Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2014
Review Case Reports[Burn injuries during MR scanning: a case report].
In this paper we report one case of skin burns in MRI caused by induced electrical currents. Two second degree skin burns occurred during imaging, while operating within all current safety guidelines. The currents are induced by the magnetic-gradient field, as well as the radiofrequency pulses. ⋯ When a loop originates within the patient for a longer time, the current can resonate and dissipate high local energy through a rise in temperature. While rare, clinicians need to be aware of this possible event. By avoiding focal skin-to-skin contact of the extremities in this case, the adverse event could have been avoided.
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Ned Tijdschr Geneeskd · Jan 2014
Review[Dromedary camels and Middle East respiratory syndrome: MERS coronavirus in the 'ship of the desert'].
Middle East respiratory syndrome coronavirus (MERS-CoV) is a novel coronavirus, identified in patients with respiratory symptoms in the Middle East. Accumulating evidence points to dromedary camels as being reservoirs. MERS-CoV has been isolated from dromedaries, and dromedary MERS-CoV is nearly identical to human MERS-CoV. ⋯ This means that the risk of human infection may be higher in camel breeding season (spring) when more naïve camels are present. Antibodies appeared to be present in dromedaries as early as 1992, while the first case in humans was recognised in 2012. Underdiagnosis, differences in risk profile, or subtle differences in the genetic make-up of MERS-CoV may explain the absence of MERS in humans before 2012, and in Africa.
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Ned Tijdschr Geneeskd · Jan 2014
Review[The chikungunya epidemic in the Caribbean: implications for travellers and physicians].
In 2013, the first autochthonous cases of the chikungunya virus (CHIKV) were reported on the Caribbean island of Saint Martin. The chikungunya virus has since become endemic in the Caribbean due to autochthonous transmission. In the presence of fever and joint symptoms in any traveller returning from the Caribbean, CHIKV should be considered. ⋯ There is no specific treatment for the chikungunya virus. A correct diagnosis can prevent unnecessary additional tests and unjustified treatment. The chikungunya virus can be prevented by the use of insect-repelling substances, nets and air-conditioning.
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Classic idiopathic trigeminal neuralgia is characterized by sharp unilateral shooting pain in the distribution of one or more branches of the trigeminal nerve. It involves a diagnosis of exclusion. Initially, therapy consists of medical therapy, preferably with carbamazepine or oxcarbazepine. ⋯ In case of surgical contraindications, there are other options: radiosurgery or a neurodestructive procedure of the trigeminal ganglion. Short-term outcomes after neurodestructive therapy are good, however effects diminish over time. Every patient with idiopathic trigeminal neuralgia in whom medical therapy has failed, should be counselled at an experienced centre in which neurosurgical treatment is available.
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Mallet finger is a very common injury, but there is still much discussion about the best treatment. Mallet finger should be operated on if a fracture is larger than 1/3 of the articular surface or in volar subluxation, because otherwise the fracture may remain unstable or there may be loss of function. ⋯ Although there is no significant difference in complications between splinting and surgery, the complications of an operation may be far more serious. In spite of the current operation indication, we should be more reluctant to operate on mallet finger.