Nederlands tijdschrift voor geneeskunde
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A 4-year-old boy visited the emergency department with a painful foot. We diagnosed osteochondrosis of the tarsal navicular, also known as Köhler's disease. The patient was successfully treated with a plaster bandage for 4 weeks.
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Ned Tijdschr Geneeskd · Jan 2010
Case Reports[Severe metabolic acidosis as a result of 5-oxoproline in acetaminophen use].
Acetaminophen overdose is a well known cause of liver function disorder and even hepatic failure. Less well known is that even a therapeutic dose of acetaminophen may lead to life-threatening problems. ⋯ A systematic approach can help us to determine the cause of a high anion gap metabolic acidosis. In unexplained high anion gap acidosis clinicians should consider the possibility of 5-oxoproline accumulation in patients with risk factors such as acetaminophen use, female sex, malnutrition, infection, diminished liver function or renal failure.
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Appendicitis was first recognised by the American surgeon Fitts in 1886. Three years later, the New York surgeon Charles McBurney (1845-1913) described the location of greatest pain in this condition: '... between an inch and a half and two inches from the anterior spinous process of the ilium on a straight line drawn from that process to the umbilicus'. He also advocated early surgical treatment and described a variety of surgical techniques.
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Ned Tijdschr Geneeskd · Jan 2010
Case Reports[Diagnostic image. A man with tongue deviation following a motorcycle accident].
A 49-year-old man complained of headache, dysarthria and difficulty in swallowing following a motorcycle accident. He had a tongue deviation to the right due to a traumatic lesion of the right hypoglossal nerve which was caused by a right occipital condyle fracture.
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Ned Tijdschr Geneeskd · Jan 2010
[Guideline on responsible teamwork: don't let it become a manacle].
The recently published guideline entitled 'Division of responsibility in teamwork within the care sector' was developed on the request of the Dutch Health Care Inspectorate. Its aim is to ensure that in a teamwork situation in the care sector proper agreements are made concerning the responsibilities of the care providers who work together. ⋯ The document does not reflect everyday practice, but an abstracted theoretical situation, in which the patient, nurse and doctor are indicated using terms such as 'subject expert', 'client', 'care professional' and 'contact'. The document emphasizes responsibilities strongly, but the quality of health care could perhaps be better served by the motivation of caregivers to provide the best possible care.