Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2013
Comparative Study[Task shifting and quality of care in practice; physician assistants compared with anaesthesiology residents in the preoperative anaesthesiology outpatient clinic].
To compare the clinical competencies of second-year anaesthesiology residents and physician assistants (PA) in the preoperative anaesthesiology outpatient clinic. ⋯ In this study in a preoperative anaesthesiology outpatient clinic no difference in clinical competencies was found between PAs and second-year anaesthesiology residents.
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A 57-year-old man with a history of laparoscopic loop colostomy presented with acute abdominal pain. An abdominal CT-scan demonstrated a closed-loop bowel obstruction. ⋯ After reposition, the bowel appeared viable. Internal herniation is a rare cause of small bowel obstruction and has a high mortality rate due to strangulation and bowel ischemia.
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A 1.5-year-old boy was referred to the Dutch Retinoblastoma Center with leukocoria, a white pupillary reflex. Fundoscopy revealed a white retinal tumor and ultrasonography showed a calcified mass. ⋯ Histopathological examination of the retinal tumor confirmed the diagnosis 'retinoblastoma'. Leukocoria is a cardinal sign of retinoblastoma.
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Ned Tijdschr Geneeskd · Jan 2013
Case Reports[Hypovolaemic shock several days after rib fractures].
A quarter of all patients with rib fractures develop a haemothorax. A haemothorax usually occurs immediately following trauma, but it can also occur with considerable delay. ⋯ A delayed haemothorax is rare but in cases of hypovolaemic shock, this dangerous complication of rib fractures should be ruled out.
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An 8-month-old boy with a medical history of prematurity and intubation presented with a severe inspiratory wheeze, caused by subglottic cysts.