Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2017
Review Case Reports[Food bolus obstruction of the oesophagus or ingestion of a foreign body; what should you do?]
A food bolus obstruction of the oesophagus and foreign body ingestion are frequently encountered in common clinical practice. There is currently no guideline in the Netherlands for management of these problems. We present two cases to illustrate how these can be managed in line with European and American guidelines. ⋯ Endoscopic removal was not possible, and a fourth laparotomy was performed to remove the fork. Food bolus obstruction is a gastroenterological emergency that warrants swift endoscopic removal. In cases of ingestion of a foreign body, the characteristics of the object must be taken into account when determining timing of endoscopic removal.
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Ned Tijdschr Geneeskd · Jan 2017
Review[Injuries resulting from accidents and violence in the Netherlands; results of an Emergency Department register].
- Injuries from accidents and violence are amongst the most important public health issues in the world, including in Europe and the Netherlands.- Using the Dutch Injury Surveillance System and the Dutch Burden of Injury Model, we describe the incidence and costs associated with injuries in the Netherlands that are registered via Emergency Departments (ED). We also map the main causes of injury by age category.- Annually, 700,000 patients attend the ED of a hospital with an injury; 1 in 6 attendees is admitted.- The societal costs of these injuries totals 3.2 billion euro per year. ⋯ Injuries occur relatively more often in children and the elderly.- The key underlying causes differ per age category. Common causes in all ages are cycling accidents, falls from heights, and other fall-related incidents.- The government should continue to deliver the public health interventions for prevention of fall injuries and cycling accidents.
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Ned Tijdschr Geneeskd · Jan 2017
Review[Are nail polish, artificial nails and piercings allowed outside the surgical area?Recommendations for the perioperative policy].
- An increasing number of patients wear nail polish, artificial nails or have piercings.- There is uncertainty about the perioperative management of these items, especially when located outside the surgical area.- In the majority of hospitals, patients are urged to remove these items preoperatively, under the assumption that they might cause problems.- Frequently, however, these items cannot be removed straightforwardly.- Nail polish and artificial nails only very rarely cause perioperative problems and therefore do not need to be removed pre-operatively.- The same applies to most piercings, except when located in or near the respiratory tract, if they have sharp endings or if they might cause problems as a result of the perioperative positioning of the patient.- Providing adequate information to the patient, knowledge about removal of these items and documentation of agreed arrangements are all important.- A national guideline concerning perioperative policy is urgently required.