Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Mar 1997
Review[Malignant hyperthermia as a complication of anesthesia: predisposition is hereditary].
The frequency of malignant hyperthermia in the Netherlands is about 1 in 200,000 anaesthesias. Five times a year, an anaesthetic procedure will be complicated by a malignant hyperthermic metabolic disturbance, which can cause death if treatment is not instituted rapidly, by the administration of dantrolene. Suxamethonium and all the anaesthetic vapours can trigger such a reaction. ⋯ So far a genetic malignant hyperthermia test is not available because of genetic heterogeneity. The in-vitro contracture test in skeletal muscle is currently used as a diagnostic test for malignant hyperthermia. Patients who are likely to be at risk based on a clinical grading score, and family members with at least a 25% chance of inheriting malignant hyperthermia, are eligible for this test.
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Ned Tijdschr Geneeskd · Mar 1996
Review[Dog bites: publications on risk factors, infections, antibiotics and primary wound closure].
To determine, on the basis of published research on dog bites, risk groups and localisations, risk factors for wound infection, effectiveness of prophylactic antibiotics and indications and contraindications for primary closure of the bite wounds. ⋯ More attention should be paid to prevention of dog bites, especially in children. Most important is adequate cleaning of the wounds. Antibiotics should be given on indication only, such as hand wounds, puncture deep wounds and immune compromised patients. Primary closure is not contraindicated.