Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2015
[Cognitive aid for emergencies in the OR--AMC bundle helps ensure that no steps are left out].
Crucial management steps in unexpected perioperative emergencies are frequently omitted by OR teams because of the suboptimal performance of the brain under stress. A cognitive aid is a tool that will help care providers to perform and speed up all the necessary management steps of a critical event. ⋯ Their use has furthermore, been standard practice in other high-risk industries for many years. Further research should therefore mainly focus on the implementation and optimisation of these tools.
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The refeeding syndrome may occur during reintroduction of carbohydrates in malnourished patients. This syndrome is characterized by reduced plasma electrolyte levels, hypophosphataemia being most prevalent. The symptoms can vary from minor symptoms to severe neurological or cardiac symptoms. ⋯ Currently, there is no single definition of this syndrome and therefore there is no solid scientific basis for screening and treatment. In this article we describe the rationale for screening and additional laboratory investigations. A prospective, controlled trial is important to define the clinical relevance of the refeeding syndrome and optimize its treatment.
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Ned Tijdschr Geneeskd · Jan 2015
[3D bioprinting of cartilage: challenges concerning the reconstruction of a burned ear].
Reconstruction of a severely maimed ear is a major challenge. The ear is highly flexible yet tough, and has a very complex three-dimensional shape. Reconstruction of a patient's burned ear is even more complex due to surrounding tissue damage. ⋯ However, 3D bioprinting is a tool to facilitate the reconstruction, and not by itself the Holy Grail. The clinical application of this technique is still at a very early stage. Nevertheless, we expect that 3D bioprinting can be utilised for facial reconstruction following burns come 2020.
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Ned Tijdschr Geneeskd · Jan 2015
Biography Historical Article[Sir Geoffrey Marshall, anaesthetist before the term existed].
At the start of World War I, relatively inexperienced physicians were responsible for administering anaesthesia to severely injured soldiers in shock. Lack of knowledge, experience and proper equipment led to high mortality rates. Based on his pre-war experience in the department of respiratory physiology at Guy's Hospital in London, the British physician Geoffrey Marshall was ordered to investigate the high mortality rates. ⋯ Marshall's main achievement was his design of a machine which could be used to reliably administer a mixture of ether, oxygen and nitrous oxide. This led to much more stable anaesthesia and a substantial decrease in mortality. After World War I, his invention became known as Boyle's machine, providing a template for all subsequent anaesthetic machines.
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A 2-year-old boy showed itchy papules and wheals, which were diagnosed as papular urticaria. Papular urticaria are a hypersensitivity reaction after insect bites. The condition can relapse even without the presence of insects or new bites. Topical steroids or antihistamines diminish the symptoms in some cases.