Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2013
Case Reports[Life-threatening psychosis caused by using sibutramine-contaminated weight-loss coffee].
Weight-loss products, which are freely available in some other countries and on the Internet, may be contaminated with ingredients not mentioned on the label. ⋯ Brazil Potent Slimming Coffee and possibly also other weight-loss products may be contaminated with sibutramine and as a result cause severe adverse reactions. It is always important to consider intoxication due to the use of herbal supplements and other OTC products in the differential diagnosis.
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A 55-year-old female experienced palpitations and thoracic pain. Coronary angiography showed a right sided aorta. The patient was diagnosed with a Kommerell's diverticulum that compressed the esophagus and trachea. During follow-up she developed dysphagia and she underwent a transposition of the left subclavian artery to the left common carotid artery followed by endovascular treatment of the distal aortic arch and thereby excluding the diverticulum.
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Bariatric surgery is becoming popular as treatment of morbid obesity. With this popularity there is a danger that it surpasses or even replaces conservative medical therapy. ⋯ There is a new Dutch practice guideline on the treatment of morbid obesity in which conservative treatment is hardly covered. There is little evidence of the highest level to support the recommendations in this guideline.
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Ned Tijdschr Geneeskd · Jan 2013
Comparative Study[The transrectus sheath preperitoneal procedure: a safe, effective and cheap surgical approach to inguinal hernia?].
The main complication of surgery for inguinal hernia is chronic postoperative pain. This is often reported following the Lichtenstein procedure. A new, open surgical technique for the repair of inguinal hernia has been developed. ⋯ The first results of this operative technique are very promising: short operation time, short learning curve and not many patients with chronic postoperative pain. In a randomised, multi-centre study which will start mid-2013 (ISRCTN18591339), the TREPP procedure is compared with the transinguinal preperitoneal procedure. The primary outcome measure of this study is chronic postoperative pain.