Nederlands tijdschrift voor geneeskunde
-
A 74-year-old woman went to the gastroenterologist because of an altered defaecation pattern. Colonoscopy could not be completed due to sigmoid angulation. ⋯ Non-specific abdominal complaints or volvulus seldom occur. Surgical intervention is rarely necessary.
-
Scientific evidence concerning the treatment of acute diverticulitis is scarce. We describe 2 patients with this condition in this article. The first, a 64-year-old man, came to the emergency room because he had experienced persistent abdominal pain for the previous 4 days. ⋯ Conclusive evidence on the best treatment for patients with frequent recurrences or chronic symptoms after an episode of acute diverticulitis is not available. Guidelines advise a personalised treatment strategy for each patient. More research is necessary on the effect of mesalazine in these cases.
-
Many ICU survivors experience physical, cognitive and mental complications of critical care. This phenomenon has recently been defined as post-intensive care syndrome (PICS). We present 2 patients who survived treatment in an ICU. ⋯ He was treated for 55 days in the ICU. He ultimately survived, but later developed a post-intensive care syndrome that had a long-lasting impact on his quality of life. Early rehabilitation and the limited use of sedatives might mitigate the severity of this syndrome.
-
We present a 41-year-old man with severe traumatic brain injury. Cranial imaging studies revealed cerebral contusion and a longitudinal fracture of the temporal bone. Several days later brain herniated into the left external auditory canal. Imaging studies showed the known skull fracture with a direct connection between the external acoustic meatus and the intracranial structures.
-
Ned Tijdschr Geneeskd · Jan 2013
Practice Guideline[Guideline 'Non-specific symptoms of arm, neck and/or shoulders'].
Complaints of arm, neck and/or shoulder (CANS) constitute an important health problem. Over one third of Dutch adults reported CANS in the past year, and over a quarter were suffering from CANS at the time of interview. Over 10% of sick leave days are also attributed to CANS. ⋯ A care pathway has also been developed, aimed at optimal timing of diagnosis and treatment and multidisciplinary cooperation. Through better diagnosis, patients with specific CANS get targeted treatments sooner. Better insight into treatment results will lead to the choice for effective treatments in cases of non-specific CANS, resulting in more patients receiving the most promising therapies.