Nederlands tijdschrift voor geneeskunde
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Gastric volvulus in children is rare and can be life-threatening if not recognised in time. ⋯ The diagnosis of gastric volvulus can be difficult. Easily accessible additional diagnostics in the form of ultrasonography, possibly followed by a barium study, may be helpful.
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Malrotation occurs when there is a failure in the intestinal rotation leading to abnormal fixation to the abdominal wall and a mesentery with a short root. Volvulus is a life-threatening complication of malrotation. It can lead to irreversible intestinal necrosis and requires immediate attention. ⋯ Case B, a 1-month-old female, was taken to the general practitioner after acute onset of crying and flexing of the legs. Case C, a 5-year-old-boy with no medical history, had started vomiting hourly. In presenting these 3 cases, we highlight the dangers of untreated malrotation and make recommendations on how to manage a patient suspected of having this congenital abnormality.
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A 42-year-old woman had symptoms of unilateral flushing and sweating of her face during exercise. The clinical diagnosis was 'harlequin syndrome'. This condition is caused by a defect of the sympathetic nervous system and is in most cases idiopathic.
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Studies have shown that the reliability and validity of the Netherlands Triage Standard (NTS) is comparable to the Manchester Triage System. The NTS has good sensitivity and specificity in the emergency room. The Dutch Society of Emergency and Accident Nurses, the Dutch College of General Practitioners and Ambulancezorg Nederland use the NTS as the guideline for both physical and telephone triage in ambulance care, primary care and hospital care with the competence of the triage nurse in a pivotal role.
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Ned Tijdschr Geneeskd · Jan 2015
[Predictive value of the VMS theme 'Frail elderly': delirium, falling and mortality in elderly hospital patients].
To determine the predictive value of safety management system (VMS) screening questions for falling, delirium, and mortality, as punt down in the VMS theme 'Frail elderly'. ⋯ The VMS screening for delirium is a reasonably reliable instrument for identifying those elderly people with a high risk of developing this condition; the VMS sensitivity for fall risk is moderate. The number of positive VMS risk factors correlates with mortality and may therefore be regarded as a measure of frailty.