Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2014
Review[Dromedary camels and Middle East respiratory syndrome: MERS coronavirus in the 'ship of the desert'].
Middle East respiratory syndrome coronavirus (MERS-CoV) is a novel coronavirus, identified in patients with respiratory symptoms in the Middle East. Accumulating evidence points to dromedary camels as being reservoirs. MERS-CoV has been isolated from dromedaries, and dromedary MERS-CoV is nearly identical to human MERS-CoV. ⋯ This means that the risk of human infection may be higher in camel breeding season (spring) when more naïve camels are present. Antibodies appeared to be present in dromedaries as early as 1992, while the first case in humans was recognised in 2012. Underdiagnosis, differences in risk profile, or subtle differences in the genetic make-up of MERS-CoV may explain the absence of MERS in humans before 2012, and in Africa.
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Alice in Wonderland syndrome (AIWS) is characterised by abnormal perception, such as metamorphopsia, macropsia, micropsia, teleopsia and pelopsia. Although brief and transient, these episodes of visual distortion may lead to great anxiety, especially in children. AIWS seems to be associated with specific viral infections, epilepsy, migraine, and brain tumours. ⋯ The cause of AIWS is unclear. When occurring in the young patient, parents often become worried. In most cases no serious pathological cause is found. Usually, reassurance is sufficient. Therefore, general practitioners should be able to recognise the symptoms.
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Ned Tijdschr Geneeskd · Jan 2014
Review Case Reports[Burn injuries during MR scanning: a case report].
In this paper we report one case of skin burns in MRI caused by induced electrical currents. Two second degree skin burns occurred during imaging, while operating within all current safety guidelines. The currents are induced by the magnetic-gradient field, as well as the radiofrequency pulses. ⋯ When a loop originates within the patient for a longer time, the current can resonate and dissipate high local energy through a rise in temperature. While rare, clinicians need to be aware of this possible event. By avoiding focal skin-to-skin contact of the extremities in this case, the adverse event could have been avoided.
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Ned Tijdschr Geneeskd · Jan 2014
Case Reports[A woman with knee locking after a partial knee arthroplasty].
A 57-year-old woman presented with knee locking and lateral knee pain after a partial knee arthroplasty. Consequently, during knee arthroscopy 2 cement particles were found and removed.
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Ned Tijdschr Geneeskd · Jan 2014
Comment[Pill matters: targeted research into side effects necessary].
The paper by Van Hunsel et al. in this issue of the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine) describes reports of side effects among users of hormonal preparations containing cyproterone acetate (Diane-35 and generics) following reports from France of fatal venous thrombosis and subsequent regulatory action. These preparations are licensed for treatment of acne and hirsutism, but are used as oral contraceptives. ⋯ It is noteworthy that oral contraceptives containing cyproterone acetate have been known to be unsafe since 2001, and still they have been used by more than 100,000 women in the Netherlands. The information from Lareb also shows that a pharmacovigilance system based on voluntary reports by physicians and patients is not sufficient to detect increased frequencies of 'common' side effects.