschr Geneeskd · Jan 2012
Case Reports[Decompression illness: minor symptoms, major consequences].
Nowadays, diving is being performed ever more frequently; it is thus important to take diving injuries into consideration in patients presenting with even minor complaints after diving. Every dive is risky and could result in decompression illness, barotrauma and/or death. We report on two cases of decompression illness: a 30-year old man, an occupational diver, and a 46-year old man, an experienced diver, who were both clinically suspected of having decompression illness and were treated with hyperbaric oxygen in a recompression chamber. ⋯ Symptoms vary and are dependent on the site affected: from minor pain to neurological symptoms and death. If patients are suspected of having diving injuries, we recommend contacting a centre specialised in diving and hyperbaric medicine. Recompression in a hyperbaric chamber is the definitive treatment for decompression illness and should be performed as soon as possible.